May 10th 2010
ADHD history goes back a little over 100 years as a documented disorder, officially that is. That was when a Dr. George Frederic Still, a British paediatrician published in 1904 in the British medical journal, The Lancet, a description of a syndrome displaying a “morbid defect of moral control.” In twenty of his patients, he found what he believed to be “volitional inhibition” disorder. What he described was clearly what is today considered as Attention Deficit Hyperactivity Disorder (ADHD).
Hippocrates (460 to 370 BC) of the “Hypocrite Oath” fame, however, beat him to it by a few years, as he described an ADHD like “disorder.” Aristotle probably had ADHD, as did Galileo, Leonardo da Vinci, Newton, Einstein, Picasso, Robin Williams, Whoopi Goldberg, Richard Branson and a long list of people who have benefited humanity and brought us to where we are today in fields as varied as science, technology, economics, mathematics and the arts. ADHD personalities have an innate creativity if it is not suppressed by misguided education.
Shakespeare also mentioned it in Henry VIII, calling it a “malady of attention.” This was “Adult Attention Deficit Disorder.”
In the 19th Century it was again mentioned in literature. Dr Heinrich Hoffman, a German doctor and author, wrote a collection of poems for children called “Der Struwwelpeter.” The poems were about some singularly nasty little children and some sad stories with entertaining illustrations on each page. The book was published in 1844 in Germany and in 1848 the English translation came out. He had a humour somewhat like a splenetic Roald Dahl. One of the poems was “Die Geschichte vom Zappel-Philipp” or “The Story of Fidgety Philip.”
The Story of Fidgety Philip
“Let me see if Philip can
Be a little gentleman;
Let me see if he is able
To sit still for once at the table.”
Thus Papa bade Phil behave;
And Mama looked very grave.
But Fidgety Phil,
He won't sit still;
He wriggles, And giggles,
And then, I declare,
Swings backwards and forwards,
And tilts up his chair,
Just like any rocking horse--
“Philip! I am getting cross!”
See the naughty, restless child
Growing still more rude and wild,
Till his chair falls over quite.
Philip screams with all his might,
Catches at the cloth, but then
That makes matters worse again.
Down upon the ground they fall,
Glasses, plates, knives, forks and all.
How Mama did fret and frown,
When she saw them tumbling down!
And Papa made such a face!
Philip is in sad disgrace.
Where is Philip, where is he?
Fairly covered up you see!
Cloth and all are lying on him;
He has pulled down all upon him.
What a terrible to-do!
Dishes, glasses, snapped in two!
Here a knife, and there a fork!
Philip , this is cruel work.
Table all so bare, and ah!
Poor Papa, and poor Mamma
Look quite cross, and wonder how
They shall make their dinner now.
The encephalitis epidemic in North America in 1917-1918, resulted in many survivors showing an ADHD like behaviour. This resulted in the condition being upgraded from a “morbid moral defect” to “minimal brain damage” and then "minimal brain dysfunction." The assumption was the survivors had suffered some brain damage. It had been observed that head injury, disease and congenital defects affected behaviour.
The plot thickened in 1937. It was discovered by serendipity that the counterintuitive administering of stimulants, like amphetamines, resulted in calmer less hyper children. The Second World War probably caused these researchers to lose their focus somewhat, because it was not until the late 1950s before the drugging of children with Schedule II drugs began to become routine. By the mid 1960s this was a usual treatment for what was then still called “minimal brain dysfunction (MBD)”.
In the 1960 the condition was relabelled as “Hyperactive Child Syndrome.” The researcher who coined this phrase, Stella Chase, thought syndrome had a biological cause. There was no consensus on this as many other researchers at this time believed the cause to be environmental. There is a long list of conditions, which result in “ADHD behaviour.”
Then in 1980, the American Psychiatric Association added Attention Deficit Disorder (ADD) to the diagnostic list. From this point on the epidemic started, fuelled by big pharma’s marketing campaigns.
In 1987, ADHD was voted in by a similar informal vote, and placed into the DSM-IV.
Ritalin, Adderall and Concerta have all been marketed with an aura of scientific exactitude and responsibility behind. Too many physicians accept what the pharmaceutical industry says without question. It is after all much simpler to medicate than to treat the patient with natural remedies for ADHD. Their consciences are stilled by the advertising mantras churned out by big pharma.
Members of the American Psychiatric Association decided on the diagnostic criteria to determine ADHD, in committee, by a show of hands.
In 1998 this situation with no consensus between the pharmaceutical companies and their sycophant doctors on one side, and doctors who focussed on treating their patients on the other, came to an end. The National Institute of Health (NIH) held a “Consensus Development Conference.”
Quotations from the “Consensus Developmental Conference” report:
“Despite progress in the assessment, diagnosis, and treatment of ADHD, this disorder and its treatment have remained controversial, especially the use of psycho stimulants for both short- and long-term treatment. Although an independent diagnostic test for ADHD does not exist, there is evidence supporting the validity of the disorder. Further research is needed on the dimensional aspects of ADHD, as well as the coexisting conditions present in both childhood and adult forms.”
“We do not have an independent, valid test for ADD/ADHD and there are no data to indicate that ADD/ADHD is due to a brain malfunction.”
“Finally, after years of clinical research and experience with ADHD, our knowledge about the cause or causes of ADHD remains largely speculative. Consequently, we have no documented strategies for the prevention of ADHD.”
In spite of that, this set the tone and direction of ADHD research for the next decade. The research is so focused on a cause (one cause) that there is a dearth of research on multiple causes. This ignores the possibility of 100 children with ADHD symptoms having it by 100 different causes or combinations of causes. Causes can be anxiety, frustration due to learning difficulties, or frustration from boredom due to under stimulation in the classroom, allergies and many many more.
In 1998 they said ADHD was controversial.
They did not have an independent validated test, such as a biological or blood test.
They admitted they had no proof that ADHD was a disease, as there was no a proven biological basis for ADHD.
That was in 1998, and neither do they have any test or proof in 2008.
If a doctor diagnoses ADHD in a child today, they use subjective reports on perceived behaviour of that child, from teachers and parents. Then they look into the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders 4th edition) and base their diagnosis and decision to medicate, with powerful and addictive drugs, on this.
What are the DSM-IV criteria based on? The committee of the DSM-IV meets in a committee room and by a show of hands, vote into existence the disorder of the day, and give it a code number in the DSM. That is how we get so many psychiatric disorders. No ADHD or ADD physiological tests or criteria are considered today, which means little has changed in 100 years, except that we are more confused now. ADHD as a disorder is an opinion, not a fact.
ADHD is real! The error is in calling it a disease. The main problem in the Attention Deficit Hyperactivity Disorder is the last term, “disorder.” If we called it Syndrome instead, then we could have Attention Deficit Personalities. Even the “Attention Deficit” part is a misnomer.
So called attention deficit people can be hyper focussed if they are interested and stimulated.