May 10th 2010
Attention Deficit Disorder (ADD) is a form of Attention Deficit Hyperactivity Disorder (ADHD). The diagnostic signs and symptoms do not describe a sickness, but describe behaviour patterns. It is not necessary to have a Ph.D. to understand that. A glance at the DSM-IV (The Diagnostic and Statistical Manual of Mental Disorders) under ADHD, and there it is in black and white. The diagnosis is based purely on subjectively perceived behaviour.
The psychiatrists and psychologists base their assessments of Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) on the behavioural criteria from the DSM-IV.
There is no physiological basis for diagnosing attention deficit disorder or attention deficit hyperactivity disorder. The DSM-IV manual itself states that very clearly:
“There are no laboratory tests, neurological assessments, or attentional assessments that have been established as diagnostic in the clinical assessment of Attention-Deficit/Hyperactivity Disorder.”
(DSM-IV-TR, page 88)
The question, “What is Attention Deficit Disorder, or ADHD?” is looking at the subject from the wrong perspective. This is because this assumes that there is a mental sickness called Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder.
There are numerous causes of ADD and ADHD like behaviour which need to be screened for.
Children with the same behaviour in two cultures will get different diagnoses. In the one culture the child will be perceived as a healthy active child, while in the other culture the child is perceived as being mentally disturbed. A true sickness is independent of culture and is not based on arbitrary guidelines of behaviour patterns in children, in a particular society. The DSM-IV diagnosis criteria create an illusion of a disease.
What is “normal” in our culture? Should we diagnose talented children as having a chemical imbalance in their brain, and give them powerful drugs, so that they become “normal” again? That is obviously absurd, put that way, but that is exactly what is being done. We have begun to see potentially gifted children as suffering from a “disorder”. There have been many famous talented people with ADD or ADHD like behaviour, who lived, or had their childhood, before the modern drugs were developed. Would they have been famous if they had been drugged like many children are in our Western culture are today?
Attention deficit disorder is often a wrong description of a creative mind with great potential.
If we called it an attention deficit personality, instead of a disorder, then maybe society (the governments) would be willing to invest in their future.
The list of ADHD personalities through the millennia includes actors and actresses, inventors, authors, artists, athletes, community activists, industrialists, statesmen and scientists. These individuals were different and thought differently to their peers. In many cases it was their ADHD “symptoms” which made them creative and successful in their chosen fields. These people were visionary, artistic, innovative and unique.
Many of these people are great role models, especially for children with ADHD. They can then clearly see what they can aspire to. The so called “chemical imbalance” in their brains made these role models talented. The list includes people like Leonardo da Vinci, Abraham Lincoln, Thomas Edison, the Wright brothers, Benjamin Franklin, Isaac Newton, Winston Churchill and Richard Branson, the founder of the Virgin empire. These people had, and have, an ADHD personality. If they were children in school today they would be diagnosed with Attention Deficit Hyperactivity Disorder. In some parts of the United States they would be forced to take medication which stunts the child both physically and mentally.
The attention deficit hyperactive disorder diagnosis is based purely on subjective assessments of behavior. A psychiatrist may do the “ADHD testing,” but this is based on subjective perceptions of teachers and parents. There is no physiological or neurological test to show ADD or ADHD in a person, as the diagnostic manual the psychiatrists use, clearly states.
The question to ask is, “What is the cause of attention deficit disorder?” If the cause of the behavior is food additives, the thyroid gland, hypoglycemia, allergies, stress due to learning difficulties or some other cause, then the person does not have ADHD, but allergies, hypoglycemia, etc. If the behavior is due to a personality trait, then coping skills are the answer, as is choosing hobbies, lifestyles and careers that suit the personality. Not everyone is suited to be an engineer, artist or social worker.
The big problem parents can have is to find a schooling alternative for the child, which can address the child's special needs. Often we tend to be unaware of the stress a child is subjected to in the educational environment.
An adult who feels ill through depression, anxiety or exhaustion, has the possibility to take some days leave. When the adult returns to the workplace, the work can be picked up from where it was left, or someone else filled in during the absence.
The child at school has a tough workload today, greater than pupils had a couple of generations ago. When the child returns to school the missed work has to be caught up, as well as trying to cope with the new work. If the cause of the stress was not coping with the work load in the first place, is it strange that the poor child behaves in a way which indicates an inner anxiety?
The concept of medicating a child is based on the assumption that there is one cause, a “chemical imbalance” in the brain. The one cause and one solution is convenient, but false. There are many causes, some alone and some as combinations of factors, which result in the child behaving in an ADHD manner. None of these causes, well over a hundred, get better, or are cured by giving a child harmful and powerful drugs. In fact the drugs do not cure the child, merely affect their symptoms.
As the famous American psychologist,Abraham Maslow said:
“If the only tool that you have is a hammer, everything looks like a nail.”
Medication artificially covers over the “symptoms” giving a feeling of relief to teachers, parents and some of the children. However the medication affects the neurotransmitter systems in the body. Science does not fully understand these systems and how they interact yet. That is why medication is a trial and error exercise.
There is no psychiatrist who fully understands the biochemical processes in any individual, because science does not have that understanding. No psychiatrist knows how a specific drug will affect a specific individual.
There are known knowns, but there are also many unknown unknowns, and we just don’t know what we don’t know...
If a physician suggests medication as a first option, the red warning flag should be flying. Before such a potentially harmful and inefficacious method is tried there needs to be a screening for the other conditions. Many children with autism have received the ADHD label and medication instead of appropriate therapy.
There are many responsible and caring physicians who understand the requirements of screening for the various other causes of ADHD behavior, and can lead the parent in the right direction.
As a simple example, a child who is allergic to gluten (a wheat protein) and/or casein (a protein in milk products) can show hyperactive behavior. These proteins cause autism in some children. A gluten and casein free diet (gfcf diet) is the solution, not medication.
Another example is sleep apnea. Does the attention deficit hyperactive child snore. Bad quality sleep is a reason some children have ADD or ADHD behavior.
The parents of a child, or the adult with ADD or ADHD feelings is ultimately responsible for which path to take: medication to cover the symptoms, finding and treating a possible cause, or finding coping mechanisms to cope with society’s pressures, and take advantage of the positive aspects of ADHD.
Medication does not cure, and has to be continuously taken, but ADHD medication does have a place in some cases, as a “crutch” over a shorter period of time, while other therapies are used to treat the child.
There are better and healthier options than Ritalin, which is a Schedule 2 controlled substance, making possession (without a prescription) a felony with over a year in jail, since it is in the same category as cocaine and methadone. Surely there are healthier ways to stimulate the young brain and focus the child's attention naturally.
If there is an attention deficit disorder, then what is wrong with the United States? In Europe there are about 10 times less “disorder cases” per 100,000 population.
Alternative Attention Deficit Hyperactivity Disorder treatments is the rational way to go before medication is even contemplated, since there are so many alternative possible reasons for attention deficit behavior patterns.
The first step is to clarify concepts:
The effectiveness of medication is an empirical issue, but the use of medication is an ethical and sociological question.
It is also important to separate diagnosis and disease or disorder. They are not the same.
Then we further need to separate cause and effect.
The symptom has a cause and is not a disorder.
There are many physicians who are aware of the faulty reasoning behind the “medication only” lobby, and can guide the child and parent through physiological testing to find an underlying cause for the ADHD condition, if there is one.
It is the cause that needs to be addressed, as in allergies or sleep apnea. There may be frustration because of learning difficulties from vision or hearing problems, and it is then those factors that need treating. Another possibility is frustration by being a highly intelligent, gifted or creative child, in which case coaching in coping strategies is the answer.
The “medication only” and the “it's the ADHD gene” schools of thought, both originate in thebasic assumption that all that exists is materia and we can know everything through our senses. The immaterial does not exist in this view.
This is unscientifically unproductive, as all major advancements in science originate in trying to explain the unknown. A few centuries ago, electricity and germs were unknown. Newton was criticised about this strange force, gravity, that could not be proved by direct measurement, but only through secondary inference, and mass was a strange quantity given to objects. Still today nobody knows what “mass” is. CERN are at present testing a multibillion Euro Large Hadron Collider to check if the hypothesis on mass carrying Higgs particles is correct.
A simple paradigm test will show that our senses are not always trustworthy.
If the child is gifted and has a vivid imagination, then maybe the “ADHD gene” is a genius gene.
Practical alternative ADHD treatments are Cognitive Behavioural Therapy and Neuro Linguistic Programming accept there is something we do not know or understand, but we can influence through cause and effect, and do not need to know and describe everything in mechanistic detail, as long as practical results are attained.
This is why we see two sides in conflict. The medication side say they are scientific and ignore Cognitive Behavioural Therapy and perceive it to not be scientific because they do not understand Cognitive Behavioural Therapy which cannot give a materialistic explanation of the mechanism whereby their methods work. The “medication” view is ironically, an unscientific view, starting from the premise that there is only one cause of ADHD and Attention Deficit Disorder and therefore only one treatment and in spite of what they say, there is no physiological or neurological basis for ADHD like behaviour.
Those advocating diet and supplements as cures are in the practical area, making new hypotheses and testing these, which is also a more scientific method than the so called scientists advocating medication.
Not all people are allergic to pollen. Of those allergic, not all are allergic to grass. Those allergic to gluten and those allergic to grass pollen require different treatments as their allergies arise from different causes.
There are two basic factors to consider with ADHD and Attention Deficit Disorder, and neither is rocket science:
What works for one person may not work for the next. If a physician does not understand something so basic, find another one who does. There are so many good, sensible, empathetic and professional physicians, we should not stay with those who repeat mantras, which contradict plain common sense.
Attention deficit and attention deficit hyperactivity are not disorders, but symptoms, which need to be addressed in order to know how to cope or deal with the ADD and ADHD behaviour patterns.
For some people it is another disorder with a treatable cause, and for others it is a personality trait. This needs coaching to handle their exuberance.