Story of an Illness

Attention-Deficit Hyperactivity Disorder, commonly known as ADHD, is defined by many as a psychiatric disorder. It was voted into existence in 1987 by a committee of the American Psychiatric Association (1). ADHD is characterized by an extended history of inattention, impulsiveness and often times, variable amounts of hyperactivity (5). ADHD is suspected in children when these otherwise normal characteristics begin to affect performance in school, social relationships or behavior. Dr. Paul H. Wender, M.D. claims that currently, “ADHD is the most common chronic psychiatric disorder of childhood” (5). According to a booklet on ADHD published by the National Institute of Mental Health, “It is estimated that between three and five percent of children have ADHD, or approximately two million children in the United States” (8). Even though there is no evidence to support the claim that ADHD is a brain disease, a biochemical imbalance, or even a medical condition at all, it is treated as such with dangerous, mind altering, stimulant drugs.

ADHD was first depicted by Dr. Heinrich Hoffman in 1845 who wrote books on medicine and psychiatry. Some say his famous poem titled, The Story of Fidgety Philip, was an accurate description of a little boy who had ADHD (8). In 1902, Sir George F. Still published a series of lectures to the Royal College of Physicians in England in which he described a group of impulsive children with significant behavioral problems (8). He reasoned they were due to a genetic dysfunction, and not poor child rearing (8). He also concluded that children who demonstrated rebellious and unacceptable conduct could have suffered some sort of trauma to the brain to cause such behaviors (1). The term minimal brain dysfunction, or MBD, was created by Still shortly thereafter. In 1979, the Food and Drug Administration ordered that MBD be eliminated as a diagnostic term and replaced it with Attention Deficit Disorder in 1980. In 1989, the term ADHD was chosen by psychiatric experts, and its symptoms have been published by the American Psychiatric Association in its Diagnostic and Statistical Manual of Mental Disorders.

Stimulant drugs became an FDA approved treatment for people with ADHD during the mid-1950’s. This class of drugs today includes methylphenidate (now sold as Ritalin, Concerta, Methylin, and Metadate CD), methamphetamines (Desoxyn and Gradumet) and amphetamines (including Dexedrine and Adderall). The Drug Enforcement Agency classifies these as Schedule II drugs, a classification reserved for the most dangerous and addictive drugs that can be legally prescribed (1). On September 29, 1970, the first Congressional hearing s were held into the concerns of over 3 million dollars in federal grant money given to the National Institute of Mental Health for the study of learning disabilities, each funded study included the use of drugs on children who were identified as being afflicted with MBD (1). At that time, between 100,000 and 200,000 American children were taking stimulants to control their behavior (4). The chairman, Representative Cornelius Gallagher, voiced his concerns about what he saw as an epidemic in the making. He states, “I am well aware of the occasional frustrations which come from the fact that children do not simply sit quietly and perform assigned tasks” “…I fear that there is a very great temptation to diagnose the bored but bright child as hyperactive, prescribe drugs, and thus deny him full learning during the most creative years” (1). Another concern raised by Gallagher as well as DR. David Healy, a chemist who testified at the hearing, was the lack of scientific objectivity found in the studies. Healy stated, “A critical search through the literature will very likely reveal that 90% or more of the research, evaluation, and presentation of these drugs was conducted by the drug companies or through investigations underwritten by the companies” (3). In discussing the objectivity of the people responsible for updating the new DSM-V, Professor Williams poses the question, “should this conflict of interest, which impacts up to 70% of the panel members, be allowed?” (11). The trend for pharmaceutical companies influencing the policy outcomes, through controlling what doctors learn from journals by funding continuing education and hiring research teams that implicitly guarantee the results that will benefit them the most is of alarming concern.

Diagnostic criteria for ADHD are controversial to say the least. In cases of many neurological disorders, such as Alzheimer’s disease, laboratory tests such as brain scans are performed, as well as blood, urine and spinal fluid samples are taken to aid in the diagnosis. Since the invention of MBD and ADHD, not a single psychological or laboratory test has been discovered to be useful in determining if a child in fact has the disorder (10). The standard evaluation forms and rating scales for ADHD are designed to compare the child’s behavior to those of other children the same age and are commonly completed by the child’s teachers (8). The diagnosis is then made by trained professionals such as clinical social workers, psychiatrists, psychologists, pediatricians, or family physicians (8). Some experts argue these evaluations may lead to cases of misdiagnosis because they are extremely subjective and numerous ADHD symptoms are often found in many other disorders such as learning disabilities, anxiety and depression (8).

The question whether or not the criteria listed in the DSM codes are truly abnormalities is one that has not been clearly answered. Dr. Baughman, a neurologist with over thirty five years of experience and author of ASHD Fraud states, “Medical diagnoses cannot be made by opinion, suspicion, or committee; there must be proven facts; a demonstrable abnormality. If there are no abnormalities, the result is exactly what we have now, a perversion of language and ethics so twisted that any normal person can be labeled as suffering from a disease” (1). Howard S. Becker explains the complexities with labeling stating, “Deviance is not a quality that lies in the behavior itself, but in the interaction between the person who commits an act and those who respond to it” (2). Some of the symptoms listed include forgetfulness, excessive talking and fidgeting, running and climbing excessively, not sitting still or standing in a line for a lengthy period of time, difficulty sustaining attention on unappealing tasks, often loses things necessary for tasks, often interrupts or intrudes on others, fails to finish schoolwork, chores or duties and has difficulty taking turns (8). While some children may indeed suffer from extreme ADHD-like symptoms and require treatment so that they can live productive lives, the symptoms listed in the DSM codes can also easily describe a normal, active child that may just require extra attention and a different approach to discipline and teaching from parents and teachers.

Children with ADHD have also been described by experts as creative, bright, energetic and often have the ability to think of more than one thing at a time (9). In fact, the diagnostic checklist for ADHD and the one used to identify children as gifted and talented is practically indistinguishable. Several famous people such as Winston Churchill, Robin Williams, Beethoven, Thomas Jefferson, Vincent Van Gough, Albert Einstein, Magic Johnson, Alexander Graham Bell, and Bill Cosby all have been labeled as possible candidates for an ADHD diagnosis (6). Obviously, these people are all highly capable, intelligent individuals who may not have accomplished the feats they had, had they surrendered to drug therapy. The common side effects associated with ADHD drugs have been known to suppress the personality traits and motivation that gifted people frequently possess (4).  According to Robert K. Merton’s Typology of Modes of Individual Adaptation, these unconventional individuals would be classified as rebels; people who go outside the social structure to accomplish their own idea of success (7). Who’s to say that one particular way is better than another?  The criteria used in determining if a person has ADHD could be merely a list of creative, yet intense qualities used to describe a genius. Sadly, ADHD labeled children are often times misunderstood. They simply don’t fit into society’s definition of normal and are thus drugged into submission. People with ADHD are different than most, but that is what makes them truly unique.

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Works Cited

(1) Baughman Jr., M.D., Fred A. ADHD Fraud. Victoria, BC: Trafford Publishing. 2006.

(2) Becker, Howard S. Labeling Theory. Ch 7 of Readings in Deviant Behavior. Calhoun, Conyers and Thio. Pearson Education Inc., Boston, MA. 2010.

(3) Breggin, M.D., Peter R.. Medication Madness. First. New York: St. Martin’s Press. 2008.

(4) Glasser, M.A., Howard N. 101 Reasons to Avoid Ritalin like the Plague. Tuscon: Nurtured Heart Publications. 2005.

(5) Mandlekorn, M.D., Theodore. A Physician’s Perspective. 2007 7 Nov, 2008 Puget Sound Behavioral Medicine. http://www.psbmed.com/resources.php4 Retrieved on February 21,2012.

(6) Martin, M.D., Victoria. ADHD: Fact, Fiction, and Beyond. A Comprehensive Study of ADHD. 12 Dec 2008. http://www.adhdtexas.com. Retrieved on February 21,2012.

(7) Merton, Robert K., Ch. 3 of Readings in Deviant Behavior by Calhoun, Thomas C., Conyers, Addrain, and Thio, Alex. Pearson Education, Inc., Boston, MA.2010.

(8) National Institute of Mental Health (NIMH). ADHD Booklet. 26 June 2008. Retrieved on February 29,2012.

(9) Peacock, Judith. ADD and ADHD. Mankato: Capstone Press. 2002.

(10) Wender, M.D., Paul H. Attention-Deficit Hyperactivity Disorder in Children and Adults. New York: Oxford University Press. 2000.

(11) Williams, Meredith. Social Deviance: Sociology 360 Blog. Blog Post 4: Story of an Illness. 27 Feb 2012. https://lms.wsu.edu/section/content. Retrieved on 28 Feb 2012.