October 13, 2004

• I believe it's very real. The kids I see these days are just unrecognizable from those I saw in the 1970s. My pet theory is that too much TV at an early cognitive development stage (i.e. age 2-6) is the root cause of the ADD/ADHD phenomenon. Hell, back in 1978 when Fat Albert came on, it was late Saturday morning and that was it for programming... you went outside and played. Now with DVDs and cable networks, kids stay in front of the tube all day.
• I can speak from experience with friends and family members that it is a very real disease. It amazes me that a medical doctor would think otherwise. I can see how it might be misdiagnosed in simply hyper children, but I know adults who have it.
• He as half a point, Soooz - ADD is often a simple blanket applied to any kid, especially young boys, who are a pain in the arse to deal with; it's a trendy syndrome, in much the same way that you mention Asperger's Syndrome on /. and suddently you find half the people with accounts claiming to have it. (No, dickwads, being shy and obnoxious is not Aspergers).
• As the poster boy for A.D.D. I have a LOT I could say about this, but I will try to limit it to the following... HEY! Let's ride bikes!
• yep. like most issues, the answer lies in the middle.
• Sorry... had to go for the cheap laugh there. Seriously, misdiagnosis is a bad thing, regardless of the malady. What is really sad is how many people who actually have A.D.D. are diagnosed with bipolar disorder or some such. Also, the fact that pharmaceutical companies are making money on something does not make it a fraud. As an MD, Dr. Fred Baughman's opinion is making him a lot of money on the lecture circuit doesn't make his opinion invalid for that reason alone. Also, Dr. Fred Baughman is going to feel pretty silly in however many years it takes them to determine the exact gene (or combination thereof) is responsible for the related maladies of Parkinson's Disease (which my paternal grandmother had), Dyslexia (which was simply called "learning disabilities" in my Father's day) and A.D.D. , which I and two of my daughters have. Research on all three currently centers on malfunctioning dopamine production (or uptake) in the human brain. Coincidence? I think not. Also, while today's medication does not represent a cure, I've seen no evidence of it leading to further illicit drug use and I've seen plenty of people who grew up before it was recognized as treatable (or raised by parents opposed to "medicating" their children) whose lives turned out to be total train wrecks. I also have a theory that the reason that illegal meth use is on the rise is largely due to the number of undiagnosed A.D.D. people attempting to self-medicate. (Apologies to those of you still awake for the long comment.)
• I think there are real problems with diagnosing children as having ADHD, and not just steming from pharma companies. About 20 years ago, I knew two boys who were 7 and 11 years old and were on Ritalin. I can't really say much with an N of 2, but both boys had single mothers with full-time-plus jobs, older sisters headed for cult-like religions, and I strongly suspect, a history of abuse. There could very well be a vast majority of people diagnosed with ADHD who have a neurological disorder. But I don't think these kids did. I think their families' time and resources were spread too thin. They couldn't manage the boys and couldn't afford therapy, so the drugs covered in their health plan were the best option. The drugs worked somewhat, and I'm sure the doctor who prescribed them was doing the best he could for the families. If you had to blame someone/something in this situation, I guess it would be the crappy health-care coverage that wouldn't cover therapy.
• That said, this guy seems like a tinfoil hat aficionado.
• At least this guy IS an MD. Our university's Family & Consumer Science department brought a "Dr. David Cohen" to campus to rail on the same subject. Lots of concerned parents were there to get medical advise from this guy, who had no problem offering his opinion. Problem is, he is a sociologist with a PhD. This is like listening to someone who knows little about auto mechanics but studies the way that auto repair shops operate and then he tells horror stories to convince people that they should never need to take their car to one. He's not a medical doctor, he's a sociologist. The thing that amazes me is how people laugh at or look down upon Christian Scientists (who don't believe in going to the doctor) but then they adopt the same position when the malady involves the brain/mind.
• I think we need to move beyond the 'let's pump 'em full of chemicals and see if that helps'mentality the US seems to have. Which is not to say that ADD/AHDH doesn't exist and isn't a problem, just that it's over diagnosed and over medicated like most things in the US these days.
• The problem is that ADD/ADHD has become a panacea for a larger problem. Pop a pill the problem supposedly goes away. Unruly children are given the diagnosis and a pill is popped. Whether the child is really hyperactive or not - who knows, but I think too much weight is given to family members and teachers to make the call and not enough children are properly diagnosed. Not enough attention is given to home environment and how the child is raised or the family dynamic might be at fault. My nephew was one such child. But to say that ADD/ADHD doesn't exist because there has been an sharp increase in the diagnosis of the disease in the last 15 years or so is preposterous. I take issue with a number of his points such as referring to it as a "no-disease" along with other psychological/psychiatric disorders which are proven to be diseases (ie: depression/schizophrenia). In fact, hyperactivity has been considered a mental disorder since the beginning of the 20th century. It was only in the 1960's that more attention was given to the disorder and renamed. Historically mental illness wasn't even considered an illness until the church stopped treating the sick as possessed. When King Henry (I think; will have to look it up, been a long time since I read this) was treated by an alienist (phrase used at the time for psychiatrists) thats when "possession" became "mental disorder" and psychiatry became a legitimate science ... but I digress. If this hadn't happened with the King, would we still be treating the the mentally disordered as "possessed" and in need of an exorcism? Guess my convoluted point is we have a long way to go before discounting a disease as being illegitimate just because the diagnosis is abused by some. side note: I'm the female poster child for ADHD
• I agree Suomynona. Most problems that manifest themselves behaviorally will require some sort of counseling help in addition to medication and most reputable doctors will tell you that. The parents are unwilling or unable to handle THAT part of the treatment must take responsibility for the consequences. Or maybe they are ALSO just a big cartel looking for their piece of that big freakin' pie.
• Remember the "crossed wires" of the 70's and 80's? Ritalin was supposed to "uncross the wires". Heh.
• Jesus. Look at the dude. I wouldn't buy a set of used tires off this guy, let alone any arm-waving ravings about some psychiatric-pharmaceutical cartel.
• what mercurious and beeza said. except for that parts about having ADHD
• From the site: Making "disease" (real diseases--epilepsy, brain tumor, multiple sclerosis, etc.) or "no disease" (emotional, psychological, psychiatric) diagnoses daily... The guy's a nutball, end of story. Psychiatric illnesses aren't diseases? What are they then? I pity the patients he takes care of in his private practice. Guys like this are what justify the entire field of malpractice law.
• i'm still undecided. I need to go medicate meself to figure this out.
• My cousin went mad and all I got was this lousy website.
• I've long suspected that ADD/ADHD is - at least to a large extent - just the latest trendy label for those bratty, over-exciteable, pain-in-the-arse kids who have always existed but who used to get their obnoxious antics curbed by a few well-deserved whacks round the head. Until I see some convincing physically demonstrable medical evidence to the contrary - as opposed to the very predictable behaviour of a generation of over-indulged, cosseted, spoilt, over-protected sprogs - I'm not inclined to change that view.
• This 10 year old article reviews the academic literature: Problems in Identification and Assessment of ADHD (self link). There has since been some research showing brain activity is different in those diagnosed accurately with ADHD, but in the real world, the diagnosis and treatment can still be made by regular MD's without following DSM guidlines.
• I was told by a psychologist that if you entered a classroom of 30 kids and one of them had (real) ADHD, you would be able to tell in the first five seconds which kid it was. Mild to moderate hyperactivity is normal in kids, but it's routinely misdiagnosed as ADHD and medicated as such. I guess the question is: at what point does a personality trait become a disease?
• >Until I see some convincing physically demonstrable medical evidence to the contrary It is exactly that view that resulted in various forms of mental illness not being given their proper recognition for decades. That being said, you may want to take a look at this: IMAGES OF ATTENTION DEFICIT DISORDER
• This guy is cracked. I don't see how 7 million wrong diagnoses somehow diminishes the 1 that is right. Second, if the stimulant treatments are so blesseed dangerous, where are the studies that demonstrate that. We've been using methylphenidate for over 60 years on kids - if it was turning them into drug addicted zombies, I'm sure someone would have noticed by now. I bet the caribbean island he got his med degree from didn't push a lot of logic in thier studies. That said, those brain pictures are cool. To answer rocket88 - when it becomes dibilitating or gets in the way of normal activity. That's the measure for almost any psychiatric disorder.
• As the dad of two boys who take ADHD medication, I would like to say that those who say that there is no such problem, or that my kids do not really have it, needs to come spend some time with them. In a prior century this type of thing would not be as much of an issue. Perhaps it was an actual advantage when hunting, or being hunted. But now, with the need to complete school and not fail elementary school, the drugs are necessary. And they make the boys happier with themselves. Finally, there is the fact that their mom is no longer literally sick with worry about them. And don't get me started on the "brown alert" issue, when a distracted child forgets to take care of business.
• "It is exactly that view that resulted in various forms of mental illness not being given their proper recognition for decades." I dispute that. Firstly, mental illness can receive recognition before it is properly understood, just as physical illness can. Secondly, demanding proper scientific investigation into phenomena is not what typically led to the appalling way certain mental conditions were regarded in times past. It wasn't the scientifically-minded who dismissed people as witches or who said that they were possessed by demons. It was the kind of dangerous fools who preferred to leap to conclusions or make unfounded assumptions rather than carefully and logically assessing the evidence. Of course, some mental conditions were treated idiotically and irrationally by so-called men of science, but their inadequacy as scientists does not damn scientific method. The answer to unintelligence is not more unintelligence. Leaping to conclusions in the absence of decent physical evidence, on the other hand, has frequently resulted in a whole pile of nonsensical and unjustified medical bogeymen and balderdash - witness the recent idiocy of the usual suspects (panicky, pampering, highly irrational parents who can't see beyond the whims, wishes and ailments of their own precious spawn) surrounding the MMR jab.
• Yeah your kids aren't retarded and annoying they have a disease which isn't your fault! Anyone who spends any time with them would know! I was misdiagnosed with ADHD. It was awesome. It allowed me to develop into someone with no fucking work ethic whatsoever and throughout highschool gave me a huge supply of stimulants. I know someone who was prescribed something like 2000mg a day, huge honkin' horse pills, and he did worse on math tests when he was on that then when he was high. There is a problem with the diagnosis of this disease. It's obvious. It might be a valid thing to suffer from but it's just way to easy to go to the sped lady and then get referred to a psychologist and then get your dextroamphetamines.
• One of my best friend's two sons has ADHD (the other one is perfectly "normal"). In first grade he was so out of control I was sure he was headed for the criminal justice system when he was older. He bit, threw chairs at teachers and other kids, destroyed everything in his room, etc. He was impossible to calm, impossible to discipline. He would scream and destroy things in his near empty room until he fell asleep. Eventually they sent him to a school for the "severely emotionally disturbed". Today he is a polite, caring, young man, though still distractible and quite hyper. He is in public school, on Straterra, with an aide he shares with two other special ed kids. I don't think ADHD is a perfect fit for him diagnostically. It doesn't explain all his symptoms. I don't think Straterra is a perfect drug (and it is the fifth he's been on). He still has bad days. But without special ed and drugs, he literally would not be able to function. ADHD may be overdiagnosed, stimulants may be overprescribed. But how can someone say a kid like him shouldn't be taking these drugs? Would it be better for him to be institutionalized? In juvenile detention?
• I don't see how 7 million wrong diagnoses somehow diminishes the 1 that is right. When the other 6 million misdiagnosed kids are pumped full of stimulants with the accompanying side effects that proceed to alter their personality and behavior. You can't help one person at the risk of everyone else.
• Until I see some convincing physically demonstrable medical evidence to the contrary Physical proof was published by the NIMH (national institute of mental health) in 1990 in the New England Jounal of Medicine, they used PET scans as part of their research. The Structural Differences include studies with MRIs, PET scans, and SPECT scans. They show subtle structural differences in the prefrontal cortex (smaller right anterior frontal cortex, and less white matter in the right frontal lobes which cause problems with sustained or focused attention), caudate nucleus (asymmetries which cause problems with self-control), and globus pallidus. They also show that the right hemisphere of the ADD ADHD brain is, on average, 5% smaller than the control groups." quoted from here Q-EEGs images of a ADD brain can be found here Another site showing a PET scan of a normal brain vs one with ADD ---> here One study (Lou et al. in Arch. Neurol. 46(1989) 48-52) found that people with ADHD have a reduced blood circulation in the striatum. But even more important might be the discovery that people with ADHD seem to have a significantly higher concentration of dopamine transporters in the striatum (Dougherty et al. in Lancet 354 (1999) 2132-2133; Dresel et al. in Eur.J.Nucl.Med. 25 (1998) 31-39). From wikipedias entry. I wont argue that the diagnosis gets abused, it's not the only disease that gets this "honour". Will dispute that Ritalin is the only choice for treatment, anti-psychotics, anti-depressants and a host of other treatments are used. I didn't get diagnosed til I was an adult and took Ritalin for two years (hated the long term effects and went off of it). Being the control freak I am I don't like doing drugs of any kind and actually seriously questioned whether or not I needed to take this drug until I did, 25 years of mental chaos taken away. The change was dramatic to say the least.
• I just found this in the NYT's. Shades of Thomas Sasz or however it's spelt. How do you feel about diagnoses? I being dx'd bipolar.