My daughter had been through 6 hours of neurological testing over two days by a highly regarded neuropsychologist in the Boston area.
When I read Lessons from Atticus: is “ADHD” a problem of not listening? written by a pediatrician, I was reminded of a remark my daughter’s former pediatrician made when I shared with him the report from the neuropsychologist indicating that she had ADHD. His response was, “She is too cute to have ADHD.” What I heard was, “ADHD is not real.” It has been almost 8 year since that appointment.
Fast forward to recent years. As of late ADHD seems to have become a lightning rod for attacks from experts and non-experts alike. It is always distressing to me when I read opinions about ADHD in the media that are not adequately substantiated.
But what is most concerning to me is when doctors, either in their office or in the media, share their opinion without also sharing the foundation for these opinions.
You see, I hold them to a higher standard than the general population when providing their viewpoint on a medical issue.
Because we rely on them to guide us…
ADHD Is A Problem Of Not Listening?
So, I was dismayed when a pediatrician dismissed ADHD in her article Lessons from Atticus: is “ADHD” a problem of not listening? by saying, “Perhaps ADHD is a problem of not listening.”
She illustrates her point with the story of an interaction she had with Sam’s (her patient) parents. Sam had problems in the classroom because of his impulsivity, and during an appointment the parents were expressing their anger at their son’s teacher for the way she was working with him.
The doctor’s conclusion was that, if the parents and teacher were able to listen to each other better, they would better be able to address what is going on with Sam.
Fair enough. Sounds reasonable to me. I certainly agree that parents and teachers need to listen to each other.
So, the take away from her story is that we need understanding and compassion between parents and teachers in order to work effectively on behalf of our children.
It Is Not About ADHD
But I don’t see the connection she makes between the lack of communication between Sam’s parents and teacher and the question of whether or not Sam has ADHD.
Yet, she uses this story that is essentially about poor communication to support her conclusion, saying, “I wonder if the current epidemic of what we call “ADHD” represents a loss of this capacity to put ourselves in another person’s skin.”
So, I’m left wondering how this story about the communication between Sam’s parents and teacher is related to the question of whether or not Sam has ADHD.
She doesn’t say.
ADHD – A Symptom of Larger Social Ills
Rather, she wonders if ADHD is a symptom of people in the education and medical systems feeling overwhelmed and not heard.
As a parent, former teacher and consumer of medical care I am sure people in these systems do feel overwhelmed and not heard at times. However, it does not follow that ADHD does not exist as a condition, as she claims.
Instead we can conclude that larger social ills, such as lack of communication in the medical system, do contribute to the overdiagnosis, underdiagnosis and mistreatment of mental health conditions, including ADHD.
Some of the possible contributing factors (social ills) for this are
- lack of access to affordable, quality healthcare
- racial bias in psychiatric diagnosis
- treatment by primary care and other non-psychiatric doctors despite their lack of training in that area of medicine
- treatment by experts trained in mental health but lacking experience and training in a specific condition, such as ADHD
- and, yes, lack of communication between patients / parents and doctors
So, while there are many factors that may contribute to the misdiagnosis and mistreatment of ADHD (and other mental health conditions), again, it does not follow that ADHD does not exist.
ADHD and Medication
With respect to medication, she says,
“The large scale medication of a whole generation of children has potential serious and profound long-term effects. These include the silencing of children whose symptoms represent complex underlying problems, as well as abuse of stimulant medication by high school and college students.”
This type of blanket statement ignores the real issue, which is that not correctly diagnosing and treating any mental health condition, including ADHD (and co-morbid conditions), has potential serious and profound long-term affects for children and adults.
And, while I agree arriving at an accurate diagnosis and treatment plan is complex, when it comes to treating ADHD, as Dr. Ned Hallowell wrote recently,
“No clinician worth his or her salt believes that all problems can be cured with drugs. But neither does a responsible clinician deny the good that medications can do.”
Saying that there is a “large scale medication of a whole generation of children” gets our attention, for sure.
But where is the foundation for this statement?
Similarly, linking ADHD treatment to stimulant abuse is also quite inflammatory, but inaccurate.
Because the question of whether kids (and adults) are being properly treated with stimulants for their ADHD is not related to stimulant abuse by high school and college students.
Kids (and adults) abuse drugs, including prescription medications. And this is the real issue we need to address.
So, Why Does This Matter For You, An Adult With ADHD?
When health care experts dismiss ADHD in such a cavalier manner, it can leave you once again wondering, “Am I just making this up? Is it just an excuse I’m making for myself?”
And, then you might not take steps to reach your potential, such as finding the expert help you need or considering all types of treatment, including medication.
Instead of being proactive in treating and managing your ADHD, you may heap blame and shame on yourself and remain isolated.
That would certainly be a potential serious and profound long-term effect of dismissing ADHD.
The Bottom Line
There is certainly a lot of rhetoric around ADHD, which makes it easy to be confused.
The key points Dr. Allen Francis shared from psychologist and ADHD expert Keith Conners offers a helpful perspective:
- ADHD is a serious and treatable disorder
- proper treatment is required to avoid serious lifetime impairments
- you must be a savvy consumer of your healthcare to get a proper diagnosis and treatment
I hope you will also continue to recognize when arguments just do not hold up to scrutiny and are more the product of bias, rather than clear evidence.
And be able to dismiss these arguments, rather than dismiss your diagnosis of ADHD.
What do you think?