ADHD for everyone!
As I have mentioned before, I almost always begin my clinical interviews by asking the patient what his/her understanding is as to why he/she was sent to see me. Sometimes, I get this answer: ‘Because I know I have ADHD (attention deficit hyperactivity disorder) or “Because I know my son/daughter has ADHD.” So I ask if someone had diagnosed ADHD in the past. The answer I often get is no. So I then ask “Well, how is it that you know you have ADHD (or that your son/daughter has it)?” The answer I usually get is “Because I saw a commercial on TV about it from one of the drug companies and I have all the symptoms.”
The thing to keep in mind here is that the symptoms that the drug companies list are often vague and designed to make people wonder if they have a condition that may need to be treated with the medication they make. For example, these commercials usually say something like “Do you have difficulty paying attention or concentrating? Finding it difficult to find things around the house? Are you restless and fidgety? If so, you may have ADHD.” Well, who doesn’t have these things happen sometimes?!
People seem to forget the word “may” and it sometimes gets translated into “knowing” a disease/condition is present before it is diagnosed. Stimulant medicines for ADHD are prescribed left and right in this country every day and it is absolutely ridiculous. Why? Because there is no way that there are so many people out there that have a condition that used to once be called “minimal brain damage.” I’m not saying there are not people that have attention hyperactivity problems. But let’s stop a minute and think of what it is due to before we start stigmatizing people with labels and throwing potent medications at the problem.
Does Little Johnny have brain damage or could he possibly have attention and hyperactivity problems because his parents are divorced, his living situation is unstable, there are two other siblings, and he is unsupervised until 7pm at night until mom comes home from work? Might that distress a kid and make it difficult to pay attention? Maybe he is hyperactive because he is trying to get attention or needs an outlet for a lot of stress. I am going to try to keep each blog entry brief, so come back tomorrow for part 2 where I will discuss more of my thoughts on this topic.
The thing to keep in mind here is that the symptoms that the drug companies list are often vague and designed to make people wonder if they have a condition that may need to be treated with the medication they make. For example, these commercials usually say something like “Do you have difficulty paying attention or concentrating? Finding it difficult to find things around the house? Are you restless and fidgety? If so, you may have ADHD.” Well, who doesn’t have these things happen sometimes?!
People seem to forget the word “may” and it sometimes gets translated into “knowing” a disease/condition is present before it is diagnosed. Stimulant medicines for ADHD are prescribed left and right in this country every day and it is absolutely ridiculous. Why? Because there is no way that there are so many people out there that have a condition that used to once be called “minimal brain damage.” I’m not saying there are not people that have attention hyperactivity problems. But let’s stop a minute and think of what it is due to before we start stigmatizing people with labels and throwing potent medications at the problem.
Does Little Johnny have brain damage or could he possibly have attention and hyperactivity problems because his parents are divorced, his living situation is unstable, there are two other siblings, and he is unsupervised until 7pm at night until mom comes home from work? Might that distress a kid and make it difficult to pay attention? Maybe he is hyperactive because he is trying to get attention or needs an outlet for a lot of stress. I am going to try to keep each blog entry brief, so come back tomorrow for part 2 where I will discuss more of my thoughts on this topic.
posted by MedFriendly | 10:33 PM
4 Comments:
Do you REALLY find that everyone being diagnosed with ADHD, truly has it? I don't. I was recently watching a television show were a woman said her 2 year old child was not only diagnosed as having ADHD, but also being bi-polar. How in the world can anyone truly diagnose a 2 year old with diseases such as this??? Whatever happened to the "terrible two's?" I feel that many children today are diagnosed with "mental" disorders because parents are too eager to find a chemical fix to their children's behavior problems. If more parents spent time with their kids and away from the television and video games, they might find that their children really aren't "broken" but simply looking for attention.
Hi Jennifer. Absolutely not. That was the point of my post. ADHD is grossly overdiagnosed and normal behaviors are being pathologized.
Thanks for responding. This is one topic that I really feel passionate about. I work with several mothers who about 90% have had one or all of their children diagnosed with ADHD. It's absolutely crazy. From personal experience, my daughters father was diagnosed with this as a child and his mother had him on every drug imaginable. He not only did NOT have ADHD, but was found to be depressed. All of the meds he was on was making him 10x worse to the point where he would sleep for days on end. This was an 8 year old. Why are so many physicians quick to diagnose and prescribe for this "condition?" Is it a fear that parents will take their child(ren) to another practitioner?
Jennifer: There are a few reasons why ADHD is overdiagnosed by physicians. First, the parents come in and right off the bat tell the doctor "I KNOW my child has ADHD and I want a pill to fix it." You see, it is much easier to try to throw a pill at a supposedly uncontrollable biological problem and much harder to do the actual work involved in making some of the hyperactive, inattentive, and impulsive symptoms go away. For example, I am always mystified at parents who bring me a child in the midst of a divorce, traumatic move, who observed and maybe was the victim of physical violence in the home and do not consider the acting out and inattentive as possibly caused by these factors rather than ADHD.
So getting back to what I was saying earlier, the doctors are confronted by a tense parent who actually wants a diagnosis of a neurological problem in their child. The doctor has limited time, doesn't want to get into a big confrontation (pediatricians are usually pretty nice people) and so they cave and give the diagnosis. Sometimes it is corect. Sometimes not. What they should do is refer the patient for a neuropsychological evaluation where a thorough interview can be done to assess for other possible contributing factors to ADHD-like symptoms and where formal testing of attention and impulsivity can take place. I have done such evaluations and have told some parents that I don't believe the child has ADHD and they get MAD at me. "Gee, I'm sorry I don't think your child doesn't have a neurodevelopmental disorder."
Post a Comment
<< Home