Bob–
Today, I saw a bright, athletic lacrosse player who is a high school sophomore. She was seeing me to follow up on a mild concussion that she sustained last week during a lacrosse game. She is doing fine from the concussion standpoint, but her mother told me that they had been wanting to ask about ADD, as prior to this injury she had been having trouble concentrating at school, and difficulty finishing her projects. Two of her teenage cousins had recently been diagnosed with ADD and were being treated with stimulants. I asked how she was doing in school. It turns out that she is excelling, getting A’s and B’s, has big college plans, and wants to be a doctor.
I said, “Well, funny you should ask me about this . . . ,” and I shared how I felt that ADD is way over-diagnosed, and how there are serious potential consequences from over-treatment, such as addiction, mood disorders, aggressive behaviors, headaches, etc. Especially since she was doing well in school, there seemed to be little justification for any treatment.
I then digressed with them on a personal tangent, something I usually avoid but which seemed appropriate in this case. I shared with them that I was pretty certain that I could have been diagnosed with ADD in high school, because I also had a lot of trouble concentrating. I don’t know if I ever turned in a homework assignment or a paper except at the very last moment, because without that looming deadline, I couldn’t bring my mind to focus on the task in front of me. But because no crutch was ever offered to me, and because I was able to do well in school anyways, I learned to develop my own coping mechanisms, and I made it successfully through college, medical school, and residency. I also learned to appreciate the positive aspects of my sometimes inattentive and distractable personality, such as curiosity, creativity, and open-mindedness. And at times, my inattentiveness could, and still does, transform into a razor-sharp focus, usually when it came to projects that hold deep interest for me, and usually after a period of time when I’ve allowed different ideas to rattle around in my head in a disorganized fashion. I’m often surprised at the connections and solutions that emerge in my mind after a period of what seemed to be inattentiveness or distraction.
I mentioned how Albert Einstein and Winston Churchill almost certainly would have been diagnosed with ADD as children, if that diagnosis had even existed back then. What would have happened to their brains and personalities (and the world) if their normal development had been altered by psychoactive medications? Instead, they were number one and number two on a list of “Most Influential People of the Twentieth Century” that I recently saw. (Did you know Winston Churchill was a highly acclaimed painter and best-selling author before he went on to save the world from Hitler’s aggression?)
The mother said, “You know, that’s how I was, too, always distracted, but I learned to cope and I’m glad I was never on medicines. I think I’ve been better off without them.” And the daughter added, “Yeah, I don’t really want to go there. I think I’m fine.” I released her to start sports again in one more week, and they left in a positive mood, hopefully feeling that she is unique, talented, and capable of healing and coping, instead of feeling diseased and broken.
Mark
