No, There is no Such Thing as ADHD

Robert Berezin, MD
210
1485

No, there is no such thing as ADHD. Somewhere along the line we have lost the understanding that kids come in all shapes and sizes. Some kids are active, some are quiet; some kids are dreamers, others are daring; some kids are dramatic, others are observers; some impulsive, others reserved; some leaders, others followers; some athletic, others thinkers. Where did we ever get the notion that kids should all be one way?

Poor parents these days are subject to pediatric ‘experts’ who proclaim that kids should follow some prescribed rates of physical, mental, and emotional growth. If they deviate from the ‘mean,’ then there is a problem. Parents are intimidated and worry that there is something wrong with their babies. Every child matures in his own way, in his own time. Every child is different. We need to throw away all the bell curves of ‘normal.’  You know – developmental milestones.

Parents worry if Johnny is a happy breast feeding pudge ball and over his appointed weight; or crawls differently; or isn’t walking yet; or isn’t talking at his appointed hour; or isn’t toilet trained yet (very few make it to adulthood without getting toilet trained). There are experts at every turn, such as those who proclaim knowledge that a pudgy baby will create fat cells which will create weight problems for life, which is nonsense. Parents, leave these poor kids alone and enjoy them. Raise them well – you know, boundaries and love.

Apparently, differences mean that we should make children conform to the idea that there is some ‘normal’ that all kids should be. If they’re active give them amphetamines; if they’re moody give them Prozac; for fears, give them benzodiazepines; and while we’re at it, lets give them antipsychotics, or Lithium and other mood stabilizing drugs. What in the world are we doing?

My focus is on the interplay of temperament and trauma to demonstrate how the fiction of ADHD took hold in the first place. Dr. Peter Breggin and others have addressed the issue of giving amphetamines to children with compelling clarity (see “Towards a Ban on Psychiatrically Diagnosing and Drugging Children”).

Every single person is absolutely unique. No two of us are alike. Even identical twins are not the same. We all have our unique constellation of temperament. I want to emphasize that by temperament, we are talking about inborn temperamental styles, not pathology (see “The Nature-Nurture Question – The role of ‘Nature’ comes from our genetic temperament”). Our temperament digests our parental nurture all the way through our development. Together they create the varied and wonderful scope of human personality. Our cortical imagination, oriented by our temperament, writes a specific and nuanced character world in each of us, which is as unique as our fingerprints. And so it is with nature and nurture for all of us. Our temperaments differ; our salient environments differ; our parents, our culture, and the happenstances of our lives differ. The specific qualities of our parents, brothers, sisters, aunts, uncles, teachers, friends, girlfriends, boyfriends, and the moment-to-moment experience of our lives are all unpredictably alive. Our adult character is created out of all of these forces and is absolutely unique. No two snowflakes are alike, but we are all snowflakes. And we all form the same way.

To understand ADHD, we need to look at differences in temperament, as well as the degree of responsiveness, abuse, and deprivation that is digested into our plays of consciousness. A typical child, often boys, may have an Active temperament. One can readily tell whether a child is active or passive. Active children sit and walk and climb early in childhood. They take off at the beach. The active child is naturally physical, physically expressive, and action-oriented. He is oriented to active, muscular, good aggression. In the context of good-enough loving, the active child, identifying with his active strength, operates as a take-charge doer. (The passive child is not oriented by muscular, good aggression. In basic orientation, he is more absorbed elsewhere. He tends to be off day-dreaming. The passive child depends more on someone else to provide shelter from the storm. He identifies as the recipient of action rather than as a doer.)

The next temperamental attribute is that our child tends to be an Externalizer, rather than an Internalizer. What does this mean? The orientation of an Externalizer is to look outward. With good enough loving, he feels secure with love from others. In the context of deprivation and abuse, he is predisposed and oriented to feel attacked or criticized by others. He locates the source of attack, hatred, or criticism as coming from a person outside of him. For example, from a legacy of shaming abuse, an Externalizer experiences being actively “shamed” by a person outside of him and will react to it. His orientation is as a blamer. As such, he would be inclined to blame, and fight with others. An Internalizer will carry a source of loving internally. In the absence of good-enough loving, instead of blaming and fighting, he will attack himself. It would be manifest as self hate. “I’m bad; I’m inadequate, I’m stupid, I’m ugly,” etc. In the context of shaming abuse, an Internalizer, would feel “ashamed.”

Our child would tend to be more Narcissistically inclined than Echoistically oriented. His orientation is to operate from his sense of self, as opposed to an echoist who operates from the point of view of other people. In the context of deprivation and abuse, his “me” orientation focuses on himself as the injured party, and isn’t as centered on thinking of others. He is furious and outraged at slights and injuries directed at him from others. He leads with an exposed nerve, and indignantly feels, “How dare you treat me this way?”

And finally this child tends to more of a Participant and less of an Observer. A Participant is naturally oriented to be immersed in and emotionally involved in activities. He easily and naturally engages through feeling. The natural orientation of an observer, on the other hand, is to process at a distance, rather than be immersed in the feeling relatedness of the scenario of the play. An Observer tends toward thinking, caution, circumspection, reticence, and figuring things out.

So what do we have? An Active, Externalizer, Narcissistic, and Participatory child. Remember, there are no pejoratives associated with these attributes. This type of constellation generates the attributes of leaders and athletes. In many cultures these children are valued, rather than devalued. These kids grow up to be fun energetic people. These kids may show behaviors which get them called ADHD. But they are normal kids. They are easily bored, need to run around a lot, may have short attention spans, except when they are interested. These actually are stereotypical boys. There is nothing wrong with them. They can be fidgety, impulsive, and concentrate poorly.

In the context of deprivation and abuse they may be prone to spin out of control. They may act out more and blame and fight. This may be a signal that something is problematic in the family and needs to be attended to. Many families don’t like to hear this, but it often means that the attention deficit may be that the parents are giving insufficient loving attention to the child.

What is called ADHD in general is merely one part of the constellation of temperaments that comprise the human condition. But even within this group, each of our temperaments vary. No two children are the same. And the specifics of deprivation and abuse vary with every child. And not only that, there are so many other issues that can be very misleading. I give one example in “How do Our Children get Misdiagnosed with So-called ADHD? – Certainly symptoms present themselves. But they need to be correctly Understood.” All of these children need to be correctly evaluated to understand what they need. It might be helping the family. It might be a more open classroom. It might be to help teachers be better teachers. But one thing is for sure – there is no ‘brain’ condition that generates some disease called ADHD. None has ever been demonstrated. And no child should be given amphetamines.

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210 COMMENTS

  1. So basically, you want to ignore all of the children who are debilitated by ADHD symptoms? And what about all of the adults who are debilitated by ADHD symptoms, for that matter? You seem to want to pretend that ADHD is a problem that only affects children, and that cannot ever be debilitating. Whether you like it or not, Dr. Berezin, there are many people out there who cannot live a productive life without ADHD meds. And the fact that you seem to want to prevent those people from getting the meds they need by sweet-talking to them and trying to convince them that meds are harmful for them, sickens me. Heck, you seem to be against all meds whatsoever, which again, is harmful. For some people with depression, meds keep them from killing themselves. But you don’t seem to care about that. Or, in my case, my meds keep me from having constant panic attacks that are so intense that I literally cannot fight them off. Before I started taking meds at age 13, I was miserable. I had such bad anxiety that I couldn’t stand to be alone at all, since being alone caused my anxiety to spiral into a panic attack. I never really got to enjoy my childhood as a result. Yet when I was put on meds, life became more manageable for me. But you’d rather ignore that fact and try to convince me to get off of meds altogether. Do you really think that’s a good idea, Dr. Berezin?

    • Adults who want to take drugs should be given that right. Children on the other hand have to be protected by their Government.
      If there is no chemical imbalance in the body/brain of a child, then they medically do not need the chemical “Ritalin”.

      You have to prove a physical defect before you give ( or force) a physical solution.

    • I am so impressed by all the thoughtful responses to this article. Why must he berate so many loving parents who are simply trying to do right by their children. I am sure there are some who drug because it’s easier but most of us do it as a last resort. There are a number of people in my family who would be classified ADHD who were not medicated and most all have self-medicated with drugs and alcohol and 4 of the 5 have been to prison due to crimes driven by drugs and an impulsive nature. Only one did well and she calms her brain with alcohol but still functions productively. What their lives might have been had they been medicated. A new article today states people with ADHD who are not medicated are TWICE as likely to die prematurely, in part due to accidents driven by impulsiveness!!

      • I don’t think the author means to demean loving parents! It is the psychiatric industry, and frankly, our school system that has done so much damage to our children and our families. I say this as the parent of two “ADHD” boys, neither of whom had any medication and both of whom can be regarded as successful adults. This might not have happened if we enrolled them in a standard school education, but we instead used alternative schools and homeschooling and avoided labeling and unnecessarily forcing them to engage in boring busywork.

        There is good research over time to show that “ADHD” kids are indistinguishable from “normal” kids in an “informal” or “open” classroom (think Montessouri). I fully recognize that these kids have a very hard time functioning in a standard classroom, but I blame the standard classroom structure, which is rigid, boring, and overly concerned with compliance to adult authority. When our kids were in an environment where they were allowed some freedom of choice to pursue things they found interesting and valuable, and to stay obsessed with something if they wanted or to change to a new task if they were “done” with the one they were on, they had much fewer problems. And that environment, which was naturally motivating for them instead of de-motivating like a standard classroom would have been, also gave opportunities to teach the SKILLS involved in organizing and focusing attention, which are definitely teachable skills but are NOT taught to these kids in a standard classroom setting.

        I am not a person to say that “all these kids need is a little discipline.” They were TOUGH to raise! But I agree with the author, there was nothing WRONG with them – they just had a more challenging temperament.

        It might also interest you to know that 50 years of l0ng-term outcome studies have shown that kids taking medication don’t do better on the average than those who don’t. This isn’t saying that no child benefits, but it is saying that for every child that does better, there is another that does worse to the same degree. Ours used no medication and are doing just fine.

        I’d like to see a link for that article, if you have one, BTW. I am always interested in new research on the topic.

        — Steve

        • Summary:

          New research provides the first direct evidence that attention-deficit/hyperactivity disorder, or ADHD, is a genetic condition. Scientists in the UK found that children with ADHD were more likely to have small segments of their DNA duplicated or missing than other children.

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          In a new study, children with ADHD were more likely to have small segments of their DNA duplicated or missing than other children.

          Credit: iStockphoto/Zmeel Photography

          [Click to enlarge image]

          New research provides the first direct evidence that attention-deficit/hyperactivity disorder (ADHD) is a genetic condition. Scientists at Cardiff University found that children with ADHD were more likely to have small segments of their DNA duplicated or missing than other children.

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          The study also found significant overlap between these segments, known as copy number variants (CNVs), and genetic variants implicated in autism and schizophrenia, proving strong evidence that ADHD is a neurodevelopmental disorder — in other words, that the brains of children with the disorder differ from those of other children.

          The research, published in the journal The Lancet, was largely funded by the Wellcome Trust, with additional support from Action Medical Research, the Medical Research Council and the European Union.

          “We hope that these findings will help overcome the stigma associated with ADHD,” says Professor Anita Thapar. “Too often, people dismiss ADHD as being down to bad parenting or poor diet. As a clinician, it was clear to me that this was unlikely to be the case. Now we can say with confidence that ADHD is a genetic disease and that the brains of children with this condition develop differently to those of other children.”

          ADHD is one of the most common mental health disorders in childhood, affecting around one in 50 children in the UK. Children with ADHD are excessively restless, impulsive and distractible, and experience difficulties at home and in school. Although no cure exists for the condition, symptoms can be reduced by a combination of medication and behavioural therapy.

          The condition is highly heritable — children with ADHD are statistically more likely to also have a parent with the condition and a child with an identical twin with ADHD has a three in four chance of also having the condition. Even so, until now there has been no direct evidence that the condition is genetic and there has been much controversy surrounding its causes, which some people have put down to poor parenting skills or a sugar-rich diet.

          The team at Cardiff University analysed the genomes of 366 children, all of whom had been given a clinical diagnosis of ADHD, against over 1,000 control samples in search of variations in their genetic make-up that were more common in children with the condition.

          “Children with ADHD have a significantly higher rate of missing or duplicated DNA segments compared to other children and we have seen a clear genetic link between these segments and other brain disorders,” explains Dr Nigel Williams. “These findings give us tantalising clues to the changes that can lead to ADHD.”

          The researchers found that rare CNVs were almost twice as common in children with ADHD compared to the control sample — and even higher for children with learning difficulties. CNVs are particularly common in disorders of the brain.

          There was also significant overlap between CNVs identified in children with ADHD and regions of the genome which are known to influence susceptibility to autism and schizophrenia. Whilst these disorders are currently thought to be entirely separate, there is some overlap between ADHD and autism in terms of symptoms and learning difficulties. This new research suggests there may be a shared biological basis to the two conditions.

          The most significant overlap was found at a particular region on chromosome 16 which has been previously implicated in schizophrenia and other major psychiatric disorders and spans a number of genes including one known to play a role in the development of the brain .

          “ADHD is not caused by a single genetic change, but is likely caused by a number of genetic changes, including CNVs, interacting with a child’s environment,” explains Dr Kate Langley. “Screening children for the CNVs that we have identified will not help diagnose their condition. We already have very rigorous clinical assessments to do just that.”

          Dr John Williams, Head of Neuroscience and Mental Health at the Wellcome Trust, which has supported Professor Thapar’s work for ten years, says: “These findings are testament to the perseverance of Professor Thapar and colleagues to prove the often unfashionable theory that ADHD is a brain disorder with genetic links. Using leading-edge technology, they have begun to shed light on the causes of what is a complex and often distressing disorder for both the children and their families.”

          • Not a month goes by without some researchers claiming to have found some genetic or otherwise scientific proof that a DSM disorder is a biological disease. If any of them had any real scientific merit, this debate would have been settled decades ago. Indeed, if you read Robert Whitaker’s books and catch up to all the studies published here in the news on MIA, you’ll see that sorts of studies are routinely junked as unreliable at best and even downright dishonest. Let’s not forget that in the early 2000’s there was a famous study be paraded around the national media claiming to prove that children with ADHD had smaller brains than children without, but then it turned out the ADHD children were on average two years younger than the non-ADHD group… 5-6 year olds compared to 7-8 year olds.

            You really shouldn’t take any of that on face value, if you care about facts and scientific validity.

          • The fact that a genetic variation is “more common” in the ADHD population proves exactly nothing. First off, correlation doesn’t mean causation – just because they occur together doesn’t mean they are related in any way. Second, if it’s only “more common,” it can’t be causal, because a lot of people who don’t have “ADHD” have the variation, and a lot of people who do have “ADHD” don’t have it. If it were causal, we’d find that 90% or more of “ADHD” people have it, and only a tiny percentage of non-diagnosed people showed the variation. Third, even if it were causal, which it clearly is not, genetic variation is not automatically indicative of disease. Genetic variation is the core of species survival. Consider that some people are born with good athletic skills and some are not. Are those lacking athletic skills disordered? Or is it just a variation, because we need some fast people but not everyone has to be fast, because they have other gifts that the fast people lack? Finally, even if it is a disease state, which is by no means even vaguely proven by this research, the “treatment” still doesn’t improve the long-term outcomes for the recipient on the average.

            Such research is, to my mind, almost completely worthless. What I really want researched is what actually helps these kids succeed better. We know that informal school classrooms are one element in a helpful environment for these kids. I’d suggest we spend a lot more time working on these classroom variations and other social ways of helping that don’t involve messing with their brains.

            — Steve

          • First of all, the quest for genes for mental disorders has been ongoing ad most of these studies are never replicated. I find it interesting that people try to throw in autism, ADHD and schizophrenia as biologically based on the same deficits as if there was any resemblance between all of them (and they are not even clear cut diagnostic categories to begin with).

            Secondly, I’d not be surprised if there was a genetic basis for “ADHD”. There is one for red hair too. We all have personalities that (as author of this article rightly describes) are partly determined by our inheritance. Like father, like son – we don’t need genetic studies to show that people from the same families tend to share some features of character. It does not make them sick.

            The only real problem is that our society today require everyone to be the same little drone conforming to a rigid set of social norms. It tries to force a society of diverse individuals with different talents, drives and personalities into one “good student/productive worker” frame. To me it sounds straight wrong, not to say evil, but maybe it’s just me. Making people confirm to social norms by drugging them into submission is unethical to say the least.

      • This is a result of circular reasoning. This person is impulsive so he/she has ADHD and hence ADHD leads to having more accidents. Or maybe being impulsive leads to more accidents? As for stimulants I have yet to see the proof that they prevent anyone from dying young or improve anyone’s cognitive abilities in the long-term. They surely do in a short term and they do it for all the people, “ADHD” or not, that’s why students take them during exam sessions and soldiers when they have to concentrate on difficult tasks and get little sleep.

    • Hannah

      Let me just share something with you. I’m 67 years old. I never in my twelve years of public education ever ran into a fellow student that had anything like ADHD. I taught high school for fifteen years, mostly 15 year old boys for all those years. I never once ran into anyone that I would have labeled as having ADHD. There were difficult students but none who should have been “medicated”. I quit teaching in 1988, just about the time that this very specious “diagnosis” made it’s appearance. It exploded immediately and now everyone and their sister and brother has ADHD. People believe way too many things that the drug companies and psychiatry want them to believe and I don’t understand this. Why would you want to be known as “ill”? But lots of people do and they will fight you tooth and nail to keep that label for themselves. Frankly, they can have it if they want it that badly but ADHD does not exist. By the way, meds don’t keep people from killing themselves, eventually those very meds cause lots of people to become suicidal or homicidal; people who never ever wanted to harm themselves or others before they began taking the toxic drugs. And did you know that the very benzos which many people take for anxiety actually end up causing tons of depression and anxiety. But you see, the drug companies keep this hushed up and they pay off lots of psychiatrists to state the opposite of what really is. And for some reason lots of Americans choose to believe the claptrap. I wonder if life became more manageable for you or if it’s really a fact that the drugs are blunting emotions and feelings so that they aren’t as up front and feelable. It’s time for people to wake up and smell the coffee before every last damned person is on the toxic drugs, except for the people running the drug companies and the psychiatrists that are forcing people to take the damned things.

      • Allot has changed since you were a teacher. ADHD does exist now. Your right though it probably didn’t back then. We have an epidemic of neurological disorders and mental disorders. The one thing I question is today’s vaccine schedule. Hmmm coincidence? 49 doses of 16 vaccines by age 6. When I was a kid it was a third of that. I never seen any autism in my school either, or severe behavior/mental disorders. Be in my shoes for a week or a month and around my daughter who has ADHD, you will realize it does truly exist. Caused by environmental, pharmaceutical, GMO’s?

        • The reason we have such a proliferation of “diagnosis” is that the drug companies have influenced the psychiatrists who sit on the committees and who literally pull these labels out of their hats right and left, and then vote them in. There is no scientific studies done to confirm these new labels; they are voted on by upper class white male psychiatrists who have a financial reason to create and vote these bogus things into reality. The problem is that just because it appears in the DSM then it must make it true. No such thing. Some of these new labels in the DSM-5 were literally pulled out of the imagination of the psychiatrist working on the committees while they were washing their hands together in the men’s bathroom. The drug companies and psychiatry have a vested interest in making sure that Americans embrace and believe in all this bogus stuff. There is absolutely no science behind any of the labels in the DSM. With each new edition of the DSM the labels have grown in number from a little over a hundred to hundreds upon hundreds. Doesn’t everyone see how the unholy alliance between psychiatry and the drug companies is trying to pathologize every part of human life so that everyone can be given drugs for their supposed “illness”?

          I’ve come to believe that autism is a real thing, unlike ADHD. I too feel that what you refer to may be causing the explosion of this problem. But I believe that there is some scientific basis behind autism while I do not believe this at all about the other labels in the DSM.

          • The Truth About ADHD

            Do you know the current scientific facts about ADHD?

            Post published by Thomas E Brown Ph.D. on Apr 25, 2013 in The Mysteries of ADD
            Over the past 15 years psychologists and neuroscientists have learned a lot about the brain and the disorder called ADHD. These findings have disproven many myths about ADHD, but a lot of this new information has not made its way to the general public, or even some physicians and educators. Discussion about ADHD, in the media and elsewhere, is often still stuck on polarized arguments about whether medications for ADHD are either miracle drugs or deadly poisons. Scientific evidence tends to be ignored. Ask your family or friends these questions about ADHD and see how many they get right:

            1. At what age does ADHD usually show up and does it ever go away?

            2. Why do people with ADHD focus very well on a few things they really like to do, but they can’t focus well on other tasks that they know are important?

            3. Are there any real differences in the development, or operations, of the brain of a person who has ADHD and someone of the same age who doesn’t have it?

            4. What is the “chemical imbalance” that people with ADHD suffer from?

            Below are brief answers to each of these questions; all are based on scientific evidence that is more fully summarized and explained in my latest book, A New Understanding of ADHD in Children and Adults: Executive Function Impairments.(link is external)

            1. For decades, official diagnostic criteria for ADHD required that at least some of the symptoms of ADHD had to be noticeable before age 7. In some cases, symptoms of this disorder show up while the child is in preschool or before. But for many, clear indications of ADHD do not show up until the individual faces the challenges to self-management that arise in high school, college years, or beyond. Studies have shown that cases where there is no evidence of ADHD until early adulthood can be just as serious and impairing as those apparent at a much younger age. Sometimes these problems are corrected as the person gets older and completes school, but sometimes they continue or get worse in adulthood.

            2. Every child or adult with ADHD whom I have ever evaluated has a few favored activities in which they have no difficulties in focusing, sustaining effort, and utilizing working memory. But they do have such difficulties in almost everything else they do. Sometimes their strong focus is in playing sports, making music, repairing cars, or interacting with video games; sometimes it is in other activities. Studies have now shown that a fundamental characteristic of ADHD is that it varies according to the context in which the person is functioning. It’s like erectile dysfunction of the mind. They perform well if the task is something that actually interests them–something that really turns them on– they’re up for it. If it doesn’t turn them on, they cannot get up for it– they cannot adequately perform. This is due to differences in the chemistry of the brain.

            3. Many people notice that all the symptoms of ADHD are problems that everyone has sometimes and that those with ADHD can focus well for activities that interest them. On this basis, they assume that those with ADHD are no different from anyone else except that they are lazy or simply lack “willpower.” Studies have shown that there are measurable differences in the brain development and functioning of those with ADHD in comparison to others of their age. Most of their brain development is similar to that of their peers. However, certain areas of the brain–that are critically important for the brain’s management system–may be delayed in maturation by three or more years. Many also have problems with development of “white matter” fibers that provide interconnections from one region of the brain to another.

            4. The term “chemical imbalance” is often used to explain the impairments of ADHD. This suggests that there are chemicals floating around in the cerebral spinal fluid that are simply not in the right proportions–as if there were too much or too little salt in the soup. Impairments of ADHD are not due to a global excess or lack of a specific chemical within or around the brain. Studies have demonstrated that the primary problem is related to chemicals manufactured, released, and then reloaded at the level of synapses, the trillions of infinitesimal junctions between certain networks of neurons that manage certain critical activities within the brain’s management system. Rapid release and reloading of “micro-dots” of two specific chemicals is necessary for carrying essential low-voltage electrical messages like sparks from a spark plug across the gaps between neurons. For those with ADHD, those chemicals are not adequately released or are too quickly reloaded to carry those messages efficiently across the neurons, unless the task is especially interesting or scary.

            These are just a few of many areas in which popular understanding has not yet caught up with science-based understanding of ADHD.

            Thomas E. Brown, Ph.D., is the Associate Director of the Yale Clinic for Attention & Related Disorders. His most recent book is A New Understanding of ADHD in Children and Adults: Executive Function Impairments. For more information on what psychology and neuroscience have learned about ADHD and the brain, see his website(link is external) or his Facebook page(link is external).

          • Sorry, but this is an opinion article, obviously “dumbed down” for the lay person. There is no actual reference to any study or scientific evidence for any of these claims. I’m certainly in agreement that “ADHD” kids are seeking stimulation and have little to no patience for things they aren’t inherently excited by. But we found that by making the more tedious activities into games, we could teach them to develop their attentional skills in a fun and non-coercive way, so that they learned how to persevere at less exciting activities because of the exciting rewards available at the end.

            I am not and will not be convinced by some authority making pronouncements about “ADHD.” I have a very solid knowledge base, both experientially and research-wise, and I KNOW that it is possible to teach these skills. And if they are teachable, it suggests to me that the problem is not a lack of capacity to create these amorphous chemical connections in the brain, it’s more a need for a lot more practice than the average kid. And there is no drug that can provide that practice. In fact, it is possible that medicating the problem may actually defer the need to learn these skills much later than they can actually be taught. Again, the adults (especially the schools) have to learn to be a lot more flexible for this to occur, and I’m not holding my breath for that to happen. But it’s not the kids’ fault that the schools are rigid and lack creativity. We actually went to the length of helping create our own school that would work for our youngest. And it did and he is doing awesome. I think that ought to count for just as much as any anecdote of someone whose kid’s academic life was saved by stimulants, don’t you?

            — Steve

          • “2. Why do people with ADHD focus very well on a few things they really like to do, but they can’t focus well on other tasks that they know are important?”
            “They perform well if the task is something that actually interests them–something that really turns them on– they’re up for it. If it doesn’t turn them on, they cannot get up for it– they cannot adequately perform. ”

            So just like, yhm, everyone? I don’t know a single person who is able to focus just as well on boring stuff they hate which is also intellectually demanding than on fun easy task that they like. If that’s a symptom than 100% of people have ADHD.

            “But for many, clear indications of ADHD do not show up until the individual faces the challenges to self-management that arise in high school, college years, or beyond.”

            That is not ADHD, that is called growing up and being faced with more stress, pressure to perform and maybe lacking adequate skills to cope with increasing workload. Is anyone who is not super successful (for a given definition of the word) ADHD?

            “However, certain areas of the brain–that are critically important for the brain’s management system–may be delayed in maturation by three or more years. Many also have problems with development of “white matter” fibers that provide interconnections from one region of the brain to another.”
            These studies are not reproducible and have shown basically every part of the brain for every “disorder”. There’s no evidence that they are retarded in development whatsoever. That they are different – sure, every human brain is different. People who are musically talented are likely to have different brains from tone deaf ones like me. Does this make any of us “sick”? Afterall it limits my ability to become a successful opera singer.

            “For those with ADHD, those chemicals are not adequately released or are too quickly reloaded to carry those messages efficiently across the neurons”
            Evidence for that please? I’d love too see a study on neurotransmitter release with synaptic resolution in alive behaving humans (well, not really but you get my point).

        • PortlandGirl, I think you make a really good point. Society has pushed us into a variety of epidemics, in the name of ‘progress.’ It’s been sorely misguided in so many ways, and has led to all sorts of personal imbalances, because society is out of balance. Unfortunately, progress is measured in dollars and cents, rather than in our quality of life.

          Technology is, in some ways, invaluable. Were it not for the internet, none of us would be having this groundbreaking conversation.

          But at the same time, email, texting, social media, etc., has changed our perception, language, rhythm, and even grammar, not to mention our transparency. All of this has made us speed up in ways that are neither natural nor for which we have been prepared. So I agree 100% with you that society has pushed us to the edge, and indeed, that will impact sensitive and creative souls quite a bit.

          Personally, I’m not a fan of diagnosing and medicating, I think these issues can be interpreted and addressed in a different way, which is alternative to the mainstream, and hopefully will catch on more fully soon, it’s definitely up and coming, especially as mainstream mental health care continues to come under attack.

          However, I do feel that how a parent raises their child is their business, and I feel we are all doing the best we can with what we know at each moment. Thanks so much for your valuable insights.

          • I’d be leaning towards an opinion that if there is any real increase in “ADHD” kids beyond what is a result of pharma’s disease-mongering campaign it’s because of internet. It has made me “ADHD” and I have never had a problem with sitting down and concentrating on a specific task. There is simply too much to easily accessible distraction that is just so much more attractive than doing your homework.

    • Apologies to Hannah – can’t get to end of all the comments to lodge a new comment. Posts such as these are so frustrating. The idea that it’s just parents not accepting their children as they are is such rubbish! My son was on his way to shutting down completely in school. You simply can’t continue to fail elementary school classes & be berated by teachers for not paying attention indefinitely without losing your self esteem completely. There was no amount of acceptance I could provide to make that okay. The drugs you disparage let him focus in the classroom & experience some measure of success in school. Homeschooling is not within reach for all families & public schools really do not offer that much diversity of teaching methods – certainly not methods designed for these kids.

      If kumbaya, lets all accept one another works in your world, more power to you. The rest of us living in the real world will continue to do the best we can even when our best involves the aid of pharmaceuticals.

      • of course we all do the best we can knowing what we do etc etc however there are a few clinics in the UK, Outcome Orientated Clinics for adolescents and children with behavioural and mental health problems that use no medication and do not diagnose. They do treat the type of children that you are talking about and they have very good outcomes. About 70% of people are discharged within two years never to return.

        Unfortunately I cannot find any articles on this at the moment, the radio broadcast in which he describes his clinic apprears to have disapeard from the web

      • “You simply can’t continue to fail elementary school classes & be berated by teachers for not paying attention indefinitely without losing your self esteem completely. “There was no amount of acceptance I could provide to make that okay. The drugs you disparage let him focus in the classroom & experience some measure of success in school.”

        Which is tantamount to admitting that ADHD is a social construct which exists for the benefit of the “one approach fits all” system and underlying social inequality (where richer or more resourceful parents can afford to provide kids with alternatives instead of labelling them as defective for being different). I understand why some parents may make that choice but it still does not make it right. If screwing up child’s brain and body development and risking serious mental and physical side effects (like cardiovascular problems or psychosis) is worth making teacher more happy and therefore not abusive towards a student then we really live in a sick world.

        • Which is why I advocate for open/informal classrooms for these kids. It has been shown many years ago that “ADHD” kids are not distinguishable from “normal” kids in an open classroom, as they have more control over their time and activities and so can more easily head off boredom that leads to behavioral problems. Since we know that stimulants DO NOT lead to increases in self-esteem in comparison to kids not using stimulants, clearly, this “square peg into round hole” approach is meeting the needs of the teachers and the system, not the needs of the kids.

          —- Steve

          • Sorry, cannot agree here. Saying classrooms should be like “X” does not make them so. And being able to keep up vs not DOES actually increase self esteem. Conversely, being in a situation day after day where you feel like you are stupid for not being able to keep up, pay attention, and retain information does nothing for esteem. My son (at 13) had the choice of meds or not & 2 days into school year begged for them. Perhaps schools will change – but countless kids like mine & their parents don’t have time to wait!

          • I know that this solution requires a lot of work and time and that currently kids don’t have time to wait. We were fortunate to be able to homeschool our oldest for 4 years after two years in an alternative magnet school within our regular Portland Public School system. For our youngest, we actually helped create a public charter school that did what we needed it to do for him, and he attended that school from Kindergarten through high school. He’s now a freshman at Evergreen State College after graduating with a 4.0 from the Trillium Charter School. The great thing about Trillium was that it was all individualized – there was no “keeping up” to be done. Kids who could do third grade math did third grade math, whether they were in first grade or fifth grade, and there was no shaming or weirdness about it – everyone accepts that everyone has their own program. It almost completely eliminates those artificial comparisons that are caused by the bizarre expectations that all kids learn all things at the same time and rate.

            I feel badly for others who aren’t as fortunate as we have been, but I also want to stress that charter schools are a realistic option in many states now, and I encourage disgruntled and disempowered parents to band together and create this kind of alternative, as that’s what the Charter School movement is supposed to be about. Additionally, many people are worried about homeschooling, but it was really not as hard as we had originally feared, as there are many groups and even community school classes that cater to home schoolers these days.

            My point is not to criticize parents for making the best decisions they can in a dysfunctional school system. What I think we need to do is pressure schools to create these alternative options that the research says works for our kids, and if they’re not willing, to go ahead and create them ourselves. The schools will not change unless we make them, but in the end, we are the taxpayers and they work for us.

            Hang in there and I hope things work out well for you and your unique and special son!

            — Steve

    • “I had such bad anxiety that I couldn’t stand to be alone at all, since being alone caused my anxiety to spiral into a panic attack.”

      I had that too. I didn’t need drugs to recover, just a change in life circumstances. People don’t get panic attacks for no reason and drugs only make temporary problems permanent.

    • ADHD is real, though it may be over-diagnosed, and people with ADHD can benefit a great deal from medication. MRI imaging of individuals with ADHD show that people with ADHD have differences in the structure and function of their brains compared with people who don’t have ADHD. Having ADHD doesn’t automatically mean that someone needs medication. A “mental difference” after all isn’t a “problem” unless its a problem to YOU in your life.

      I have ADHD. I was diagnosed as an adult (though I struggled with, what I now recognize was ADHD symptoms, my whole life). I take a stimulant medication, and it has dramatically improved my quality of life. I only wish that I had been diagnosed and had started treatment earlier in my life.

      Having ADHD feels driving down a highway at night in a raging storm…you can keep the car on the road, but it takes every ounce of your attention and it is incredibly stressful. You go through life feeling as if you’re constantly “missing” 1/3rd of what is going on around you. You run the risk of “driving off the road” at any moment.

      For me, taking medication is like driving down the road on a sunny day…you can do it with little effort and no anxiety…which leaves so much more “room” in your life for other goals/activities/relationships. Medication allows my brain to function at the speed and the efficiency that it has always “wanted” to.

      Eating an “ADHD-friendly (low carb, low gluten) diet, getting vigorous daily exercise, and taking supplements (Magnesium, zinc, omega-3s, ect) helped somewhat…I tried them all prior to seeing a psychiatrist, and they remain very important in helping me manage my ADHD. But, for me at least, “lifestyle interventions” didn’t help with my symptoms enough. I needed medication as well.

      Within 30 minutes of taking my first dose of stimulant medication, I felt my mind “quiet down” for the first time ever…I suddenly no longer felt as if I was constantly being mentally “pulled” this way and that by competing impulses and distracted by things I didn’t want to be distracted by.

      Medication is a “tool”, and it isn’t right for everyone…but I think its incorrect to imply that ADHD isn’t “real” or that people can’t derive great benefit from it. People should be evaluated by a psychiatrist if they think they have ADHD (it can be over-diagnosed, and other mental issues can be confused with the condition…so don’t just rely on your family physician…see a specialist).

      I think, if a person has significant symptoms, they should consider trying medication…for me, starting ADHD medication gave me a LOT of insight into my ADHD symptoms. It provided a new “mental reference point” that allowed me to better understand myself and how my mind functions. That is VERY valuable insight that is useful even if someone chooses not to continue taking medication beyond a brief trial.

      • I agree that ADHD is real, but over diagnosed. I say this as someone with it, who also has a brother who was diagnosed in 1983 (somewhere on this website said it wasn’t a diagnosis until the late 80s…not true). I think of ADHD as being similar to autism in that both are developmental conditions, yet most people on this website and elsewhere don’t dispute the existence of autism. True ADHD is associated with neurological quirks like fine motor deficits (you should see how I hold a pencil). These are traits that tend to be retained into adulthood.

        I am concerned about the quick jump to meds and long term use of them. Because I am female and usually did well academically, my diagnosis didn’t come until I was 30 and dealing with medical issues that made me unable to use my tried and true “stimulant” of daily exercise. I have learned the hard way that I have too much anxiety ( my other coping mechanism) to go near a stimulant- am still dealing with the shitstorm that came from that experience 2 years ago. My brother had some brief stints on stimulants during periods where he needed extra help, but the bulk of treatment was play therapy with other kids with developmental issues (some of whom he is still friends with). He considered this helpful, and I wish this was more how treatment played out today.

        For those on this “spectrum” I do think it is helpful to have some validation of our different wiring. Particularly if you are female, and expected to be useful and efficient in things like household chores. That doesn’t mean I use ADHD as an excuse, but it’s easier to to make some peace with the things I don’t do well and think of appropriate strategies for coping. I see strengths of ADHD too (like hyperfocus used appropriately), and wish this was more encouraged.

  2. from my observations I have to agree with this article. When my husband started elementary school, he was the little boy that got sent out to the hallway to sit in a chair because he couldn’t behave. Soon after his mother took him to a psychiatrist and had him labeled with ADHD and put on Ritalin. All this of which I’m relating has been told to me both from my husband and my mother-in-law. Anyways, he went to the psychiatrist regularly and all that was done was he was prescribed more and more Ritalin through the years. The psychiatrist never sat him down and taught him coping mechanisms for dealing with his ADHD. His mother gave him Ritalin so he’d behave in school. He got more Ritalin after school, so that he would sit still and do homework. he got even more Ritalin on the weekends when his mother couldn’t handle him any longer. Then during school vacations he got shunted off to family because his mother couldn’t handle him. His mom blames her nervous breakdowns on him as well. I think the wrong person was being taken to the psychiatrist and getting medicated. Everything that both my husband and his mother has said results in the conclusion that she wasn’t ready for motherhood. But instead she brainwashed him and told him time and time again that unless he was Handicapped and unless he was on Ritalin all the time he was never going to be successful. My husband has since seen a 3-4 psychologist since we’ve been married and none of them have concluded that he has ADHD or that he needs to be on Ritalin. The story isn’t over. My husband has a younger brother. They are 18 months apart. His younger brother has been living with Juvenile Rhuematoid Arthritis. He was never labeled handicap. He was always taught that the world is oyster and whatever he puts his mind to he can achieve. His mother didn’t shunt him off to other family nor she tell him he had to be drugged to be successful and he has a physical impairment that affects his day-to-day life. There may be people out there who actually have ADHD, but as for my husband I think it was a label put on him so that he could be legally drugged for his mom to better be able to live with him. Just so you know, he stopped using Ritalin while in college and graduated. He has since then been successful in the military and at the career path he has chosen afterwards. All of my research, I have done a lot has said that ADHD is genetic. If that’s true how come my husbands parents haven’t been diagnosed with it and neither has our 3 children. The three kids have no issues in school and no extra hyperactivity than a normal child.

      • Check it out for yourself but many would say your son is in fact “hyper stimulated” but that stimulation is not expressed externally (through observable behaviors) but internally (in the brain). The brain is so overly stimulated only very limited affect and functioning is possible – judged by teachers and parents as “better” The brain is actually incapacitated to some extent by the stimulant.

        • A number of people on this website have commented on Finland and other Scandinavian countries and how they treat ADHD. They use less medicine based on their statistics. However, as far as I can tell ALL of these countries believe ADHD exists. My son is currently off meds and I am having his blood tested for iron, magnesium and zinc levels. My son is not physically hyperactive for a 10 year old boy. I am also concerned and investigating whether his gifted attributes are being mistaken for ADHD. He has appts with a neuropsychologist and a neurologist. At this point I am praying it is only ADHD and nothing worse. Remember, AIDS didn’t exist until it did. Ebola didn’t exist until it did. There was no hepatitis C epidemic till there is. Vaccines are bad until there is a measles outbreak. I hope and pray I can find something for my son that doesn’t involve prescription medications. I also found the following interesting.

          “What do you know about ADHD that the following institutions don’t?

          American Medical Association (AMA)
          Canadian Medical Association
          Canadian Psychological Association
          Canadian Psychiatric Association
          Surgeon General of the United States
          National Institutes of Health (NIH)
          Centers for Disease Control and Prevention (CDC)
          American Academy of Pediatrics (AAP)
          American Academy of Child and Adolescent Psychiatry (AACAP)
          (See the bottom of this page for more details Real Science Defines AD/HD as Real Disorder).

          They all say ADHD exists and is a real condition.

          What research have you done that show’s that all of the organizations above are wrong?”

          Clinical Evidence of the Existence of ADHD as a Real Condition.

          75 international scientists were deeply concerned about the periodic inaccurate portrayal of ADHD in media reports. So they “created this consensus statement on ADHD as a reference on the status of the scientific findings concerning this disorder, its validity, and its adverse impact on the lives of those diagnosed with the disorder as of this writing (January 2002)”

          Here’s one particular quote I like

          “To publish stories that ADHD is a fictitious disorder or merely a conflict between today’s Huckleberry Finns and their caregivers is tantamount to declaring the earth flat, the laws of gravity debatable, and the periodic table in chemistry a fraud.”

          Two anterior regions of the corpus callosum were significantly smaller

          in ADHD boys. MRI scans assessed the frontal circuitry in 18 ADHD boys in comparison to 18 matched controls. They found that two anterior regions of the corpus callosum (the rostrum and the rostral body) were significantly smaller and concluded that this was evidence for frontal lobe dysfunction and abnormal development. The callosal fibres in the rostral body relate to the premotor cortex, which is critical for “the suppression of relatively automatic responses to certain sensory stimuli”. This is consistent with a defect in the person’s ability to inhibit responses, which is considered by Barkley to be the fundamental deficit in ADHD.

          Brain Imaging Data of ADHD. It’s Not Just 3 Neurotransmitters

          Psychiatric Times August 2004 Vol. XXI Issue 9. Amir Raz, Ph.D.

          Neuroimaging assays have most consistently implicated abnormalities of the dorsal prefrontal cortex and basal ganglia in ADHD.

          Reduced metabolic rates have been reported in the left sensorimotor area in children with ADHD and in the premotor and superior prefrontal cortices of adults with ADHD.

          Positron emission tomography data from 10 adolescents with ADHD found reduced metabolic rates versus healthy controls in, among other regions, the left anterior frontal area, showing negative correlation with numerous symptom severity measure.

          Smaller volumes of the right prefrontal cortex have been reported in children with ADHD compared with healthy controls.

          Magnetic resonance imaging data demonstrated smaller right globus pallidus nuclei in boys with ADHD relative to a control group.

          Individuals with ADHD had significantly smaller brain volumes in all regions, even after adjustment for significant covariates. This global difference was reflected in smaller total cerebral volumes and in significantly smaller cerebellar volumes.

          Unmedicated children with ADHD also exhibited smaller total white matter volumes compared with controls and with medicated children with ADHD.

          fMRI studies have reported abnormal activation of the striatum, prefrontal cortex and anterior cingulate cortex in ADHD.

          Whereas control participants activated the anterior cingulate cortex, participants with ADHD seemed to rely on the anterior insula–a brain region typically associated with responses in more routine tasks not involving conflict.

          Brain Scans Reveal Physiology of ADHD

          Psychiatric News 2004. New high-resolution, three-dimensional maps of the brains of children with attention-deficit hyperactivity disorder indicate significant and specific anatomical differences within areas of the brain thought to control attentional and inhibitory control systems, compared with brain scans of children without ADHD.

          The images are thought to be the most advanced to date to reveal the anatomical basis of the disorder. Includes two 3d scan photos.

          Cerebral glucose metabolism in adults with ADHD

          The New England Journal of Medicine. Researchers measured adults with ADHD with a PET scan. None of the adults had ever been treated with stimulant medication. RESULTS. Global cerebral glucose metabolism was 8.1 percent lower in the adults with hyperactivity than in the normal controls. The largest reductions were in the premotor cortex and the superior prefrontal cortex–areas earlier shown to be involved in the control of attention and motor activity. The largest reductions were in the premotor cortex and the superior prefrontal cortex–areas earlier shown to be involved in the control of attention and motor activity.

          The dopamine theory of ADHD

          Australian and New Zealand Journal of Psychiatry. The dopamine theory of ADHD is supported by neuroimaging, genetic and stimulant medication studies, which confirm an inhibitory dopaminergic effect at striatal/prefrontal level. Anterior and posterior attention systems are involved in inhibition, working memory and orientation. Attention deficit hyperactivity disorder symptoms and subtypes are likely to reflect deficits in both inhibition and working memory, and may be heterogenous.

          • I think your responses, and there are many, are very instructive. For you, and by extension your child, ADHD is real and what you’re doing is “right” You’re just not persuadable at this point of any other view. If any of those organizations had actually proven the existence of ADHD I’d agree with you but they haven’t. They’ve agreed that people who act in a particular kind of way should be given a particular label and particular drugs. They can’t point to a blood test, an MRI or other imaging test (pre drug of course) to verify the existence of this so-called disease. I feel bad for you because you’ve been so misled by Pharma, Psychiatry, Schools, and who knows else and it’s your child who will pay the ultimate price for your decision. I know this probably isn’t penetrating but I’m obligated to try!

          • David. You say I am not “persuadable”. But what you don’t know is that I did not used to believe in medicating. I thought there were ADHD issues but they could be dealt with through discipline and diet and other natural ways until I started raising a child with ADHD. You also say there is no scientific evidence of ADHD but I find all kinds of studies r.e. differences in the brain of ADHD people. Also there is an Israeli study that presents more physical evidence r.e. eye blinking, attention and ADHD.

            http://www.sciencedirect.com/science/article/pii/S0042698914001187

            As well as the following studies.

            Two anterior regions of the corpus callosum were significantly smaller

            in ADHD boys. MRI scans assessed the frontal circuitry in 18 ADHD boys in comparison to 18 matched controls. They found that two anterior regions of the corpus callosum (the rostrum and the rostral body) were significantly smaller and concluded that this was evidence for frontal lobe dysfunction and abnormal development. The callosal fibres in the rostral body relate to the premotor cortex, which is critical for “the suppression of relatively automatic responses to certain sensory stimuli”. This is consistent with a defect in the person’s ability to inhibit responses, which is considered by Barkley to be the fundamental deficit in ADHD.

            Brain Imaging Data of ADHD. It’s Not Just 3 Neurotransmitters

            Psychiatric Times August 2004 Vol. XXI Issue 9. Amir Raz, Ph.D.

            Neuroimaging assays have most consistently implicated abnormalities of the dorsal prefrontal cortex and basal ganglia in ADHD.

            Reduced metabolic rates have been reported in the left sensorimotor area in children with ADHD and in the premotor and superior prefrontal cortices of adults with ADHD.

            Positron emission tomography data from 10 adolescents with ADHD found reduced metabolic rates versus healthy controls in, among other regions, the left anterior frontal area, showing negative correlation with numerous symptom severity measure.

            Smaller volumes of the right prefrontal cortex have been reported in children with ADHD compared with healthy controls.

            Magnetic resonance imaging data demonstrated smaller right globus pallidus nuclei in boys with ADHD relative to a control group.

            Individuals with ADHD had significantly smaller brain volumes in all regions, even after adjustment for significant covariates. This global difference was reflected in smaller total cerebral volumes and in significantly smaller cerebellar volumes.

            Unmedicated children with ADHD also exhibited smaller total white matter volumes compared with controls and with medicated children with ADHD.

            fMRI studies have reported abnormal activation of the striatum, prefrontal cortex and anterior cingulate cortex in ADHD.

            Whereas control participants activated the anterior cingulate cortex, participants with ADHD seemed to rely on the anterior insula–a brain region typically associated with responses in more routine tasks not involving conflict.

            Brain Scans Reveal Physiology of ADHD

            Psychiatric News 2004. New high-resolution, three-dimensional maps of the brains of children with attention-deficit hyperactivity disorder indicate significant and specific anatomical differences within areas of the brain thought to control attentional and inhibitory control systems, compared with brain scans of children without ADHD.

            The images are thought to be the most advanced to date to reveal the anatomical basis of the disorder. Includes two 3d scan photos.

            Cerebral glucose metabolism in adults with ADHD

            The New England Journal of Medicine. Researchers measured adults with ADHD with a PET scan. None of the adults had ever been treated with stimulant medication. RESULTS. Global cerebral glucose metabolism was 8.1 percent lower in the adults with hyperactivity than in the normal controls. The largest reductions were in the premotor cortex and the superior prefrontal cortex–areas earlier shown to be involved in the control of attention and motor activity. The largest reductions were in the premotor cortex and the superior prefrontal cortex–areas earlier shown to be involved in the control of attention and motor activity.

            The dopamine theory of ADHD

            Australian and New Zealand Journal of Psychiatry. The dopamine theory of ADHD is supported by neuroimaging, genetic and stimulant medication studies, which confirm an inhibitory dopaminergic effect at striatal/prefrontal level. Anterior and posterior attention systems are involved in inhibition, working memory and orientation. Attention deficit hyperactivity disorder symptoms and subtypes are likely to reflect deficits in both inhibition and working memory, and may be heterogenous.

            PET, SPECT Studies Find More Evidence of Dopamine’s Role in ADHD

            From Medscape. Free registration required. Studies using positron emission tomography (PET) and other approaches suggest new details about the underlying biology of ADHD. Released here at the 50th annual meeting of the Society of Nuclear Medicine. 3 different studies mentioned.

            Caudate nucleus volume asymmetry predicts ADHD symptomatology in children.

            Journal of Child Neurology. 2002 Dec;17(12):877-84 Schrimsher GW, Billingsley RL, Jackson EF, Moore BD 3rd. Department of Psychology, University of Houston, Houston, TX, USA.

            A greater degree of right to left caudate volume asymmetry predicted subclinical inattentive behaviors in a sample of nonreferred children. This finding is congruent with neuroanatomic models of attention emphasizing lateralized alteration in prefrontal/striatal systems. The results support the view that clinical ADHD is the extreme of a behavioral continuum that extends into the normal population.

            ADHD is characterized by a delay in cortical maturation

            Proceedings of The National Academy of Sciences of the USA
            We found maturation to progress in a similar manner regionally in both children with and without ADHD, with primary sensory areas attaining peak cortical thickness before polymodal, high-order association areas. However, there was a marked delay in ADHD in attaining peak thickness throughout most of the cerebrum: the median age by which 50% of the cortical points attained peak thickness for this group was 10.5 years (SE 0.01), which was significantly later than the median age of 7.5 years (SE 0.02) for typically developing controls (log rank test χ(1)2 = 5,609, P < 1.0 × 10−20). The delay was most prominent in prefrontal regions important for control of cognitive processes including attention and motor planning. Neuroanatomic documentation of a delay in regional cortical maturation in ADHD has not been previously reported.
            Supporting info and movies here

            Cortical Thinning of the Attention and Executive Function Networks in Adults with ADHD

            Cerebral Cortex 2007 17(6):1364-1375. ADHD has been associated with structural alterations in brain networks influencing cognitive and motor behaviors. Volumetric studies in children identify abnormalities in cortical, striatal, callosal, and cerebellar regions.

            We carried out a structural magnetic resonance imaging study of cortical thickness in the same sample of adults with ADHD… Compared with healthy adults, adults with ADHD showed selective thinning of cerebral cortex in the networks that subserve attention and EF. In the present study, we found significant cortical thinning in ADHD in a distinct cortical network supporting attention especially in the right hemisphere involving the inferior parietal lobule, the dorsolateral prefrontal, and the anterior cingulate cortices. This is the first documentation that ADHD in adults is associated with thinner cortex in the cortical networks that modulate attention and EF.

            Attention and Executive Systems Abnormalities in Adults with Childhood ADHD: A DT-MRI Study of Connections

            Cerebral Cortex 2008 18(5):1210-1220; doi:10.1093/cercor/bhm156. In this study of adults with childhood ADHD, we hypothesized that fiber pathways subserving attention and executive functions (EFs) would be altered. To this end, the cingulum bundle (CB) and superior longitudinal fascicle II (SLF II) were investigated in vivo in 12 adults with childhood ADHD and 17 demographically comparable unaffected controls using DT-MRI. Relative to controls, the fractional anisotropy (FA) values were significantly smaller in both regions of interest in the right hemisphere, in contrast to a control region (the fornix), indicating an alteration of anatomical connections within the attention and EF cerebral systems in adults with childhood ADHD. The demonstration of FA abnormalities in the CB and SLF II in adults with childhood ADHD provides further support for persistent structural abnormalities into adulthood.

            Volumetric MRI analysis comparing subjects having ADHD

            with normal controls. Despite similar hemispheric volumes, ADHD subjects had smaller volumes of (1) left total caudate and caudate head (p <0.04), with reversed asymmetry (p < 0.03); (2) right anterior-superior (frontal) region en bloc (p < 0.03) arid white matter (p < 0.01); (3) bilateral anterior-inferior region en bloc (p <0.04); and (4) bilateral retrocallosal (parietal-occipital) region white matter (p < 0.03). Possible structural correlates of ADHD response to stimulants were noted in an exploratory analysis, with the smallest and symmetric caudate, and smallest left anterior-superior cortex volumes found in the responders, but reversed caudate asymmetry and the smallest retrocallosal white matter volumes noted in the nonresponders.

            ADHD: More Prevalent Than We Thought?

            LARISSA HIRSCH, MD Instructor of pediatrics at New York Presbyterian Hospital, medical editor for KidsHealth.org and CHARLES A. POHL, MD, professor of pediatrics and associate dean of student affairs and career counseling at Jefferson Medical College in Philadelphia

            There are frequently stories in the news and talk among the public of the over-diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) in today's hypervigilant society. However, a study recently published in Archives of Pediatrics and Adolescent Medicine may serve to debunk this common belief…Interestingly, only 47.9% of the caregivers of children who met the DSM-IV criteria in the past year reported that the disorder had been diagnosed in their child…Children from the lowest income group received less consistent treatment than those in higher income groups.

            The Froehlich study indicates that we are under-diagnosing ADHD. We need to be on the lookout for children with this disorder, make an accurate diagnosis, and do our best to follow affected children closely.

          • It’s interesting that you quote all of these studies in support of ADHD as a brain disorder since they do not converge on one conclusion. They all implicate various regions of the brain and there seems to be little reproducibility. If it was really so clear that there’s some functional difference, would you not expect most of these studies to converge on one/few brain regions instead of being “all over the place”?

            I know fMRI and PET sound kind of fancy but they are extremely unreliable and studies using them are wrought with bad statistics and artifacts. I’d suggest read a bit about the methodology before you quote them as a proof of anything. I’d start with the IgNobel prize for the observation of the thought process in a dead salmon.

          • I actually applaud what you have done, but there’s also caution. I live in the biggest charter school experiment in the nation. Virtually ALL of our schools here are charter schools. Unfortunately, that does not mean that we have a wide, diverse array of schools or an easy path to getting into the school with the right fit. Check out this report that came out this week:

            http://keranews.org/post/new-charter-school-study-suggests-marketing-trumps-academics

            Ultimately, we have two main kinds of schools now: 1. competitive schools that are good schools with diverse student bodies but often leave different learners in the dust and 2. “no excuses” schools that insist on strict adherence to the rules. Even if you find a school that fits…competition to get in is stiff and many are disappointed.

            We are getting a new private school option this fall – unfortunately, there’s no way we could ever afford it, at least not in our current situation. The school would be well designed for kids w/ ADHD – go at your own pace, choose your own projects, etc. But the price tag leaves us and many others out. Similarly, homeschooling would only work if I could afford not to work, which I can’t.

            It was challenging when my son was first diagnosed – for all involved, my son, me, my husband, teachers, etc. But he’s at a point where he is HAPPY. He can and does excel. Is it easy? No. But meds do help. The meds gave him breathing room to learn how to work with his strengths – a space he couldn’t even see before then.

            A friend has a son with ADHD who is now an adult in his 20s. When I fretted over the diagnosis and the meds at the outset she told me she didn’t regret one single pill she gave him. He had gone from a kid who was bouncing off of walls and unable to be in any kind of classroom to one who could manage his day, manage his schoolwork, and get into the college of his choice. He is now a successful, happy adult who has been able to choose a career that works with his strengths and, therefore, alleviates the need for meds. (He takes them occasionally but not most days.)

          • Bummer about the school situation! I totally understand why lacking alternatives you do whatever you need to do to get your son through to the other side. You’re obviously a caring and well-educated mom. I’m sorry to hear that charter schools in your locale have not provided the promised range of options. Do you mind sharing where you are? I kind of like to track on the Charter School movement, even though we’re out of the school-seeking business now that all our kids are grown up.

            Your last comment is also interesting. There was a good study on employer satisfaction with “ADHD” employees that found that employers are just as satisfied with them as anybody else. The author’s hypothesis is that this was due to the fact that the adults could choose a profession and work environment that works for them. It is a crying shame that school students don’t have the same options. Wish I could ship you the money to pay for him to go to the private school – it sounds like the perfect kind of setting.

            Life is most definitely not fair, especially to kids!

            —- Steve

      • It has long been understood that stimulants do NOT act differently on the “ADHD” brain. Judith Rappoport gave stimulants to “normal” teens back in 1978 and found that they had the exact same reaction to low doses – reduced motor activity, increase focus, decreased distractibility. She suggested that the reason it appeared different in “ADHD” kids is only because people were looking for that result.

        The current understanding is that “ADHD” kids are hyper and intense because they are seeking stimulation. The drug provides artificial stimulation and so they appear “calmer” to someone who was finding their activity level annoying to them.

        There is absolutely no evidence that children with “ADHD” have a “chemical imbalance” in their brains. There is some emerging evidence about some small difference in dopamine receptor density, but of course, we should expect that any population will have some differences in dopamine receptor density, as they would in height, weight, eye color or muscle mass. I think the author would suggest that such differences are a natural variation and only become a “disease” when these kids are forced to do things all day that they are not genetically programmed to find very interesting or enjoyable.

        —- Steve

      • RE: Why does a STIMULANT that would send others into hyper speed mode actually CALM my son down???
        ______
        Have you ever seen these stimulants send others into hyper speed mode ?
        My guess is you have not. That is a myth , these drugs have the exact same effects on everyone. Another myth is people who “have” ADHD don’t get high from stimulants.

        The last myth “not addictive if taken as directed”

        That is ASS BACKWARDS, after addiction sets in you stop taking as directed !!

        The reason these drugs calm people down is the high they produce is calming. I should know I took these things every day for 7 years.

        I think every parent should adjust for body weight and take there child’s ADHD drug dose themselves for a few days to see what life is like going from Amphetamine high to a crashing low every single day like these kids do.

        It really is the only way to understand whats going on.

        • There is definitely such a thing as long term brain damage as a result of psychotropic drug exposure.

          I went to school in Ireland in the 1960s and 1970s and the teachers were strict but nice people. Some kids were academic and some weren’t, it was as simple as that.

      • That is utterly ridiculous. All stimulants calm people down. People who smoke crack or snort cocaine wind up “vegging” on the couch, motionless, staring into the T.V. screen. It’s only as the drug is wearing off that they tend to become twitchy and hyper due to withdrawals. I don’t know where people get this idea that amphetamines make you hyper. When the brain and body are overloaded, they begin to “shut down” to compensate.

        You might also be shocked to learn that alcohol, which is a central nervous system depressant, has a tendency to make people “rowdy”, very, very hyperactive.

      • Stimulant does not send people into “hyper” mode. Students regularly abuse stimulant in order to be able to better concentrate on learning before exams (often with mixed results which tends to be replicated by study of a long-term benefit of stimulants on academic performance or rather lack thereof). So do people in the military who have to concentrate for prolonged periods of time. The idea that stimulants act differently on “ADHD” people is a myth perpetrated by pharma in order to convince that giving known narcotics to kids is a OK because “they react differently to it”.

  3. Dr. Berezin’s article is dangerous and just plain wrong. I am the mother of a child with ADHD. I absolutely embrace him as a unique and wonderful human being. He is bright, funny, warm, and compassionate–he also has ADHD. No question. If I ever wonder if my son was misdiagnosed, I only have to observe him without his medication, and it becomes clear to me that he isn’t just “quirky” or “active.”
    I resent the idea that parents who medicate their children for ADHD are intolerant, impatient people who are simply medicating a problem away because that’s the easy way out. I would expect such an attitude from people who aren’t familiar with the problem, but from a psychiatrist teaching at Harvard Medical School? How truly sad.
    Do you know how much more involved it is for me to treat my son’s ADHD than it is for me to just tell him to “sit still and be quiet” all the time or just embrace his impulsivity? We go to a psychiatrist for med reviews every six weeks, he goes to therapy, his meds cost money, and he has a special IEP at school. If disciplining my son out of his attention disorder were possible, believe me, I’d do it. It would cost me a lot less in time and money. But it wouldn’t be enough. And I love my son way too much to make him struggle constantly with an uphill battle rather than to help him all I can.
    Doesn’t Dr. Berezin realize my son would behave if he could? Children want their parents’ love and approval. They don’t want to be yelled at all the time. Even when medicated, my son is still impulsive and has tremendous trouble focusing. The medication he takes simply gives him a fighting chance to attend to things in school and actually learn something. I think not recognizing your child’s ADHD and not medicating it is downright cruel.
    Dr. Berezin, listen to parents who know what they’ve experienced firsthand instead of making them feel bad for recognizing and treating their child’s very real problem. What’s next? Are you going to say asthma is psychosomatic (remember that was a pervasive idea years ago?) and that people who use inhalers are weaklings?
    If you truly listen to mothers like me and you still question whether or not ADHD exists, I can send my son to your house for the weekend unmedicated. If you then still think there is no such thing as ADHD, your precious medical degree isn’t worth the paper it’s printed on. Good luck with your misguided ideas.

      • There are a couple bad apples that want to medicate their children for their own convenience, but that is not the majority. Good parents don’t want an excuse to drug children. You are fortunate to have that perspective however, because you obviously have not had to struggle with personally dealing someone that has this disability.

        • In all my years of schooling and in all my years of teaching fifteen year old boys I never ran into anyone with ADHD. I ran into plenty of students who suffered a lot of things due to things that they had been forced to experience or were still experiencing, but they didn’t have ADHD. I quit teaching in 1988, right about the time that the APA created this very bogus “diagnosis” and then there was a horrible explosion of everyone having ADHD. Believe in it if you want, but I am 67 years old and never saw anything like this until psychiatry and the drug companies convinced the American public that it exists and then everyone embraced it. I believe all of this is an example of mass delusions taking place in our society since I can’t explain it any other way. People are all to willing for some reason to believe that they’re “ill” when they are not ill at all. People no longer want to deal with human emotions or feeling terribly sad, or bad times. Instead they would rather get some bogus label slapped on them so that they can take toxic drugs that numb them out and make them into emotional zombies. Frankly, I’m not willing to believe this or to embrace it but it you want to do so go right ahead. But I feel for the children whose brains are being irreparably damaged and changed through no choice of their own. Everyone else is making the decision to drug their socks off.

      • Then what do you suggest to avoid expulsion from school for lack of impulse control. He has been to therapy, behavior camp, anger management. So far he is taking fish oil, vitamins, he eats healthy (fruit, vegetables, limited sugar, whole grains, organic meat, no soda, eliminated artificial dyes) is well loved, has mom and dad at home, is disciplined with time outs, loss of privileges or toys, loves to read, he watches limited shows and only after homework is completed, he has limited game time on the weekend that he gets by earning tickets from the teacher by doing his work in class, he gets exercise, he is gifted (99.4% per the psychologist testing), is in a gifted magnet program, has tons of interests, gets plenty of sleep. I do role playing and bought him lots of books on managing impulsivity. He hates the homework and classwork. He says he’d rather die than do homework. He reads better than most college students.

        • Lovemylittleboy,

          I also have a gifted child, who I love. I’d recommend you read the book “Misdiagnosis and Dual Diagnosis of Gifted Children and Adults.” It may help you. It basically points out that the “symptoms” of ADHD and the typical character traits of a gifted child are almost identical.

          I’d also recommend you get him reading material that is at his reading level, and in subjects that are commensurate with his personal interests. I know I was told my son should be reading philosophy books and such when in was in seventh or eighth grade.

          And do tell your child he is in the top 99.4% in intelligence, and that you’re so proud of him for being so bright. Let him take pride in his asset. As a Christian, though, I would recommend you also remind him to be grateful for the wonderful gift God has given him. I personally found building my children up, and letting them be proud of who they are as individuals is very important, but it’s also important to keep them modest.

          If you continue to have troubles at that school, you may want to consider other options. I will tell you my school district told me that they weren’t equipped to deal with the kids who get 100% on their state standardized tests, so recommended I find a school that was. The boarding schools do give very good scholarships to bright children. That may or may not be a good alternative for your child, but you may want to look into it.

          • Thank you for your thoughtful post. I am aware about the issue between giftedness and ADHD. Currently he is off meds and I have become aware that I was giving him the wrong fish oil. I ordered the right one now. We hope to stay off prescription meds but he says his brain feels calmer when he is taking them. It’s awful. Kind of damned if you do and damned if you don’t. I have four male relatives who were ADHD and had they been medicated they might have been able to control their impulses and not gone to jail. Better parenting might have helped but we will never know now.

          • Also, when I said he reads better than most college students I was not implying that he is reading books at that level. He loves books on Star Wars, Legos, Mega Man and Captain Underpants. I still read to him and explain concepts and words he doesn’t understand. He read the forst four Harry Potters but I think that was a little early so he’s saving the last books till he’s ready.

          • Lovemylittleboy,

            I don’t know how old your son is, knowing that might allow me to give you more age appropriate advice with a gifted child. For me it wasn’t difficult to recognize the traits of a gifted person, because it was like I was ‘raising my father,’ as a girlfriend and I used to joke, we both felt like this. Both our fathers were former successful ethical American bankers, who aren’t impressed with what the ‘too big to fail’ banks / government have done in this country in recent years.

            I personally believe it’s wise you have weaned your son off drugs, and know the psych drugs have very long withdrawal effects, much longer than the psychiatric industry admits to. But my personal expertise is in researching the antidepressants and neuroleptics, not the stimulants, so there are others here who know more about that than I.

            Krill oil is what you’ve switched to now, I presume? I personally believe more in a healthy diet, in other words incorporating fish into one’s diet, rather than supplements. But, again, I’m not an expert on supplements. There was a good article today on MiA that pointed out that the fluoride in our water system seems to increase ADHD diagnoses. And I know I personally feel much better when I drink primarily distilled, or non-fluorinated water. This may be something else you consider as a diet adjustment for your son.

            I would encourage you to help build your child’s self esteem, and explain that he doesn’t need those drugs, because he’s not “mentally ill,” he’s just highly blessed by God. The doctors got confused. And explain it just takes some time for his brain to heal itself. But human brains are an amazingly beautiful creation that do, indeed, heal themselves (there are quite a few articles now coming out pointing out the plasticity of the human brain).

            My prayers are with you and your son.

        • Dear Lovemylittleboy,

          It sounds like you are doing an amazing job and that your boy is so lucky to have you.
          I am also a mother trying to see my child through a different, but very terrifying ‘psychiatric illness’ without resorting to psychiatric drugs as I do believe psychiatric drugs are so powerful, so mind altering, and not really tested for the LONG TERM. I am afraid that the standard treatment prescribed by so many experts will hinder rather than help my child’s recovery, and that in the future people will be saying ‘I cant believe they used to drug children that way’.
          Here are a few thoughts I had about your comments:
          It sounds like your child is very bright, and it doesnt sound like he or you should have to worry about him doing his hated homework, It sounds like it would be way better for him to be engaged in projects he wants to do instead and that this could be written into his IEP.

          Also if ADHD exists as a disorder, this still doesn’t mean that the medications used to treat it are safe or effective’. I suspect that my child’s distress is likely a combination of a more predisposed nervous system interacting with emotional stresses – but even if his distress was completely caused by neurobiological factors – that still wouldn’t necessarily mean that long term use of psych drugs are safe for him.

          Best of luck to you on your journey of figuring out how best to help your son,

          • Actually one of the serious concerns for kids who are put on stimulants is that they may later develop psychosis and be “diagnosed” as bipolar or schizophrenic (and put on even worse drugs). Psychosis is a well known side effect of stimulant use in addict populations.

    • I am so tired of these articles that are misleading and plain insulting. They insinuate that parents medicate their kids for some private school entrance or report card pissing match with the neighbors. YES- ADHD inattentive and hyperactive types exist. Period. Change the name, perhaps the cause is not figured out, and maybe we don’t have it exactly right. THAT DOES NOT MEAN THAT IT DOES NOT EXIST. This doctor clearly does not have personal experience in raising a child that struggles with this disorder. By the way, I do not think it is a flaw, and personally, I feel that it is only a disorder because you have to be ONE WAY to succeed in our school system. Unless of course you can afford an alternative education program for your children; good luck finding one and I hope you have an extra $30K per year laying around- I don’t. So instead of posting things that are unproductive and harmful to those who have the disorder, perhaps Dr. Berezin can post his idea of what the solutions are for people that have such strong hyperactive or inattentive characteristics so as to fall into the category of “diagnosed”. Next this guy is going to say depression doesn’t exist, and that people just need to suck it up and change their perspective.

        • AhinLV, as you say having this disorder really does a number on kids. Please tell me what this so calles number is, what exactly is your child going through? Is he harming himself or others. Is is looking for people to argue or fight with. Can he not properly feed and cloth himself? What is it that makes you believe he should be labeled ADHD? I have a high spirited 7 year old that I’m positive any psychiatrist paid by the drug companies would deem my child with ADHD, but I’m sorry I’m not going to take the easy way out and drug my child because its to hard to take the time to find different ways to let my child ” cope” with the problem. There is no such thing as ADHD. My child is going 500% from the time he wakes up till his head hits the pillow. I could write you a novel of all the so called problems he has, ie; can’t sit still, doesn’t do well in school , can’t focus and all the other ridiculous labels thay like to throw out there. These are children, they are meant to be this way to learn and live not to be drugged because their parents can’t handle them!

          • Maggie,

            I respect your decision and made the same for a long time. The comments are filled with the “number” that the disorder does on kids. I believe we all have personality traits that can lead us to be hyper, and maybe to an irritable person’s standards, “too hyper”. And to a perfectionist parent, their distracted and active minded child may be “too inattentive”. But that is not what the commenters that I have read thus far are discussing here. I hope your child never becomes discouraged or depressed as a result of underachievement, and I hope you never have to be concerned that they may not successfully complete high school. I don’t know what the solution is and I wish I did, but that does not mean the struggle is not real, or that all these parents can’t handle their kids. Maybe you really just don’t understand what some people go through.

          • Some children are diagnosed simply due to being active and bored and this is a problem, possibly driven by drug companies and lazy parent and teachers but this does not mean that the issue does not exist. Children diagnosed ADHD and NOT medicated are statistically more likely to drop out of school and become dependent on illegal substances. A new article today says they are also TWICE as likely to die prematurely. So, if we decide to medicate we are taking a chance. And we (and you if he actually has ADHD) maybe taking a chance by not medicating. This is the conundrum and it would be helpful if people like you, who want to pass judgement on other dedicated and desperate parents so quickly, would consider that there are things you don’t know or understand and try to be more helpful in a thoughtful way instead of thinking your situation automatically applies to ours.

          • I am not aware of any data to support that contention. The Raine study, the Montreal ADHD study, the long-term arm of the MTA study, and a recent Finnish vs. USA study all indicate that high school dropout rates are not improved by stimulants. In fact, the Raine study found kids who took stimulants were much more likely to drop out (9 times), though that has not been replicated anywhere I know of. And the data on drug abuse has historically been equivocal – there is some indication that cigarette smoking is more common with kids who were exposed to stimulants, and kids who are still taking stimulants in HS appeared in one study to be less likely to abuse substances, but the rest of the research has shown no consistent differences.

            Two of my kids “actually had” ADHD, to the extent that they fit the criteria perfectly and had no particular trauma or other explanation for their behavior (other than two young and semi-clueless parents!), plus a mom and grandpa who also would qualify. Neither of them abused substances, and both graduated from HS with honors. The one who dropped out of HS and got into drugs was the “normal” one! Which goes to show that no one is really “normal” and who does or does not drop out of HS or use drugs is a very, very complex affair, and simply medicating or not medicating a child who fits these criteria is not a very powerful variable in determining their ultimate outcomes and experience.

            I’d still love to see a link to the article about dying prematurely. Accidents are the only outcome that has scientific backing for being affected by stimulants, according to the OSU Medication Effectiveness study back in 2002 or so. Saying they have twice the likelihood of dying prematurely sounds concerning, but I’d have to see what the absolute probabilities are to determine how important such a difference would be in the real world. (I.e. the difference between .001 % and .002% is pretty tiny, whereas the difference between 10% and 20% is huge, even though both are “twice as frequent.”)

            — Steve

          • RE: “people like you, who want to pass judgement”

            I took the drugs for 7 years. I know MORE than you about this subject.

            Adjust for body weight and take your child’s drug dose yourself and get back to me.

            There is no other way to understand it.

          • Yes. Doing dangerous things. Hitting others, cut a little girls hair, pushing by the side of a river. Raised in a proper and respectful household, not perfect but at least average or better.

          • AHinLV,

            I hope you’re then aware of the studies which show that medicated “ADHD” kids not only don’t do better academically but in fact do worse in life in general (there was a recent study from Canada reported here at MIA on a large population long-term). So medicating your kid, while it may appear helpful to “calm” him down may be in fact counterproductive.

            http://www.thestar.com/news/canada/2012/09/26/adhd_drugs_suspected_of_hurting_canadian_kids.html
            http://www.nber.org/papers/w19105
            “Our results are silent on the effects on optimal use of medication for ADHD, but suggest that expanding medication in a community setting had little positive benefit and may have had harmful effects given the average way these drugs are used in the community.”

    • But are you prepared to deal with — or watch your son have to deal with — the life-long consequences of brain damage likely to be caused by those drugs? Instead of being so quick to lash out at this author, maybe you should read around here some more and pick up the book that birthed this site (Anatomy of An Epidemic)… There is A LOT of science, including replicable studies, human and animal studies and even in vitro studies that all show that psychiatric drugs have long-lasting, and sometimes even permanent deleterious effects on the brain. With the absolute worst being from the neuroleptics, which cause actual brain shrinkage, but are being used more and more commonly for children with ADHD to treat the long-term “side effects” caused by the stimulants, not just limited to stimulant psychosis either, but for sleep issues and aggression, etc.

      As a child I was put on stimulants for so-called ADHD, eventually had a bad reaction to them and wound up on cocktails of drugs. I wound up with permanent irreversible movement disorders, out of school by the 8th grade, and am 32 having spent my entire adult life on SSI living in my parents attic. Meanwhile, I have no history of mental illness in my large family of 5 children’s and dozens of aunts, uncles, nieces and nephews. I am a living example of why parents and the public need to pull their heads out of the sand and face the science clearly showing that these drugs cause brain damage, and of course brain damage is at the very least going to complicate the rest of your child’s life, if not completely destroy it. With every day it gets worse.

      • I am really sorry this happened to you. Don’t think I medicated without much tears and consultation and desperation. Any drugs, even natural supplements can have bad consequences. But I know 4 maybe 5 people who I believe have ADHD with severe impulse control issues in my own family, living lives of drug use and prison who might have had a better chance at decent lives with medication. It’s a horrible decision to have to make and one I do not take lightly. It keeps me up at night and keeps me in tears constantly.

        • There is no evidence that stimulant use prevents criminality or helps in achieving academic success. In fact opposite may be true at least for some problems kids can face:
          http://www.nber.org/papers/w19105
          In fact childhood use of stimulants may be associated with higher risk for psychosis and developing “serious mental illness”. If you feel like you have to medicate your kid’s ADHD it’s your decision but for the love of god, if he happens to get psychotic don’t buy into him being “bipolar” or “schizophrenic”.

      • Jeffrey – Listen, I’m first hearing of your exact story here, and wondered if you had tried getting anywhere with examining DPAFU? For myself, psych drugs and forced treatment scenarios definitely contributed to some already active tendency to depersonalize due to early childhood traumas. Sexual and verbal abuse and manipulation on the one hand and real threats of instant death in traffic accidents on the other. I’m not trying to suggest that you should self-diagnose, and don’t at all believe that the careproviders are onto anything more than survivors can learn for themselves. I’m just saying–you can translate sometimes between the official varieties of symptoms and your own in the specific sense, and then come away with hints for how to adjust.

        I also have movement issues and some disorder of agency along with that cognitive problem. Derealisation, depersonalization, fragmented memories (feeling like they happened to no one in particular, very impersonal), and on top of that identical replications of emergency actions that I took to avoid a serious accident about fifteen years ago. I mean repeated re-plays of my hands and feet working on the controls of my bike. For a long time, I did not know what was going on, but eventually could piece it together. I even get the distorted facial musculature from my chinstrap and muscle spasms from the weight of the helmet on my neck. Maybe there is rhyme and reason underlying your own problems, more than absolutely random nerve firings? Just wondering on your behalf and for myself.

  4. And in adults ? Let’s assume that there is no so such thing as ADHD. The course of action from an ADHD diagnosis that is applied to those with these temperaments and trauma responses is still effective in helping these individuals function. Even if ADHD does not exist, the treatment course allows those with the diagnosis to function and alleviates much misery and confusion. Yes it may well be just a variety of human temperament but it is not a temperament that is compatible with contemporary society and day to day survival. A biased social construct ? Possibly. Reality? Yes. I need my meds to function in the world as it currently exists…ADHD or not. Unfortunately, I cannot change the core paradigms of the world in which I must operate. I can only modify myself to accommodate it. Not an ideal solution but in the time I have to make a life, it is the solution available to me.

    • Thank you for your thoughtful comment. My husband was diagnosed with ADHD after 40+ years of misery and feeling something was wrong but not being able to put his finger on it. Until diagnosis and medication, he was never able to hold down a job or manage money, or do anything involving planning, which led to us almost getting divorced. The consequences of this disorder or temperament are real in 21st Century America. While I agree that many children are over-diagnosed and over-treated, it is simplistic black and white thinking to assume this condition does not exist in any form.

    • ” Yes. I need my meds to function in the world as it currently exists…”

      But your “meds” are pharmacologically identical to cocaine and are certainly going to damage your heart at the very least. I’m sure that life for many people would be made better with drugs, but the issue is that it’s not ultimately worth it. There are more important things than functioning in the world as it is instead of forcing it to change. Not being addicted (physiologically dependent) to a class II controlled substance should definitely rank up there among’st the most important things that anyone should check off their lists for healthy and responsible living.

      • my step mother needed alcohol, and lots of it, to exist in this world.

        Unfortunately it nearly killed her.

        I have not heard, so far, of an illness that needs daily alcohol intoxication as a treatment.

        The argument that someone needs a perticular psychoactive substance to exist does not mean a disease is active. It merely means someone likes the effect of the drug.

  5. I’m sorry Dr. Berezin, I do not agree with you about ADHD being non-existent. While I agree that not all children are alike, ADHD does exist. Both my husband and son have been diagnosed with ADHD. I agree that drugs are not always the answer, but it does help. When your child is incapable of sitting still because it “hurts” him, it feels that “bugs are crawling inside my skin” you try to do everything in your power to make your young child feel better. That may include drugs.
    I’ve been working in the educational field for 15 years. My son is on a strict routine at home, he has his responsibilities, he knows what behaviors are expected of him; and while he is at home, he is not on medication because he is allowed to run all over the house and climb on the furniture, and exhaust all the energy he has. While in school however, he is not given that privilege. He is expected to sit at a desk for almost 6 consecutive hours a day. That is an impossibility for even adults, let alone a small child. His ADHD medication helps with that. Yes, he still gets the “wiggles”, but it is controlled with the medication.
    Speak to parents who are dealing with this first hand before saying that they are just giving in to “experts”.

    • It is so very sad how the parents of today a brainwashed by media and paid psychiatrists from big pharma companies. Sounds like your child has restless leg syndrome not ADHD. Poor children, anything they say to doctors now a days gets labeled with ADHD. Im an adult and have the same leg issues as your little one, guess I have ADHD as well. Children arent meant to sit still for 6 hours a day in school, it’s insane. We want to teach our children at younger and youner ages and try to adultify their under developed brains by age 10. Children in Finland don’t start kindergarten until age 7, and do not go for 6 hours or more a day. 1 in 10 kids are diagnosed with adhd in America, yet 1 in 1000 children are diagnosed in finland and are very rarely treated with drugs, but the look of the ADHD disorder is very prevelant in Findland. Its not a disorder, it’s part of children being children and growing and learning and trying to go through their way in life. ADHD is absurd.

      • What is interesting is that Finland’s rate of medication is much, much lower than the USA, and yet a recent study showed a very similar array of outcomes for their “ADHD” diagnosed kids. I have no problem with adults choosing stimulants for themselves if they think they are helpful, but it’s pretty clear after 50 years that despite the horrific warnings that “your child will be more likely to drop out of school and become a delinquent if you don’t get him treated,” stimulant treatment does NOTHING to alter these outcomes on the average.

        I do believe that lots of kids (including two of my own) exhibit these “symptoms,” and I KNOW they are a whole lot harder to raise. They also do much worse in standard school classrooms. But I think it’s the job of the adults, especially the schools, to figure out how to help these kids learn self-management skills, because in the long run, stimulants don’t help these kids develop the skills they need in order to survive, and may even make it easier to think things are going OK until it’s kind of too late.

        Another recent study showed that just waiting a year for Kindergarten admission reduced the “ADHD” diagnosis rate by THIRTY PERCENT!!! Think of this – almost a third of kids diagnosed ADHD could be saved this diagnosis if they waited a year to start school! I am sorry, but it’s a pretty sketchy diagnosis if a third of the kids who “have it” no longer “have it” a year later.

        I empathize with parents who have to meet the challenge of these kids, but I can say from experience that there are other ways that work better. Alternative classrooms and creative discipline methods (which you can’t just learn from any old book or professional, because a lot of professionals don’t know these techniques) were the keys to our success. Read “Raising Your Spirited Child” for more on this.

        Just because kids are hard to raise or don’t fit into standard classrooms doesn’t mean they are mentally ill!

        —- Steve

      • This information came from a study in Norway.

        “We have neurobiological research that clearly shows differences among persons with the diagnosis. We know there is high percentage of hereditary connections. We know that specific genes are involved.”

        “So there is distinctly a biological foundation for the diagnosis.”

        Does a clear biological foundation necessarily mean that medication is the answer?

        “No, but medicines represent a solution that is well documented. It works for 70-80 percent of the patients and reduces symptoms.”

        “That said, internationally it’s understood that medication isn’t enough on its own. In Europe we recommend starting with psychosocial measures, accommodations and parental guidance before starting initiating medications.”

        This from Finland:
        “ADHD is a common disorder among adolescents in northern Finland, with an estimated prevalence of 8.5%, consistent with rates of ADHD noted in other studies of adolescents,” Dr. Smalley and colleagues report in the first article, which examined ADHD prevalence. ADHD was 5.7 times more likely to be present in boys than in girls.

        A total of 18.2% of the subjects (3.2 times as many boys than girls) had a lifetime diagnosis of ADHD. Compared with individuals in the control group, the adolescents with a lifetime diagnosis of ADHD had a greatly increased risk of having a disruptive behavioral disorder (odds ratio [OR], 17.3) and an increased risk of having a mood disorder (OR, 2.9) or anxiety (OR, 2.4).

        If we had the social net that these countries have then maybe we could do it without medication. But, note, both of these countries ACCEPT that there is ADHD and that biological evidence of it does exist.

        • Why do I donate my time warning people about psychiatric fraud and the drugs ?

          Adjust for body weight and take your child’s dose of ADHD drugs yourself for a few days.

          You will have your answer.

          Sure to outside observers the person high and drug impaired may look “better” but if you have never taken ADHD drugs and felt their effects on your own mind and body you have nothing useful to add to this conversation.

          • That is a specious and nonsensical argument. If you don’t have ADHD then the medicine will affect you differently. You probably didn’t have ADHD. I took a similar stimulant medicine (prescribed by a doctor) for weight control when I was in my 20’s. My cousin found me at 2 in the morning standing on the kitchen counter cleaning the ceiling!

          • Also, my son says he feels better on the meds. He says his brain feels calmer. He is currently off them and I am trying multiple things to keep him off them if at all possible.

        • The point I was making is that the rarity of stimulant treatment in Finland does not lead to worse outcomes for the Finnish youth in comparison to the highly-medicated US population. So regardless of whether it is considered a disease or not, stimulants don’t improve long-term outcomes. Hence, my conclusion that we are wasting tons of time and money on something that doesn’t help except in the short term. I’ve presented the evidence on the huge advantage of “ADHD” kids educated in informal/open classrooms. Why not get on board in helping these classrooms become more common, rather than arguing about whether “ADHD” is a disease when we know the “treatment” doesn’t actually create the long-term improvements in the general population that have long been expected but have never materialized?

          And BTW, the fact that Norwegian or Finnish psychiatrists agree that “adhd” is a real disorder doesn’t mean anything much to me. Physicians have in the recent past agreed that Benzedrine is not addictive, nor was valium, that cigarettes did not cause cancer, that midwifery care was dangerous (even though it appears to be as safe or safer than doctor care), that formula teeding was as good or better for babies than nursing, and that thalidomide and Viiox were safe and effective drugs. Professional agreement is subject to bias just like any other agreement.

          — steve

      • Thank you for pointing out some very important facts. We are drugging bored children who just want to be kids but who are expected to excel and be young adults in kindergarten. Our huge expectations for our children at younger and younger ages are destroying our children and when they act out against such insanity we drug them and tell them that they have some kind of “illness”. Frankly, I find it totally disgusting, especially after teaching 15 year old boys for a number of years. We put our kids in boring schools and expect them to excel at everything and when they don’t we drug them. Go figure. I have to wonder whose needs are being met here with all this.

        • I’m happy I’m not a child today. How many kids are allowed to spend 90% of their time playing and doing so mostly without or with very little adult direction and supervision? We are over-educating and over-controlling kids and depriving them of a possibility of personal development.

      • I believe you have your facts wrong. It’s not 1 in 1000 that are diagnosed ADHD it is 1 in 1,000 that are medicated. The diagnosis rate is about 8.5% which is only slightly lower than in America. Also, please note that the Finnish DO believe that ADHD exists.
        From the UCLA article.
        The study started in 1986, when researchers from Imperial College, London, and Finland’s University of Oulu began studying 9,432 children in northern Finland. They tracked the children from the early fetal period to adolescence (age 16 to 18). UCLA researchers then joined in the effort to examine the adolescents for ADHD behaviors, using a standard screening survey and diagnostic criteria. Among the 6,622 respondents to the survey, a subset of 457 likely cases and controls were evaluated for ADHD and other psychiatric disorders. The estimated prevalence of ADHD among these adolescents was 8.5 percent, with a male-female ratio of 5.7 to 1.
        If we had the social network they had we might be able to avoid medicine also. I’m curious about their long term studies showing how the medicated versus non-medicated children fare.

        In addition to Smalley, UCLA researchers involved in the study included Lorie A. Humphrey, Sandra K. Loo, James T. McCracken, James J. McGough and Stanley F. Nelson.

        Funding was provided by the National Institute of Mental Health, the Juselius Foundation in Finland and the Academy of Finland.

    • ” While in school however, he is not given that privilege. He is expected to sit at a desk for almost 6 consecutive hours a day. That is an impossibility for even adults, let alone a small child. His ADHD medication helps with that. Yes, he still gets the “wiggles”, but it is controlled with the medication.”

      Wow… because he just wont sit still? You talk about these drugs like they are inconsequential. It’s pharmaceutical cocaine! It’s class II controlled substance! It’s AMPHETAMINES!!! Those drugs are among’st the most powerful and most damaging drugs in the world and for what? To save his life? To keep him from running into traffic? No, to get him to sit still in his seat… wow.

      • And why, indeed, is he denied that privilege? What evidence is there that denying a child the right to run around and have fun leads to a better education or a more satisfying life? That is the gigantic elephant in the room that the “ADHD” industry and our school systems are completely unwilling to look at.

        Bored kids don’t learn much. Those suffering from “ADHD” are the canaries in the coal mines. The biggest difference between me and them is that I was too scared to let the teachers know what I really thought of the bullshit I was expected to tolerate, especially in elementary school. I would have done anything to escape that slow torture. I admire these “ADHD” kids for making it clear they aren’t willing to put up with it, and I feel very sad that the adults in our society are too narrow minded and cowardly to listen to their message.

        —- Steve

  6. I have raised three kids who have never had to be placed on any medications the however almost 5 yrs ago my husband and I took in a 1 yr old little boy who is now almost 6. He was developmentally delayed and diagnosed with ADHD. At first I told myself he did not need meds he needed therapy. My husband and I made it a point to get him in therapy and to work on his behaviours. We did everything we possibly could to prevent him from following into the medication categorey. He was on the verge of being kicked out of daycare #2. By the time he entered 4k I was consatantly getting phone calls from teachers, bus drivers even his in school therapist. he could not be controlled and very very impulsive to the point nobody knew what to do. It had NOTHING to do with parenting because we love him and nourish him like he is our natural born child. He gets a lot of attention in our family. We also spend time working with him. Finally, the doctor recommended seeing a psychiatrist who also felt even at his age he needed the medication. Once he started his medication he was a completely different child. He is doing really well in school, he is focused on actually learning and at the same time he is not zombied out he stil runs and plays and very much active likea normal boy should be. So I do dis agree with what this article is saying. Unless you have actually had to raise a child with ADHD not just see a child in a office for 30 minutes to a hr and automatically think there is no need for this type of labeling. My child and I are living proof of how much his medication helps him. Before medications he was uncontrollable! At 3 yrs old there was even a concern for his safety as well as others. We are still working with him even with his medication. some kids once they hit puberty tend to out grow the ADHD and do fine off of medication and then there are others who need it all the way through adult hood. Me being one of the adults. My medication helps me focus at work and at home verses when I do not have it my mind constantly races and I cant even read one page on a book with out being distracted in my mind. Everyone is entitled to there own opinion but please stop telling people what they need and don’t need when in all actuality you have never raised a child who suffers from ADHD. Try dealing with all the phone calls, letters, and threats of your child being kicked out of a child care because your child is hard to control. Try being the parent that has to work and can not afford to miss days of work or the parent who may be reprimanded for leaving work because they have to go to the school to deal with issues with their child when it can all be helped. Its not just some mind thing that can be fixed over night it is a chemical imbalance that helps. Just like estradol helps a woman with imbalance of chemicals in other areas of the body or testosterone helps with a man. ADHD medications helps with the brain. Thank you and have a great day!

    • I hear you on this! My daughter was kicked out of 5 daycares by 5 years old. On an IEP from Pre-School and eventually placed in a “Behavioral classroom”. After this was still unsuccessful and after 106 school referrals in one year, then another 109 the next I decided on meds. Medicine was definitely last resort. Wishing I would had done it sooner though! I tried other methods first, gluten free, limited sugar, dye free, fish oil, neurotransmitter supplements etc . This doctor obviously has not been in a home or a school with a child who suffers from ADHD.

      • The terrible twos (relatively speaking) happen. Drugging children? You aren’t thinking of the repercussions, are you? What you get out of the pill bottle, I’d like to remind you, is not the “perfect” child. What you is a drugged child. Hopefully this child can be weaned off the drugs you give him. When it comes to new “mental disorders”, adult ADHD just made the DSM-5. I imagine that many adult “sufferers” will have arrived there through a prescription they, too, received as a toddler.

        • What experience qualifies you to have this knowledge that ADHD does not exist? Have you participated in research efforts in refuting the disorder in children that have been diagnosed? I did not know anything about the disorder until I dealt with it myself. I have a very healthy, well behaved son that struggles with the disorder. I tried everything to help him, and finally caved to medication because the disorder has taken such a toll on him. Yet you say things that point to bad parenting; people can’t handle their active kids. My suspicion is that you have no qualifications with regard to this issue. I further suspect that you enjoy the idea that people are just bad and taking the easy road at their kids expense and enjoy slinging your opinions around like you know what you’re talking about.

          • I was talking about the terrible twos, the terrible twos that can, on occasion, extend at least as far as the disastrous sixes, and beyond, to the atrocious tens. ADHD is not in my lexicon. Sorry.

  7. I guess everyone is entitled to an opinion and just because your name has MD at the end doesn’t mean your opinion holds any more weight to it than any other outside observer of a person with ADHD. You sound like all those parents who say, “he’s just an active kid”, or “he’s just being a kid”. Wrong! You don’t live with it day in and day out like we do. My son coming home in tears because he’s not able to complete assignments in class or he has a meltdown in front of his peers due to his frustrations–these are real issues he deals with. And shame on you for suggesting our children are possibly being abused at home! If it were just behavior issues, his medication would not have the effect it does on him. He doesn’t become a zombie when he takes it, it just helps him to be able to focus on his tasks at school and to control some of his impulsiveness. He also sees a therapist (thank goodness it isn’t you!) in addition to his medication. I’m a strong advocate for the children who have ADHD. They are misunderstood, bullied, and struggle with day-to-day life issues that many people take for granted. Years ago, these children would have been labeled “troublemakers” in the school system, many would barely pass through the school system, and end up living less than desirable lives. Now, thanks to advances in diagnosis and medication in this area, these people can go on to not just pass through the school system but actually excel and go on to higher education and live successful lives. It’s the kind of thinking you exhibit that shows a lack of understanding in this area. I only wish you could spend a day in the shoes of a person with ADHD and then you tell me if it’s just a made up disorder.

  8. Polemics seem to be an integral part of all issues in America. Nature versus Nurture, Whole Word learning versus Phonics, ADHD exists, ADHD doesn’t exist. Everywhere you look you see this – and guess what? Some people can do awfully well financially and in their careers by simply hunkering down on one end of it.

  9. I’ve been around children, mostly boys, who were so ADHD that they were almost literally bouncing off the walls. My adopted daughter, by contrast, is in the “VERY ACTIVE” category. YES, these children often do not THINK about normal danger; they rush in where angels fear to tread and they are also often difficult to teach. I think some of the most extreme cases DO need some type of medication. Others benefit from a strict diet, and most need firm but loving discipline and help with impulse-control. Many are just not constituted to live in our artificial society; they have too much energy to be confined doing busy-work in school for most of the day, and many have no good areas or even the time to run and play at home. High-energy children are high-maintenance; they don’t always fit well in a classroom setting, especially at the early ages that we send children to school. In a small apartment or condo, they go crazy. In short, our society is partially responsible for creating the ADHD “epidemic.”

    Sometimes (not in all cases) things DO get better over time. When our daughter was tested, we were given gloom-and-doom; I was down for two weeks after hearing the grim predictions about her future. We were already homeschooling her, and we just decided to keep-on-keeping-on, even if things went slowly at times. She had basic lessons in math, English, and reading, and we tried to do as much as we could “hands-on.” Now she’s in middle-school, and few people would think of her other than as a happy, active, even bright child. She doesn’t like to read, but she CAN read if she needs to, and she can do basic math and is starting pre-algebra. Energetic? Yes! Her best friends are her dogs, and they have daily adventures together “exploring”; when she’s grown she’ll probably be into camping, mountain climbing, dog-training, or even search-and-rescue. Our religion (Christianity) teaches that there is a place for EVERYONE in this world. God did not make us with cookie-cutters. Everyone just has to find his or her niche where he or she can thrive and blossom.

  10. To Another Voice:
    In your day, maybe the children who were sent to remedial classes or Vocational Technical School or the dropouts actually had ADHD and people just said they were “dumb” or incorrigible. They didn’t know about ADHD at the time. I’m sure if you talked to many modern day teachers, they would tell you ADHD does exist and they see it often. Perhaps in your day, ADHD didn’t exist and it does now because of something in the environment, food supply, etc. But it does exist. Don’t tell me I just want to drug my child. How incredibly misinformed and rude.

    • aendrums:

      I think you are misinformed. I taught primary school. All children were there. And this is a larger question than rudeness.

      My father, who was a physician saw this tsunami of drugs coming and predicted the damage they would do. For the sake of your child, become acquainted with the growing literature on pharmaceutical drugs and the lawless companies that make them. I liked Peter Gotzsche’s book “Deadly Medicines and Organized Crime,” and, of course, there’s Robert Whitaker’s “Anatomy of an Epidemic.” There are many more. In fact, there is a list of 100 relevant books on this site. Become informed yourself.

      • Currently there is an epidemic of Hepatitis C. Now there is a drug that can, in most cases, CURE you in 4-6 weeks. Will you be warning people off that drug too. It is dark ages thinking to believe that only the body can be ill but not the brain. Like fundamentalists who will treat a broken arm because they can “see” it but not give treatment for cancer and let their kids die because it’s not visible to them. Ultimately we may find ADHD is something else. Let me know when you have the scientific proof for that.

        • Ridiculous comparison. It is clear and easy to tell who has hep C and exactly what causes it, as well as whether any treatment prescribed works or not. None of this is true for “ADHD.” Impossible to objectively distinguish from a normal condition, no universal cause, and no measurable variable to tell if treatment is working. Of course, I’d be thrilled for a Hep C cure. But the most ardent ADHD proponent acknowledges that there is no “cure.” Absolutely no comparison. Not to mention that you can’t improve Hep C by moving the child to a different classroom!

    • Ah, but they don’t have Voc Ed curricula in most schools now, do they? It was understood in my day that not every kid was bound for college. Still is that way in Europe, but nowadays, US schools train everyone for college, even though only 20% of our population gets a 4-year degree. If our schools were more flexible and allowed for different temperaments, a lot of these kids would do just fine. I believe 80% of the problems for these kids are caused by our school system. Alternative ed made ALL the difference for ours!

      —- Steve

      • Agreed and I can say this from experience since I was a high school teacher for a number of years but retired just before the explosion of the bogus ADHD epidemic onto the scene. Everything is geared now to people going to college, whether they want to go there or not. Many kids would be very happy to learn a trade but of course there are no jobs for trades these days since big business and the Koch brothers decided to outsource all good jobs to other countries.

      • Steve I can finally agree with you on something. We need other training for some kids. The problem in the past was that schools were usually directing minority kids (except Asians) to “shop” classes. They need to bring back shop and mechanic training. America actually has a shortage in some of this. Recently my husband brought home a flier from the City of Los Angeles with a number of job openings from secretarial, clerk, drivers, lawyers and nurses. The highest paid job was for a Heavy Equipment Mechanic starting at over $100,000 a year!!

      • Good point. Like our society does not need plumbers, car mechanics, construction workers… oh, wait most of these jobs have been shipped off to the 3rd World already.

        Some kids are neither talented for becoming academics nor do they want that and there’s nothing wrong with it. They are still important as human being, maybe even more than another unemployed young adult with a degree, tons of debt and no job to pay it off.

    • Stimulants don’t improve educational outcomes:

      http://www.nber.org/papers/w19105

      “We ask whether this increase in medication use was associated with improvements in emotional functioning or academic outcomes among children with ADHD. We find little evidence of improvement in either the medium or the long run. Our results are silent on the effects on optimal use of medication for ADHD, but suggest that expanding medication in a community setting had little positive benefit and may have had harmful effects given the average way these drugs are used in the community. “

  11. Yes, ADHD does not exist, and judging from the number of reactive and negative comments you have received from your post, you must have hit on something there. Sensitive issue so-to-speak. Indeed MD’s and PhD’s have opinions to which they are entitled. The same may be said of children, despite any admonition to be seen, not heard, and despite the labels attached to them by doctors of differing faiths. For example, conduct disorder, oppositional defiant disorder, unruly in the classroom disorder, etc., etc. I remember when conduct was a mark on a report card rather than a “disease”. Parents need to realize that parenting is not, and never was, a picnic. Although, of course, there are things to be said for taking picnics, too. Problems with schoolwork, after all, can lead to some meddlesome education official coming up with ADHD as the “answer”. It is not, and never was, the “answer”. Thanks for this post and, please, keep them coming. Perhaps we can succeed in resolving into a successful adulthood some of these problem youths that some people are so very intent on producing, and doing so before it becomes too late. If so, your message would be a very encouraging one, wouldn’t it? Well, that’s the message I’m getting loud and clear.

      • I’m slogging away at it but they’re overwhelming the few of us who are trying. I too am wondering why there’s this huge response of true believers all of a sudden.

        Methinks the good doctor has stirred up the hornets’ nest. I am a former teacher and the only teachers who I see and hear talking about ADHD are the ones who don’t really want to deal with all the difficulties that American kids are bringing into the classroom these days. American education is BORING AS HELL and it’s totally understandable why so many kids rebel and act up. As a teacher I used to walk down the halls during my off period and listening to what was going on in the other classrooms. It is awful. I don’t understand why the kids don’t rise up and take over the damned schools but of course they won’t and can’t because most of them these days are drugged to the gills for supposedly having ADHD. Give me a break! Lazy teachers are the ones who recommend that their students be drugged for their bored behavior.

        And all of these posters here who are singing the praises of the ADHD label don’t mention the large numbers of parents who are getting their kids diagnosed so that they can get the drugs that are given to the kids. There is terrible abuse going on with these drugs on the parts of some parents, too many parents. Getting your kids diagnosed can also get you an SSI check until those kids are 18. Many of them roll right on over into the adult disability rolls at that point. But the parents posting here don’t want to discuss this problem either.

        • I mentioned both of those things. There are bad apples, but that is not the majority. I also mentioned that it is a disorder in the context of our ONE WAY FOR ALL education system. I don’t get outside assistance or funds from SSI, nor do I know anyone that does unless it’s an extremely severe form and coupled with something else. Best of luck to you, but you may not understand all of what goes on. There is a reason that people are responding passionately to this article, perhaps you are missing something. No-one is singing praises of ADHD labeling. I have opted to respond because there is something accusatory and defamatory in this article and subsequent comments.

          • You are too right about the educational system. My biggest problem with the labeling is that it takes our professionals off the hook for trying to actually find solutions for our kids. We actually had to help create our own charter school so our youngest could be protected from the kind of crap they get in school. If you look at the “ADHD” definition, it’s a list of traits that makes it difficult to teach you in a herd-management school classroom. Luckily, we had the means and support to make a better plan!

            — Steve

      • I, too, agree. By the way, thank you Dr. Berezin, for this article. It seems like MiA was invaded by a bunch of NAMI moms, or something. No offense intended, it’s just that ADHD technically is not a proven disease, the doctor is correct. And the possible side effects of the stimulants can be serious, plus long run outcomes for children so diagnosed and drugged have not been good.

        But I do, and have for decades, work with children from all walks of life. I do realize children can be unruly. Right now I volunteer with 30 underprivileged children who all have issues. I absolutely agree, it can be exhausting to try and help them. But I do see that you can get through to them by showing them loving care and by logically explaining to them why things should be done a certain way. I even helped my own child overcome the many issues related to child abuse, he went from remedial reading in first grade to valedictorian of his high school class, just with love and no psychiatric care. It’s not easy, but drugging children is not the answer.

      • David: Yes in deed, the defenders of ADHD diagnosis are coming out of the woodwork on this one: contributors whom I have not seen on MIA before. The United States has the largest percent of its population incarcerated along with one of the largest percentages of its population under some form of psychiatric supervision. With the high rate of foster children falling under the purview of one or more of these systems, it is getting harder and harder to distinguish between the system of incarceration and the system of social welfare. The impetus to drug test “welfare recipients,” demonstrates the impulsive desire of the “upstanding'” members of society to control the troublesome rabble. “The path to hell is paved with the best of intentions.”

      • Wow. How sad that you only want to hear from people that agree with you. And Steven, the “true believer” comment is really horrendous. I have put hundreds of hours of research into this and thousands of hours into my child. I don’t need a perfect child and I don’t even care about his grades. I only need him to be happy and well and not physically hurting anyone.

    • Beautiful children are beautiful children. With ADHD is nonsense. All I can say to you is show me the evidence that your child is “diseased”. I would suggest that you cannot do so because such evidence just doesn’t exist. Alright then, you can pretend otherwise until you have a geezer with ADHD, so-called, but, contrariwise, facts are facts.

      • My children are not “diseased” other than they can not cope with a diseased Educational Model. I am a 48 year old ADHD personality. It is awsome most of the time, and annoying when I have to sit still in a meeting. (I knit to cope) I don’t care what stupid label they put on it. The stimulant is a tool to cope… I don’t see ADHD as a problem… just an explanation of a type of person that doesn’t fit the square hole that government wants us to fit into.

        You can have all the high and mighty lofty ideals you want, but in the end me and my kids gotta cope with what we have…

        • Right, but just to put things in perspective, nobody had ADHD 60 years ago. Nobody had ADHD during the WWII years. Nobody had ADHD during the great American depression. Nobody had ADHD in the roaring twenties. Nobody had ADHD because it had not been invented. ADHD didn’t officially become an “illness” until the APA voted it into the DSM III, and so before 1980, when ADHD became an official “disease”, it didn’t have much of a tangible existence. We certainly weren’t in a place where 9 % of the male children in the USA are said to have it, and a great number of them are taking stimulants for it. It, for most of the world’s existence, simply didn’t exist. Children were problems to raise, surely, they just weren’t problems in themselves (i.e. perceived as “diseased”).

          • I may agree with you that this didn’t seem to be a problem 60 years ago. but the environment, food supply, air, water, is not what it was 60 years ago.

            We didn’t have that freaky modified wheat we have now. Granted alot of people don’t starve because they have altered the wheat to produce more per head…but that stuff messes with alot of our systems.

            They didn’t have Genetically modified Corn and Soy. These 3 things are in almost all the processed food. Most americans eat processed food. Even if you get the wheat berries and make your own bread you are still using the modified wheat.

            They didn’t have everything stored in plastic. We have no real idea what all the DDT and other pesticides that were used during my granparents era is having on the DNA of future generations. They were not using the level of antibiotics and growth hormones in the meat we eat now.

            Our envirnoment is so different than it was before.

            Scientifically they (who ever they are) can not prove or disprove whether these things are having an adverse affect on our brains and our bodies… but just cause you can’t find the cause doesn’t mean it isn’t causing something. I would be pretty niave to believe that all these chemicals in our air and water and food supply is not causing issues.

            True… I am adding one more to the mix…but if it allows me to function and my son to function in the environment I find myself in. It is what I must do.

          • Well, if you are going to invent a disease, it helps if you can invent a history for it as well. The better to sell drugs, my dear. Certainly, if you look, you can find all sorts of suspected maladies going way back but, bottom line, you didn’t officially have an ADHD until 1980, and you didn’t have 9 % of America’s male children labeled with it until the 1210s. People have been having children for ages, that much is undisputed. Now, whether they had some kind of “disease” that made them fidget and disrupt the nursery, that much is very much in question. Excuse me, I think we can go further than say it is in question. I think we can say it is absolutely a fiction.

          • Well Frank you make comments about there being no history for ADHD and say it was just created in 1980 because that’s when it went into the manual, as if somehow that is when a disease begins. I cite you a historical reference and you say it is made up. So here are some more for you to say are made up so you can keep making comments without citing references and continue supporting the flat earth brigade.
            Sir George Frederic Still first Professor of Pediatrics at Kings College in London in 1902 describes the cases of 20 children (15 boys, 5 girls, does that ratio sound familiar) who show a “defect of moral control as a morbid manifestation without general impairment of intellect without physical disease”. They show an “exaggeration of excitability, impulsiveness and failure to control emotional activities”, with a “quite ABNORMAL INCAPACITY FOR SUSTAINED ATTENTION”. “Both parents and teachers noted this feature in some of my cases as something unusual” he said. Franz Kramer (1878-1967) and Hans Pollnow reported of a “hyperkinetic disease of infancy, motor drive and restlessness and difficulty playing with other children”. German Physician Heinrich Hoffmann in 1844 wrote books called “FIDGETY PHIL” and “JOHNNY LOOK-IN-THE-AIR” to help children who were dealing with “inattentive difficulties” who were often “easily distracted by stimuli”. In the book Johnny is so “distracted” that he collides with a dog and falls in the river. In 1937 Charles Bradley reported a positive effect of a stimulant medication for kids with these behavior disorders characterized by a “SHORT ATTENTION SPAN, MOOD LABILITY, HYPERACTIVITY, IMPULSIVENESS and SHORT MEMORY.” Ritalin was created in 1954 for these children who were already known about for years.

          • Red flags for me go up when I read about defective “moral control”. I wouldn’t buy into any “diseased” morals in the first place. If we’re moralizing, and these kids have broken some sort of unwritten rules to some secret code. Okay. That doesn’t mean we’ve got a medical problem any more than juvenile detention means medicine for any child either. Unruly and sick are not synonyms as far as I’m concerned. What is the ‘normal capacity’ “for sustained attention”? I wouldn’t even ask. A child is a child, and a child should not be expected to behave as adults do. Children have always been inattentive and fidgety, alright, does that mean that we must make childhood a “disease”, and then extend it into adulthood, or unto the grave? I think not. Thinking along those lines has gotten so many kids into special ed if you know what I mean. Kids will be kids. That doesn’t make them “diseased” Now that a college education is seen as so important to success, or achieving a redeeming salary, they need an ADHD ‘slow learners’ “disease” to deal with the handicap. You think? Well, the problem is now we’ve got adult ADHD because that’s what happens to children they mature. If the “disease” matured with them, so much for lax morals. Methylphenidate has got to be as bad as it sounds, but if we call it, say, Ritalin, somebodies going to buy it. Look, chemicals are chemicals, and one thing you can say about chemicals is that they shouldn’t go into the growing bodies of children. We know these stimulants can stunt growth, but that’s only part of it. We’re also talking about the effect speed has on a growing brain, the organ of thought. Exercise, activity, sunshine, good food, anything has got to be better for the child. However calling the kid “diseased” is certainly not going to be good for his or her ego, let alone chances. To top it all off, concretely, as in PHYSICALLY (as opposed to abstractly of course), what “disease”?

        • Frank. How telling that you seize on one word in my entire statement to make your argument. This was the 1800’s and “moral” was the type of word that they used then. One again, you ignored all my cited references to historical documentation to spout your own comments without citing any references or acknowledging that you are misinformed when you say no one had ADHD 60 years ago. These doctors also use the termed “impulsive” and “hyperactive”, “inattentive” and the moral term related to their actions of hurting others. Indeed, many studies have shown (see below) that prisoners have substantially higher rates of ADHD and medication reduces crime and violent attacks by helping to control impulsivity. So in that context “moral”, especially for the 1800’s, was an appropriate word.
          http://www.medscape.org/viewarticle/719862

          • As if it were inappropriate, given lax parenting, some say skills, and run away psychiatric labeling. The fact of the matter is that people, children here, without any “illness”, are being treated as if they were “ill”.

            You can take a handful of children from other centuries, and link them to a slew of children today, only by twisting exception into norm. Well, I’m content with exception remaining exception. It’s just one of those ways in which we keep a drip from becoming a flood.

            Children were children long before anybody started talking children with ADHD. Personally, I prefer it that way. If we were to draw an ADHD line, let us say, with these events taking place before the advent of ADHD, and those events taking place after…Well, you get my drift. Children don’t cease to be children even if you claim childhood a “disease”. Certainly, no drug is going to “correct” them.

          • “prisoners have substantially higher rates of ADHD and medication reduces crime and violent attacks by helping to control impulsivity”
            Prisoners are presumed to have higher rates of all “disorders”. It’s a prime example of circular thinking which takes a behaviour which is labelled as criminal and classifies is as mental illness and then saying that mental illness caused it.
            As for the papers you cite: I think everyone agrees that some kids are more active than others. It’s a part of normal human variation. Which has not been a problem before in human history (it may have been beneficial) but has become one with the modern model of education. The question is: is drugging kids for who they are and preventing them from developing their own characters and talents is a better response than building accommodating, more natural environments? We didn’t evolve to live in small boxes and put our kids in chairs for several hours straight every day. The society is sick not the kids.

  12. ADHD is MOST definitely real! Obviously you have never lived with a child or adult who has ADHD. Not only does the child suffer, but the entire family suffers with sometimes ADHD can include very dangerous behaviors, impulsive, meltdowns, aggression etc! My daughter is 11 now, but by the time she was 5 she had been kicked out of 5 daycares for her “bad behavior” as I was constantly told. She was on an IEP by Pre-School and placed in a “Behavioral” SLC classroom by 2nd grade and when that didn’t work (109 school referrals one year and 106 the year before that) and after 3 years of behavior intervention and weekly counseling, she was placed in a therapeutic school this past year. She was not dx with ADHD until age 9, almost 10. First dx with ODD and OCD by age 5. I did not put her on medication and wish I would had done it years sooner, now that I look back on her chaotic life. Today is her first day on Concerta. Before deciding on meds I had her on a gluten free diet, limited sugar, dye free, plus neurotransmitter supplements and fish oil for 4 years! She is well loved and cared for by us. Deciding on medication is not an easy decision and definitely is not parents first choice. Shame on you for saying ADHD does not exist!!!!

    • ODD OCD ADHD, if that’s progress, you might try regressing. I’m glad if she’s doing better. It would be my hope that she turns into a healthy young woman someday, however giving children amphetamine is not my idea of a good policy. We’re not talking about sugared aspirin here. Some people home school their children. Some children like to finger paint. We’re not asking what she likes to do, and if she’s doing it. Anyway, those questions are for you to ask and deliver on, not me.

      • Thank you. I hope she turns into a healthy young woman someday too. The route she has been on is very scary due to the behavior aggression and meltdowns. She is quick to anger. I don’t like putting her on amphetamine’s either, trust me. It’s a very scary path for me. She is also epileptic but has been seizure free for a year now without meds. Stimulants can lower the seizure threshold… They can also increase heart rate. It was not an easy decision, but her quality of life is awful, so I’m going to try this for a few months and see. The “natural” route helped but not enough. I wish I was in a position to homeschool…. She is a very smart and talented girl, and loves art. She has art therapy once a week. I need to get her back into sports too, but even then she has been “kicked out of programs”. It’s non stop phone calls, meetings and letters. I don’t wish our path on my worse enemy.

        • Don’t beat yourself up. My younger sounds like your daughter. quick to anger… issue with peers, on an IEP in pre-school. Having tried the no medication with the older…I didn’t have any reservations on the meds. I use the lowest does possible. he still exhibits some systems… I don’t want to medicate him to a thorozine level. He needs to learn coping tools, as I did, because we didn’t have meds for this when I was a kid… but the meds allow him to be on the average level of energy and emotional levelness. He sometimes refers to his medication as his “so I can be nice” He very aware of what the meds are doing to help him.

          I agree. Quality of life is important, and constantly being frustrated because everyone else is going at snail speed … would make me meltdown!

          Portland girl… You would enjoy the article from the New York Times. “A Natural Fix for A.D.H.D” october 31,2014. You think it is about fixing it… but it is really saying what this guy is saying in a much less judgemental way… made me feel proud to be “ADHD”. It might help your daughter not take the lable ADHD as a bad thing… but a badge of HONOR!

          • just to repeast there are places that help people withoug diagnosis or drugs and yes, they would be diagnosed with severe ADHD elsewhere.

            I cannot find the link to the radio programme about this at the moment. Suffice to say parents and children show a high degree of satisfaction and recoreded outcomes are good.

  13. Although I will concede that ADHD is over diagnosed that does not mean it is not real….children do come in all different sizes, abilities, and personalities…however children affected by ADHD are not just unique in their make-up – they are unique in how they do anything – my daughter has severe combined ADHD – I say SEVERE and i mean it!! She has no impulse control at all…she has had staples in her head multiple times because being hurt once, twice even three times doesn’t register for her as “hey don’t do that”. She isn’t stupid….I swear in fact she tests off the charts for our area, 30-50 points higher than our district averages. She can orally answer any question you ask her about schoolwork, or a book she read (even if she read it a year ago) but it takes her HOURS to write out 14 spelling words, do 20 math questions and 1 3 line reading log – by hours I mean some nights homework takes 6 hours…that’s supervised homework, in a quiet area, no distractions and being reminded to focus anywhere from 1 to 100 times in a single night. Reading a 20 page book about something she isn’t interested in can take a week of being told, reminded, begged, cajoled, bribed and yelled at to do her damn homework…however she will read a 10 chapter book in 3 or 4 hours if she is interested in it and no one interrupts her. Her chores – picking up laundry, sorting laundry, putting her dishes in the kitchen, picking up her toys can take HOURS sometimes her whole Saturday is a battle of the wills to get her chores done before she can do something fun….however if she comes across a packet of colored paperclips she can happily play with them for 12 hour forgetting to eat if not reminded (literally having to get in her face to get her attention). There there is anger and impulse control that comes with knowing to use your words not your fists when someone bumps into you, or is bugging you with questions (think lil annoying sister) although my daughter has gotten better in the last year with her temper tantrums and her anger it is still an issue one minute she can be all sunshine and happy with lego’s and then all of a sudden a tornado of anger over a block can take 30 minutes to calm down over. Other times she can’t see the forest for the trees, someone at school being mean, teasing and bullying her she doesn’t understand that it isn’t a friendly joke between friends (think 3 years of horrid teasing over her uniqueness and shes only 9) then coming home and crying no one likes me, even when i talk to them about things they like, they turn their back and laugh at me…she can’t sit still (ever) she chews everything – her hair, finger and toe nails – the collars of her shirts – toys – pencils – even the side of her bed if it fits in her mouth she will chew it…..any of these things on their own is NOT an issue…however all combined makes for one hell of a stacked deck against you!

    My daughter is a superhero – between routines – reminders – and medication she is able to live a mostly normal life. She has a social worker to help her with her emotions and making friends. She has an amazing teacher who helped put an end to bullying in the classroom this year when she witnessed first hand the type or bullying that was happening. She has a school team that is willing and able to accommodate her as needed and they are flexible about what works and what doesn’t. She has a mom in her corner that is strong and firm when needed (battle of the wills), yet kind and gentle when needed(think emotionally upset over something the rest of us wouldn’t bat an eyelash at).

    However there is one thing my daughter will never be able to battle or overcome….that is people like you! She can’t make you see that being different is okay but that needing help is okay too. You wouldn’t deny a diabetic child insulin, you wouldn’t deny an asthmatic child their inhaler, you wouldn’t deny a seeing impaired child their glasses….why would you deny children who are struggling just to be happy and to function somewhat normally the right to do so without your blind judgement and hatred and assumptions that you know better than the thousands of parents out there!!

    Until you live with an ADHD child you have NO CLUE what you are talking about. Having ADHD is not the same as parenting a child with ADHD. My daughter is amazing, smart, funny, loving and caring…she however was a TERROR to live with before her diagnosis and eventually her medication. I couldn’t leave her alone in a room she could get hurt climbing shelves, jumping off of beds, hanging out the window or she could hurt her little sisters in a fit of anger…I wasn’t a mom i was a warden before she was diagnosed. My daughter has no idea how she affects the rest of us, she doesn’t see or understand her younger sisters intense jealousy over discipline, time, and ability. She doesn’t know that some nights i cry for hours agonizing over a way to get her to do her homework in an hour liek her peers instead of 3 hours. She doesn’t see her father struggle to control his own frustration when she has a battle of wills over her refusing to eat her sandwich because there is jam or honey on it even if she asked for it…or how our extended family thinks she just needs a good spanking to learn to behave…

    So until you parent a child with ADHD…do everyone a favor and BE KIND or BE QUIET…in fact do both!!

    • Awsome! I feel better already…. Thought my child was the only one… phew… they can be exausting! SUPER smart…My child said this last night “this doesn’t do anything it is only for aesthetics” and he is 8.

      But to get him to pick up his legos… aaaagh 4 hours of fighting him with comments like “if you would just do it… 10 minutes and you can go back to having fun… insteat of spending 4 hours fighting me” Hang in there! They are great kids…

      • I think you described beautifully your struggles with your child for which you may well want a lot of skilled help. However that does not mean the diagosis is valid or that drugs are the best treatment.

        There are people who succesfully offer help to people like you and your child without diagnosis or drugs. Not many, but they do exist.

        That in itself is sufficient in my mind to call into doubt the existance or use of the diagnosis

      • We had to be very crafty about such things as cleaning up. Mostly, I learned to make them into games. I’d ask how fast he could do it and put on a timer, or I’d race him to see who could get more in the box, or I’d bet him a quarter he couldn’t clean up in less than X minutes. We also did contracts and positive reinforcement (sticker charts, etc.) It was a lot of work, but it was worth it. Both my “ADHD” types are healthy adults with great work ethics, despite no official “treatment” by the authorities. But we had to avoid standard school classrooms, especially in elementary school, as they are quite toxic to any kid with this kind of temperament!

        — Steve

  14. I think Dr. Berezin’s post may have evoked a less negative response if he clearly acknowledged that problems with inattention, hyperactivity, and so can be very real, and can sometimes be helped by drugs like stimulants.

    Importantly, neither of these observations contradict his main point that the diagnosis of ADHD is not scientifically valid (i.e., “real”).

    For ADHD to be a valid diagnosis, evidence would have to exist that ADHD symptoms are caused by a disease that can be revealed with a biological test. Although ADHD has many biological correlates, science has yet to reveal a brain disease that causes it, and there does not exist a biological test that can accurately diagnose ADHD or reliably distinguish between ADHD and other behavioral problems. These are not controversial statements among scientists who study ADHD.

    Scientifically speaking, the notion that there exists a categorical biological disease called ADHD that people have is simply false. That diagnoses like ADHD are not valid is widely acknowledged by people like the director of the National Institute of Mental Health (http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml).

    ADHD is a label that describes but does not explain a set of thoughts/feelings/behaviors. The diagnostic criteria for this label were chosen based on committee consensus and have been widely derided as unscientific.

    To the pro-ADHD commenters, the fact that you, your child, or someone else you know has struggled with inattention and/or hyperactivity does not make ADHD a valid diagnosis. But it does mean that problems sometimes described as “ADHD symptoms” are real. I think people like Dr. Berezin who write about ADHD not being “real” risk needlessly invalidating and angering people by not making this important distinction more clear.

    • I agree that the “not real” framing is not helpful. It is certainly very “real” that there are kids that meet the “ADHD” criteria, and that these kids are difficult to manage (I know mine were!) The problem is that these behaviors, real as they are, don’t constitute a DISEASE as they have been purported to do. The reason I say that is because there are a ton of possible REASONS why a child might behave this way. Some of them probably are medical – low iron, sleep apnea, certain allergies, sensory integration difficulties, fetal alcohol syndrome, lack of sleep, side effects of medications, head injuries, and many more medical problems can manifest these symptoms. But there are also social causes: child abuse/neglect, especially early in life, lack of boundaries in the home environment, inappropriate expectations by parents and/or teachers (look at what is expected of Kindergarteners today vs. in the 60s!), reduction in recess and outdoor time, emotional immaturity, domestic abuse at home, all have been associated with these very same symptoms. AND there are some kids who just are like that, and it’s normal for them to be that way. Kids who are bright and very active get bored easily, and the average school classroom is, let’s face it, pretty dull. Some kids (I was one) are able to just white knuckle it and do what they are asked, no matter how repugnant or painful, but some are not able to, and these kids act out. Is the fault in the child’s brain chemistry, or the classroom that fails to challenge them?

      I ultimately agree with the author: kids are all different and need different approaches. We had no idea what we were doing with our oldest and made some serious mistakes that made his childhood harder on him and us. But as a result, we were prepared for our youngest and took a different approach, and he’s a much healthier and more functional young adult. Not that our oldest is dysfunctional – he’s got two jobs and works hard, never got into trouble with drugs or the law, is loved by his employers, etc. Has a little trouble with girlfriends, but otherwise he’s a totally normal and functioning grown up, despite no “treatment” for “ADHD”. There is nothing WRONG with him other than that he is a unique person who meets his needs in unique ways some times. The younger is just an amazing young man and no one would ever think he had a “mental disorder” in his life. He’s a super athlete, has lots of friends, does great in school, and is a highly responsible college freshman, no drugs or alcohol or dangerous activities or teen pregnancies or any of the horrible predictions for “untreated” ADHD. It’s because we learned that staying away from standard schools is important, and we learned that discipline looks very different for active, oppositional kids. I really do need to write a book on the subject…

      Anyway, I have great compassion for those raising such a child, because they’re a HELL of a lot of work and it’s not always so rewarding in the short run. But difficult is not diseased. It’s not that “ADHD” doesn’t exist as a behavior pattern, it’s that just because you kid fits that behavior pattern does not mean that s/he is “mentally ill” and needs “treatment.” Sometimes there is a medical problem. But sometimes, s/he just needs the time and space to grow up, with some extra discipline and skill-building along the way, and some freedom from the bizarre and unreasonable demands of today’s standard school classrooms.

      —- Steve

        • But it doesn’t say, “prevents the mind or body from working properly in certain settings where properly is arbitrarily defined by adults with their own agenda that may or may not be appropriate for the child’s age and development and temperament.” Context is critical in evaluating what is a “disease.” Culture most definitely comes into play.

          Try this one on: stimulants are known to improve athletic performance in the short term. What if athletic excellence instead of academic performance were the standard required for adult success in society? Would we be willing to say that non-athletic kids have ‘athletic deficiency disorder’ and consider stimulants a “treatment” for it? After all, it does create social and emotional distress, creating low self-esteem and self hatred in some – ask any non-athletic kid about gym class some time! So why not give stimulants if they help kids perform more on a par with their peers, so they can stay out of trouble and feel better about themselves?

          Think hard before you dismiss the analogy. It really amounts to the same thing. Certain kids don’t do well in a certain environment that we’ve decided they need to function in. They are diagnosed and given performance-enhancing drugs so they’ll be more successful. But these kids are almost always skilled and successful in other areas that aren’t valued, or are so academically talented that they aren’t really learning anything in the school environment. Why not change the expectations instead of trying to force these square pegs into round holes year after year?

          —- Steve

  15. Obviously, there is more than merely one reality that exists in the world. Although the question remains as to whether or not these divergent realities can co-exist peaceably and with mutual respect of personal boundaries. Personally, I think there’s room for more than one reality on the planet. It’s called ‘diversity.’

    • did it. Functioned better at work. was less frustrated. Was able to have a conversation and stay on topic. My multitasking superpower went all to Hell, but I was calmer, and more productive.

      Better living through chemicals. Maybe our current fake food supply is causing a chemical deficiency in our brains.

      But I can tell you I did not get all hyper and run around like I was on speed… The complete opposite. So who knows.

    • This argument makes no sense. If I take ADHD medicine it will not affect me the way it affects him because I do not have ADHD. If it didn’t affect you, maybe you were one of the people who WERE misdiagnosed. HE says his brain is calmer and he feels better when taking it. Right now he is off it and I am trying everything I can find to keep it that way but it may not be possible.

      • The drug will indeed impact you. As has been pointed out to you before but you were dismissive, if you were to adjust the dose to your weight you would indeed feel the same drug effect your child does. The chemical imbalance theory has been disproven for many years now. These drugs are NOT correcting any imbalance in your child they are actually creating a brain imbalance (brain damage) that he may never recover from. Let’s hope and pray you keep him off these brain disabling drugs and the brain has enough plasticity to recover from what was done.

      • I’d appreciate it if you’d stop saying that! I already showed you proof and there is almost universal agreement in the psychiatric world that ADHD drugs DO NOT have a different effect on “ADHD” kids or adults. They are general stimulants and have a generally stimulating effect on everybody. Rapoport concluded that the only reason we saw this effect as different with “ADHD” kids is because we wanted to see it and felt relieved that it occurred. Non-ADHD kid had EXACTLY the same range of reactions as those diagnosed with ADHD. End of story.

  16. I agree with the Author in that there is NO ADHD. We are what we are, but the real issue here is that our current educational system REQUIRES that our children sit still, and focus for hours at a time. I have two boys age 20 and 8, They both have been diagnosed with ADHD. The older one I resisted until he was 15… thinking he was “normal”. And he is normal. He got his ADHD temperment from ME. I am an adult with an ADHD temperment. At 15 we thought he had memory problems. After tests it was determined his memory worked fine, he just didn’t pay enough attention to certain things to remember them. We put him on stimulants. And my boy who struggled through school came home and said “mom, I just read a book, a whole book, I was never able to do that before”. My older child hated school, because he was always the one that was in trouble for being a distraction.

    You tell me we need to change the educational system. GOOD luck with that. It is too late for my older child and too late for my younger. At 4 years he was exhibiting the same personality traits of ADHD and I was happy to give him the medication…because I have seen the trauma and shame, and low self esteem my older son felt from the educational environment, and I was not going to have that happen to my younger one.

    I give my son ADHD medication, not because I think there is anything WRONG with him, but because I have to find a way for my son to be successful in the environment he is forced to be in by our educational system, that wants robots and clones. I don’t want my son to be a clone…. but there are not alternatives that are viable for my son where I live… we are stuck with what we have. This child has been tested as gifted and is in the gifted program in his school…which is 3 hours every friday.

    The rest of time he has to conform to the rest of the school’s precribed society norms. I didn’t medicate the first child, and I feel pretty guilty about it, as he has struggled and is still not performing at his potential due to years of self doubt because he didn’t fit the US Educational Profile.

    My younger son does not take his meds on the weekends or during the summer. I will give my son the tools he needs to get through his education and he will find a career that is stimulating and engaging that will allow him to use his amazing energy and creativity to its fullest.

    If I do not give him the tool of ADHD medication he has a real possibility of heading down the same path of frustration and hopelessnes that my older son is traveling.

    I do not have the power to change the cattle mentality of our education system. Who can? It needs to happen.

    I do not force the medication on my son. He is a very smart little boy, and he understands that the medicine helps him cope with his environment…. and if he didn’t want to take it anymore I would respect that choice.

    • Great post – you have really captured the dilemma parents find themselves in. We avoided standard public schools like the plague for exactly that reason – we KNEW our boys would not be successful in that environment, because they are NOT robots or clones and we didn’t want them to be. I’m sorry you and your son have had to go through this. I wish I could have your son enrolled in our charter school – it was a great place for Kevin!

      —- Steve

      • Oh dear, your son, Lovemylittleboy, can sit still for hours, yet he gets a medical diagnosis for not paying attention!

        It sounds like he can pay attention to things he is interested in.

        I’m much the same but instead of saying I am diseased and need drugs I think of myself as independantly minded and need coffee….and cake….. and biscuits (or cookies as you Americans say)

        • Actually I have self-diagnosed myself with adult ADHD when I first went to work. I have real problems to read professional literature and protocols and I can’t concentrate on writing my labbook but I can spend hours reading fantasy and sci-fi at home. What is that – “adult onset ADHD”?

          This is ridiculous. People are different and not everyone is happy with being a good robot.

  17. WOW…this has generated some response!

    Dr Berezin
    I happened to be reading the section of your book last night that relates significantly to the basic types and am delighted to see you address it directly to ADHD on this site.

    I have absolutely no doubt that as a child I would have been diagnosed with very severe ADHD. I am just SO glad that diagnosis wasn’t around then because I hate to think what would have happened to me had it been.

    While my parents undoubtedly loved me and did the best they could, they couldn’t even begin to entertain the idea that they and the family environment might have something to do with my behaviour. I struggled through childhood with the help of the odd kind teacher or counsellor and the occasional parent of friends who saw through my antics, supported me and showed appreciation for the sort of lively, inquisitive, thoughtful, sensitive, and thoroughly challenging child I was. Being a girl, this sort of behaviour was even LESS acceptable than it was for a boy.

    It was lonely, but I gradually learned how to manage my self and by mid-teens was both a high level sportsperson and excelling academically.

    In my adult years, marriage, parenting, career etc have come and gone as have the inevitable crises associated with them. These crises have given me cause to examine my self, my ideas and beliefs, my childhood, family etc, both in and out of therapy.

    The only time I have crashed through into full blown “mental illness” has been as a result of prescribed and correctly taken psychiatric medications.

    Perhaps because of my particular “self” and physiology I am more sensitive to drugs than are others, but had they been forced on me as a child I hate to think what might have happened.

    As a successful and high functioning adult who had never used any sort of psychoactive drug (other than the odd glass of wine), the correctly taken “psychiatric medication” sent me crashing right through the pits of hell. However, by the time that happened at age 50, I had developed enough resilience (or just plain guts or intrinsic selfhood) to navigate my way out the other side. I doubt I could have done that in the fog and fire the drugs had brought down on me. I needed full access to the particular qualities of my intrinsic self to survive.

    All children are given certain intrinsic qualities to help them live their lives with integrity and to develop into who they may be. They may be difficult, they may be messy and inconvenient but basically, those qualities are what THAT PARTICULAR CHILD NEEDS to survive and thrive.

    I know that as a now-aging adult I still need lots of physical activity, lots of intellectual challenge and diversity, a degree of people contact that I can modulate and control, access to artistic and creative pursuits etc to stay balanced. I suspect I always will. That is the annoying person who is me. I still struggle at times, and I manage those struggles because I haven’t had the intrinsic qualities I need to do that drugged out of me.

    I personally don’t believe in god(s), but I think those who do would call them “God-given” qualities. They are the child’s God-given birthright and to steal them away with drugs is just plain cruel and unethical (is “evil” the word?).

    No need to feel attacked by being told that your parenting isn’t perfect. And there is no need to attack the bringer of such earth shattering news. No matter what you say, the parenting you received wasn’t perfect and the parenting you give won’t be either .

    Recognize that inconvenient and painful truth and take the time and make the effort to learn how to love your child(ren) a little differently.

  18. “In the United States, at least 9 percent of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications. In France, the percentage of kids diagnosed and medicated for ADHD is less than .5 percent. How has the epidemic of ADHD—firmly established in the U.S.—almost completely passed over children in France?”

    ”French child psychiatrists…view ADHD as a medical condition that has psycho-social and situational causes. Instead of treating children’s focusing and behavioral problems with drugs, French doctors prefer to look for the underlying issue that is causing the child distress—not in the child’s brain but in the child’s social context. They then choose to treat the underlying social context problem with psychotherapy or family counseling. This is a very different way of seeing things from the American tendency to attribute all symptoms to a biological dysfunction such as a chemical imbalance in the child’s brain.”

    https://www.psychologytoday.com/blog/suffer-the-children/201203/why-french-kids-dont-have-adhd

    • I’m glad the psychiatric practitioners in other countries are not as delusional as those in the US, who seemingly believe that all problems in living are “life long incurable, genetic mental illnesses” caused by “chemical imbalances” in people’s brains, especially since the “chemical imbalance” theories were disproven, if I recall correctly, about twenty years ago.

      I do so hope the US medical community, and the pharmaceutical advertisers, will some day stop false advertising and promoting belief in the chemical imbalance theory of mental illnesses, especially since false advertising is technically illegal in the USA.

      • They’re only interested in profit, not health.

        What is most baffling to me is how a group of clinicians in one country claims great success in how they address these issues, and we are still fighting about it, while the rate of diagnosis, suffering, and family turmoil continues to climb here in the USA. This article was published 3 years ago. Where is the communication??

        There is another agenda here, having nothing to do with health & well-being. Some say it’s greed for money, while some say it’s because of power intoxication, and others say it’s sheer ignorance on the part of the mental health field, which does not nearly know what other healers know about the heart and mind.

        I’m sure it’s a few things, but overall, I’m saying that the bottom line here is fear of change: if we were to resolve these issues, a lot of people would need to find another way to earn a living.

        • Alex,

          I, and many others, had to find another way to earn a living after the banking industry’s housing bubble destroyed the design and construction industries. So I don’t actually think that is a good excuse for doctors continuing to hypocritically harm people.

          I think the problem in the US definitely has to due with greed, power intoxication (or should that be called “delusions of grandeur”?), and likely denial. I’m certain it’s very difficult to awaken to the reality that almost everything you were taught in school and read in medical journals was all just based upon psycho / pharmaceutical fraud. I know it took me much longer than one would think to truly come to the grips with the betrayal I dealt with by the medical community and my ex-religion. How embarrassing I used to believe doctors and pastors were respectable and trust worthy people. I had no idea that pastors and doctors have historically, and are still today, in the business of covering up child abuse.

          As a believer, you may like this piece of true trivia from my story. After my child’s preschool learned I’d been handed over the medical evidence of the abuse of my child, they ended up unexpectedly closing their doors forever, on 6.6.06.

    • Here’ another article stating the French rate is actually 3.5%-5.6%. Who knows. But I do know they have a much narrower description so fewer kids can be identified and because of their medical system the average wait is 8 MONTHS to see a doctor regarding the problems. Curious about the long term results.

      Prevalence of attention deficit hyperactivity disorder and associated features among children in France.

      Lecendreux M1, Konofal E, Faraone SV.

      Author information

      Found this article in Psychology Today. Estimated ADHD rate in France

      BACKGROUND:

      Earlier studies point to the prevalence of attention deficit hyperactivity disorder (ADHD) to be similar around the world. There is, however, a wide variety in estimates. The prevalence of ADHD in youth has never been examined in France.

      METHOD:

      Starting with 18 million telephone numbers, 7,912 numbers are randomly selected. Among the 4,186 eligible families, 1,012 (24.2%) are successfully recruited. A telephone interview is administered to all families about a child in the 6 to 12 age range. It covered family living situation, school performance, symptoms of ADHD, conduct disorder (CD), and oppositional-defiant disorder (ODD), and other features of ADHD.

      RESULTS:

      The prevalence of ADHD in France is between 3.5% and 5.6%. The population prevalence of treatment for ADHD is 3.5%. ADHD youth are more likely to be men than women, and, compared to non-ADHD children, ADHD children are more likely to have CD and ODD. Having ADHD is associated with a family history of the disorder. The ADHD youth are more likely to have had learning difficulties, to have repeated a grade, and to be functioning academically below grade level.
      The epidemiology of ADHD in French children is similar to the epidemiology of ADHD in other countries. The disorder occurs in between 3.5% to 5.6% of youth and is more common among boys than among girls.

  19. Wow.
    We certainly had an opportunity to hear from both sides on this debate.

    I’ve made my position known about psychiatric drugs, particularly when it comes to kids.
    But I think it’s helpful to hear from parents who are doing the best they can with what they’ve got.

    Once again, I strongly feel it’s a stretch to say that *nothing* is going on with the brain in *all* of these circumstances. I don’t believe in a “chemical cure,” but I think the jury is still out on whether there may be some “imbalances” at play – after all, the body (including the brain) and mind are inter-connected.

    Some of these kids may benefit from better nutrition; others from exercise; changes in family dynamic; more structure and discipline; others, creative outlets; neurofeedback, a multitude of options.

    I don’t believe in “ADHD” per say, but I do know that “cerebral allergies” – sensitivities to processed foods, nutritional deficiencies, and other very real medical conditions can sometimes be the culprit(s). The other thing that gets under my skin is the disproportionate number of boys who get this diagnosis (not girls). At the risk of being tarred and feathered for being politically incorrect (it’s not the first time for me), I think the public schools are geared toward educating girls.

    Boys are not always so good at being little girls. They’re more physical as a group, and often don’t do well all day in a classroom environment; especially, when many schools have very little physical education (often alternated with art and music, every third day, if they’re lucky). This will really get me in trouble (oh well, here goes): We are feminizing a generation of boys. Boys need to be boys.

    My two (politically incorrect) cents.

    Duane

      • I have an issue with calling this “feminization”. It implies that the feminine is all about false drama, banality and gossiping and is highly insulting to all women.

        I think our society could do with a bit more “feminine” values like taking care for children and elderly, empathy, showing and respecting human emotionality etc.

        • B – I don’t know what you’re imagining I said to Duane. My understanding is simply grounded in study of Ann Douglas’s book. That suggests to me that you brought the issue with you and are misconceiving of your personal issue’s relation to what I said from memory of her thesis. How did all these things get wrong about conventionally understood behaviors typical for women and girls? I don’t know what you mean. Duane said that schools might work best for girls here at present, seemed so in a way, maybe true. He perceives what he does and isn’t arguing in hard and fast terms like some demagogue. My take was that he meant to remain open to new information so the very notion of saying this f-word is nothing for me to have an issue with, period. Does your issue start there with the first sighting of “feminization” or are you bothered only with my rejoinder independently of it’s focus on Duane’s experience and apparently long term considerations. I perceived openness and care on his part and am speaking to that by recalling the scholarly work linked above.

        • B – Please allow me to offer this final word of resolution in the spirit of communicating with a positive attitude, and also since it got off-topic and is doubly sour to leave it dangling like a conflict of negation. As far as the idea of feminization that was coming from my reading, the reception of the author’s work over the years has changed dramatically for the better. My first encounter suggested to me that she had the right idea, and she included tons of primary source material. She knew that we were patriarchal, and that different kinds of feminization are desirable and that many kinds happen. What she hated about modernity in America is a lot of what you hate four decades down the road. You can have bold feminization, reactionary feminization, bewildered feminization, and the unfair feminization of men. You want to know how to have equality before the law and equal opporutnity to pursues happiness work out: you have to study how things happened. Talk to you later–

  20. I also disagree with the idea that there is no such thing as ADHD. I was labeled “hyper” as a child and drove my mother crazy as she reports that I rarely slept more than 4 hours a night, was constantly climbing things and taking risks such as climbing up onto the roof when I was three and dancing around. My mother was told that girls do not “get” ADHD and she was told to limit my sugar and red food coloring. Ha! Of course, the idea that sugar or food dyes make children more “hyper” has long been disbunked but I grew up deprived of Kool-Aid and popsicles and it did nothing to help. I also got straight A’s in school and was labeled gifted. However, once in high school, things began to get far more difficult for me as I had not developed any study skills (bs-ing their way through things is part of the magic of ADHD-we are great scanners and think best when under pressure). I had a horrible time sitting still and took to coming up with my own coping mechanisms that I had no idea were abnormal-I thought everyone had to chew an entire 24 pack of gum to sit still in algebra! I had to doodle in order to focus, or tap my fingers, shake my leg, sing songs in my head, and constantly sharpen pencils, make trips to the restroom and reorganize my bookbag to keep from literally crawling out of my skin trying to sit still. College was the same. Fast forward to my late thirties; I had a challenging job as a social worker, three children, a home, etc to manage…it all began to crumble as I could not stay organized or remain focused, I talked way too fast for most people and could never find anything I was looking for. My supervisor suggested I get evaluated. So, at 37, I was evaluated and diagnosed with ADHD and prescribed medicine. So many people on here have said that unless you’ve taken the drug, don’t give it to your children so here it is…the first time I took my Vyvanse, I actually called my mother to ask if I was talking really, really slow. She thought I was crazy but for the first time, I experienced what I think most people have as normal speed thoughts and processes. The whole world slowed down and I was able to listen to one song for the entire duration and not change the station 15 times, I could actually “listen” to what people were saying to me instead of pretending to listen while my brain was doing it’s “bullet train of thought on steroids” thing. I could remain calm in traffic instead of getting aggravated. What my doctor told me was that the medication doesn’t fix things but it slows your thoughts down enough for you to learn to be organized, learn social skills, learn life strategies that will carry over when you are not medicated and in my experience, this is very true. I still take my medication for work, but on the weekends I don’t (I like to eat and it does suppress my appetite some and dry my mouth out badly), but I can still follow routines and structure I put into place while medicated to ease frustration and stress. It’s real and medication has changed my life dramatically. And I was never in trouble in school, got good grades and was considered bright-but I couldn’t sit still to save myself and couldn’t organize myself out of a paper bag!

    • Taking drugs as an adult because they make you feel better (as you’ve described yourself you didn’t need them to be successful and long-term studies show the same thing) is a different thing than giving them to kids. I am for legalization of drugs in general and if someone wants to smoke weed or take amphetamines because of how they make him/her feel or think – it’s a personal choice. But the kids have no say in that and they are also developing. There are many drugs which do little to no damage to adults (amphetamines are not even one of them – they have considerable side effects) while being very dangerous to developing bodies.

  21. Is ADHD over diagnosed? Probably. My own sister told me a few months ago that she thinks her child is ADHD because he doesn’t mind her. He doesn’t mind her because he has no respect for her. He doesn’t have any symptoms of having ADHD. There are no magic pills for bad kids (or bad parenting). I have seen instances of overmedicated children whose parents simply did not want to deal with them – admittedly! I agree that it is an issue in some homes. But not all homes! Bottom line. There is no magic pill. My kid was diagnosed as ADHD. He takes medication. He also goes to therapy and I go to therapy to help him. We also work several techniques at school and at home. I’m constantly reading books and educating myself. I have never once let my kid say “It’s not my fault – I didn’t take my medicine.” Even though it’s the biggest tool in the toolbox, I never want him to lose power over his life.

    To make a blanket statement that ADHD doesn’t exist only incites frustration in parents who are doing everything they can for their kids.

  22. To all the commentators who were diagnosed with ADHD or have kids diagnosed with it, I am curious about something? Was anyone ever tested for sleep disorders, particularly sleep apnea, since apparently folks who turn out to have it were misdiagnosed with ADHD? One sleep doctor estimates the percentage is 35% although I admit I don’t know where he got those figures from.

    Not asking to be judgmental by the way but just wondering. So I thank you in advance for your responses.

    By the way as an FYI, I was diagnosed with ADHD and later turned out to have sleep apnea. I don’t feel the misdiagnosis of ADHD prevented me from correctly getting diagnosed with sleep apnea as there were many other issues going on. But I just wanted to let you all know why I was curious about your experiences.

  23. This is what works in addition to loving parenting and causes no harm regardless of what nonsense the AMA or Psychiatry say about anything or their so called “scientific ” inquires come up with. There’s hardly anything beyond their guild protecting activities above all else , certainly that ranks for them far above your children’s well being . The exceptions are rare and beware they all have a good song and dance . What works see below .
    http://www.generationrescue.org
    Traditional Naturopathy
    Homeopathy
    Study also Russell Blaylock MD retired ,google RussellBlaylockMD and ADHD
    Energy Healing for example wwwYuenMethod.com

  24. Dr. Berezin – Way to draw fire. Most of us know here know that David Healy just stops and calls this kind of support for the ADHD label and drugging the effects of parents getting brainwashed. Old-fashioned shock doctor that he is, he’s still good for making that point.

    I understand that you know about the conception of disease and psychopathology and much of the subtlety of talking about the differences of real and existent and constructed and combinations of these descriptive predicates. Most people don’t konw what it means to “construct” and just assume the picture of some thing as what makes for a disease, and I know that you realize that. Only a few would understand that bonafide medical conditions are also not immune to being re-constructed in different terms and being declared inexistent. But it’s so different with psychological problems with no relevant anntomical abnormalities present to explain functional differences, and all sorts of psychsocial factors in play that illuminate all the problems immediately in terms of what is actually known already about how we react to and suffer from various kinds of stress. If you get people up in arms like this about their own mis-reading of what “exists”, it’s a commendable first step here, no doubt about it. If people recognized what sort of elitism it was that is represented in the reductionist fairy tales they re-tell for free, they would cringe. I agree that Steve should start his book, and take a page out of yours for motivation.

  25. An amazing and intense discussion going on here.

    The “conditions” being treated as ADHD seem to primarily involve the inability or outright refusal of children and others to accomodate the dehumanizing demands (e.g., sitting still, shutting up and “learning”) put on them by a world culture in the grip of capitalism, in which human values have been replaced by dollar values, and in which we are all expected to worship the corporate bottom line.

    Speed makes everything more interesting and bearable, including your lame-ass teacher. I’ve aften questioned why, along with “learning disabilities,” a category of “teaching disabilities” doesn’t exist, with teachers being given ritalin or the like to make them more tolerable.

    • Good idea Oldhead . It seems as though a remake of the movie with some changes based on the book “Lord of the Flies” by William Golding could be very instructive. Imagine a movie about a group of psychiatrists, therapists, social workers, big pharma ceo’s and teachers that advocate drugging children stranded on an island with no cell phones having to fend for themselves , having limited supplies but finding a big barrel of assorted neuroleptics and amphetamines among their provisions. Fred

  26. Dear Robert,
    To me your point about ADHD being invalid/unreliable, and thus nonexistent, is quite correct.

    However, I think the way you make your point is not totally clear and perhaps a little brusque, and that may be why it got such negative responses from people who can’t handle it.

    In my opinion, you might be helped to explain that while the symptoms that get unrealistically lumped into the illusory ADHD diagnosis do exist, in innumerable varieties and degrees – that the organizing “illness” of ADHD is a fabrication based on the false notion that these symptoms cluster together in some reliable way, i.e. occur together at above a chance level of frequency as a syndrome.

    If you could explicate that – and if I am correct in understanding what you mean – then I think that people would understand better that while their child’s difficult experiences in concentrating or controlling themsevles or whatever are real, there isn’t necessarily any reliable or valid illness category behind their subjective unique problems.

    I’m speaking here from experience in fighting the same battle, trying to argue that Borderline Personality Disorder, my area of interest, is not a real valid “disorder” but instead an illusory clustering of symptoms that vary endlessly in degree and kind. As you know people like to think in categories even if they are phantom ones (this makes me think of Kahnemann/Tversky’s heuristics and biases theory), because it makes them feel safer and if they “know” what is going on, even if they really have no idea. It’s important to remember that and to not too brutally or harshly take people’s illusions away too quickly, if we want to reach them and change their thinking.

    I sometimes use the metaphor that a constellation of stars is not real, it is just an imposition or order or a pattern onto a group of stars that does not exist in nature. A similar but subtly different type of thinking could be applied to personality disorders or ADHD.

    • “As you know people like to think in categories even if they are phantom ones (this makes me think of Kahnemann/Tversky’s heuristics and biases theory), because it makes them feel safer and if they “know” what is going on, even if they really have no idea.”

      In the old days people believed in demons, now it’s ADHD.

    • transformation – I can’t tell if you are engaged with your topic here. The point of explaining straightforwardly or roundabout that mental disorders don’t exist is that their status as medical problems is moot. Since BPD, ADHD, whatever are not discrete entities they can’t get identified and treated in a person. There just is the whole person who you can bet has tried or hopes to change, and you “help” them. But they do all the work, not you.

  27. As an assistant psychologist in the UK working within a specialist service to assess, diagnose and treat Autism and ADHD, I find Dr Berezin’s comments regarding ADHD to be wholly offensive to both myself as a clinician and the client groups I help.

    I have helped to assess enough adhd clients to know that there is a common thread amongst all of their difficulties – Poor short term memory, poor planning and organisation, difficulties sustaining attention and concentration and impulsivity. ALL of the clients we assess have the difficulties listed above to a degree that has seriously impacted upon their ability to hold employment, sustain and maintain relationships etc – I am forgetful and get bored sometimes yes, but not to the detriment of losing my marriage/relationship or being fired frequently because I cannot sustain my attention long enough to complete tasks or frequently forget to pick up my children from school!

    I help to facilitate psycho-educational (CBT based, as this is where the evidence lies currently e.g. see Dr Ramsey/Dr Susan Young) courses for newly diagnosed adults with ADHD to help with symptom management and guess what, IT WORKS MORE RELIABLY than medication as it helps clients make a permanent change in the way they lead their lives which in turn reduces the overall impact of their adhd symptoms. We follow clients up months after a course to see how they are progressing using clinical interviews and measures such as WSAS to get a ‘snap shot’ of life after the course.
    If there was not some kind of difference in the neuro-development of these adults from childhood why would specific strategies based on the work of Ned Hallowell, Mary Solanto, Stephanie Sarkis and Russell Barkley all help to improve the lives of the clients I see? Surely I am wasting my time if Dr Berezin’s opinion is to be believed!

    It is precisely views like this that make a lot of our client group reject any support as they end up believing ‘it’s all in my head’ – how invalidating do you want to be towards another persons experience!?

    Dr Berezin states somewhere in his article that he has come to believe in the diagnosis of autism… why? It is just as fraught with diagnostic inconsistencies and can look a lot like personality disorders such as schizoid/schizotypal or psychosis. As an aside, as a service we are increasingly seeing more adults who would have been traditionally labelled as schizoid or schizotypal for autism assessments due to their lack of interest in others and as sensory differences in autism are so poorly recognised and understood by other professionals that this often gets labelled as ‘psychosis’.
    The way we describe these conditions to clients who come to our service is under the ‘umbrella’ term of neuro-developmental conditions – differences in wiring in which there have been numerous studies to illustrate – I would invite you to look at Dr Russell Barkley’s work on neurological differences in adhd to balance some of your skepticism.

    • In your position as a mental health cop, of course, you are a believer. Otherwise, you would be in a different profession.

      Human is human. To paraphrase Dorothy from the Wizard of Oz, “I don’t think we’re in a hunter gatherer society anymore, Toto.” Does this make people who are not sick “sick”? Even though you’re the mental health cop, you don’t have to tell me, I know better, and I am not a believer.

      You hardly need to feel you are wasting your time no matter what enterprise you are engaged in. “Different strokes for different folks” as they used to put it. I would suggest though that much reliable research is needed before we come to any conclusions, and before your belief may be said to be entirely dis-proven.

      Great thing to see that you are helping people cut the speed with CBT. Drugs disable the brain, for starters, and speed is no exception. Determining whether you are actually seeing “illness” symptoms or drug effects, in many cases, well, I don’t imagine you would even want to go there. It’s not where you’re investment lies. (Or even, whether the improvements seen in CBT were due to taking the offender off drugs.)

      As for autism, of course, we’ve got another diagnosis here, and quite possibly another etiology. I doubt anyone would find compelling evidence for neurological differences in ADHD without changing brain structure chemically first, that is, drugging the offender. Perhaps it is a factor that Dr. Russell Barkley has neglected to research. In much research today, because it is directed at selling pharmaceuticals, this is the case.

    • I think that is very exciting that you are finding a psycho-educational therapy approach so effecftive for a group of people who may otherwise have been treated with very powerful drugs. I look forward to having a look at your resources.

    • I agree 100% that people with concentration or attentional difficulties deserve help, and I also believe from direct experience with my own kids that attentional skills can be learned. I applaud you for applying CBT principles systematically to this population and wish your enthusiasm would spread. In addition to working better than medication, these techniques impact the long-term welfare of kids and adults in a positive way long after treatment has discontinued, a claim that stimulants are still unable to make after 50 years of research.

      That being said, I don’t know why you need to take personal offense at this article. It posits, very simply stated, that some kids are born with different personalities and temperaments, and that having a different temperament doesn’t mean a child is ill or disordered mentally. What’s offensive about that? Sure, there will be evidence that on the average, “ADHD”-diagnosed kids’ brains may work differently. However, the evidence to date suggests that far from being a unified diagnosis with a common cause, “ADHD” brains are all over the place in terms of what is different. The bottom line is, some kids find paying attention more difficult than others, and we really don’t know the reason, or that there is one reason causing all of these cases. In fact, it’s a very fair assumption that they are NOT all caused by the same thing, as we know that issues as divergent as sleep apnea, anemia, domestic abuse, poor attachment, and fetal alcohol exposure can all cause “ADHD” symptoms.

      I guess my bigger question for you is this: if we can teach kids and adults to improve their attentional capacity in the large majority of cases, and if we can mitigate what appears to be somewhat delayed development in these areas by admitting them to school later (Canadian study shows a 30% reduction in diagnosis for kids admitted a year later to Kindergarten), or by putting them in open classrooms, why are we giving drugs to so many of these kids instead of doing things that actually have a positive long-term impact? I actually don’t give a crap if you call it a disease or not – the point is, individual kids need different approaches, and using the right approach “heals” these kids’ “mental illnesses” and they are able to be productive adults. Whereas there is no consistent evidence that long-term stimulant use does anything to improve those long-term outcomes that we care about.

      I suggest putting your personal feelings aside and asking yourself instead why so many people are so strenuously objecting to “treatment as usual” for “ADHD.” You yourself seem to acknowledge that the current treatment is not what is actually needed. What’s wrong with simply viewing these kids as having different needs instead of pathologizing them? What’s wrong with teaching them the skills they need in the context of an educational environment instead of making it a “mental health disorder?”

      The fact that someone’s brain is different is not de facto proof of disease. Men are much more likely to commit rape or other violent crimes, to beat up their partners or their children, to use drugs, to be arrested and serve time in jail, and so forth. They clearly have a “chemical imbalance” in having a huge overproduction of testosterone in comparison to women, and the genetic linking to this behavior is simple enough for a 9th grade biology student to see on a slide. Their brain scans are different from women’s brain scans, and even the size of certain parts of the brain are different. Does that make mean diseased, just because their brains are male brains and that these brains are associated with higher violence and crime? Or did men develop differently because our species needed men to be more aggressive and impulsive and more willing to attack prey or defend their homes from other species and other humans?

      Species survival depends on genetic diversity. There is no reason to assume that those who have an extra hard time coping with dull and repetitive tasks assigned by others are ill in any way. Nor does NOT finding them ill mean that they aren’t entitled to help in developing the skills that they need to survive in today’s economy. No insult is intended – it is just a different way to look at the behavior, and in my view, it’s a way that leads to much better solutions, including your skill-building approach, whose effectiveness (in my experience) is almost always passionately denied by most who are invested both emotionally and financially in the currently accepted treatment paradigm.

      — Steve

    • You’re aiming to do something the right way, and the way itself agrees with Dr. Berezin’s purposes. The difference is one of explanation, and the explanatory approach that’s less familiar to you might work out to be just what the doctor ordered so that you can keep your mind open to what counts in deciding if every patient you get by referral is evaluated perfectly. You wouldn’t want such an awesome success rate for you and the attending physicians just ruined with a smudge of false positive, would you?

    • And yet you yourself seem confused. You group Ned Hallowell and Stephanie Sarkis (both self-proclaimed experts, with little substance to commend them) with esteemed researchers Russell Barkley and Mary Solanto.

      You also are mistaken about Dr. J. Russell Ramsay’s research. His and Dr. Tony Rostain’s CBT model for ADHD assumes a foundation of medication for ADHD adults with anything more than mild symptoms.