The Inherent Unreliability of the ADHD Label

Philip Hickey, PhD
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I imagine that everybody on this side of the issue knows by now that the eminent psychiatrist Jeffrey Lieberman, MD, Chief Psychiatrist at Columbia, and past President of the APA, called Robert Whitaker “a menace to society.”

This outburst of petulance – the latest in a string of similar deprecations – occurred on April 26, 2015 during an interview with Michael Enright on CBC (Canadian Broadcasting Corporation) radio’s “The Sunday Edition.”  The grounds for Dr. Lieberman’s vituperation were that Robert had dared to challenge some of psychiatry’s most sacred tenets!

In the subsequent discussion, it was noteworthy that nothing emerged that would justify characterizing Robert as a menace to society, and the general consensus seemed to be that the eminent doctor was just having one of his little rants.

. . .

But in all the furor, it was largely ignored that, in the same interview, Dr. Lieberman had said something else, which in my view warrants additional discussion.  He was conceding the general point that sometimes people are given prescriptions for psychiatric drugs needlessly.  This is at about minute 25:35 on the recording.  Michael Enright asks:  “you could be over narcotizing?”, and Dr. Lieberman replies:

“Absolutely.  I had an experience with my own son.  I have two sons.  My older son was going to nursery school, and they said he’s not paying attention and were concerned.  ‘You should have him tested.’  We had him tested.  The neuropsychologist said, ‘Well there’s some kind of, you know, information processing problems, you should see a pediatric psychiatrist.’  I said, “Well, I am a psychiatrist, but I’ll take him to see a pediatric psychiatrist.’  We took him to see a pediatric psychiatrist, spent twenty minutes with him, and he started, you know, writing a prescription for Ritalin.  I said, ‘Why?’ and he said ‘Well, he’s got ADHD.’   I said, ‘I don’t think so.’

So, long story short, he ended up graduating from University of Pennsylvania, law school at Columbia, he’s in a top law firm.  So, yes, it happens, and part of that is social pressure.”

I could not find a transcript of the interview, so I made the above transcript myself, and I have checked it several times for accuracy.  In reading the passage, five points come to mind.

Firstly, the “diagnosis” was made in twenty minutes.  This is not actually surprising.  In my experience it is pretty much the norm.  But for years, Dr. Lieberman has been extolling the professionalism and thoroughness of psychiatry, but nevertheless, dropped this admission into the interview without comment or criticism.

Secondly, Dr. Lieberman, as an eminent psychiatrist, had no difficulty resisting the pressure to accept the prescription.  For many families, this is not the case.  Indeed, during my career, I worked with a number of parents who had been threatened with child custody suits if they didn’t get their child examined by a psychiatrist and “on Ritalin.”

Similar pressures exist with children in foster care.  If the child displays any kind of problem behavior, including distractibility/over-activity, a psychiatric consultation is mandated, a prescription is written, and there is no one to speak up for the child, or to challenge what is being done.

Thirdly, I think it’s noteworthy that Dr. Lieberman rejected the prescription.  If ADHD is an illness, and a licensed pediatric psychiatrist diagnosed this illness, and the same licensed pediatric psychiatrist wrote a prescription, shouldn’t Dr. Lieberman have played it safe and given his child the pills?  After all, they’re safe and efficacious!  Surely it would have been wiser to play safe rather than risk depriving the child of needed medication.  Or could it be that Dr. Lieberman’s faith in the efficacy and safety of these products stopped short of actually giving them to his own child?

Is Dr. Lieberman aware that many parents who refuse psychiatric “medication” in this way are reported to Social Services for neglecting the child’s medical needs?

Fourthly, Dr. Lieberman’s son was “diagnosed with ADHD” by a pediatric psychiatrist while in pre-school, but didn’t take the pills.  Nevertheless, he graduated from Columbia law school and is now an attorney at a “top law firm.”  That’s food for thought.

Fifthly, and most importantly, Dr. Lieberman’s disagreement with the pediatric psychiatrist highlights one of the major weaknesses in the psychiatric system: its intrinsic unreliability and subjectivity.

Let’s take a look at what Dr. Lieberman and the other psychiatrist were disputing.  Obviously I don’t know when this interaction occurred, but if we put it around 1990, then DSM-III-R  would have been in force.  Here are the criteria for ADHD from that manual (p 52):

  1. A disturbance of at least six months during which at least eight of the following are present:
    • Often fidgets with hands or feet or squirms in seat (in adolescents, may be limited to subjective feelings of restlessness)
    • Has difficulty remaining seated when required to do so
    • Is easily distracted by extraneous stimuli
    • Has difficulty awaiting turn in games or group situations
    • Often blurts out answers to questions before they have been completed
    • Has difficulty following through on instructions from others (not due to oppositional behavior or failure of comprehension), e.g., fails to finish chores
    • Has difficulty sustaining attention in tasks or play activities
    • Often shifts from one uncompleted activity to another
    • Has difficulty playing quietly
    • Often talks excessively
    • Often interrupts or intrudes on others, e.g., butts into other children’s games
    • Often does not seem to listen to what is being said to him or her
    • Often loses things necessary for tasks or activities at school or at home (e.g., toys, pencils, books, assignments)
    • Often engages in physically dangerous activities without considering possible consequences (not for the purpose of thrill-seeking), e.g., runs into street without looking 

Note:  The above items are listed in descending order of discriminating power based on data from a national field trial of the DSM-III-R criteria for Disruptive Behavior Disorders

   2. Onset before the age of seven.

3. Does not meet the criteria for a Pervasive Developmental Disorder.

Note:  Consider a criterion met only if the behavior is considerably more frequent than that of most people of the same mental age.

My Random House Webster’s College Dictionary gives the following meaning for the word criterion:  “a standard of judgment or criticism; a rule or principle for evaluating or testing something.”

Even a cursory glance at the APA’s criteria shows that they are entirely unsatisfactory for this purpose.

Take the first item from the list:  “often fidgets with hands or feet or squirms in seat (in adolescents, may be limited to subjective feelings of restlessness)”  There are several factors that prevent this item from serving as a criterion in the above sense of the term.

Firstly, children’s behavior (and indeed adults’ behavior) varies from time to time and from place to place.  A child might, for instance, be fidgeting in one classroom and not in another; or only in the period immediately preceding lunch.  Where and when should the rating be made?

Secondly, the word “often”, which occurs also in seven other items, is not operationally defined and will inevitably mean different things to different people.  An “old-fashioned” person who believes that children should sit still and pay attention, might consider one or two squirmings excessive; while a more liberal teacher might set the bar a good deal  higher.

And how in the world can anyone reliably assess an adolescent’s “subjective feelings of restlessness”?

Similar observations can be made about all the items.

The point here is:  what were Dr. Lieberman and the pediatric psychiatrist disagreeing about, and how could such a disagreement be resolved?  The other psychiatrist might have said:  “your son is easily distracted by extraneous stimuli”;  or:  “your son often talks excessively”.  Dr. Lieberman could reply:  “no he isn’t”; “no he doesn’t”.  And that’s it.  There is no way to objectively resolve such a dispute.  There is no fact or observation to which one or other of the parties could point, that would clinch the matter. And that’s a fundamental problem, because ultimately all psychiatric “diagnosis” is tainted by this kind of subjectivity.  In the final analysis, a person “has a mental illness” because a psychiatrist says so!

In the situation described by Dr. Lieberman, apparently his view prevailed, and from his statements in the radio broadcast, it is clear that he believes his view was correct.  But this is a meaningless position, because the only criteria that exist to resolve the disagreement are inherently unusable for this purpose.  Nor is DSM-5 any better.  This latest edition of the manual contains 13 of DSM-III-R’s 14 “criteria” (with some minor verbal changes), and some additional items which are no less vague.

What Dr. Lieberman apparently took from his interaction with the pediatric psychiatrist  is that sometimes pills are over-used.  But the message he should have taken was that what psychiatrists call ADHD is nothing more than a loose collection of vaguely-defined behaviors, whose purpose is to foster psychiatry’s self-serving hoax that these behaviors constitute an illness, which requires it to be “treated” with stimulant drugs.

90 COMMENTS

  1. Every time I read the DSM criteria for ADHD, I cannot believe people take it seriously. One has to remind onself that most of the American public don’t know how to think critically about scientific concepts like reliability, validity, or even basic causality. The cynical side of me is tempted to say that the majority of parents who let their children be drugged for “ADHD” are from the lower half of the IQ continuum, i.e. are not intelligent (or not very educated). That might be true, but it would only be one part of the explanation why so many fall prey to this scam.

    Perhaps if Lieberman’s son had been born in a working class family, he would have been given Ritalin for the exact same “symptoms” that Lieberman wouldn’t allow to be treated, and would today be living in his mom’s basement as a drugged up zombie rather than working at a prestigious law firm.

    Much like with ADHD, I agree with Hickey that schizophrenia, bipolar, major depression etc. are not reliable nor valid illnesses.

    However it occurs to me while reading this that an outsider would ask, what does cause these forms of distress that could be loosely labelled psychosis or depression? These people do have real problems. Saying they’re not real illnesses is not a total explanation.

    From my psychodynamic background (e.g. Fairbairn, Winnicott, Bion, Kohut, Kernberg, Masterson), I’d going to share the loosest psychodynamic explanation…. the relative strength of positive (libidinal) and negative (antilibidinal) influences and object (personal) relationships throughout life are what is causing most of the behaviors and feelings that lead to these inappropriately concrete “diagnoses”.

    Positive influences include all good relationships (parents, peers, teachers, etc), both in quantity and quality over a lifespan, as well as aspects of life that makes people more secure and able to function like having a safe home or a good school. Negative influences include abuse of all kind, traumatic events, and neglect/deprivation of the positive influences, like lack of a secure home, lack of two parents, lack of a good school, lack of friends.

    The more that a person is subject to a strong quantitative predominance of negative influences, the more likely that they will start to evidence psychotic experience by early adulthood (mislabelled “schizophrenia”, “bipolar”, or sometimes “borderline”)…. in these cases severe splitting of the good and bad self/object units will cause constant problems in correctly perceiving oneself and others…. while if the imbalance in good vs. bad experience is less severe, they may get labelled with things like “major depression”, “anxiety disorder”, “adjustment disorder”, etc… in these cases there is a stronger positive self/object unit and less severe splitting…. and so on, up the developmental continuum.

    If the positive experiences strongly outweigh the negative experiences, then a state of relative psychic health, functionality, and ability to have rewarding interpersonal experiences will predominate. This is called by psychiatry “Healthy Personality Disorder” or “The Myth of the Normal Person.” They are developing neuroleptics to treat this disorder before it gets too widespread!

    I’d guess that the various “symptoms” clustered into the ADHD myth are simply individualized reactions to stress and negative relationships that can occur to different degrees at different times to anyone along the developmental continuum.

  2. Hi Philip,

    Thanks for pointing this out in the interview. It illustrates so clearly that this is a top-down social control mechanism. No one even listens to ‘differences of opinion’ – and especially psychiatrists.

    These guys are paid to do what they do. And the levers are social. You can’t win a witchcraft trial once you’re in it unless the judges choose to let you go for their own reasons. You can’t get out of a psychiatric diagnosis or an involuntary hospital stay because these are decided in advance on social bases to which you are peripheral. The fact that you’re even being considered for the ‘treatment’ is an indication of your status.

  3. There is no ADHD diagnosed among the children of the Amish . Then again they get no putrified pseudo scientific vaccinations .
    How many kids get heavy metal dental installations ? How many get molested at home ? How many live on devitalized unlabeled Frankenfoods dreamed up for monopolistic profit by Monsanto .
    Basically I agree with Philips analysis most especially the last sentence of his article . Also when gestapo psychiatrists have the power to take people ‘s children away for non compliance to their really insane self serving dictates the people long ago should have risen up to crush these predators and their support systems.

    • The Amish community is a very closed off society and that includes the gene pool. About 90 percent attend one- or two-room private Amish schools. “Do the Amish have problems?
      Yes…… They are humans and, like all human societies, have their share of problems. Sometimes rebellious youth act out and abuse alcohol or use drugs. Some marriages turn sour. There are documented cases of incest and sexual abuse in some families. Although such problems do exist, there are no systematic studies to enable comparisons with other groups or mainstream society. In general, the Amish way of life provides many sources of satisfaction for most of its members.

    • Hello Fred,

      I have not heard of any ADHD stats on the Amish community, but I have read that the Amish experience no autism. They do have their share of anxiety, suggesting that even optimal parenting (if that is an attribute of their way of life) and a wholesome, close-to-nature lifestyle may not be fully protective against psychiatric conditions. I do not know the vaccination practices of the Amish, but an interesting theory for the absence of autism in their community is the lack of technology (e.g., no electromagnetic pollution).

  4. Thanks again, Philip, for pointing out the spurious nature of psychiatry. I would like to agree with you in regards to the fact some psychiatric / psychological practitioners absolutely do threaten patients into taking the psychiatric drugs. My therapist threatened me by saying if I did not take all the drugs exactly as told that “all the doctors would call me paranoid.”

    And I’d like to point out the ADHD label is a good description of an active and intelligent young boy who is bored to death by what has become the sad joke of an educational system that we have here in the US. And I would like to point out that the school social workers are trying to get their hands on all children who are outside the bell curve, including well behaved young boys who get 100% on their state standardized tests. I know, because this happened to my family. Thankfully, I already knew what a sick joke the social work / psychological / psychiatric / medical industries were by this point, I was able to point out high intelligence is a “genetic problem,” so my school district eventually confessed “we’re not equipped to deal with gifted children,” and I sent my child to private school for high school.

    Drugging all the intelligent children, so the powers that be may maintain their positions of prominence, will lead to the destruction of this country, which many online are ironically pointing out seems to be the goal of those who want a “new world order.”

    • Psychiatrists tend to enjoy the position of judgement on other people. But what I’ve noticed is that psychiatrists often appear to have deep rooted character problems themselves. This can be seen in their views and behavior.

      Psychiatrists as a collective often stick out as being strange (a bit like members of other extreme organisations).

      • I agree, Fiachra, those I dealt with in the psychiatric field were not only strange, but hypocritical, compulsive liars, and completely delusional – I know because I read their medical records. I confronted my psychiatrist on my second to last day with him, about the plethora of misinformation in his medical records. And rather than confessing to his delusions and stupidity, he writes in his medical records about my real life, “credible fictional story.” And he wanted to drug my child, rather than going to DCFS as require by law, and reporting that the medical evidence of abuse of my child had been handed over, too.

        Absolutely, there is something terribly wrong with an industry whose primary actual function within humanity is profiting off of turning child abuse victims into “bipolar” / “schizophrenics” with their neuroleptic drugs. Two thirds of so called “schizophrenics” today are people who dealt with child abuse or adverse childhood experiences, according to John Read’s research. And the neuroleptics can create both the negative and positive symptoms of so called “schizophrenia,” via neuroleptic induced deficit syndrome and neuroleptic or polypharmacy induced anticholinergic toxidrome.

        There is definately something wrong with the psychiatric industry today, and that comes from a person who is supposed to be a judge according to 40 hours of unbiased psychological career testing. How bizarre to live in a world where our enemies are industries and corporations.

        • I totally agree with you that the drugs cause the “illness”. And that they can drive you mad. Nearly every hospitalisation I’ve had was a drug reaction event.

          I don’t believe in “schizophrenia” though.

          I remember witnessing a child once telling one of their family members to stop taking their medication because they were worried that they might become a drug addict.

          The family member said that they had to take the drugs because of the circumstances that had led to their hospitalisation and then the child said “yes I know, but that was when you were upset”.

          • Hi Len ,

            I’ve seen the clip. It might be the commentators identification (brain disorder) but it’s not mine. When I came off the strong gear (suitable for “S..”) I was programmed in the direction of strong fear. I was able to work my way through this fear and learn how to deal with it. My Recovery was as a result of coming off strong drugs and my psychiatric treatment was very unsucessful.
            If I had followed the Medical Advice given to me at the time I’d still be “sick”.
            Psychotherapy was what I had asked for at the beginning – I tried both and psychotherapy was what worked.

      • “Psychiatrists as a collective often stick out as being strange (a bit like members of other extreme organisations).”

        In general the psychiatry’s guild bi***ing and moaning about being stigmatized, as funny as it is, is actually based in real public perception. which having a personal experience with several of them I totally see where it stems from. There was not a single one of them who didn’t seem like he/she has a severe problem, most often in the direction of being narcissistic or almost (completely?) psychopathic. I honestly don’t know if the profession draws such people in because of it’s abusive nature (which I think is a part of it) or do the people turn onto this overtime given the systemic dysfunction. I guess it’s a bit of both psychiatrist come off as pricks and weirdos not only to the unfortunate patients but public as a whole.

          • There are good doctors and there are bad doctors…..there are good therapists and bad therapists…there are good workers and bad workers and bad workers….there are good people and bad people. I do not not know for sure if this doctor just was making a flippant comment or if he was serious. As a therapist this is not an idea i would support or agree with. One cannot say that just because one doctor is bad they are all bad. There has to be a grey area……In my experience I have worked with some excellent doctors,therapists,nurses,psychologists and social workers but I can count several who were not very good at all. The people I currently work with are very compassionate about helping people recover from their mental health problems.

          • “There are good doctors and there are bad doctors”

            The same was said about cops. And now with all the videos coming out seems like there are almost no good cops. The problems is not the bad apples, it’s the orchard. When you have a sick corrupt system as psychiatry is, the individuals matter very little. Even when someone manages to stay “good” they’re forced out or have to operate on the fringes or act against their morality.

      • Sorry, Len, but that link is just a bag of propaganda to “explain” something without providing any basis. Ritalin was supposedly introduced “as scientists began to develop a better understanding…” but there is nothing about what the original “understanding” was or what was “better” about their new understanding.

        Remember also that Bradley’s experiments were on encephalitis victims whom we KNOW had actual brain damage. A REAL history would note that researchers ASSUMED that kids who were inattentive had “mimimal brain damage” that reflected Bradley’s cohorts but was not visible or testable, and that despite 50 years and hundreds of millions of dollars of research, no such brain damage has ever been detected. It would also note the history of the DSM, as it changed from the DSM II to the DSM III and altered the criteria to avoid any stated theories as to the cause of ANY disorder, including “ADHD”. And that this was done in large part so that psychiatry could regain their market share by pushing the idea that these “disorders” were biological in nature and required drugs to “treat.” But none of that appears in the “history” you quote. For some REAL history of ADHD, try “The Myth of the Hyperactive Child” by Peter Shrag and Diane Dvorky.

        Propaganda is not the same as history.

        —- Steve

    • Fiachra,

      Great question. When I was in first grade, there were 50 children in the classroom. There was one teacher (no aides, or paraprofessionals), and there wasn’t a single “symptom” of ADHD ever! Teachers recognized that paying attention is something that has to be learned, and they devoted a great deal of time and energy to this.

      • Diagnosing children in the 60’s. http://www.adhdnews.com/testforum/test219.htm ADHD did exist but is was rarely diagnosed by doctors. Many children just suffered with poor grades and just manged to get by. I had learning problems and not one of my teachers seem to notice or care when i was in school during the 1960’s. I am where I am today working as an Occupational Therapist because my mother was my life coach. Going on an on about how ADHD and other mental health problems does not help anyone. This is what is called stigma and it is a major barrier to recovery from a mental illness.

      • I’ve stated this exact thing many times. I went through 12 years of public education and never ran into any classmates that were ADHD. I taught high school classes for fifteen years and never once had a student that I would have labeled with this flim flam term. I quit teaching in 1988, just about the time that we experienced this explosion of supposed ADHD students. It’s all made up, a matter of flim flummery and selling of snake oil and yet so many parents fall for it. Teachers push it so that they won’t have to put up with difficult students in class.

    • Hi Fiachra,

      if you are referring to ADHD as a DSM “diagnosis,” sure, it’s rubbish but the same can be said of any psychiatric label in DSM. The symptoms of ADHD (a better word to use might be brain fog) are quite real. As to why there are more symptoms today than there were 50 years, consider some of the environmental factors that have changed during the last 50 years, at least here in the U.S., where the “diagnosis” or overdiagnosis is more rampant:

      **the radically diminished nutrient content of our food (fruits and vegetables) and poor diets that promote inflammation (i.e., diets based on gluten, sugar and grains);
      **increased exposure to all sorts of toxins and pesticides (e.g., in the U.S., our personal care products contain many more toxic ingredients than what is allowed in Europe);
      **overuse of antibiotics.
      The irresponsible growth of modern technology may also turn out to be a factor.

      Is the condition overdiagnosed? Of course. Should drugs be the treatment? Absolutely not, especially for children. But it is important not to throw the baby out with the bathwater by denying the symptoms (inability to focus or retain things; poor memory; poor organization etc.) which are real and amenable to non-drug interventions, such as supplementation with nutrients (vitamins/minerals) and probiotics; and dietary changes…gluten-free, sugar-free, anti-Candida).

  5. Thank you Philip for this thoughtful and clear analysis of Dr. Lieberman’s shared experience with his son. I am always searching for “common ground” and your points suggest that he actually agrees with much that we post about the problems with psychiatry as it is practiced today. Too bad he said such a horrible thing about Robert Whitaker…just so unfair…

  6. “Dr.” Lieberman like so many “professionals ” today will save themselves and their family while thy voraciously sell other people and their children down the river in order to maintain their lifestyle their position of power and of course their cash-flow.
    Cancer doctors do the same thing pushing chemo and radiation on others even though the majority wouldn’t allow it on themselves or their own family.
    I know a dentist that will install mercury laden fillings into your children’s mouths without any hesitation . But in his parents mouth or his children’s never.
    We must wake up to see all the licensed authorized predator so called professionals around us.
    Aren’t many universities funded by robber baron’s and designed to turn out foot solders for corporations owned by robber baron’s whose dream’s of control and eugenics are the main undercurrent of their business plan’s ?
    Psychiatry may be one of the worst manifestations as they openly attack children in broad daylight . Some others are not far behind.
    I’d prefer discussions with them to take place in an honest court of law but the pharma cartel has already bought those.

  7. I believe that the psychiatrists who concluded that ADHD is a mental illness are the absurd ones in this case, and not the children.

    The fact that they believe that a drug can help an individual acquire consciousness and become a responsible human being instead of being impatient is another demonstration of absurdity.

    Dr. Lieberman was afraid to destroy his son’s life with a psychiatric drug because he knows that psychiatric medications are useless and harmful. The chemical substances that interfere in the functioning of the human brain cause numerous problems and have many dangerous side effects.

    Wish this doctor would also care about what happens to other people’s children when their parents trust a psychiatrist…

    Thank you for denouncing this crime.

  8. Aah, Philip – as much as I want to understand your view, you sadly stay on the side of the dark-ages closed-minded, perhaps because you haven’t lived with actual ADHD symptoms that have been ruled out as ANYTHING else.

    I am proud to be raising worldwide awareness for this “difference,” and

    a) I am not on meds for it

    b) I have had everything else ruled out, and

    c) Many in prisons have ADHD/ADD symptoms. We must see ALL sides to this….not just be anti-psychiatry. It saves lives (though it hurts some as well).

    You are part of the minority here, thank God. Yes – we must educate people on over-medicating and diagnosing, but many are also under-diagnosed! ADHD is INCREDIBLY real, in a small percentage of society. Let’s learn to accept that, like autism, schizophrenia, depression and other issues.

    Dark-ages “Scientology” black and white thinking hurts ALL of us. Let’s wake up, folks. I see ALL sides, but I am not so ignorant to suppose mental health issues don’t exist….that is insane in itself.

    I digress. Back to raising awareness I go.

    – Jeff

    • We’ve been over and over this again and again so it’s not even worth trying to explain anything to anyone is says that their open minded and then smugly state what you just posted above. No one is saying that people don’t have issues; what we do state is that these issues are not “illnesses” as you want to present them.

    • Jeff,
      Of course ADHD symptoms are real, although they’re not really “ADHD” symptoms – they’re just whatever problems with attention and focus that individual has for whatever reasons. Yes, they can be real, serious and disabling.

      The issue is that these symptoms don’t in any way form a discrete, reliable, valid illness, let alone one that needs medication. Put in another way, two people who have individual varieties of these symptoms do not have a common illness, and/or the same clusters of attention-focusing symptoms don’t occur reliably enough above a chance level across a large population to constitute a reliable illness. But all these people do have various real problems with attention and focus for different reasons and in different degrees. It’s a behavioral-emotional problem, which is different from a brain illness.

      I hope you can understand this. Good for you for not being on medications and for dealing with your issues.

        • Actually – yes and no.

          First of all if you don’t identify where the problems stem from any intervention you give is likely to fail, especially in the long-term, unless you by chance decide on something that’s targeting the root causes. So for some kids these kinds of problems may be caused by being too tired and providing them with a reasonable schedule which allows time for rest and unsupervised play will do the trick. If you want to put it under therapy it’s up to you, I’d call that responsible parenting.

          There are problems which are caused by children being neglected and abused and there therapy may be helpful but not as much as first fixing the child’s environment – no therapy will help someone who is being abused on a a daily basis.

          There may be problem where kids have underlying medical/nutritional needs and these need to be addressed.

          None of these though justifies the use of stimulants. They may “help” in short term, not surprisingly, as amphetamines are known to help with concentration and attention (that applies to all people and not only “ADHD”) but in the long-term the effects of the drugs diminish and in fact the big population studies on presumed “ADHD” kids on and off meds show that the off meds group does better (for the citations I encourage you to browse through MIA blogs as I don’t recall it from the top of my head – one was done in Canada very recently). There’s also some evidence taht even the short-term effects may be overestimated as the drugs induce feelings of confidence about one’s performance that are not always justified and make kids more manageable which is reported as improvement by teachers and caregivers even if it does not affect the actual performance. Add to that the fact that these drugs have serious side effects on physical and mental development, not the least of them being a cause of psychosis (a well known effect of amphetamines) and using these drugs on kids becomes questionable to say the least.

          • 1. Proper diagnosis is key to successfully treating ADD. There should be no 15 minute diagnoses in the doctor office. A child needs a complete physical exam including vision and hearing tests. If all this is clear then they child needs a thorough and complete evaluation for ADD by a trained psychologist specializing in ADD. Once the diagnosis is obtained and IEP needs to be started by special education services. Accommodations and assistance from professionals like Occupational Therapists should be included. A family should try all non medication strategies before beginning trials of medications. There are now several non stimulant medications that can be tied like Strattera. Academic struggles for a child usually begin around 2nd grade when demands for learning begin to increase.
            Brian scans have looked at the ADD brian and have discovered differences but scans at this time for diagnosis are still experimental.There is a brain wave test which is FDA approved…..http://www.healthline.com/health/adhd/brain-scans#ADHDDiagnosis1
            Abuse in the family milieu should also be evaluated and treated with therapy and behavioral interventions.
            There are potential side effects from all medications whether they are taken for physical or mental health reasons. One should continue to work wit a doctor who has expertise in ADD to get the right medication combination. My 18 year old daughter has benefited from everything I have described here and now is doing quite well in first year at college. She continues to take medication and has good insight into her diagnosis.

          • Len, that’s a nice piece of fiction that never happens in clinical practice that you’re describing there.

            Are you mentioning this Straterra by the way:
            “Strattera (atomoxetine) increased the risk of suicidal ideation in short-term studies in children or adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD).”?

      • Exactly. Fever is a real thing but it doesn’t mean that there exists a genetic “high-temperature disorder” which has to be treated with aspirin for the rest of your life. And even this analogy doesn’t show the absurdity well enough since fever you can actually measure.
        The biggest elephant in the room of DSM “diagnosis” (among all the other bulky animals) is the fact that there’s no normal state you can compare them too. For every physical illness there’s a normal state: cancer – no cancer, infection – no infection, diabetes – normal sugar range. For psychiatric disorders this is never defined in any way that can be useful. Even when you have illnesses defined by a subjective range like said diabetes – you have an upper norm and a lower norm which you can measure and it doesn’t change depending on who’s looking. There’s no normal amount of fidgeting and attention that anyone can define. Not to mention that it changes during the day and depending what you’re doing and in what environment you are.

        I think the most ridiculous statement that people make about ADHD is that kids with the ADHD “have problems concentrating in general but they become super concentrated on things that interest them”. No sh*t. Like all the other human beings from the dawn of our species. And people eat statements like that up and nod and act like they were just presented with quantum theory of gravity or something.

          • And of course, according to the DSM-5 you have only two weeks to grieve! Then you develop that horrible malady and disease known as Major Depressive Disorder!

            Grieving people tend to make everyone else uncomfortable because no one likes to talk about or think about death for very long. We tend to deny death and the fact that we all die. Grieving people must talk and remember and tell stories and cry and the process may take years to complete, not two weeks.

      • Stephen…”One of the charges leveled against psychiatry’s diagnostic categories is that they are often “politically motivated.” If that were true, the framers of the DSM-5 probably would have retained the so-called “bereavement exclusion” — a DSM-IV rule that instructed clinicians not to diagnose major depressive disorder (MDD) after the recent death of a loved one (bereavement) — even when the patient met the usual MDD criteria. An exception could be made only in certain cases; for example, if the patient were psychotic, suicidal, or severely impaired.

        And yet, in the face of fierce criticism from many groups and organizations, the DSM-5 mood disorder experts stuck to the best available science and eliminated this exclusion rule.

        The main reason is straightforward: most studies in the past 30 years have shown that depressive syndromes in the context of bereavement aren’t fundamentally different from depressive syndromes after other major losses — or from depression appearing “out of the blue.” (see Zisook et al, 2012, below). At the same time, the DSM-5 takes pains to parse the substantial differences between ordinary grief and major depressive disorder.

        Unfortunately, the DSM-5’s decision continues to be misrepresented in the popular media”…….http://psychcentral.com/blog/archives/2013/05/31/how-the-dsm-5-got-grief-bereavement-right/

  9. You very effectively expose how hypocritcal Dr. Lieberman was and what a sham diagnosis ADHD is. When my grandson was about 10 he was diagnosed with ADHD because he supposedly wasn’t concentrating adequately in school (his parents refused medication). When it was pointed out that he would spend hours reading books in his room, the psychologist said that was only because he was interested in the books, so that didn’t count. Being able to concentrate on video games also didn’t count. If the ADHD diagnosis wasn’t being so widely used to harm children by drugging them, I would consider it humorous to imply that you have an illness if your mind wanders because you’re bored.

      • This kind of approach is why 11% of American children ages 4-17 are diagnosed with ADHD, with many of these children being drugged. My guess is most of us have at least some trouble concentrating on boring, mundane tasks. And if you’re immature (i.e. young), it may be even more of a problem. This doesn’t mean you have a disorder. And it doesn’t mean you need to be given potent medications.

      • “People with ADD do not have any trouble concentrating on things they like….it is the boring mundane tasks like math,school work and chores which they have trouble.”

        Yeah. Just like EVERYONE else. Or are you trying to tell me that “normal” kids just can’t stop doing their homework and spend hours memorizing irrelevant facts without protest. It’s ridiculous to say that. Of course everyone has easier time to concentrate on things that they like and are interested at – it’s like a definition of interest.

        • Just wondering are you a parent?…Going from own personal experience and living with my daughter who has ADD I will disagree with you. Children and adults without ADD can do the necessary boring mundane tasks like chores,managing a checkbook and taking a boring class which is disinterested but needed for graduation when they need to. On the other hand those with ADD struggle and often get distracted on to other activities which are more interesting. A healthy prefrontal cortex can turn on when it needs to do necessary but boring tasks. One is not going to be able to be successful in life with just doing things they are interested in.

          • There are so many distortions and circular arguments here in this article, Len…

            For example,

            1) “However, brain-imaging studies have shown that children with this disorder have an underlying neurological dysfunction, which likely accounts for their behavior” – in other words, there is no proof that neurological “dysfunction”, whatever that specifically means, causes the behaviors that supposedly constitute ADHD.

            Throughout the article, the authors function on the assumption that the behaviors labeled ADHD constitute a reliable / separable / discrete illness… but they never provide any proof of this. Rather, they constantly assume the unproven conclusion that ADHD is real and valid (ADHD the reliable illness, not problems in attention and focus, which are very real… there is a difference).

            2) “There has been increased interest in ADHD as a heritable neuropsychiatric condition linked to pathogenesis of brain dopamine” – This is stated as it it were fact… no proof is ever given, including in the articles cited. All the observed brain difference in people who supposedly have ADHD are correlational, and could be entirely caused by the environmental stressors in each individual situation, or by poor parenting passed down from generation to generation by those who supposedly “have ADHD.” Jay Joseph writes well about this here:

            http://jayjoseph.net/publications

            3) “Twin studies indicate that 75%–90% of ADHD is caused by genetic factors. If one person in a family is diagnosed with ADHD there is a 25%–35% probability that another family member also has ADHD, compared to a 4%–6% probability for someone in the general population.”

            Twin studies do not prove this…. this is bullshit masquerading as science. Twin studies are fatally flawed for many reasons discussed by Jay Joseph in his articles here, the biggest problem being false assumptions that identical twins experience equal environments to non-identical twins – https://www.madinamerica.com/author/jjoseph/

            3) “Dopamine is a powerful brain neurotransmitter that controls feelings of well being” – It would be more realistic to say that complex interactions between environmental situations/relationships and a person’s brain influence their level of well-being. People aren’t just drones whose feelings are determined by their neurotransmitters.

            4) “In terms of genetics, especially as related to ADHD, a number of genes have been associated, and these candidate genes are all involved in the reward cascade.” – Again these are simply associations/correlations between genes certain people have and observed behaviors. There is no causation proven, nor does ADHD necessarily exist because of the associations observed.

            5) “It is an impulse disorder with genetic components that results from imbalances of neurotransmitters. Its effects can be eased by treatment and counseling. The biological basis for this disorder has been established by a number of investigators” – This is called lying. It has never been proven that genes or biology CAUSE problems with attention.

            6) “Numerous studies indicate that 20%–30% of siblings of ADHD children also have ADHD. This is 2–7 times the frequency found in non-ADHD children.” – Duh… siblings share a similar environment and similar stresses, including lack of social support and poor parenting.

            7) “ADHD is not caused by poor parenting, family problems, poor teachers or schools, too much TV, food allergies or excess sugar.” No, in fact poor parenting and family problems can cause serious problems with attention and focus, as common sense would suggest.

            8) ‘Kenneth Blum, Bernard Downs, Roger Waite, and Lonna Williams own stock in, and are officers of, LifeGen Inc., a company involved in DNA-directed nutrition for ADHD.” – Why would you trust an article about supposed ADHD by people who are officers at a company which stands to profit if more kids are diagnosed with this pseudoillness? Open your eyes…

          • bydtransformation….not surprising that you would find ways to not agree withe article. I will leave you this. It seems that many believe in “God” yet no one can provide any evidence that he or she exists yet many continue to believe. Are you going to be critical of their beliefs an burn their bibles and churches because they cannot provide the evidence. Of course not. The brain no doubt is complicated and treating mental illness is not a perfect science but neither are all physical illnesses. Not everything in medicine is that simple and concrete

          • Len,
            Is this a joke? This is the first time I’ve heard religious beliefs being used as an analogy (loosely) supporting the validity of supposed brain-based mental illnesses.

            I am in fact a Scandinavian descendant of the Viking people who once ravaged the churches and monasteries of England. But, I have now managed to control these base impulses, so I no longer burn Christians’ books and churches. However, I am critical of some religious beliefs that are unsupported by evidence. I’m not sure how that relates to “mental illness”, although I sense your statement as a covert admission that certain psychiatric beliefs are little more evidenced than superstition and witchcraft.

            To other commenters, this statement by Len is a pretty sad example of the lack of real arguments in favor of brain-based mental illness conceptions. When you have to avoid direct responses to an argument and make appeals to the Almighty, you know you’re in trouble… thanks for furnishing this revealing example, Len.

    • Just because the Mayo Clinic says that ADHD and ADD exist doesn’t make them diseases or illnesses. The medical model claims all kinds of things where it comes to psychiatry and to matters of the mind and most of it is just pure bunk and horse manure.

      You seem to claim all kinds of things and yet offer no real proof of what you state.

          • Len,

            That is no different than respecting a medical facility for one department but being concerned that another one is not up to par. This isn’t an either or situation.

            By the way, a specialist who as considered to be a top doc in my area nearly committed malpractice with a relative and me. He didn’t heed my warnings about having an adverse reaction to a med and while fortunately, no hard occurred, it could have been very serious.

            So I hope you can forgive me for my skepticism. On a more positive note, I have a great cardiologist who is not listed in any top doc list locally. But on all the patient rating lists, she received several great ratings. Normally I take these with a grain of salt also but just to confirm what I had read, I casually asked her nurse during the first visit about them. This woman’s expression said it all about this doc.

            Regarding psychiatrists, there is one who is a sleep specialist I would see in a heartbeat if he was in my area. He doesn’t just throw meds at a problem like most psychiatrists do and has a good understanding of non med remedies that are better than many alternative health practitioners.

            Again, this is not an either or situation as you have to look at the total picture and not make assumptions based on ratings that might not mean anything.

  10. Len said,

    “”My 18 year old daughter has benefited from everything I have described here and now is doing quite well in first year at college. She continues to take medication and has good insight into her diagnosis.””

    So many parents claim their kids are doing well on meds but yet, we never hear anything from them as to whether that is true or not. So once again, I challenge you Len, as a parent, to let your daughter post honestly on this site how she is doing whether she agrees or disagrees with you.

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