Researchers Question the Utility of an ADHD Diagnosis

A new article examines the usefulness of an ADHD diagnosis and suggests alternatives

Peter Simons
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A new article published in the International Journal of Qualitative Studies on Health and Well-being addresses the utility of the ADHD diagnosis and provides alternatives to the controversial medicalized treatment for common behaviors of children.

Attention-deficit hyperactivity disorder (ADHD) has received intense critical attention in the research literature recently, as has been reported on here at Mad in America. Researchers suggest that overdiagnosis and overmedication are the order of the day for children whose behaviors are challenging for adults—such as teachers and parents—to control.

Some researchers argue that despite its flaws, the diagnostic category of ADHD still has utility since it may inform treatment and destigmatize behaviors that others find problematic.

Dr. Sami Timimi, the author of the latest article, addresses this argument. He is a researcher at the University of Lincoln, UK, and a psychiatrist specializing in children and adolescents. Timimi has written extensively about ADHD and is the author of Naughty Boys: Anti-Social Behaviour, ADHD and the Role of Culture. In this article, he argues that the diagnosis of ADHD is not necessary for treatment and that, in fact, it may make it more difficult for children to receive the supports that are best supported by the research literature.

Timimi first takes issue with the prevailing belief that psychiatric medications are associated with better outcomes. Previous literature, he writes, “concluded that 75% of people entering community mental health centres in the USA are either not responding to treatment, or deteriorating whilst in care.” That is, receiving mental health treatment is associated with either no improvement or actual harm, three-quarters of the time.

Sami Timimi, MD at “Pharmaceuticals – Risks and Alternatives,” 15th of October, 2016

When discussing the literature specific to ADHD, Timimi explains the findings of the primary study, the American multi-modal treatment of ADHD study (MTA). The study appeared to support the conclusion that ADHD medications improved outcomes. However, according to Dr. Timimi, the 3-year follow-up actually showed worse outcomes for children prescribed ADHD medications.

“Those who used more medication during the 3 years were more likely to experience a deterioration in ADHD symptoms, had higher rates of delinquency, and were significantly shorter (by an average of 4 cm) and lighter (by 3 kg) than those who had not taken medication.”

Additionally, the study suffered from numerous methodological problems—in fact, most children in the control group were prescribed medication as well. However, critics argue that the only way to determine appropriate treatment is by matching it to the symptoms demonstrated by the child—the diagnosis. Timimi addresses this concern by citing the peer-reviewed literature which suggests that “The process of matching treatment models to a diagnosis results in virtually no clinically significant impact on outcomes.”

The aspect of “treatment” that appears to have the largest impact on positive results is the therapeutic alliance—or the extent to which children feel that the therapist understands their experience. Timimi suggests that this element could be provided without the need to diagnose the child with a behavioral disorder.

Additionally, Timimi argues that in the medical profession, the diagnosis serves to explain the cause of the disorder. If someone learns that they have diabetes, that means that they have been tested for a particular metabolic process that causes their symptoms. However, in the psychiatric profession, diagnoses serve only to categorize symptoms: one knows that they have ADHD because they have the symptoms of ADHD, and the category of ADHD does not explain what internal process “causes” those symptoms. According to Timimi:

“If I were to ask the question ‘what is ADHD?’ then it is not possible for me to answer that question by reference to a particular known pathological abnormality. Instead I will have to provide a description, such as ADHD is the presence of the behaviours of hyperactivity, impulsivity, and poor attention (plus a few extra qualifiers such as age of onset). Contrast this with asking the question ‘what is diabetes?’ If I were to answer this question in the same manner by just describing symptoms such as needing to urinate excessively, thirst and fatigue, I could be in deep trouble as a medical practitioner as there are plenty of other conditions that may initially present with these symptoms and diabetes itself may not present with these symptoms in a recognizable way. In order to answer the question ‘what is diabetes?’ I have to refer to its pathology involving abnormalities of sugar metabolism. I would then get independent (to my subjective opinion) empirical data to support or otherwise my hypothesis about what may be ‘causing’ the patient’s described experiences (such as testing the urine and/or blood for levels of glucose). In the rest of medicine therefore, my diagnosis explains and has some causal connection with the behaviours/symptoms that are described. Diagnosis in that context sits in a ‘technical’ explanatory framework. In psychiatry what we are calling diagnosis (such as ADHD) will only describe but is unable to explain.”

Timimi suggests that attempting to categorize ADHD as a medical disorder leads to ineffective and potentially harmful treatments—such as the controversial use of psychostimulants. He further argues that these treatments prevent children from receiving other forms of support that could be more helpful.

Timimi presents several types of alternative treatments, including a relational model that focuses on children being emotion-seeking, rather than attention-seeking. This model follows the consensus in the psychological literature on the importance of attachment and relationships for children. In the model, instead of focusing on what children are doing “wrong,” parents and therapists should concentrate on the ways children are attempting to meet their needs for emotional support from their parents, teachers, and peers—and ways that they can better provide that support. Communication is essential, including listening to the child’s experience.

In an interview published in Psychology Today last year, Timimi clarified this position:

“I argue that diagnoses like ADHD reflects an ambivalence that neoliberal Western culture has toward children that is often manifest in the tendency to problematise ‘childish’ behaviors and then ‘medicalise’ them, sparing all concerned from the more difficult task of accepting, understanding and supporting the imperfect and often contradictory ways children develop and find emotional security.”

 

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Timimi, S. (2017). Non-diagnostic based approaches to helping children who could be labelled ADHD and their families. International Journal of Qualitative Studies on Health and Well-being, 12(sup1), 1298270, http://dx.doi.org/10.1080/17482631.2017.1298270 (Link)

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Peter Simons
MIA Research News Team: Peter Simons comes from a background in the humanities where he studied English, philosophy, and art. Now working on his PhD in Counseling Psychology, his recent research has focused on conflicts of interest in the psychopharmaceutical research literature, the use of antipsychotic medications in the treatment of depression, and the general philosophical and sociopolitical implications of psychiatric taxonomy in diagnosis and treatment.

16 COMMENTS

  1. No parent of a child with ADHD is trying to control them…NONE…we simply are trying to help our children be able to succeed where otherwise they might fail or be hurt or be excluded or punished (educationally) for their inability to focus or control their actions/choices (think fidgeting or unable to sit down, or unable to write a paragraph) No one medicates a child to control them…to think you can control an ADHD child is to never have been a parent of a ADHD child!! Until a person walks the roles of parent…no matter how much work they do with ADHD children as a doctor or a teacher they really do not understand the nonstop ongoing emotional “tornado” that surrounds as child with ADHD whether it is destructive habits, disorganization, inability to sit and wait, the inability to write neatly or coherently a paragraph or story, sometimes even just a sentence…never mind the energy drain, physical toll on siblings or parents…if a routine, therapy and medication are all needed to help a child, then that is between the parent, the child and the doctor!

    • I read your post but cannot see how it relates to the article. At the moment it reads to me like you are posting about a personal bugbear that may or may not relate to it.

      Timimi runs a child and adolescent clinic where many children who would at other clinics get a diagnosis of ADHD are helped. His clinic on the whole is drug free and diagnosis free. It also has far better outcomes than most other CAMH’s clinics.

      Some of the clients come from other clinics and are on drugs and have diagnosis. Most of those, once they have heard the benefits and downside of diagnosis and drugs decide to drop them, though some decide to keep them. I therefore think that if no diagnosis, no medication and lots of conversation are all needed to help a child then that is between the parent, the child and doctor. However this was not the main point of the article.

      I can see your personal experience and opinions are counter to Timimi’s practice however the article on the whole is not about that, it is about scientific outcomes of a variety of studies. Could you therefore go back to the article and copy and paste bits of it and then tell me how your post relates to the article? That way I and perhaps others might be able to debate with you.

    • As a dad who helped raise two classic “ADHD” boys, I can empathize with your statements. It sometimes feels like others expect us to “control” our children when it is very clear that these kids make their own decisions and HATE being controlled in any way that feels arbitrary to them. And I would say I also resented anyone who felt they “knew” how I should parent my kids without any actual knowledge of what it’s like to be in my shoes.

      That being said, I am a scientist and a mental health professional as well as a parent. I appreciate Timimi’s work because he’s always been objective and not afraid to disagree with the establishment if the data tell him they’re wrong. If you look at the long-term DATA regarding “ADHD” interventions, it is VERY clear that long-term outcomes are NOT improved by the long-term use of stimulants. That being the case, it seems pretty shortsighted as a society for us to insist on stimulants as a primary intervention and to disregard or minimize the potential benefits of psychosocial interventions which have a greater chance of making these kids’ lives better in the long run.

      Additionally, you and I may not be interested in controlling our children, but there are most definitely parents and especially teachers and other professions who have control as their main objectives. There were a number of studies done back in the 70s showing that the optimum dosage for academic attention was much, much lower than the average dosage, and that most doctors increased the dosage to the optimum for behavioral control, which dosages actually diminished the child’s ability to attend to schoolwork.

      So I urge you not to throw out the baby with the bathwater. You seem an intelligent and committed parent with the best of intentions for your children and all children. I strongly suggest you re-read the article and pay attention to the actual DATA that is presented, and forget what it means about you or me or your particular situation. If we think about the welfare of all kids, the data is pretty clearly telling us that we need to look at stimulants as at best a short-term intervention, and we need to look at a whole range of other options as a means of really helping these kids become functioning adults. Some examples are: alternative schooling (child-centered classrooms), meditation, exercise, nutritional interventions (low iron is particularly common), addressing sleep apnea, teaching parenting skills specific to intense or oppositional children, teaching self-management skills, and many others. If we really care about helping these kids, we have to get past our own personal fears and ego and look objectively at what has proven to help. At least with regards to the kind of long-term outcomes that matter to most of us, like delinquency rates, college attendance, high school dropout rates, social skills, and self-esteem, stimulants fail the test.

      You might want to read Corrina’s MIA post on anecdote vs. aggregate that was posted just today. It is very much applicable to this discussion.

      —- Steve

      • Please don’t refer to your kid as an ADHDSuperstar. Wouldn’t calling him a superstar be enough? Anyway, that’s up to the kid. Is he okay with being referred to that way? Even if he is, not all are, because such labels obfuscate truths about people.

        Why even bring up the notion of “my ADHD child”. The simple truth is, that this is (supposedly) a kid who has difficulty being focused. And you say drugs help him. While, it would be a lot better to hear from the kid himself, I will assume that what you are saying is true. So the truth of the matter is “my child is a whirlwind, unfocused and drugs help him be focused”. Period. The term ADHD is pointless to describe this simple truth.

        “then that is between the parent, the child and the doctor!”

        Actually, it is not, since it is the kid that is being labelled and taking drugs. It’s solely up to how the kid feels about it. But of course, if the kid is very young, I can understand.

        “No parent of a child with ADHD is trying to control them…NONE”

        Don’t be too sure of that. Psychiatric labels of all kinds have been used by abusive parents to perpetrate further abuses on children, cover up their own mental problems/abusive nature and invalidate their kids’ protests and pleas for help since time immemorial. This place is replete with such cases.

        Take up a few legal cases in psychiatry and you will understand it better.

        You may not be such a parent. But don’t generalise it.

        • My daughter is a superstar…and ADHD superstar it is as much a part of her as her hair color or if she had a disease like diabetes or cancer…I call her a superstar because we face walls and hurdles all the time…when we have to wait inline some where and people behind us comment how shes in and out of line, or literally swinging off the red rope…or commenting about my lack of parenting because of it…or when a teacher rolls their eyes at me when I meet them early in school year and mention my daughters ADHD right before I give them the line “If anything concerns you call us right away so we can tackle issues as a team, like if shes disorganized, or not turning in her homework I need to know those things sooner not later at which point they sigh with relief that am not trying to use her ADHD as an excuse to get out of being responsible for her actions…my daughter has hit that stage where she tries to blame things she does on her ADHD so it is twice as important that I teach her that ADHD is not a crutch – it is just one more thing that she has to work with not work around! My daughter is a trooper she talks to me, works with me, and adjusts each year to new harder to cope with expectations (think academically) each year the bar gets set higher and higher and although orally she could probably answer any question required accurately if she could keep her thoughts focused, when she has to write she not only has to focus her thoughts, but she has to focus her hands to write out what she is trying to say in a coherent way as well, it is HARD but she does it…she is therefore a superstar!!

          The diagnostic term for my daughter that we do not tell her..but is in her school record is she is “twice exceptional’ she has ADHD and she is a mathematics “genius” according to the testing, she tested at a 10th grade level in January and then a 11th grade level in May…so we use superstar to show our support for the hard work she is doing and the progress she is making with how she handles it…I could go around calling her a whiz or a genius but I fear the EGO she would grow from it…

  2. Peter,
    I love the summation that Timimi gives at the end as he points out the problem of our fast-food culture. We would rather a magic pill than deal with the underlying issues that take more time and effort but ultimately prove more rewarding and long-lasting by building strong and stable attachment relationships.
    Sam

  3. Another useless psychiatric “disease” with an equally useless treatment. There are a number of garden variety sources of hyperactivity involving things like allergic reactions and food sensitivities, nutritional and glandular problems. Most physically serious is probably heavy metal poisoning (think of having a hyperactive child in Flint). Psych speed isn’t going to treat things like this.

    • And there are also kids who naturally hate sitting still and love exploring their environment in a physical way. Such kids have NOTHING wrong with them at all, but are inconvenient for adults to manage, and “treatment” is usually nothing more than an attempt to make them easier for the adults to deal with.

        • Too true. Good experiments in the 70s showed that “ADHD” kids are indistinguishable from “normal” kids in an open classroom setting. Too bad we don’t care enough to create them. We actually helped create a charter school for our kids that allowed for lots of free movement, interage classrooms, signing up for desired classes instead of just assigning kids to teachers, democratic classroom rules, etc. Our youngest, who would TOTALLY have qualified as “ADHD” in Kindergarten (his nickname was “Wild Boy!”), had no behavioral difficulties whatsoever and graduated with honors. I’m just sorry that most kids never get that chance.

    • My daughter has severe combined ADHD…it is not some made up disorder that she is diagnosed with for whatever BS reason you think parents want there child to be labeled. When she was younger, 2-5 I was not a mom, I was a warden…I had to be beside her every minute that she was awake to protect her for herself…and her sibling from her (our now youngest was not born before she was diagnosed). The few times that I was not literally right beside them (literally went to the bathroom, or went to kitchen to grab or make a cup of tea) bad things happened…she would get frustrated over a toy or her little sister copying her and would lash out, it could be a push, a hit, a punch or a bite….or she would climb on beds or couches and jump off like she was a wrestler (and no she had never seen a wresting show ever!) When left alone to her own devices she would literally pick the paint off the walls (no it was not lead based paint, and no she didn’t eat it!), she would pop heads off of dolls, she would remove the paper from every crayon or break them in half pushing so hard when she was coloring, and then refuse to use them because they were broken. She was picky as hell with her food, she lived(s) off of peanut butter, whole-wheat toast, granny smith apples, raw – carrots, peas, broccoli and cauliflower…mostly…we thought wow what a stubborn little girl we have, we emphasized empathy, sharing, trying new things, being confident, being independent, keeping our hands and feet and teeth to ourselves, we pushed words instead of actions…we tried time-outs…we tried behavior charts, we tried responsibility charts, we took items away, we never really were a TV family at that point but that was gone too…video games never were introduced because who gives a child that you can’t leave alone for 3 minutes too pee a video game? I even admit, a few times when nothing else seem to be making a dent I spanked her…not out of anger or frustration…but because our relatives didn’t want her at there homes or to spend time with her because of her “attitude” and they told me over an over and over that a good spanking would cure it..boy were they and I wrong…

      Part of my daughters preschool was in a ‘closed classroom setting’ with 1 teacher and 3 aides for 9 students…they were not sure what was causing her biting, refusal to potty train, her refusal to sing, sit down or play with other kids…between some speech evaluations and OT and careful observations and redirection they taught her to write her name…that is what her preschool teacher told me…a year and half with her and the only thing I taught her was to write her name…because she already knew her numbers and how to count to 20, her letters, shapes, colors and the names of every object you could possibly ask her to name…the speech therapist told me “I taught your daughter the sounds every letter makes, because she would only work with me if I taught her to read the words, not just see an image she is very stubborn but that will do her so well when she is an adult” and my 1st thought was…”if i don’t kill her before shes an adult, you mean” and I was only half joking…18 months of work, therapy and constant restraint doing exactly what they told me too and the only thing I feel like I accomplished was pointing out to my 3/4 year old was that no one else was in preschool in pull-up so she decided 1 day she didn’t need them anymore and never used them again..

      Come kindergarten I am called in over and over and over and over…not only does my kid know the answer to every question they ask/require before graduating K, she knows the answers on the 1st day and shouts the answers out or raises her hand so enthusiastically that she knocks the kids down around her to be called on…but is distracting the other kids and not letting them learn, or shes is elbowing kids in the face when they repeatedly tap her on the shoulder after she told them to stop….or shes in a scream match with another boy in her class (which i will say acted just like she did when I look back and think about it) so the diagnosis/solution…”your daughter is so bored cause she knows this already we are gonna keep her busy”, they had her sort beads, or crayons, or run notes to the office because there was no one who could challenge her and still teach the kids who were below grade expectations

      First grade she does better…no friends, no one wants to play with her, they exclude her, and her writing assignments take her longer to do than other kids, so her teacher kindly lets her (makes her) stay in at recess to finish them – when he finally tells me whats going on, he admits shes super smart but not applying herself out of “sheer stubbornness” so I get stricter at home and add to her homework everything she doesn’t finish in class and feel like I am deflating a balloon of hot air that my kids somehow is filled with that thinks she is above her schoolwork, teacher and me….

      Grade 2…my kid who can do math in her sleep is failing math…not because she can’t do math no…it is because she won’t follow the specific directions that require her to circle the numbers in the word problems, and underline the key word (difference, sum, product) and because she can’t do timed math fact tests…in fact the four students in her class that were in “intervention” were on set H or higher and my daughter was still on set D (this is November) I go home and I cry….because my daughters parent teacher conference which should have been 1 teacher and my daughter and I was 2 teachers a special education teacher and me with me wishing my daughter wasn’t there so I could break down and cry and beg for help with the demon child I had for a daughter….because at home SUCKED – I couldn’t leave her alone for a minute…staples in her head for reckless choices multiple times CHECK….physical harm to her sibling when she was upset CHECK (x100) destroying toys CHECK ruining books CHECK losing homework, or books or magazines or pencils CHECK it was hell and I was in prison…I had to sit in her room every night till she fell asleep or she would stay up till midnight, 1, 2 or 3 in morning because she could…or the hours and hours my daughter agonized over no one whats to be my friend, I try mom, i try to talk about the things they like, I try to be nice, I share my pencils when someone needs…but no what does she get in return kids spitting cookie into her hair at lunch, 2 boys making sexual comments about her butt and the whole 2nd grade wrote a petition and signed it to have her kicked out of school for being “weird” and tried to give it to a teacher….

      I was at the end of my rope overall…that is not to say there was no good stuff it was just so far outweighed by the negative that it was hard to hold on too…my daughter could read chapter books in a few hours if everyone left her alone…she could play for hours with lego or even a pack of colored paper clips…if she was left alone…she could do math for hours…if left alone…you know who doesn’t leave her 7 year old sister alone for more than 2 minutes…the younger 5 year old who doesn’t like to read, who doesn’t like to color, who doesn’t enjoy TV Or movies and whose only quality that drives her older sister nuts is her need to be around other people…yup that is who she is at her core…a people person and her favorite person is/was her older sister…who just happens to be the most anti-social leave me alone person in the world (when I have a book,math, TV show or current favorite item to play with) I was being assaulted on all fronts and to make the mountain worse…between the age of 5 and 7 for my oldest, my husband spent 455 days out of state working) and I had NO support his family didn’t want to help with my daughter because she was exhausting…my family lives 12 hours away…and my neighbor at that point was an elderly woman with dementia and her craziest daughter who leeched off of her and stole her money manipulating her into making decisions)

      Then one day…her teacher…says to me casually as I was walking down the hall to go to another meeting about something else…You know I watched your daughter today, really watched her and in about 5 minute she did 127 different actions and I don’t think all of it was in her choice to do them” and stopped and I looked at her…this was right before Christmas….and I said…what do you think I should look into…and she said ask your doctor about ADHD. You know in movies when time stands still and you get that kick in the face…that was my kick…i went out to car where hubby was and told him and hes like “yeah I have been thinking that for a while now, he reminds me of Seth as a child” and I punched him in the arm..literally…”why didn’t you say something sooner, I have been going crazy and I had no clue, no nothing no reference to what ADHD was”

      In the few weeks of early December I researched like a crazy. We had a doctors appointment, got some ‘surveys to fill out for us and her teacher’ and a checklist of things she does…it had 18 options on it…my daughter met 16 of those 18, when her teacher filled out hers which had 24 options on it, she had 22 out of 24 checked…and our doctor asked some questions face to face and told me she had 11 of 12 of his markers for ADHD. He then tried to explain it, and I cried….they were tears of joy at that point I had a lifeline….I had something tangible I could adapt too or work with…or solve…or to find help for…severed combined ADHD her doctor told us, and told us that it was the hardest to treat, work with and that it would be a long road ahead of us with lots of trial and error, lots of checking in to make sure she was healthy, eating okay, sleeping okay and not too ‘toned down’ that she couldn’t shine. He made it very clear that he did not want us to think that medication would make her a puppet that would listen…and I told him…I don’t want to lose her…I just want her to be able to be herself without hurting herself, someone else and without spending her recesses in detention…

      It took me a few weeks to really accept medication as part of her treatment…first we just let her drink tea at lunch and after school and it helped a little…we added in a strict routine which had helped when she was younger a little and that made a difference too) we added in social worker at school for 30 minutes a week to help focus on her emotional state in the classroom, crying/anger outbursts and to help her learn to make friends in an environment I could not be a part of…then I let her take a low dose medicine for a week and her behavior report came home at the end of the week filled with compliments, good notes, and in 3 weeks her math grade went from a D to a B and by the next report card her math was an A her writing was a B (up from a D) and her neatness with spelling went from a F to a C (her teacher at one point gave her oral spelling tests early in the year because she couldn’t read her answers)

      Our life changed…I was no longer a warden…yes my daughters still fight…they still scream…my oldest still loves to be left alone to read a book or build with lego and my middle girl loves to be with her doing whatever her big sister is doing….but I know she won’t hurt her the way she use too…we have had to adjust her medication over the last 4 years upping in a little, adjusting the times/doses to help when she needs the help the most….and she finally made some friends this year

      My daughter is still a ball of energy, that fidgets constantly and chews her hair and rips a parts erasers when she watches TV or chews the end of her pencils so much that no one else would want to touch them and bites her fingernails…she loves to run, she plays the violin, and she loves to run, she tested at a grade eleven math level in the 5th grade and can pass her English classes when the teachers does or doesn’t factor in her ADHD (think PARCC testing scores where the marker has no clue my daughter has ADHD) so academically my daughter is helped enough she can do her school work, but she still gets demerits weekly for skipping through the halls instead of walking, the PTA was inspired by her to buy and put standing desks in the older grades first…and the OT spend some of her yearly budget on extra exercise balls so that one could be in every classroom my daughter would be in…just in case she needed it (and apparently she did)

      There was a day back in the fall of this past school year, where I was so sick with the flu and I got a migraine on top of it…that I forgot to give my daughter her medication on a school day…I received 6 phone calls that day about her disruptive, rude behavior, she got 10x as many demerit points, and her it took her about 4 hours to do her homework that night versus 20-30 minutes it normally took her to do homework…we went to the pharmacy after school to get some meds for me…and as we were walking through the store she couldn’t keep her hands off of EVERYTHING and it hit me…and I asked did you take your meds this morning and she was shocked and said no…i immediately sent her teacher(s) a message and explained and everyone one of them sent me back a message with roughly the same comment “we had no idea her ADHD was that bad”.

      Do I want my child to depend on medication to get through life, no…but without it…she can’t be her best self…we as a family…barely survive when my oldest gets the FLU (she does not take ADHD medications when she gets the flu so that she can take something to manage her FLU symptoms) but until she is an adult I have to make the decision that is in her best interest and knowing that physically, emotionally, and mentally she is safer, happier and more able to do the things she loves to do when she is medicated…that is hand down the right choice for her, for now.

      So please…stop assuming that every case of ADHD or ADD is just some parent needing to drug, or control or otherwise medicate their child into submission based on your opinion that it is a made up disease or diagnosis for some conspiracy of big pharma or food allergies or heavy metal poisoning….

      I promise you…you could not last 3 days with my family and my daughter if she was not following her routine and medicated…maybe now that shes 11 it won’t be so bad…but I tell you…I don’t want to find out!!! When she was younger…I couldn’t cook, clean or even go pee without something happening…I literally use to shower at 1 or 2 am when my husband was out of town for work, and I would set an alarm for 4 hours and that was the only sleep I got because I had to be up before she was to keep her safe…I had to literally turn my bedroom into a toy playroom so that when things got bad both girls had a safe room to play in separately and I had to literally sit in the tiny corner of the hallway that was between the bedroom doors so that neither of them went into the other room just to have 15 minutes of something not crying, screaming, fighting or being hurt…we even at one point had to dismantle my daughters bed because she would climb on it and jump off towards the window, or the door, or you, or the toy bin…or her siblings…o amount of staples in the head, bruises or talking to her about safety helped “I am so sorry mom I didn’t remember I would get hurt, this is just another bruise mom, why can’t I remember that I get a bruise every time I jump off the bed?”

      Oh and I think I forgot to mention my daughter runs for a minimum of an hour a day…shes a runner and has been since she could walk..so it is not a lack of exercise…at one point we even had a mini trampoline so she could jump whenever needed to burn off more energy…and she does chores too…

      I know I have become a rambler at this point, but you all talk like I am an abusive mom, just trying to control or medicate my kid into submission because I can…or because I enjoy it…or because it makes her special or something…

      I think ADHD is over diagnosed….and that leads to kids who do not need medication taking it….I also agree that some forms of ADD and ADHD can be greatly helped by other options besides medication…however I strongly DISAGREE when you assume that no child has ADHD and that it is just a fad diagnosis or that medication is wrong for all children…until you walk in my shoes…in the shoes of any parent with a child that is severely affected by ADHD you just cannot understand where we are coming from…maybe if we were richer and I could just throw money at the problem maybe there would be some other help for my child but in our current situation there is nothing more I can do, and I refuse to do less – do I benefit from my daughter being medicated…yes …yes I do…I get to be a mom…not a warden…I get to go to the zoo with my kids…i get to go to the park…I get to read a book when they read…I get to watch TV even some days…but I don’t medicate her so i can watch Grey’s Anatomy…I do it so she can enjoy life too…something she was not doing before!

      • @Momof:

        People of all kinds write here. But I think, one generally accepts that the behaviours associated with all psychiatric labels, be it ADHD or Internet Gaming Disorder, or schizophrenia are very real. And they could be problematic to the person with those behaviours or their care-takers.

        Many of us who post here have been severely negatively impacted by the labels we were labelled with. Some of us were even labelled with disorders for side effects of drugs we were prescribed. We have had labels used to abuse us and gaslight us and to obfuscate our truths. So, keep that in mind.

        One empathises with your situation and I will give you the benefit of doubt and assume that you are indeed a good mother.

        Just one thing. You mention the feeling of it being a “lifeline” when you “found out” that your child “had ADHD”. I felt the same way when I received my first label when I was 16. It was many years down the line that I realised that nothing came to me from it, and not only did it not explain any behaviour, but by rewording and quasi-medicalising my behaviour, it created even more severe problems and made me susceptible to even more labelling.

        Yes, this is my experience and also the experience of some others here. I won’t generalise it.

        But, if indeed your daughter is happy with whatever her treatment is, and life is better, why not? But it remains to be seen what she will feel like, 10 years down the line, 15 years down the line….

        • My daughter is now, encouraged to tell us how she feels about her ADHD and her treatment, although at this point in time as her mother and guardian I get the final say I always take into account what my daughter tells me…as we both grow and learn how to help her be her best, some of that is her helping herself…she has to put extra effort into being organized so she uses alarms on my phone (I don’t think any 11 year old should have a cell phone) to maintain the schedule that she designed…she figures out how long she thinks she needs/wants on an activity and then we set the alarms accordingly…yes I know lots of parents do not include the child in any discussion but if my child had cancer or diabetes or a life threatening allergy I would like to think I would then also include them in discussions about their health -maybe that makes me the exception instead of the rule…but even our doctor talks to our daughter and asks her questions before he addresses me about the topic, I find it refreshing (most of the time)! If my daughter decides in 3 or 5 years or 10 years she doesn’t want to medicate anymore, I will support her decision..even if I dont agree with it…but age or more so maturity can be a huge factor in ADHD management…so we shall see where she ends up!

  4. Great Article Peter

    I think Dr. Timmimi has finally ‘put to bed’ any notion that ADHD is a Disease or Disorder. After many years of research and many ‘tax payer $$$$$, no empirical evidence has been found that would classify ADHD as a Disease or Disorder. After a 22 year investigation into the underpinnings of ADHD, it has occurred to me that ADHD is the most misunderstood behavior problem that has ever been described ( Dr. Still, March 1902).

    ADHD is only a problem for those who observe or are the objects of the behavior, however, the children or young adults who present this risky, obnoxious and over-all bad behavior, receive a benefit from it. What benefit ? A Dopamine Increase. So low dopamine levels are the cause of ADHD ? NO! Low dopamine levels are the cause of the ADHD behavior…ADHD behavior is a temporary CURE for lower than normal Dopamine levels just like a Ritalin Tablet is a temporary cure for the behavior. So, a Ritalin tablet increases Dopamine levels? No, Ritalin tablets are a Stimulant and they are re-uptake inhibitors.

    Re-uptake inhibitors keep dopamine in the neuronal cleft during the effective period of the tablet.
    During this period, the child or young adult can relax and not preform ADHD behavior. they can think and solve problems, plan and perform at near normal levels. When the effective period of the tablet is over, the child is ‘once again’ called upon by the Autonomic Nervous System (ANS) to get back into the ADHD behavior again. All of this takes place in the Child’s unconscious mind . the Child or Young Adult does not know why they do the behaviors they do; they may even, in a quiet moment, confess to you that they don’t know why they do bad things, and they are telling you the truth. Kids diagnosed with ADHD are perfectly normal both mentally and physically: in fact, the must have a very good sense of ‘right or wrong’ or ADHD would not work for them.

    So, What is the cause of ADHD? The cause of ADHD are the factors that cause lower than normal levels of dopamine in 11% of our children, ages 4-17.

    Chet Bush

  5. Could the author of the original please cite what specific data he is using to come up with this finding (not the article, what data in the article):

    75% of people entering community mental health centres in the USA are either not responding to treatment, or deteriorating whilst in care.

    And speak to the recent neurological imaging research that seems to find brain differences in those diagnosed with ADHD. (e.g., Konrad and Eickhoff, 2010, Rubin et al, 2005).

    Thank you

    • Let us see them do this in clinical practice. This brain imaging crap is brought on here all too often. If any psychiatric label is such a discrete entity, let us see them do this imaging in clinical practice for diagnosis and discard checklists of all sorts.

      Also, please explain why long timers in psychiatry end up having up to 10 labels. For example, why one single person has the following labels:”schizophrenia, borderline personality, OCD, bipolar disorder, schizoaffective disorder, panic disorder, ADHD”. What does the brain of the “10-label disorder” person look like?

      Since there is no mind without a brain, even “Internet Gaming Disorder” (which is also a real label describing a real problem) will have neural correlates. So what?

      It sounds so smart and scientific, this “neurological imaging research”. It is worthless information in the setting of real life, and a simple conman tactic that obfuscates the truth of real-life clinical psychiatry and is something used by psychiatrists to give credence to their views and authority in real life, even though they will never check a person’s brain for anything.

      It would be just as truthful if they said, “look, you have a brain, which is why you have thoughts, and if you don’t like your thoughts, here’s a drug which may help you”

      P.S. I’m responding to the comment, and have nothing to say about the article.