Tuesday, July 7, 2009

Reason #327 Why ADHD Is a Baloney Disorder

by: Dr. Dathan Paterno

Quick, think of some neurological disorders. If you’re having trouble, how about these well-known disorders: Muscular Dystrophy, Cerebral Palsy, Spina Bifida, Parkinson’s, Lyme disease, Epilepsy, Hydrocephalus, Lou Gehrig’s Disease. All of these are very well-established diseases, with known pathophysiology (that means we can see where the brain or tissue has gone wrong or is adversely affecting the body).

ADHD is completely different. There has never been any pathophysiology evidenced for ADHD. There are theories, of course, but nothing has ever been demonstrated, despite billions of dollars spent over decades. No microscopic or macroscopic differences, no structural or chemical differences have ever been discovered.

Another crucial difference…think of all those neurological disorders. Do any of them get better when someone pays attention to them, when the person has greater discipline, or when there are novel stimuli present? The idea is laughable, isn’t it? Imagine expecting the symptoms of a child with Cerebral Palsy to disappear simply when his or her parents unite in their expectations or a young man with Parkinson’s to stop shaking when he is playing a highly interesting game. It just does not happen. Why? Because those are true neurological disorders.

But the symptoms of ADHD improve dramatically under at least three conditions: when the child is presented with novel stimuli, when the child has strict, consistent limits, and when the child has significant one-on-one attention. If something is that responsive to three things that every child NEEDS, how can that be a neurological disorder? It simply stretches the bounds of credulity beyond what a critical thinking person can tolerate. Neurological disorders do not get better when the person’s environment offers them things that normal people need.

ADHD is not a real disease. It is not a neurological disorder (or what they sometimes call a “neurobehavioral disorder”, which is a nonsense term.) ADHD is simply a description for a list of behaviors that are annoying to parents and teachers and for which they currently do not know how to effect change.
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  1. Wow,...just wow! I could not agree more. Well said!

  2. I am an adult with ADD (not ADHD) my brother, his son, and my daughter have it as well. We would all tell you the same thing -- medication for us all was a miracle. Be it Ritilin, Adderal, or the now defunct Pemoline, to suddenly not be going in circles, being constantly distracted, etc made such an enormous difference in our lives that it cannot be adequately expressed. If you don't have ADD, it guess it is easy to think of it as baloney.My wife would bring me ADD books, etc and I said it was nonsense. After a complete neurological evaluation however, I consented to take medication I was about fifty at the time...OMG! What a blessing!

  3. Anonymous #2:

    I respectfully disagree with your premise. It seems to me that you conclude that because your symptoms have improved from taking stimulants that that justifies a diagnosis. It simply does not follow.

    Certainly both adults and children struggle with attention, concentration, impulsivity. There is no doubt about that. Certainly both adults and children who take stimulants often see those "symptoms" improve. There is no doubt about that. But it is illogical to conclude that those symptoms are due to some neurological disease.

  4. Anonymous #2:

    Another thought...you mention having a "complete neurological evaluation". How do you know it was complete? What standards do you use to determine if an evaluation was complete?
    I highly doubt that your doctor performed a "complete" evaluation.

    As for the medication issue, I have no issue with people taking medication. That is 100% your choice and I respect that. Again, I know that drugs affect behavior. Still, that does not make ADHD a legitimate disorder...at all.

  5. I respectfully disagree as well, having lived over 30 years before being diagnosed. Since starting medication, time makes sense to me as a linear concept - I am able to plan into the future, am not continually running late, and am usually prepared for what I need to do ahead of time. The medication isn't the cure, of course, but to say that it's a "baloney diagnosis" is really disparaging to people who spend a lot of time suffering unnecessarily.

    Would I argue that children are over-diagnosed and either overly or improperly medicated? Absolutely. But that's a whole different post altogether.

  6. Anonymous #2,

    I absolutely do not disagree with your perception that your life is better--even radically so--since you started taking medication. I'm glad for you.

    Still, that does absolutely nothing to validate the diagnosis of ADHD as a real neurological disorder. I stand by my belief that ADHD is a social construct and not a real disease. Again, don't misunderstand me: the individual problems are real (difficulty paying attention, disorganization, etc.). But that is not a disease. ADHD is still a baloney diagnosis; my believing so does not disparage you or those who suffer poor attention and concentration or disorganization (I happen to have struggled mightily with those in my lifetime, so I can relate).

    Is there anything you can offer as evidence that it is indeed a true neurological disorder? I'm more than willing to listen; if I'm wrong, I would surely like to know!

  7. The below was taken from the NINDS, National Institute of Neurological Disorders and Strokes

    Attention deficit-hyperactivity disorder (ADHD) is a neurobehavioral disorder that affects 3-5 percent of all American children. It interferes with a person's ability to stay on a task and to exercise age-appropriate inhibition (cognitive alone or both cognitive and behavioral). Some of the warning signs of ADHD include failure to listen to instructions, inability to organize oneself and school work, fidgeting with hands and feet, talking too much, leaving projects, chores and homework unfinished, and having trouble paying attention to and responding to details. There are several types of ADHD: a predominantly inattentive subtype, a predominantly hyperactive-impulsive subtype, and a combined subtype. ADHD is usually diagnosed in childhood, although the condition can continue into the adult years.


  8. Your description is typical of ADD (not ADHD).

    Punishing her for an inherited condition hardly seems fair and in fact can only do harm to her self esteem.

    She needs a neurological examination by a doctor who has expertise in treating ADD/ADHD. He will advise you on medication, motivation,sympathetic acceprence, parental councilling and academic remediation.

    I advise on adders.org Here on this website you can also download some of my articles that will give you more insight.

    Good luck!

  9. Anonymous, that's no evidence at all--it's simply an assertion! We all know what the symptoms of ADHD are; that says NOTHING about whether it is a personality disorder, neurological disorder, or a normal trait that is a poor fit with our culture.

    Again, I challenge you to provide EVIDENCE (not assertions, even by people or groups with cool acronyms) that ADHD is a neurological disorder.

  10. Another Anonymous,

    Who is this "she" you are saying who needs a neurological examination?

    ADD and ADHD are equally bogus diagnoses.

  11. I am currently studying pathophysiology, and I understand very well the relationships among human anatomy, pathology, physiology, and pathophysiology and I remain unconvinced that without physical pathology there is no disease (or disorder).

    I think that your statement "ADHD is simply a description for a list of behaviors that are annoying to parents and teachers and for which they currently do not know how to effect change." is flawed in three major respects.

    1. it assumes that the behaviors of a person with ADHD are considered to be annoying to parents and teachers.

    2. It assumes that effecting change in a child's behaviors relies on the parents and teachers alone, as if the child has no interest in effecting change, as if the child is not "annoyed" by his or her "behaviors".

    3. It assumes that only children are affected by ADHD.

  12. Marnie,

    Thank you for your comments and challenges.

    Let me clarify a few things. First, you said that you are unconvinced that without physical pathology there can be no disease or disorder. That is fine as far as it goes (although I vehemently disagree), but to call a series of behaviors a neurological disorder with no evidence of pathology is incorrect. If one were to say that ADHD is a cluster of related symptoms that get in the way of academic or work performance, that is certainly better. But to say it is a neurological disorder is manifestly FALSE.

    Second, Yes, I do assume that behaviors of children DIAGNOSED with ADHD (no one actually "has" ADHD, since it doesn't really exist) are annoying or bothersome to parents and/or teachers. This is a necessary condition of the diagnostic process; in fact, no one would ever be referred for evaluation if the child's behaviors weren't annoying or bothersome to a teacher or parent. Almost NO children are bothered by their "symptoms" until and unless the adults in their life are. Part of the diagnosis REQUIRES "impairment", which can be in school, home, relationships, work. If a child's schoolwork or home relationships are "impaired", you bet your britches that is going to be annoying to parents or teachers. THAT is what gets the child in the mental health system.

    Similarly, yes, almost no children are annoyed by his or her behaviors, except to the degree that they are disappointing, annoying, hurting, or otherwise bothering the adults in his or her life. I've worked with children for 18 years and I have NEVER seen a child independently bothered by his activity level, distractibility, or any other ADHD-like symptom.

    Last, I never suggested that only children are affected by ADHD-like patterns. Of course adults struggle with the same things! My focus, however, is on children, since I work with parents to "cure" their children of the baloney diagnosis of ADHD. Adults are far less maleable than children and are indeed often bothered by their ADHD-like symptoms, with or without external feedback or pressure. That's a different ballgame altogether.

  13. Two years ago, my 37 yr old son jumped on the ADHD bandwagon. I believe it started when he became a stay at home dad to his newborn daughter. He needed something that would keep him up with her so that he wouldn't get tired. He somehow convinced his Dr. that he has ADHD and without any type of evaluation, was given Adderall. He since got a divorce and has custody of his daughter twice a week who is now 3 yrs. old. He is totally hooked on this drug (90 mg. daily) and even runs short before he goes back to his pill pushing Dr. Along with Xanax and Adderall, he sadly needs rehab. But he doesn't see it. My husband and I have gone to two different pyschologists out of desperation. We even pleaded with my son's psychiatrist...he claims my son needs rehab...after pushing him pills!!! He is not a child and I feel like I am slowly going to watch him OD. Help!!