Is ADHD a disease? And are novelty-seeking jobs really a cure?

From the NY Times article
From the NY Times article

When a piece like this comes out in the NY Times  it doesn’t always help the cause of seeing ADHD as a real issue, that people struggle with daily, and that those that are affected by it do deserve help. We don’t tell the short-sighted to try and manage without glasses, so why assume that the ADHDer has to settle down to difficult daily tasks without medication (or drugs, as the piece annoyingly calls them)?

First, is the author, a professor of Clinical Psychiatry Richard A. Friedman right to call it a disease? Not really. It confuses what it is, and it is already confusing enough – as disorders go. Disease is something one contracts, or that one gets over or rid of – like malaria or typhoid. Because ADHD is neurodevelopmental, ie the brain can develop and grow out of it, or at least many of the symptoms can be helped, it is better seen as a bundle of traits or a different brain wiring than a disease. You can’t give ADHD to anyone else after all, only your offspring because of the genetic link.

Secondly, are novelty-seeking jobs really a natural cure? Or small classes in school? Not really, not when inattention means that that adult or child will underachieve in any environment, unless some accommodation can be made to assist them to keep on task and pay attention – medication, coaching, teacher’s tricks. They aren’t going to learn or perform well in any environment, if they can’t stay focussed.

Finally – the jump in diagnoses does seem scary when you put it into percentages, but it is obvious really. Neuroscience is new science – a generation ago, people were just told to shape up,  mental health was seen as a shameful area of the medical profession, people were stuck in psychiatric institutions and the key was thrown away.

Given the genetic component of the condition, if a child has a positive diagnosis – it doesn’t take very long until one of the parents looks back at the difficulties in their life, and realises that they may have ADHD, too, ad that it’s just they were branded naughty, wrong, undisciplined, or are reading this in jail (expert Dr Ned Hallowell estimates that 20% of the US prison population have it – much of it undiagnosed). This then leads them to seek a diagnosis and medication (some of which is not apparently that different from caffeine – another Dr Ned observation) which then leads to what the author calls an “epidemic”.

Remember, in the UK, up until 2006, after the age of 18 it wasn’t even possible to get further medication for ADHD because it was deemed to have disappeared overnight, and adult ADHD did not even exist. Of course, if you take this as the base point, statistics and percentages are going to go off the Richter scale as people come forward to ask for help.

So, before suggesting that all ADHDers find a natural “cure” by following the path of our most famous UK ADHDer Sir Richard Branson, and become entrepreneurs ( hopefully without too much of the novelty-seeking risk taking associated with the condition, complete with pilots dying in test runs to space), let’s look at what the  new brain science is teaching us about this complex condition first. The more we learn about it, and the better we treat it and support those that have it (think of those unnecessarily locked up prisoners, who might have take a different course if not branded “wrong”, disobedient or dangerous at an early age) the better we might harness their human potential.

Only then will we have something approaching a natural “cure”.

 

 

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