ADHD, a neurobehavioral disorder, is diagnosed through a psychiatric assessment. Essentially, information about you is collected, some other diseases must be ruled out, and then you get a diagnosis. There is no blood test or study that can be done to verify your diagnosis, meaning error and over-diagnosis is possible. The possibility of error sounds even more like a reality when you look at the symptoms/criteria associated with ADHD. Some include: difficulty focusing, daydreaming, talking nonstop, impatience. To be quite honest, I've experienced all of these symptoms at some point in my life. However, I wouldn't say that I have ADHD. Neither would many others, apparently, as ADHD is currently considered one of the most over-diagnosed diseases.
Bringing in approximately $3 billion every year to pharmaceutical companies for ADHD medication, I begin to wonder whether or not we are just craving diagnosis. Maybe our culture has begun to over-embrace the idea of diagnosing a disease and treating it with medication. What if these children are just hyper and distracted? What if it's just a phase? What if those characteristics are symptoms for a different, more severe disease? With appearance-driven disorders like ADHD, one cannot be sure. Taking this uncertainty into consideration and recognizing that there are some children taking 119 pills every week for their disorders, it seems necessary to question whether or not it's okay for doctors to so heavily rely on medication for "appearance-based" disorders. Though medication can sometimes help ADHD patients, it also isn't necessary in some cases. In others, the child may even be misdiagnosed.
With all of this in mind, I would say that our society needs to step away from medicine and try to fight off the craving for a diagnosis. We should more thoroughly examine these disorders and diseases and not let the ease of prescribing medication overshadow the complexity of these "appearance-based" disorders. Perhaps more emphasis must be put on lifestyle changes, such as, in the case of ADHD, finding ways to limit distractions or teaching those with the disorder how to naturally subdue their symptoms. Medicine will always be an option, but certainly shouldn't be the convenient way out. Appearance isn't everything and sometimes what may seem like a certain disorder will end up being something completely different. Let's eliminate our urge to label and medicate and take a more thorough look at how we are handling diseases and disorders.
(Saw Stephanie's comment like halfway through writing this one) Some of these subjective diseases have serious complications involved. For example, depression could lead to suicide. But in the case of ADHD, the complications are much less severe. Whereas treating depression provides obvious benefits, such as decreasing suicide rates, treating ADHD seems to lack the same clear-cut benefits. I agree there is something wrong with our diagnosis of ADHD. I find the problem to be that the disease reflects our culture, and treating the disease doesn't help treat whatever cultural problem the disease stems from. I say it's stemmed from our culture because to me that's the only explanation for its sudden rise. So what part of our culture is causing attention issues? The same part of our culture that really took off in the 90's, with the rise of ADHD: technology. Technology allows for easy distraction, and thus this thing we call ADHD. As Stephanie mentions, there might indeed be a real disease here, independent of the cultural incentive. But if we somehow deal with the cultural problem, we can better realize who needs the real help.
ReplyDeleteAnd there are definite risks involved with "false" diagnosis. First of all, it provides the subject with a way out. Rather than helping the subject focus more, you run the risk of allowing that subject to not focus and have an excuse for doing so. Secondly, the drugs involved have side effects and should be considered dangerous like any others. Finally, does this diagnosis unintentionally encourage us to put every difference among people under the microscope, labeling it and treating it, rather than appreciating it and finding a role for it in society?
You expanded upon many of the ideas I brought up in this post- very interesting additions! Yes, I agree with you that there are several reasons why more people are being diagnosed with ADHD. I remember talking about this idea in English- how we currently live a more sedentary lifestyle..sitting at the computer, at a desk, etc. This wasn't how life was before. People were used to doing more physical activity and laborious work. As I talked about in my last post, major changes came about when the technological revolution took place. Perhaps our culture is having a hard time adapting to these changes? Even more strange is the question of "evolution" throughout this time....do we evolve, both physically and mentally, to adapt to these new circumstances? Maybe some of us do, making us more equipped to live this newly sedentary lifestyle, and some don't, making them the ones that are considered "disease-ridden". Interesting.
ReplyDeleteYour point about simply over-diagnosing is likely true as well. Like I discussed in the post, we like to have a name for things. We don't like the unknown or the mystery. If someone feels like something is wrong, they want there to be a name for it and for there to be a solution...instead of just being different. Sometimes this is good, especially with depression, which if left unnoticed could lead to self-harm or even worse, suicide. However with ADHD, kids and adults may just be hyperactive or distracted...not diseased.
It's definitely difficult to come up with a solution. Currently, people are usually diagnosed after a psychiatric assessment and concerns from either a parent or teacher. I think further research must be done about it....maybe there is a more clear-cut indicator of this disease? Something that could help us know for sure if someone has it? I'd like to look into it to see if any research is currently being done regarding this.
Depression is certainly a different story. Though there is some controversy regarding how it’s handled, it is definitely more clear. Like you said, if untreated, those affected may turn to self-harm or even worse, suicide. For this reason, it’s definitely one that shouldn’t ever be dismissed. However, ADHD is a lot more mysterious and ambiguous. As I mentioned in my reply to Stephanie’s comment, technology is a huge factor that has led to our more sedentary lifestyle. I’m glad you’ve brought this up. I appreciate what you said about trying to cure the cultural problem we currently have associated with this disease. I never thought about it in this way. If we recognize that we ourselves have made this situation get out out hand, we may be able to change our outlook on the disease itself. Perhaps it is truly a major disease, however if we recognize how our culture has changed and how, as a result, ADHD has become more prevalent in society, we can both treat it more effectively and/or better recognize it for what it is. Like you said, there is a lack of clarity, and it certainly needs to be resolve. However, would just recognizing this change in society and lifestyle be enough to help? Or would we need to take some sort of measure to aid in this? If so, what would it be?
ReplyDeleteI agree with the risks that you mention about false diagnosis. It provides both the patient and health care professional with a way out. It just sometimes seems like we overmedicate, seeing as it is the easiest solution. This is common with ADHD, it seems like. Parents will be completely fine with medicating their kid because if they truly have this disease, it will help suppress it, and even if they don’t and they’re just super-hyper and distracted, it will suppress this behavior. However like you mentioned, all medicine has side effects. And if it’s used too leisurely, it can come back with repercussions later on in life. Also, you brought up a great point regarding long-term solutions. Medicine is a temporary solution. It helps for some hours and then you’re back to how you were before. As one of the articles I linked to this post mentioned, it’s much more effective to work with the patient to promote a better lifestyle with ADHD. Instead of just relying on medication, it’s better to teach the patient ways of preventing distractions, creating a schedule or plan to follow, or find ways to work with the patient to help them be a successful individual in society. That is something they can use for the rest of their life and could even lessen the disease. Obviously medicine is crucial at times, however with “long-term disorders” like this one, it is much more helpful to provide more natural, lasting solutions rather than a handful of pills to suppress the symptoms.
I think this point you make at the end is an answer to your question about recognizing the problem as cultural. We need to find ways to incorporate those with ADHD into our society rather than medicating them to conform them to "the normal way". If we do so, and recognize it as the best solution, then ADHD need not be a concern. The problem here it that it becomes chicken-egg. If we wait to stop diagnosing until society finds a way to accept those with the disease, then the disease may never be accepted. This is because people will have no reason to change their views if medication is solving the issue. But if we stop first, before society has reached acceptance, then those suffering from ADHD may not be immediately accepted and may call for medications, thus proving to themselves medication is the only answer. So how do we overcome this circular trap? That tis the question.
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