It is a central theme of this website that there are no mental illnesses/disorders, and that the psychiatric medicalization of ordinary human problems is arbitrary, spurious, and destructive.
The widespread acceptance of ADHD as a mental illness/chemical imbalance has no scientific underpinning, but rather is based on marketing and promotion. The ADHD “diagnosis” is particularly destructive, in that it targets children, and serves as the justification for “treating” these children with dangerous drugs.
The APA’s criteria for this so-called illness are set out below:
a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
b) often has difficulty sustaining attention in tasks or play activities
c) often does not seem to listen when spoken to directly
d) often does not follow through on instructions, and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
e) often has difficulty organizing tasks and activities
f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
h) is often easily distracted by extraneous stimuli
i) is often forgetful in daily activities
a) often fidgets with hands or feet, or squirms in seat
b) often leaves seat in classroom or in other situations in which remaining seated is expected
c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults may be limited to subjective feelings of restlessness)
d) often has difficulty playing or engaging in leisure activities quietly
e) is often “on the go” or often acts as if “driven by a motor”
f) often talks excessively
g) often blurts out answers before questions have been completed
h) often has difficulty awaiting turn
i) often interrupts or intrudes on others (e.g., butts into conversations or games)
A positive “diagnosis” requires six hits from either the inattention list or the hyperactivity/impulsivity list. What’s very clear, however, from even a cursory reading, is that all the items are matters of discipline/misbehavior.
MISBEHAVIOR AND DISCIPLINE
Fifty years ago every one of these items would have been seen as a disciplinary problem. The schools would have been taking appropriate action, and in extreme cases, talking to parents, etc…
Indeed, fifty years ago parents would not have been sending children to school with these kinds of misbehaviors. The only reason that these misbehaviors are considered to constitute an “illness” is because the APA says so. There is no actual evidence of any kind to support this claim. The APA simply decided that these children are sick and need drugs. There are no objective tests for ADHD, and no established organic pathology. The “diagnosis” is based entirely on subjective reports from parents and teachers.
The psychiatry-pharmaceutical alliance is nothing if not entrepreneurial. The APA created the “illness,” and pharma created the drugs. The drugs used to “treat” this misbehavior are stimulants, pharmacologically similar to nicotine and cocaine, and have many dangerous side effects.
In my 2009 post on ADHD I cited a nationwide prevalence rate of 7.5% for school-age children, and drew attention to the fact that this had almost doubled since 2000. A recent NY Times article is quoting a prevalence of 11%! Psychiatry continues to claim that this kind of diagnostic expansion is the result of more cases being recognized! In reality, the criteria are so vague and so ubiquitous that they can be stretched to embrace almost any child. Pharma marketing is encouraging parents to bring their children in for evaluation, and the ever-cooperative psychiatrists are making the “diagnoses” and pushing the drugs. It’s a well-oiled machine, and it’s working perfectly – for the psychiatrists and the pharmaceutical companies.
And now – DSM-5 is extending the net even further. In DSM-IV, there was a requirement that the symptoms were present before age 7 and caused significant impairment in activities. DSM-5 will raise this threshold to 12, and require only that the “symptoms” impact daily activities. DSM-5 will also make it easier for adults to receive this “diagnosis” by reducing the adult threshold from 6 to 5 items. And remember, the more people who receive a “diagnosis,” the more drugs get sold. And also remember, 69% of the DSM-5 task force have ties to the pharmaceutical industry. But we can be sure that this didn’t affect their decision-making in any way, and that their only motivation is to help alleviate human suffering.
Meanwhile, an interesting study has just been published in Pediatrics. Interventions for Preschool Children at High Risk for ADHD: A Comparative Effectiveness Review, by Alice Charach, MD, et al. The research examined 55 earlier efficacy studies and concluded that parent behavior training (PBT) showed “…greater evidence of effectiveness than methylphenidate…” (Methylphenidate is one of the stimulant drugs used to “treat” the behaviors labeled ADHD. It is marketed under the brand name Ritalin.) In other words, grandma was right: children need discipline and correction, a simple fact that every generation has understood and taken on board until the pharma marketing juggernaut and its psychiatric accomplices decided to sacrifice children on the altar of corporate profits.
Or, in fairness, there could be another explanation. Perhaps ADHD is an illness that responds to improved parental discipline? I wonder if that might work for pneumonia!