Recently a psychiatrist diagnosed me with ADHD and prescribed me Ritalin, following talking to myself and my mother (whom she was asking questions about me as a child).
The purpose of this post is discuss my thoughts about the initial relevance and impact of this diagnosis.
It is also to document what my current understanding of ADHD is, before I do any serious research.
There are two common reactions I would like to discuss, when I’ve mentioned it to people.
- “Are you relieved?”
- “Is ADHD even a thing?”.
I think both of these are interesting and relevant discussion angles. I’d like to make it clear I don’t have a negative emotional response to either point.
Before we get too far ahead of ourselves, we should discuss:
What is ADHD?
ADHD, in my understanding, and it’s important this is only my current understanding, having not don’t much research, is mental condition characterised by three behavioural symptoms:
I think what’s important, is highlight that ADHD is defined by these symptoms, unlike a more tangible disease, like cancer, AIDS or the common cold, where you can physically see the cancer cells, or test for the virus.(Now arguably something like the common cold is more likely to be diagnosed by its symptoms, not by looking for the physical cause. However, if we wanted to prove it, we could still find the original virus).
ADHD on the hand, it’s unknown what ‘causes it’ – all the diagnosis is, is identifying the patient has this collection of distinct behavioral symptoms.
This does then, lend itself to the question ‘Is ADHD even a thing?’ – after all there is no virus or physically different brain structure to identify. (Actually the ADHD brain structure totally is different).
My understanding is that ADHD is caused by naturally lower levels on dopamine in the brain – meaning that the ADHD brain is constantly looking for more stimulation in order to trigger a dopamine release. This is what causes the ADHD symptoms.
(NB. I’m aware that there’s a major contradiction here! On one hand I’m saying that ADHD is defined by its symptoms, and on the other I’m saying ADHD is caused by something. Edit coming soon).
The medication – stimulants, stimulate the brains as to satisfy this ‘itch’, and allow the person with ADHD to focus on what they were otherwise doing.
“Are you relieved?”
The short answer is – yes, there was an immediate feeling of relief.
The rationale for this is pretty straight forward – if there is something that has been bothering you (and certainly there was, otherwise would not have been consulting a psychiatrist in the first place) then a diagnosis provides and answer and gives you direction to start tackling the problem – resources to read, people to talk to etc.
And certainly, looking at the symptoms of ADHD, the diagnosis does resound with me.
- Impulsivity? Certainly when I was a teenager and my early 20s. These days I’d argue that I’m actually perhaps less impulsive than a lot people (I like knowing what I’m going to do).
- Hyperactivity? Apparently as a kid, and at times yes, I like to dance about the office at times.
- Inattentiveness? Frequently – and I think this sometimes annoys people when it seems that I’m not paying attention.
However, I’m quite aware of a psychological quirk called the Barnum effect.
Essentially the Barnum effect is the observation that certainly personality traits, though seeming specific, resonate with everyone.
These are traits like (straight from Wikipedia):
- You have a great need for other people to like and admire you.
- You have a tendency to be critical of yourself.
- You have a great deal of unused capacity which you have not turned to your advantage.
- While you have some personality weaknesses, you are generally able to compensate for them.
- Your sexual adjustment has presented problems for you.
- Disciplined and self-controlled outside, you tend to be worrisome and insecure inside.
- At times you have serious doubts as to whether you have made the right decision or done the right thing.
- You prefer a certain amount of change and variety and become dissatisfied when hemmed in by restrictions and limitations.
- You pride yourself as an independent thinker and do not accept others’ statements without satisfactory proof.
- You have found it unwise to be too frank in revealing yourself to others.
- At times you are extroverted, affable, sociable, while at other times you are introverted, wary, reserved.
- Some of your aspirations tend to be pretty unrealistic.
- Security is one of your major goals in life.
The Barnum effect is precisely the reason that horoscopes resonate with people. People read the characteristics of their star sign, and think ‘That’s so me!’. But these characteristics, though seeming specific and individualistic, will actually resonate with anyone reading them.
So I’m aware that when I’m told that I exhibit these three particular behavioural symptoms, and I identify with them, that it’s possible that these are just simply particularly normal behavioural patterns, and not something specific to me.
A second consideration here is: “Ok, I’ve been diagnosed with ADHD – so what?”
Unlike something like cancer, or a brain tumour, where once the disease has been identified, it can be treated – the tumour can be removed – the diagnosis doesn’t actually change anything, I still need to deal with my life and behavioural patterns.
On this point, it’s not as entirely [helpless] as that. The diagnosis gives specific resources to consider using, or support groups to look at.
And the medication is something specific and will possibly help.
Is ADHD even a thing?
This kind of question can be offensive to some. The same kind of thing can be applied to other conditions:
- Is depression even a thing? Or are they just lazy?
- Is gender disphoria even a thing? Or have they just sexually confused?
- Is homosexuality even a thing? Or are they just a deviant?
- Is otherkin even a thing? Or are the just a teenager looking for a unique identity?
(I’m trying to find examples where it’s you could at least have a debate whether it’s a ‘thing’ or not, I’m struggling a little).
I think certainly – it’s reasonable to see these things as a bit greyer than physical conditions like cancer or serious mental conditions like schizophrenia (unless all schizophrenic patients are faking or exaggerating the voices they hear, schizophrenics’ brains clearly operate dramatically differently to rest of us).
Make no mistake – there is controversy about whether ADHD is a thing.
When I went to the library to find books on ADHD entire books are dedicated to the controversy of ADHD.
It is a condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM), however it’s worth mentioning that the DSM isn’t infallible. A good example is how homosexuality used to be in the DSM – which I guess is subject to criticism because today homosexuality isn’t seen as something that needs to be managed or cured.
In my mind there are two controversies.
– Is ADHD even a thing?
In this day of internet, information and social media addiction, one could argue that short attention spans are simply a product of this world of instant data and a lot of it. I myself do have something of a social media habit. However, this arguments neglects that ADHD was recognised before the age of the internet.
Or in a different vein – ADHD is simply a different personality type, and not something that needs fixing or treating with stimulants.
I think that it’s reasonable to suggest that ADHD is a personality trait, just like people angering easily might be a personality trait, or people being shy might be a personality trait. But that doesn’t mean ‘therefore we shouldn’t do anything about it’. A shy person might find that they’re looked over for promotions for example, and so they’d do well to learn how to manage their personality such that they’re still able to have a progressive career.
– The treatment of ADHD with stimulants.
I think this is probably the more solid controversy, where it’s a concern that especially we’re giving children reasonably powerful stimulants to manage the condition. The medical profession is criticised for not being creative in managing ADHD, and simply jumping straight to giving children stimulants.
My understanding is that overtime the use of stimulants and the diagnosis for ADHD has become more accepted.
Before my diagnosis a new age friend of my shared this video on her Facebook. This quite clearly shows the anti ADHD-diagnosis/anti-treatment viewpoint.
(When I googled I found another one which is a much stronger anti-drug message)
Bonus Round: Do you feel ripped off that you weren’t diagnosed earlier?
This question came up from my psychiatrist, when I mentioned my blog Things David Has Lost. She interpreted the blog title as an expression of regret, rather than its quite literal meaning.
The question here is reasonable – one could argue that had you been diagnosed and treated earlier then you might have been more focused at school, have a more advanced career by now etc.
But firstly that assumes that the ADHD diagnosis is useful in the first place, which we’ve already talked about.
And secondly, this is classic paradox of choice like thinking. When imagining what ‘could have been’ it’s easy to assume that that path would have been all smooth sailing, which isn’t necessarily the case.
Mainly – I want to read more to understand actually what ADHD is, and what it’s causes are.
I want to read about how medication is used to treat it.
Also – need to come in and tidy up some of the overt hanging threads in this post.