Furious Seasons

November 14, 2007

Is ADHD A Fraud?

That's the question posed in an editorial on MSN UK, coming on the heels of recent news that kids with ADHD essentially turn out just fine over the long-term. I'm still not clear on what the implications of those studies are for the meds-or-no-meds debate, but the author has her views. And a charming lede:

"It was probably nailing my teacher’s coat to the desk while he was still wearing it that did it. That and glueing his packet of peanuts to the classroom ceiling, at a precisely-calculated five millimetres beyond his furthest reach.
"It was the climax of what I – and most of my pre-teen classmates – considered a sustained comedy campaign, a bit of light-hearted high-jinx designed to redress the teacher-student balance of power. It wasn’t my first and nor would it be my last, even though this particular incident triggered a catastrophic sense of humour failure in said faculty member, who mysteriously vanished overnight.

"Had I been born a decade or so later, I doubt I’d be writing this today. Rather than spending almost 20 years inventing new ways to terrorise a succession of teachers, lecturers and employers – fuelling other forms of creativity, including writing, in the process – I’d have been given a massive dose of Ritalin and left in a corner to rot."

Ah, yes. Like this author, I have aired my concerns about how I would've been doped into oblivion had I been born 20 years later. Unlike her, I don't really think parents are to blame for all the ADHD, bipolar child craziness afoot in Western culture these days. But here's how she went after it:

"There are, of course, some children who genuinely need pharmaceutical intervention. However, more often than not, this so-called disorder is really the result of combining excessively spirited children with criminally sub-standard parenting skills – quite the Molotov cocktail. In cases where a child becomes disruptive due to lack of parental care, affection or stimulation, the impairment belongs not to the child, but to the surrounding adults."

Elsewhere, she quotes a doctor who states that ADHD is the biggest healthcare fraud in history. While I think there's a lot to criticize about how ADHD and bipolar disorder have been applied to children, I sometimes worry about the source of the more extreme assessments.

I'm a bit puzzled that a journalist from a fairly reliable news outlet would set about using Fred Baugham as a supportive interview. Baugham may be right on some of his points--ones other docs such as Larry Diller make--but he's also the medical advisor for the Citizens Commission on Human Rights, a front group for the Church of Scientology. CCHR and CoS claim that mental illness doesn't exist at all, and while I am a big skeptic of much of what goes down with mental health diagnosis and treatment in Western Culture, I think it's fair to say that mental illness is real, it actually exists and if anyone needs proof of that, then I can take you on a walking tour of Seattle's streets and jails. Whether mental illnesses exist to the degree doctors like Harvard's Joe Biederman claim--or whether they even exist in small kids--is another matter entirely. Bipolar disorder at 2 percent I buy. Bipolar disorder at 5 percent or more strikes me as an example of social hysteria and doctor self-justification disorder.

You can take all this up on a message board on this topic that MSN UK has going. It was up to 43 pages when I looked. Go join the fun.

Posted by Philip Dawdy at November 14, 2007 11:39 AM

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Comments

"Whether mental illnesses exist to the degree doctors like Harvard's Joe Biederman claim--or whether they even exist in small kids--is another matter entirely. Bipolar disorder at 2 percent I buy. Bipolar disorder at 5 percent or more strikes me as an example of social hysteria and doctor self-justification disorder."

My take on this as a person who is in the classroom for a job, is that for the most part it's "social hysteria".

Here's the deal: kids in a classroom. Confined, structured, 20-30 kids. Anyone remember not being able to wait for recess? I was separated for talking I don't know how many times, and was in the office for playing with soap in the bathroom, talking, breaking dresscode--all by 3rd grade.

Kids are kids, and that's why recess works. The teacher, to gain control of the class, must have all kids "the same" in the "box".Teachers now, as opposed to the 70's for instance--have more on the agenda to get completed[taught] and are under pressure to get the work done--needing kids attention in a jam-packed, fast-paced day---because parents expect more from public schools than ever.

So the pressure is there for the teacher, which trickles down to the child, to conform and sit still, or possibly end up labeled ADHD. Once that label and med walks into the school--the child has it in the file, and it's a bitch to remove.

The parents become under pressure to medicate, and quite often, the phrase of the day for the medicated child who is still acting up,from teachers is: "Did the child take his/her meds today?"

The pharmaceutical revolution has [I dare say]influenced teachers and parents alike, with tempting offers of a medicated child who will now "fit into the box" in class. It's not that simple.

I'm not saying some kids need meds or not--I'm just saying as I see it happen, and how it was when I was an unmedicated motor-mouth.[and did fine].

Posted by: Stephany at November 14, 2007 12:41 PM

Science writer Jonah Lehrer has a post on this, too.

What interests me about this finding is that it suggests that ADHD is largely a matter of developmental timing. Given time, the cortex eventually matures. Perhaps this will lead us to be a little more reluctant to treat the condition as a neurological disorder, best treated with a powerful stimulant.

Posted by: MvB at November 14, 2007 01:25 PM

On my site I mentioned a report of alleged "something biologically different" in ADD brains.
LINK

"Brain matures slower in kids with ADD, researchers say"
CBCLINK
CTVLINK
I call this junk science as the ADHD children in question(223 children with ADHD and 223 others) were likely medicated, and the medication could likely be a factor in brain developement.

psychwatch LINKgoes on another approach, going with the assumption the data is valid. If the study is valid it still does not make ADD a disease any more than a brain scan that indicates LEFT-HANDEDness is a disease in need of treatment.

Posted by: mark p.s. at November 14, 2007 04:15 PM

Mark,

Among other scary things, here's one - it wasn't too long ago that educators thought that left handedness was a disease in need of treatment.

The adhd diagnosis assumes that there is only one temperament that is correct, pulls all children who demonstrate any iconoclastic tendencies or creativity out of the mainstream and destroys their brains with drugs. Whopee! Imagine where we'd be if no original thinkers or rebels had ever been allowed to express themselves after the age of 7 or 8 in the past.

Posted by: Sally at November 14, 2007 06:28 PM

MvB, thanks for the link to Jonah Lehrer--I hope someone in Seattle is going and taking notes!

Posted by: Stephany at November 14, 2007 06:29 PM

I agree. To just put the blame on poor parenting seems a little cheap to me, too. Although I think, there actually is a lot of poor parenting - and teaching - today, due to the trends in society Stephany mentions.

I also was a bit puzzled to see Fred Baugham quoted. There are other critics who don't have his Scientology-background and thus seem more credible, at least to me.

Nevertheless, I got the impression that you maybe haven't quite got the point when it comes to the term "mental illness". Szasz - and Baugham alike, as I see it, although I'm not an expert on Baugham - do not say that there's no such thing as mental suffering when they deny the existence of "mental illness".

Their point is that mental suffering has got nothing to do with genes, imbalances in the brain's metabolic system, some biological brain dysfunction. It is not a brain disease, like diabetes is a disease of the body, as the term "mental illness" implies.

Personally, I agree completely to this view and, consequently, use "crisis" instead of "illness". "Mental illness" as a term is only good for one thing: discrimination of the person who is labelled "mentally ill".

Posted by: Marian B. G. at November 15, 2007 03:43 AM

I have to say that I'm a bit concerned with the dismissal of Baugham just because of his ties to a certain religion. He is a neurologist. Someone with a medical degree and the ability, and legal authority, to diagnosis diseases. His argument is that there is no diagnostic test or biological component for ADHD. That's a valid argument no matter the ties to any group.

Now I'm not a member of the CoS and do not agree with it's views, but as a doctor who regularly diagnoses diseases his research and opinion on the subject of a true disease should be respected.

Posted by: Aimee at December 16, 2008 02:36 AM