Saturday, October 8, 2011


The psychiatric diagnostic manual (DSM) which psychiatrists and other mental health care professionals refer to, classifies and names mental health conditions.  For example, a patient who displays six out of nine symptoms from two subsets of symptoms related to inattention and hyperactivity/impulsivity will receive the diagnosis of ADHD or attention deficit/hyperactivity disorder.  And with the diagnosis comes a 'treatment.' Not only is the term for this 'disorder' disparaging it is also grossly inaccurate.  I have had a number of patients sit in front of me and  cry when I have had to say, yes, according to the DSM IV (latest edition), you have a mental health condition and it's called ADHD. 

The term for this 'condition' has actually come a long way since the early 1900s when the term 'Defect of Moral Control' was used. After that it evolved into 'Post-Encephalitic Behavior Disorder' and then in the 1960's to 'Minimal Brain Dysfunction.' In the term ADHD there is 'deficit' and 'disorder'. It's also been referred to as a disease and an illness among other things.  It's no wonder there is such a negative stigma that accompanies the term. And no wonder why so many newly diagnosed cry as if receiving a life sentence.  Given that more than 4.5 % of the adult population could fulfill the criteria for ADHD, that's a hell of a lot of tears and life sentences!

But what is ADHD? It's an imbalance of catecholamine metabolism in the cerebral cortex (thereby affecting higher cortical functions) and an imbalance between the norepinephrine and dopamine systems in the prefrontal cortex. There is no true deficit of anything. ADHDers CAN pay attention and often times pay way more attention to something than a non ADHDer. There are pros and cons to this. The pro is that when something does catch the attention of an ADHDer, their attention can be lazer-like and interminable. On the other hand, if something does not catch their attention but should (like paying taxes) it can be unintentionally easily forgotten.  Is this a disorder? a condition? Or is it simply another expression of our neuro-diversity that is challenged in today's world where paying taxes, sitting for most of the day and filling out forms with deadlines is what's expected?
Excuse me, I just saw a lion go by-gotta run!

1 comment:

  1. LOL gee can't remember if I'd read this before seeing you as a client? But I am copying it and sending to my daughter who has due issue with her label of bpd. Excellent. I hope I can find someone at least partially as insightful when in AU! Thank you for everything, best to you and your son.


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