ADD/ADHD: real or ************?

[Ray Brady]

As a lifelong sufferer of Attention Surplus Syndrome, my primary hope is that we will someday find a better acronym.

 

[Jodie]

Yes it's real. I'm the father of a person who was medically diagnosed as ADD (no H, in his case). In the process of taking him to doctors over the years while this diagnosis was being discovered, I found that I was/am almost exactly as he is. I suffered terribly with school and any tasks that weren't in my 'sweet spot' of interest.

Seeing the benefits of his diagnosis and subsequent medication, the differences are like night and day. He's getting very good grades, is able to focus and most importantly LEARN.

Whether it's diagnosed in the 'right' amount is not the issue. What's important is that in many cases, the diagnosis and treatment of ADD/HD has life-changing implications.

My son had the same problem, he was diagnosed in middle school but none of the medications worked for him. We continued to try different brands each with horrible side affects, mainly insomnia.

When he was 15 his blood pressure was elevated on a physical exam we were getting for applying for membership at a fitness center. He had blood work done and his HgbA1C was 450, he had converted to type two diabetes.

No one in my family was ever diagnosed with type two diabetes at such a young age. Upon researching the medications, I learned that there was a connection between insomnia, resulting elevated cortisol level, and the onset of diabetes.

http://www.sciencedaily.com/releases/2011/10/111003080419.htm

I caution anyone whose child is given this diagnosis to pay very close attention to the side effects. I would rather have a absent minded son than one with diabetes, it was only a fluke that we found out he had it before it became a crisis situation. The subsequent health problems related to diabetes will be a concern for the rest of his life.

 

[bumlet5]

Please correct me if my interpretations are wrong.

I do think rather than just throwing a diagnosis on a child and placing them on medication, that a more thorough exam could be done.

To me this sounds like you think the process for clinically diagnosing ADD is minimal. What do you think the process involves?

If certain things in the child's environment can be altered to prevent medicating unnecessarily then I think those things should be attempted if feasible.

Perhaps rethinking how we educate our children with the expectation that they sit still for extended lengths of time and that we all stick to the same generic curriculum is in order.

Do you think that ADH(in this case)D behavior is just kids being kids?

 

[stilicho]

....

Also, what do you think of ADD/ADHD?

Isn't it a subset of other mental illnesses? Is it possible that weak forms of neuroses and psychoses are "downgraded" to avoid the expense of treatment and safe removal of the "sufferers" from the general population?

 

[jiggeryqua]

I have a friend who was recently diagnosed with Asbergers.

I don't know much about ADD/ADHD, but I am intimately familiar with Aspergers (not self-diagnosed, though I know there's a lot of that going on). It's an easy mistake to make, I know, but it's turned into 'Ass Burgers' often enough that I'd plead with you to make every effort to update your internal dictionary.

 

[Dancing David]

My only concern is that it's over-diagnosed.

Which is a different issue, the first line should always be environmental and behavioral changes, then medication should be considered.

 

[Dancing David]

If my kid was diagnosed with it I would like a second or third opinion.

Exactly, teachers are not trained in assessments. It takes quite a bit of data, including observation and time/behavior studies to make a good assessment. It is important that the disorder shows in all environments.

You can tell a lot by when the child can appear to focus.

 

[Dancing David]

If certain things in the child's environment can be altered to prevent medicating unnecessarily then I think those things should be attempted if feasible.

.

That is best practice, behavioral and environmental changes are always the first line of action.

 

[Dancing David]

My son had the same problem, he was diagnosed in middle school but none of the medications worked for him. We continued to try different brands each with horrible side affects, mainly insomnia.

Then most likely he does not have ADHD, at least the doctors I knew felt that way. They should have done more extensive psychological and neurological evaluations.

If the medications are not working then a change is diagnosis is indicated. there are so many things that look like ADD, especially some of the more interesting learning disorders. Depression in particular, after the LDs is often a good one to look at.

 

[Dancing David]

Isn't it a subset of other mental illnesses? Is it possible that weak forms of neuroses and psychoses are "downgraded" to avoid the expense of treatment and safe removal of the "sufferers" from the general population?

Hi, neurosis is a term largely no longer used as it is not useful. Psychosis is not anything like ADHD. Who removes people from the general population, that is no longer the case here in the US.

 

[quadraginta]

If my kid was diagnosed with it I would like a second or third opinion.

If they were diagnosed with only one opinion it wouldn't have been done right to begin with.

 

[quadraginta]

Working with Special Education for 4 years now I can say that I have first hand seen people try to get their kids diagnosed with "anything" so they can get services for their kids. Ex. I had my son diagnosed as ADD. He's not on medications and I have him labled so he qualifies for CTT and intervention services in his school.

I want these services and don't want to pay for them and as long as he is diagnosed he gets it. (I think they may have changed his disability to learning disabled though)

I have a friend who told me for years about the hard traumas of raising her autistic son. When I met him I thought he must be another son because the kid is definitely not autistic and she sort of revealed later that once he got diagnosed he qualified under IDEA law and FAPE for tuition at this very expensive private school.

I know plenty of women with kids that are probably diagnosed like this. I also have plenty of stories where parents don't want the kids labeled so they refuse services the kid needs etc.

I think it is definitely over diagnosed in schools. I don't think it's over diagnosed medically though.

That last sentence is disturbing. It seems to suggest that you are in a school environment which diagnoses children without the involvement of the medical community. If that is the case then I am unsurprised the results are less than satisfactory.

As to your first point, there are always people who try to take undeserved advantage of social support programs (or any pool of money, for that matter.) This does not mean that the programs are not useful, or that the problems they address do not exist.

Most of the time I see someone trying to conflate these issues it is to imply that this is evidence that the illnesses or the goals of the programs are somehow at fault for the abuse of the system.

They aren't.

 

[Jodie]

Please correct me if my interpretations are wrong.
To me this sounds like you think the process for clinically diagnosing ADD is minimal. What do you think the process involves?

Do you think that ADH(in this case)D behavior is just kids being kids?

From what I experienced it is all anecdotal with other people, teachers mainly, that validate the observations. There is no blood work or concrete physical test to diagnose this condition. If the condition is real, like any other condition, it would exist on a continuum of severity, and the amount of severity is subjective. In my son's case, it may have been kids being kids, or their might have been an underlying issue not diagnosed.

He is 24 now and majoring in physics even though I could not get him to open an Algebra book in middle school. He was recently diagnosed with an anxiety disorder and has had three panic attacks in the last five years that I know about. The anxiety could have played into the chronic insomnia although it is also a side effect of ADD meds. He remains unmedicated and tries to deal with it on his own terms although at this point, I think medication would be warranted, to prevent the attacks from being more frequent as he gets older. There is no such thing as a stress free life.

 

[quadraginta]

Yes it's real. I'm the father of a person who was medically diagnosed as ADD (no H, in his case). In the process of taking him to doctors over the years while this diagnosis was being discovered, I found that I was/am almost exactly as he is. I suffered terribly with school and any tasks that weren't in my 'sweet spot' of interest.

Seeing the benefits of his diagnosis and subsequent medication, the differences are like night and day. He's getting very good grades, is able to focus and most importantly LEARN.

Whether it's diagnosed in the 'right' amount is not the issue. What's important is that in many cases, the diagnosis and treatment of ADD/HD has life-changing implications.

My family had much the same experience. My son was diagnosed in the Eighties, before there was an "H", and before it had become fashionable to disparage the disease. After many months of involvement by family, teachers, and physicians of several disciplines he was prescribed a minute quantity of Dexedrine, once a day.

It was as though someone had flipped a switch. He went on to perform well in school and athletics, and later to finish college.

He managed to get along without meds after a while, but to this day (a couple of decades later) his coffee budget remains prodigious.

 

[Professor Yaffle]

Well I know its isn't diagnosed willy-nilly in the UK. Kids with symptoms are referred either by their GP, or by a school nurse, to a child and adolescent mental health team. They then have to be assessed in several settings to make sure its not a situational problem. First line treatment will usually be family/parental intervention - ie training the parents better strategies for managing the behaviour, and if possible behavioural intervention by specially trained teachers at the school. Only in more severe cases, where this intervention isn't sufficient, will drug treatment be used in addition.

Here are the NICE guidelines:

http://www.nice.org.uk/nicemedia/pdf/CG72QRG.pdf

 

[Dancing David]

That last sentence is disturbing. It seems to suggest that you are in a school environment which diagnoses children without the involvement of the medical community.

School psychologists can not prescribe medications, not can school social workers. Neither can diagnose.

In Illinois, ADHD will not qualify you for special education services unless your academic performance does not meet yur test scores. It will qualify you for OHI (Other Health Impairment) and under a 504 plan you can sort of get SPED services, but compared to the other SPED students ADHD is a small fraction of SPED students.

 

[temporalillusion]

I just wanted to say thanks for your posts in this thread Dancing David.

 

[quadraginta]

School psychologists can not prescribe medications, not can school social workers. Neither can diagnose.

This is the situation as I understand it, which is why I found the apparent alternatives truethat seemed to be describing to be problematic.

<snip>

I think it is definitely over diagnosed in schools. I don't think it's over diagnosed medically though.

I'm not sure how it can be over-diagnosed in the schools without it being diagnosed there to begin with, and there is a clear dichotomy between that and diagnosis by medical professionals implied in the statement.

Perhaps I misunderstood what was being said there. If so, my bad.

In Illinois, ADHD will not qualify you for special education services unless your academic performance does not meet yur test scores. It will qualify you for OHI (Other Health Impairment) and under a 504 plan you can sort of get SPED services, but compared to the other SPED students ADHD is a small fraction of SPED students.

I am reminded of the hype and hysteria that frequently accompanies condemnation of other social support systems, like foodstamps and Medicaid, where, when you drill down below the surface of all the lurid, alarmist reports of abuse and fraud it turns out that the systems are generally working about as well as can be expected from any real world p.o.v.

 

[Dancing David]

I just wanted to say thanks for your posts in this thread Dancing David.

My wife is a school social worker, I know more about adult mental health, and computers.

Teachers, well they are teachers, they have a very difficult job, I do not think I could do it. But their views of student behavior are based upon their constant exposure. So they tend to have biases. But I have seen the students who vibrate in place.

 

[Rolfe]

A colleague of mine has a young son who was diagnosed fairly recently. This was a long process, and they didn't give him the diagnosis until they'd done a lot of testing and tried this and that behavioural therapy. She was very resistant to the idea of his being medicated (why I don't know because she lives on Prozac). In the end she gave in and said, OK, but if it isn't a miracle cure we're not continuing with it.

It was a miracle cure.

I don't see any evidence of its being over-diagnosed round here, but I don't know how things might be in the wilds of Merika....

Rolfe.