Can ADHD be turned off and on?

In My Humble Opinion
1

My daughters boyfriend has an 8 year old son. This child has been diagnosed as having ADHD. I personally question the diagnosis. I am not a doctor and I have not been around this kid all that much, but from what I have read on WebMD there are a number of symptoms that must be present when this alleged disease is diagnosed. This kid shows practically none of these symptoms. He might be a tiny bit hyperactive, but the kid is 8 years old. I think that the single biggest thing that makes me believe he has been misdiagnosed is the fact that he can turn his misbehavior on and off like a light switch. And his “symptoms” almost always appear when he wants to do something that he has already been told he can’t do. When this happens he becomes an absolute TIRD. He pitches fits, whines, cries and gets extremely mouthy like there is no tomorrow. Once he has been sternly disciplined, especially if it has been in front of other people, he turns his tirade off and goes around an apologises to everybody. My own personal non-medical opinion is that this kid is just a spoiled BRAT with a capital “B” that needs to have some serious disciplinary rules put into place and enforced.

So my question is can ADHD be turned off and on like a light switch or should they consider getting a second opinion?

2

Here’s my layman’s understanding of ADHD: The ADD brain is weak on the ability to produce the stimulant chemicals needed to help one focus and for the brain to be ‘quiet’. Without that internal stimulus, the brain yammers around, jumping from idea to idea. So ADD children tend to seek to provide that stimulus externally. They fidget, they raise hell, etc.

What can turn ADD on and off is that if you are doing something you really like, the enjoyment and excitement of what you are doing causes the brain to quiet down and you can almost enter a trancelike state. As a kid, I used to ‘hyperfocus’ on things that really interested me. I’d study it day and night, think about it when I wasn’t reading about it, talk about it constantly, etc. If I was forced to be pulled off that task onto something I didn’t care about, then no matter how hard I tried, I just couldn’t stay focused on it. My grades as a result were sometimes all over the place. If a course happened to match what I was interested in, it was straight-A time. If it didn’t, I really struggled to pay attention and to be able to focus on the material.

Some have theorized that this is why ADD people tend to gravitate towards occupations that have a high quotient of external stimulus - cops, firemen, pilots, actors, etc. There they can be highly successful. But take that same person, stick them behind a desk and tell them to shuffle papers, and they’ll be hopeless, disorganized, unable to remember what they are supposed to do, and generally miserable.

Without any scientific backing for this, I’ve aways wondered if the rise in ADD diagnoses in adults has to do with our elimination of smoking - nicotine is a powerful stimulant. I wonder if many smokers weren’t self-medicating ADD to some extent. Anyway, most ADD medications are stimulants of one sort or another.

So ADD isn’t just a condition that makes you crazy all the time. It’s a condition that requires the brain to seek external stimulus for what it’s lacking internally. If it can be provided in a productive way, ADD people can be wildly successful. Their brains facilitate ‘big picture’ lateral thinking, the ability to embrace large concepts instead of focusing on small details, etc. Thomas Edison, for example, always had about 50 inventions on the go. When he got interested in one, he’d hyperfocus on it and come up with wonders. If he lost interest before it was complete, he could just drop it and forget about for years, despite the fact that a week earlier it was all he could think about. Luckily for Edison, he managed to construct his life around the way his brain worked, and he was wildly successful. If he had been stuck, say, filing papers at the patent office, he might have been a miserable failure.

None of this is to say the kid you mention has ADD. I do believe some kids are diagnosed as ADD simply because they are poorly behaved. But the symptoms you describe could be perfectly consistent with ADD. For example, pitching a fit when he’s told do so something that he doesn’t want to do. If he’s hyperfocusing on something, being pulled out of that is extremely frustrating. He can’t stop thinking about it, so being told that he must do something else could be extremely frustrating for him.

Of course, spoiled brats behave the same way.

And there’s never anything wrong with a second opinion.

3

First of all, to answer your question; yes, the symtoms of ADHD can appear sporatically, and in fact, that is one of the hallmarks of ADHD. Although it is characteristically though of as a problem with paying attention, the actual problem is controlling attentional focus, and many people with ADHD will demonstrate a behavior that is referred to as hyperfocus; an acute, sometimes almost austistic-like ability to focus on one object or activity to the exclusion of the outside environment.

Of course, a child may behave bratty and refuse to pay attention as a way of acting out, but often ADHD appears to be a sort of subversive or passive/aggressive resistive behavior when it is actually an attentional focus problem. This tends to become aggrevated when the parent or teacher treats it as voluntary bad behavior, and the result is that the child learns to act out in frustruation as a way of getting attention to the problem. So it’s not necessarily an either/or situation; it may be something of both.

You say that the child has been “diagnosed” as having ADHD, but don’t indicate the extent of the diagnosis. If this was a GP in a 15-minute office call setting, or even a school counselor or therapist making an ad hoc analysis, that is really insufficient to discern between ADHD and other possible pathologies. I’d recommend having a clinical assessment (a series of attentional, focus, visualization, and intelligence tests) done by a qualified neurological diagnostician. This is somewhat expensive (~US$1,500), but while it isn’t absolutely definitive it can definitely indicate whether there is or isn’t an attentional component to the problem quite separate from an anecdotal diagnosis. The best choice for treatment is to consult a child psychologist, as they are most familiar with this type of disorder.

The problem in dealing with the issue with discipline alone is that the child doesn’t know how to do better; it’s like yelling at a student with uncorrected myopia to stare harder at the board. Drugs may or may not be a part of the treatment, but the child also has to learn how to discipline and stimulate himself as well as unlearning bad behaviors he may have picked up as incidental coping measures. The one thing you don’t want to do is tiptoe around the issue and expect everyone else do as well; whatever the problem is (whether ADHD, some other neurological disorder, or just plain bad behavior) it needs to be dealt with rather than shoved in a corner or labeled and boxed.

[post=6453013]Here[/post] is a (rather long) post I made on the topic some time ago that several people seemed to find of use. I really recommend reading the books listed in the first paragraph. [thread=301210]Here[/thread] is another thread on the topic, and [post=5818011]this and the next post[/post] were some thoughts I had on the topic that supplement the above.

Sttranger

4

I really like your description Sam Stone, the whole thing, not just the part I posted, but I would suggest a change in this line to doing something you find really stimulating. Yes if you like it, it is more likely that you will find it stimulating, but it is the level of stimulation which causes the hyperfocusing, not the level of ‘like’ in my humble O.

As for the OP, being stearnly disiplined might provide the level of stimulation for the 8 yr old to ‘switch modes’.

5

If someone actually has an electrical/chemical imbalance in their brain, no. The closest to “turning it off” is to take their medicine. They still have the condition, but it’s (hopefully) under control. Diabetes works like this (for example).

If someone says they have ADD/BiPolar Disorder/trendy-disease-of-the-decade when asked why they can’t do homework or hold a job (but manage to play Everquest 14 hours a day) then yes, they can “turn it off” when they find something fun to do.

That you rarely heard of ADD/ADHD/etc. before Michael Fay got his heiney whipped in Singapore, then suddenly every other slacker had it, should make you wonder. You can only focus on what’s fun? Sounds like a disease custom-made for the entitlement generation.

Sure, there really are people with a problem, but for every one who does there’s several more who complain about genetics as they pull another large fry from the McDonald’s take-out bag.

6

Hey there Cynical Optimist, did you think you could post that crap NOT be pitted? See you over there.

7

a) Anything you can turn on or off within yourself as you find desirable &/or usefu is, by definition, not a pathological condition. It’s a tool. The dislike of other people for you making use of it on occasion is entirely beside the point, except in the sense of accountability for your behavior (if you can switch it off, you’re entirely accountable for what you do)

b) Even things that are different within yourself that you can’t just switch on or off are only pathological if their undesirability, to you, significantly outweighs their positive tradeoffs. If, let’s say, you are prone to “pitch fits” and become an intolerable “turd” when people thwart you, that may be pathological for you (it may lose you friends, may reduce your employability) or it may not be (it may accentuate your ability to get your way and to ride roughshod over folks who attempt to thwart you, at least often enough that the payoffs outweigh the deficits).

Both of the above totally and completely apply even if the difference in question turns out to be a textbook example of whatever “chemical imbalance” is purportedly referenced by the diagnosis ADHD.

8

The lastest I’ve heard is that researchers are looking into the part of the brain that does “executive function.” It organizes your head, I guess, and that’s where ADD folk are deficient. (Here’s a brief introduction.)

9

Well, this is IMHO. Leaving out the H part, I don’t think Cynical Optimist wrote anything that was unsuitable to the forum. But if you’ve a need to Pit, you might throw in a link so the rest of us can watch the sideshow.

Stranger

10

Suggesting that I’m most likely faking a medical diagnosis just to be part of the “entitlement generation” is pretty fucking insulting. That sort of tripe generally ain’t worth bothering with, but why you’d defend it is beyond me.

11

I didn’t take it that way. I agree that ADD is overdiagnosed and there are definitely misconceptions about it. One of the biggest is that if someone has ADD they cannot focus on anything ever. That is not true, so if by ‘turning it on and off’ you mean sometimes able to focus on something, then the answer would be yes. However, the disorder itself cannot be turned on and off.

My husband has ADHD and he is able to focus on some things sometimes. The issue is more about prioritizing, he has a difficult time ordering tasks in his head and following through on them in a logical order. He is very creative and a great idea person but it is difficult to get him to start one task, see it through to finish, then start the next task, etc. the way most people do. He is more likely to do a bit of this task, then a bit of that, etc. sometimes in what I would not call a logical order.

We have a one year old son and I am aware that ADD is partly genetic and so I have been doing research and asking our pediatrician about it. From what I have read he has up to a 50% chance of having it, but the home environment affects the chances too, and definitely has an effect on the severity of the condition. Changes in the way the child is treated and his life structure can affect his symptoms. Stress and a chaotic home can make it worse. However, not everything a child with ADD does is due to the disorder, of course children are impulsive and manipulative all by themselves and children who are coddled for their condition may learn to use it as an excuse or a way to manipulate.

12

Who, exactly, is the agent turning the ability to focus on and off? To say that I can turn it on and off necessarily implies I have control over when I can and cannot focus. It is a short step to incorporate a previous poster’s claim that for every one legitimate ADD person there are several who are faking it (chicken pot, chicken pot, chicken potpie!), and come to the conclusion that those posting about being ADD on the SDMB are probably faking it, and even if they’re not, they can still “turn it on and off” and are therefore disengenuous at best.

I’m ADD. I can’t turn it on and off. It does whatever the hell it wants and I try to cope with it. To imply that I am responsible for when it’s particularly troublesome is offensive.

13

No offense meant, of course. I’m just giving it from my perspective. I don’t think you intended to be hurtful.

14

Meh. I figure such unsolicited speculation and thinly veiled calumny says a lot more about the source than the topic at hand. Why feed the fire with another thread where the complainant can vent their invective so freely? But that’s just me being I’m too lazy to take offense at so weak an argument. Have on, handsomely.

Stranger

15

Actually, ADD is both over-, or perhaps mis-, diagnosed, and at the same time, egregiously underdiagnosed in the general population, especially among adults. Because it can have the appearance of, and often co-morbid with, other behavioral or neurological issues it often slips under the radar, which is why an objective assessment by a trained diagnostician is important.

I couldn’t have said it better and certainly any more succintly myself. It is better thought of as a condition, like being too short to reach the top shelf, that requires training and mitigation, than a progressive, chronic disease that takes its course regardless of mitigation.

Stranger

16

Sorry, never pitted anyone on the boards before and was unaware of the protocol.

Link to the Pit thread

17

No, I agree that ADD cannot really be turned on and off. That is actually one of the ways it is different than someone who is, say, just lazy or unmotivated. However, when some people observe a person with ADD they might see them focusing quite well while doing one particular task and think ‘see, that kid has ADD and he is still able to focus when he really tries’ so I was just saying that, like you said, people may think it is able to be turned on and off. It is just a definition issue - if someone asks me ‘can ADD be turned off’ they might really be asking ‘can people with ADD ever concentrate on anything’ so I was just saying the answer to that question would be yes. I have learned when I talk to people about ADD to try to find out what they are really asking, and I was just pointing out that having ADD does not mean you can not focus on anything ever. That is one of my pet peeves and I think a big misconception about ADD. Hopefully that makes sense. I understand you are sensitive about the issue but no offense was meant by me - like I said my husband has it and we are very aware of the difficulties it brings. I am trying to learn more about it so I can learn what to do for my son if he does have it.

Chicken Pot Pie is one of the funniest tv episodes ever, BTW.

18

I think a good way to describe it is that you cannot concentrate in normal amounts-hyperfocus can be just as debilitating as not focussing. You get so caught up in some minute detail that what should be a ten minute task takes an hour or more.