Those who are criticizing the medical community - I haven’t really heard what your alternative proposal is. Should all medications that treat mental conditions which do not have a proven physiological cause be disallowed? If not, then what is your proposal?
There* is* a substantial and growing amount of medical evidence that the syndrome is due to an underactive hypothalamus, not producing a normal level of dopamine (a chemical which regulates many brain functions). You can dismiss the evidence as not being “hard”, or even sufficient, and you wouldn’t be entirely wrong, but do recognize that the hypothalamus is deep inside the brain and hard to study in action without PET scans. Add to that the evidence, based on observation and experience with many ADD patients, that stimulants targeting the hypothalamus (generally methylphenidate in its various forms, including Ritalin) are effective at controlling the problem, and that these effects are too seen in PET scans. Less-focused stimulants such as caffeine and even nicotine also are useful, especially by patients who “self-medicate”, but have other effects on the rest of the body.
As others have already said, live with it, or with someone who has it, and you’ll be convinced it’s real. Fortunately, we’re past the stage where it would be ascribed to demonic possession - I hope.
I remain unconvinced that ADHD really exists, however I certainly recognize the possiblility. On the other hand, I am convinced that this is the most overdiagnosed “condition” in the history of child care and that Ritalin is the most overprescribed medicine since, like, ever. Brain-altering chemicals are being given to children whose brains are still forming, often based on nothing more than a complaint from a teacher. I don’t know what the long-term consequences for these children will be, but I shudder to think what harm we will realize we have done a few decades from now.
Most of the cases of ADHD that I have seen up close (and I HAVE seen a number of them) were what I would more properly have called “rambunctiousness”, often with parents who are determined that their children act less like children and more like adults. btw, based on my mother’s reports, I would have been a pretty quick and easy diagnosis of ADHD. Thank Mom that I wasn’t medicated for my condition. Of course, my mother did learn early on that giving me sugary foods was a bad idea.
Interestingly, in most of the cases I have seen, I would certainly NOT accuse the parents of being cold. In the most egregious example I know of, one of the parents was abused as a child and is adamant about not punishing their own child. The result is a child who has no boundaries or any notion what boundaries are. I’m not a big fan of corporal punishment (I have, on occasion, spanked my kids), so I would NOT say that “this kid just needs a good whoopin’.” I would say, however, that the child needs discipline and training. In my experience, ADHD kids actually tend to be quite bright, which means they also need challenges.
For any parents who are reading this, I wouldn’t presume to tell you how to raise your kids, but I will beg you, for their sake, please think of medicines like Ritalin as an absolute last resort. There are outstanding books out there written by Behaviorists (who aren’t big fans of medication) specifically for dealing with hard-to-manage kids. Parenting is hard work under any circumstances, and with hard-to-manage kids it can be a walk through hell. Creating boundaries and discipline requires patience, consistency, and time, but it is achievable. At best, a pill may affect behavior in a seemingly positive way, but the underlying need for training remains.
I am hesitant to generalize very far, but I have definitely observed instances where children misbehave and the parents, rather than taking any disciplinary steps in response, give the children a pill. To my mind, this punishment is far too harsh, the consequences are not fuly known, and the children don’t really understand it.
I also want to point out that I do NOT think that there is something “wrong” or “bad” about these parents. I do think that their parenting skills are lacking. And good parenting skills–particularly with hard-to-manage kids–are NOT intuitive for most people and can be quite difficult to learn (and even more difficult to implement).
A great many psychological “diagnoses” are little more than collections of descriptions of behaviors. I think the real doubt, which is a little harder to categorize, is whether there is an organic condition that can/should be corrected pharmaceutically. My children aren’t old enough to be hit with that label yet, but they are enough like me that I won’t be surprised if one or both of them gets this label later by someone. Nonetheless, I probably won’t ever fit your criterion because I am not convinced that the organic condition exists and, if it does, no one will ever convince me that one of my children has it.
Even so, I have two bright rambunctious children who can be quite a, um, challenge. I also have a degree in psychology and was raised by a clinical psychologist (behaviorist, obviously). Do I qualify for the discusion?
-VM
Now you’re on to something, VM. From your first post, I didn’t quite understand where you’re coming from because science is making some great progress in the way the brain works, much coming from research originally related to the study of how drugs affect the brain (you’d be amazed of the kinds of things I allowed myself into when writing essays for composition class :D).
Basic factors involved in these disorders are neurotransmitters, the way they are being brought into the brain and the way the brain breaks them down again. I was particularly interested in research that indicated the channel that released one particular neurotransmitter into the brain was a quarter that of a ‘normal’ person. These same neutransmitters also play a large part in depression.
However, you are also completely right that a lot of the symptoms of the disorders mentioned can have various origins, many of them behavioral. It’s a complicated mix, of which a decent family therapist will be able to tell you an enormous lot (my dad’s one). There was a great programme on the BBC which showed how parents perpetuate certain behavior in children by overlooking some basic psychological principles.
For instance, one mother had trouble getting their children to eat, until it was pointed out to her that her habit of not eating with the children was the cause (a job related habit). As soon as she sat down to eat with her children, they quickly mended and ate with her. Similarly, two twins would just drop down on the floor, kick and scream wildly, whenever they didn’t get what they wanted and the mother didn’t know how to deal with them other than give them what they wanted. When she followed the advice to simply ignore this child and even pay positive attention to the other child who wasn’t exhibiting this behaviour, it took about six days for the raucus child to mend his ways.
I’ve also read a great book called Natural Prozac by Dr. Robertson I believe (who was smart enough to let someone who is a skilled writer actually write the book, he merely telling the man what he wanted in there - what a great idea) and although the name put me off initially (sounding very … ehm … self-helpish in a bad way) it turned out to be a great overview of how neurotransmitters in the brain are influenced by their environment, including things you eat.
Now these are three large areas covering an incredibly complex (and interesting) field, i.e. that of the brain. The brain is very complex and so are its interactions with itself, the environment and other people. But its mysteries are being unravelled amazingly fast in the last decade (the basic principles of how the two most prominent neuro-transmitters - dopamine and serotonine - work in governing various aspects of behavior are so far reaching and elucidating that I consider their unravelling one of the most important advances in psychology/neurology … well … ever).
Unfortunately it can take very long for people to catch on, even professionals, and your worries are legitimate. Medicines like prozac or ritalin are and have been used far more than warranted. For instance when diagnosing depression, you can determine now fairly easy what kind of depression a patient is suffering from, but how the person has reached the state of depression and ergo how the patient will be able to change his/her life to prevent returning to this state is more important for mending the situation than simply medicinal treatment. The latter can be essential in facilitating a patient with the strength to do something about his or her life and temporarily break the negative spiral that allows depression to perpetuate itself, but in the end the cause for the depression needs to be taken away or the patient will always fall back or worse. On the other hand, without the drugs it may be impossible for a patient to break the cycle of depression. Behavioral therapy and the drugs combined can get the job done. That this is not always done or not always successful is, unfortunately, as much a factor of cost and practicality as anything else - behavioral therapy is very labor intensive, takes a lot of time, and is therefore very costly.
I hope that you will not make the error that you seem to suggest you are intending to make, and that is being extremist about any one of the three approaches to the issues. I agree that many problems would be solved by parents having a slight bit more of a clue on how to raise children which after all is one of the most complex and responsible things out there and at the same time one that you don’t require any kind of training for (though of course thankfully through child-protection laws at least now there are limits to how far you’re allowed to screw up). But there are physical causes for some problems, and some behavioral issues result in a permanent physical change in the mind that may be most effectively overcome by normalising that state through medication that would otherwise prevent behavioral treatment from taking hold.
Outta curiosity, what would convince you?
I personally am convinced that ADHD really exists, since I happen to have it myself.
The op is questioning the use of the terms “disease” and syndrome" and there seems to be much confusion as to the terms mean.
For example
Not to this member of the medical community or to anyone else I know. Disease often can be self-limited. Colds. Many viral infection and quite a few bacterial ones, even. Many vision problems. Dis Ease. An alteration in function such that normal function is impaired or is associated with discomfort or harm.
The medical definition of disease does not mean we know what causes the disease. It does not rule out environmental etilogies or imply anything else other than that there is dysfunction.
How do we study diseases? How do we learn if they have discrete physiologic causes or are the result of environmental factors or can be best treated with medication or by talk therapy or by ignoring it?
Well, first we have to define what it is we are studying. If I am studying Hogkins Lymphoma I want to be sure that someone else means the same thing when I read an article about some work someone else is done. And so it is with cognitive/behavioral disorders. And here is where the word “syndrome” comes into play.
“Syndrome” just means a set of signs and symptoms that travel together. It does not imply that a cause is known or understood or that best treatment is identified.
So for cognitive/behavioral disorders we start by establishing that certain signs and symptoms cluster together and that they are indeed associated with dysfunction. And we label according the way things seem to cluster together. And then we study.
We can then find out the natural history (progression to a worse state or to resolution?); we can share information about what relieves the dysfunction (be it behavior management, medication, or astral projections); we can investigate possible etiologies (be it “cold mothers”, or genetic predisposition, or learned behavior, or toxin, or whatever). We sometimes learn that things that seemed to clump together are actually several different things that have different courses and/or different causes and/or different best treatment approaches. But we can’t learn those things until we start as above. As we learn we refine our terms. Split some things apart; clump others together.
It is without a doubt a difficult process. The border between function and dysfunction can be very blurry sometimes and can vary depending on the society and a persons place in society. They can vary depending on who you ask. There are some subjective judgements required. For some there is no debate that dysfunction exists, for others it is not as clear. Some clinicians and individuals are pretty liberal with a defintion of dysfunction and others extremely conservative. There is a fair amount of overlap at the edges between different clusters as well. Some individuals fit more than one label at a time. There are few single tests or markers to guide us. Causes seems to be multifactorial and the same biology may manifest different in different enviroments. These clusters may indeed turn out to be umbrellas for several different entities. Best treatment will vary for individual cases and may include medication and/or intensive cognitive-behavioral therapy for some, and a good kick in the pants for select others.
But none of these difficulties invalidates the process as the only one we got.
Now as to the questions of physiology and treatment - using the tools as described above one can look at the evidence for each specific condition. They are not all the same. You cannot lump ADD and autism and ODD and depression all together. Each one would require a thread of its own. But all deserve study and to study them requires trying to define the terms.
I have three boys, the older two are ages 14 and 11. They were both normal children with no major behavioral problems. While they were small, I agreed with the opinion that ADHD and ADD were overdiagnosed and overmedicated. Mostly because I didn’t have any experience with it and didn’t know what the hell I was talking about.
Then along came my 6-year-old. Totally different ballgame here. This boy can’t concentrate on one thing long enough to eat a meal. It can take him up to an hour to do something as simple as getting dressed, and he needs to be reminded over and over and over as to what he needs to do. Now he’s doing a little homework every night, and that takes major effort on his and my part to complete. His daycare is considering kicking him out because it’s right across the street from his school and they walk them back and forth. He often endangers the rest of the line walking to and fro because the wind can blow, and he gets distracted, and is having a hard time holding it together to even get across the street safely. At school, his teacher has to face his desk to the wall in order to block out distractions. He also has a personal aide to help him with this.
I’m in the process of getting a referral to have him tested for ADD. Everyone that deals with him- teachers, therapists, babysitters, and family members, agree that he probably has it. I’m anxiously awaiting the time when he will be on medication (maybe not Ritalin, there are newer and safer meds now) because I know how hard he’s struggling right now, and I know that this has to be helped. I can’t even imagine him making it in the world as he is right now. I fear for his safety if he grows up like this.
I can see how, if you don’t deal on a daily basis with a child with one of these conditions, you could doubt that they really exist, and maybe be of the opinion that it’s behavioral, and they “just need an ass-whoopin’”.
But once you’ve had a child like this, you begin to see.
Playing a bit of the devil’s advocate here, but when I was in the middle of my senior year I suffered from a deep blue funk that made me feel very anxious about my future (or lack thereof) and generally awful. I tried to convince my parents that I was depressed, but they blew it off as “going through a phase”.
To say the least, I was pissed. How dare they not take my pain seriously! But of course it wasn’t the end of the world, I survived (mostly) intact and even managed to grow up a bit. In retrospect, I can now honestly say that I’m glad they didn’t believe me and therefore didn’t become enablers to my very self-destructive behavior.
Do you actually know of any case where this has happened? If so, what happened when you reported it to your state’s medical board?
This is an idiotic statement. No doctor is going to prescribe a narcotic to a child based on a teacher’s complaint. Additionally, Ritalin has been prescribed to children for many years - plenty long enough for evidence of long-term damage.
Well, then, why are we here? If your mind is so completely closed to the possibility, it seems pointless in the extreme for you to pursue it. “It doesn’t exist and even if you prove it I won’t believe it.”??
Gee, I had missed that one:
Well, if you are immune to actual evidence from PET scans and similar diagnostic tools, I guess that this Forum is appropriate for your witnessing for B-mod.
My son has been through a number of programs in which behavior is the prime focus. The school, private psychologist, and we parents have all worked closely together to present a uniform and united presentation of what is expected of him and the behaviors that are appropriate and inappropriate. Nevertheless, when he misses his meds, he is clearly unable to conform to the expected behavior. I truly hope that your children never suffer from anything worse than rambunctiousness; it sounds as thought they will be condemned to a lack of treatment if they ever do suffer such a disability.
So let’s establish the questions here.
Can/should cognitive/behavioral disorders be thought of as diseases?
Yes, whether one understands the causes or not and whether one agrees on proper treatment or not.
Is there a clear bright shining line between normal and abnormal, between functional and dysfunctional?
No. And while this is not unique to behavioral disorders (eg diabetes has had its definition change - what fasting blood sugar level qualifies - as more is understood about the benefit of earlier tighter control; hypertension also has a fade into normal, etc), it is clear that many people fall into a gray zone between normal and dysfunctional with regards to behavioral features. The social nature of behavior, the fact that “normal” is relative to the needs of the society, make the definition of disease a bit squishier for cognitive/behavioral disorders than for many other disorders. So how much dysfunction warrants intervention? Well that depends on what kind of intervention and what data we have for benefits vs risk of the intervention for the individual conditions.
Since the focus seems to be on ADD, we can look at some real data. Medication works fairly well at relieving current dysfunction with little long term side effects. Cognitive behavioral therapy can be effective in some but requires much time and resource investment by the family. There are too few well trained therapists to make this a viable option for many, and for many it will fail as a stand alone intervention (see Tom’s experience for illustration.) Long term the benefit is less clear. Less later substance abuse, but no clear data that long term function is otherwise improved. Diagnosis requires significant dysfunction in more than one domain. A teacher complaint is not enough. A child whose parents are ineffectual but who responds to discipline at school does not have ADD.
Whose statement is idiotic? I am describing events that I have, in fact, witnessed. A teacher tells an uneducated parent that their child has a condition and needs Ritalin. The parent reports this to the child’s pediatrician (NOT a psychologist or psychiatrist) and the pediatrician prescribes the drug that has been requested.
I think that for a doctor who is not trained in human behavior to do this is idiotic. To imply that I am an idiot for describing events that I have witnessed serves no purpose that I can think of, unless you are trying to indimidate me into not trusting my own memory. As it turns out, I trust my memory more than I trust your evaluation of my intelligence.
For instance, I clearly remember my experience immediately after I graduated with my psychology degree. I worked at a mental health center, specifically with children considered to be at risk or to have special needs. Many of them were victims of child abuse. One child in particular had been removed from abusive parents and placed in an abusive foster home (this system is ugly, guys). I sat in–as a guest, not a participant–at a meeting where representatives of 5 different state agencies discussed the child and decided, without any of them having ever seeing him in person, that he should be placed on Ritalin. This moment was a crucial one in my life because it was the moment that I decided that I definitely would not be pursuing the field of psychology any further.
Calm down and put away your torch. If you will reread my entire post, you will see that what I said is more nuanced than this. If I could have expressed my thoughts in the pithy, but foolish, manner you are crediting me for, my post would have been much shorter.
I am not prepared to write a thesis here. Let me make a few points, and then I’ll try to summarize in a way that you wil be able to lower your hackles an inch or two.
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As has been mentioned, many psychological diagnoses are based on what is known as a “constellation” of behaviors. The current diagnoses of “Attention Deficit Disorder” and/or “Hyperactivity Disorder” are based on observable and quantifiable behaviors and behavior patterns. Am I suggesting that these behaviors don’t occur? Of course not. The key issues here are whether these behaviors are symtomatic of an underlying brain disorder or malfunction, what in fact is meant by “normal” brain function, whether or not such dysfunction is treatable or reparable using pharmaceuticals, and what other effects might be produced by such treatment. In other words, I will quickly and comfortably stipulate that there are, in fact, children who behave in the ways described here. However, I resist the diagnosis because of the unstated assumptions about what may be properly labeled as brain dysfunction and whether or not these behaviors are representative of it. I am particularly resistant in this case because of my concerns about the popular treatments that are being used and the potential consequences.
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While it is true that we have learned an amazing amount about the human brain in recent years, the fact remains that our knowledge only scratches the surface of true understanding of this amazing product of human evolution. A great deal of our knowledge is still more of a recognition of correlations than an understanding of causes and effects. We do know that particular functions appear to be localized. We know about a number of neurotransmitters and that they are used by the brain in differing circumstances. One of the most amazing things about our brains is our ability to learn. At its base, it appears to be a mechanical process: When you learn a new fact, connections between neurons are reconfigured to contain this fact. We can examine brain activity and notice that levels change during various “mental” activities, such as learning, thinking, and feeling. One poster pointed to studies that seem to indicate that the hypothalamus is differently sized in ADHD children. This is useful knowledge, but it doesn’t, in and of itself, answer some pretty important questions. For instance, does this mean that the brain is improperly formed? Does it mean that it is not fully developed? Does it mean that some parts of the brain may develop at different rates in different children? Are these children missing something? If so, will they always be missing it, or can they be expected to grow it later? If they don’t grow it later, can the missing functions be provided by a different part of the brain? Does it grow in response to need? For instance, if we use medicine to lessen the need for the missing structure, will that decrease the likelihood of its development?
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Some people can easily grow big, strong muscles with a little exercise. Others have to work very hard at it. Some can gain strength but seem to never be able to increase muscle mass. In many ways, the administering of Ritalin to children seems, to me, similar to administering steroids to people who want larger muscles.
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Drugs like Ritalin, which alter the chemical contents of the brain are not function-specific. They do not seek out those parts of the brain that are in need of their services; instead, they act on the brain as a whole. For instance, if we were to determine a need for more dopamine in one part of the brain and administer a drug that increased dopamine levels, the drug would increase these levels throughout the brain, not just in the one part in need. There are no signposts along the blood-brain barrier, and if there were, we do not have medicines that would be capable of reading them.
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Purposeful behaviors, such as studying, looking both ways before crossing the street, and searching for a hidden cache of cookies, depend on training and practice. Different people have different aptitudes for different skills. I can learn new facts and problem-solving methodologies extremely quickly and with little need for extended practice or review. At the same time, I have a very difficult time learning many “artistic” skills, like drawing or playing a musical instrument. These skills require a great deal of effort and practice for me to acquire. While I am disappointed by this fact of my existence, I do not believe it to be evidence of dysfunction. I DO believe that it increases the cost and effort required for me to, say, learn how to play the piano. When we engage in deliberate efforts to teach skills to another person, the activity is called “training”. In areas where a person has a natural aptitude, training is much easier than in areas where there is little aptitude. If the aptitude is significantly low, the act of training itself may require unique skills on the part of the trainer and an understanding of training techniques that are outside of what most people would think of as “common sense” teaching.
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Life skills like recognizing boundaries, obeying rules, and focusing on solving a problem are learned during childhood. Training in these skills is one of the core functions of a parent. I think it is obvious that some children have less aptitude for learning these skills than others. If you want to describe this situation as ADHD, then I am okay with it.
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If we think of syndromes like ADHD as being similar to a “disease” like, say, the flu, then giving drugs like Ritalin is analogous to taking flu medicine. Both may lessen obvious symptoms, but neither has any effect on the underlying problem. The body will resolve a bout with the flu on its own, and masking symptoms relieves pain without causing harm. As far as I know, the brain will NOT resolve any underlying deficiencies that cause ADHD on its own. If I want to learn to play the piano, there is no pill that will teach me. I can take medicine that might make me mind the lack of ability less, but–if I intend to play the piano–I will eventually have to put in a great deal of hard work to learn the skill, any medical interventions in the meantime notwithstanding.
Okay, so here is my summary. I am not saying ADHD doesn’t exist in the way that you are giving me credit for. I am denying the assumptions associated with the diagnosis. And while Ritalin may make children more manageable, I am not personally convinced that this solution is less harmful than the problem being addressed. I am also very concerned about the potential side effects of this treatment. Brain development continues long after many other parts of our anatomy are pretty much “set”. Decisions to change the chemical environment of a developing brain are ones that I personally would only take as an absolute last resort.
If you give Ritalin to an adult, it has an effect similar to speed. If you give it to a child, it has an apparent calming effect. This “paradoxical effect”, which we don’t understand and can’t explain, in and of itself is clear evidence that we have major holes in our understanding of brains and how they develop. Making a daily regimen of administering brain-altering chemicals of this sort is a big fucking deal, and I say again, if it is considered at all it should be as an absolute last resort.
Which leads to my statement that no one will ever convince me that one of my children has ADHD. The reason is simple, I will not give Ritalin to one of my children. No one else will, either, while I am living. And I will not give credence to any diagnosis–regardless of any proof supporting it–that will subsequently be used to justify interfering with the development of my childrens’ brains.
For those parents here who are giving this to your children. I do NOT think that you are bad people, and I do, in fact, completely understand the confusion, fear, and desperation that can result from trying to train children who appear incapable of being trained. I encourage you to make every effort to find other ways of managing your child’s development. And if you do conclude that medication is the only viable option, I do sincerely hope that you are not inadvertently doing them permanent harm. This is most definitely not a case where I would derive any sort of satisfaction from saying, “I told you so.”
All other issues aside, it is not my place to judge another parent, and I certainly do not intend to deny or belittle the difficulties they might be facing. That said, my children will not be taking this drug while I am still living and capable of defending them. If this seems irrational to you, then so be it.
-VM
I’m always bewildered by people who take it on themselves to assume that parents who use meds are not doing it as a last resort after CBT and/or behaviour mods have not worked. And of course the assumption of ignorance is always a thrill.
I also find it amusing to be lectured by someone who doesn’t have kids with ASD or ADHD. More power to you if you will never allow anyone to give your kids ritalin, dex or strattera. Whacko the diddlyo! Stick to your guns! Of course it’s easy to announce that one will never give one’s child a particular medication when one’s child isn’t diagnosed by several healthcare practitioners as having ADHD. I, myself find it really easy not to give my younger child ritalin despite his, at times appalling, level of hyperactivity. He’s not ADHD. It’s a lot easier to be a good parent to him than it was to be a good parent to his older brother who most definitely does have ADHD. Behaviour mods work with my younger son.
Not in my experience.
You sound like you have just enough knowledge to speak about the subject… until you come to the part where you talk about training and skills. Actually, it’s not that kids with ADHD or ADD don’t know how to do these things, like cross the street- it’s that they are easily distractable and have difficulty holding focus long enough to complete a task. How is this something that is learned? Maybe to a certain extent, but I can assure you, I’ve been the same mother to each of my boys and I don’t think I just forgot to teach the youngest how to pay attention. And you come across as downright condesending when you decree to allow parents of these children to “call it ADHD”. Why how very gracious of you to permit me to label my failure as a parent and/or my son’s obviously lower intelligence as Attention Deficit Disorder. (Actually he has average to above-average intelligence and has no problems learning, it’s just the paying-attention part that’s faulty.)
I don’t know what cases you’ve eye-witnessed or not, but I assure you, the process of becoming medicated is by and large a lot more complicated than the occasion you mentioned, at least in my neck of the woods.
If you ever parent a child with one of these conditions, please get back to me. I’d be interested in hearing how your hypotheses change.
I take back the idiotic part in referring to YOU then - other than your example, I have never heard of any doctor ever anywhere prescribing a narcotic for a child based on nothing more than a teacher’s recommendation. I would sincerely hope that any doctor who did do that was instantly disbarred (I can’t think of the word, but the medical equivalent thereof.) The situation you describe goes far beyond medical malpractice.
Have to argue that one. I was diagnosed as an adult. I take Ritalin. Your statement “if you give Ritalin to an adult” is entirely too general. If you give Ritalin to any individual - including a child - who does not have this disorder, the effect is similar to speed.
Incidentally, I was not an unruly or hyperactive child. I was an A student, and a model “good kid” who read voraciously and excelled in art, science and mathematics. My disorder slipped through the cracks until I was 30 and on the verge of suicide. Ritalin has made me a functional human being - I was in therapy for three years in addition, but the effect of the Ritalin alone has been HUGE.
I had a Psych teacher in high school that though that ADD, ADHD, etc. existed, but everyone had them to a degree. He even thought that you have to have OCD to an extent to go far in the business world.
I think I agree with his assessment. My friends all tell me I have ADD because I can go from one topic to another on a whim, leaving everyone clueless as to when I changed topics and why, and I get distracted by ANYTHING. That said, if I feel like I need to, I will sit my ass down and focus on my studies.
I have a friend who I always say has OCD because she plans her day out to the minute (seriously) the day before and gets freaked out if it doesn’t go as planned. And I’m certain that the organization she has helps her get such high grades.
I know the actual disorders may differ from the names I and my friends have given them, and what I’m describing with me and the girl may not be ADD and OCD. I just wanted to throw the idea out there though, because it’s an interesting one.
Not so much. For another example, look at depression. Everybody gets bummed out sometimes, but there’s a big difference between that and having clinical depression.
As someone with Asperger’s, I think I have an answer… because it makes it damn convenient for parents, psychiatrists, and those that are diagnosed.
As a child and, later, as a teenager, I struggled through many situations without understanding how I was messing up things so badly. I was told I was very intelligent and good at figuring things out, yet I had trouble understanding what people meant in daily conversation. I couldn’t read signals and gave all the wrong ones myself.
I was not introduced to the idea of Asperger’s for many years, but it has given me a new way of understanding my childhood, and, more importantly, a body of literature that I can use to understand how to act in more acceptable ways. If you lose the idea of Asperger’s as a distinct condition, you are left with examining the behavior traits currently included in that label seperately. This is what people attempted with me for years before AS was a common label; it got them nowhere. People couldn’t figure out how someone so “bright” could act so “stupid” sometimes. I myself couldn’t figure it out.
So, what are the advantages to using labels for certain sets of behaviors? It makes for an ease of discussion amongst professionals, gives ordinary people who don’t research psychiatry on a daily basis access to literature on their condition that they can understand, and, as my parents are discovering with my younger brother who also has AS, gives parents the ammunition they need to ensure that the educational experience does not penalize the student for factors beyond his or her control.
What, exactly, are the advantages to not giving my set of difficulties (and some strengths) that I share with many others a name? What advantage could there possibly be in instead of identifying me as someone with AS, I was instead identified as, say, “An otherwise intelligent but absent-minded and physically awkward person who is unable to relate to his peers or share his emotions with others, who focuses intently on one thing or a small set of things at a time to the exclusion of family even if such focus is shown to be self-destructive”?
I do not take medication for AS, but the diagnosis has helped me so much. It has shown me that the path to success (being normal enough to hold a steady job and not live in fear of doing or saying something that will get me fired) lies in painstakingly learning those things that society expects its children to pick up on their own at the onset of social interactions. I’m not there yet, but then, everyone else has had a 24 year head start on learning these social nuances. I’m getting there.
Before my diagnosis, I only knew that I was doing something wrong. I had no idea how to make it right or even what my problems were in the first place. Now, I am taking slow but steady steps towards traditional social behaviors. So… what’s your alternative?