We need to get away from the idea that having a disorder is dehumanizing or a sign of personal weakness. It’s not as if the person is any less human because he is imperfect. Having ADHD is not a sign of “weakness” anymore than having an allergy. Stop blaming the patient.
I know it’s not about laziness.
But also, God didn’t pass down the ADHD criteria from on high. ADHD is a descriptive diagnosis- it describes a set of behaviors. In this sense, it’s a bit of a tautology- ADHD is ADHD because it fits the criteria for ADHD which was derived from looking at people with ADHD. It’s all a bit circular.
In reality, like most psychological disorders, the boundary is basically arbitrary, defined as “around the point where it affect’s a person’s ability to live a normal life in this culture.” THis doesn’t mean it isn’t real, or it isn’t a problem, or it’s “all in your head,” or a sign of weakness. But it’s also not exactly the same as a broken arm. It’s a stretchy, complicated, culturally bound phenomena with fuzzy boundaries.
And I’m grateful that you have found a treatment that has enhanced your life.
But what I can’t, 100% reconcile is that you have a learning disorder whose major symptom is that you are unfocused and unmotivated to the point where you score about one grade level down from what you score with medication. I am also unfocused and unmotivated to the point where I score around one grade level lower than I would score with the same medication. What is the difference?
You’re self-diagnosed and he’s not?
I really don’t understand what you’re getting at with this line of argument. For one thing, I don’t think that taking a pill to increase focus/motivation/etc. will be as helpful to “everybody” as you think. I’m perfectly capable of focusing on what I’m working on and staying motivated as much as I want to. I don’t need a pill to help me with that. Some people do. Maybe you’re one of them. Maybe you’re not. You seem to think that you are. I am unsure what this is supposed to prove one way or the other.
The big difference being that I WAS motivated but physically (mentally?)couldn’t bring myself to focus. I tried everything I could thing of. I tried every technique I was given. I had tutors, I stayed late with the teachers, I tried different environments (in my bedroom, in the basement, with the radio on, with the radio off, in front of TV, in total silence etc)…and a bajillion other things. I was motivated like all get out…it just didn’t happen. My brain just had a very difficult time focusing on a single thing. I always, and still do, compared studying to trying to eat a big rock. I could work on it for hours, gnawing at the same spot over and over and over and you won’t even have made a scratch. That’s how I always felt after I was done. Like I did all that work and didn’t retain any of it.
I was motivated, I wanted to do better, I tried as hard as I could…it just didn’t happen. The funny thing is, I’m smart. I know I’m smart. You know that stupid cliche “You have potential.” They always said that to me and I knew it was true. I could work things out logically in my head that I hadn’t been taught and that people that had better grades then me were stumped by, but come test time, with harder problems that we had to study for, I was screwed (but I always did really well on the standardized testing). In the end, being the logical person and not being able to find symbolism for shit in a literary work, that’s probably why I wound up a hard science person.
One trick I did learn was to keep myself occupied with something else. When I was little and had to go to church I always made sure to bring something to fidget with. A rubber band to play with, a pen to take a part of put back together a hundred times etc Otherwise I’d end up counting ceiling tiles.
By the time I was in college I actually found the best way to deal with lectures was to be doing something else.
Now, in physics, this wasn’t a problem. If you weren’t taking notes, you were screwed. In Psych, my prof gave us the lecture notes. His idea was that he’d rather you were paying attention to him rather then scribbling down everything he said and not really ‘hearing’ him. I found that the best way to not have my mind wander was to do my Calc homework during that class. Oddly enough, he was totally fine with it. I even OK’d it with him. I sat right up in front. I hardly ever lifted my head, but he called on me randomly to make sure I was paying attention, I raised my hand when he asked questions. I kind of found my groove in that class and had a cool teacher that was okay with it.
Not everyone: my father took anphetamines to study for his reválida (an exam which was a general review of everything they’d learned in college - if they failed it they didn’t graduate) and promptly fell asleep, so deeply that his studymate couldn’t wake him up. Since it looked like normal sleep except for being so deep, the friend moved him from the chair to a bed and crammed through the night as intended. Many of my relatives (including myself) have unusual reactions to relaxants, excitants or both.
I know that hyperactivity is real, intrinsic inability to focus is real, being bored in class due to not being challenged enough is real, being better at multi- than single-tasking is real, but also that they tend to get clumped together, and that the hyperactive ones (who may or may not have focus and/or boredom problems) are much more visible than the non-hyperactive ones. I think the focus should be on learning how to deal with whatever your problem is on your own as much as possible - this may include pills or not, depending on the person (severity of the symptoms, type of symptoms, what other mechanisms are available).
I had a hyperactive classmate (no focusing problems once his extra energy was burned off; our teachers would send him to run a few laps on those mornings when they saw he was extra-bouncy) who eventually became our high school’s PE teacher, and one of the reasons he’s a very good one is that he knows not everybody has his energy levels. I also had a coworker who’d been diagnosed as ADHD in childhood, been on medication on and off, always done his homework with his mother staring at his back… and in his 30s when I met him, he would wrap up any self-assigned tasks in record time, but be unable to progress on other-assigned tasks unless he had someone staring at his back: he’d internalized the wrong “control mechanism”.
The US military, for one, seems to think that it does. Amphetamines have been used in military contexts as a performance enhancer from WWII right up today. The effects of amphetamines on study are so well known that I found an article in a law journal arguing that major standardized academic tests should include randomized drug testing to mitigate the unfair advantage caused by illegal use of performance enhancing drugs. Interesting, a lot of the literature I am finding on non-ADHD use of amphetamines for study enhancements are in the realm of law, where it brings up the same questions as performance enhancing drugs in sports. Here is a quote from one:
This all brings up a lot of ethical concerns, especially since (as Nava illustrates), amphetamines are unpredictable drugs that are certainly not suitable for everyone.
How are mental performance-enhancing drugs different than, say, steroids that improve physical performance? Why is it ethical for Joey P to take a drug that will improve his grades by one level, but not for me?
It just seems messy and complex to me- which is fine. Life is messy and complex.
Yes, distractibility is a spectrum, like height is. And like height, its expression can be affected by environmental conditions during gestation and the growing years.
It’s not necessarily a learning disorder and doesn’t necessarily lower your grades. That’s just the most likely way to get diagnosed. And, yes, it’s hard to pick out ADHD from anxiety and ADHD-PI from depression. But if most people can sit still, while you can’t and amphetamines calm you down when they would make most people twitch, then there’s something going on.
I’m ADHD-PI (predominantly inattentive), which I think is a completely stupid category and which I’m sure will be changed again and again while they’re figuring things out. But when I went on the meds, my blood pressure dropped. (Since I was already taking blood pressure meds, the shrink made me track my blood pressure for a two weeks before, and then for months after starting the Adderall.) I’ve learned since that this isn’t uncommon.
I’m reading Quirk : a journey to the source of personality by Hannah Holmes. Even though “It’s a stretchy, complicated, culturally bound phenomena with fuzzy boundaries,” apparently researchers can breed ADHD mice to study. So the boundaries are fuzzy partly because we don’t have a good description yet on what’s going on. That’s not quite the same as making things up.
Who says it’s not ethical for you to take this drug? It’s perfectly ethical, assuming you have a diagnosis. For all you know, you could have diagnosable ADHD. Unless your point is that ADHD is a fake made-up diagnosis. Is that your point?
It’s easy to see what the difference is when its a condition that actually affects you, but a lot hard when it’s one that doesn’t. Compare it to something else, and I think it’ll make a bit more sense. For instance, one person may be fat because they have a medical condition, someone else is fat because they eat to much and don’t exercise. It’s easier to see the difference there because we can more easily quantify things like diet and exercise. But, even there, people who have legitimate illnesses there suffer social stigmas for the same reason because the causal observer can’t tell the difference.
As for why one person can take drugs but another can’t… I’m not sure there’s a good answer for that, and I’m not sure I agree. There’s risks involved whether it’s a medically recognized illness or its just lazy. Personally, though I’ve thought I may have some form of it, I’ve never wanted to pursue any drugs because while I have some difficulties, I’ve also found things that help me operate, like multi-tasking, getting lots of exercise, meditation, and all that. But in so doing, I have to acknowledge that it’s not unlikely that someone may have it more seriously than me, or those methodologies may not be as effective, or in some ways I have other advantages that help counteract some of them.
I think of it like HGH (growth hormone). Children who are way too short will have it prescribed, and you can give it to your normal child to try for a basketball player, but you’ll have trouble finding a doctor to prescribe it for that.
Out of curiosity, Even Sven, have you seen a psychiatrist? You might find that if you talked to one that might actually put you on something for your laziness (that sounds odd when I write it like that)? Maybe it’ll be Adderall or Dexedrine (time release) or Provigil or an antidepressant. Just because you don’t think something needs to be treated doesn’t mean a doctor doesn’t.
Personally? I’m pretty sure I am just slightly lazy. I’m working full-time while getting good grades in a full-time master’s program at a top university. It’s not a pathology that I’d rather watch Hulu than do write my paper tonight.
When my son was diagnosed with AHDH we all thought “finally!” because we’d been suspecting it since he was around 2. Even my grandfather, a pediatrician, mentioned to us that he seemed ADHD to him. These days he’s on medication (a patch that delivers the medication steadily throughout the day as well as a short-acting pill he takes in the morning) and the difference is amazing. We can tell right away if he’s forgotten his medication for the day. He acts several years younger than his age, engages in fiddly activities like playing with string, and can’t focus on things like homework (or classwork, as his teachers have reported).
It’s not a cure-all, of course. He still doesn’t like to do homework and has to be almost coerced into it, but when we finally get him sitting down at the table with the homework in front of him, he’s able to work through to the end, which he would not be able to do without his medication.
His psychiatrist back in Ohio told me that I had ADHD as well. He said that based on the interactions he had with me when I came in with my son he had no doubt–he was 100% sure–that I had ADHD. He also said that 60% of people with Tourette’s Syndrome (which I have) also have ADHD. Unfortunately at the time I didn’t have health insurance so I couldn’t follow up on it.
I finally got on medication for it from my psychiatrist here in Massachusetts (now that I have insurance through my husband) and I have to say I notice a difference. My primary difficulties before were that I’d be working on something and I’d get sidetracked by something else I was supposed to get done, that I was certain I’d forget if I didn’t switch over and do it “right now”… this led to a daisy-chained string of half-finished tasks. The other problem came with listening to people when they talked to me. I’d get distracted very easily and miss something they said. Sometimes I’d catch myself, but then I’d get totally sidetracked by the fact that I was sidetracked, and I’d still end up missing something that was said. I’d have to listen to the rest and hope that the missing part became obvious, or else admit that I hadn’t been following and ask them to repeat themselves. Not a good position to be in.
Being on Adderall has helped with both of those things. My official dosage is to take one in the morning and one at noon, but I’d say that half the time I don’t take the noon pill. If I feel like I’m focusing okay I don’t feel like I need more. I also don’t take my medication on the weekends unless I have something to do that requires a lot of concentration, like going through boxes of stuff in the attic to decide what to keep and what to get rid of, which isn’t very often.
All that said, I think that ADHD is probably overdiagnosed in both kids and adults. I don’t think it is misdiagnosed in either myself or my son, however, and we’re both doing much better on medication than we did before.
I know we’re kind of off it now, but just to mention it again. I wanted to point out that this is what I mean by it not being degrees of laziness. You mention “It’s not a pathology that I’d rather watch Hulu than do write my paper tonight” For me, it’s not that I’d rather have been watching TV then doing homework, it’s that I’d try to do homework and all of a sudden I’d realize that I’d been doing something else altogether for the last hour and then say “Crap, mom’s gonna kill me when she finds out that I spent all that time reading Boy’s Life or making something out of Construx instead of studying for my spelling test” then I’d spend just enough time studying for my spelling test that I could prove to my mom that I knew all the words, but by school tomorrow they were all long since forgotten and I’d get a shitty grade. It’s not that I was lazy, it’s not that I didn’t want to study, it just that I got easily distracted and honestly, really and truly, wouldn’t even realize it.
What I think she might be saying—and correct me if I’m wrong—is that despite there being no conclusive test for ADHD, and despite the fact that almost anyone who takes stimulants will get some of the same positive effects from them that someone with an ADHD diagnosis would, we all have to pretend as though there’s a bright line somewhere, with on one side the pathologized group and on the other side putatively “normal” people who are merely looking for a lifestyle medication/performance enhancer. And the truth is there is no such bright line; there’s a very gradual spectrum, and there are probably a lot of people who don’t “need” ADHD medications who receive them and a lot who’d benefit from them who don’t. The only conclusive thing a diagnosis of ADHD says about you is that you answered a doctor’s yes-or-no questions and successfully convinced him or her that you meet the arbitrary definition. If you’ve done that, you get to take speed before you study for a test; if you haven’t and you do, you’re a criminal.
Reading this flip and dismissive-sounding summary of what you perceive as the situation makes it hard for me to take the rest of your post seriously. If I’m misinterpreting some nuance, I apologize. I myself am under the influence of drugs at the moment, in the form of codeine-laced cough syrup.
This is a pretty reasonable summary of what I was ham-handedly trying to express.
Also, there needs to be some way to open dialog on this without the defensiveness. Nobody is saying that ADHD is a personal failing, or a fake disease, or that people should not be able to reach the medication that works best for them. It’s not fair to fall back on that to shut down all conversation.
Anyone who’s seriously interested in the nature of ADHD should read this lecture by Russell Barkley, who’s one of the leading authorities on the disease.
Actually, people are saying that. Fewer in this thread than on TV, but there are any number of people, (and posters to this thread), who are willing to acknowledge that “someone” might actually suffer from ADHD, but that most of the time it is just being used to provide excuses for lazy scholarship/parenting/teaching/whatever. If you want to remove defensiveness, eliminate the offensiveness.