Attention Deficit Disorder: Why All the Commotion?

Attention Deficit Hyperactivity Disorder, or ADHD, classified as a developmental disorder, not a personality disorder, is certainly the cause of great debate, as more and more children are diagnosed and treated for this. ADHD is also, interestingly enough, a disorder in which the reverse could be said- rather than more children being diagnosed, we now see more adults, and even into middle or later generations, receiving their initial diagnosis and treatment for ADHD or ADD. Unlike Bipolar or other mood disorders, which we used to believe only occurred in adults and has caused great controversy as it is being diagnosed in adolescents and children, we now have taken a childhood “illness” and begun to treat adults and even geriatrics. I personally find this fascinating.  I wonder if somewhere there is an organization protesting the diagnosis of ADHD in parents after the age of 50?  And if not, should there be? This is not meant to be facetious or flippant in any manner, it is meant to address the question of if neurobehavioral disorders exist, (and I believe that they do), mustn’t we acknowledge that they could potentially exist at any point in the human life span?  And if that is the case, that the disorders exist in a child, an adolescent, an adult, or an aged geriatric patient, aren’t they all deserving of appropriate treatment that might alleviate their symptoms? I believe that they are.

Often I compare mental to medical illnesses, when trying to do teaching with my clients. If we looked at childhood diabetes, would anyone be outraged that more and more doctors were detecting symptoms at an earlier age, and initiating treatment early, thus reducing the risks of further complications throughout the life span? We vaccinate (those of us who believe in the use of immunizations) our infants and children to prevent them from developing debilitating diseases, we provide antibiotics for ear infections to prevent hearing loss and the segue into rheumatic fever and cardiac disease from streptococcus organisms, and no one ever protests quite so loudly about treating children’s symptoms, until we start entering the world of the neurobiological or behavioral disorders. If a child is experiencing distress, shouldn’t that actually be the key that guides the diagnosis and treatment?

Many years ago, when my daughter was diagnosed with ADD, I was reluctant to give her medications, even though I was the one who initially sought evaluation and treatment. Even as a nurse, the meds were scary to me, and the idea that my daughter needed them was disturbing. An excellent pediatric neurobehavioral specialist suggested to me that I give them a two week trial- that a few weeks certainly wouldn’t hurt my daughter in any way, and then I could make a better judgment about the use of methylphenidate (generic Ritalin). I would have made the decision to continue after observing the change in Jess’s behavior, but it became not my choice, when she came to me after a week or so, maybe 10 days, and said ‘wow, this must be what everyone else’s brain feels like all the time”. She was able to focus, to stay on task, to remember and process better. Jessica was 7 at the time, maybe 8. No matter what I personally felt about any “labeling’ that would occur , or about her taking medications, the fact that SHE felt they improved the quality of her life, that SHE felt they reduced her symptoms, seemed to me to be the final factor.

My daughter was very fortunate, in that the short term use of medication allowed her to focus on developing alternate coping skills. She was fortunate in that I was able to work an extra job or two in order to send her to a private school with 10 students per teacher, where she excelled, and continued to excel after we stopped the meds due to side effects.

At 22 years of age, she is an accomplished, self assured, happily married wife, homeowner, and self-employed computer consultant. Looking back at her behavior at the age of 7, when she couldn’t find her homework, much less remember to turn it in, I had serious concerns about her academic (and thus the rest of the aspects of her life) future. She was not treated because I didn’t LIKE her behavior; it was because her symptoms interfered with her life in a way that would have had serious long term consequences. Isn’t that one of the reasons we develop treatment possibilities in the first place- to reduce or eliminate symptoms, and to improve the quality of life.