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  1. #1
    Don't pet me. JAVO's Avatar
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    Default ADHD Does Not Exist

    One behavioral neurologist thinks that ADHD doesn't exist...

    Excerpts:

    If someone finds it difficult to pay attention or feels somewhat hyperactive, "Attention-deficit and Hyperactivity Disorder" has those symptoms right there in its name. It’s an easy, catch-all phrase, which saves time for doctors to boot. But can we really lump all these people together? What if there are other things causing people to feel distracted? I don’t deny that we, as a population, are more distracted today than we ever were before. And I don’t deny that some of these patients who are distracted and impulsive need help. But what I do deny is the generally accepted definition of ADHD, which is long overdue for an update. In short, I’ve come to believe based on decades of treating patients that ADHD — as currently defined by the DSM and as it exists in the public imagination — does not exist.

    ...

    However, there are some instances in which attention symptoms are severe enough that patients truly need help. Over the course of my career, I have found more than 20 conditions that can lead to symptoms of ADHD, each of which requires its own approach to treatment. Among these are sleep disorders, undiagnosed vision and hearing problems, substance abuse (marijuana and alcohol in particular), iron deficiency, allergies (especially airborne and gluten intolerance), bipolar and major depressive disorder, obsessive compulsive disorder, and even learning disabilities like dyslexia, to name a few. Anyone with these issues will fit the ADHD criteria outlined by the DSM, but stimulants are not the way to treat them.

    http://time.com/25370/doctor-adhd-do...ist/?hpt=hp_t4

  2. #2
    Senior Member OptoGypsy's Avatar
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    Disorders are human traits (human nature) that the majority doesn't understand so they find a need to label it i.e parents not understanding that their child isn't uptight with a stick up their anus yet so they need to find out why they don't act like adults

  3. #3
    As Long As It Takes.... Redbone's Avatar
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    Very interesting. I've had a dx of ADHD. I think in my case, it's just "normal" functioning for an Ne-dom. I admit that Concerta helped me keep focused on things...made my thoughts/actions more linear? So, I got more done but it also took something away, too. I didn't take it for long.

  4. #4
    Emperor/Dictator kyuuei's Avatar
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    Quote Originally Posted by JAVO View Post
    However, there are some instances in which attention symptoms are severe enough that patients truly need help. Over the course of my career, I have found more than 20 conditions that can lead to symptoms of ADHD, each of which requires its own approach to treatment. Among these are sleep disorders, undiagnosed vision and hearing problems, substance abuse (marijuana and alcohol in particular), iron deficiency, allergies (especially airborne and gluten intolerance), bipolar and major depressive disorder, obsessive compulsive disorder, and even learning disabilities like dyslexia, to name a few. Anyone with these issues will fit the ADHD criteria outlined by the DSM, but stimulants are not the way to treat them.

    http://time.com/25370/doctor-adhd-do...ist/?hpt=hp_t4
    I'd say in part that I agree, to label it a symptom even if the pathology is idiopathic. It was definitely a step in the right direction to give this issue a label.. and not chalk it up to disruptive, bad kids, or flaky adults that won't grow up. They always thought my father was just a bad student--he was a great student, he just couldn't concentrate. PTSD made that worse for him. Depression has expounded upon it in a way I didn't know was possible for him.

    But of course, when you give something a name, all the hypochondriacs follow too... There are people who feel they have ADHD/I-cant-study-syndrome/I-need-constant-breaks-which-makes-school-hard-disorder... And these are perfectly acceptable, and somehow lumped into real medical disorders and symptoms. No one learns how to study overnight--it takes active effort 'leveling up' your abilities doing something you just genuinely might not like to do. I take 5-10 minute breaks every 15-20 minutes of active studying. It takes me forever to study, and sometimes I don't even get to entire sections of the book by the time the test arrives. But the sections I DO know, I know for sure.
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  5. #5
    Senior Member prplchknz's Avatar
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    I can't focus, but I don't have ADHD, I know this for a fact
    In no likes experiment.

    that is all

    i dunno what else to say so

  6. #6
    hypersane Hive's Avatar
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    Too tired to read the article right now, but:

    ADHD is caused by abnormal substance levels in the brain, mainly by deficient amounts of dopamine. I agree that it's overdiagnosed and the way we go about things in society today probably makes a lot of us mimic the symptoms, but I don't really doubt that it's a real condition. But with the ADD/ADHD epidemic that runs rampant, I guess reactions like this were to be expected.

    But I will read the thing tomorrow and see for myself.

  7. #7
    Freaking Ratchet Rail Tracer's Avatar
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    I think, for the majority of people, inattention or bad concentration is just a symptom of other factors. I mean, we have a lot more stimulating/addicting things today than we ever had a century ago. And trying to concentrate on something that we find less interesting is just harder to do. That, or inattention or bad concentration is just a symptom of another condition like lack of sleep or thinking too much about something else.

    For some people, reading a book is a lot more boring than surfing the web or playing games. It isn't because the kid has less focus than other people, it is that the kid is focusing on something that is more stimulating to the kid than reading a book. And, if we were to go back 1-2 centuries ago, reading would have easily fulfilled that role of stimulation.

  8. #8
    Senior Member cafe's Avatar
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    I was DXed with it. I don't know if it's real or not. I know I'm easily distracted and have a low tolerance for boredom. I can read a novel no probs, though.
    “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs.”
    ~ John Rogers

  9. #9
    Artisan Conquerer Halla74's Avatar
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    Hello everyone,

    I have ADHD, and I have a few things to say.

    The article referenced in the OP is an opinion of a single medical practitioner. So, before dismissing tomes of evidence from every corner of the human experience that ADHD is a real phenomena, please read the information below to ensure that your understanding is more vast than the opinion of one man.

    One thing that Dr. Richard Saul did not address directly is that the criteria for diagnosis of ADHD in DSM IV-TR vs DSM-V are not that different at all. Please read the DSM-V fact sheet below for clarification:

    (DSM-V) Attention Deficit/Hyperactivity Disorder (Fact Sheet)

    FROM: http://www.dsm5.org/Documents/ADHD%20Fact%20Sheet.pdf

    "The definition of attention-deficit/hyperactivity disorder (ADHD) has been updated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to more accurately characterize the experience of affected adults. This revision is based on nearly two decades of research showing that ADHD, although a disorder that begins in childhood, can continue through adulthood for some people. Previous editions of DSM did not provide appropriate guidance to clinicians in diagnosing adults with the condition. By adapting criteria for adults, DSM-5 aims to ensure that children with ADHD can continue to get care throughout their lives if needed."

    Changes to the Disorder

    ADHD is characterized by a pattern of behavior, present in multiple settings (e.g., school and home), that can result in performance issues in social, educational, or work settings. As in DSM-IV, symptoms will be divided into two categories of inattention and hyperactivity and impulsivity that include behaviors like failure to pay close attention to details, difficulty organizing tasks and activities, excessive talking, fidgeting, or an inability to remain seated in appropriate situations.

    Children must have at least six symptoms from either (or both) the inattention group of criteria and the hyperactivity and impulsivity criteria, while older adolescents and adults (over age 17 years) must present with five. While the criteria have not changed from DSM-IV, examples have been included to illustrate the types of behavior children, older adolescents, and adults with ADHD might exhibit. The descriptions will help clinicians better identify typical ADHD symptoms at each stage of patients’ lives.

    Using DSM-5, several of the individual’s ADHD symptoms must be present prior to age 12 years, compared to 7 years as the age of onset in DSM-IV. This change is supported by substantial research published since 1994 that found no clinical differences between children identified by 7 years versus later in terms of course, severity, outcome, or treatment response.
    DSM-5 includes no exclusion criteria for people with autism spectrum disorder, since symptoms of both disorders co-occur. However, ADHD symptoms must not occur exclusively during the course of schizophrenia or another psychotic disorder and must not be better explained by another mental disorder, such as a depressive or bipolar disorder, anxiety disorder, dissociative disorder, personality disorder, or substance intoxication or withdrawal.

    Care Beyond Childhood

    The ADHD diagnosis in previous editions of DSM was written to help clinicians identify the disorder in children. Almost two decades of research conclusively show that a significant number of individuals diagnosed with ADHD as children continue to experience the disorder as adults. Evidence of this came from studies in which individuals were tracked for years or even decades after their initial childhood diagnosis. The results showed that ADHD does not fade at a specific age.

    Studies also showed that the DSM-IV criteria worked as well for adults as they did for children but that a lower threshold of symptoms (five instead of six) was sufficient for a reliable diagnosis.
    In light of the research findings, DSM-5 makes a special effort to address adults affected by ADHD to
    ensure that they are able to get care when needed."


    -----------------------------

    Also, I think it is of benefit to understand the terms defined below before formulating an opinion on any mental disorder, or people who have them:

    Mental Disorder (synonym for “Mental Illness”)

    FROM: http://en.wikipedia.org/wiki/Mental_disorder

    “A mental disorder (also called a mental illness or psychiatric disorder) is a mental or behavioral pattern or anomaly that causes either suffering or an impaired ability to function in ordinary life (disability), and which is not developmentally or socially normative."

    “Mental disorders are generally defined by a combination of how a person feels, acts, thinks or perceives. This may be associated with particular regions or functions of the brain or rest of the nervous system, often in a social context. Mental disorder is one aspect of mental health.”

    --------------------------------------------

    So, for an example of how any human being can become significantly pre-disposed to developing ADHD at some point in their lives, please read the following article about the effect of oxygen deprivation prior to birth. Oh yeah, before I forget, I was born a blue baby. My umbilical cord began to separate prior to my delivery. My Mom was sent home when she went to the hospital the first time, and told that she was not in full labor yet. Her water broke and still she was told to walk around the ward until I arrived. Sometime the next day I was born. My parents and the doctors and nurses who were there for my delivery were horrified at the color of my skin when I was born. This can happen to ANYONE. And, heads up, depriving a human being of oxygen for enough time can result in changes/damage to tissues and/or organs (e.g. THE BRAIN), which might very well cause them to function differently for the remainder of the individual's life.

    ADHD linked to oxygen deprivation before birth

    FROM: http://www.sciencedaily.com/releases...1210080833.htm

    “Children who had in-utero exposure to ischemic-hypoxic conditions, situations during which the brain is deprived of oxygen, were significantly more likely to develop attention deficit hyperactivity disorder later in life as compared to unexposed children, according to a new study. The findings suggest that events in pregnancy may contribute to the occurrence of ADHD over and above well-known familial and genetic influences of the disorder.”

    ...and...

    Hypoxia (medical)

    FROM: http://en.wikipedia.org/wiki/Hypoxia_(medical)

    "Hypoxia (also known as Hypoxiation or Anoxemia) is a condition in which the body or a region of the body is deprived of adequate oxygen supply. Hypoxia may be classified as either generalized, affecting the whole body, or local, affecting a region of the body. Although hypoxia is often a pathological condition, variations in arterial oxygen concentrations can be part of the normal physiology, for example, during hypoventilation training or strenuous physical exercise…

    … Hypoxia is also a serious consequence of preterm birth in the neonate. The main cause for this is that the lungs of the human fetus are among the last organs to develop during pregnancy. To assist the lungs to distribute oxygenated blood throughout the body, infants at risk of hypoxia are often placed inside an incubator capable of providing continuous positive airway pressure (also known as a humidicrib)."


    Ischemia

    "…Ischemia, meaning insufficient blood flow to a tissue, can also result in hypoxia. This is called 'ischemic hypoxia'. This can include an embolic event, a heart attack that decreases overall blood flow, or trauma to a tissue that results in damage. An example of insufficient blood flow causing local hypoxia is gangrene that occurs in diabetes.[citation needed]
    Diseases such as peripheral vascular disease can also result in local hypoxia. For this reason, symptoms are worse when a limb is used. Pain may also be felt as a result of lactic acid created as a result of anaerobic metabolism.


    --------------------------------------

    I also think it is worth checking out the World Health Organization's definition of mental health...

    Mental health: a state of well-being

    FROM: http://www.who.int/features/factfiles/mental_health/en/

    December 2013

    Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

    The positive dimension of mental health is stressed in WHO's definition of health as contained in its constitution: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

    This fact file highlights the important aspects of mental health and disorders. The images include pictures drawn by children who participated in the WHO Global School Contest of Mental Health in 2001.

    ------------------------------------

    I could go on for hours about this, but I can't because I have a lot to do right now.

    In closing, I do not disagree that there are some people who will seek an ADHD diagnosis when they do not have it, and there are also doctors who might over diagnose people with ADHD, or over prescribe ADHD medications. However, I don't think that any of the cases I just mentioned, alone or in combination, make up the majority of people in this world who are living with ADHD, and whose lives are affected by it each and every day.

    As is the case for ANY mental illness, the best outcomes are reached when a person with ADHD utilizes an appropriate combination of medication and counseling.

    Another thing to consider is that a lot of effort has been put into treating mental illnesses with modern pharmaceuticals as opposed to older medications.
    If you think CNS stimulants are overprescribed, then how over-prescribed are SSRIs and SNRIs?
    Please.

    Finally, I'd like to clarify that I am not on a soapbox at this point. There is no shame or glory in having ADHD. It is what it is. If you have it, then you can choose if you want to treat it, or not. And if you do want to treat it, you have to work with your doctor, psychiatrist, and counselor to find the right scope of treatment that results in giving you more benefits than consequences.

    I'll probably chime in later, but for now I must bow out.

    Keep The Faith,



    -Halla74

    ---------------

    P.S.

    Below are the DSM-IV TR criteria for ADHD if you wish to compare it to the DSM-V criteria I mentioned above...

    (DSM-IV TR) Diagnostic criteria for Attention-Deficit/Hyperactivity Disorder

    FROM: http://behavenet.com/node/21488

    These criteria are obsolete.

    DSM IV - TR

    (cautionary statement)

    A. Either (1) or (2):

    (1) inattention: six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

    (a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
    (b) often has difficulty sustaining attention in tasks or play activities
    (c) often does not seem to listen when spoken to directly
    (d) often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
    (e) often has difficulty organizing tasks and activities
    (f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
    (g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
    (h) is often easily distracted by extraneous stimuli
    (i) is often forgetful in daily activities

    (2) hyperactivity-impulsivity: six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

    Hyperactivity

    (a) often fidgets with hands or feet or squirms in seat
    (b) often leaves seat in classroom or in other situations in which remaining seated is expected
    (c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
    (d) often has difficulty playing or engaging in leisure activities quietly
    (e) is often "on the go" or often acts as if "driven by a motor"
    (f) often talks excessively

    Impulsivity

    (g) often blurts out answers before questions have been completed
    (h) often has difficulty awaiting turn
    (i) often interrupts or intrudes on others (e.g., butts into conversations or games)

    B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.

    C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).

    D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

    E. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorders, or a Personality Disorder).

    Code based on type:

    314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type: if both Criteria A1 and A2 are met for the past 6 months
    314.00 Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: if Criterion A1 is met but Criterion A2 is not met for the past 6 months
    314.01 Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type: if Criterion A2 is met but Criterion A1 is not met for the past 6 months

    Coding note: For individuals (especially adolescents and adults) who currently have symptoms that no longer meet full criteria, "In Partial Remission" should be specified.
    --------------------
    Type Stats:
    MBTI -> (E) 77.14% | (i) 22.86% ; (S) 60% | (n) 40% ; (T) 72.22% | (f) 27.78% ; (P) 51.43% | (j) 48.57%
    BIG 5 -> Extroversion 77% ; Accommodation 60% ; Orderliness 62% ; Emotional Stability 64% ; Open Mindedness 74%

    Quotes:
    "If somebody asks your MBTI type on a first date, run". -Donna Cecilia
    "Enneagram is psychological underpinnings. Cognitive Functions are mental reasoning and perceptional processes. -Sanjuro

  10. #10
    Senior Member cafe's Avatar
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    I'm a poster child for inattention.
    “There are two novels that can change a bookish fourteen-year old’s life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs.”
    ~ John Rogers

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