COMMENTARY | Of all the op-eds that would rile Americans, one claiming that ADHD, the widely-known acronym for attention deficit hyperactivity disorder, does not actually exist is a real doozy. Millions of Americans, after all, have been diagnosed with ADHD and are actively medicating themselves with a myriad of stimulants. It has long been controversial how frequently parents seek to medicate their kids at the first sign of hyperactivity or a tendency to daydream, by rarely has a medical professional said that the condition of ADHD itself does not exist. Yet that is exactly what Dr. Richard Saul, an experienced behavioral neurologist, is asserting. According to TIME, he has even written a book about how ADHD is not a condition in and of itself.
Before everyone vents anger and hatred toward the good doctor, it is important to note that he is not claiming that all people diagnosed with ADHD are not unwell, but rather that what we call ADHD is instead a complex of underlying conditions. Many ADHD diagnoses are due to problems ranging from sleep deprivation to allergies to hearing and vision difficulties. Like many critics of ADHD medication, Saul worries that we are raising a generation of stimulant-addicted young men and women, unable to function normally without their meds.
How much of what Dr. Saul says could be true? Is it possible that ADHD has been used as a catch-all for a number of separate conditions that lead to difficulty focusing? I remember, as a boy, being re-tested for asthma by a doctor who wondered if my original diagnosis was not simply a catch-all used to explain my frequent wheezing and shortness of breath. He did not want me taking doses of asthma medication if I didn’t actually have asthma.
It turned out I did have exercise-induced asthma, but it was interesting to find out that asthma, due to its increasing commonness, was suspected of having been a catch-all diagnosis.
Of course, there are many incentives to diagnose a child with ADHD, ranging from behavioral regulation to academic accommodations to a simple desire to affix a name to unwanted childish behavior. Regardless of the accuracy of Dr. Saul’s diagnosis of ADHD itself, we do need to take a deeper look at our obsession with diagnosing behavioral disorders in our youth. How much of our diagnosing is based on a genuine desire to treat a real problem,,,and how much is based on want of a convenient crutch?
It’s complicated, and I realize that.
When I was young I used my asthma diagnosis as a crutch sometimes. Though my asthma was a real problem, sometimes resulting in emergency nebulizer treatment, I also took advantage of it to sometimes not have to push myself. Looking back, I regret that. I wish I had pushed myself.
At age 24 I made a conscious effort to wean myself off of my asthma medication. It turned out that, for some reason or another, I no longer needed it to help me run. Five years later, I feel so much better not having to rely on my old Albuterol (though, to be honest, I still use it if I am sick with a flu or other intense respiratory infection), In fact, I am entirely medication free. And it is liberating.
I know my experience is uncommon for asthmatics and that most individuals cannot hope to wean themselves off of their medication, nor should they attempt to do so. But for those who safely can, it is rewarding and worthwhile. And Dr. Saul has given us some more to think about in regard to looking down that path.