This text appeared on Huffington Post Québec in french. Click to read
Given the abstract concepts in psychology, it is often almost impossible to prove anything with infallible methods. Conversely, it is equally complex to discredit the myths of popular psychology. This is exactly where psychiatry is capitalizing, particularly in the case of attention deficit hyperactivity disorder (ADHD). The most difficult thing is to discredit persistent myths when the majority wants to believe in them.
Although experts in ADHD have prestigious titles with lots of letters, like neuropsychologist, the “science” behind ADHD could not be less objective. The diagnosis of ADHD is exclusively (!) made through questionnaires, with criteria such as “I often lose my pencil.” The majority seems to ignore it, but there’s still no way to diagnose ADHD with magnetic imaging (1) or any other means that could be seen as “natural.”
There are hundreds of research articles published in scientific journals that have found differences between the brains of a control group and a group with ADHD, such as a lower connectivity (2), or a smaller cerebellum (3). Yet, these results are absolutely unable to diagnose ADHD, since they are not specific to those with ADHD (1) and to persons with psychiatric problems. An average is a very poor predictor when applied to one person. Similarly, we often hear people claim to have a “chemical imbalance” in the brain. There is currently no established standard of “good” or “bad” chemistry. In short, what is called ADHD is a description based on behavior rather than a neurological profile. There is no way to diagnose ADHD without asking the patient (often as young as 6 years old) if he is hyperactive.
Therefore, when asked whether ADHD is a disorder or normality, it must be based solely on the behavior described, as “ADHD” does not refer to any established biological reality. Is it really a disorder to be hyperactive in class? Is it really a disorder to be agitated when working in a cubicle 40 hours a week? Maybe everyone needs novelty, and some need more novelty than the average person? Almost all the symptoms or phenomena associated with ADHD are easily explained by a quest for novelty or excitement. For example the use of recreational drugs (4) or higher rates of injury (5) … or just hyperactivity, which is manifested just in unstimulating environments.
Indeed, the researchers concluded that hyperactivity is a homeostatic system that seeks to overcome the lack of excitement (6). Remarkably, ADHD “allows” to play video games in a problematic fashion (7), which seems inconsistent with the hypothesis that an abnormal brain prevents hyperactive people to concentrate for long periods. Equally curious, a vibrating chair can relieve symptoms of hyperactivity (8), which seems explicable only by the fact that it stimulates. ADHD is not clinically impairing in sports, in so far as it is believed that ADHD is often present in athletes (9). Especially since our evolutionary course much more like sports than a boring course. Especially in males, who hunted, which probably explains that there are up to 16 times more boys with ADHD (10).
Experts do as usual, and reject these ambiguities with other ambiguities, such as by saying that ADHD, even though we do not really know what it is, must be on the Y chromosome (11). The important thing is that they come with an explanation that continues to give us the illusion that ADHD is a disorder that requires treatment with psychostimulants. Because any other solution is mysteriously absent from scientific research. Curiously, the diagnosis of ADHD comes with the freedom to choose from a range of psychoactive drugs, all extremely expensive (and profitable) … but do not come with a simple free advice about the consumption of sugar or caffeine.
The ADHD epidemic emerges in a society where almost nobody wants to take care of the development of children. Whether it is the daycare, school, milk formula, or a psychiatrist, there is always a contractor who replaces the parents. A society in which a woman in their twenties and often with little experience should occupy and entertain thirty children for the whole year. Can we blame her to refer an agitated child to a psychiatrist? Can we really blame the parents who see their child being unable to concentrate, and seems to move towards an unglamorous career? Nobody wants to have a child who will become a manual laborer, which is usually paid less than the most inactive jobs. It explains that children from wealthier families have more ADHD diagnoses. That’s why they call psychostimulants “mother’s little helper” because it is for the parents and the authorities that make the job of forty parents at once. Not for children. Because they, they just need activity.
The term “hyperactivity” makes sense in relation to the environment. No one is hyperactive at recess or during a game of dodgeball. For adults, not everyone is ready to become a manual worker to spend their excess energy when they have the intelligence to study at university.
So who would believe that hyperactivity is normal, and that each person needs daily novelty, and that nobody needs Ritalin to thrive? People without ambition?
1. Weyandt, L., Swentosky, A., & Gudmundsdottir, B. G. (2013). Neuroimaging and ADHD: FMRI, PET, DTI findings, and methodological limitations. Developmental Neuropsychology, 38(4), 211-225. doi:10.1080/87565641.2013.783833
2. Konrad, K., & Eickhoff, S. B. (2010). Is the ADHD brain wired differently? A review on structural and functional connectivity in attention deficit hyperactivity disorder. Human brain mapping, 31(6), 904-916. doi: 10.1002/hbm.21058
3. Seidman, L. J., Valera, E. M., & Makris, N. (2005). Structural brain imaging of attention-deficit/hyperactivity disorder. Biological psychiatry, 57(11), 1263-1272. doi:10.1016/j.biopsych.2004.11.019
4. Rooney, M., Chronis-Tuscano, A., & Yoon, Y. (2012). Substance use in college students with ADHD. Journal of Attention Disorders, 16(3), 221-234. doi:10.1177/1087054710392536
5. Lahey, B. B., Pelham W. E., Stein M. A., Loney J., Trapani C., Nugent K.,. . . Baumann B. (1998). Validity of DSM-IV attention-deficit/hyperactivity disorder for younger children. Journal of the American Academy of Child & Adolescent Psychiatry, 37(7), 695-702. doi: 10.1097/00004583-199807000-00008
6. Zentall, S. S., & Zentall, T. R. (1983). Optimal stimulation: A model of disordered activity and performance in normal and deviant children. Psychological Bulletin, 94(3), 446-471. doi:10.1177/0149206309335187
7. Mazurek, M. O., & Engelhardt, C. R. (2013). Video game use in boys with autism spectrum disorder, ADHD, or typical development. Pediatrics, 132(2), 260-266. doi:10.1542/peds.2012-3956
8. Fuermaier, A. B., Tucha, L., Koerts, J., van Heuvelen, M. J., van der Zee, E. A., Lange, K. W., & Tucha, O. (2014). Good vibrations-effects of whole body vibration on attention in healthy individuals and individuals with ADHD. PLoS One, 9(2), e90747. doi: 10.1371/journal.pone.0090747
9. Stabeno, M. E. (2004). The ADHD affected athlete. Canada: Trafford Publishing.
10. Szatmari, P., Offord, D. R., & Boyle, M. H. (1989). Ontario Child Health Study: prevalence of attention deficit disorder with hyperactivity. Journal of child psychology and psychiatry, 30(2), 219-223. doi: 10.1111/j.1469-7610.1989.tb00236.x
11. Mulligan, A., Gill, M., & Fitzgerald, M. (2008). A case of ADHD and a major Y chromosome abnormality. Journal of Attention Disorders, 12(1), 103-105. doi:10.1177/1087054707311220