ADHD: Myth or Reality?

Picture a kaleidoscope. Its colors are beautiful, vibrant, intense, and jumbled. When the kaleidoscope is turned, the jumbles reconfigure themselves and they’re always interesting, but all of the colors are always there. No filter exists to keep out some of the colors. There is often no rhyme or reason for the different ways the colors choose to fall inside the kaleidoscope. Such is the life of a person born with Attention Deficit Hyperactivity Disorder. The brain acts as a kaleidoscope, and like that pleasant little toy, it is unable to filter or exchange thoughts and ideas in a workable pattern, unable to focus on a single color. All of the colors intermingle.

For approximately the last twenty-five years, Attention Deficit Hyperactivity Disorder has become a term that is widely recognized. But when a poll was initiated in 1997 to determine what Americans understood about the disorder, it was evident that most know very little about it. Answers to the poll’s question, “what is ADHD?” Ranged from “it’s something kids get wen their parents can’t handle them” to “there’s really no such thing.” Some answers were at least on the right track: “It’s some sort of brain thing, mostly in kids.” Unfortunately, a majority of answers to the questions exhibited skepticism about the very existence of ADHD, a situation with potentially troubling consequences for those who suffer from the disorder.

ADHD needs to be seen and understood as a real, treatable neurological disorder, because the negative consequences for individuals with the condition who remain untreated spreads into all segments of society. Without identification and treatment, ADHD can have serious consequences that include school failure and/or drop-out, depression issues, failed relationships, underachievement, and substance abuse.

The Surgeon General released a formal report in 1980 to acknowledge ADHD as a neurological disorder caused by several different factors. The report explains that the exact cause is still unknown, but enough studies have been conducted which point to genetics, perinatal complications (problems during pregnancy), and perhaps environmental issues, such as prolonged exposure to lead-based paints.

When doctors and scientists noticed that stimulants seemed to work for reducing the effects of ADHD, the “dopamine hypothesis” was born. :It contends that ADHD is created by an inadequate supply of dopamine in the central nervous system. Dopamine is a chemical which is created in the brain stem. It’s responsible for mental alertness, purposeful movement of the body, and it is partially used by the body to control the distribution of adrenaline, another essential chemical produced to induce energy and excitement. Dopamine is also capable of reducing appetite and inducing insomnia, two notorious side effects of stimulant use for treatment.

ADHD has been determined to have definite genetic components. 35 to 40 percent of people diagnosed with the condition will have a close relative who has been diagnosed, as well. Approximately half of all parents with ADHD will have a child who exhibits symptoms of the disorder. Research continues its attempt to pinpoint the cause of ADHD, and scientists have discovered not only dopamine itself as a potential source, but also two complex genes that are known as dopamine receptors and transporters. Not only does the body produce an inadequate amount of dopamine, but in many cases the genes intended to receive and transport the chemical to necessary areas are ineffectual. .

The symptoms of ADHD vary with each individual. The three main facets are inattention, hyperactivity, and impulsivity. Sufferers who are primarily inattentive have a difficult time keeping their minds on just one task and may become bored after only a few minutes of concentration. They are able to give intense attention to a task they enjoy or are practiced with, but focusing and organizing to complete a new endeavor can be extremely difficult. Those who exhibit symptoms of hyperactivity have a hard time remaining still for any length of time. Often they physically cannot sit quietly without movement. Being forced to remain motionless to such a person could almost equate with torture; they simply must be in motion to maintain mental stability. Hyperactivity in teens and adults will look different than the same symptom in children. Older people will feel intensely restless and try to accomplish many tasks at once, bouncing around from one chore to the next. The primary symptom of impulsiveness creates an inability to curb immediate reactions, or to think before speaking or acting. As a result, these sufferers will blurt out inappropriate comments, or in the case of children, run into the street without looking or considering the wisdom of such an act. Impulsivity makes the concept of “delayed gratification” non-understandable, and these individuals tend to strike out, both verbally and physically, when they experience intense emotion. Those with ADHD may exhibit one or all three of these primary symptoms. Most will, however, manifest one or two of the symptoms most of all. Some unlucky sufferers do experience all three regularly.

Determining if a person has ADHD is a multifaceted process. Many biological and psychological problems can mirror similar behaviors, so comprehensive evaluation by a professional is essential to establish a diagnosis. Such an evaluation should include an assessment of all aspects of the patient’s functioning level: academic, social, and emotional. Case histories obtained from those closest to the patient should be carefully evaluated to establish a pattern of behavior. There are several types of professionals who can diagnoses ADHD. School psychologists can note the presence of existing criteria, but he or she will refer the individual to an outside source for formal diagnosis. Clinical social workers and private-practice psychologists can diagnose the condition, but they are unable to prescribe medication. Nurse practitioners, neurologists, psychiatrists, pediatricians and other medical doctors can diagnose and treat the disorder with medication.

Medication for ADHD is sometimes seen as a sort of cop-out, something parents and teachers inflict upon children to ensure compliance and decent behavior, but such an assessment is patently false. Many Americans are convinced that ADHD is being over diagnosed and our nation as a whole is being over medicated, but the Journal of the American Medical Association disagrees. Obviously, as the ability to properly evaluate and diagnose conditions like ADHD becomes more sophisticated and widespread, the number of those found to have the disorder will increase. Comprehensive studies initiated by the Journal indicates, so far, that there is little basis in fact for the notion of children being medicated for any reason other than the valid one, which is to increase the level of functioning for someone with ADHD. It is currently estimated that between three and five percent of all Americans have ADHD.

There are many different myths and fears about the stimulants used to treat symptoms of ADHD. One commonly held idea is that those who use these medications will become addicted to them, but there is no evidence to support this fear. In fact, one study conducted by the American Medical Association has proven that out of 300 participants, only one-tenth of one percent of them had any issues with addiction. Another common misconception about medication for ADHD is that a person on it is more likely to abuse drugs and alcohol, but actually, just the opposite is true. One AMA study followed thousands of children with ADHD for ten years, and it was concluded that those who were medicated actually showed less inclination for substance abuse than those who were unmedicated. Untreated ADHD, conversely, seemed to increase the likelihood of later addiction problems.

Medication is certainly not the only answer for the issues and symptoms that plague those who suffer from ADHD, but it is one answer that has the power to help children and adults alike. Many physicians blame media misinformation for the many myths surrounding ADHD and medicated treatments for it. ADHD is not a phantom condition created by physicians or teachers to control classrooms. Hard, cold evidence had been carefully and methodically gathered, studied, and evaluated by scores of medical professionals. ADHD has been recognized by all major professional medical, psychiatric, and educational associations. It has also been formally recognized as a real medical condition by the courts of the United States and the United States Congress.

ADHD is not only a childhood condition. It is estimated that approximately 80 percent of children who currently take medication for the disorder will need to continue to do so into their adulthood. Adults previously undiagnosed and untreated are generally unable to hold down jobs, maintain long-term relationships, or function as productive members of society. Experts speculate that upwards of 40 percent of our prison population are untreated sufferers of ADHD. As untreated adults move through life, they could experience depression, anxiety, substance abuse problems, academic failures, vocational problems, and intense emotional distress. Once they have been treated, however, adults with ADHD can go on to lead productive lives and cope reasonably well.

Most ADHD patients greatly benefit from counseling as well as medication. Those with the disorder need to learn how to cope with the struggles and challenges that face a person with this condition. Medication goes a long way to help in the struggle, but it is by far not the only means of treatment, nor should it be seen as a “cure-all.” It is part of a treatment process, but not the only part. Professionals who understand ADHD are invaluable sources of education and support, and many websites, support groups, and print materials-magazines and books-exist to aid those with the disorder. Additionally, family members and friends should be encouraged to take advantage of support networks for coping with this disorder. Dealing with an individual who has ADHD provides special challenges and stress; it benefits those closest to the sufferer to create his or her own support system.

ADHD has traditionally been seen as, not only a children’s disorder, but primarily a male disorder. Medical experts now suspect that many females have gone undiagnosed as a result of a large percentage who suffer from the primary symptom, inattention. These girls are considered “flighty”, “weird,” or “spacey.” Teachers might comment that “her head is always in the clouds.” Women with ADHD who remain undiagnosed suffer from depression and anxiety 70 percent more often than their treated counterparts.

Attention Deficit Hyperactivity Disorder is a real, treatable, understandable disorder. Counseling, education, and medication can all help in dealing with this condition. Those who suffer from ADHD and never receive treatment are doomed to the underachievers, the ones with low self esteem. They wonder, “what’s wrong with me? Why can’t I function like everyone else?” They wonder why they can’t control themselves, why they’re so “bad.” And the one who remains undiagnosed with primary inattention symptoms can’t understand why she’s such a slacker when she desperately doesn’t want to be. These people spend their lives with anger turned inward.

With a support network of caring individuals to help hold the kaleidoscope so it won’t jumble too much, those with ADHD can learn to cope and even, perhaps, embrace the vibrant, chaotic images that encompass their lives. Life is all about the colors.