Overdiagnosis or Misdiagnosis? There Is No Proof of ADHD Disorder

Overdiagnosis or Misdiagnosis? There Is No Proof of ADHD Disorder

Even though we have ample proof that ADHD is at least overdiagnosed, we still haven’t proven that it doesn’t exist. On the other hand, I question if anyone can prove that it does exist. There are no objective tests that prove the existence of ADHD or any other psychiatric disorder. The diagnoses are all based on subjective measures. That fact alone doesn’t prove that they don’t exist, but it should be cause to use greater scrutiny.

Dr. Sami Timimi, who has authored several books on child psychiatry, contends that there is no proof of ADHD. While there have been attempts to identify objective tests and measures of ADHD as a disorder, none exist to date. Even in seemingly objective neuroimaging studies, he warns that researchers have yet to compare un-medicated children diagnosed with ADHD with an age-matched control group.

Sample sizes in these studies have been small and have produced a variety of inconsistent results. In no study were the brains considered clinically abnormal, nor is it possible to work out whether any differences seen are caused by (rather than being the causes of ) different styles of thinking, or are the result of the medication the children had taken.

He also identifies an interesting fact: that prevalence rates of ADHD vary considerably, from less than half of a percent to 26 percent in studies because of the uncertainty of description.

I’ll be the first to agree that there is something different about the people typically diagnosed with ADHD. However, if the symptoms can be better explained by something else, and if that different explanation makes better outcomes possible, we should be certain to explore that as a possibility. Doctors, by virtue of the Hippocratic oath, should be bound to consider an alternate explanation.

IF NOT DISORDER, THEN WHAT?

There were once six blind men who were asked to describe an elephant. The one who touched the ear said it was like a fan. The one who touched the trunk said it was like a large pipe. The others who felt only the belly or the tail or the leg or the tusk had different explanations. When they were told that they were each right and that they had each described a portion of the elephant, they still couldn’t fathom the entire beast.

Like the story of the blind men and the elephant, the descriptions of the underlying condition responsible for ADHD fall short when offered from a limited view. The underlying condition is one of intensity.


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The description in the DSM* of ADHD is limited by its purpose of identifying the disorder by the negative aspects of intensity. This lack of understanding of the underlying condition of intensity contributes to both misdiagnosis and a lack of education about and healthy development of intensity.  (*DSM = The Diagnostic and Statistical Manual of Mental Disorders)

The Spectrum of Attention: From Inattention to Hyperfocus

Overdiagnosis or Misdiagnosis? There Is No Proof of ADHD DisorderEvery natural human trait can be viewed by either its negative or positive side. In truth a trait is the combination of all its aspects, negative and positive. If you can think of a trait that seems to belong to only one side, you’re not thinking of a trait but of an aspect of a larger thing. For example, inattention is not a trait, but an aspect of the larger category of attention. On the one end of the spectrum of attention is inattention, and on the other is hyperfocus.

Instead of experiencing just the middle range of these traits, people who are often diagnosed with ADHD experience more of the range. They go from inattention to those things that are not interesting to hyperfocus on those things that are interesting to them.

It’s natural for any human to pay closer attention to something that’s interesting and less attention to something that is not as interesting. However, when a subgroup of people have a greater range, we then make the low end of the range and the high end of the range symptoms of a disorder.

If we consider the trait of activity, on one end we have lethargy and on the other we have both impulsivity and hyperactivity. It’s interesting to me that we accept lethargy as within the range of normal, while the other end of the spectrum is considered abnormal.

ADHD Diagnosis: Concentrating Only on the Perceived Negatives

If we concentrate only on the perceived negatives of having a greater range, we’re missing half the picture. With a greater range of attention, we are never inattentive; we are always taking in more than others. We have the ability to take in information that is going on around us that others screen out.

This has been described as missing the “space bubble” that others use to screen out unimportant stimuli. But when the thing we are attending to is of great importance to us, we have a super space bubble. Nothing else matters. We can stay on a single subject or activity for a very long time without noticing anything else going on around us. This is then called hyperfocus and considered a symptom. Instead of looking at the positive side of this greater-than-average ability to attend to a single thing, we say that this is evidence of being “stuck.”

By concentrating on the negative interpretation of each of the traits, we are ultimately convinced that we have a problem. The worst part of this is that we are never encouraged to develop the positive side. It becomes a self-fulfilling prophecy. We see only the negative, we concentrate on the negative, we have it pointed out to us on a regular basis, and we become only the negative.

For ADHD professionals, know that intense people are becoming self-aware. A psychiatrist, psychologist, school counselor, coach, or pediatrician who has a solid understanding of intensity will always be valued. This doesn’t mean the end of your involvement with these people. It’s only the beginning of what should be a much more satisfying journey together, one where you can actually offer some help in development of their inherent gifts and a better understanding of their distress.

Important Points for the Impatient

  • There is no proof of ADHD as a disorder. There exists no objective method of diagnosis for ADHD. Even the neuroimaging studies have failed to produce adequate tests with comparisons to “normal” brains in subjects of the same age.

  • If there is no proof of disorder, there is no cure offered, and the treatment used to manage the condition can be deadly, we have to look for another explanation. If there is an alternate explanation that offers a better outcome, in good conscience doctors should be required to consider it. Adherence to the Hippocratic oath should require them to consider it. We should consider it for ourselves.

©2012 by Martha Burge. All rights reserved.
Reprinted with permission of the publisher, Conari Press,
an imprint of Red Wheel/Weiser, LLC. www.redwheelweiser.com.


This article was adapted with permission from the book:

The ADD Myth: How to Cultivate the Unique Gifts of Intense Personalities
by Martha Burge.

The ADD Myth: How to Cultivate the Unique Gifts of Intense Personalities by Martha Burge.ADHD coach Martha Burge proposes that what is commonly understood as ADHD is actually five intense personality traits: sensual, psychomotor, intellectual, creative, and emotional. Once properly understood, people with these intense personality traits can develop them into gifts. The ADD Myth raises awareness of the underlying condition of intensity, and helps people who previously thought of themselves as broken develop more fulfilling lives.

Click here for more info or to order this book on Amazon


About the Author

Martha Burge, author of: The ADD MythMartha Burge is an ADHD coach, mother to two sons diagnosed with ADHD, and a very intense person. She holds a BA in Psychology, an MA in Organizational Development, and coaches adults with ADHD, gifted adults and parents of intense and gifted children. She speaks to groups (including the Celebrate Your Life conference in Chicago in June, 2012). She is active in the Mensa community and is a trusted coach to Mensa members. Visit her website at http://www.intensitycoaching.com/

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