When did normal childhood behaviour become a disorder? By Timothy Collins
Memories of elementary school are likely a bit of a blur for most adults, but I still remember some of the characters I called friends back then.
Kenny could never sit still and frequently wandered out of our classroom to check out adjoining classes. His was a sort of smorgasbord approach to education. Beryl ate glue and drew marvelous pictures of horses, usually not during art periods. And a boy named Udo liked to take things apart – including Miss Thorlandson’s desk clock – just to see how it worked. It was an eclectic group of children, but no one ever dreamed of diagnosing any of them with a psychiatric disorder.
No, being a kid only started gaining disease status in the 1980s. It was about that time that my son, Stefan, was caught reading Jurassic Park during a Grade 3 math class. The teacher called my wife and sternly reported that this was aberrant behaviour typical of Stefan. She said that he obviously suffered from Attention Deficit Hyperactivity Disorder (ADHD) and needed help to concentrate. Ritalin was suggested.
We did some research and didn’t think it applied to Stefan. Despite repeated urgings from the school, we never put him on drugs to modify his at-times challenging behaviour. Nor was he ever labeled with a disorder, a label that would have followed him throughout his school years.
Today Stefan holds a responsible position in the Canadian military, a job requiring concentration and strict attention to detail. At times he handles explosives. He also has a four-year-old son, who started kindergarten this year.
Carter arrived at school with an insatiable curiosity and the attention span of a hummingbird; a bright, happy and intelligent little guy who can admittedly drive an adult soul to distraction. Like his dad at that age, Carter is a gloriously challenging little person.
So when Carter’s kindergarten teacher called to say that Carter should be seen by the school psychologist, I can’t say I was surprised. Carter had “ants in his pants”, and frequently failed to sit still during “circle time”. He almost certainly suffered from ADHD, she said, and advised that there are medications that would “help Carter to cope”.
It was a serious diagnosis offered up by a person with no training in pediatrics, psychology or psychiatry. But that didn’t stop her from making the diagnosis or suggesting a drug regimen for a four-year-old. That overreaching is one of the greatest problems with the whole ADHD phenomenon, according to Fred Baughman, M.D., author of The ADHD Fraud: How Psychiatry Makes “Patients” of Normal Children. “They represent an expertise that they simply do not have,” he said.
Let’s be fair. ADHD is a real condition, and it’s possible that in some cases medication is warranted and helpful. The problem is that the diagnosis is often initiated by unqualified individuals and that parents may be inclined to follow the advice without doing their own due diligence.
Mental Health Canada reports that 10 percent of 10-year-olds in Canada have been diagnosed with ADHD. Boys are six times more likely to be diagnosed with the disorder than girls. They have no explanation for this gender discrepancy. (At the risk of being accused of sexism, I’ve always known that little boys represent very different challenges than little girls. Little girls rarely push toys up their noses to see if they’ll fit.)
Dr. Baughman argues that ADHD is simply an amalgamation of common childhood behaviours and maintains that the “disorder of childhood” should never have been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).
Since 1984 there has been a twentyfold increase in the number of children – now more than three million according to Health Canada – who are being prescribed some combination of Ritalin (methylphenidate), Adderall (amphetamine, dextroamphetamine mixed salts) or other psycho-stimulant drugs for ADHD. And that number is growing, exponentially.
These drugs will enhance anyone’s concentration, says Dr. Baughman – not just children who have “ants in their pants” during circle time. That’s why the U.S. military has regularly given amphetamines to combat pilots. But that concentration comes at a heavy price including headaches, personality changes, depression and even death by heart failure.
There have been recent red flags raised from the scientific community. In 2011, Otfied Hoffe, the president of the Swiss National Advisory Commission on Biomedical Ethics, condemned rising ADHD diagnoses and treatment. He said that pharmacological agents that induce behavioural changes fail to educate the child on how to achieve these changes independently. He added that medication curtails children’s freedom and impairs their personality development. In other words, drugging children makes them easier to handle, but teaches them nothing.
Then in 2012, shortly before his death, the man who played a major role in labelling this psychiatric disorder back-pedalled on the subject. In Der Spiegel magazine, Dr. Leon Eisenberg stated that ADHD was a prime example of a “fictitious disease”. He said that it was hugely over-diagnosed and primarily served to enrich pharmaceutical companies.
Stefan was a handful and I’ll admit, at times, drugging my son to make him sit still had a certain allure. But we realized that he was simply being a child and we helped him manage his impulses through love, attention, discipline and time.
It was hard, but it was the right approach for us, and it’s the approach that Stefan is now taking with my grandson. I have a feeling Carter will turn out just fine.
Freelance writer Timothy Collins lives in Victoria, B.C. His two grandchildren have renewed his passion about childhood issues, particularly those surrounding education.
How ADHD medication has helped me. By Glen Herbert
All my life I’ve had issues with anxiety and depression, moodiness, and just getting things done. I was diagnosed with anxiety almost 10 years ago, and have been taking medication since. Last year, I was at the maximum dose and still struggling, so my doctor suggested that I consider trying ADHD meds. That’s how she said it. Not “you might have ADHD,” because she knew that I would tell her that she’s crazy. Instead, it was “why not give it a try?” and then a discussion as to why she was considering it, and why I might as well. And that’s how I was diagnosed with ADHD at the age of 43.
Since taking the medication my life has changed considerably – drastically – for the better. There are some things that I don’t even want to admit – such as the fact that I no longer have angry outbursts at my children because, well, I used to do that. Now I can control myself.
But that’s just one thing. My self-perception has improved. I’m outgoing. I talk to people at the gym or at the schoolyard during drop-off and pickup. My wife and I don’t fight. I sleep better. I’ve decided to dress better in order to show people that I take myself seriously and would like them to as well. I’ve become fit because I want to care for myself, rather than hurt myself through eating crap or smoking.
I used to think that ADHD was made up, and that kids were being medicated to normalize them. But I see things differently now. If I were to describe it simply, I’d say: I used to struggle just to get to baseline; to get to that point where I’m not yelling, or crying or struggling to contain an inexplicable irritability. I used to struggle to get to the point where I didn’t mind being with other people because I lack confidence or self worth. Now, the baseline is the starting point, and my energy is focused on living life, on interacting with others, on enjoying the time I spend with my family.
Yet, whenever ADHD appears in the media, it’s often from the perspective of disbelief. A common claim, as in a cover article in a recent issue of Esquire, is that we are medicating childhood, or more specifically boyhood, drugging our children into complicity. But unless you go further than the water cooler discussion, to truly look at what the diagnosis is, what the therapies are, or have experienced them yourself, you don’t know what you’re talking about. Still, the criticisms remain – it’s a cash cow for “big pharma”. But we don’t levy that criticism against chemotherapy, though that’s big pharma, too, isn’t it?
There is a common suggestion that many children are misdiagnosed. My father’s rare form of cancer was misdiagnosed by three dermatologists as a skin irritation caused by the soap he was using. By the time someone finally recognized what it was, he was past the point of effective treatment.
Thankfully, a misdiagnosis of ADHD isn’t as dire. You take the medication, or you don’t. If it helps you, great. If not, then maybe it’s not the right diagnosis.
People believe, falsely as it turns out, the idea that the only way that ADHD presents itself is through Chris Farley-style antics. But, that’s not it. It’s complicated. It involves cognitive flexibility, anxiety, social maladaptation, impulsivity. There is, actually, some delicacy in our understanding of ADHD beyond separating the clown from the class.
Is ADHD real? Who knows? But mental health is real. And the medication that I’m taking is real. It allows me – finally – to be the person that I want to be, and to present myself to the world in the way that I’ve always wished I could. Some kids might not do well with medication, and some kids – like me – might not do well without medication. And maybe one day they’ll mourn, too, for all the things that might have been.
Burlington, Ont., writer Glen Herbert is a frequent contributor to ParentsCanada.
Originally published in ParentsCanada magazine, August/September 2014.