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Thursday, July 31, 2014
Attention Deficit Hyperactivity Disorder
ADD Diagnosis vs. Difficulty Paying Attention
I have read your description of ADD in the NetWellness "Health Topics" area and it confirms a suspicion that I have held. The symptoms sound like "symptoms" that many people experience. I wonder when a person crosses the line to become diagnosed with ADD. Throughout my education, I have had difficulty focussing on lectures, etc. This has been a source of frustration, but I have managed to complete my education despite that. Is ADD just a symptom of 90s culture? Of children who are overfed, watch too much tv and don't get enough attention? How much historical evidence exists of cases of ADD in the 1900s and early 20th century that went undiagnosed? Does ADD exist in other countries to the same extent that it does in the U.S.? Thanks for considering my questions.
Your question is a very important one. Although I fear that most people with ADD, particularly those from poorer social settings, have their diagnoses missed, there are also a group of persons who get incorrectly diagnosed because some of the symptoms of ADD can be seen with other problems, including "children who...watch too much tv and don't get enough attention." However, the definition is much more involved then just having difficulty sitting through lectures.
First, please see the "History" question in this section from October 8 of this year. It answers some of your questions.
Second, in general, one "crosses the line" when a LARGE number of symptoms are causing MALADAPTIVE behavior/function and are inconsistent with the individual's expected DEVELOPMENTAL level(For instance, a four year old might do things that are difficult for her parents but could be very expected at her age. Yet, if she did the same thing at 17 it could be very developmentally inappropriate). The specific criteria currently in use can be found in the Psychiatric book known as the "DSM IV". You may want to take a look at the NADDA web site listed below.
Additionally, completing ones education does not verify lack of ADD. Many bright people have ADD including such diverse occupations as engineers, nurses, physicians, brick layers and truckdrivers. People often have an amazing ability to develop alternative strategies to accomplish things, whatever our difficulties are.
Finally, many neuropsychiatric diagnoses contain symptoms seen in people without the disorder. Major Depressive Disorder includes such symptoms as changes in eating patterns or difficulty with sleep. Obviously, many of us go through periods of experiencing one or both of those symptoms without having a major depression.
Thanks for the question.
Susan Louisa Montauk, MD
Formerly Professor of Family Medicine
University of Cincinnati