Is ADHD really a “disorder”?

boy in detentionMore than one in ten children are now diagnosed with ADHD at some time between the ages of 4 and 17.  Is it possible that we are diagnosing a normal variation – a condition that isn’t really a disease?

That is a possibility recently discussed by psychiatrist Richard A. Friedman on the opinion page of the New York Times (“A Natural Fix for A.D.H.D.”)  He explains that recent research shows that people with ADHD are “hard-wired for novelty-seeking.”  These individuals, he believes, may not have a disorder so much as a set of traits that don’t match well with the demands of school and work.

In people who appear to have difficulty with focus and attention, and tend to act impulsively, the problem may be not so much in their brains, but in a world that just isn’t very interesting to them.

If someone you love has ADHD, you may be aware that some activities can grab their attention and the person can focus for hours!  Even some subjects in school may be easier than others to pay attention to.  The reason is that when we feel pleasure in an activity – whether it be a video game, music, or high-risk activities like extreme sports, for example – the brain releases the chemical dopamine.  It turns out that children and adults with ADHD are actually less sensitive to dopamine (they have fewer dopamine receptors) than most people.  That  may be why so many activities, like a typical reading or math class, seem boring to them.  Apparently the stimulant drugs like Adderall and Ritalin often used to treat ADHD help by blocking the re-absorption of dopamine, and thus  increasing the levels of dopamine in the brain.

People who seem to “grow out of ” ADHD may in fact have changed their environments more than their brains.  Leaving school and finding a job that involves a lot of novelty, such as travel and meeting new people, may be the key for many people.

The author of the New York Times article thinks that ADHD has been diagnosed more frequently since young people are spending so much of their free time in the highly stimulating world of video gaming and social media.  Dr.  Charles  Gallagher, a psychologist at Psych Choices of the Delaware Valley, treats a lot of kids and adults with ADHD.  He comments that “In some ways it’s odd to say that our electronic entertainment culture is affecting our attention and concentration, when we might be just as correct to say that our attention and concentration is changing our culture, actually driving our electronic entertainment culture.”

On the other hand, Dr. Gallagher does believe that ADHD can be seen as a disorder, one which should be taken seriously.  He sees it destroying some people’s lives, people who find themselves “going off track or never getting on track in the first place.  I think the impact on relationships is often overlooked because other aspects of people’s lives are so disrupted.  Somehow the heartache of trying to live with someone with ADHD is often low on the list of clients’ priorities to address in treatment.  Untreated,  students with ADHD are often frustrated, difficult to deal with, and fail in school.”

Individual and/or family therapy can help people to manage their ADHD and improve their relationships with others.  It can be helpful, as the author of the New York Times article states, to find work or school situations that are a good fit for the curious, adventure-seeking mind.  But therapy, and often medication, can also make a big difference.

Dr. Noah Freedman, medical director of Psych Choices, explains that ADHD medications can help the person stay focused, or shift focus appropriately, and stay better organized in their lives.  Dr. Freedman explains, “Rather than working on the reward center of the brain, these medications use dopamine to suppress irrelevant stimuli, so that the organizing part of the brain can function better.”

To make an appointment with Dr. Charles Gallagher or another therapist at Psych Choices, call 610-626-8085 or use our Make An Appointment page.  After consultation with the therapist, if you decide that medication might be useful, you can make an appointment to see one of our psychiatrists.


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