View Full Version : ADHD Advocacy (or the lack thereof)


APSJ
03-16-11, 08:26 PM
ADHD is diagnosed in about 1 in 10 children, is thought to be underdiagnosed, and is known to be associated with a whole host of adverse life outcomes. I'm not going to go into detail here on this, but support for these statements is readily available elsewhere on the forum and online.

That being the case, it stands to reason that ADHD should be viewed as a significant public health concern, efforts made to inform people about its impact, symptoms, how to seek diagnosis, and that effective treatments are available. While such efforts exist, they are small scale for the most part, with the exception of commercials for medications paid for by pharmaceutical companies.

The disorder has been known, by one name or another, for decades, and its existence is not subject to serious debate in the medical/psychological community. And yet, skepticism is widespread among the lay public. The notion that it was invented by pharmaceutical companies as a way to make money off medication is quite prevalent. Many of those who don't subscribe entirely to this view take the 'moderate' 'reasonable' position that it might exist, but is significantly overdiagnosed, despite the fact that research has repeatedly pointed in the other direction.

While similar sorts of misconceptions exist with regard to other conditions, the misperceptions about ADHD seem particularly tenacious, and do not seem to be on the decline. Further, people seem to adhere to their mistaken views, often gleaned from conversations with others, or poorly researched articles in the popular press, with a passion, expounding on the drugging of children and loss of work ethic with a moral zeal.

Why is this? Why can't we, those of us with ADHD ourselves or in our families, make people understand? Is it our responsibility or someone else's? If someone else's, whose?

I think a lot of factors contribute to the problem, some more than others, and I've listed them in the poll in the hopes of getting a sense of what others feel the main obstacles are, and perhaps fostering a discussion on how they can be overcome. (Note: poll is public, who chose what will be visible)

Once I've gotten a good number of responses, or when it becomes clear I'm not going to, I'll give my take.

Fortune
03-16-11, 09:15 PM
I voted everything but "other", although in retrospect I think a couple don't actually pose serious obstacles. They're all obstacles to varying degrees, though.

I'll have to think a bit before I can elaborate further.

Surly Dave
03-16-11, 10:26 PM
Why is this? Why can't we, those of us with ADHD ourselves or in our families, make people understand? Is it our responsibility or someone else's? If someone else's, whose?



I think you bring up a good point here. Over all, the advocates seem to either fall into two groups: the, "I can make some money out of this" group or the "I'm a victim of someone who has ADHD and I'm going to tell everyone how to fix it!" group.

While there are various Doctors and professionals who have published helpful books, people seem to grab that good information capitalize on it.

And so many of the 'support' groups I've seen are about how to cram a square peg into a round hole, not really offering support to the ADDer but merely trying to get them to 'buck up' and conform. Or at least cough up a buck.

I think that these two loud voices drown out the voice of the person with ADHD or the parents of those with ADHD. Plus, with a society that so often judges people by the letters at the end of their name (PhD, Dr) or a diploma on the wall, the testimony of some average Joe with ADHD who has failed out of college a few times, lost jobs and families, and has just had a major victory in his life because he's finely developed a system (coping skills) that allows him to consistently find his keys, glasses and wallet every morning just doesn't fly.

I know that I try to be a positive advocate to my doctor, counselor, pastor, even to my audiences by just being honest about how the condition has affected me and others in my life, educating them and ever being on guard against the, "It's a moral issue" attack. Honestly, I'd love to be a 'motivational' speaker and go around educating people on ADHD not from the point of view of a victim or a professional, but from the point of view of someone who deals with it on a daily basis.

Hmmm...I'll have to think about that for a while.

Abi
03-17-11, 02:30 PM
I voted for everything except "gifters" and "relatability of symptoms"

(Whereas I find the gifter perspective ridiculously stupid, I don't think it's as much of an issue as, for example, ADHD denialism or anti-medication stances. It's only a few who will say "Yes, ADHD exists, but its a gift" The whole idea is too bizarre, IMO, to present a serious obstacle to ADHD advocacy. )

For "other" I would add.. the false mind/body dichotomy that leads to mental/neurological disabilities not being seen as real disabilities;

and

philosophies that promote such things as "nobility in suffering" and blame maladaptive behaviour on "poor discipline", "God's will", or any other number of inaccurate things.

APSJ
03-17-11, 10:05 PM
I think you bring up a good point here. Over all, the advocates seem to either fall into two groups: the, "I can make some money out of this" group or the "I'm a victim of someone who has ADHD and I'm going to tell everyone how to fix it!" group.

I think that these two loud voices drown out the voice of the person with ADHD or the parents of those with ADHD.

Interesting. There does seem to be a greater emphasis on 'self-help', supporting the person with ADHD in 'overcoming it', and 'tolerating' it, than for many other conditions. I've actually seen very very little in the way of demanding recognition of differing needs for those with ADHD outside of communities like this one.

The 'nothing about us without us (http://en.wikipedia.org/wiki/Nothing_About_Us_Without_Us)' principle doesn't seem to have gained a great deal of traction when it comes to ADHD.


For "other" I would add.. the false mind/body dichotomy that leads to mental/neurological disabilities not being seen as real disabilities;


I agree, and think this goes along, to some extent, with the notion that it's not a 'real' disability, and the division from the disability rights community generally.

Fortune
03-17-11, 11:57 PM
I say that division from disability advocacy is an internal barrier. After having started a couple of threads where the topic of ADHD as disability was discussed extensively, it seemed that quite a few people were unwilling to accept the possibility that ADHD could really be a disability, despite causing impairments for those who have it. If people are not willing to accept it is a disability, and even argue that accommodations should not be necessary, how do you get advocacy going?

I think this is linked with the gifter perspective. Although, I'll say I don't really see a problem with people finding possible advantages due to their disabilities, and I wonder if Barkley's really accurate that there are no advantages associated with ADHD. The problem seems to be where it's all gift and no disability.

Most of the rest are pretty big external obstacles, and cause a lot of trouble. All but two people in this household I live in (that is, seven people) either have ADHD or at least have enough symptoms to be noticeable if not clinical and yet I have to keep pointing out that it causes difficulties with certain things and one can't just expect results by angrily demanding them (not from me, from others).

The total trivialization is a huge problem.

m1trLG2
03-18-11, 01:55 AM
I tend to think that ADHD is over diagnosed. I agree it's a significant health concern and that their is a HUGE lack of education about it but until MD's are no longer allowed to diagnose and treat ADHD without specialized training is psychiatric disorders I am afraid I will continue to feel there is an over diagnosis. Especially in young children. It's hardest to diagnose in young children and therefore this diagnosis should only be done by a professional that specializes in psychiatric care in these situations. This is not a popular opinion but I thought I'd share it since your polling. It's very hard for a child under the age of about 9 or 10 to be self-aware enough to diagnose this disorder with. A lot of it falls to observation of the child and that information is very subjective in nature.

I recently read that they have found brain differences both in activity and actual shape and size between ADHD and non-ADHD brains. My hope is that a brain scan becomes part of the requirement for official diagnosis and treatment. I think this would help more clearly indicate what is ADHD and what is not. This in turn would help with stigma and the lack of knowledge people have about the disorder. So much of our stigma has to do with the fact that it's not something you can point to and say, "See here's my ADHD."

anonymouslyadd
03-18-11, 02:17 AM
It's interesting this thread caught my attention this morning. I had a date from near hell with a girl who is a research coordinator at one of the most well known, prestigious hospitals in America.

The conversation of my ADD came up as I am one to find out the persons level of acceptance as soon as possible. She began this rant about how kids are overly diagnosed with ADD. She spoke about people making the assumption that people have ADD with just a few symptoms present. In a sense, she was right.

I should note that she seemed well spoken on the symptoms, and by this I mean knowledgable. But overdiagnosed? I don't know. I talk to a math teacher who teaches special ed who said that there are many in her class who are undiagnosed.

So, what gives? I know that if a Research Coordinator with a Master's Level education feels there is an over-diagnosed trend there is a problem.

m1trLG2
03-18-11, 02:30 AM
I've made many posts on teachers so I won't re-hash the situation but I speak as a teacher with both a Psychology B.A. and M.A. and I can tell you that ADHD diagnosis is highly specialized and that teachers do not always receive accurate information about the disorder. Unless this person has a copy of the DSM-IV and knows the criteria from memory I don't think that they can make that statement. A LOT of people, not even just teachers, but a lot of people have become very warped that ADHD = hyper. There are so many kids that truly have the disorder that are never hyper and there are so many hyper kids that get labeled with it that don't have it.

I tend to take a teacher's opinion with a grain of salt in this area because the education teachers get about any psychiatric disorder is minimal at best. I would go with the person who has spent 6-8 years of school studying only psychiatric disorders over a person with one or two psych based classes under their belt.

If you look up the criteria for ADHD and how many of those and in what areas they need to be met then you may agree that it's overally diagnosed. It's similar with depression. A lot of people are diagnosed and treated with depression that don't meet the full diagnostic criteria. There are too many untrained people out their making official or unofficial diagnosis.

Psychology is a field that gets little respect as a specialized profession because being 'wrong' isn't seen as detrimental as a heart surgeon being wrong. Many people take one or two classes and feel that they can start diagnosing psychological disorders (not saying that this is your friend, just talking generally). It's even made fun of in TV shows when someone is enrolled in a psych class and starts giving out advice. All I can say is that truly being able to even identify true symptoms is a lot more than just saying, "oh that kid is hyper" or "that kid isn't paying attention ever!". It has to do with the setting, the expectations, the factors that lead up to and follow these 'problem times', are they able to respond to verbal redirection... there is a lot more than just observing that even goes into establishing a behavior as a symptom.

Anyway, this is a long way of me saying I still think it's overdiagnosed... and for the reasons I have just talked about.

Fortune
03-18-11, 02:58 AM
I've heard a lot of opinions and seen one debunked study that says ADHD is overdiagnosed, but I am curious as to whether there's any serious research to this effect.

As I understand it, as with most neurological studies, the brain differences tend to be trends across the population, which means significant overlap with non-ADHD brains. Like, there's not a specific demarcation where you can absolutely say for sure that a brain is ADHD or not. Admittedly, they're talking about scans detecting autism in the future, so I wouldn't rule it out.

I don't believe the stigma is specifically about not having something to point to, and from prior experience, people don't care if you have something to point to, they just don't respect the idea that people with disabilities have a harder time getting things done than people who are temporarily without disabilities. It's the same kind of attitude that leads people to suggest that someone who stands up from a wheelchair is faking it and can "really walk," even though many people who use wheelchairs do so not because they are unable to stand, but because their mobility is significantly impaired.

m1trLG2
03-18-11, 04:50 AM
I think it's hard to really have quantitative studies about the over or under diagnosis of ADHD when there is so much differentiation in the diagnostic process. For example, there are many mental health professionals that will not diagnose the disorder in children younger than 7 at the earliest. There are others who are willing to label at 4 years old. Similarly, there are MD's diagnosing and medicating without ANY training in psychiatric care by simply completing an online, 9 question checklist and then there are psychologists who say that because someone is able to perform their tests they don't have it.

If you ask me there is only one way to do it completely objectively and that's brain scans. There is actual brain shape and size differences in ADHD brains having to do primarily with the pre-frontal cortex.

With that said though, I am not saying that those who wouldn't pass the "brain scan test" don't have some problem. All I'm saying is that perhaps there is another issue that maybe it isn't ADHD. In addition to brain scan though, I think that a lot of this could be better understood and observed if the process of diagnosis was unified. I would eliminate anyone without a diagnosis by a psychologist, psychiatrist, or neurologist as having the disorder as part of a statistical study. This includes people diagnosed by a physician.

I would then create clear cut onset criteria. The diagnosis of ADHD is an Axis I diagnosis which surprises me given its criteria. It seems to me that it should be an Axis II diagnosis and is often comorbid with other Axis II diagnosis.

The third thing I would do is create an ADHD testing battery. Right now you may see five people go to five different shrinks and get five different testing batteries. This leaves a lot of room for interpretation.

I think the stigma thing in my experience has been due to the fact that people think someone claiming to struggle with ADHD is lazy and just doesn't try. I can't show them exactly how I struggle because it's internal. I can't show them the 1000 things I have in my brain every second of every day, so they assume because it's not an obvious issue that it's not 'real'. Just like a lot of people with depression get told to just "snap out of it". People don't get that depression is a chemical imbalance.

I don't know, it's just my thinking. As a college student I see a lot of people go to an MD with their internet research memorized so they can answer correctly to the 9 question survey and get the Adderall to pass their classes. It makes me very angry to see something I consider a serious problem be treated as a joke. I also see a lot of people saying kids have ADHD because they are some of the few kids left that have energy and imagination. We treat energy and imagination as a bad thing. Or things like my 5 year old can't sit still. I'm like, he's five!

I am looking for a way to circumvent unreasonable expectations of behavior and find measurable evidence to support putting so many children on drugs just to "calm them down" and make our lives easier. I'm very troubled by it.

peripatetic
03-18-11, 05:11 AM
briefly (because it's late, but i DO love this thread, apsj, and want to note my "other" reasons):

1. too often the face and loudest voices of "what it's like to live with adhd" and "the treatment/"management" of adhd" are either:

those of people who are NOT themselves experiencing life with adhd, but have a partner/child/parent/friend/etc with adhd and so deem themselves experts on how to "deal" with us or the "toll" adhd takes on relationships, etc.

those who have appointed selves experts on adhd because they've investigated the disorder and self-diagnosed

those who have been diagnosed as adults and do not demonstrate/manifest what would be considered more profound/severe symptoms, who do not have all of the symptoms and/or whose lives have largely been working out for them as have developed enough coping mechanisms/support network/other to (even if stumbling quite a bit) make it to adulthood without being identified

with the move to ensure those without adhd are supported in/through having to deal with us, and allowed to verbally/emotionally abuse us because of how trying we are, there's more understanding and support given to how awful it is for a person WITHOUT adhd than for the person with the actual disorder. and we let it happen by not confronting them and by letting their struggles become the face and voice of the results of adhd. not only that, but we let the idea that we are falling short because not eradicating all symptoms or, ****, because being a person with similar proportions of laudable/...less-than-ideal qualities be reduced to everything being a consequence of having adhd and our failure to communicate "properly" (because every non is perfect at that :rolleyes:), among other things.

with the face/voice increasingly being those who are undiagnosed or diagnosed late, it's like there's this backlash to remove the "stereotypical" adhd kid bouncing off the walls, but instead of explaining that we grow into adults with variations on a theme, it's like we're dismissed for not being the hip new thing...and it also seems like it's because our existence is perceived as undermining the legitimacy of those who weren't identified as children, or that we've known and so should've gotten it together by now.

i'm not saying anyone does or does not have adhd, and of course there are exceptions--especially given geographical/health care access differences--but the more lax the criteria become to include more and more people whose lives are not clearly and significantly and obviously impacted by maladaptive behaviors that are evident to professionals without question, the more those of us who fit that model are viewed as just not trying to "manage" our adhd. barring some radical extenuating circumstances, i personally find the idea/claim/suggestion that one can be "severely adhd" and yet professionals do not or are reluctant to diagnose, that one has made it through basic education, much less graduated from college or beyond, or overall kept things together well into adulthood is absolutely preposterous.

2. there's too little consideration given to the significant obstacles adhd presents and how different they and the results of them are from non-adhd behavior. everyone is NOT "a little adhd"; people without adhd do NOT "have adhd days"; having adhd isn't reducible to losing your ****ing wallet/keys/etc from time to time, or being chronically late, or daydreaming or finding college difficult and so forth. yes, the symptoms may include those results, or may not universally, but the idea that everything you do is because you have adhd is absurd, and creates the concurrent idea that either a. because everyone does those things from time to time and yet don't have adhd, nobody has adhd as a disorder or b. that everyone is a little adhd and since most are functional then there must be a character/willpower flaw in those who aren't.

side note: i think it's also quite likely that those with severe adhd who are not caught as kids are less likely touted as faces/voices of adhd because incarcerated, homeless or dead...which consideration really deals one hell of a blow to that whole "adhd is a gift" position.

3. too many overemphasize how "different" the subtypes are. if we can't even advocate for each other, understand and support each other, and see our common issues and symptoms, and instead focus on ONE difference between hyper/hypoactivity....how the hell can we advocate for ourselves and each other and be taken seriously by those without adhd?

meadd823
03-18-11, 05:19 AM
There are some excellent responses to this

I chose other = my other is that my main observations are not listed

#1) There is genuine ADHD advocacy going on right in front of your noses - it just isn't being recognized as such - not even by those who are doing it.


#2) Advocacy does not equate social change Even if it does cause social changes the changes may be so subtle occurring over a long period of time so that they are not detectable. For some reason because social change is not over night many believe it is not happening at all - True social change takes time. Adult ADHD has just started being recognized by professionals in the field of psychiatry itself less than twenty years ago.

In 1993 when I got diagnosed I had a family doctor I worked for tell me he did not believe adult ADHD existed - So I showed up to work the next day un-medicated. It was the me-ADHD way of educating the ignorant, By 10:00 he was a "believer"! :o


#3) To many are expecting others to do the advocating for them, this includes those who feel the need to hide their condition - Please do not misunderstand I am not saying it is wrong or bad to hide your condition for some keeping your diagnosis hidden may be necessary however if you are hiding your condition for what ever reason you are not advocating for the social changes.Our ADHD is our collective problem and so it up to us to advocate for ourselves and our loved ones

which brings me to my main and final point


#3.5) ADHDers are too easily distracted , to disorganized and either unmotivated , too easy over whelmed and those of us who are motivated are to often lacking direction, or social aptitude. The very nature of ADHD makes us less likely to be effective advocates - because to advocate requires the very skills lacking in those of us who are ADHD! {damn-it}


. . .. .

m1trLG2
03-18-11, 05:32 AM
I agree. I have a question that is related to this but stems from another post. I saw someone list the questions asked to them about their "problems" and I'm wondering how well people feel those questions really capture the sometimes hell of having ADHD. Here's my "response":

Do you have difficulty with any of the following?

Difficulty staying focused during lectures at school

************To me this is more than a problem staying focused. In fact, it's not even that I can't keep my eyes on the guy and hear his words, it's that my brain refuses to process them. I hear the words but I can not make them stick. My brain is teflon. It feels closest to a lack of focus only I want to listen, I want to learn, I would trade anything to learn... but the words literally go in one ear and out the other. I just don't feel like this can be a simple yes/no answer. I think someone with ADHD has so much more going on that "lack of focus"... does that make sense? The question I get most often about ADHD is, doesn't everyone struggle to pay attention in a boring lecture? I'm sure they do, the difference is when they say, "Hey brain listen" their brain is like, "sure thing boss!" (at least this is how I understand it)

Constantly drifting off in the middle of conversations with people to the point where you were actually offending people who felt like I was just being rude
************ Again, it's more than drifting off. It's not like you're day dreaming. At times for me it's like everything I hear is missing every third word. I can not process it, I can not make my brain hold it's "focus". Most often it's that every third word in a conversation triggers a totally unrelated thought in my head that I have no control over and off my brain scampers. I try to quiet it and say pay attention but again, no control. For me personally I have little to no auditory learning ability... and I'm constantly having to ask people to repeat themselves for me.

Difficultly staying focused doing school work, and doing chores around the house.
*********** Again, it's not a lack of focus. It's saying I need to get this assignment done, I know I need to get it done, I want to go do it, brain says no. I argue and say oh yes we will do this but my brain just refuses. I can read a book for hours and never get past the first page. There are times where I literally have tried yelling the words just to get it to stick but still nothing.

The worst part of ALL of this (for me) is that I never know when it's going to hit. Sometimes I am lucky and I can focus and listen and then the floor drops out and I lose it. I feel like I can't rely on my mind at all. When I do have "good times" I feel this pressure to get as much done as I can before it's gone.

I don't know. My point is these questions which are part of an ADHD assessment are not even touching what (in my opinion) are the real symptoms of ADHD. The symptoms that set our struggles apart from 'normal' boredom or focus issues.

I don't know if any of this makes sense.

peripatetic
03-18-11, 05:53 AM
two things:

There is genuine ADHD advocacy going on right in front of your noses - it just isn't being recognized as such - not even by those who are doing it.

1. that's an excellent point. what generates real change and understanding, in my experience, is far less the result of a showy display and far more the daily exchanges that happen over months, years, decades as a result of just living life.

In 1993 when I got diagnosed I had a family doctor I worked for tell me he did not believe adult ADHD existed - So I showed up to work the next day un-medicated. It was the me-ADHD way of educating the ignorant, By 10:00 he was a "believer"! :o

2. in reading about your experience with an uninformed professional i want to note that i acknowledge there ARE ignorant, untrained and even incompetent persons in the healthcare field. there are also professionals who are interested in learning/willing to learn and many people diagnosed as adults (for whatever reason not identified as children) who serve as advocates in more and less formal ways. what i mean is that there are those who offer the piece of the picture that DOES include late diagnosis and do so with aplomb both more formally (on an adhd forum, for example) and informally (an exchange that offers another a wider perspective).
. . .. .

peripatetic
03-18-11, 06:06 AM
i think that makes complete sense.

i don't know why the questions are framed the way they are, but what comes to mind is that they were written by someone observing adhd behavior and not someone experiencing it. like....we appear to not listen to others, to constantly drift off and be perceived offensive/rude, to have difficulty with "focus" or chores or boring lectures and so the questions are framed from that perspective...the one of observing...which makes it hard for us to answer.

i, at least, am not so great at positioning myself outside my behavior (and if i were i think i'd be a hell of a lot more relationship savvy, to say the least, because at least i'd get what others are inferring and be able to explain myself...or try to) and so saying to what degree i exhibit what's presumed to be my experience because the questions are about how i'm perceived and there's a substantial disconnect in what i experience/intend/have in mind and what comes out in action/comportment/speech.

in other words, it's like we're not speaking the same language because inquiries based on outside assessment of subjective experience that often doesn't neatly match up for any number of reasons.

m1trLG2
03-18-11, 06:19 AM
I guess my point though is I don't feel like the questions are specific enough to pinpoint ADHD over someone who can still listen when they want to.

I don't know what it's like to not have ADHD but I talk to my boyfriend a lot about it and he is a non-ADHD and he tells me that he can choose to pay attention. The question doesn't address the issue of wanting to focus and not being able to, it's more geared towards finding yourself in bored a lot. At least that's how I see it. Anyway, it's those questions and their "open for interpretation" style that causes me to question whether there is an over or under diagnosis of ADHD.

m1trLG2
03-18-11, 06:22 AM
AND! for me it's not a "difficulty"... it's an impossible task. There are times where if my life depended on listening to someone I could not do it. Like I said, it's like teflon for a brain. It does not matter how hard I try, it's in one ear and out the other. The use of "difficulty" over simplifies the issue. In my opinon.

Fortune
03-18-11, 09:55 AM
I suspect a lot of people who present their lives as being together are covering for a lot of the havoc they've had. I have tried to be honest about how my life course has actually gone, and I've had a silly amount of pushback about whether I'm actually honestly reporting these things - even to the point of attempts to convince me I must actually have something else despite the fact that my symptoms were obvious in childhood and the something else would not have been - and despite not having the actual symptoms of that something else. I did have one guy in one of my two aforementioned threads who has a home, family, car, career try to tell me that ADHD can't really be that bad because he was told he had severe ADHD. These things seem pretty incompatible, but I can't quite compare where I am to other people (treated or not) because I don't only have ADHD and other symptoms I have are also impairing in some environments.

So I guess what I mean is I see people who may claim severity of symptoms, but who managed to cope their entire lives claiming it's not that big deal (whether it really is or not, and whether they're trying to cover for how bad things are), and I see people who seem to think that it's difficult to slip through the cracks undiagnosed, despite not having personally experienced such a thing themselves.

And the questioning of whether any diagnoses are valid is unfalsifiable. There are so many criteria in use that anyone's diagnosis regardless of life history and presentation can be deconstructed as probably invalid because they made it out of childhood or because it's overdiagnosed in childhood. And yet, it seems like Barkley saying that a very important element of dealing with ADHD and the public is the assumption that the symptoms are moral failings. So instead of a diagnosis, people get a lifetime of condemnation. I am not saying people who do get a diagnosis don't get that same lifetime of condemnation, but the way symptoms are judged as signs of bad behavior sometimes means that no one identified it. This is especially likely for people who are in their 30s-40s as education about ADHD during their childhood was pretty sparse, and a lot of professionals didn't know what it was. Of those who did, many didn't have useful treatment regimens - my mother was told to give my sister black coffee and not let her have any sugar.

And I guess I do not see the point of questioning whether late DXes or self DXes are valid or not even if individuals are not questioned as to validity. It seems to me that challenging problematic and wrong viewpoints instead of suggesting that the people involved are unreliable in some way would be more productive, more likely to produce information that is useful for ADHDers diagnosed at any age.

I just don't see proposing such a thing as being any more useful than suggesting that the subtypes are too different to have anything in common. It just creates a different, and this time murkier and less definable division.

And yes, I am self dx'd, although my therapist saw it the first time I saw her without having to be told in the first place, and she continues to suggest that I likely have it, and need a diagnosis so we can move forward with particular kinds of therapy. So I am kind of invested in supporting people who are questioning what the havoc in their lives has been and not suggesting that their age implies that their ADHD is either not present or not severe enough to really count. And I am not saying anyone argued this specifically, but I think it is a logical conclusion to bringing up the idea that making it out of childhood without a diagnosis is unlikely.

I am also in favor of giving people information when they openly assume that because of their problems they must have the worst case ever, or that ADHD isn't really that impairing because it hasn't caused them as many problems.

Fortune
03-18-11, 10:02 AM
And regarding what m1trLG2 said about axis 2 comorbidity, I found this study regarding personality disorders in people who have ADHD, autism spectrum disorders, or both (http://ajp.psychiatryonline.org/cgi/content/full/163/7/1239).

I found it interesting that their sample had no one with histrionic personality disorder and very low numbers for schizotypal and narcissistic personality disorder among ADHDers.

What is the reason for making it Axis II? The fact that it is easily treated (although not fully treatable) with medication, and that ADHD is not a matter of actual personality traits seems to me to rule that out.

To be fair, after reading far more than my fair share about axis II disorders, I am not really convinced of the validity of axis II as a separate diagnostic category at this point. They seem to be based in fairly old and not much examined assumptions about personality development, and recent research shows neurological differences in those who have personality disorders, as well as treatment modalities that can be effective, especially for borderline personality disorder. Obviously, I am not an expert, but it seems to me that the category serves primarily to stigmatized patients as untreatable and non-compliant. This seems to be breaking down to some extent, at least.

m1trLG2
03-18-11, 03:57 PM
And regarding what m1trLG2 said about axis 2 comorbidity, I found this study regarding personality disorders in people who have ADHD, autism spectrum disorders, or both (http://ajp.psychiatryonline.org/cgi/content/full/163/7/1239).

I found it interesting that their sample had no one with histrionic personality disorder and very low numbers for schizotypal and narcissistic personality disorder among ADHDers.

What is the reason for making it Axis II? The fact that it is easily treated (although not fully treatable) with medication, and that ADHD is not a matter of actual personality traits seems to me to rule that out.

To be fair, after reading far more than my fair share about axis II disorders, I am not really convinced of the validity of axis II as a separate diagnostic category at this point. They seem to be based in fairly old and not much examined assumptions about personality development, and recent research shows neurological differences in those who have personality disorders, as well as treatment modalities that can be effective, especially for borderline personality disorder. Obviously, I am not an expert, but it seems to me that the category serves primarily to stigmatized patients as untreatable and non-compliant. This seems to be breaking down to some extent, at least.

I completely support the axis II disorder, and yes it is interesting that most of the co-morbid personality disorders are the ones that are often associated with negative or anti-social behaviors.

I had this whole response typed up for you but deleted it because I couldn't see clearly where I was going with it.

Our teacher had us think about what a personality really is and how we could define it and i remember that made the whole axis thing make a lot of sense.

Essentially your personality is your essence, it's a life long pattern of behavior. You can try to put up road blocks to change undesireable behaviors but the process is still going to take that route. You can not "re-route" who you are.

Think of this. Why do you like your favorite color? If I told you to pick a new favorite color could you just abandon your old favorite without ever thinking about it again? Probably not. You could probably "fake it" and train yourself to identify this new color as your favorite but it will never 'feel' the same as your old favorite. This is like a personality disorder. It's not that it's untreatable, but it's never truly changeable.

m1trLG2
03-18-11, 04:00 PM
And regarding what m1trLG2 said about axis 2 comorbidity, I found this study regarding personality disorders in people who have ADHD, autism spectrum disorders, or both (http://ajp.psychiatryonline.org/cgi/content/full/163/7/1239).

I found it interesting that their sample had no one with histrionic personality disorder and very low numbers for schizotypal and narcissistic personality disorder among ADHDers.

What is the reason for making it Axis II? The fact that it is easily treated (although not fully treatable) with medication, and that ADHD is not a matter of actual personality traits seems to me to rule that out.

To be fair, after reading far more than my fair share about axis II disorders, I am not really convinced of the validity of axis II as a separate diagnostic category at this point. They seem to be based in fairly old and not much examined assumptions about personality development, and recent research shows neurological differences in those who have personality disorders, as well as treatment modalities that can be effective, especially for borderline personality disorder. Obviously, I am not an expert, but it seems to me that the category serves primarily to stigmatized patients as untreatable and non-compliant. This seems to be breaking down to some extent, at least.

lol this article in sweet. I wrote a simliar article but mine was how personality and ODD/conduct disorder affect ADHD diagnosis and treatment. How the effects and diagnostic criteria of one disorder (ODD/Conduct) defined a lifestyle that made the diagnosis of ADHD impossible as a separate disorder. The symptoms of one disorder created a situation that helped cultivate the other.

Fortune
03-18-11, 04:10 PM
Think of this. Why do you like your favorite color? If I told you to pick a new favorite color could you just abandon your old favorite without ever thinking about it again? Probably not. You could probably "fake it" and train yourself to identify this new color as your favorite but it will never 'feel' the same as your old favorite. This is like a personality disorder. It's not that it's untreatable, but it's never truly changeable.

This is interesting because I own nothing in my original favorite color (green), but I do own things in my more recent favorite colors (like blue). I don't really miss green, although I still like it. :D

lol this article in sweet. I wrote a simliar article but mine was how personality and ODD/conduct disorder affect ADHD diagnosis and treatment. How the effects and diagnostic criteria of one disorder (ODD/Conduct) defined a lifestyle that made the diagnosis of ADHD possible as a separate disorder. The symptoms of one disorder created a situation that helped cultivate the other.

Yeah, I found it pretty interesting.

Are you saying that ODD/conduct disorder created a situation to help cultivate an ADHD diagnosis or vice versa? I am not sure I parsed that sentence correctly.

m1trLG2
03-18-11, 04:44 PM
I'm not saying favorite color doesn't change naturally. But if I said now that your favorite color had to be green... you may be able to prentend it was but you'd still have love for blue at your heart.

I wish I had my computer with the copy on it with me so I could post my abstract. Essentially I argue that the symptoms of either one negate the ability to identify the symptoms of the other. So lets say ADHD is my primary diagnosis. The diagnostic criteria that has to be met in order to obtain that diagnosis naturally creates a setting in which the diagnostic criteria of ODD are cultivated. So impulsivity is a good example. Being impulsive leads (by nature) to reckless behavior. The diagnostic criteria for ODD list many impulsive behaviors, such as stealing. So you have ADHD, impulsively you steal something, boom you meet that criterian for ODD. However, a trued diagnosis is only valid if the symptoms can not be attributed to anything else. So for depression symptoms can't be attributed to a recent death in the family. Well... how can we tell if that child would steal if they DIDN'T have ADHD? If they had "normal" control over their impulses. The defining aspect of ODD is deliberate acts however, I think that's hard to conclude with an ADHD diagnosis.

I don't know if that makes any sense at all.

daveddd
03-18-11, 05:07 PM
I completely support the axis II disorder, and yes it is interesting that most of the co-morbid personality disorders are the ones that are often associated with negative or anti-social behaviors.

I had this whole response typed up for you but deleted it because I couldn't see clearly where I was going with it.

Our teacher had us think about what a personality really is and how we could define it and i remember that made the whole axis thing make a lot of sense.

Essentially your personality is your essence, it's a life long pattern of behavior. You can try to put up road blocks to change undesireable behaviors but the process is still going to take that route. You can not "re-route" who you are.

Think of this. Why do you like your favorite color? If I told you to pick a new favorite color could you just abandon your old favorite without ever thinking about it again? Probably not. You could probably "fake it" and train yourself to identify this new color as your favorite but it will never 'feel' the same as your old favorite. This is like a personality disorder. It's not that it's untreatable, but it's never truly changeable.

some new treatment methods in personality disorders are showing great promise in changing underlying issues , and maladaptive traits

especially in borderline(like fortune said) and narcissism

they are allegedly treating far more than behavioral issues (self injury,impulsiveness , relationship skills) like cbt does


along with pharmaceutical interventions doing well for some

daveddd
03-18-11, 05:12 PM
and your odd and adhd issue makes perfect sense to me

or it could be the other way, psychopaths (which a lot of times started odd) show extremely high levels of impulsivity and inability to delay gratification


another axis1/ axis 2 correlation issue ive read about is substance abuse and anti social personality disorder

some dont like that most people with substance issues can meet criteria for aspd , considering the behavior subsides with sobriety


does anything in your article mention ODD behavior ceased with treatment of adhd?

m1trLG2
03-18-11, 05:14 PM
I think that the personality disorders need to be broken up or re-named. Which I'm sure they will in the upcoming DSM. I don't know much most of the personality disorders other than the basic info. I am devoted almost exclusively to the development of anti-social personality disorder. I look at it's "life" from ODD to Conduct Disorder to Anti-Social. Then I look at all of those through a ADHD lens to try and find areas in which true diagnosis is cloudy. I also study only ODD, Conduct, and ADHD 'in person'... I do not treat adults and only use other research when looking at anti-social.

I can tell you though, I have met some kids that make your spine shiver. To watch a child inflict pain on others and have that be the only time you see an emotional reaction from them and have it be a joyous grin... it's really hard to believe that this is not an inborn issue. I'm talking 6 year olds from homes with "normal" siblings and families... and then the child who tortures animals and gets pure elated joy from it.

Idk... I love my work. I can't wait to get back to it.

m1trLG2
03-18-11, 05:20 PM
and your odd and adhd issue makes perfect sense to me

or it could be the other way, psychopaths (which a lot of times started odd) show extremely high levels of impulsivity and inability to delay gratification


another axis1/ axis 2 correlation issue ive read about is substance abuse and anti social personality disorder

some dont like that most people with substance issues can meet criteria for aspd , considering the behavior subsides with sobriety


does anything in your article mention ODD behavior ceased with treatment of adhd?

No, I attribute ODD diagnosis to prolonged issues with ADHD that affect the normal social development. Things such as social stigma, hyperactivity and inability to control oneself as obvious antisocial behaviors thus alienating the child... so these side effects of ADHD produce the 'perfect storm' for the symptoms of ODD to develop. If a child is unable to effectively deal with being ostracized for his inability to act in a prosocial manner then to me it makes sense on a 'normal' spectrum to develop the symptoms of ODD, which through this lens can be seen as acts of self-preservation.

It's not unusaul for outcasts to push others away when they are pushed away first. An ADHD child has little control over his behaviors and thus can not make the decision to act prosocially. Therefor in order overcome this they go to the opposite extreme.

daveddd
03-18-11, 05:20 PM
http://www.youtube.com/watch?v=cnV4RnWcmWo


this is interesting

m1trLG2
03-18-11, 05:32 PM
it's more than just shape and size... i think predisposition is only one aspect.

m1trLG2
03-18-11, 05:35 PM
I agree with this. Environment has so much to do with all of this.

daveddd
03-18-11, 05:46 PM
yea but then how do we explain the example of the kids you deal with from good homes

not all psychos are killers, its the ones who are/become sadists


how does that happen?

m1trLG2
03-18-11, 06:04 PM
environment is not exclusive to home. Perhaps there is something at school, the park, day care, babysitter... I also looking at parenting and how child behavior affects parenting.

daveddd
03-18-11, 06:27 PM
environment is not exclusive to home. Perhaps there is something at school, the park, day care, babysitter... I also looking at parenting and how child behavior affects parenting.

i have read theories that psychopaths use grandiosity as a unconscious issue of very low self esteem


and due to an inability to express feelings or emotions , substitute projective identification as a way to express them

up to and including anger, rage , shame and guilt, which can involve crime and murder

APSJ
03-19-11, 01:09 AM
I say that division from disability advocacy is an internal barrier.

I think it’s both, really...yes, many of us don’t see the common interest with the disability rights community, but I also suspect that many without ADHD would bristle at the suggestion that ADHD be classed with more ‘legitimate’ disabilities, particularly physical ones. To a large extent, thought, the external component is a consequence of the internal.

I tend to think that ADHD is over diagnosed. I agree it's a significant health concern and that their is a HUGE lack of education about it but until MD's are no longer allowed to diagnose and treat ADHD without specialized training is psychiatric disorders I am afraid I will continue to feel there is an over diagnosis.

I don’t want to get too into this here, as it’s sort of tangential to the advocacy question, but my understanding is that the research really does point pretty clearly in one direction here, and that is underdiagnosis. However, it’s more complex than this, and it doesn’t mean that people’s perceptions that in their community, its overdiagnosed is necessarily wrong, as there appears to be wide variation based on geography, and socioeconomic factors. So, while underdiagnosed overall, it is likely overdiagnosed in some communities. I dug up a thread I started a long time ago on this here: http://www.addforums.com/forums/showthread.php?t=70612 which details a study to that effect.

In essence though, I think your article’s premise here:

lol this article in sweet. I wrote a simliar article but mine was how personality and ODD/conduct disorder affect ADHD diagnosis and treatment. How the effects and diagnostic criteria of one disorder (ODD/Conduct) defined a lifestyle that made the diagnosis of ADHD impossible as a separate disorder. The symptoms of one disorder created a situation that helped cultivate the other.

can be seen as supporting this. Behavior that in one child will result in an ADHD diagnoses can result in an ODD diagnosis, or just frequent penalization in another, and there are pretty clear patterns as to which kids get put in which categories.

I recently read that they have found brain differences both in activity and actual shape and size between ADHD and non-ADHD brains. My hope is that a brain scan becomes part of the requirement for official diagnosis and treatment. I think this would help more clearly indicate what is ADHD and what is not. This in turn would help with stigma and the lack of knowledge people have about the disorder. So much of our stigma has to do with the fact that it's not something you can point to and say, "See here's my ADHD."

I do think this could help, but my sense is it’s a long way off. I agree with Fortune, however, that it’s not a major contributor to understanding and acceptance:

I don't believe the stigma is specifically about not having something to point to, and from prior experience, people don't care if you have something to point to, they just don't respect the idea that people with disabilities have a harder time getting things done than people who are temporarily without disabilities. It's the same kind of attitude that leads people to suggest that someone who stands up from a wheelchair is faking it and can "really walk," even though many people who use wheelchairs do so not because they are unable to stand, but because their mobility is significantly impaired.

There are a lot of conditions that are diagnosed ‘clinically’ that are more accepted than ADHD, and yes, even those with very visible disabilities face a level of doubt and judgment.


1. too often the face and loudest voices of "what it's like to live with adhd" and "the treatment/"management" of adhd" are either:

those of people who are NOT themselves experiencing life with adhd, but have a partner/child/parent/friend/etc with adhd and so deem themselves experts on how to "deal" with us or the "toll" adhd takes on relationships, etc.

those who have appointed selves experts on adhd because they've investigated the disorder and self-diagnosed

I agree entirely that the former group is far more prominent than it should be, and this *is* a problem. There are shades of the whole autism speaks commercial controversy...or there would be, except there’s no backlash...this is just the status quo for ADHD discourse, and that says something in itself..

The latter group I don’t see as having nearly as much sway as the former...the very vocal self-diagnosed/educated experts who dictate to others what ADHD is, and how it can be overcome are an enormous frustration, but I don’t think they’re taken all that seriously, and I don’t think they’re a real barrier to advocacy in the way the former is.

with the move to ensure those without adhd are supported in/through having to deal with us, and allowed to verbally/emotionally abuse us because of how trying we are, there's more understanding and support given to how awful it is for a person WITHOUT adhd than for the person with the actual disorder. and we let it happen by not confronting them and by letting their struggles become the face and voice of the results of adhd.

Again, I can’t help but think of the autism speaks controversy (which I just realized not all may be familiar with, so: http://www.time.com/time/health/article/0,8599,1935959,00.html ) and again, the phrase ‘nothing about us without us’, which has been a central fixture in the disability rights movement...and the fact that we, those of use with ADHD, just don’t demand this level of respect by and large. I do wonder whether this is an obstacle to advocacy or a symptom of the lack of it?

with the face/voice increasingly being those who are undiagnosed or diagnosed late, it's like there's this backlash to remove the "stereotypical" adhd kid bouncing off the walls, but instead of explaining that we grow into adults with variations on a theme, it's like we're dismissed for not being the hip new thing...and it also seems like it's because our existence is perceived as undermining the legitimacy of those who weren't identified as children, or that we've known and so should've gotten it together by now.

I don’t know that I’d characterize it quite this way, but I do agree that there’s a trend toward minimizing the experiences of those with the more stereotypical presentation. I don’t think it’s intentional, but rather a byproduct of the fact that as the condition *does* become better known, those who’re diagnosed will include a wider range of symptoms/severity.

Discussing severity, excepting one’s own, seems to be a taboo, and that’s understandable: nobody whose life has been seriously hampered by ADHD (and to be diagnosed, you *do* have to be impaired, so this is, or should be, true for all with the diagnosis) is likely to think of their issues as the result ‘mild’ ADHD, especially given that ADHD itself is seen as poor excuse by much of society. No, if you’re going to accept that your struggles are the consequence of ADHD, it *must* be severe ADHD, as normal ADHD couldn’t account for it. Except, it does, by definition, or it’s not mild ADHD, it’s not ADHD at all.

So, yes, I can well see those of us with the ‘classic’ manifestation, in which diagnosis occurs in childhood, or we become one of those statistics on negative life outcomes, as not fitting the above framework. If the person whose career isn’t as successful as their innate talent for their field and effort should warrant has *severe* ADHD, then what’s true for them should be true for us, leading to this:

i'm not saying anyone does or does not have adhd, and of course there are exceptions--especially given geographical/health care access differences--but the more lax the criteria become to include more and more people whose lives are not clearly and significantly and obviously impacted by maladaptive behaviors that are evident to professionals without question, the more those of us who fit that model are viewed as just not trying to "manage" our adhd. barring some radical extenuating circumstances, i personally find the idea/claim/suggestion that one can be "severely adhd" and yet professionals do not or are reluctant to diagnose, that one has made it through basic education, much less graduated from college or beyond, or overall kept things together well into adulthood is absolutely preposterous.

And, since telling someone else their ADHD isn’t as severe as they say is taboo (after all, who are we to judge someone else’s experience?) we do end up with this intractable problem of self-identified ‘severe’ sufferers who got through most of their life untreated, thus proving it can be done if you’re just smart/hard-working/strong-willed enough.

I think, overall, that the increasing acceptance of ADHD as a condition that exists in adults, and can have varying manifestations, is a positive development, but in combination with the pre-existing trivialization of the condition it sets up this unfortunate dynamic, in which acknowledging that one is on the mild end of the spectrum, could, I imagine, feel like acknowledging that it’s not a legitimate ‘excuse’ for one’s functional impairment. In truth, one’s life circumstances have an enormous amount to do with how impairing one’s ADHD is, and I can well imagine (in fact, I don’t have to, because I know at least one person..) that someone with a milder case than me could end up struggling more, by falling just below the threshold where diagnosis would be pushed, and thus not having the benefit of understanding and treatment.

So, in the end, I think this is an outgrowth of what I meant by ‘denial/trivialization’ and ‘stigma’ in the poll. When I see someone describe ‘severe’ ADHD in a manner that to me sounds more like ‘borderline ADHD’ I can’t help but read it as “I have real problems, unlike most of you” and think it’s a symptom of internalizing the notion that it’s either not real, or somehow a moral failing.


#1) There is genuine ADHD advocacy going on right in front of your noses - it just isn't being recognized as such - not even by those who are doing it.

This is true. This forum is advocacy of a sort, and individuals can engage in it every day, but it’s still my perception that it’s much smaller scale than it should be, and is for many other conditions, particularly given ADHD’s prevalence.

#2) Advocacy does not equate social change Even if it does cause social changes the changes may be so subtle occurring over a long period of time so that they are not detectable. For some reason because social change is not over night many believe it is not happening at all - True social change takes time. Adult ADHD has just started being recognized by professionals in the field of psychiatry itself less than twenty years ago.

Change, whether social or legal, is the goal of advocacy, even if it doesn’t always follow, and advocacy on a large scale can yield change that is dramatic, even if it takes time, but the advocacy itself, particularly if visible can yield subtle changes. But, I don’t see enough of the sort of advocacy that yields either sort of change occurring with regard to ADHD. Yes, it takes time, but for this issue, I don’t think the timer has been started yet, and it’s high time it was.

#3) To many are expecting others to do the advocating for them, this includes those who feel the need to hide their condition - Please do not misunderstand I am not saying it is wrong or bad to hide your condition for some keeping your diagnosis hidden may be necessary however if you are hiding your condition for what ever reason you are not advocating for the social changes.Our ADHD is our collective problem and so it up to us to advocate for ourselves and our loved ones

This is definitely the case, and the nature of ADHD does make it harder, particularly when it comes to revealing it in the workplace, for example. The symptoms of ADHD are exactly what many employers look to avoid in employees, and identifying oneself as having them is a tall order, even if one can demonstrate that one can control them.

I’m in a position where I can be open about it without fear, but recognize that many are not. However, as long as it’s something that needs to be hidden, it will be perceived as something people should *want* hidden from others...embarrassing or shameful.

#3.5) ADHDers are too easily distracted , to disorganized and either unmotivated , too easy over whelmed and those of us who are motivated are to often lacking direction, or social aptitude. The very nature of ADHD makes us less likely to be effective advocates - because to advocate requires the very skills lacking in those of us who are ADHD! {damn-it}

This is true...and sadly, not very encouraging....


So I guess what I mean is I see people who may claim severity of symptoms, but who managed to cope their entire lives claiming it's not that big deal (whether it really is or not, and whether they're trying to cover for how bad things are), and I see people who seem to think that it's difficult to slip through the cracks undiagnosed, despite not having personally experienced such a thing themselves.

And I guess I do not see the point of questioning whether late DXes or self DXes are valid or not even if individuals are not questioned as to validity. It seems to me that challenging problematic and wrong viewpoints instead of suggesting that the people involved are unreliable in some way would be more productive, more likely to produce information that is useful for ADHDers diagnosed at any age.

I feel like this is a persistent problem: questioning the legitimacy of others experiences, or making assertions about others based on oneself. Whether this is in the form of someone saying that another cannot identify with them because of a different subtype, that another can overcome their issues by X, Y, and Z if they really tried because one was able to, that everyone with ADHD is super creative because one is, etc.

I see no utility in questioning the legitimacy of others experiences or diagnoses...if someone says they have ADHD, then they have ADHD as far as I’m concerned, but if they start drawing generalizations about others with ADHD using themself as the archetype when they clearly aren’t, that’s when it becomes a problem.

meadd823
03-19-11, 05:01 AM
I guess my point though is I don't feel like the questions are specific enough to pinpoint ADHD over someone who can still listen when they want to.

I don't know what it's like to not have ADHD but I talk to my boyfriend a lot about it and he is a non-ADHD and he tells me that he can choose to pay attention. The question doesn't address the issue of wanting to focus and not being able to, it's more geared towards finding yourself in bored a lot. At least that's how I see it. Anyway, it's those questions and their "open for interpretation" style that causes me to question whether there is an over or under diagnosis of ADHD.

From what I have learned when talking to non-ADDers is that they can chose what stimuli to focus on and what to ignore by simply "willing" themselves to do so. I get bombarded by every sight, sound, tactile sensation, thought until it becomes overwhelming and I have to physically move or my brain shuts down completely.

The reason that the questions are not as specific as you would like is that ADDers experience their ADHD differently - If the questions get to specific as I have demonstrated with my contrasting experience you will miss a lot of folks.


I can tell you though, I have met some kids that make your spine shiver. To watch a child inflict pain on others and have that be the only time you see an emotional reaction from them and have it be a joyous grin... it's really hard to believe that this is not an inborn issue. I'm talking 6 year olds from homes with "normal" siblings and families... and then the child who tortures animals and gets pure elated joy from it.

Why in the hell would you watch??

environment is not exclusive to home. Perhaps there is something at school, the park, day care, babysitter... I also looking at parenting and how child behavior affects parenting.

If I had a child who caused harm for pleasure I would have to have them removed from my presence one way or another -For the record not all psychopaths, or anti-social people are dangerous.


The diagnostic criteria that has to be met in order to obtain that diagnosis naturally creates a setting in which the diagnostic criteria of ODD are cultivated. So impulsivity is a good example. Being impulsive leads (by nature) to reckless behavior. The diagnostic criteria for ODD list many impulsive behaviors, such as stealing. So you have ADHD, impulsively you steal something, boom you meet that criterian for ODD. However, a trued diagnosis is only valid if the symptoms can not be attributed to anything else. So for depression symptoms can't be attributed to a recent death in the family. Well... how can we tell if that child would steal if they DIDN'T have ADHD? If they had "normal" control over their impulses. The defining aspect of ODD is deliberate acts however, I think that's hard to conclude with an ADHD diagnosis.

Not all impulsive acts of the ADHDer are going to be malicious or out of rebellion – The behaviors may not be socially appropriate but that does not mean the intent was destructive or an act of meanness – ADHD social impulsive is not as likely to be manipulative – just impulsive.

Not all hyper impulsive ADDers are aggressive or ill tempered. I am tired of being lumped with a bunch of people who are deliberately malicious simply because I share a few traits and no one bothers to investigate my intent or lack thereof .

People with conduct disorders will typically blame others where as many with ADHD will tend to blame themselves



One with conduct disorder will not listen because they do not care where as the ADHDer will zone out but still care.

ADHD does not equate deceitfulness – many are the opposite = honest to a fault.

. ADD behaviors although problematic are due to a failure to control issue where as conduct disorder behaviors are from a desire to be controling. Intention is at the heart of the difference and close observation should reveal this – Is the child's act random or targeted? Are behaviors always mean and aggressive.

Like many other conditions a person can have both ADHD and conduct disorder. I have a lot of hyper impulsive tendencies with my ADHD and I am sick to death of “experts always trying to lump people like me with those who have some personality disorder. Just because I am impulsive does not mean all my impulsive behaviors are going to be aimed at harming others – I am just as likely to be impulsively honest with compliments as I am, criticisms

I think we fail to look at how as a society we fail to acknowledge and accept diversity may have as much to do with some of these things as genetics. ADHDer may not be born with anti-social personality but how we are treated due to our difference may certainly contribute to behaviors that are anti-social – after all if ADDer spend their life times being expected to be some thing they were never designed to be and ostracized because of this then we as a society are teaching ADD children how to be anti-social by treating them "anti-socially" just because they are different. The rejection of ADHD kids is blamed on the ADHD kid - no one considers investigating the lack of diversity tolerance by "normal" children, So what does our ADHD kid learn - how to blame the person on the receiving end of our anti-social behavior - ADHD does not make kids anti-social society does - they are acting as they have been programmed by their environment to.

I can be rebellious but that has nothing to do with my lack of respect for authority. I get sick of being expected to be some thing I was never born to be if I am punished for not being able to pull off the impossible then yeah I might just be a bit angry about that –– When kids are punishment for things they have no control over then you are setting them up for what you call conduct disorder.

An example : When I was young I was paddled every Sunday for wiggling I church – The service was not for young kids I did not understand what was being said , it was over two hours long with no breaks and I was physically hyperactive. I even squirmed in my sleep – Sitting for two hours was physically painful for me so I wiggled and for that I got paddled every Sunday.

I was going to hurt regardless of what I did because I was being expected to do some thing I was unable to do because no one bothered to investigate my intent behind wiggling in church every Sunday.

If I was good and sat still for two hours it physically hurt l but if I relieved the hurt by moving the adults hurt me for wiggling – Had I been reared in that environment my entire life then I might have become anti-social but not because I was born that way. Despite the fact this was only a two year period of my life I grew up hating church – even trough psychologically I understand. Some reactions are ingrained.

Irregardless conductive disorder and impulsive type of ADHD are not the same thing even if they exist in the same individual.

meadd823
03-19-11, 05:02 AM
This is true. This forum is advocacy of a sort, and individuals can engage in it every day, but it’s still my perception that it’s much smaller scale than it should be, and is for many other conditions, particularly given ADHD’s prevalence.


How large should it be ? Compared to which other conditions - ADHD gets more “play” than dyslexia. Bipolar, schizophrenia , all of the “invisible” disabilities are under advocated for – the huge difference between my ADHD and my dyslexia is the medication controversy only because there is no medication for dyslexia

What other conditions are you referring to ? Not all physical condti0ons are “accepted” by society. I have a daughter who has metabolism problems and she is over weight and people treat her crappy because e of her weight assuming she is lazy, and does not care about her appearance - I have literally come unhinged on family member making comments about her weight – if she could be slim and the model of attractive she would -

Invisible conditions?? You are talking to some one who has two conditions one of which was diagnosed when I was in grade school – There is even a specific imaging signature that shows up when people like me read yet that does not stop people from treating me like an idiot because my spelling sucks. Many assume I just don't care – My husband spent the first five years of our marriage trying to teach me phonetics because he no savvy phonetically deaf – and he lives with me! My mom finally had enough one day and lit into him.




Change, whether social or legal, is the goal of advocacy, even if it doesn’t always follow, and advocacy on a large scale can yield change that is dramatic, even if it takes time, but the advocacy itself, particularly if visible can yield subtle changes.


ADHD is covered under the legal definition of “handicap” it is not the lack of laws but lack of social acceptance and guess what it is part of being a minority. There is always a sub-set of people who are unable to unwilling to accept those who are “too different” because they fear that which they do not understand.

If you are under the impression that other social minority groups do not face bias by society you are oh so very wrong. All minorities are subject to bias by a sub-set who view themselves as the majority

What is missing is what you specifically mean by adequate advocacy and social chances .

Surly Dave
03-19-11, 05:50 PM
I'm kind of curious about what would we expect out some sort of legal change? I mean, what sort of legal accommodations should we demand? What sort of changes would we want in the work space? I struggle with this, because it's not about adjusting the height of a work bench or putting braille on signage. I can see making learning materials available to suit more learning styles, but you can legislate allowing someone to drift off?

Fortune
03-19-11, 05:58 PM
In the US, accommodations are already required by the ADA. The problem is people tend to think of superficial things. You don't accommodate by allowing people to drift off - people already drift off, whether ADHD or not. There are ways to accommodate drifting off - in school it's things like having a note taker, or recording the class, and so on.

APSJ
03-20-11, 06:55 PM
How large should it be ? Compared to which other conditions - ADHD gets more “play” than dyslexia. Bipolar, schizophrenia , all of the “invisible” disabilities are under advocated for – the huge difference between my ADHD and my dyslexia is the medication controversy only because there is no medication for dyslexia

I think the medication issue is a large part of why dyslexia gets less 'play'...namely that there is money to be made off of ADHD medication, so for better or worse, there is money to be made pushing people toward diagnosis and treatment.

I have a (different) learning disability as well, and it it frustrating to note how much less is available, just in terms of information.

But, I also don't think that pharmaceutical industry backed information campaigns, etc. are the sort of advocacy that we're lacking in when it comes to ADHD, specifically, the sort of self-advocacy that leads to social change, lessening of stigma, and acceptance.

It is true that all of the invisible disabilities are under-advocated for, but I don't see the same sort of skepticism directed toward learning disabilities, autism spectrum disorders, or even anxiety and depression as I do toward ADHD. That's not to say there's none, obviously, but if I tell someone I can't read a clock because I have a learning disability, I feel less apprehension about their reaction than I do telling them I can't sit through a presentation because of ADHD.

What other conditions are you referring to ? Not all physical condti0ons are “accepted” by society. I have a daughter who has metabolism problems and she is over weight and people treat her crappy because e of her weight assuming she is lazy, and does not care about her appearance - I have literally come unhinged on family member making comments about her weight – if she could be slim and the model of attractive she would -

No, and your example may well be one that's even less accepted than ADHD. I don't suggest it's the worst advocated for or least accepted, just worse advocated for, and less accepted than most, particularly given the state and longevity of knowledge in the medical community, and its prevalence.

ADHD is covered under the legal definition of “handicap” it is not the lack of laws but lack of social acceptance and guess what it is part of being a minority. There is always a sub-set of people who are unable to unwilling to accept those who are “too different” because they fear that which they do not understand.

If you are under the impression that other social minority groups do not face bias by society you are oh so very wrong. All minorities are subject to bias by a sub-set who view themselves as the majority

Well, the legal definitions of handicap and disability don't list conditions, by and large, and where they do, they don't include ADHD. Under the IDEA, for example, which *does* list learning disabilities, ADHD is only covered under the category of 'other health impairment'.

It does seem like there's virtually always a subset of the population who is particularly intolerant of the different, but that doesn't mean we should be accepting of such attitudes, or complacent about them, or that they're the same for all manner of differences.

I'm well aware that other minority groups are subject to discrimination, but also that, largely due to advocacy, many minority groups have become less and less subject to discrimination, and that such efforts by and on behalf of those with disabilities, are in their infancy relative to many of the groups one think of as subject to discrimination. Consequently, discrimination against those with disabilities is becoming a larger and larger percentage of reported discrimination generally, as other kinds diminish, and more people with disabilities are comfortable asserting their rights.

What is missing is what you specifically mean by adequate advocacy and social chances .

That's a good question! I don't know the answer to the first part...what effective advocacy would look like. I think a significant first step is, as you noted in an earlier post, more people being open about it, but that needs to happen in the context of a movement explaining why people should be comfortable doing so, and others supportive of them.

The answer to the second part is, basically, an end to the circumstances I described in my first post, where people feel comfortable, even proud, to question the legitimacy of the disorder and denigrate those diagnosed with it as merely lazy or mindlessly drugged kids, and it is no longer viewed as a moral failing.

In the US, accommodations are already required by the ADA. The problem is people tend to think of superficial things. You don't accommodate by allowing people to drift off - people already drift off, whether ADHD or not. There are ways to accommodate drifting off - in school it's things like having a note taker, or recording the class, and so on.

Yes, exactly. The legal framework is largely there...not a great deal of change is needed, at least not change specific to ADHD. What is needed is for it to be understood that these accommodations need to be provided, and they don't mean the person is less capable generally. One example is testing, whether it's a college exam, the SATs, MCAT, LSAT, Bar exam, or a pre-employment screening/aptitude test. Requests for accommodations based on ADHD (or learning disabilities for that matter) are often fought tooth and nail by the testing institution.

fidgetido
03-21-11, 02:36 AM
I checked off "other" but not sure where I am supposed to explain...

My other includes a culture that is so ADD it does not recognize ADD as a "disorder." honestly, just thikn about it a bit... yes, a bit....

Culture is created by people. If our culture fits the criteria for ADD then how did that culture get created? By accident?" No... by people. If the majority of behaviors and mindsets in the US are "be distracted, impulse control problems, short term thinking, be entertained, be spoiled, be impatient, 24-hour news cycle, gadgets, gadgets and more gadgets," just how can ADD be a disorder, eh?

Honestly, what my doc calls "dopamine deficiency spectrum disorder" is widespread in the whole wester hemisphere. guess who left Europe for the new world? Guess who outmigrated in huge numbers? Guess who stayed behind? let's see, alcoholism, nicotineism, cocaine, methamphetamine, weed, and caffeine abuse, buying, splurging, gambling, all kinds of risk taking, impulse buying, low frustration tolerance, domestic violence, violence in general, large prison populations, the list goes on -- all have been significantly related to "mutations" of the dopamine genes (d1-d5 and dat, and more I think).

ADD is just one of many of those DDSD types.

ginniebean
03-22-11, 01:25 AM
Interesting. There does seem to be a greater emphasis on 'self-help', supporting the person with ADHD in 'overcoming it', and 'tolerating' it, than for many other conditions. I've actually seen very very little in the way of demanding recognition of differing needs for those with ADHD outside of communities like this one.


I look for things about adhd on the net all the time. I haven't, outside of the classroom setting seen anything about differing needs for those with adhd.

"It can be managed" is a phrase that has become one of minimization and denigration. In other words "you're not managing like you SHOULD be".

overcome is a word too that is always in play, it's this heroic narrative that is so 'feel good' but it's completely unrealistic.





I tend to think that ADHD is over diagnosed. I agree it's a significant health concern and that their is a HUGE lack of education about it but until MD's are no longer allowed to diagnose and treat ADHD without specialized training is psychiatric disorders I am afraid I will continue to feel there is an over diagnosis. Especially in young children. It's hardest to diagnose in young children and therefore this diagnosis should only be done by a professional that specializes in psychiatric care in these situations.

In extremely young children perhaps, but in fact adhd is much more difficult to diagnose in adults because of the lack of developmental milestones.

More PCP's need to get involved, the sheer volume of people with adhd would overwhelm specialists if there was any sort of screening done.



i think that makes complete sense.

i don't know why the questions are framed the way they are, but what comes to mind is that they were written by someone observing adhd behavior and not someone experiencing it. like....we appear to not listen to others, to constantly drift off and be perceived offensive/rude, to have difficulty with "focus" or chores or boring lectures and so the questions are framed from that perspective...the one of observing...which makes it hard for us to answer.


ADHD is framed negatively and this is a problem. It's starts with research experts and gets worse as it filters down.

Look at some of the words used

procrastination- instead of a failure of the executive functions when a command dies prior to execution.

boredom - rather than restlessness caused by a lack of dopamine

Then there are those used by the social experts ..accountability, responsibility, the list is almost endless and they are all moralisms. The message then becomes that we lack maturity and morality.