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Old 03-11-06, 07:17 PM
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An edited compilation of a debate about ADHD, psychiatric disorders and meds.

I put * * * to indicate deleted text.

This kind of interchange occurs frequently in the Forums. The arguments don't change, just the newcomer espousing strong opinions.

For some background on ADHD and diagnosis see:

Originally Posted by Drummergod35
I was made aware recently that only a neurologist can officially diagnose a brain "disorder", "disease", "syndrome" etc,. as this is the only individual officially qualified. Diagnoses by a psychologist/psyschiatrist is completely subjective.

... There is no physical test to ascertain the presence of any abnormality.
Originally Posted by Drummergod35

QUOTE= Fly Away


Because there are no 'tests' that you can take that dx ADD does not mean there are no physical, biological reasons behind the disorder. There are many diseases that have no hard and fast tests to say, definitively, yes you have this disease or no, you do not. MS is one. There are many, many more. Practising medicine would be so easy if there were tests for all the physical problems people have. To dx many physical illnesses the doctor looks at the symptoms and determines from that the illness. This is what is done with ADD too. There is a definite biological basis for ADD.


Hi Tim. Thanks for writing. I personally do not believe in giving any unnecessary drug to a child. But I do have one who could not function without it. He is now in college. We fought medication his entire school career because of the confusing information that effected our understanding of AD/HD. You should always be skeptical before putting something in your child's mouth that may not be needed. Maybe I can give you some new information.

My neurologist at Duke Medical University explained to me that neurologists are not necessarily experts on attention deficit disorder. The technology used in viewing the brain abnormalities is new,very expensive, and for the most part unnecessary.He suggested that I have testing done locally with my family doctor and a psychologist.

There are other methods of determining the presence of AD/HD that are very reliable and less costly. Psychologists and psychiatrists evaluate clients/patients to determine whether or not they have other mental or physical illnesses or disorders because other illnesses and disorders can mimic AD/HD.

Someone can correct me if needed, but the bottom line is that AD/HD is an abnormality that responds to treatment in most cases. You can split hairs all day long over words such as disease, disorder, condition, and syndrome.

Just because the disorder (my name of choice today) can not be seen under a microscope doesn’t mean that it doesn’t exist and interrupt the quality of someone’s life. I have epilepsy- ideopathic. Meaning: we just don’t know why. But I still have it and I need medicine to keep from injuring or killing myself or someone else. There is no physical test to be taken that will tell me anything. We can only go by the VISIBLE symptoms which occur.

Diagnosis is based on evaluating symptoms, ruling out other disorders, and taking note of the disruption that's taken place over the course of a person's life.

My question is to those who have chosen not to take stimulants or other drugs. Do you manage your symptoms without drugs and if so, how? Can somebody help me with this?

Originally Posted by Drummergod35
I hear what you are saying. However, if someone is diagnosed with ADD, ADHD, we are frequently told he or she has a "chemical imbalance". Be this as it may, where is the physical proof? A neurologist specializes in diagnosing brain and nerve malfunction, disease (as these disorders are commonly called) To indicate brain abnormality, one would have to prove this either by physical test or biological proof.
Hello Tim!

Just want to say that I was not diagnosed with a chemical imbalance, but a neurological disorder.

Depression is one example of a chemical imbalance and because of scientific studies, we know that a depletion of serotonin is to blame in most cases. One way we know this is through research and trials of medications such as SRIs. The SRIs prove to relieve the symptoms of depression just like aspirin relieves a headache. Are you saying that depression is subjective? If you are, you have never been depressed. If the medicine works.....

Stimulants take care of many of the symptoms we are attributing to AD/HD if you have the disorder. It does nothing for, or even aggravates conditions if you do not. The answer to your confusion is in the scientific process that is behind defining all illnesses

( disorders, diseases, what have you..)

* * *

quote=say whaaaat?

hey tim you should go to it shows images of peoples brains who have adhd. it proves that they're different from "normal" peoples brains. people with adhd have actual problems that they cant control becasue the're brains work differntly.
Originally Posted by Drummergod35
Those studies confirm brain atrophy and other forms of brain damage. The commonality is that these cases are also those already on a medication and most have been for a while. This cannot be said for cases not on any medication.

Also, any link sponsored by the AMA, APA, NIMH or CHADD I don't personally hold a lot of stock in. These sources have obvious reason to be bias and support labeling and medication. Over the last 50 years it would be safe to say that a cure is not in the best interest of Big Pharma or in fact
the mental health industry period.

You must understand that when J Jensen of the National Institute of Mental Health and Chadd (he is a member of their advisory council) says Quote: "studies have consistently pointed towards disturbances in brain functioning, particularly in brain areas responsible for attention and memory." Jensen used the wording: "pointed toward disturbances in brain functioning" because there was no proof of brain malfunction at the time. Just as there is none today.

As far as medications being effective, ok sure. They are effective in handling symptoms. What about the source of trouble? The source is'nt known, so you medicate? We medicate the common cold to handle symptoms such as a runny nose and cough with NyQuil. These drugs are a far cry from NyQuil and many are highly addictive. You'd think with all the billions of tax dollars spent on research over the last 18 years there would be a drug that handles source troubles. (even if there was a source of trouble and none have been found.)

As far as OCD being a disease, I'll say this. In medicine, strict criteria exist for calling a condition a disease: a predictable group of symptoms and the cause of the symptoms or an understanding of their physiology must be proven and established. Chills and fever are symptoms. malaria and typhoid are diseases. Diseases are proven to exist by objective evidence and physical tests. Yet, no mental "diseases" have ever been proven to medically exist.

You're correct that diagnosis is a subjective process. Otherwise, there would be no such thing as "misdiagnosis," since either no diagnosis would be given, or every physician would give the same diagnosis. I'd also like to add that Alzheimer's dementia is a common disorder diagnosed by both psychiatrists and neurologists for which there is no definitive test. The only way to confirm a diagnosis is via postmortem examination of the brain.

You're also correct that there is no physical evidence as yet linking a brain abnormality or "chemical imbalance" as a cause to any mental illness. (There is some correlational evidence, but correlation is not causation.)

Finally, you're correct that allergies and other conditions can easily mimic ADHD and should be ruled out by a physical exam before starting ADHD meds.

However, that's where it ends. A psychiatrist is perfectly capable of diagnosing ADHD, and possibly moreso than most neurologists. I would be willing to bet that most neurologists do not have any specific training in ADHD, while most psychiatrists do. (This probably does not apply to pediatric neurologists.)

Furthermore, there is solid statistical proof that medications for several mental conditions (whatever you want to call them) are effective. Ritalin is one of the most heavily studied drugs out there, and every new drug has to go through at least 4 or 5 clinical trials for efficacy to make it to the market (I forget the exact number of trials required, but it's somewhere in the range of 3-5.)

Finally, I did some searching (, and a couple online medical dictionaries) to make some sense of the statement that disease requires a pathogen to be present. None of the sources I looked at would confirm that.

It's funny, too, how you mentioned OCD as not being a disease. In fact, OCD can be caused by a strep infection of the brain. Google "strep brain ocd" for more info.


I don't know who told you that...... but it's NOT true. Licensed pyschologists can and do diagnose ADHD, depression, Tourette's, OCD and schizophrenia, etc. I've been doing it for 21 + years here in Minnesota. There are absolutely no restrictions on the diagnoses within the DSM -IV-TR, other than the professional be licensed and competent. All states require licensed psychologist's to post their professional competencies in their office. When I added diagnosing & treating ADHD to mine, I had to demonstrate to the state licensing board that I had received the proper course work, training (CEU"s) and/or books read (more CEU's) to be able to justify adding that.That meant sending in the certificates from the workshops or showing documentation that you actually read those books, etc.
* * *


I think your ideas are a little off base, and you might be at the wrong forum if you think these ideas are going to be uncritically accepted. For example, I don't agree with your definition of a "disease." I think most physicians would probably say something along the lines of "a disease is any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person. Sometimes the term is used broadly to include injuries, disabilities, syndromes, symptoms, deviant behaviors, and atypical variations of structure and function, while in other contexts these may be considered distinguishable categories." ( Notice that nowhere in the definition is pathogenisis mentioned.

As for drugs not treating the underlying cause of ADD, okay, I agree. Pumping me full of stimulants isn't going to take away my ADD, but it does help manage it. A great parallel here is with asthma, which I also happen to have. If it were not for this great drug called albuterol which effectively treats the symptoms of asthma, I would be dead almost 25 years by now. (Hint, if you have asthma, don't go to a grain mill, even if your grandparents are farmers... hehe.) I could trot out probably a dozen studies confirming a link between strep infection and some cases of OCD, but, since you won't believe links sponsored by the AMA or APA, I doubt you'd believe them, since the physicians doing the studies are probably members of these organizations.

As for your last statement, asking me to justify the "over drugging of our nations [sic] children," that is like asking me if I have stopped beating my wife yet. The question itself is loaded and assumes that children are being overmedicated en masse (which may or may not be true). Of course I am not going to support overmedicating anyone, but the simple fact is that for the cluster of symptoms (i.e. the "syndrome") that make up ADD, there are many medications that are proven effective in treating them.

As with all medications, one has to always weigh the benefits vs risks, and there are always risks. I agree, too, that one should have a thorough physical to rule out conditions that produce similar symptoms, such as thyroid dysfunction and allergies. If an underlying medical condition is found, then it should be treated. In fact, the DSM criteria state that an ADHD diagnosis is warranted if and only if symptoms are not due to any other medical condition.


Hello Tim.

****The Structural Differences include studies with MRIs, PET scans, and SPECT scans. ******They show subtle structural differences in the prefrontal cortex (smaller right anterior frontal cortex, and less white matter in the right frontal lobes which cause problems with sustained or focused attention), caudate nucleus (asymmetries which cause problems with self-control), and globus pallidus. They also show that the right hemisphere of the ADD ADHD brain is, on average, 5% smaller than the control groups.

They also show differences in blood flow in certain parts of the brain, as well as chemical abnormalities in Attention Deficit Disorder – ADD ADHD subjects.

The studies on Essential Fatty Acid levels in Attention Deficit Disorder – ADD ADHD subjects vs. non-ADD ADHD subjects are interesting. The ADD ADHD groups had significantly lower concentrations of key essential fatty acids than did the control groups, and about 40% of the ADD ADHD group showed signs of EFA deficiency (increased thirst, frequent urination, dry skin, and dry hair). Low levels of Omega 6 EFAs contributed to higher incidents of illness (colds, flu, etc.), and deficits in Omega 3 EFAs contributed to problems with learning, behavior, sleep, and temper. These studies support the case for EFA supplementation as a part of the overall treatment approach to Attention Deficit Disorder – ADD ADHD.

Obtaining an EEG from a neurologist is rarely helpful.

EEGs will show differences from non-ADD children. Typically there is excessive slow brainwave activity, particularly in the Theta band (4-7 Hz.). However, ninety-five percent of all Attention Deficit Hyperactivity Disorder - ADD ADHD - kids have "normal" EEGs. What we mean by "normal" is they don't have big epileptic spikes, or things like that, that a neurologist would say are "abnormal." But when you compare them side by side with a non-ADD kid, they are much different.

An EEG may be helpful if the child is going to be treated with EEG biofeedback, but in terms of being helpful for a diagnostic work-up, it is rarely helpful. However, if the parent interview revealed that the child had some potential neurological problem, as seen in sleep walking, or a history of seizures, and so on, then an EEG would be a good idea.


ADD is being shown as a different kind of brain. Areas that control impulse (ie... what keeps us from being culturally appropriate) Have less cells than certain parts of the temporal lobe... There is no "net deficiancy" in brain cell number but a difference.

Does not sound like "disease" to me. It think the difference involves both chemical AND physical changes... especially during the development in the brain.
* * *
If I were a man with no legs who could paint amazing pictures, should I become a marathon runner instead? No! Am I productive? Yes! Am I disordered? No!

We just keep on trying to fit our square heads in round holes . We are then told we are disordered because they don't fit... think about it


What do you think should be done with suicidal people? Should professionals just say hey why don't you just go kill yourself until we find physical proof that you are severely depressed?

Originally Posted by Drummergod35

No, I did'nt say that. I think that after all this time and money spent on research, literally billions upon billions each year in the promise of a cure with no source found quite honestly has scam written all over it. I think the drug companies are getting fat and the lobbyists hired by them help to push certain bills up the line and drugs past the right people so that can become publicly consumable. I think we are over drugging.

What to do? Well, we could start by giving a severly depressed person a complete physical exam. A close friend and MD in Los Angeles mentioned a commonality in depression cases in that a high percentage have poor diet, don't exercise, and take vitamins and essential minerals. After my divorce I was severely depressed. This is totally normal. Did I go see an Psychiatrist and get some prozac? No. I went to see my MD and she gave me a full physical. She told me I was very low on B vitamins and also informed me that drinking almost comletely robbed my body of any vitamins I was getting through food, and I ate pretty healthy stuff.

QUOTE=Kimalimah I have to disagree with you here since there are many fields where huge amounts of money are spent on research and drug development...cancer, MS, cystic fibrosis, AIDS, even the common cold. It doesn't make it a scam just because there are no answers yet. If we stop looking we will never make any more progress.

As consumers and members of society I do believe that we have the obligation to be informed and active politically, so that when the kind of manipulation you speak of occurs (I agree, it does), it can be held in check. I know, too, that this is easier said than done, but simply labelling it a "scam" doesn't help the end users.

Organization, clear , concise, substantiated data, contacts for voicing concerns, etc. is what I would be looking for, so that I felt I could maybe make a difference.

I agree 100% that a complete physical examination is the first step for any concerns and that a "softer" approach is always the best place to start when possible. However, the case of depression is to get the depressed person involved in those things you mention (diet, exercise) when they aren't capable of doing more than sleeping and coping.

I speak from first hand experience. I fought for over 10 years through sheer willpower to overcome my depression. Exercise and diet was a part of that, but I still lost the battle. In the end, the stresses in my life from dealing with 2 ADD kids (one extreme ODD, too) was more than my physical body could handle.

I had a complete neurological, physical, ob/gyn, and psychological workup. The end diagnosis was "exhaustion" body just couldn't do it anymore. I started anti-depressants (something I swore I would never do) and am finally winning back my life. I don't intend to take them forever, and my doctors agree, but until things change in my environment (kids do grow up ) I need the extra help.

I don't believe you were trying to imply what Tara suggested here. I think maybe only one word was missing... "there are OFTEN alternatives though..." and "We don't ALWAYS have to....". Just as you feel strongly about not medicating, others feel strongly about the opposite and this leaves room to discuss it. IMHO



There's a Huge difference between situational depression and a Major Depressive Disorder. Most people going thru some type of grief will be sad; which is "normal" under those circumstances. At the very least, it's called an Adjustment Disorder ( most people going thru the same thing would feel the same way). The main differences are the lenght of time the person has been depressed and the impact of the symptoms (transient vs longer lasting ).

Among it's numerous defintions, ADHD is a proven brain based disorder.The risk factors for untreated ADHD are profound. If you don't believe me, then please check out Sandra Rief's 2003 book.....The ADHD Book of Lists; page 20. It provides an evidenced based (research validated) list. The impact to the Executive Functions alone (listed on pages 5,6 & 7) shows how potentially devastating the disorder is. You can't trivialize a major neurobiological disorder as something that doesn't require the consideration at least of medication as part of an overall treatment plan. An adult is obviously in a better position to decide for themselves whether or not to treat their ADHD (or any other disorder ) than say a child.

Medication is always a personal choice in any treatment plan. However, ADHD is absloutely NOT something that vitamins, diet or excercise will serve as clinical treatments for. Yes, everyone needs all of those; whether they have ADHD or not. For a child with ADHD, they need the best of both approaches in order to have a "fighting chance" at succeeding in life.


* * *
I am trying to share one experience in which I have first-hand knowledge.

I am trying to tell drummergod that if doctors had based my treatment on the results of technical test results as proof of my seizure disorder, where would I be??

The only "proof" neurologists had to go by were history and the possible "subjective" reports by my family and friends.

I am trying to make my point by comparing the testing of the neurological disorder epilepsy, to that of adhd since in doing so, the same types of equipment would be used.

*Both epilepsy and adhd are neurological disorders
*Normal test results from equipment such as mri, eeg,etc. in both disorders are common. Many times we cannot pinpoint the origin of the problem.
*Testing is often inconclusive and is always extremely expensive.
*Both disorders have symptoms that can often only be reported by the patients themselves and friends and family...
*Both disorders respond well to medicines that have been scientifically tested and approved.
*Both may cause significant impairment to an individual's quality of life, and may benefit from treatment.


I did take a pill for my depression
After getting a full exam by my MD I went on Lexapro
What that did was create a barrier to all the intense emotions I was feeling.
It gave me the break I needed from depression.
To get myself back.
And that was the goal.
I'm no longer taking anything for depression and I am not depressed.
Taking an antidepressant was the thing I needed to do at that time to help myself.

This post is not me saying hey everyone run out and get drugs. I'm showing another side to how a person can help themselves.
Lexapro was my only experience with that type of drug.
I've never taken AD/HD meds and that was my only time with an antidepressant.

We all have to be allowed to do whats right for ourselves. No one can tell me what drug to take or not take. Especially when they haven't walked in my shoes.

* * *


Good grief Tim;

"disorder", "disease", "syndrome" "abnormality" "disturbances in brain functioning"

Even in my darkest hours I have NEVER EVER thought of myself using any of those terms. I hope for your sake that you are just trying to stir things up and not being challenged by someone to validate your "illness" (Been there done that) We are here to help.
Originally Posted by Drummergod35
Unlike medicine, there is no scientific basis for any of these “psychiatric disorders.” To indicate someone has a disorder means that there is an abnormality of some sort. Why then is there no physical proof whatsoever that these diseases, disorders, syndromes exist or a test which can differeciate ADD from say ADHD? We hear the term "chemical imbalance" yet there is no physical test that assertains the presence of any abnormality. Also, diagnoses by a pyschiatrist or psychologist is completely subjective. This has been admitted by the National Institute of Mental Health itself.
Originally Posted by Drummergod35

We hear that depression is a "disease" yet no pathogen exists and again, no physical proof.
(scratching head)

First of all there are virtually no lab tests for depression; including all forms of Bipolar, Schizophrenia, Tourettes Syndrome, Obssesive Compulsive Disorder,etc.

As far as your statements about there being "no scientific basis for these disorders, you are completely mistaken.

Here's the "proof"
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