ADHD is simple, yet complicated. The diagnosis is so simple to give, but it’s created complexities in our society. There’s people out there so convinced they have ADHD, they’ve made it their mission to “spread awareness”. The label has become such a part of their identity–such a strawman to lay their blame upon–that they get angry if you dare suggest ADHD might not actually exist. (If you’re a believer, don’t get your torch and pitchfork out, yet. I’m more of a fence-sitter on this one.)
To be diagnosed with ADHD (and this is straight from the CDC), you must exhibit different symptoms that must have been present since before the age of twelve. (There’s a lot of arbitrary “just so’s” to this diagnosis.) I’ll mark the ones that apply to me with an “x”.
- Inattention: (6+ symptoms required in the past six months for children, or 5+ for adults):
_ Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
_ Often has trouble holding attention on tasks or play activities.
_ Often does not seem to listen when spoken to directly.
_ Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
_ Often has trouble organizing tasks and activities.
x Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
_ Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
x Is often easily distracted
_ Is often forgetful in daily activities.
Seeing this list, it’s easy to see how a teacher can pressure parents into getting a diagnosis for their child.
Sure, I tend to get distracted … but who doesn’t in this crazy digital age? Even in the 80s, most children were thinking about their favorite after school cartoons, or that new video game they got. They probably had a sugary “complete” breakfast, and would almost definitely follow it up with a sugary/carby lunch (thanks to the Lipid Hypothesis-based Food Pyramid). It’s no wonder these children would squirm in their seats, barely able to wait until the clock struck 3 PM.
I dislike homework but, again, who doesn’t? I’ve trained myself to handle and finish assignments just fine without medication, and in fact I do a great job at it, if grades are anything to go by.
None of those other checkboxes sound much like me, but in the past, I did have to train myself to be a good listener when others were talking to me. My first grade teacher noted that I would “let my mind wander”, which basically means I was lost in thought … which means I was a thinker. It’s easy to diagnose “not a good listener” if the child doesn’t know they should look the speaker in the eye; Teachers often assume a child isn’t listening just because they aren’t making eye contact.
- Hyperactivity (6+ symptoms required in the past six months for children, or 5+ for adults):
x Often fidgets with or taps hands or feet, or squirms in seat.
_ Often leaves seat in situations when remaining seated is expected.
_ Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
_ Often unable to play or take part in leisure activities quietly.
_ Is often “on the go” acting as if “driven by a motor”.
_ Often talks excessively.
_ Often blurts out an answer before a question has been completed.
_ Often has trouble waiting their turn.
_ Often interrupts or intrudes on others (e.g., butts into conversations or games)
I already mentioned how I chew on my fingernails when I get nervous, although I do it a whole lot less than I used to. I also shake my right leg while sitting for an extended period of time, but again, I’ve made a conscious effort to do it less.
I never used to fidget until I witnessed my mom bouncing her leg every morning while reading the paper. I don’t know why, but around the age of seven, I felt compelled to mimic that action and, over time, it developed into a bad habit. (I never stopped because I figured it was probably good for blood circulation, and maybe even good exercise for someone with a desk job.)
Later, I learned that leg shaking is primarily a cultural thing. Japanese tourists who come to the US are surprised to see how many of us shake our legs while sitting still. Go to any US airport and you’ll see it among many of the “neurotypical” folks, but it’s apparently a rare phenomenon in Japan. In this US, this behavior is definitely not uncommon, but its presence certainly didn’t help my diagnosis.
- In addition, the following factors are required for a diagnosis:
_ Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
_ Several symptoms are present in two or more settings, (such as at home, school or work; with friends or relatives; in other activities).
_ There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
_ The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.
Define “several”. Some doctors may interpret that as needing just two or three check marks between the two categories, whereas others may interpret it as needing two or three within any single category.
Also, define “clear evidence”.
Many of these, with enough word weaseling, can apply to just about anyone. With a loose enough interpretation, everyone can be diagnosed with ADHD.
But, since most of these checkboxes don’t apply to me, I’m in the clear, right? Then how did I manage to get diagnosed?
The Story of the Strange Room
My mother brought me to the “hottest” child psychologist in the city. They made us wait alone in the strangest waiting room I’ve ever experienced. There were no chairs, no end tables with magazines, no front desk, and no sign-in.
It was a long, echoey chamber with a low ceiling and dim lights, a bit like a warehouse basement, and it was full of periodic floor-to-ceiling “stripper poles”. There were no decorations on the walls aside from a large mirror, and there was no carpeting. What’s more, it was just us. No one else was in the room. This should’ve been the first red flag for my mother to take her child and leave. But we stayed. Some toys for very young children sat in the corner. I was too old for those, so I left it alone. We had no choice but to stand and wait.
And we waited, and waited. Even mom began to fidget and complain.
Finally, seven year-old me got bored. I held onto one of the bars and spun around, as any child would. Nothing too crazy, just a simple lazy lean-and-circle, then a slow walk between two of the bars, weaving between them as we were left to stew in wait.
Turns out that mirror was a two-way mirror. I was being observed the whole time. The psychiatrist was checking off boxes based on what she saw.
Not long after, they allowed me in for an “interview” and wouldn’t let my mom attend. That should’ve been an even bigger red flag for my mother, but she let me go as she stayed behind in the strange waiting room.
Now alone with the psychologist, she had me just where she wanted me. She was able to manipulate me by asking leading questions in order to check off even more boxes.
Between my first grade teacher’s complaints, my impromptu interrogation, and the psychiatrist’s explanation to my mother about how I swung around the poles, they were able to get the diagnosis and get me on a steady dose of Ritalin. They used that two-way mirror as a “gotcha”, leaving my mom on the backfoot as they asked a barrage of questions like, “Does he sometimes forget to feed the pet?” “Does he make his bed every morning?”
This child psychologist knew how to use trickery to get her diagnosis. It turns out, someone who’s been trained in human psychology knows how to manipulate people–Go figure. When you realize my mother had read about how “amazing” this child psychologist was in the newspaper, you begin to see the whole scam. Meanwhile, my first grade teacher was reading in her teacher’s digest about how ADHD has become an “epidemic”. And of course concerned faces were talking about it endlessly on the evening news. It’s a well-oiled machine that ensures more insurance money flows to Big Pharma.
I’ll never forget the drive home as my mother scolded me, saying she was embarrassed and disappointed by my behavior in the waiting room. You see, my mother wanted to prove the teachers wrong, but we had fallen right into the trap they’d set, and she was blaming me. She tends to get embarrassed about such things to this day and didn’t want to eat crow.
What my mother perhaps didn’t realize was that she’d fallen into the trap that the teacher and psychiatrist set up for her, manipulating her into putting me in that situation in the first place. And if I really did have a chemical imbalance in my brain, well, she wasn’t exactly being supportive.
Nick Enlowe 