Controversy Over ADHD Diagnosis

The diagnosis of ADHD, especially in children but also in adults, has increased dramatically in the past years and received a great deal of public attention. In particular, the medicines commonly used to treat ADHD-like behaviors are prescribed so frequently that in nearly every classroom in America, at least one or two students will be taking such a medication. Add to this the ambiguous nature of the behaviors listed as symptoms for an ADHD diagnosis, and it is easy to understand why ADHD and the associated treatments are quite controversial.

How do we know if the difficulties we face are a mental disorder, or just the result of trying to put square pegs in a circular hole? Our society expects a great deal of regimentation and routine from us, especially in a public school or a workplace; for some people, this expectation is irritating but manageable, and for others it may actually feel natural. But for yet others, it may feel virtually impossible to follow strict routines, focus on tasks that are not entirely enjoyable or stimulating, and avoid giving in to perhaps more natural impulses such as runinging, playing, talking when one feels like talking, and allowing one’s attention to go wherever it goes.

Common questions people facing an ADHD diagnosis might ask include:

Does my child really have a disorder, or is it just that school is boring because she is so smart and creative?
Is my child’s hyperactivity really a problem, or does he just have a lot of energy because he is young?
Must I medicate my child to make him behave in school, or can I teach him some relaxation skills, put him in a smaller classroom, or change his diet to accomplish the same thing?
How do I know if my trouble focusing is a big enough problem to warrant treatment?

Distinguishing High Energy from ADHD

One way to distinguish between a person who is overly energetic or creative for the regimentation of school or most jobs and a person with diagnosable ADHD is to discover whether the attention problems and impulsivity occur only in one or two situations, or happen in every context of that person’s life. If a child cannot sit through math class, but has no trouble watching a two hour movie in one sitting, can carry on an intelligent conversation with an adult, and loves to play chess, ADHD is probably not an appropriate diagnosis. On the other hand, if impulsive, frantic behavior is present at school, at play, out shopping with mom or dad, talking on the phone, at the dinner table, and during bedtime stories, ADHD may be present.

How Therapy Can Help ADHD

Psychotherapy is effective for the treatment of the symptoms related to ADHD because it addresses behavior modification. Children and adults with ADHD can have a difficult time regulating their emotional and behavioral response to situations. Learning effective coping strategies is one way that these individuals can gain control over their symptoms. Therapists can also help people design a plan for organization and prioritization, key areas of difficulty for those with ADHD. When the client begins to feel like an active participant in their recovery, they become empowered and their confidence and self-esteem, which are characteristically low for people with ADHD, begin to grow. Goal setting, reward and consequence, and emotional regulation are other areas that are addressed during psychotherapy for ADHD.

Even if ADHD is not diagnosed, difficulties concentrating at school or at work can be very troublesome–no matter if we blame “the system” or the person with the attention challenges. Therapy, with or without medication, can help children and adults learn to stay more focused, manage impulses, and discover what learning and working environments and aids can help increase their attention. A therapist–especially one with a specialization in attention issue or school concerns–can work with parents, teachers, and the child in question to fine tune the learning environment to better suit the child’s learning style and needs. A therapist can also help discover whether attention issues are really the root of the problem, as in many cases learning disabilities, anxiety, anger, problems at home, or other emotional or cognitive challenges can be masked by a child’s acting out. Children can always explain their inner experience to adults; therapy can help uncover the true nature of the child’s inappropriate or troubling behavior.

The Medical Model and ADHD

In many cases a person diagnosed with ADHD will be prescribed medications by a doctor or psychiatrist to control and manage their symptoms.