Another ‘ADHD doesn’t exist’ article recently oozed from the blogosphere and stained the Internet with a combination of error and cruelty. Bad science–no matter how oft-repeated or popular the conclusion–is still bad science. I’ve loved science ever since I was a little kid; it pains me when it is mangled this badly.
I’ll reduce this blogger’s lengthy arguments to the two main points he made. First, he argued that behaviors that are normal at low levels don’t become abnormal simply because their frequency increases. Little kids are supposed to run around, so little kids who run around more than others aren’t abnormal, just more active versions of normal. ADHD, therefore is a fraud and doesn’t exist.
This logic, broadly applied, would eliminate much of modern medicine and save Medicare trillions of dollars:
Everyone gets tearful sometimes, so frequent tearfulness is actually normal. Depression doesn’t exist.
Everyone gets short of breath sometimes, so frequent shortness of breath is likewise normal. Heart failure and asthma don’t exist.
Everyone has some germs in the bloodstream, so more germs in the bloodstream is also normal. Septic shock doesn’t exist.
In each of these cases, it may be hard to pinpoint the exact line between normal and abnormal, but there is no question that abnormal amounts of each deserve compassionate treatment.
Second, he argued that behaviors that are normal in one context but abnormal in another are context problems, not medical conditions. He cited himself as an example. He said that the same behaviors that impaired his performance in chemistry class (which he flunked twice) have allowed him to excel in his current profession of blogging where debate and idea creation are rewarded. He recommended taking kids out of school to put them in a more stimulating environment where their ‘context problems’ just disappear.
If this line of reason made any sense, a lot of medical conditions that you thought were problematic are simply context issues:
Inability to climb stairs at 10,000 feet above sea level isn’t heart disease if it disappears at sea level. It’s a ‘context problem’.
Bathing naked at home is normal, so doing it in a public fountain isn’t exhibitionism, it’s a ‘context thing’.
Inability to hear conversation in a noisy restaurant can’t be hearing loss if it disappears when there’s no background noise. Just stop conversing in the wrong context and there’s no problem.
The ‘context problem’ argument is often used in ADHD-doesn’t-exist discussions. Pulling ADHD kids out of traditional school and placing them in a more compelling environment can help them succeed, but it doesn’t train them to work in the variety of environments—both stimulating and not—that adults need to work in. Adults who can calculate their interesting bonus checks, but not their boring taxes don’t have to worry about their ‘context problem’ as much as their ‘legal problem’.
The particular blog post that I’m excoriating here was packed full of scientific error. The blogger didn’t know that neuroscientists have found numerous abnormalities in ADHD brains. He didn’t know the science behind diagnostic symptom assessments and assumed they were arbitrary. Unfortunately, he didn’t understand the concept of impairments. He thought the word impairments means “causes hassles for lazy adults”. He didn’t appreciate that impairments refers to ruined lives: suicide, school failure, job loss, depression, auto accidents, addictions, incarcerations and relationship failures.
In short, another blogger flunked the science of ADHD. This is not surprising, given his results in high school chemistry and disinterest in improvement. Publishing bad science on the Internet doesn’t make him a scientist, even if readers agree with him. His facts don’t have a ‘context problem’; they have a ‘science problem’.
In school, class clowning can deflect attention away from one’s ignorance. In adulthood, inflammatory blogs appear to have the same purpose.
Great blog- thanks for sharing. I don’t know why I am always surprised by other’s ignorance when it comes to ADD, ADHD, depression, and anxiety but I am??? I think that this blogger has ADD- what are your thoughts Doc.? The idea of a school where kids are put in a more compelling environment has been tried and was unsuccessful. Your “context” can’t always be controlled and adapted to fit one’s needs. People need to be able to function in all different kinds of “contexts.” There is wonderful helpful information on the internet but you can’t believe everything you read and take it as truth. Our family is very thankful for you Dr. Mason!!
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Great read, thank you!
thank you dr. mason
we need refuting of this type of ignorant BS
Well done, Oren!
As I’ve always said, no one “denies” ADHD as a legitimate diagnosis like those with “in denial” ADHD. 😉
This young man, as I see it, is self-medicating with provocation and his idea of fame.
The fact that one alleged “foremost ADHD expert” planted the seeds for this type of distortion just makes it worse.
If his colleagues had called him out during the most egregious years, perhaps it could have been mitigated. Instead, the wagons were circled.
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P.S. And it’s just as one would expect from Glenn Beck’s enterprise.
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great, thank you dr. mason
i also like ginas expression “(…) self-medicating with provocation and his idea of fame”.
it may very well be possible that the authors flawed comprehension and/or lack of ability to read his sources carefully and properly (due to ADHD) play a role in this kind of unnessesary crusade…
to bad about the damage it might inflict on others.
I wonder, if i could get your opinion on the contents of the following article i came across lately:
my question is:
am I too far off, considering this as a (by the authors as well as the publishers unwittingly
performed) description/publication of a poster-boys(family) life under the condition/spell of ADHD?
makes fascinating reading, anyway –
gmy, an apology to you, as I thought I answered this months ago. Just found it today with no response. Hmmm. Did I neglect to hit ‘Send’? Again?
You are probably right. ADHD is a perfect fit for the parade of successes and failures in poor Hartley’s life. A word that was commonly used at the time was ‘ne’er-do-well’ which may be a synonym for ADHD behavior before the diagnostic description was available.
It’s not ethical for a physician to diagnose someone who hasn’t volunteered for the process, but wild guesses about the mental states of long-deceased characters are considered fair game, somehow. Not accurate, but at least entertaining.
Thanks so much for addressing this!! I have to somewhat shamefully confess I actually used to read this particular blogger’s posts….back in the day. 🙂 I’ve grown more frustrated with him over the last 6-9 months, and haven’t read him for awhile. When I saw this headline, that was the absolute last straw. Couldn’t find how to delete him from my inbox fast enough!!! (I also didn’t actually read the article….didn’t think it would be the healthiest thing for me to get that angry right now.)
I really enjoy your blog. You have a true gift for taking information that is complex and making it easy to understand. Thanks for sharing that with us!!!
Straw men for everyone!
It is not a matter of whether or not people suffer from attention problems, but rather one of whether they should all be classified as having the same axis I problem without examination of relevant biomarkers, and whether all nails start to look like amphetamine deficiencies when one only has mixed amphetamine salts in one’s toolkit.
Isn’t it both? Everyone with an attention problem deserves diagnosis *and* individualized therapy, no? My toolkit includes my relationship with my patients, a well-trained, supportive and available staff, a couple dozen medications, an equal number of proven adjuncts and infinite combinations of them all.
Thank you for your continued dedication to those of use who live this on a daily basis. I recently saw a remake with a twist of Miracle on 34th Street over the holidays. The same theme…….was Santa Clause Real. Instead of carting in letters from children in the courtoom at the end of the movie, this time the writier pulled out a dollar bill and drew everyone’s attention to the words “In God We Trust.” The lawyer argued that our government uses those iconic words on our currency even without solid proof that God exists. The point was….that the potential of taking away a belief for certain groups could be so spiritually and emotionally damagaing that sometimes believing gives people hope and faith to continue on. I immediately drew the connection between the movie and what it’s like to convince people that ADHD is real and exists.
I’m not quite sure what this bloggers ultimate intention was by trying to refute the science that exists regarding ADHD. I think it’s fear and lack of education that drives these individuals. A trait, deficit, disability, or diagnoses is not the equivalent of medical name calling as some seem to portray that image of two chidlren bullying each other on the playground. We have got to get over our fears of being different. Who cares? The reality is…there are expectations in this world and the world probably won’t bend to the minority group that has ADHD.
Medicine is a combo of science and art. I believe that Dr. Hallowell said that when considering medication for ADHD, one always has to weigh the benefits with the risks. If an individual functions and pays better attention which gives them a better quality of life at school, work, home and in realtionships, why not treat them? I’ve never seen any ADHD specialist out with a butterfly net trying to capture people to drag them into their office.
I’d only be weary if one offered me the purple Kool-Aide.