Information, Ideas, and Insight into Adult ADD and related issues with the occasional inclusion of other insundry, unrelated rantings.
This issue is much too deep and much too involved to dismiss with a casual statement of “get off your lazy backside, pay attention, and conform.”
Published on April 29, 2004 By mrperky In Health & Medicine
There's a terrible conspiracy going on. It begins when a kid is restless in school (gasp!). It continues when the teacher suggests that the child may have problems with self-control (horrors!). It progresses when a pediatrician diagnoses ADHD and prescribes Ritalin (zounds!). It ends with a disconnected little child who is drugged up, alienated, and out of touch in the classroom, but is no longer restless (shivers!).

This is quite the little myth that is perpetuated by a wide range of persons, from lawyers looking for gainful employment to senators looking to get into/stay in office to contrarian medical professionals.

The basic premise is this: The drug companies, Ciba (Novartis), Eli Lilly, et al., are conspiring with Doctors and Pediatricians, the American Psychiatric Association and ADD special interests group to create a disorder that isn't there in order to sell pharmacopoeia to the so called sufferers of this disorder.

Conspiracy theory. Ahh, how sweet the sound. JFK was killed by the mafia, UFO's landed in Roswell to chat up the government officials there, and Microsoft has the common welfare of all people as its main priority. Please remove your tinfoil hats now.

It is the mythmakers' assumption that:

* Our children (ages 5 through 18) are ignorant because they think this medicine actually helps them.
* Parents are ignorant and will listen to whatever a person in authority tells them.
* Teachers are ignorant and only want a quiet classroom, the welfare of individual children be damned.
* Doctors are ignorant and only want to make money by receiving incentives from the drug companies.
* Drug companies are ignorant in thinking that no-one will see through their trickery.
* We are all ignorant because we fell for this horrible scam.
* We are all ignorant because we see improvement in our children when there is no improvement there.

Some of my rebuttal of these assumptions comes from the personal experience of 5 years in dealing with ADHD in my child and from the personal experience of dealing with ADHD and Adult ADD in myself for my entire life. However, where possible, I will show other web-based proofs when possible in order to avoid the obvious logical fallacies.

Our children (ages 5 through 18) are ignorant because they think this medicine actually helps them.

Much of the time our children are unable to express fully what the medication is doing for them. They know that they seem calmer, seem to get along better with other students, and seem to enjoy learning more than ever. As parents, we see increased study power, better interactions with peers, improved self-image from not being told “Stop that” so frequently, and better personal habits from actually being able to pay attention to the details. I have asked my son Alex, who is on Concerta, a time-release version of Ritalin, how he feels about taking the medicine. His responses are positive and indicate that he knows that his performance level is higher when he is on medication. We will frequently drop his Saturday or Sunday doses in order to monitor his reactions and make sure that dependency/addiction is not forming. The evidence abounds on the internet for the positive effects of medications for ADD. In “Ritalin: Miracle Drug Or Cop-Out?” PBS’s Ken Livingston states:

“The child for whom Ritalin (or one of the other drugs) works tends to remain "on task" longer and, therefore, tends to complete more work. This includes work on exams and homework assignments, with the result that the child's grades may actually show improvement. The child tends to become more cooperative, to follow directions better, and thus to get along better with other children and with the teacher.”

The positive effects of Ritalin are also expressed by adults who take the medication. The Informed Parent describes the response of an adult who went on Ritalin the first time in order to resolve ADD like symptoms. The patient was moved to tears at being able to complete basic tasks that required attention when he was unable to do so at all before Ritalin.

Parents are ignorant and will listen to whatever a person in authority tells them.

Are the parents in your child’s school not like the parents in mine? Are North Carolina and Texas different than the other states in the union? Is Missouri the only “Show Me” state? When a doctor says my child has a major problem, I seek a second opinion. When a teacher says my wonderful child is problematic, my first response is to question the teacher and their methods. Do we really believe that Coke is it (saw it on TV), that Rush is right (heard it on the radio) and that the congress will not raise taxes? Indeed, our country is built on the premise of challenging authority. Sorry, I’m not buying that line.

Children can have a negative reaction to the medicine. There are always some who do because body chemistry is a hard thing to figure out. When this happens, will parents leave their children on the medication because the doctor said to? If the Doctor said your child has measles, and really it’s just a broken leg, do you believe them? Any parent truly looking out for the welfare of their child will not accept what does not seem to be truth; not in advertising, not from presidential candidates, not from the church, nor from physicians.

Teachers are ignorant and only want a quiet classroom, the welfare of individual children be damned.

Are there teachers who rule with an iron fist, who squelch any self-expression, who rain on the self-image parade of their students? Sure, there are. However, the typical teacher is far from these bad examples. They care about each student and work with parents and other educators to spot problems, build self-esteem, manage personal issues, and work to bring each student’s performance up to their level of ability. I will say that we have had teachers who have been less informed on ADHD. However, each teacher has been keenly aware of the issues and has worked tirelessly to resolve conflicts.

School systems, school boards, and the state governance of schools are completely different, however. The motivation there is for the test. How does the classroom measure in the standardized test, how does it compare to other classes in the school, and how does it compare to the other schools in the district, county, region, state, or country? At that level there seems to be little care for a student as an individual. It is this failure that creates the distrust of schools that we feel and see in the media.

Doctors are ignorant and only want to make money by receiving incentives from the drug companies.

In these days of medical malpractice suits, of high-priced lawyers, and of insane jury awards, it amazes me that a doctor would not be squeaky clean in their practices. This motivation likely does not exceed, however, the ethical promise of all doctors in the Hippocratic Oath. While there are examples of doctors who are unethical, the experience I have is pediatricians and specialists do have the child’s best interests at heart. They are sometimes combative or reactive to parents who insist that they know best and that the doctor is not knowledgeable about the subject.

In adults, however, the experience seems to be less sure, particularly for the case of Adult ADD. This is such a new subject that a doctor is more likely to accept the self-diagnosis of a patient, particularly an informed patient. However, there is also a distinct decision by doctors to avoid prescribing stimulants in such situations.

Once again, as in the schools, there are controlling interests that affect the performance of a Doctor. HMO’s, Local Governments, and Hospital boards again do not have the direct interests of the patient at heart, and are instead solely interested in the bottom line. Except where such lack of interest in the patient’s welfare actually affects the bottom line.

The suggestion that the private practice physician is interested in prescribing medications based on incentives from drug manufacturers bears some examination. Every doctor’s office I’ve been in has pens, pads, signs, and other materials branded with the logos and trademarks of certain drugs or drug manufactures. Lipitor and Prilosec are two of the most recent offenders I’ve seen. Drug manufacturers also provide samples of medications to doctors as well. These samples and the advertising within the office can only be designed to increase sales of those items. However, the suggestion that the doctor will over-prescribe medications from those advertisers, to the contrary of their oath and the potential welfare of their patients, assumes that the doctor is more in the pocket of the drug company that I am willing to believe.

Drug companies are ignorant in thinking that no-one will see through their trickery.

At first glance, this seems like the Martha Stewart defense line: No one would be stupid enough to think they could get away with that. There are so many watch dog agencies, so much media attention, and so many concerned individuals that a company would never get away with perpetuating such a scam on such a large level. Since they cannot get away with cheating like this, the assumption is to think that the companies are ignorant enough to think that they can. Maybe, but it seems like a big stretch.

We are all ignorant because we fell for this horrible scam.

On this website, as well as others, I have felt the scorn, ridicule, and negative vibes coming from others because they think I am ignorant. Suggestions range from I need to be suspicious, to I have my head in the sand, to I must be completely stupid and my child will hate me for drugging them against their will for a disorder that doesn’t exist, to I need to get off my lazy rear-end and get to work.

I’m not the only one that has been told these things. The ADHD News Adult ADD forum has many examples of adults who have been denigrated by peers, parents, co-workers, and even medical professionals. Are all of us ignorant? Are so many persons, from professionals down to children, so misguided in thinking that this disorder exists and that we have it? The truth is that the disorder does exist. Also true is that the media backlash against the treatment of ADD has caused a tremendous amount of distrust of ADD and the stimulant treatments available.

We are all ignorant because we see improvement in our children when there is no improvement there.

I took two years to attain a diagnosis of ADHD for my child. I worked for over four years to understand the disorder in him, all the time recognizing many of his symptoms in myself. I’m not in a hurry to seek the diagnosis, not in a hurry to get him or myself on medication, and not in a hurry to seek an end to the symptoms. He and I will have these symptoms for our entire life.

Yet, my wife and I have placed my child on Concerta, which is a time release version of Ritalin. This medication _does_ have positive effects on his performance, outlook, and self-image. The negative effects, such as minor appetite loss, are minimal and are quite manageable.

Is this the situation for all ADHD children or ADD adults? Quite possibly. There is considerable anecdotal evidence available online stating the benefits of medication. From the website, “A journey into Attention Deficit Disorder”, a viewer wrote:

“At age 36 and only through dating a wonderful woman who was working as a Licensed Clinical Social Worker in the Emory University Neurology dept. did I discover and later receive a diagnosis of having Adult ADD. During her research to help my son who has ADD, my friend found evidence that ADD may be an inherited trait. After six months of persuasion and nearly leaving me, she finally got me to go in for an evaluation with a self-professed Adult ADD Shrink (all pun intended). Within 3 hours of taking Adderall, I felt a 180 degree turn in my attitude. Where everyday I would have an argument or confrontation with someone in the office I now was calm and quiet through meetings and with my co-workers. If you know anything about the Technical Recruiting field you know that this is a very intense line of work with massive egos and flaming tempers. For two weeks I went through an intense emotional upheaval, painfully looking back on two failed marriages and a life of bad decisions. Sometimes I would just sit and cry and others in overwhelming disbelief that I had lived that way all my life. I had been an angry little demon and had become an angry adult.” (note: Adderall is a stimulant medication for treating ADD.)

So, what are we to make of the debate over the existence of ADD and the use of stimulant medications to treat it?

Perhaps the most damning thought of all in the entire debate is that giving a stimulant medication to a child to calm them down is so contrary to common sense. Given our justified fear of stimulants anyway (speed, cocaine, etc) we have many negative connotations attached to Ritalin et al. In an address to a congressional committee, Lisa Marie Presley stated:

“I have spoken to children who have been forced to take a cocaine-like stimulant to control their behavior; I have shared their sense of sheer desperation. Children have been wrenched from their family's care simply because their parents favored an alternative, drug-free approach to addressing educational and behavioral problems. The psychotropic drugging of millions of children has to stop.” (Lisa Marie Presley Takes A Stand For Children's Rights)

This quote underlines the fear that we have of giving ADHD children stimulant medication. The problem in this fear actually comes down to ignorance. Those having the fear do not understand that the effect(s) of a stimulant on a child or adult with ADHD is completely contrary to common sense. After receiving a stimulant like Ritalin, the ADHD child will calm down, and not speed up. This result has to do with the processes that neurotransmitters in the brain go through. Brookhaven National Laboratory explains it like this:

“This latest study, on humans, indicates that Ritalin significantly increases levels of dopamine in the brain, thereby stimulating attention and motivational circuits that enhance one's ability to focus and complete tasks.”

Further stating,

"We now know that by increasing the levels of extracellular dopamine, you can activate these motivational circuits and make the tasks that children are performing seem much more exciting," said Volkow. "By raising that level of interest, you can significantly increase the ability of the child to focus on the task."

And adding,

“Volkow added that Ritalin also works to suppress "background" firing of neurons not associated with task performance, allowing the brain to transmit a clearer signal.”Random activation of other cells can distract you, and children with ADHD are easily distracted," she said. "Ritalin suppresses that background firing and accentuates the specific activation, basically increasing the signal-to-noise ratio and increasing a child's ability to focus."

Conclusion

It is my desire that this discourse has prompted you to take a second look at ADHD in children or ADD in Adults. Perhaps the debate is not as it seems due to the influencing factors of a biased media. The issue is much too deep and much too involved to dismiss with a casual statement of “get off your lazy backside, pay attention, and conform.”

Comments
on Apr 29, 2004
From someoen who has worked in the pharma industry, and seen expensive dinners, gifts and actual hookers offered to physicians .... I tend to lean toward the conspiracy on this one.
on Apr 29, 2004
My point was that it is a conspiracy throughout so many areas that the conspiracy is unsustainable. Perhaps the pharma industry is tainted, but all of the rest of the conspiracies have to be upheld or else the whole meta-conspiracy will collapse.

Could it be that there is no conspiracy, instead there are persons who pick up the negative information from the media and then use their common sense in declaring that children "should not be forced to take a cocaine-like stimulant to control their behavior."
on May 16, 2004
Can you crosspost this over to the livejournal adults_add group? Your contributions would be very welcome there I'm sure
on May 25, 2004
If a child has a disease that is properly diagnosed, medication is readily available to correct the problem. The problem with the ADHD 'diagnosis' is that there is no diagnostic tool currently available. Ritalin and its associated offbrands are being given to children who are misbehaved. That is; parents who cannot or will not take the time to instill values and discipline in their child are opting for medication instead. Medication has become the parent. All one has to do these days is watch TV to see the proliferation of medications offered to the general public. All you see these days are car and drug ads. Medication has become the quick fix for these children and may have detremental effects. I challenge anyone to offer proof that ADHD exists and that there is a diagnostic tool to either prove or disprove ADHD in anyone. Baring that I think that parents should make the decision to medicate or not, and accept the responsibility and accountability for their actions.
on Jul 02, 2004
Unfortunately, the NIH, in their consensus statement, state that while stimulant medications reduce core symptoms, they don't improve educational or social outcomes for ADD / ADHD sufferers.
on Jul 02, 2004
I have known three children who have been medicated for this, and frankly there has been zero improvement. My opinion is that there were never "sick" at all. The symptoms of ADD are far too general, and can be related to sleep problems, diet, environmentally-caused emotional problems, trouble with friends and parents, etc.

One child that I know had been removed from his parents home and was living with the grandparents, very religious people who basically hated the mother and father. The child was thrust into church, denied the right to see his parents, was overweight, shy, and thrust into a new school. The diagnosis? ADD.

As I said on the other thread, I feel for people who really may have this disorder, but for the most part I think it is a "Emperor's New Clothes" scam the majority of the time. Greeting card companies promote holidays, and drug companies promote illnesses.

on Jul 08, 2004
>>Unfortunately, the NIH, in their consensus statement, state that
>>while stimulant medications reduce core symptoms, they don't
>>improve educational or social outcomes for ADD / ADHD sufferers.

Claritin reduces the core symptoms of my allergy attacks, but doesn't improve my educational or social outcomes. Should I stop taking it?

My point being that educational or social outcomes are not the only measures of the efficacy of the drug(s). Besides, how many other factors are involved that affect social or educational outcomes? Everything from bad clothing choices to pimples and smelly feet affect you socially. Teachers, bad choices in friends, changing schools, parents, and television all affect our educational outcomes. I can't see how an effective control group can be built that can look past these factors and declare that a drug does not improve educational or social outcomes.

-- MrPerky
on Jul 08, 2004
"Claritin reduces the core symptoms of my allergy attacks, but doesn't improve my educational or social outcomes... Besides, how many other factors are involved that affect social or educational outcomes"


I think you have hit upon the main reason most people have problems with the ADD diagnosis. ALL the symptoms of ADD can be described as such, and the promise of treatment is always the promise to improve just what you seem to think is irrelevant. What you are saying is akin to "Sure, you may not see any improvement with the symptoms, but at least you don't have to worry about ADD."

Claritin advertises relief from allergy symptoms. ADD drugs advertise relief of ADD symptoms. Maybe you should watch the drug commercials again. "Is your child having problems in school?" blah, blah. You've honestly made as good a argument for the conspiracy theorists as against them.
on Jul 12, 2004
Mrperky,

I guess my comment was added to sort of say ... well if taking a medication for ADD / ADHD doesn't improve the social or educational outcomes ... there's not much else left with ADD / ADHD except the irritation of a child who won't sit quietly. The Claritin analogy isn't applicable, because it does deal with the core issue of why you take it.

Yes, you're right there's lots of things that can affect social or educational outcomes: the NIH consensus statement (The consensus panel, BTW, isn't associated with the ADD/ADHD business, but consists of respected scientists who review the literature, listen to experts and others, and arrive at a statement about their subject: in this case, ADD / ADHD) shows that, basically, there's no underlying improvement from taking stimulant medication. Sure, they sit more quietly, but ther're still subject to alcohol and drug abuse, poor education, low self-esteem, etc. Whereas Claritin "cures" my itch/sneeze, so I can concentrate on my situation etc.

Bottom line: Ritalin et.al, doesn't work on the real issue parents really want change on: positive social and educational outcomes.

on Jul 14, 2004
Jay - There are issues with ADD symptoms that need attentionoutside of positive social and educational outcomes. I mostly want to have a semblance of a normal life instead of being distracted all the time. The distractions force me to hyperfocus constantly or else risk losing my job for non-performance. ADD exists outside of children.

-- MrPerky
on Jul 14, 2004
"I mostly want to have a semblance of a normal life instead of being distracted all the time. The distractions force me to hyperfocus constantly or else risk losing my job for non-performance."


But it works backwards. They use those secondary aspects to diagnose the disease to begin with.
on Jul 16, 2004
RIght, mrperky,

I understand that (ADD doesn't go away just because you grow up). While stimulant medication works to reduce some of the symptoms, I'll respectfully suggest that it's not really that good of a solution. A far better solution is to change the brain wiring through the right type of progressive mental exercise - to expand the ability to pay attention and working memory.

We just finished working with a 15 year old kid, on academic suspension for poor grades/distractability, diagnosed with ADD. After a few months, he reported that his teachers now liked him because he was able to pay attention, he didn't "zone out" anymore when his friends were talking; and he recently won the "most improved student" award at his school. His mom recently told me they were going to reduce his medication to 1/2 dose, with a view to eliminating it entirely.

There's several programs that can possibly help with your situation ... see my posting here ... Link. Our program is good of course, and I think Brain Train was specifically designed for ADD, as was Play Attention (www.playattention.com) Good luck ...

JW