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Yes, ADHD is Over-diagnosed

BlabbingBy Rick Green,

‘Oh, everyone thinks they have ADD nowadays. It’s over-diagnosed. It’s the internet. And cell phones. And everyone’s trying to do 9 things at once. Fifty years ago there was no such thing as ADHD.’

Comments like that used to set me off on a rant, ‘Actually, no. Everyone does not have ADHD! Attention Deficit/Hyperactivity Disorder is driven by genes. It runs in families. It’s highly heritable. And it’s usually there at birth. Or even before! In fact, one doctor in our film, ADD & Loving It?! who has four sons…’

The other person would tune out. While I yammered away…

My message, though one I never openly stated, was simple: ‘You’re an idiot for saying that! You have no idea what you’re talking about!’

Actually, they may be right!

But seven years after we launched TotallyADD.com, having read a library of books on ADHD, (And co-written one book on ADHD.) interviewed scores of experts for our videos on ADHD, , thousands of adults who have ADHD (Or who love someone who does) I can see the truth in those dismissive comments.

Or should I say, SOME truth.

Which surprises me.

First, Let’s Define ‘Over-Diagnosed’

What constitutes ‘over-diagnosed’? You could argue that if even one person is diagnosed with something that they don’t actually have it’s been over-diagnosed. But that’s true of every medical condition there is.

In fact, a proper diagnosis is tricky. One of our most popular videos, Embracing the Diagnosis, lays out 13 common challenges to getting a proper ADHD diagnosis. (And how to overcome each one.)

Clearly this is not what most people mean when they claim it’s, ‘overdiagnosed.’

Perhaps what they mean is that it’s ‘misdiagnosed.’

Someone suffering from Bi-Polar, who is incorrectly diagnosed as having ADHD, is not ‘Over-Diagnosed.’ They’ve been ‘Misdiagnosed.’ They’re struggling with a real problem. It’s just not properly identified.

My public school teachers ‘Misdiagnosed’ me as bored, messy, uninterested, and slow. (And I suppose I was bored, messy, and uninterested in school.) Cause they didn’t have a better name for it. They did have a few names for me, however.

But I digress. ADHD Awkward Moment

But I don’t think ‘It’s misdiagnosed’ is what people mean when they sneer, ‘ADHD is so over-diagnosed.’

My sense is that they mean, ‘There’s nothing wrong with you that a smack on the side of the head wouldn’t fix.’ But that’s not polite to say out loud. So they suggest this mental health issue is over-diagnosed. Or that it’s not even a ‘real’ disorder.

Despite 4,000 studies and millions of people’s experience.

Alternative facts, as it were.

Consider what they actually said.

Now, let’s look at their initial ‘dismissal’ again. Read it slowly. Calmly, if you can.

‘Oh, everyone thinks they have ADD nowadays. It’s the internet. And cell phones. And everyone’s trying to do 9 things at once. ADHD is over-diagnosed. Fifty years ago there was no such thing as ADHD.’

That kind of attitude is what inspired me to make ADD & Loving It?!

It was infuriating! And total nonsense! Or is it?

Could there be a tiny bit of truth in there? Hmm..

Let’s break it down, line by line.

ADD & Loving it sale banner2

 

First…

‘Oh, everyone thinks they have ADD nowadays.’

Notice, they didn’t say everyone has ADD nowadays. They claimed that everyone thinks they do.

Which these days, might be true, right?

Well, okay, maybe not every single person on the planet, but far more than the 4 to 5% of adults who are actually struggling with this mindset have wondered if they indeed had a ‘bit of that ADHD.’

Our friend, Jennifer, set her twitter account to notify her everytime someone tweeted #ADHD or #ADD. It was astounding.

‘Overwhelmed today! I think I’m developing ADD or something!’

‘I lost my new sweater. I’m so ADHD sometimes.’

‘So antsy when my mom visited. My wife said I must have ADHD. LOL.’

So yes, you could argue that these days, with the pace of life and the amount of change, almost everyone thinks they have ADHD. It’s a bit of a joke. To those who don’t have it, anyways.

For those of us who do, who are always overwhelmed, losing things, and restless, it’s not all that funny. (Though the TotallyADD community can laugh about it with each other.)

Every ADHD specialist I’ve spoken to concedes that, yes, in some parts of the country it’s over-diagnosed amongst kids. And that needs to be addressed. In other areas it’s the opposite.

But amongst adults, ADHD is still woefully under-diagnosed. The exact figure is difficult to know. I’ve heard that less than 1 in 6 adults in North American who have this mindset are aware of it. In the rest of the world it’s even lower.

Let’s consider the next sentence:

‘It’s the internet. And cell phones.’

Based on my own experience and talking with other adults who have ADHD, we are more susceptible to the lure of the web. Endless novelty. Odd connections. Constant surprises. Anything you can think of, no waiting.

And there’s a growing body of evidence that this technology is rewiring our brains and shortening our attention spans.

But having 90 open tabs doesn’t cause ADHD. It may be something a person with ADHD does… (Sound of me clearing my throat) But it doesn’t cause ADHD… At least, that’s been the standard belief.

Internet Addiction is starting to become a series subject for research. Several years ago I read a study that found a few hours on the internet started to rewire how the brain worked. Last year an ADHD specialist told me there’s actually interest in researching whether social media and mobile technology is actually creating ADHD symptoms.

YouTube? Messaging? Poking? Tweeting? Texting? Sexting?… It does seem attention spans are shorter. Things are rushed. Messages are full of mistakes. So, yes, I’d have to concede that more and more people show some signs of ADHD.

That doesn’t mean being online all the time is creating people who qualify as having ADHD. But who knows. Time, and some reliable scientific research, will tell.

What you should know, is that doctors were describing kids who struggled with all the symptoms of ADHD long before the Internet. Or computers. Or cell phones. Or even phones. As far back as the 1700’s! (The video, ‘What Is ADHD,’ delves deep into the history of the diagnosis, the neurology, and the symptoms.)

Next statement?

‘And everyone’s trying to do 9 things at once.

I’m guilty of this. Or I was. Until research revealed that multi-tasking is not more efficient. (Dang!) I had lots happening, which felt great, but nothing finished, which caused me to pay fines and late fees.

Who isn’t doing the work of 2 people these days? Most people I know complain about being overwhelmed. Having a ton on the go is a source of pride. Or a necessity to make ends meet. And that pressure leads to overwhelm, struggling with time, distractions, restlessness, forgetting things… All signs of ADHD.

Next sentence:

‘ADHD is over-diagnosed.’

When we were making ADD & Loving It?!, the star of the program, comedian Patrick McKenna, asked Dr. Margaret Weiss about the common belief that, ‘Stimulant medications for ADHD are over-prescribed.’

Dr. Weiss paused for a moment, then explained, ‘I think that the difficulty with that statement is that it implies that medication is either over-prescribed or under prescribed.’ She admitted that many families are expecting too much from their children, filling their spare time with dozens of activities: Sports. Competitions. Music classes. Dance lessons.

Dr. Weiss also noted that the percentage of people who actually find a doctor they trust, then learn about medication, start a regimen, and stick with it, is actually a small subset of the ADHD population.

Compliance is terrible. (But that’s true of every medication.)

Every parent and most adults we’ve interviewed were extremely reluctant to try medication. Including me. 18 adults talk about our own reluctance to try a stimulant in our series on ADHD Medication.

Medication is, as one doctor points out, ‘The last thing anyone wants to try.’

Next statement?

’50 years ago there was no such thing as ADHD.’

Technically, yes, that’s true.

Half a century ago, ADHD was called Minimal Brain Dysfunction. Which a few folks think might actually be a more accurate name. (I explained why in other blogs.)

Lately specialists and researchers are framing ADHD as an Executive Function Disorder, which I kind of like as well.

So the name may change again. But doctors were describing children with ADHD-like symptoms way back in the 1700’s, and 1800’s. (Mostly German doctors. Apparently being restless, impulsive, talkative, interrupting, and scattered are not proper Teutonic traits. I wonder if they had T-Shirts, ‘Don’t be rushin’ if you’re a Prussian.’)

So, yes 50 years ago kids were diagnosed with, ‘Minimal Brain Dysfunction.’ If they were lucky. If they weren’t lucky, they were labeled as lazy, stupid, trouble-maker, difficult, underachiever, or loser. And the treatment plan was simple: ‘Try Harder.’

As for Adult ADHD? That wasn’t on anyone’s radar until the late 1980’s.

Okay, the final statement:

‘I don’t believe in ADHD. I think it’s just an excuse.’

Okay… Hmm. Technically, that’s true. They honestly believe ADHD is an excuse. Fine. They can believe whatever they like.

I used to argue with them. But then I realized that’s what I used to think before I was diagnosed.

And in fact, more than one person with ADHD has confessed to me that when they were first diagnosed they did use it as an excuse now and then.

Difficult not to, especially in the early days.

I can tell you that most people soften their opinions when they learn about things like the genetic research, the neuro-imaging studies that shows ‘this brain is different,’ the role of neuro-transmitters, and especially, the difference that treatment makes.

But education takes time. And if you push people… it backfires.

Any first year Psychology student can tell you that no human being has ever changed their mind when told, ‘You’re an idiot for saying that! You have no idea what you’re talking about!’

It took me years to realize this. (Eventually, I discovered a much better strategy. See below.)

Three Ways to Deal With Denial?

So, how do you change people’s minds? Here are five strategies.

Strategy #1: Be generous! ‘You may be right,’ is a more diplomatic way of saying, ‘Yes, and pigs may fly.’

Strategy #2: Show them ADD & Loving It?! Scores of people have thanked us for making this film. It transformed how their spouse, parent, colleague, or relatives viewed ADHD. ‘They finally got it!’ It’s funny, dark, surprising, and built on solid science.

My whole purpose in creating this program was to get through to people who were dismissive of my own ADHD. I was shocked to learn how many people have had their stubborn beliefs and dismissive opinions swept aside by this. When I asked one of the ADHD specialists I talk to a lot, he said it works because it’s not a ‘the person who has it trying to convince them. The family has already dismissed the person’s claims. They can talk themselves blue in the face, and it will only make other people even more entrenched in their beliefs. Plus, you have a wide range of experts, and you have a lot of humor, and Patrick and Janis’s story touches people in a way that medical checklists never will.’

The Simplest Option?

Strategy #3: Don’t bother. Life is short. Just nod and walk away. Save your breath. And use your energy to deal with your ADHD so you can get on with your life.

You are not the ‘Idiot Whisperer.’

I like this strategy. But I’ve never been able to do it. (Too self-righteous I suppose.)

ORIGINALLY PUBLISHED: Yes, ADHD is Over-diagnosed

February 2, 2017 Rick Green

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9 Responses to “Yes, ADHD is Over-diagnosed”

  1. tashg says:

    We just had my daughter EEG brain scanned whilst in the US: bigly ADD – it’s UUUUGE. It helps with the previous denial within and outside the family and I’m hoping that SCIENCE data will help with school and others as well….

    . My friends are a bit irritated that I say Blah blah blah this is because of my ADD all the time, but I only got diagnosed a coupla years back and it’s still a bit freaky how much that stuff drives EVERYTHING in the brain. So yes I do go on a bit much. They don’t say I don’t have it though … they’re too busy dealing with patiently sending me back stuff that I left in their houses from my last visit :D.

  2. ladygogo says:

    Rick, like strategy # 3. yeah, it’s the smart thing to do.

    I just never have the self control to do it. :-0

    They should have a school where you could go and practice, like karate moves or something.

  3. bleachboy10 says:

    LOL!The end was the best, well, I read it all and it was all good but sometimes we just have to face the fact that, You’re not the Idiot Whisperer.”
    thanks!

  4. Rick says:

    Keep learning more, Wayne.
    Our video ‘Facing the World’ gives some great tips on how to handle people who are dismissive, ignorant, or hostile, and have no idea what they are talking about.
    The best strategy that I’ve found, after almost a decade of arguing, is to simply ask questions that expose the fact that the person is perpetuating myths or doesn’t know the facts. (Lots of very nice people have no idea. At one point before I was diagnosed, I was probably one of them.)
    For example someone says: “I think parents are just relying on drugs because they’re too lazy to discipline their kids.”
    I get flushed and angry, I notice I’m about to ape-snot on them, and I force myself to breathe, smile, pause, and then ask, “Maybe. But think of a dozen parents you know… how many of them are casual about putting their kids on drugs? How many parents do you know who’s first reaction to the possibility of ADHD would be, “Well, let’s just put them on a stimulant medication, and if that doesn’t work we’ll look at diet, supplements, better sleep habits and so on…”
    The other person usually is silent. Thinking. Then a sheepish smile… “Hmm, good point.”
    Works much better than, “Don’t be stupid!!! What parent…”

  5. mcfarlane says:

    When I hear,” ADHD is Over- Diagnose” or I don’t believe in ADHD”, it usually mean that the person who made the statement is too lazy to look into ADHD and has chosen to be ignorant about ADHD. All students are our future.
    Wayne ( trying to learn more) McFarlane

  6. Rick says:

    Steph, I agree that it’s a shame that the ADHD assessment isn’t covered by the Canadian Health Care system. What I suggest, and what I did… (And come to think of it, the whole reason ADHD has become my mission in life)… is to get as educated as you can ahead of time, before you see a doctor.
    For people who are concerned that they may have this mindset but are unable to afford a proper diagnosis, or can’t find a doctor who knows how to do a proper assessment, learning more by watching videos is so powerful.

    You arrive at the doctor’s educated and up to speed. And if the doctor is unqualified, you’ll recognize it quickly, and save yourself time, money, and frustration.

    A young woman I know has become a doctor spent part of her internship in the hospital’s psychiatric clinic. She was astonished that the leading psychiatrist had a copy of our book, ‘ADD Stole My Car Keys’ and was recommending it to all of his patents, saying it was the best book in the world for presenting the adult symptoms in a way that people got it, and actually enjoyed the process of learning. What shocked her, was that the Doctor had been recommending the book for several years, but had never heard of TotallyADD.com!!

    “Oh? They have a website?” He had no idea.

  7. Rick says:

    Wow, Brett, thanks for the kind words! A thrill to be included with Dr. Hallowell, who has done so much to lower people’s fear.
    I’m so glad what we’re doing at TotallyADD is making a difference for you and your clients. Thanks for spreading the word. I hope our video on Coaching is helpful for people who are unsure about what you do, or how coaching works, or the difference it makes. It addresses every concern I had, or that I’ve heard from other people who are undecided. And it’s pretty darn funny. http://totallyaddshop.com/products/add-and-coaching#.V03E7teSMRo

  8. brett says:

    Rick, this is such a FANTASTIC post!! I’ve ben a long-time follower (and a Professional ADHD Coach) and I’ve used so many of the strategies that you mention here, many of which I’ve picked up by purchasing and watching your videos, as well as becoming a member a few years ago now, of TotallyADD.com. I recommend your site to practically everyone of my clients. Partly because it is Canadian based (I’m in Newfoundland, and it is brutally difficult to find great Canadian Content with respect to ADHD) but mostly because I honestly believe that it has become one of the greatest online ADHD resources that exists… anywhere! The way you walk the fine line between the poignancy and ridiculousness of ADHD is nothing short of brilliant. I’m a big fan! I credit two individuals as my “ADHD Heroes” since my diagnosis 7 years ago at age 42. You and Dr. Hallowell. It’s by listening, reading and watching you both that I was able to find the energy to take a strength-based approach to my own ADHD and find my calling to become a Coach. And sometimes I forget to feel (and express) gratitude for those who inspired me…. but it’s blogs like this that wake me from my preoccupation with the work of building my coaching practice into something viable, and my own world in general, and remember that I didn’t get here alone. Thanks for all you do, Rick!

    Brett Thornhill

  9. steph says:

    Hi Rick,

    Well said. Life is short. My 15-year-old son had just been diagnosed and trying to convince explain it to his grandparents is some days like pushing water up a hill.

    I also wanted to thank you. “ADD and Loving it?!” opened my eyes and mind. It was mentioned to us by a counsellor that our son may be battling this and he recommended watching your documentary. By the end of if, we turned to each other and were “yeah, let’s get him tested”. Just sad that in Canada, the full psychological testing needed for adolescents isn’t covered. I could really rant on that one, but that would be an entirely different conversation.

    Thank you for this site. It’s been a great source of support for my husband and I. Just wish that there was a section that specifically targets adolescents. Teenage years and ADHD is a hell of a combination.

    Cheers,
    Steph

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