Is ADHD a new disorder? Is ADD the result of our modern lifestyle? Our junk food? Our addiction to gadgets, computers, the internet? It’s true that the pressures of modern life can make anyone appear to qualify as ADHD—overwhelmed, restless, stressed, forgetful, confused, making mistakes, losing things…
And I understand that you have a genetic history with ADHD, that your mother was involved in this?
Yes. Actually, my mother became involved and interested in ADHD in the 1950’s…
and at that time the current paradigm of understanding mental difficulties was really the psychoanalytic view. The people who were working with her did not find children with disruptive behaviour disorders very receptive to psychoanalysis, and so they were looking for someone who would be interested in taking on these children and so she started what became a long-term, follow-up study.
The name has undergone many different changes from Minimal Brain Dysfunction to the hyperactive child to Attention Deficit Hyperactivity Disorder to Attention Deficit Disorder. But whatever the name, the characteristics of the people who have this difficulty have stayed remarkably consistent with what was originally described by George Still in 1902;
in other words, that they have a pattern of behaviour of overactivity, restlessness, difficulty sticking with things, difficulty with focus and difficulty with holding things in mind.
I think that the core disorder has remained very consistent throughout different historical periods. What has changed is with time we have become increasingly aware of the breadth of the spectrum from many different points of view.
Early on this was a disorder which was really defined by the wild red-headed, disruptive latency age boy.
We now recognize that it’s a pattern of behaviour that can make preschool life very difficult. We’ve also recognize that even though with time adults may look less overtly hyperactive, they still have that pressured internal feeling of restlessness and difficulties with functioning. So we have broadened our definition so that we can look at the whole lifecycle.
The other thing that’s changed is initially with ADHD what people were most concerned about is the impact of being hyperactive or disruptive on the classroom, the teacher. So the children who were brought to the physician were the children who were causing trouble at school. As time has gone on, we’ve become aware that actually a lot of the disability from the patient’s point of view is not just disruptiveness to other people, but the difficulty in organizing, planning, paying attention, holding things in mind and getting things done, activities of daily living.
So there has been a big shift in our focus to recognize that where the disability of ADHD for others may be based on disruptiveness, disability of ADHD that endures through the lifecycle and causes impairment for the patient is often the difficulty with attention.
I think that if you go on Facebook or any other probe, you’re going to find that the concept of ADHD is being integrated into our social language and our conceptualization. That doesn’t necessarily mean that it’s being de-stigmatized and it doesn’t necessarily mean that it’s being adequately understood, treated, or that we have come to the point where we know how to provide these children and families with the supports that they need. So there’s been progress, but there’s actually a lot more progress that still needs to happen.
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