CHAPTER 1

There Is No Such Thing as ADHD

The hardest part about gaining any new idea is sweeping out the false ideaoccupying that niche. As long as that niche is occupied, evidence and proof andlogical demonstration get nowhere. But once the niche is emptied of the wrongidea that has been filling it—once you can honestly say, "I don't know," then itbecomes possible to get at the truth.

—Robert A. Heinlein, The Cat Who Walks Through Walls

I know I have very few standing beside me in my stance that there is no suchthing as ADHD. The vast majority of psychiatrists, psychologists, educators,parents, and others believe at their core that ADHD is truly a disorder. I'm notanticipating that this little book will change their minds. The ideas they haveare well substantiated by years of practice and documentation. The longer theseideas exist, the more valid they appear.

I contend that while perhaps well-meaning, this description of intense people ashaving a disorder is a farce. Millions of people have been taken in by it, andmost of them believe that their participation in the farce is in the bestinterest of their patients, their children, and themselves. It is with greatconviction that I tell you that labeling these people as disordered not only isan error, but also contributes to creating the dis-ease it intends to treat bywithholding the understanding and development of their true intense and giftednature.

THE DSM AND A CULTURE OF DISORDER

ADHD began as a construct in someone's mind. Psychiatrists see mental disordersor potential signs of mental disorder in every patient that presents to them.The very fact that a person goes to see a psychiatrist means that thepsychiatrist must find a diagnosis in order to bill for the visit. It's a rewardsystem. Find a diagnosis, get paid. It's that simple. The possible diagnoses arefound in the DSM, which is created by consensus of a group of people whoregularly get together and publish a book. This book contains descriptions ofevery mental disorder. By definition, if a condition is in the book, it's adisorder; if it's not in the book, it's normal. You can see how important thisone book is to the way we see ourselves in this culture.

The DSM is sometimes treated like the Bible of the psychiatric profession. Itstates its primary purpose is to provide a guide for clinical practice indiagnosing psychiatric disorders. Because we are forever learning aboutdisorders, the DSM goes through a continual review process, resulting in newversions being published every few years. The DSM-5 is scheduled to be releasedin May 2013.

As happens with manuals like this one, people who use it tend to anoint it withpowers beyond its intent. It is sometimes seen to define the entirety of mentalhealth and disorder. Common sense tells us that there is no way a singlereference book can include all the information needed to identify every type ofmental disorder that exists within the human population. We can also guess thatwith such a broad scope, there is at least a possibility that the criteriasupplied could be used to indicate disorder within what should be healthy humandifferences. But the glow around the book continues.

Before the first printing of the DSM, little had been done to categorize mentaldisorders. Each mental hospital had its own system. The federal government wasinterested in collecting statistics on mental disorders, but the lack of aunified system to categorize these disorders made the effort impossible. As aresult, the American Psychiatric Association (APA) took on the challenge toproduce a system that could be used nationwide. The first printing of the DSMwas based on input from both mental hospitals and the Department of VeteransAffairs. Considering the sources, there wasn't much emphasis on childhooddisorders or development.

In 1966 Dr. Samuel Clements wrote an article on minimal brain dysfunction inwhich he describes a number of learning or behavioral disabilities found inchildren with average to above-average intelligence. He identified the effect onmotor activity and attention span. The label "minimal brain dysfunction" likelyresulted from the fact that he believed the cause of these disabilities to beminor damage to the brain stem. This may have been the first formally accepteddescription of ADHD, although it has been recognized in one form or another bymental health professionals for at least a century.

By the time DSM-II was printed in 1968, the label had been adjusted to"hyperkinetic reaction of childhood or adolescence" with a one-line description:"This disorder is characterized by overactivity, restlessness, distractibility,and short attention span, especially in young children; the behavior usuallydiminishes in adolescence." This change reflects the APA's efforts to avoidlabeling a disorder according to the cause of the disorder, mostly because theyknew they were only guessing at the cause. There was no evidence of differencesin brain structure or functioning. By this time, Ritalin was already in use totreat hyperactivity.

MEDICATION GOES IN SEARCH OF PATIENTS

Once there was a description of ADHD as a mental disorder and a pharmaceuticaltreatment option available, the disorder seemed to go in search of patients.This practice is very different than the treatment of any other type of mentaldisorder. In the case of paranoia or schizophrenia, the patients bringthemselves to the doctor for treatment. ADHD goes in search of patients, muchlike many newly discovered and much-advertised physical ailments such asrestless legs syndrome. "Ask your doctor!" It should be no surprise that thepharmaceutical companies are paying for those ads. But are they also fundingADHD awareness?

Medication for ADHD is a multibillion-dollar industry. It's clear that thepharmaceutical companies have a lot to gain from an increase in diagnosis. It'salso becoming clear that they have the resources to influence the outcome.

In 1987 CHADD (Children and Adults with ADHD) was founded to support people withADHD. According to a transcript from PBS NewsHour's Merrow Report, CHADD wasfunded by Ciba-Geigy, secretly...