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Steve Hansen Some thoughts on the rush to diagnose ADD

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Steve Hansen

Posted: Tuesday, July 24, 2012 12:00 am

"I know my husband John has ADD."

I had just received a phone call from some friends I hadn't seen in years. Mary was concerned about John's perceived impulsivity and his inability to stay on task.

"What makes you think so, Mary?" I inquired.

"I saw it discussed on one of those TV doctor shows. It fits him perfectly. Don't you agree?"

As a retired psychotherapist, I always shudder when I hear something like that. The world does not need more narcissistic TV docs making people think they are sick in order to sell self-help books.

For those who may not know, ADD is an acronym for attention deficit disorder. It's a diagnosis that has been around since the late 1930s. However, few people ever heard of it until television talk show hosts popularized the concept.

Modern textbooks describe two types: It can be with hyperactivity — ADHD — or without hyperactivity — ADD. Basically, the terms refer to people who are impulsive and have short attention spans. Symtomatology often is observed in school settings where kids can be seen daydreaming, fidgeting and sometimes being disruptive.

No one should take the little information I've provided here and assume that anyone has an attention deficit. It's far more complicated. To do so would be similar to saying: "My friend feels tired and doesn't want to eat. Therefore, she must have cancer."

Many factors play into the evaluation, which should only be made by an experienced clinician who understands differential diagnoses. The "disorder" itself can be controversial. As with most psychiatric and behavioral labels, conclusions are usually subjective and based on a totality of the evidence. At the same time, one needs to rule out other possibilities. There is no blood test for ADD.

Once a behavioral issue like this becomes popularized in the media, it's amazing how many new cases emerge. This is not meant to imply that legitimate cases of ADD and ADHD do not exist. However, it's become far too easy for many professionals to get rid of a complaining parent or patient by simply making a quick diagnosis and then recommending a stimulant medication.

In the short run, most kids' attention spans usually do show some improvement by using stimulants. But just about everyone's concentration improves with this type of medication. So, I believe it is safe to say that an anecdotal response to medication hardly confirms a diagnosis of attention deficit disorder!

But getting back to Mary's phone call, I continued:

"No, Mary. From what I know about John and based on my clinical experience, I doubt that he fits criteria for ADD. However, I'm not going to get into the difficult position of diagnosing friends or family."

I could tell she was not happy about my observations.

"Well, I think you're wrong, and I'm going to have it checked out," she concluded.

I have no doubt that Mary will find a professional who agrees with her. Suddenly, a "new" case of ADD will be "discovered."

As a result, John will take his medicine and continue to ignore the symptoms from an untreated personality disorder. At the same time, he'll get a sympathetic ear from friends and family.

The plan should work well for now — at least until the media has an opportunity to popularize another obscure and controversial diagnosis that again, will fit John "perfectly."

Steve Hansen is a Lodi writer.

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