I do not find any mental diagnosis to be as controversial as that of attention deficit disorder or attention deficit hyperactivity disorder. To me, ADD is this generation’s buzz of an affliction. The medical community is divided whether or not such a disorder even exists, and I have my own prejudices about this alleged condition. The ADD Myth: How to Cultivate the Unique Gifts of Intense Personalities by Martha Burge attempts to explain ADD and devotes most of its pages to analyzing the ADD patient’s brain in a different light and to developing programs to nurture this different brain.
The first chapter, entitled “There Is No Such Thing as ADHD”, grabbed my interest immediately. For those who doubt the existence of ADD, this is the most important chapter in the book. Its subsections had such headings as “Why Schools and Parents Seek Diagnosis”, “Not All Distress or Difference Is Mental Disorder”, “Too Common to Be a Disorder”, “There is No Proof of Disorder” and “If Not Disorder, Then What?” which clearly revealed the author’s intentions. Burge states, on page one no less:
“I know I have very few standing beside me in my stance that there is no such thing as ADHD.”
Before however we become acquainted with Burge’s work, we are greeted by a foreword written by Allen Frances, MD and Chair of the DSM-IV Task Force, who writes:
“Burge describes ADD as harmful ‘myth.’ I see it more as an overdone fad. We both agree that ADD is currently being wildly overdiagnosed, but Burge would get rid of it altogether, while I endorse ADD as a useful diagnosis when cautiously and correctly applied to the small percentage of people at the far extreme of the Bell curve in their hyperactivity, impulsivity, and inattention.”
Frances is not as convinced as Burge is in regards to the mythical existence of ADD, yet he does agree to its transitory state in medical history. It is one fad that will be supplanted by another come the next generation. In the meantime, Burge as well as Frances are trying (I believe in vain) to put the brakes on the ADD bandwagon. ADD diagnoses are increasing among young children year after year. Why is there an ADD epidemic?
People want answers. Parents and teachers want a simple explanation for their children’s or students’ increased states of restlessness and inattention. Find the reason Johnny can’t sit still because it’s not his fault. An explanation is not enough, for once parents find the reason for their child’s zero attention span, they then want someone to do something about it. This is a phenomenon of our times, where no one takes responsibility for life’s bad news and everyone believes anything can be cured by a magic pill:
“I’m not one of those antidrug advocates. I believe in better living through chemistry; it’s just that this should be done with a solid understanding of the risks. Drugs should be used only when there are no other options. To prescribe such strong psychotropic drugs to children for an illness that cannot be proven seems irresponsible, particularly if the intent of the prescription is only to improve performance in school.”
Popping pills is apparently easier than finding the source of the problem. According to Burge, at least 5% of young children are taking some kind of prescription drug (like Ritalin) for their ADD, and a higher percentage among boys:
“Once there was a description of ADHD as a mental disorder and a pharmaceutical treatment option available, the disorder seemed to go in search of patients.”
Burge spends the remaining fifteen chapters of The ADD Myth talking about different kinds of intensities, or ways of perception. ADD is not a neurological disorder, she says, but merely a state of relative intensity. Those diagnosed with ADD are more intense in feeling, in absorbing information and in expressing themselves. They do not need drugs, psychiatric counselling or faddish excuses of diagnosis. ADD itself may be misdiagnosed based on sexism:
“Although I believe 100 percent of the ADHD diagnoses to be misdiagnoses, I think the reason that boys are diagnosed more than twice as often as girls is that girls are more likely to express ‘hyperactivity’ vocally.”
Thus while girls may be just as hyperactive as boys, they tend to manifest this hyperactivity in the form of stereotypical loquaciousness. While excessive talkativeness is an intense behaviour in itself such that it causes disruption and reveals the speaker’s distraction and inattention, it is not viewed in as negative a light as restlessness or loud complaining, which is more typical of the behaviour of boys. This is one of the subjective and spurious characteristics of ADD, having one trait for girls and one for boys.
Burge has done her research and finds no consistency on standard ADD testing. All such testing is based on subjective modelling, which leads to erroneous diagnoses of ADD and a convenient deus ex machina for parents who want a cure in the form of a pill named Ritalin:
“Treatment options for these ‘disorders.’ which may be nothing more than intensity, are medication and therapy. If you’ve been down this road, you have probably found the treatment to be less than ideal. Years can be spent on a path that cannot provide much help because the underlying condition isn’t understood. If intensity is treated like a mental disorder, the outcome is a sensitive person who now believes herself to be disordered. Instead of understanding and taking advantage of the growth possibilities this condition affords, she changes her self-image to fit that of a person with a disorder.”
After the profound claims Burge makes in chapter one, she spends the rest of the book outlining exercises to train the brain by managing one’s intensity. She teaches how to take in and process information and how to express oneself and live as a healthy individual. There are many exercises in meditation and imagination, as well as instructions in self-talk and in keeping a journal of one’s dreams. I had wanted to read The ADD Myth mainly for its first chapter, so it is ironic that I found the rest of the book, on Burge’s often new-agey methods for dealing with one’s own personal level of intensity, to be rather boring. However if anyone knows me as a book reviewer, I read every book to the end, no matter how spacy or boring it becomes.
Burge did not discuss a cause that I attribute to the epidemic of ADD diagnoses among children: that of our click-happy on-line world, where nothing can happen fast enough. We expect things to happen as soon as we think of them, and grow impatient if whatever we click on takes more than one second to load. Children do not have to wait as long for information as those of my generation. When I was a child, we had to change channels by getting up and walking to the TV. To make a phone call, we had to be at home or stay at home to await a call. Then we had to use a dial; we didn’t have a push-button phone till I was twenty years old. If we needed to find out information, we had to pull out the books or make a trip to the library. Today’s generation of young people have their television, their telephone, their encyclopedia, their camera and every conceivable game in the palm of their hand. It does not surprise me that children have decreased attention spans if they grow up never having to wait for anything. Their brains are not evolving as fast as technology is, thus creating a neurological “lag” that leads to attention deficit, hyperactivity and restlessness. I would be very interested in finding out the prevalence of ADD among children in societies that are not as technologically progressive. Would Amish children show traits often attributed to ADD? Would poor rural households, those without the money to pay for their child’s cellphone or high-speed Internet, be less likely to produced ADD-afflicted children?