New draft guidelines for detecting ADHD in children appear to medicalise and brand normal behaviour, if you believe the Royal Australian College of Physicians.
http://www.theaustralian.news.com.au/story/0,25197,24210209-23289,00.html

They claim that normal childhood behaviour like fidgeting will be diagnosed as ADHD, and that the numbers of children receiving medication could grow significantly.

"Features include fidgeting or squirming in their seat, blurting out answers before questions have been completed, having difficulty awaiting their turn, butting into conversations or games, and talking excessively.

Other symptoms include making careless mistakes in schoolwork, not following through on instructions, failing to finish chores, losing things and being easily distracted and often forgetful in daily activities."

When the people who stand to make money out of a practice criticise it, then I think you have to take their criticisms seriously.

I can think of some rather large Pharmeceutical giants who would be most interested in promoting this..... :)

Perhaps analogous to posters spamming the Forum, do you think, GrahamY?

Having failed to browbeat an Australian government into abandonment of the Pharmaceutical Benefits Scheme, is Big Pharma (or their factota) now trying to swamp the PBS with a wave of unsustainable costs for medication for an undefined and open ended 'condition', that of childhood?

This, from the link you gave: "The diagnosis [for ADHD] is based on the criteria developed by the American Psychiatric Association, known as DSM-IV. Children exhibiting either six symptoms of inattention or six symptoms of hyperactive and impulsive behaviour are said to have ADHD."

A covey of Yank shrinks.

Would a Yank shrink be automatically authorized to practice in Australia without specific Australian acceptance of his/her study and training credentials? Correct me if I am wrong, but I think the answer to that is 'no'. Why then accept the position of an association of such unaccredited persons with respect to diagnostic guidelines?

What is the Federal government hoping for? An excuse to have to fold on keeping the PBS because of 'financial unsustainibility'? Is it hoping to get off the hook of responsibility for such an eventual outcome by being able in due course to claim that it was the Royal Australasian College of Physicians that actually set the diagnostic guidelines?

I think Big Pharma regard the Australian PBS as effectively a prices watchdog, and an obstacle to their being able to hike prices at will in a market able to be easily guilt-tripped into spending 'whatever is necessary' on behalf of their children.

Irrespective of anything contained within the US-Australia free trade agreement, the decision as to whether or not Australia retains its PBS is a domestic political matter. No foreign interference in that is acceptable.

So retention of the PBS is a standing contradiction to the terms of the free trade agreement? Too bad. We've had a change of government since that agreement was struck.

I agree with you. When those who stand to benefit from a proposal warn against it, it IS time to take notice.

I wouldn't say ADD or ADHD are complete horsepooh, but they're near enough. Naughty kids were so much better off before it was invented, when they were held responsible for their own behaviour.

We already have too many perfectly normal kids getting branded and filled up with amphetamines. Roping more in is just crazy.

Dear Graham,

I fully agree with you. It is time
we took notice. The medical institution
has grown steadily in size. The pharmaceutical
industry has now become one of the largest
in the economy. Health insurance has become
a major personal or social cost. And many
events of life that were once considered
natural and inevitable have now been redefined
as medical and modifiable, even if they don't
involve "disease" in any clinical sense.

Hyperactive children have
long been disruptive in classrooms, where
their behaviour used to be considered a
discipline problem. Then researchers
discovered that a stimulant drug, ritalin,
had the unexpected effect of pacifying
children. Having found the "medicine,"
doctors soon discovered the "disease" of
"hyperkinesis" which, is the Greek word for
"overenergetic." I guess the only up side from
this is that offenders are now treated as
"sick" people rather than punished as "bad"
people.

Then you've got childbirth. Today it's become
a major medical event,as has getting fat,
or being unable to sleep. Medicine can even
intervene in the physical appearance of age.
Plastic surgery is booming. Death, too has
become a medical event. It usually takes place
in a clinical setting, where doctors sometimes
make judgements about whether to keep people alive
or let them die, or even hasten their deaths.
Some researchers are trying to discover how to
stop the aging process, so that we can live
forever.

What we need to do is not to let things
go unchallenged where we feel that medicine
has overextended itself. Doctors need to be
challenged by demands for patient's rights -
ranging from the right to full information,
to the right to die in dignity.

But it's not going to be easy. Medicine has
achieved an impressive position, and remains
one of the most dominant and highly regarded
institutions in our society.

My experience is that the symptoms of ADHD are definitely more commonplace in children today than they were a few decades back and, I agree, we should be concerned at the medicalisation of these and other behavioural problems.

As with depression, which is also on the rise, the pharmaceutical industry has been quick to exploit the situation and to derive huge profits through peddling its so-called cures.

My research and my own life experience has convinced me that neither condition is medical, as much as it is dietary. Both are exacerbated by the sugar-rich and nutrient-deficient junkfood diets prevalent in today's fast-paced western societies, and both can be overcome through switching to a nutrient-rich diet based on wholesome and unprocessed food.

This is a far safer and more effective treatment than medication but of course it will never be promoted because there's no easy profit in it.

When my boy was in Grade 3, two years ago, his teacher tried to have him diagnosed with ADD/ADHD, on grounds that effectively came down to the fact that he was not keeping up with her program. He was forced to undergo an evaluation process through the Health Department which fortunately did not conclude that he was "afflicted", but was lagging in some developmental indicators. It was, however, sufficiently ambiguous that it could have been used to justify medication if his mother and I had been prepared to countenance it. We were not.

That teacher took a redundancy package at the end of that year and my boy was very lucky to have a teacher in the next year who was obviously more skilled and more committed to his students. He flourished and is now at the top of his grade 5 class in several subjects, including maths, which his grade 3 teacher assured everyone he was completely incapable of learning.

I suspect that many of the poor kids who wind up on medication are simply in need of a decent teacher and some caring, committed parents. It's all too easy to allow a kid to be doped up for the convenience of the adults around him, especially time-serving teachers who have passed their use-by date. Good on the AMA.

Antiseptic

"I suspect that many of the poor kids who wind up on medication are simply in need of a decent teacher and some caring, committed parents."

I agree, 'a decent teacher and some caring, committed parents' are certainly important if children are to thrive in any educational setting.

Even the 'decent' teachers though, will soon tell you that in any given class there are usually at least two or three students, and often more, who have great difficulty in sitting still and maintaining concentration for more than a short period. They're in the same setting with the same teacher but their response is very different to the majority of the students who are focused and getting on with the task at hand.

Yes, quality teaching and loving and consistent parenting are both critical. But they don't provide the complete answer as to why an increasing percentage of students are experiencing ongoing problems with the jitters and minds that just won't focus.

One theory that was around a few years ago was that ADHD and similar 'maladies' were invented to provide an excuse to drug children. This was to be an expansive program that would eventually lead to a docile, compliant population that would be easily controlled by the politicians. I've been searching around but can't find any trace of the theory now so either it's been shot down in flames or suppressed as too near the truth. I don't know.

What could cause some reason to support the theory is the accelerating push for gun control in recent years. Also, the 'dumbing-down' of our people via mind-numbing rubbish on TV etc. An unarmed, docile, sheeplike population would be putty in the hands of their masters.

Shades of 1984, Brave New World, Logan's Run? Prophetic? I hope not.

Bronwyn,
I am uncomfortable with your Generalization about the causes of ADHD and depression. I would agree that in SOME patients this maybe so but as the basis of an absolutist statement?

There are many possible causes for Depression, some hormone driven, others organic and some like Bipolar types 1& 2 are brain chemically induced. You are right that not everyone is able to be successfully medicated and all have varying degrees of success. In some case food choices can make a difference but a cure?

EVERYONE
I have two sons who were misdiagnosed as having two different forms of ADHD suite and were for a time medicated.

One turned out to be simply under challenged, bored. Solution, Changed his school.

The other had/has Central Auditory Processing Disorder (CAPD it’s on the net)). Because of our ignorance and the misdiagnoses (plural) now in mid twenties he is suffering the consequences of not getting the right help when he needed it.

We thought he was a quiet child he tested well IQ wise and did well in primary school if a little over pedantic with his work and often slow to complete tasks. He liked structure. But his performance progressively deteriorated as he went up in high school. Sadly the real cause wasn’t suspected until year 11 a truly traumatic time.

Unlike ADHD there are specific tests for CAPD it is measurable. A friend’s child had been diagnosed as ADHD (-) and medicated with little effect. On our suggestion they had her CAPD tested and now she is doing well in high school due to the addition of Visual Cues that are there in primary school and progressively less available in high school.

My point is that not all instant diagnosis are correct. Nor that CAPD is the solution. If your child is diagnosed ADHD (-) it’s worth the effort to look for other possible explanations, we wish we had.

Examinator

"Bronwyn, I am uncomfortable with your Generalization about the causes of ADHD and depression. I would agree that in SOME patients this maybe so but as the basis of an absolutist statement? "

I made no claims whatever and certainly no 'absolutist statement' about the 'causes' of either condition.

Similarly to your comments on the causes of depression, I too see both conditions as resulting from a complex interplay of multiple genetic, environmental and lifestyle factors.

"In some case food choices can make a difference but a cure?"

Once again, I didn't claim that food choices were a 'cure'. I said they were a 'treatment'. There is a difference.

Food does affect brain chemistry. There's a lot of literature on the subject and more and more people are starting to see the connection and trying to understand it further. The dietary requirements are quite specific and take time to fine tune. With perseverance and committment though they can make a definite and sustained difference in clearing the mind, calming the nerves and lifting the mood.

Bronwyn, if we're going to discuss depression here as well as ADHD, there is plenty of evidence these days that exercise affects depression. So it may not be just what goes into the body in food, but what comes out as sweat!

I agree, Graham, exercise is a great antidote to depression.

Haven't seen any literature on it, but it probably helps with ADD too. ADD and depression are linked and the two conditions share many common characteristics. Most adults who suffer from one condition also experience at least some symptoms of the other. Not sure whether this holds for children as well, but my feeling is it certainly would once they hit adolescence.

Bronwyn,
I thought you were advocating "alternative" traetments.I obviously over interpreted your words...SORRY
While logically and ( Scientific testing, sparse though it is) there are some limited values to these (or any treatments).
I wasn't meaning to attack rather adding the missing qualifications.
(My attacks are far less subtle and reserved for far more blatant sprays with antisocial intent.)
BTW I find yours and Foxy's usual comments worth the read. Hence my disquiet with this one. Again sorry

Graham,
There is some evidence from sports medicine research literature that exercise realeases endorphins into the brain which may help (albeit temporarily) some minor depression in some people....a minor high.
However, in psychotic depression and Bipolar etc it doesn't do enough to interupt the depression. Good point though

examinator

Thanks for your kind words and gracious apology. Much appreciated.

May we long continue to cross paths on OLO!

Hyperactivity and attention deficiency and neither medical nor pharmaceutical problems. Ignore anyone in a surgery or pharmacy who thinks they are. They're talking through the back of their neck.

Anyone who loves football, tennis, swimming and playing the drums, who gets stuffed full of junk food and junk drink, and spends most of their day cooped up in a cage doing maths, physics and chemistry runs the risk of becoming hyperactive and driving their jailers to distraction.

The solution will always be to let children run free and roam wide on bellies full of good food.

Graham "when the people who stand to make money out of a practice criticise it....".

You seem to have isolated an heretofore unknown ethical bone in the body of this science who have thus far merely drugged, molested, zapped or shredded their clientele back to normalcy.

The Harry Bailley Deep Sh!t Award for you, complete with black box presentation packaging.

Bronwyn and Graham

I think you're on the right track.

I believe depression and ADHD are intimately related. They come from the same stable.

When adults are coooped up in cages, fed flour and sugar and deprived of sunlight and omega 3 fats they become depressed. When kids are cooped up in cages, deprived of omega 3 fats and fed flour, sugar and food additives they become hyperactive.

The medical solution? Drug them!

If you'll tell'm often enough, they'll believe ye'!
Once a year they (psychiatrists) hold a worldwide meeting where they discuss amongst other things, what new treatable diseases they could add to their portfolio. Here is a great response from some of these critters who look after our kids and grown-ups.
http://au.youtube.com/watch?v=bguQkX1M1Pg
Other great info:
http://www.naturalnews.com/psychiatric_drugs.html

Here are some more:
http://au.youtube.com/watch?v=Lk4hWWPv9EY&NR=1
Especially this one!
http://au.youtube.com/watch?v=-P6_FwpVo_s&feature=related

There seems to be a lot of speculation going on in this thread, by a lot of people who have no idea of they're talking about.

I've hesitated posting anything on this thread. I can just imagine some moron using this as an ad hominem attack when they disagree with me. But what the hey... As someone who had (and probably still has) ADD (not ADHD – there's a big difference) I'll share my story anyway...

When I was 15, I remember one night watching that show “Unsolved Mysteries” with my father, and I was continually asking him questions that had already been answered.

My father eventually turned to me with a curious look on his face and asked me if I ever have trouble paying attention at school. It didn't occur to me at that particular moment, but I approached him days later and told him that I had realised – after he raised the point – that I was in fact having difficulties focusing in class. My mind would uncontrollably wonder off, and I would start thinking deeply about something entirely different.

My parents took me to a psychologist who asked both my parents and myself many questions, ranging from, “did I cry a lot as a baby”, to “did I feel that I could easily relate to people my own age”. The psychologist then gave me an IQ test.

Although my IQ fell in the middle of the 'Above Average' range (intelligence has nothing to do with ADD), the areas in which I was weak – along with the responses my parents and I gave to the questions – confirmed that I did in fact have ADD.

The psychologist didn't like the idea of medication and advised that I only use it as a last resort. But a year later, after failing school despite my adequate IQ, I bit the bullet and went to see a psychiatrist for the medication. After the psychiatrist checked the psychologist's analysis, he decided (very cautiously mind you) that I was a candidate for medication. The psychiatrist then prescribed me dexamphetamine.

Continued...

...Continued

The drugs worked a treat!

While on the medication, I was getting straight A's in my classes and could focus better than most other kids. I even noticed my vocabulary increase drastically in a very short period of time.

There are many myths about ADD and ADHD. Most people don't even know the difference between the two!

It infuriates me when I hear Right-wing, armchair expert so-and-sos making ignorant comments like:

“All they need is a good whack around the backside!” or;

“Children aren't responsible for their own behaviour anymore”.

Especially since I had ADD – which is the introverted version of ADHD. In fact, babysitters and school teachers would always describe me to my parents as a “quite little angel”.

Could it be diet?

Maybe partially.

But my parents always fed me very well and would NEVER let me eat junk food at all – EVER! In fact, my parents never once fed me fast food, and lollies and ice cream only ever came at Christmas.

Is ADD/ADHD related to depression?

Probably.

In my experience, depression was the end result of many years of intense frustration and low self-esteem throughout my childhood. ADD and ADHD are extremely frustrating experiences for both children and adolescents, and one can only be frustrated for so long before that turns into depression.

In my early twenties, I was diagnosed with severe depression. I've been off the medication for years now, but I can remember the frustration and depression being so intense, that I often wished I could smash my head against a wall until I was dead.

Is ADD/ADHD a new phenomenon?

No.

Contrary to popular belief, ADD and ADHD have most-likely always exited. Children with ADD were once just considered 'quite children', and children with ADHD would have been passed-off as 'devil children'.

Is ADD a curse?

Yes and no.

While it's an extremely frustrating experience, it does have it's benefits...

http://www.mental-health-matters.com/articles/article.php?artID=836
http://www.mental-health-matters.com/articles/article_test.php?artID=836&page=1

I can honestly say I fit every one of these categories.

Continued...

...Continued

In fact some of the most influential people throughout modern history were believed to have ADD or ADHD, and it's quite obvious (especially to myself) when you look at how they behaved, what they achieved and how they achieved it. People such as Beethoven, Sir Isaac Newton, Leonardo da Vinci, Van Gogh, Winston Churchill, John F Kennedy, Thomas Edison, Benjamin Franklin, John Lennon – even comedians such as Robin Williams, Bill Cosby and Jim Carey.

Micheal Phelps has ADHD and used swimming to burn-off his excess energy. Now he holds the record for the most medals won at an Olympics.

Yes, these people achieved a lot, but believe me... For every success story, I'd be willing to bet that there are hundreds of tragic stories of undiagnosed people who died miserable because they were made to believe they were just "stupid", or "bad".

Is ADD over diagnosed?

I don't think so. If anything, ADD is under-diagnosed because children with ADD are quiet and never seen to be, or have a problem.

Is ADHD over diagnosed?

Probably.

Although, I suspect a couple of the reasons that people think it's more prevalent nowadays is because of the spread of information via technology, and the fact that we're now more aware of it.

Of course over-diagnosis is a potential, problem and we need to be cautious of that too. But we must never let ignorance win, or lose sight of the fact that there is a problem out there, and that there has been for a very long time.

AJ Philips has contributed a series of posts based on "knowledge", as opposed to other posts that are based on sheer and utter ignorance, stupidity and rigidly held false, layman "OPINION".

I stopped contributing to this ridiculous "opinion" forum some short time ago, after realising that so many of the bigoted and inaccurate "opinions" here are given a tiny degree of credence by the simple act of viewing them. Uneducated ignorance deserves to be ignored.

My grandson reads this forum occasionally and that's how I came to know of it's existence. He informed me of this topic because he knows I have experience with the subject matter.

For anyone who has any real degree of education regarding ADD, ADHD, depression, plus Aspergers Syndrome and the other various forms of autism, it would be an exercise in FUTILITY to try and "communicate" the reality of these disorders to the pathetically ignorant, bigoted, and inaccurately "opinionated" people on these woeful pages.

It's impossible to communicate with people who hold inaccurate, bigoted, ignorant lay "opinions" on serious medical subjects.

AJ Philips, I appreciate your efforts, but it's a hopeless task. This site is populated primarily by a tiny number of repeat "regulars"........ this is not a popular forum. We have well over 20 million people in Australia, and only a mere handful of them contribute to this "opinion" forum. The forum has ZERO credibility. This is because of the incredibly LOW standard of contributers, as evidenced by this topic.

For anyone who knows the "facts" about these medical disorders, I'd advise them to NOT contribute, as all you will get is a defensive ignorance in return. By contributing, you will be giving succour to that ignorant valley of "opinion".

I shall now return permanently to my retirement from this ridiculous "opinion" site.

AJPhilips, thank you very much for sharing your story.

Unlike the 'opinion' of the contributor after you, it is important for people with personal experience to tell their story.

After all, the opinions of socalled experts are quite wide ranging, not unequivocal at all.

There is probably truth in both sides. I agree with AJ in that ADHD is probably overdiagnosed. I went through a situation with my stepson when he was little. ADHD was easier to diagnose with the comfort of easy medication than the proposition that there were other factors requiring a lot more effort and committment from the adults in his life-parents and teachers.

Medicating a child should always be seen as the very last resort when all other avenues are exhausted.

Children develop at very different rates and humans beings do not all learn the same way, through auditory delivery with some visual queues. Some of us learn mainly kinestetically. It is tragic to see children fidget away while a teacher is babbling away with perfectly meaningless noise when doing or seeing makes more sense.

What concerns me is this need to come up with a 'disorder'. We know so much and are learning more about how brains develop throughout life and the different ways humans learn, yet we are becoming increasingly less tolerant when all six year olds are not behaving and learning the same way.

There is no doubt that there are disorders, but aren't we becoming very quick at comparing and judging all children to a very narrow yardstick and then looking for a pharmaceutical quick fix?

philips:"
I shall now return permanently to my retirement from this ridiculous "opinion" site"

Oh look, the signal to noise ratio has just improved.

Do take the rest of your sock puppets with you, won't you? I'm sure you need all the imaginary friends you can invent.

Yvonne:"Medicating a child should always be seen as the very last resort when all other avenues are exhausted."

Spot on. The process of assessment and diagnosis seemed to work OK for my boy, I must say, but I do wonder how much of that was because his mother and I are able to understand and offer (admittedly inexpert) opinions on the options being offered? For a parent with poor educational attainment the process must be truly daunting. It's not easy to stand up to a strongly-opinionated teacher, let alone the various experts that are rolled out through the assessment process. Mind you, I don't think it's intentionally that way, just that busy people may not choose to take the time to explain adequately to someone lacking the basic tools to understand the explanation. I suspect that some kids end up medicated largely because of the ignorance of the parents.

Yvonne:"aren't we becoming very quick at comparing and judging all children to a very narrow yardstick and then looking for a pharmaceutical quick fix"

Also spot on. There is a growing trend in out society, raised in many other threads, to treat the possibility of aberrant behaviour rather than its actual expression. "We can't take the chance" is a phrase I have grown to hate, as it nearly always means some individuals are going to suffer because some other person has done something wrong. In this context, medication is seen as a way of avoiding "taking the chance" that rambunctious kids may be disruptive for a teacher or parent. It's quite pernicious.

I'm deeply offended by some of the comments I've read here. One person even implied that depression wasn't real, like it was just medicalising something that wasn't medical at all. I've had close association with depressed people, through my nursing career. Also, I've been involved with both children and adults with seriously chronic, debilitating ADHD. Depression has had a very long, hard battle to overcome it's stigma, and only a fool these days would deny it's medical verification. Unfortunately, stigmatised conditions like ADHD are just beginning to fight the stigma battle against an uninformed general public. It's just so terribly sad that people believe it's the sufferer's fault, the parent's fault, the education system's fault, and I even had someone come up to me a few years ago blaming the Labour party and it's social policies for ADHD. Treatment for ADHD is most certainly not merely popping Ritalin down someone's throat, as has been falsely suggested. Proper treatment is a far reaching, multi faceted approach that often requires no medication, and sometimes requires medication. No one thing alone works for any one adult or one child. A specific treatment regimen may be perfect for one person, yet completely unsuitable for another, just like most medical conditions. Both my father and my grandfather have the same heart condition, yet their treatment is radically different.

A "pharmaceutical quick fix" for ADHD is precisely what the profession is NOT seeking, despite the awfully skewered, incorrect public opinion about this.

This horrible lack of understanding by some people of the devastating effects of depression and ADHD, and the causes, makes me very sad. I only pray that they themselves never suffer chronically from these debilitating disorders.

It doesn't further the debate when contributors like philips and SallyG sweepingly disparage the efforts of earlier posters, and yet make no effort to quote and refute particular statements so that those who made them can defend their positions.

It's all too easy to weigh in and make scathing comments from the lofty heights of professional superiority. It's much harder it seems to cogently argue a convincing case. No one here is about to be cowered by having qualifications waved in their faces.

We do all welcome any thoughtful and considered opinion though, whether lay or professional, and will happily debate any perceived weaknesses in our arguments with any detractors, no matter how arrogant their approach.

Hear, hear Bronwyn.

Sally, you are not the only one who has had contact with mental illness.

Antiseptic has related his personal experience with his son and ADHD and I have touched on this as well.

As for depression, and how the medical profession treats this that's a whole other can of worms.

Incidentally, I've had some 30 years experience in nursing. There is nothing more limiting to gaining a bigger and more complete picture of any medical issue as professional arrogance towards socalled 'non professionals' opinions and experiences. It never ceases to amaze me how easily 'professionals' can dismiss contrary experiences of patients and their associates. If it doesn't fit, dismiss it.

Hear, hear SallyG and AJPhilips.

You have both shown there's more than one side to the topic of ADHD, and I welcome your intelligent and well thought out contributions, based on your personal experiences and knowledge. Thank you.