Nick Gabel 3/8/2010 English 162 Persuasive argument

Throughout history, many individuals have experienced symptoms of what is now referred to as Attention Deficit Hyperactivity Disorder or ADHD for short. Evident as early as the 18th Century in Sir Alexander Crichtons book An Inquiry Into the Nature and Origin of Mental Derangement, he describes what he calls mental restlessness (Crichton 272). ADHD was officially added to the DSM (Diagnostic and Statistical Manual of Mental Disorders) in 1968 (Skinner 1), but only until recently has this controversial condition come under scrutiny. Despite numerous associations and academies recognizing ADHD as a valid disorder; others insist that it is a fabrication of pharmaceutical companies and modern society (Slife 204). It is these contrary thoughts which raise questions about the legitimacy of ADHD, and with apparent consequences, made evident by Russell A. Barkley in the journal Clinical Child and Family Psychology Review , We fear that inaccurate stories rendering ADHD as myth, fraud, or benign condition may cause thousands of sufferers not to seek treatment for their disorder and goes on to say Among scientists who have devoted years, if not careers, to the study of this disorder there is no controversy. (Barkley 89) Barkley, along with a vast amount of others, clearly accept the fact that ADHD is a legitimate disorder and should be treated as such. Before one can fully understand either side of the issue, a general understanding must be known about some of ADHDs causes, basic symptoms and current treatments that are offered. ADHD is marked by specific symptoms seen in adults, but occur much more frequently to the point of disruption in their day-to-day activities (DSM IV). Some symptoms of the inattentive type (previously known as ADD) include having trouble keeping attention, organizing activities, being forgetful in daily activities

and frequently losing personal belongings (DSM IV). Apart from the inattentive ADHD type, there exists a distinct impulsive type of ADHD. This separate form is marked by clear hyperactivity and impulsive behavior such as fidgeting, excessive talking, having trouble enjoying leisurely activities quietly or interrupting others (DSM IV). ADHD can also make itself evident through other psychological conditions such as anxiety or insomnia (Young et. all 203-217). As common as these symptoms may seem, modern diagnoses of ADHD are not given out like candy. Within the DSM IV are very specific criteria that distinguish this disorder from typical childhood or adolescence behavior. Thanks in largely to modern science and medicine, we have only recently been able to determine the true causes of attention deficit hyperactivity disorder. After much testing and analysis, psychiatrists, psychologists and doctors have been able to determine the chief causes of ADHD. One of these causes that have been found was discovered through the use of brain scans. Testing has shown that when carrying out executive functions, the frontal lobe, or more specifically the striatial area of the frontal lobe appeared to be less active in ADHD patients than in normal patients (Selikowitz 102). This frontal lobe deficiency has been shown to associate itself with an impairment of what are called executive functions (Selikowitz 104). These higher-order brain functions are responsible for many necessary qualities an individual would need to manage day-to-day activities and succeed in their endeavors. Some of these qualities include emotional control, planning, organization, and the ability to self-monitor (Selikowitz 104). Brian impairment, however, is not the only cause for ADHD; another large contributor to the prevalence of this disease is the presence of defected genes. Defective or abnormal variants of genes play a large role in the acquisition of ADHD. Mark Selikowitz, in his book entitled ADHD: The Facts elaborates on the hereditability of this disorder:

The figures obtained from concordance rate studies can be used to calculate the exact contribution made by genes to the causation of a disorder. This is known as the hereditability factor and in ADHD this is approximately 95%. ADHD is therefore primarily a genetic disorderthe childs environment plays only a very small part in its causation. (Selikowitz 103) Most of the genes associated with ADHD deal largely with a common neurotransmitter called dopamine (Selikowitz 111). The most studied of these genes are the dopamine receptor gene and the dopamine transporter gene (Selikowitz 114). These genes are abnormal in ADHD patients and inhibit the bodys ability to bind to dopamine and respond to changes in the brains chemical makeup (Selikowitz 115). Some of these genes are not simply confined to ADHD, but are present in other diseases as well. This is why what is called co-morbidity occurs, or the co-existence of other diseases, because of apparent similarities in genetic makeup between conditions. It is not uncommon for an individual with ADHD to experience symptoms and even be diagnosed with other similar disorders, such as mood disorders or anxiety (Gardner 42). However hopeless it may seem for individuals with ADHD, pharmaceutical companies have many different types of medications and treatments available for those suffering. One of those most common, and most scrutinized forms of treatment for ADHD, is the use of medication. These medications include various types of stimulants as well as some non-stimulant medication. Stimulants are often the go-to drug as Arthur Robin describes in his book ADHD in Adolescents: Diagnosis and Treatment, Stimulants are the first-line medications, as they appear to be the most effective and safe agents. They have been shown to be effective in ameliorating the core symptoms of ADHD, as well as improving academic productivity and social interactions. Stimulants such as Arthur Robin describes are available in many forms of medication such as Adderol, Ritalin, Cylert and Vyvanse (Robin 233). Although these medications have been proven effective, other individuals seek a

more cost efficient and sustainable alternative treatments. One of these treatments is a specially adapted dietary supplement that contains high amounts of Omega-3 and Omega-6 fatty acids, such as those found in fish decreases inattentiveness (Johnson et. all 349). With all of the data that exists, it is exceedingly hard to deny the existence of this disorder. From as early as the 1700s, ADHD has affected the lives of thousands of individuals. As much as 4.7% of Americans are affected by this condition, and as awareness is rapidly growing, more families are realizing the legitimacy of either their childrens or their own condition (Barkley 206). In recent years, the media has projected an image of greed-ridden pharmaceutical companies exploiting the concept of mental illnesses such as ADHD to create more revenue through additional medication. While the intentions of those companies are questionable, as many pharmaceutical companies have been criticized for their handling with medications, the existence of ADHD is hardly a conspiracy. Through strict criteria and painstaking research, ADHD is no more a sham than it is an accepted scientific fact. As the Diagnostic Statistical Manual of Mental Illnesses states, an individual must have a serious deficiency of a psychological mechanism that is universal to all humans (DSM-IV vii). Russell Barkley continues to elaborate on this criteria as it relates to ADHD in his journal Clinical Child and Family Psychology Review, As attested to by the numerous scientists signing this document, there is no question among the worlds leading clinical researchers that ADHD involves a serious deficiency in a set of psychological abilities and that these deficiencies pose serious harm to most individuals possessing this disorder. (Barkley 89). As ADHD typically is concerned with the mental functions and attentiveness of individuals, research has shown further physical and developmental harm that can become of an individual with ADHD. Studies done by Barkley at the National Institute of Mental Health have shown some dramatic statistics involved with ADHD patients and their tendencies. According to Dr. Barkley, ADHD sufferers

are 32-40% more likely to drop out of school, and only 5-10% actually complete college (Barkley 89). He also offers some insight into the effects ADHD can have in the lives of children and adolescents as he states, Moreover, children growing up with ADHD are more likely to experience teen pregnancy (40%) and sexually transmitted diseases (16%), to speed excessively and have multiple car accidents, to experience depression (20-30%) and personality disorders as adults (Barkley 90). These surprising statistics speak for themselves and the numerous professional organizations that recognize ADHD as a serious psychological condition. Through my own personal research, I have yet to find an established professional organization that denounces the existence of ADHD as a legitimate psychological condition, simply because you cannot deny scientific proven fact. The idea of ADHD as a means of population control and corporate greed do take root in some debatable practices but certainly do not hold true when it comes to the actual condition of ADHD. These conspiracy theories are a fabrication of the media who, in turn, deny all existing scientific data that exists about the disorder and continue to irresponsibly report such ideas as a means to create some fictitious contrast to what is currently known. Through treatment of ADHD, many critics, as well as supporters and sufferers alike have come to realize some of the successes and failures of modern treatment. Critics argue that many physicians are quick to throw a prescription at someone and in effect cure the individual of their ailments, but I personally know this is simply not true. Modern doctors and practitioners are specifically taught contrary to these thoughts. Simply labeling and stuffing pills down the throats of adolescents violates any moral and practical teachings that the world of healthcare has taught caregivers throughout the centuries. I have experienced the effects of ADHD criticism first-hand when I, as well as the other 4.7% of Americans was diagnosed with ADHD (Barkley 206) and I think that it is best to describe my experience with being diagnosed with ADHD to clarify the extent to which an individual has to go to

become diagnosed with ADHD. While I am not going to gloat or preach out of self-pity, my encounter with this disorder has given me some insight into this condition. As most Americans are, I was referred to my pediatrician by my lack of effort and concentration in the classroom by one of my teachers in elementary school. After a meeting with the pediatricians, I was then referred to a psychologist and about a week of intellectual testing. After the drawn out, but yet entertaining testing, my results were analyzed using strict and defined psychological criteria and I was found to have ADHD. It was not until a later visit and re-evaluation in high school that I was made aware of the details of the actual disorder. Due to much of the media hype and scrutiny, I was surprised to find that my pediatrician was leery on prescribing medication (mine specifically is a controlled substance) while in high school and I was going to be re-evaluated. This evaluation made me aware of the seriousness of the disorder. After filling out inventories, taking multiple IQ tests and interpreting information, I was found to have a distinction between my written and verbal IQ which consequently is the entire premise for which ADHD is built on. After weeks of testing and referrals just for an individual diagnosis, it is increasingly hard to assume that diagnoses are simply handouts, or that children are simply labeled and cured. Determining if an individual has ADHD is far too elaborate to be criticized, despite the few criticisms that do exist. Of the criticisms that do exist, there are some that hold significant value within the psychiatric community. One of these criticisms is the blatantly obvious fact that Ritalin, one of the most prescribed medication for ADHD, has devastating side effects. A leading pharmaceutical information website, RXlist.com, lists the most sommon side effects for Ritalin in their page about the drug: Nervousness and insomnia are the most common adverse reactions but are usually controlled by reducing dosage and omitting the drug in the afternoon or evening. Other reactions include hypersensitivity (including skin rash, urticaria, fever, arthralgia, exfoliative dermatitis, erythema multiforme with histopathological findings of necrotizing vasculitis, and thrombocytopenic

purpura); anorexia; nausea; dizziness; palpitations; headache; dyskinesia; drowsiness; blood pressure and pulse changes, both up and down; tachycardia; angina; cardiac arrhythmia; abdominal pain; weight loss during prolonged therapy. (RXlist.com) These are not the only listed side effects either. Rxlist goes on to list other side effects, such as Tourettes syndrome. One of the most observed side effects by both critics and pharmaceutical companies, not to mention the world alike, is death. One of the most pronounced opponents to ADHD, Dr. Fred A. Baughman, has been a clinical psychiatrist for over 35 years. He has written several books, and in one of them, he describes a death caused by Ritalin. This following passage was taken from his book; The ADHD Fraud: How psychiatry makes patients Of Normal Children: Stephanie Hall lived from January 11, 1982, until January 5, 1996, dying the morning after her Ritalin dosage was upped, a drug she has been taking for five years, beginning soon after her school initiated the process of having her diagnosed for ADD. Between 1990 and 200 there have been 186 deaths from methylphenidate according to the FDAs MedWatch program, and that number continues to rise. But this information should not hinder the everyday ADHD or ADD sufferer. Despite the many drawbacks of modern ADHD medication, there are some alternatives that have arisen. Like I mentioned earlier, the use of Omega 3 fatty acids such as in fish and other oils also helps in the treatment of ADHD. John Dye, of www.healing-arts.org elaborates on the value of nutitional supplements for ADHD treatment: Studies have indicated that certain nutritional supplements may be beneficial in ADHD. It has been argued that ADHD is not simply a disease of malnutrition however, as studies have shown that the diets of normal children do not differ significantly from those with the disorder. The concept of "biological individuality" suggests that these children may have unusual, genetically

determined biological requirements. The underlying metabolic stress and indicated nutritional support may likely vary from one child to another. (Dye 15.3) But nutritional aids arent the only idea put forth to treat ADHD. Psychologists have introduced what they call Behavioral Interventions to assist in the treatment of the disorder. Behavioral interventions are not just one-to-one general psychotherapy. They are targeted, specific techniques targeted at the problematic behaviors commonly associated with attention deficit disorder impulsivity, inattentiveness and hyperactivity. There are over 175 studies showing the effectiveness of these techniques. (Grohol) ADHD has been identified throughout our culture and cultures across the world. With new cases every day, its legitimacy cannot be denied, nor can it be ignored. Many studies and thorough neurological scans have shown the existence. Despite some of ADHDs drawbacks, such as the extreme concerns with the medications involved, this disorder can still be treated and side effects avoided. Using various nutritional programs and behavioral conferences or interventions we can avoid the darker side of medicating with pharmaceuticals. Through the treatment of ADHD, we can help to better our society in both the treatment of this disorder, and the collective understanding of ADHD. Without this understanding, some may never meet their full potential, or suffer from a number of associated risk behaviors associated with ADHD. The hindrance of diagnoses because of the interpretations of the media and few distinguished individuals is unacceptable in the world that we live in. The simple practice of research on ADHD can debunk some of these myths and clarify the legitimacy for the well-being of our society and the mental health of our family, friends and inevitably, ourselves.

Works Cited Barkley, Russel A. "Clinical Child and Family Psychology Review." International Consensus Statementon ADHD (2002): 89-92. Print. Baughman, Fred A., and Craig Hovey. The ADHD Fraud: How Psychiatry Makes "patients" of Normal Children. Canada: Trafford Pub., 2006. Print. Crichton, Alexander. An Early Description of ADHD (Inattentive Subtype): `Mental Restlessness' (1798) Print.http://kadi.myweb.uga.edu/The_Development_of_the_DSM.html Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. Washington, DC: American Psychiatric Association, 1998. Print. Dye, John M. "Treatments for Children with ADHD: Nutritional and Dietary Therapies." The Healing Center On-Line. Web. 06 Apr. 2010. <http://www.healingarts.org/children/ADHD/nutritional.htm>. Child and Adolescent Mental Health, Volume 6, Number 2, Dye, John M. "Treatments for Children with ADHD: Nutritional and Dietary Therapies." The Healing Center On-Line. Web. 02 Apr. 2010. <http://www.healing-arts.org/children/ADHD/nutritional.htm>. Gardner, Richard A. Hyperactivity, the So-called Attention-deficit Disorder, and the Group of MBD Syndromes. Cresskill, N.J.: Creative Therapeutics, 1987. Print.

Grohol, John M. "Non-Drug Alternatives for ADHD Proven Effective | World of Psychology." Psych Central - Trusted Information in Mental Health and Psychology. Web. 06 Apr. 2010. <http://psychcentral.com/blog/archives/2008/08/19/non-drug-alternatives-for-adhd-proveneffective/>. Johnson M, Ostlund S, Fransson G, Kadesj B, Gillberg C (March 2009). "Omega-3/omega-6 fatty acids for attention deficit hyperactivity disorder: a randomized placebo-controlled trial in children and adolescents". Journal of Attention Disorders 12 (5): 394401. "Ritalin (Methylphenidate Hcl) Drug Information: Uses, Side Effects, Drug Interactions and Warnings at RxList." RxList - The Internet Drug Index for Prescription Drugs and Medications. Web. 06 Apr. 2010. <http://www.rxlist.com/ritalin-drug.htm>. Robin, Arthur L. ADHD in Adolescents: Diagnosis and Treatment. New York: Guilford, 1998. Print. Selikowitz, Mark. ADHD: the Facts. Oxford: Oxford UP, 2004. Print.Dietzl, Laurie M. ": What Is Executive Functioning?" LD OnLine. 2008. Web. 23 Mar. 2010. <http://www.ldonline.org/article/What_Is_Executive_Functioning%3F>. Young, Susan, and Jessica Bramham. ADHD in Adults: a Psychological Guide to Practice. Chichester [u.a.]: Wiley, 2009. Print.