In an article published this month in the Canadian Journal of Psychiatry, McGill University psychiatrist Dr. Joel Paris says the diagnostic criteria for adult ADHD are so broad they could easily describe anyone who has trouble focusing…
ADHD, Paris said, is a neurodevelopmental disorder rooted in childhood. According to the official diagnostic criteria, an adult can’t have ADHD if he or she did not have it as a child.
“I do a lot of consultations for family doctors, a couple of hundred a year,” he said. “And some patients are coming in having received this diagnosis and stimulants without sufficient data to support it.
“They complain of various things — I can’t focus or I can’t multi-task, I can’t get things done, I’m disorganized,” he said. But they have no history of ever having been in trouble at school, or being sent to the principal’s office or pulled out of class.
“Once you’re on stimulants, and you feel they help you a little bit you may just take them for the rest of your life,” Paris said. High doses of stimulants can cause high blood pressure and arrhythmias, or erratic heart beat in people with underlying structural changes in their heart. Health Canada recently strengthened warnings that an array of ADHD drugs can increase the risk of suicidal thoughts.
Stimulants can also make mental disorders worse. “You don’t want to take speed — and this is essentially speed — if you’re schizophrenic or have bipolar disorder, anxiety disorder, sleep problems or a whole host of other psychiatric conditions,” said Dr. Allen Frances, a professor emeritus at Duke University who chaired the task force that produced the fourth version of the DSM, the Diagnostic and Statistical Manual of Mental Disorders used the world over to diagnose mental illness.
“Pharma has already created a wild and dangerous epidemic of prescription narcotics,” Frances said. “Next on its agenda is pushing the sale of prescription speed.”
“If we want to allow people to take speed for performance enhancement, or make it legal for recreational purposes, there should be a discussion of that,” said Frances, author of Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma and the Medicalization of Ordinary Life.” …
Under comments:
stmccrea • 9 days ago
Possibly the most important statement in this article may be missed in all the emotional and controversial rhetoric in the article and the comments. Namely: these drugs can be very destructive to people who have other psychiatric issues, such as psychotic symptoms, high anxiety, severe depression and/or manic behavior. As a person who works with foster kids, I have seen many examples of anxious kids (often with PTSD symptoms) given stimulants who then become manic or aggressive and are then diagnosed with “bipolar disorder” and put on antipsychotic drugs that they don’t need and that have extremely serious side effects. I have seen adults get into this pattern as well when unknowingly treated by unethical or incompetent psychiatrists who are unable or unwilling to distinguish between a side effect and a client’s actual symptoms. Fortunately, adults are much more able to inform themselves of these risks than are the children I work with.
If adults find stimulants helpful in their lives, I see no reason why they should not be able to obtain them. But I do think informed consent is extremely important, both for the reasons I stated above, and because when they are misused (as they frequently are, especially by college students, apparently), stimulants can be extremely addictive.
—- Steve
mukwah • 10 days ago
I used to love ritalin.
All Things Chronic 