ADD or Me Me Me?
I read an article today about the misdiagnosis of Attention Deficit Hyperactivity Disorder (ADHD) in children – and the conclusion of this study, conducted by investigators at Michigan State, concludes that some kids are getting “diagnosed” merely because they are the youngest kids in their classes.
The true diagnosis of ADHD is based on observation of things like inattention, forgetfulness, distractibility, and at a level that causes impairments in academic performance, job performance, and relationships. In children it can be a handy diagnosis to toss at kids whose interpersonal style is disruptive, demanding etc., and in school aged kids, being the youngest, can have a significant impact on their ability to adhere to classroom rules.
Let’s shift this to adults. I don’t have enough appendages to list the number of adults who tell me they have Attention Deficit Disorder (ADD) and use this as an excuse for dismissive and rude behavior. Don’t get me wrong – some proportion of them have been worked up, and meet criteria for the disorder. And the net result of this disorder can be very unsettling for the adults who actually have it – translating into difficulty holding jobs, disrupted social relationships, and a general sense of frustration. But many people do like to walk around, having never been seen by a healthcare professional, and talk about their “ADD”. And ironically, their attentional abilities are just stellar when they are focused on their charming little selves, it just tends to erode when the needs of others are in demand.
I have watched people tune out of conversations and say – I can’t deal with sitting still like this – I am ADD. I have trouble listening to other people’s problems – I am ADD. Oh look at me fooling with my cell phone in the middle of our conversation – can’t help it – I am ADD.
That bullshit doesn’t fly with me. My initial temptation is to pull out my neuropsychological testing kit and determine whether the person has frank attentional impairment on the basis of psychometrically validated tests. If they are going to talk the talk………
Because let’s face it – how many people are really going to say – I can’t sit still and listen to you, I want to keep checking my phone for texts to see if something better is going on BECAUSE I AM NARCISSISTIC. Nope –it’s easier to simply say I have ADD.
Now, obviously some adults really do have Attention Deficit Disorder, and this diagnosis is established on the basis of interviews, observation, and testing. And in such cases, a variety of strategies can be employed ranging from medication (e.g. methylphenidate (Ritalin)) to rehabilitative strategies such as organizational skills, carefully crafted work environments, therapy, and meditation.
We live in a society where it is difficult to pay attention – no doubt about it. Blackberries and I-phones, texts and emails. Television and internet. A thousand options, and far fewer minutes. We are on a grail quest for the next best thing. Something better is usually lurking around the next corner- because in our current lexicon and culture – new is always better. New car, new house, new lover.
Lack of empathy can look like and be experienced as inattention. I once dated a man, who would literally walk out of the room when I would tell him about my day. And when I called him on it – he said,
“I’m sorry – I just have trouble paying attention”. He pays mighty fine attention to his cell phone when he hoped that someone more compelling would be available to him. But since he has ADD he probably didn’t have sufficient attentional capabilities to note that I never called him back again.
Call a duck a duck If you are selfish and narcissistic – just own it. Don’t use a legitimate neuropsychological condition as a screen.
