A response to Time Magazine Article, “ADHD Does Not Exist” by Richard Saul, MD
These days there’s always someone proclaiming against the diagnosis of ADHD. For instance Dr Richard Saul, a neurologist writing recently in a Time Magazine article with the rather authoritative sounding title, “ADHD Does Not Exist.”
My response? Not so fast . . .
Yes, as Dr Saul points out, there are many disorders that can look like ADHD. So does this mean that ADHD doesn’t exist? Absolutely not. Let’s not paint with so wide a brush. The real world is more subtle than that.
As an NYC child, adolescent, and adult psychiatrist, it’s particularly jarring to hear that ADHD doesn’t exist, since so many of the patients I see every day are dramatically helped by having their ADHD recognized and treated.
For instance, Rebecca (not her real name) struggled every day in school from not being able to concentrate. A decade of psychotherapy did nothing for this. Finally when she became the mother of two young children, she was overwhelmed with the stress caused by forgetting and losing things she and her children needed.
At her first visit with me, we discussed her current symptoms, and I also asked her in detail about other common symptoms of ADHD. We reviewed her childhood experiences including her school history, and I took a thorough medical history as well. I spoke with her primary care physician to make sure her laboratory studies were up to date and that there were no current medical problems. And after all this was done and I was convinced she had ADHD, we sat together and discussed treatment options.
Just knowing that there was an explanation for why she had such a hard time getting organized (you mean I’m not just lazy?) helped her immensely. She chose to try a stimulant medication (they’re the most effective for most ADHD patients), and it took a few tries before we found the right one (Vyvanse) for her.
Her daily life has markedly improved. So has her marriage.
I’d hate to have to tell her that her ADHD isn’t real. And I don’t think she’d believe me.
I agree with Dr Saul that many doctors just throw stimulant medications at patients, without carefully checking to see whether it’s ADHD or something else (such as a sleep disorder or anxiety, or trauma). But to me this just means that a patient should be careful to seek out a trained psychiatrist who is able to spend enough time finding out.
I advocate for everyone to have a thorough evaluation with a psychiatrist — even better, a child psychiatrist, who is likely to be the most highly trained in diagnosing and treating ADHD. These are the docs who through a proper evaluation can tease apart what’s truly ADHD, and what might be something else.
© Copyright Roey Pasternak, MD 2014