Here’s the thing about ADHD: Everybody thinks they know what it is. If you’re feeling like you have to get a report done but first you just have to check your email one more time? That’s ADHD. If you can’t stop yourself from texting in a meeting? ADHD. If your kid gets all rammy because he’s cooped up inside all day? Why, that’s a little ADD/ADHD, too, right?
The latest research tells us that ADHD is driven by the brain and its neurotransmitters, especially dopamine. But because our information-rich culture is so seductive, because recess is so scarce, because parts of the ADHD diagnosis are so broad and because everyone loves to diagnose casually, “ADHD” has become shorthand for multi-tasking and our addiction to it.
This is just the kind of cultural confusion Dr. Perri Klass tried to address in a recent New York Times article. Dr. Klass writes that in spite of the certainty that the disorder really exists…
…I’ve lately read a number of articles and essays that use attention (or its lack) as a marker and a metaphor for something larger in society — for the multitasking, the electronic distractions, the sense that the nature of concentration may be changing, that people feel nibbled at, overscheduled, distracted, irritable.
Russell Poldrack has published yet another one of the articles Klass refers to on The Huffington Post. He throws around some science-y terms, but essentially, Poldrack, a neuroscience researcher at the University of Texas, Austin, confuses a metaphor for a disorder. He writes:
It’s clear (at least to me) that the inability to focus that is being driven by the speed and richness of our informational environment bears at least some resemblance to the inattention that marks ADHD. For example, some of the diagnostic markers for ADHD in the DSM-IV (which is the guide that psychiatrists use to diagnose the disorder) include “often has trouble keeping attention on tasks,” “often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period,” and “is often easily distracted.” Sound familiar? (emphasis added)
Sure, those few clauses that are “some of diagnostic markers” will sound familiar to many people. Sure, our culture makes it hard to focus. Sure, we’re overly distracted by all kinds of attention-grabbing electronic whatnot everywhere. That’s not the same thing as ADHD. (I’d also point out to Mr. Poldrack that Perri Klass is a woman, not a man.)
Poldrack suggests that environment can influence behavior and being inattentive isn’t just the result of genetics. Sure. There are people out there who’ve been diagnosed with ADHD without a family history of the disorder.
More to the point, there are people out there who have trouble focusing and who don’t have attention deficit disorder or ADHD. Calling an aspect of modern life a brain based disorder is using that disorder as a metaphor. It’s not scientific it’s cultural. Poldrack suggests that with research we might find that all the multi-tasking and information overloading with which we live might affect “the same neurotransmitter systems that are dysfunctional in children with ADHD.” OK. We might find that’s true at some point, but, how do I say this? That’s Not the Same Thing As ADHD.
ADHD in children is a lot different. Symptoms of ADHD include, ironically, incredible focus. Children with it can be oppositional, talkative, intensely curious, painfully anxious. They can be impulsive in a way that breaks your heart because it can be hard for them to play. One of my kids has ADHD, and even though the term gets used so much that some friends almost sighed with relief — just ADHD! — when my kid’s diagnosis finally came down, the disorder and its long term risks are serious. Drug abuse, alcohol abuse, depression, and suicidal thoughts, these can all afflict teens with ADHD. And then there are the incredibly good odds that one day my incredibly impulsive kid is going to get behind the wheel of a car (a heart stopping thought). This is what comes along with “just” an ADHD diagnosis.
Perri Klass did us all a great service by teasing out what’s nature and what’s culture when it comes to ADHD. From where I sit, I think we all need to understand that living with ADHD isn’t the same thing as living with the temptations of a smart phone.
What do you think? In your experience is ADHD more about the brain or about our culture?
photo credit: Josh Giovo/ Wiki Commons