Why I Don’t Believe In ADHD

A mother asks why I don’t believe in attention-deficit hyperactivity disorder, commonly known as ADHD.

First, let it be known that I don’t “believe” in any psychological/psychiatric diagnosis. I don’t “believe” in bipolar disorder, schizophrenia, oppositional defiant disorder, autism spectrum disorder, and so on. If the diagnosis is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), I don’t believe in it.

There is not one DSM diagnosis that has objective validity, meaning NONE of them have been proven to reliably correlate with any biological state. It has not been proven that any of them are genetically transmitted, for example. Isn’t it fascinating, therefore, that psychologists and psychiatrists often claim otherwise? Isn’t it fascinating that psychologists and psychiatrists often tell patients and parents that the diagnostic behaviors in question are the result of “biochemical imbalances” and “brain differences” when neither claim has been proven? Isn’t it fascinating that psychologists and psychiatrists make the foregoing assertions without having performed or ordered physical examinations? By some magic, these folks can sit across a room from a patient and without so much as touching him, tell that he inherited a gene that has caused some central nervous system anomaly. It’s absolutely amazing! How do they do that?

The answer is, they don’t do that. They are faking it. They are faking it because they don’t know what they’re talking about, so they make stuff up, stuff that has no scientific basis whatsoever, and then they charge people for it. The legal term for that is “engaging in deceptive business practices.” It’s a felony, punishable with fines and even imprisonment.

How do they get away with it? They get away with it because their licensing boards protect them. If an eight-year-old child’s parents complained to a state’s psychology licensing board that a psychologist, without ever performing or ordering a physical examination of the child, told them their son has a biochemical imbalance, diagnosed the child with ADHD – a condition, the psychologist said, inherited from the child’s father – and recommended the child begin taking a stimulant medication (that has never reliably outperformed a placebo in controlled trials), the psychology board would likely do nothing.

And by the way, hundreds of parents across the USA have told me that exact story, the only difference being that even when I encouraged them to do so, they did not report the psychologist in question for engaging in deceptive business practices. Not to my knowledge, anyway. I don’t blame them, really.

So, back to the question: Why don’t I believe in ADHD?

The answer is, I DO and I DO NOT believe in ADHD. I believe that significant numbers of children exhibit the behaviors included in the DSM’s diagnostic criteria. These kids are impulsive, highly distractible, jump randomly from one thing to another, don’t complete tasks, and so on. I DO NOT, however, believe that the children in question have biochemical imbalances, brain differences, or inherited something called attention-deficit hyperactivity disorder from their fathers, who just happen to be the parents usually accused of passing on a gene that has never been identified.

I also believe that the DSM description of ADHD describes relatively normal boy behavior (which explains why fathers are generally fingered for harboring the fictitious ADHD gene). It describes some girls, yes, but for every girl it describes, it describes three to five boys, depending on which study one references. When I was in grade school, I’m reasonably certain that I fit the DSM description for ADHD. Praise God my parents and teachers simply believed I was a candidate for motivational punishment when my classroom behavior reached a tipping point.

I DO NOT believe that the ADHD diagnosis is based on objective physiological findings. Said another way, the ADHD diagnosis, like ALL psychological diagnoses, is nothing more than a construct. By way of contrast, leukemia is not a construct. Leukemia is an objective reality. Diabetes is not a construct. Diabetes is an objective reality.

As somewhat of an aside, I also believe that early-onset autism (as opposed to that “spectrum” thing) will someday be found to have objective reality. In other words, I do not believe EOA is a construct, nor do I believe it is psychological in nature; therefore, it should not be listed in the DSM.

Concerning the drugs routinely given to children who qualify for a diagnosis of ADHD, I believe that when they “work,” they do so because of the placebo effect (a belief rooted in the findings of several peer-reviewed studies). Or they “work” because stimulants increase attention span, but then, the drugs in question will increase nearly everyone’s attention span (which is why their consumption rate increases significantly during the week of college final exams). Quite simply, as one’s attention span is increased, one’s tendency to impulsivity decreases. One does not have to “have” ADHD for these drugs to “work.”

I’ve said all of the above many times before, mostly in my syndicated newspaper column. As a consequence, I’ve been often accused of “blaming parents” for ADHD. I plead not guilty. I believe ADHD behaviors have exploded to epidemic proportions since the 1960s because beginning in the latter years of that interesting decade, America’s mental health industry successfully marketed a radically new, anti-traditional parenting paradigm to America’s parents. The paradigm in question both enabled child misbehavior and disabled parents’ ability to respond effectively.

How, exactly, did the new paradigm so disable? I will take up THAT very question in next week’s essay. Stay tuned!

Copyright 2023, John K. Rosemond