Post by Amtram on Aug 22, 2014 15:58:11 GMT -5
Looking through tweets tagged with #ADHD, I found an article by Jeff Emmerson entitled "ADHD: A Damaging Label That is Often Incorrect." In fact, it is one of at least a few posts on his blog that approaches the diagnosis stigma from the wrong direction, as far as I'm concerned. Worse, in this piece, he cites Dr. Joel Schwartz, who has some incredibly wrong-headed ideas about ADHD of his own. (Like it doesn't exist and Ritalin and Adderall are chemically identical to cocaine. . .)
Yes, there is a stigma about mental illnesses and neuropsychiatric conditions, but as we've seen over the last week or so, the worst part of the stigma isn't the label, but the difficulty people have getting past it and getting treatment. The solution isn't to further stigmatize the label as an artificial construct of society or a money-hungry pharmaceutical industry, but to give legitimacy to invisible illnesses so people aren't ashamed of having a diagnosis. The other solution, of course, is to expand treatment options and availability so fewer people are trying to cope with untreated invisible illnesses.
You see, when you get that diagnosis - that "label" - you can finally breathe a sigh of relief. You can stop living your life like Sisyphus, constantly trying to get your personal rock to the top of your personal hill only to have it roll right back down again. Instead of trying to do things the way everyone else does and failing, you can understand how you think, feel, and function differently, and choose to try different and more effective ways of coping and compensating for those differences. You don't need to wonder why you can't do something. You know why, and you can choose to try another way of doing it or find a way to succeed without doing things that are too difficult to do well.
When I got my diagnosis, I was 6 years old, and this was back in the 1960s. Stimulant medications had actually been in use already, but they were not common. I got play therapy that helped me learn to control myself better so that I could function in school, and once I was able to sit still in class and do my work, I was "cured." That was the way it worked back then. And, of course, the common understanding was also that you grew out of it during adolescence.
Well, here I am at 54, and I wasn't cured and I didn't grow out of it. But since everyone around me told me that I was and I had, I spent more than 30 years thinking I was lazy, unwilling to live up to my potential, incredibly stupid for someone so smart, and a plethora of other "character flaws." Let me tell you what's more damaging than a diagnosis - spending more than 30 years being all kinds of a failure and a disappointment despite working your a** off to fix something that's an inherent part of the way your brain works. There is no shortage of people willing to tell you how you didn't measure up, and they only fuel the already raging fire of the horrible things you say to yourself because these things you mess up are so easy for everyone else, how can you not do this?
In my 40s, I rediscovered ADHD when visiting our town's new library. I cried as I read "Driven to Distraction" and "Women with ADHD" and "You Mean I'm Not Lazy, Stupid, or Crazy?" At first it was because I realized that all this time, I wasn't some horrible person who just didn't put enough effort in, and if only someone had told me, I could have been so much happier. Then it was because I needed to work so hard to figure out what I had to change to make my life work better. I had had several therapists who had exhorted me to "change what you can change, accept what you can't change, and know the difference between the two," but without knowing that I still had ADHD and what that meant for me, I had absolutely no way of knowing that last one. Once I did, then I was finally free to, well, accept that there were things I couldn't change once I knew what they were, and make an intelligent, well-considered choice as to how to deal with them.
If I had known this before, that process would have been a lot smoother and less emotionally draining. When you're an adult approaching middle age, you're weighed down by emotional baggage, and have a ton of behaviors that you need to identify, unlearn, and replace with ones that are more positive and effective. This is much harder than avoiding the baggage and learning good behavioral strategies right from the get-go.
There's no guarantee that if I had gotten therapy for a longer period of time, or my parents had been better educated about ADHD, or the schools had continued to work with me after I'd stopped being overly disruptive, that I would have been able to function without medication. The fact of the matter is that at this point in my life, even with knowledge and some excellent therapy, I can't put what I know to use without stimulant medication. Believe me, I've tried. But maybe there are some kids out there who would, and that would be great. And maybe there are other kids who might need meds so they can learn better behavioral strategies, who can function without them later. And then there are some who absolutely need the meds no matter what, but can still be happy and productive because they're getting help and acceptance.
But none of that will happen if we look at ADHD as some imaginary thing that's overhyped or an excuse for bad behavior or a way to sell medications. Blaming the "label" instead of accepting that the label represents a real set of problems that we should help people with is much more damaging than the label itself.
Yes, there is a stigma about mental illnesses and neuropsychiatric conditions, but as we've seen over the last week or so, the worst part of the stigma isn't the label, but the difficulty people have getting past it and getting treatment. The solution isn't to further stigmatize the label as an artificial construct of society or a money-hungry pharmaceutical industry, but to give legitimacy to invisible illnesses so people aren't ashamed of having a diagnosis. The other solution, of course, is to expand treatment options and availability so fewer people are trying to cope with untreated invisible illnesses.
You see, when you get that diagnosis - that "label" - you can finally breathe a sigh of relief. You can stop living your life like Sisyphus, constantly trying to get your personal rock to the top of your personal hill only to have it roll right back down again. Instead of trying to do things the way everyone else does and failing, you can understand how you think, feel, and function differently, and choose to try different and more effective ways of coping and compensating for those differences. You don't need to wonder why you can't do something. You know why, and you can choose to try another way of doing it or find a way to succeed without doing things that are too difficult to do well.
When I got my diagnosis, I was 6 years old, and this was back in the 1960s. Stimulant medications had actually been in use already, but they were not common. I got play therapy that helped me learn to control myself better so that I could function in school, and once I was able to sit still in class and do my work, I was "cured." That was the way it worked back then. And, of course, the common understanding was also that you grew out of it during adolescence.
Well, here I am at 54, and I wasn't cured and I didn't grow out of it. But since everyone around me told me that I was and I had, I spent more than 30 years thinking I was lazy, unwilling to live up to my potential, incredibly stupid for someone so smart, and a plethora of other "character flaws." Let me tell you what's more damaging than a diagnosis - spending more than 30 years being all kinds of a failure and a disappointment despite working your a** off to fix something that's an inherent part of the way your brain works. There is no shortage of people willing to tell you how you didn't measure up, and they only fuel the already raging fire of the horrible things you say to yourself because these things you mess up are so easy for everyone else, how can you not do this?
In my 40s, I rediscovered ADHD when visiting our town's new library. I cried as I read "Driven to Distraction" and "Women with ADHD" and "You Mean I'm Not Lazy, Stupid, or Crazy?" At first it was because I realized that all this time, I wasn't some horrible person who just didn't put enough effort in, and if only someone had told me, I could have been so much happier. Then it was because I needed to work so hard to figure out what I had to change to make my life work better. I had had several therapists who had exhorted me to "change what you can change, accept what you can't change, and know the difference between the two," but without knowing that I still had ADHD and what that meant for me, I had absolutely no way of knowing that last one. Once I did, then I was finally free to, well, accept that there were things I couldn't change once I knew what they were, and make an intelligent, well-considered choice as to how to deal with them.
If I had known this before, that process would have been a lot smoother and less emotionally draining. When you're an adult approaching middle age, you're weighed down by emotional baggage, and have a ton of behaviors that you need to identify, unlearn, and replace with ones that are more positive and effective. This is much harder than avoiding the baggage and learning good behavioral strategies right from the get-go.
There's no guarantee that if I had gotten therapy for a longer period of time, or my parents had been better educated about ADHD, or the schools had continued to work with me after I'd stopped being overly disruptive, that I would have been able to function without medication. The fact of the matter is that at this point in my life, even with knowledge and some excellent therapy, I can't put what I know to use without stimulant medication. Believe me, I've tried. But maybe there are some kids out there who would, and that would be great. And maybe there are other kids who might need meds so they can learn better behavioral strategies, who can function without them later. And then there are some who absolutely need the meds no matter what, but can still be happy and productive because they're getting help and acceptance.
But none of that will happen if we look at ADHD as some imaginary thing that's overhyped or an excuse for bad behavior or a way to sell medications. Blaming the "label" instead of accepting that the label represents a real set of problems that we should help people with is much more damaging than the label itself.