Streams

Does ADHD Exist?

Tuesday, February 18, 2014

Behavioral neurologist Dr. Richard Saul argues that ADHD, one of the fastest growing and widely diagnosed conditions, is not a condition on its own, but is a symptom complex caused by over 20 separate conditions, from poor eyesight to bipolar disorder to depression, each of which requires its own specific treatment. He's the author of ADHD Does Not Exist: The Truth About Attention Deficit and Hyperactive Disorder

Guests:

Dr. Richard Saul
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Comments [34]

Stavros Saripanidis from Thessaloniki, Greece

This hyperactivity can be due to organic brain lesions, or be a consequence of the neglecting the child.
Child hyperactivity leads it to chaos, because it moves in space without purpose.

Hyperactivity is characterized by high kinetic activity of the child, but this is without purpose, with children going from one task to another.

As toddlers, no one could employ them in a game for a long time.
At 6-10 years of age, they still do not know how to play.
Playing is very important for spiritual growth and personality formation for a child.

These children leave unnecessarily their position in the classroom, disturbing others, creating discipline problems.
"Without movement with purpose, there is no perception, learning or knowledge." Maria Summer (1984)

In hyperactivity, we should bring the child to movement with purpose. For this to happen, and for the child to learn to observe, they must first come into harmony with their breathing, experience tranquility and relaxation.

Perception is a continuous process, which is constantly changing with the addition of experience (5-6 years of age), with the ability to discriminate, with the development of abstract thinking.

So, perception is an important prerequisite for the development of cognitive processes-functions.
Vision and hearing play an important role in perception.

A hyperactive child is not growing spiritually, only physically.
It is wrong to be severe or punish hyperactive children, as this may exacerbate the problem and their disorders.

Management and treatment of hyperactivity and ADHD, without drugs.
When affecting the movement of the child, there is a problem in soul-body-breath.

In our view, hyperactive children should be treated as a whole, holistic method of treatment (ganzheitstherapie).

This method, developed and perfected by Maria Summer in Rankweil Austria, is for quick and effective treatment of disorders of speech, voice, breathing and learning, in approximately 60 sessions, without medication.

Myokinetic exercises invented and perfected by Maria Summer are not gymnastics, rhythmic exercise, yoga, or meditation.

Athanasios G. Chasapis, Psychologist-Specialist speech therapist using the holistic method.

Stavros Saripanidis, Consultant in Obstetrics and Gynaecology.

Chasapis Athanasios studied, for many years, at the speech therapist Center and Institute of breathing run by Mrs. Maria Summer, and participated in many seminars for Advanced Speech Therapy abroad.

He then transferred and extensively used these practices of the holistic method (speech-voice-breathing-attention-learning disorders-etc.) in his speech therapy Practice in Greece, from 1982 until now.

He is the author of a forthcoming book in German, which describes extensively the pioneering holistic method of Mrs. Maria Summer, who died in 2007, without leaving a textbook behind.

Feb. 23 2014 10:10 PM
asdf

Not the host's fault but this segment needs a rebutting guest to call this one out on some of his statements and put his entire position into context. I am not that rebutting guest, however, I am confident that what this guest is really describing has nothing to do with ADD/ADHD directly. It is an indictment against Obamacare.

Drugs cost 10 dollars per month. Cognitive Psych .therapy costs around $100 per session, max 16 sessions annually AFTER deductible. ADHD coaching costs around $200 per hour (not covered by insurance). These therapies are excellent and ought to be employed as steps that precede drugs, but many people cannot afford the extra $2,000-$20,000 per year required.

No doctor would disagree that lousy vs. good treatment for ADD/ADHD summarizes the essential difference between health care vs. health insurance/Obamacare.

Feb. 22 2014 12:02 PM
bkparent from NYC

The guy's argument is sort of a mish mash. He seems to say that it is overdiagnosed, therefore it doesn't exist; and also that maybe kids are just bored, not getting enough exercise, or have parents who want to put their kids on drugs to improve their grades which he says is "fairly common" whatever that means. Or maybe its actually Aspergers! (Seriously?!?)

If you experience the symptoms of ADHD and respond to the treatment - and, as some of the other commenters note, this actually allows you to live a productive life within our modern society -- then his analysis is not particularly meaningful or helpful. And if you don't, then just get a life and stop beating up on people who take stimulants for attentional problems. And, speaking of the side effects, you know what is depressing? Untreated attention problems.

I'm sorry, but this guy is making a very poor impression.

Feb. 21 2014 11:04 PM
Timothy A. Perez from US

LET ME SET THE RECORD STRAIGHT.

ADHD is a real condition, that has been over-diagnosed as well as mis-diagnosed and thus has created a tarnished image of being a "fake" disorder. So it makes the people with real ADHD seem less legitimate.

I am an adult with moderately high ADHD, who has had it since childhood, and I would not function properly in society and everyday life without medications. I would consider myself successful in my career and family life. However, without medication and management techniques I would have tremendous difficulty performing even simple tasks most people do on a daily basis.

If anyone ever has a question of authenticity in regards to the subject of ADHD being a disorder, I say talk to me first.

The best metaphor I can use to describe what it's like to live with this condition is having a multi-core CPU supercomputer for a brain, except you're cpu (brain) only has a fraction of the power it needs (dopamine) to run properly.

So in conclusion, I'm greatly offended by the implied statement that it doesn't exist. However, I could agree that perhaps there's a subset of ADHD just as there are multiple forms of autism.

Feb. 21 2014 12:19 PM
Douglas Kelban from Bellmore, N.Y.

While I, as a mental health professional, agree on the need for thorough evaluation, including neurological, neuropsychological, and psychiatric evaluation, with concerns for co-morbid conditions, and not just giving medication to every problematic child as a matter of course, I find even the title of his book misleading and harmful. ADHD DOES definately exist, and differences in brain function between ADHD kids and kids without it confirm it. The title of the book (and maybe the book itself is better: I admit I haven't read it) sounds like the typical dramatic, self-promoting titles professionals use to sell a lot of books. Anyone who would actually claim that ADHD actually doesn't exist as an syndrome in it's own right, is doing a grave disservice to parents and children who must deal with it. As for medication paranoia, I have seen myself, and studies bear out, the dramatic difference proper medication can make in the lives of ADHD children who truly need it: the rate of future dropping out of school, trouble, and drug abuse is much higher in non-treated children with ADHD. It seems that the truth Dr. Saul is really illustrating, judging by the title of the book, is that he likes money and wants to sell a lot of books.

Feb. 21 2014 08:10 AM
Judith

Listening to this program is very upsetting. When my son was on Ritalin his IQ rose by 18 points:140. He was periodically tested and went to physiatrist even after medical benefits expired. Your guest seems limited in interacting with children in the classroom or at home.

Feb. 20 2014 11:44 PM
Marvin Berman PhD from Ridgewood, NJ

I am sorry I missed the show and in many ways agree with Dr. Saul and would like to add that there are empirically validated ways of assessing brain activity that can support or disconfirm a diagnosis of ADHD. It is also quite possible to remediate the behavioral and emotional challenges that folks face with non-drug, non-invasive techniques that have been proven in the scientific sense of the word effective. In fact, the American Academy of Pediatrics has noted that EEG biofeedback training is as effective as medication and behavioral interventions in the treatment of ADHD. I'm a provider of this type of training and there are many other providers in the NYC area who offer this type of help that can deliver a permanent resolution of these types of symptoms. www.quietmindassoc.com

Feb. 20 2014 03:45 PM
rh from nyc area

It begs the bigger question - can something diagnosed purely based on symptoms be called a disease? Autism is diagnosed only based on symptoms. ADHD is diagnosed purely based on symptoms.

People just don't get that kids are just the same as they were before, except we used to say kids were obnoxious, rude, antsy, energetic, disrespectful, any of a host of behavioral traits. Now we diagnose, medicate, and classify them.

If your kid has a symptom that is affecting their schoolwork, try to find the medical or psychological cause, and only medicate if it is crippling. My friend doesn't like that her 11 year old daughter is rude and disrespectful, and insists she has a psychological condition. Yet she lets her daughter get away with murder (like hitting her mother in public, swearing, arguing in public). The girl has been on multiple medications and is getting side effects from them. Who is the sick one?

In that regard, it reminds me of the Belgian child euthanasia law. No one has to prove that the child is indeed suffering unbearable pain, just that the parent insists that the parent cannot take seeing their child in pain any more.

Feb. 19 2014 05:26 PM
thatgirl from manhattan

Stephen - No matter what consumers/patients ask for, be that an antihistamine or an antibiotic (the latter of which is never advertised to consumers--so very many are not), the doctor him/herself has the final word on whether the patient will be prescribed what's demanded--or anything, for that matter. If our doctor's simply caved to our "demands" for drugs we supposedly see on television and otherwise, then it's time to question the doctors' rationale for same, no?

Managed care demands that doctors provide a diagnostic code in order to treat a condition in any way--pharmaceutically or otherwise. If a doctor diagnoses, then it's to the doctor.

Advertising, as you know, doesn't automatically create demand. Someone would have to identify with it in order to even remember it, and in this culture of DVR-ing, channel surfing and multitasking, it's doubtful advertising alone is driving them to the doctors' offices to make these "demands." Consumers are researching their conditions to the nth degree via the internet, which hosts no end to information about both conditions and medications, much of it not considered advertising at all. Would you deny them this source of information? Would it be better that they could only access information via doctors, not all of which are equitably educated? Certainly not.

And would you assign Rx drug television (and otherwise) advertising with really comprising "information?" The FDA doesn't allow any performance claims whatsoever for drug advertising; listen to the copy some time. most of the 30 second real estate is filled with the required disclaimers such that it would be impossible, even if claims were allowed.

The AMA can't "ban" Rx advertising--and won't. They are as beholden to the pharma industry as anyone in this equation. Congress won't do it, either--pharma's allowed to lobby them. No ending that cash source soon.

So what to do? Continue to teach critical thinking skills that filter for marketing messages, versus valuable information, perhaps, but given the small percentage of drugs that are actually marketed to consumers (really--it's a vast landscape, and few brands can afford that kind of bandwidth), somehow "banning" it won't help; it hasn't stopped liquor or cigarette consumption, has it?

Feb. 18 2014 01:47 PM
Yvette from Stamford, CT

As an ADHD mom of an ADHD child, I just want to clarify some things. The kids in my family have inherited it in the same way we have inherited eye color. My brother and I have it, my sister and my other brother don't. One of my kids has it and the other doesn't. A mix of various different symptoms is an oversimplification. Inability to focus, sensory issues to clothing and noise, poor impulse control, poor social skills, high IQ, low grades, poor handwriting...it comes as a set in our family. When a mom has it, how does she help her child with consistency when that is one of her biggest problems? Behavioral and Cognitive therapy would be great if the psychologist would follow us around 24/7 for a few months. I have been avoiding medication for my son. At the same time, if there is something that helps him to navigate puberty without the burden of the symptoms of ADHD and the additional social pain it carries, I may have to consider it a little more seriously.

Feb. 18 2014 01:08 PM
jm

Henry:

Did you see The Atlantic article from a few years ago suggesting the Orchid Theory in relation to ADHD?

http://www.theatlantic.com/magazine/archive/2009/12/the-science-of-success/307761/

Even though I know my brain functions in a way unlike many others, I do still consider my condition to be more of a feature than a bug in many respects. Unfortunately the Unites States isn't very accommodating to us, given the lack of single payer, emergency financial assistance, lack of mandated vacation days and worker protections, and "bootstrap" attitude prevalent in not only the Puritanically-infested lifestyle, but especially in the homegrown Libertarian-hippie contingent that is fond of using the phrase "big pharma" (I see some of them are here, proposing that recess and food will cure all).

I've accomplished some incredible feats as a result of my condition, but this approach is unsustainable past a certain age unless I marry a spouse who is willing to support me. I don't have a shortage of energy and ambition, but my follow-through used to leave me spinning my wheels with drained resources. I was once working at a job that required much focus, and had also been trying out Paxil for depression. It didn't end well, and my bosses scheduled a surprise "intervention" to confront me about some recent mistakes. Only my revelation that I was on medication convinced them to give me another chance.

In the real world, my retirement account now requires consistent habits that give me at least a modicum of tolerance for corporate acceptance. If Adderall allows me to successfully exist within this context for several hours a day, I shall continue to use it.

Feb. 18 2014 01:02 PM
Carolyn Suess from Bethlehem, PA

Dr. Saul, I agree with Pam, one of your callers. She articulated the same issue my husband and I experienced when our son was in kindergarten. He was 5 years and one month old, while most of his classmates were 6 years old. To us, it was obvious he was developmentally behind his classmates, even though he was the only child in his class capable of counting to 100 and able to read. His teacher insisted we meet with her and the school district psychologist about his inability to follow instructions, and their suspicions he had ADHD (e.g., he would go to an activity center where children were using scissors and construction paper, rather than one where they were using glue and paper – in short, he wanted to do the activity with scissors instead of the one with glue). We were asked to have our pediatrician evaluate our son for ADHD. Fortunately, our pediatrician did not concur with our son's teacher's suspicions and we did not go down the path of dosing him with Ritalin. What was especially alarming to me was the number of my son's classmates who were already taking Ritalin. ADHD seemed to be an epidemic at the time. Today, our son is a 23 year old holds a BS in Computer Science/Business from Lehigh University and will be graduating with his MS in Computer Science this May. He is emotionally well adjusted, is dating a lovely young lady, and will be starting his career as a software developer after his graduation. I wish your book were available 20 years ago. It would have spared me from so much worry and frustration. Thank you for sharing your findings on The Leonard Lopate Show today. -CKSuess

Feb. 18 2014 01:02 PM
ericf

Wasn't Asperger's syndrome dropped from the DSM recently?

Feb. 18 2014 12:44 PM
V

Isn’t the source of this problem the Johns Hopkins founder who recommended bundling symptoms into one diagnosis? Perhaps there was a link between him and the drug companies which provided an “incentive.” Academics need to take more responsibility for our society’s thinking and choices.

Feb. 18 2014 12:37 PM
jm

I too was diagnosed as an adult, and had this condition as a child long before the consumer internet (even with plenty of recess and outdoor activities). I never had the ability to do more than 10 minutes of homework a day, yet thankfully somehow managed to graduate with an excellent GPA. After several failed tests with antidepressants in my 20s and 30s, Adderall was an epiphany; after my first month of realizing I could follow through with tasks, I cried with the relief that I could finally function as other "grown-ups."

While I can understand why the guest might be concerned, how would this realistically played out in adulthood? Who is going to pay my bills as I take months or years to test the best solutions, especially in this economic climate? Would I be eligible for disability aid? What about the effects of failed antidepressant tests on my career?

Feb. 18 2014 12:36 PM
Ellen LoGuidice from Westport, CT

My son struggled in school until 10th grade. After failing English as a sophomore we finally had him tested by a nuero-psychologist and he was off the charts ADD. He takes Vyvance and is now in college and doing very well. He takes part in the student special services at his school where he can have more times for tests and can take his tests in a quiet room. He only takes the pill on school days, never on weekends or in the summer. If ADD doesn't exist, why does this stimulant work for him? He is not depressed or bi-polar and does not have asbergers.

Feb. 18 2014 12:35 PM
Marie from Everywhere

People need to wake up to the FACT that "Big Pharma Rules All" in our society now. Big Pharmaceuticals rule the world with MONEY and they OWN DOCTORS. It is "Big Pharma" that is INVENTING these "diseases" and maladies--right AFTER they get an expensive drug developed to "treat" the disease they just invented. The psychiatrists are complicit in this corruption, as they are the ones who go along agreeing to accept these made-up disorders. Psychiatrists today have made it unacceptable to FEEL ANY EMOTION or FEELING other than the "emotions they sanction." That means, any emotion you feel other than happy, content, or CALM is UNACCEPTABLE to THEM and you must be treated for "your unacceptable feelings"!!! PEOPLE DO NOT ACCEPT THIS BS. PURE BS. It is changing what is LEGALLY ACCEPTED EMOTION in our world. This is insane. Do not go quietly like a lamb to slaughter swallowing these pills because your emotions or physical behavior is "unacceptable to PILL PUSHERS." Big Pharma is exactly the Demon who has "developed" these Anti Depression pills--you know, the ones that cause people to commit suicide. And this is ALL LEGAL because Big Pharma have their BIG LOBBIEST in Washington, DC to hold the Senate hostage to make sure the do not pass any laws that would make this truly illegal in the United States. PEOPLE WAKE UP!!!
Good for this Dr. for speaking up.

Feb. 18 2014 12:34 PM
Stephen from Manhattan

I couldn't agree more with Dr. Saul regarding the problems caused by direct-to-consumer advertising of prescription drugs. Prescription drugs are NOT a consumer item like a new car or laundry detergent. Patients asking their doctors about the latest drug — that may or may not effectively treat whatever symptoms they're having — has only contributed to the rise of U.S. health care costs and Big Pharma's profits without actually improving public health. Oddly enough, such advertising is never mentioned in the ongoing debate about Obamacare. Surely the AMA's lobbyists are just as powerful as Big Pharma's. Can't the AMA lobby to ban such advertising to consumers? The U.S. and New Zealand are the only two countries who allow such advertising.

Feb. 18 2014 12:33 PM
Stephen from Yorkville

Has there been any research about treating the symptoms of ADHD with medicinal cannabis?

Feb. 18 2014 12:32 PM
matt from Manhattan

As a 12th grader, I was found to NOT have ADD after two days of testing. Last year, at 33 years old, I filled out a one-page work sheet and was immediately started on Focalin.

I think the meds help. And by working on several ingrained bad habits, I am starting to recover from what I call my "wasted years."

However, I feel there should have been more questions asked of me before handing over a strong stimulant like Focalin...

Feb. 18 2014 12:32 PM
Beatrice from Brooklyn

I feel like a lot of the pressure to medicate comes from our schools. Our public schools are not set up to deal with kids with attentional or behavioral issues. It's easier to tell parents to medicate their kids than it is to change the system. There also aren't the right school for gifted/ADHD kids.

Feb. 18 2014 12:29 PM
Cara

Agree with doctor to look for other causes. My son's bloodwork showed elevated antibody levels. Antibiotics and ibuprofen relieved all of the comorbid symptoms. Stimulants made him more hyper and he developed tics. The best doctors are now saying check your child's blood for the answers. Many of these children have dysfunctional immune symptoms. their diagnosis might be PANDAS / PANS. Heal the immune system / gut and you may have huge improvements!!!

Feb. 18 2014 12:28 PM
John A

Couldn't ADHD increase simply be indicating increased Internet and other media addictions?

Feb. 18 2014 12:25 PM
Rachel from Brooklyn

I don't feel that Dr. Saul fully answered a recent caller's question about whether a bell can be un-rung in diagnosees' neurology -- perhaps he's correct that there are those who "shouldn't have been medicated in the first place," but given that they WERE medicated and now have something of a dependence on the meds, does Dr. Saul feel that a gradual stepping down of their medication can eventually return them to a pre-diagnosis state (and, with CBT, etc etc etc, perhaps a more functional version of that), or is it just "too late" for them?

Feb. 18 2014 12:24 PM
Maria from Morningside Hts.

Recess before Ritalin! In Catholic school in the 1960's we were out in the yard as much as at our seats!

Feb. 18 2014 12:23 PM
Henry from Sunnyside

I was diagnosed with ADD as an adult. Knowing the symptoms helped me understand a lot about myself, but I have resistant dealing with it as a condition or disease. We live in a complex world and we all navigate it in different ways. Tom Hartman has argued that the "condition" maybe be an evolutionary holdover from our hunter and gatherer days. As agricultural societies became dominant, we had to adapt and switch from the cat-like behavior that helped us survive as hunters and gatherers and stay in one-place and über focus and stay in one-place to be successful in the new landscape.

Now as communication and transportation technology advances are making us a more mobile and global society that needs to switch attention rapidly, will we soon be diagnosing people as MADD – Multi Attention Deficit Disorder and start drugging them?

Perhaps the answer is not turning the human experience into a disease but recognizing our individual traits and characteristics and finding careers, hobbies, and activities that fit us.

Feb. 18 2014 12:22 PM
Ben from Queens

Does Dr. Richard Saul have suggestions for individual diagnosed w/ ADD/ADHD and wish to get off stimulants?

Feb. 18 2014 12:20 PM
David from brooklyn

I wonder if Dr. Saul has any familiarity with Dr. Thomas Hartman's writings on the subject that also suggests that ADHD is not a disorder, but alternate versions of neurochemistry that may be older remnants of a human species that existed and operated in a world far different then has come to exist in the last 1000 years or even since the industrial revolution.

Feb. 18 2014 12:17 PM
John A

A lot of younger people raised to think that pills and not willpower is the solution to everything will also add illegal drugs to their use regimen - my observation of online blogs.

Feb. 18 2014 12:16 PM
Kate from Hamilton Heights

Of course it doesn't exist. This is one of those insane things that humans do, which is to make things up that don't exist that everyone gets in a panic about. ADHD is a way to medicalize some pretty normal but inconvenient behavior in children.

Feb. 18 2014 12:13 PM
Larry from Brooklyn

Stimulants improve attention to some degree in everyone! Coffee, anyone?
Effectiveness of stimulants is not evidence that someone has a disease.

Feb. 18 2014 12:11 PM
oscar from ny

In the military there's still some who don't believe this and call it plane malingering.. There is point a body and mind give up, but the strength of the horror should work into an advantage and maximize your capabilities in a battlefield ..but seems there's an underhanded threat inside the military who is trying to destroy the minds of these soldiers..why do you think there are so many suicides..

Feb. 18 2014 12:11 PM

Try avioding gluten!!

Feb. 18 2014 12:11 PM
Sarah from Scarsdale

My 8 year old son was just diagnosed with ADHD (combined type) as well as high-functioning ASD after a nueropyschological evaluation. He also exhibits sensory processing dysfunction (clothing and noise sensitivity). The first recommendation is medication to mitigate his ADHD symptoms that really get in his way in the classroom. I have bought into the medicine piece reluctantly (we are already on a second try of meds and it's only been 2 weeks) but feel that I have to try it to see if it might really help. But it's very uncomfortable feeling like your using your child's brain as a science experiment. How can I figure out - what REAL testing can be done, and where (I live in the NY area) - to get a handle on what is the source of his problem/disorder/way of being? I don't even know what to call it. He's an amazing kid. How can we best help him? Thanks so much.

Feb. 18 2014 11:58 AM

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