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ADHD Theories – Neurological Disorder

Each of us is responsible for our own health. ADD (Attention Deficit Disorder) and ADHD (Attention Deficit Hyperactivity Disorder) occur in all countries and in all races, it is universal in humankind. Yet in different parts of the world ADHD is treated differently.

In the USA it is still stimulant drugs as main treatment of choice. In Australia it is a holistic approach including therapy, diet, education of parents and adjustments in schools, but stimulants are relegated to use as a last resort in severe cases. In China nutrition is an important factor and medication does not feature.

To understand ADHD theories in depth requires years of study and understanding a vocabulary that is specific to that particular niche. Words, which are used in everyday language, can have specific meanings and nuances, which differ not only from normal usage, but even from usage in another branch of science.

However there are areas where the average intelligent person can have an opinion on a subject, even if it differs from an expert in that subject. This is in considering paradigms. Paradigms are basically our subconscious understanding of the world around us. An atheist and someone who believes in God will respond to and understand the same experience differently.

Our personal experiences also shape our paradigms. If we take vitamin supplements in winter and do not get the flu, then we are open to accepting nutrition as a way of strengthening our immune system. We may then be less willing to take a flu vaccine even if the authorities may urge us to do so.

The popularity of alternatives to medication is much a result of negative experiences with drugs, and positive experiences with alternatives, be they some form of therapy, or supplements. This in spite of some researchers and doctors who say we get all the nutrients we need in our daily diet and do not need vitamins and minerals.

We do not have to be intimidated by scientific sounding gobbledygook. It is legitimate to ask for explanations from the experts. If the expert is evasive, then it is probably because s/he is not so sure of him/herself. If the expert tries to evade by putting us down, then s/he is probably too arrogant to see his/her own mistakes.

Paradigm blindness, comorbid with arrogance, is the greatest threat to scientific advancement, especially with attention deficit. This is explained in Attention Deficit Scientist Disorder (ADSD).

All theories start with assumptions, which set the paradigm through which the results from the study will be interpreted. The contents of the theory can be perfectly logical and correct step-by-step, but if the original assumption is wrong, then the theory will be wrong. There can still be many truths buried in it, each of which adds to our understanding of this controversial condition, but the final conclusion will be erroneous.

Seeing ADHD as a neurological disorder is the result of an original assumption that it is a disorder. That assumption defines how the evidence is interpreted. When the evidence is correct, the interpretation needs to be considered with a positive critical approach. The choice of following one assumption in one direction or another is a personal choice. There are equally qualified experts on both sides of the debate.

This interpretation is based almost exclusively on the unproven assumption that the patterns seen in the brain are the cause of the attention deficit. The brain imaging could be recording a symptom, or the brain's response, to attention deficit in many of the cases. Boredom intollerance is one of the causes of ADD and ADHD behavior, and can be expected to give precisely the results we see in brain imaging.

ADHD and ADD are officially categorized as a neurological disorder characterized by hyperactivity, forgetfulness, mood shifts, poor impulse control, and distractibility and is always present from childhood.

In neurological pathology, it is currently considered that there are physiological causes for ADHD. It is a chronic syndrome caused by abnormal brain functioning for which no medical cure is available, but daily maintenance dosing of stimulant drugs allows the sufferer to lead a normal life.

It is believed that when a person develops ADHD, the executive functions of his/her brain are impaired. Executive functions include things like paying attention, ability to concentrate on a task or “stay on task,” self-motivation, problem solving, organizing and planning.

Brain scans have in recent years been used as evidence for this theory. The fact that ADHD type of behavior correlates with brain disorders does not imply that a brain disorder is the cause. A certain brain scan can show brain activity caused by some other condition.

Depression for example results in a decrease in the volume of the brain. Synapse density decreases. The brain scan from the depressed person and an ADD/ADHD person can be identical. On the other hand a disorder in the brain can cause ADD or ADHD behavior. In young children depression can result in ADD or ADHD like behavior patterns.

The historical picture of ADHD as a disorder dates from 1902 when the British physician George Still described a condition similar to ADHD, which he called a defect in moral control. The disorder's names evolved through minimal brain damage and minimal brain dysfunction to hyperkinetic or hyperactive. The focus was until recently on children and in particular in school.

Sitting long hours at school in a classroom is a relatively recent development in society. This is a particularly unnatural activity for young children. ADHD is a disorder in this area.

The second area it is a disorder is in an adult who chooses a career, which does not fit an ADD or ADHD personality. Working in an open plan office can be particularly taxing for a person with attention deficit.

The main authority on clinical diagnoses of psychological behavior, the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision), defines ADHD is a genuine disorder, but it does not manage to define what a disorder is.

The arguments against ADHD being a neurological disorder say:

  • ADHD is a diagnosis based on a manual and there are no laboratory or radiological tests or specific physical features by which it can be diagnosed.
  • Diagnostic criteria have changed frequently, on the average every eleven years.
  • There is no psychiatric curative treatment, so long-term therapies are required, yet there are alternative therapies based on cognitive behavioural therapy and coaching, which do work.
  • The rates of diagnosis and of treatment substantially differ between countries and cultures.

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