Acceptance of ADHD: A Ways to Go
ADHD: The Force. ADHD profoundly influences the children affected by it at school, at home and in relationships with other kids. If you set out to design an environment with the goal of driving an ADHD youngster crazy, day in and day out, you couldn’t come up with anything better than school. Sitting still and concentrating on boring material are not two of an ADHD child’s strengths! It would be nice to go home and relax, but at home ADHD often makes for intense sibling rivalry, frequent discipline conflicts, frustrated parents and stressed-out marriages. Outside playing, ADHD kids are often bossy, aggressive and rejected by peers. Will all these difficulties just be outgrown? Unfortunately, most ADHD children take a good portion of their troubles with them into adulthood.
ADHD: The Prejudice. Given the strength of this negative ADHD force, it’s surprising that there still exists in this country (and around the world) a distinct prejudice against both the diagnosis of ADHD and against treating the problem with medication. The diagnosis itself is said to be an excuse for bad behavior on the kids’ part as well as an excuse for bad parenting on moms’ and dads’ part. This belief continues in spite of the powerful genetic evidence that has been around for years. The strongest bigotry, though, is directed toward medication treatment. Why are you drugging our kids!? What sense does it make to give a hyperactive child stimulants!? Why make the drug companies rich!? These are persuasive messages to people who don’t take the time to really learn about and understand the ins and outs of ADHD.
Why does the prejudice persist? Drug companies have always been favorite whipping boys and the media can’t seem to help themselves when a juicy ADHD drug story goes around, but the prejudice has a deeper and—to me—more disturbing cause. Mental health professionals often make a distinction between what they call “internalizing” vs. “externalizing” disorders. An internalizing disorder, such as depression, causes pain to the person who has it, but the problem does not necessarily bother other people. Amy is nine and her parents just got divorced. She is depressed and your heart goes out to her. But her behavior may not bug her teacher, her friends, or even her siblings so much.
But ADHD is an externalizing disorder which is kind of the opposite of Amy’s problem. With an externalizing disorder, the person who has the problem may aggravate other people, but his behavior may not bother him so much. That’s why some people call this kind of thing a “garlic” disorder. While Amy’s depression may inspire sympathy in those who become aware of it, John’s ADHD simply makes them mad. John’s distractibility bugs his teacher, his bossiness bothers his peers, and his trouble following the rules gets on his parents’ nerves.
The result? Sympathy for Amy; little sympathy for John. With Amy’s problem you want to understand and help her out. Internalizing problems inspire compassion and sincere efforts at treatment. With John, however, you (and the society you live in) want to judge John unfavorably and shape him up (usually by means of punishment, not treatment) as quickly as possible.
Multiply these psychological dynamics thousands and millions of times and you have explained—in large part—our national intolerance for ADHD and its therapy. Surely not everyone feels this way. Some folks can keep their minds open and sympathetic even when they’re faced with the repetitive and aggravating behavior of an ADHD child or adult. And some folks can understand that there are over two-hundred carefully controlled studies showing that medication for ADHD is safe and effective—though not curative. But most people are probably not that forgiving or well informed. There’s still a long way to go.
by Dr Thomas Phelan