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ISSUE 121 VOL 5 PUBLISHED 10/26/2007

Pay attention or get medicated

By Emily Williams
Opinion Editor

Friday, October 26, 2007

America is a treadmill -- it's moving fast.

Americans are runners. We're moving fast.

So be careful, watch your footing and above all, don't fall off.

Focus. Focus. Focus.

I am not writing to question the credibility of Attention Deficit Disorder (ADD) and Attention Deficit/Hyperactivity Disorder (AD/HD), because the conditions' neurological underpinnings are well established by tenable scientific research.

Truth: the disorder is caused by an inability to activate the frontal area of the brain, and in regards to the neurological differences between ADD and AD/HD, lower levels of norepinephrine neurotransmitter tend to cause ADD.

I am writing, however, to question America's influence on the undeniable rise in ADD and AD/HD diagnoses over the past twenty-five years.

What role does our society play in stigmatizing inefficiency, a result of ADD and AD/HD? Why did we begin identifying distracted and hyperactive behavior as pathological in the first place? After all, if no one had considered the behavior deviant, no one would have thought to further investigate the behavior's scientific cause.

Throughout history, reputable professionals have posed similar questions and developed corresponding theories for why humans seek medical answers for disorderly behavior.

For example, Sociologists Peter Conrad and Joseph Schneider discuss in their publication, Medicalization of Deviance: From Badness to Sickness, the societal will to cleanly diagnose behavior that threatens the social mold.

Conrad's first case study investigated hyperkinesis, a childhood disorder characterized by hyperactivity and lack of concentration. Sound familiar? Hyperkinesis then became Attention Deficit/Hyperactivity Disorder.

I consider it dangerous to slide incongruent social tendencies under the heading of a disorder. If you think about it, ADD and AD/HD patients seek medication because the social consequences of their disorder fail miserably at aligning with our hurried, success-oriented culture.

Here, disorganization is socially unacceptable. Here, inefficiency is socially unacceptable. Here, anxiety is socially unacceptable. (Note: ADD and high anxiety levels walk hand-in-hand.)

Instead, the American culture honors the consistently successful. And if you're radiant, composed and humble in tandem with your success then, by golly, we have a winner!

Why don't we have any room in our lives for disappointment? Because we must feel happy! And organization breeds happiness. Feelings of completion breed happiness.

One student diagnosed with ADD during her sophomore year at St. Olaf shared how ADD affects her ability to complete her homework.

"When I would read, I would realize I wasn't reading," she said. "I'd look at the clock and I'd get frustrated and I'd start the sentence over again. Through my frustration, anxiety symptoms would arise triggering an elevated heart rate, dizziness, fatigue and nausea, which triggered ADD symptoms, creating a downward spiral until the only thing your body's fit to do is fall asleep."

She then explained her medication's effect. "It's like reaching the next stage of being awake. It focuses your thought process like a camera lens, but it doesn't change the thoughts that you get."

This student testifies to checking her clock and feeling anxious about her inability to read at a "normal" pace.

On one level, time caused the problem. St. Olaf's culturally informed expectations of its students threatened her individual pace.

The Diagnostic and Statistical Manual of Mental Disorders (DSM), or the bible of psychology, has undergone four revisions to refine the diagnostic criteria of specific disorders and to remove some disorders entirely from its definitive list.

AD/HD, as listed in the DSM IV, is comprised of five diagnostic specifications that strike me as repetitive and reflective of the behavior of innumerable stressed out individuals.

First, the patient must exhibit either inattention or hyperactivity-impulsivity. The DSM IV marks inattention by the failure to pay attention (circular reasoning!), failure to correct careless mistakes in schoolwork or professional work, failure to listen when spoken to directly and failure to engage in tasks that require sustained mental effort.

When frustrated and overworked, I am all of these things.

I realize that a psychiatrist is at liberty to make a diagnosis only if his patient exhibits the symptoms of AD/HD for at least six consecutive months.

However, I learned in my psychopathology course that psychiatrists also rely on intuition ("It hasn't been six months, but my patient has been dysfunctional for the past four. It's due time we medicate."). It is here that the diagnostic waters turn murky.

Next, the DSM IV describes hyperactive-impulsive behavior as fidgeting with hands or feet, squirming in seat, running about or climbing excessively, talking excessively and interrupting.

Strangely, one must begin exhibiting these symptoms before the age of seven.

Since when have children under the age of seven ever gathered the self-control to refrain from squirming and climbing?

I would worry about a seven-year-old who did not exhibit these "symptoms." Children learn by exploring, and for many children, physical activity facilitates discovery.

The AD/HD diagnostic code sets the bar far too low for comfort, a bar under which the American population does the limbo.

"Just arch your back a little more! Yep. Now you've got it!"

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