More importantly, who should decide if someone is mentally disordered? What if our psychiatrist is wrong? Such labeling not only creates self-doubt in the patient’s mind, it also attaches a social stigma that is often hard to dispel.

“Harmful dysfunction”

Some cases are easy to diagnose. If someone shows unusual behavior that can be harmful to himself or others, he clearly needs professional help; for example, patients suffering from major depressive disorders often have suicidal thoughts, and are likely to attempt it if not given timely help.

This example easily fits the notion of “harmful dysfunction” that Dr. Russell Barkley, a renowned psychiatrist and ADHD expert, proposes to describe the criteria for mental disorder. I agree with Dr. Barkley, up to this point.

Is there a “universal” human behavior?

But then he continues (italics are mine for added emphasis),

For there to be a legitimate, valid disorder, there must be hard scientific evidence that there is a failure or a deficiency in some mechanism that is universal in human beings, a physical mechanism like a heart, a liver, a stomach, a brain. But it can also be a mental mechanism such as … behavioral inhibition.

and again,

Mental disorders are failures or serious deficiencies in mental mechanisms that are universal to the design of this species.

I can not disagree more! I do not have to be a psychiatrist to know that unlike a physical mechanism like heartbeat, where even a slight irregularity can cause serious bodily harm, the range of human behavior is just too vast to have a “universal standard”.

Take the lack of behavioral inhibition, or “disinhibition” as Dr. Barkley calls it, which is considered by many as the strongest symptom of ADHD in kids. But each of us, ADHD or not, shows almost a continuous range of behavioral responses, from sublime poise to annoying impulsiveness. Where should we draw the line, and stamp someone (mentally) disordered?

Is ADHD behavior pattern a harmful dysfunction?

I am not at all convinced there is enough evidence to call ADHD behavior even a dysfunction, let alone harmful. I argue instead that it falls within the wide behavioral range of normal people. (Small wonder that the biggest disagreement today about ADHD in kids is on what is a normal behavior.)

You have two choices. One, accept Dr. Barkley’s (and most others’) view of a narrow range of what constitutes permissible normal behavior, determined by his “universal mental mechanism” (which I believe to be flawed). It is then easy to banish all ADHD-related behavioral patterns outside this restricted range, and brand them dysfunctional.

Or, accept my expanded view and broaden your tolerance for normal behavior to include ADHD. If ADHD is normal, by definition it cannot be harmful. That is, I believe ADHD should be taken as a special class within the highly variable human personality (with some unique traits), rather than a clinical disorder.

It is intriguing that while Dr. Barkley talks of universality to make his case for dysfunction, he invokes “cultural context” to argue potential harm from ADHD. In addressing the question “Does ADHD produce harm to the individual?”, he says (italics are mine),

Now that of course is going to be culturally relative because it depends on the demands that the culture makes on that mental mechanism.

In other words, if your culture is made up of happy-go-lucky folks who love fun and games (as some European cultures are), ADHD is probably a blessing. Whereas, if you belong to a culture that is more work and less fun (as is much of today’s western culture), ADHD can harm your life and career prospect.

That is, unlike most physical (and some mental) deficiencies, ADHD with its behavioral oddities can at most cause only long-term harm, and can possibly be even “cured” by a suitable career move that suits your special abilities.

Is ADHD a real disorder?

To wrap up for now, my answer to this question by Dr. Barkley is that ADHD is real alright, a real personality, not a disorder.

In a later post, I will use evolutionary insights to argue further in favor of ADD being a normal trait. Stay tuned.

Still, the diagnosis made a huge impact on me, by throwing a bright spotlight on a significant chunk of my past life that was somewhat in the dark. Today I understand many struggles, and triumphs, of my life and career that remained unexplained before.

I have devoted every spare minute since then researching on ADD, driven partly by the urge to know more about myself, and also to share with you everything that I learn about this global, and modern, scourge. ADDing Up grew out of this ongoing effort.

Early triumph, late struggle

As a school-going kid, my grades suffered early, but improved in high school and kept getting better afterwards. Since then I breezed through all exams with A+ scores, and by the time I completed Masters graduation (in physics), I was well on course to becoming a brilliant career physicist.

This much of my life is easily explained. I always liked physics and math more than anything else, and my effort on a subject was in direct proportion to my interest in it. As school year progressed through Masters, my curriculum became more and more physics-specific, and grades improved accordingly.

But, once I began doctoral studies, as if a switch flipped inside me, and my  career path suddenly turned uphill. Being free from exams, and lacking a strong internal motivation to stay focused in my study, I spent too much time with friends, and less on research. I did eventually complete Ph.D. (in physics), but it was due more to talent than perseverance.

Mismatch of “productivity” and “potential”

Knowing what I could accomplish if tried enough, my productivity (number of research papers I wrote) was well below my potential, or talent. This mismatch of potential and productivity has dogged my career ever since. I also lacked “staying power” on a single subject, and in the decade since Ph.D., moved from physics to, first chemistry, and finally to biology.

Because I never lacked in talent, and had the subject of choice for Ph.D., I did not understand this persistent lack of motivation, until now. Today I know that my problem has a biological origin inside me, and has nothing to do with my surroundings or friends. ADD, which arises from a certain type of brain structure, weakens our ability to sustain focus over long periods of time.

Exam vs. research – different demand on focus

My power of sustained focus was never really tested in school, because I was intelligent enough to excel in exams with little effort, which needed my attention only in short “bursts”. If grades are a measure of productivity in school, mine was evenly matched with my potential back then.

Talent alone, though, is never enough to do productive research over several years, and perseverance – staying focused through life’s many little bumps and bruises – is usually a bigger virtue.

That is why my internal “ADD switch” flipped when I began doctoral research, because I always struggled to keep myself focused through those distractions. It often took me a long time to complete even the routine projects, and productivity dropped as a result. My struggle continues to this day.

Missing early signs may raise adult ADD risk

Because I did not show typical early signs of ADD as a kid, such as consistently poor grades, difficulty with assignments, inattentiveness, hyperactivity or discipline issues, I never looked for an answer inside me when similar problems (like focus issue and poor productivity) showed up later in my life.

Also, people were not much aware of ADD when I was a kid, and “symptoms” like bad grades and indiscipline were usually blamed on poor parenting. On the contrary, good parenting, such as a comfortable home and help with study, can hide many of these symptoms, and the kids would face problems later when they move out and begin living by themselves (as it was with me).

Lack of awareness might have led to missing many of the early signs in our generation, and a rise of adult ADD cases. Today we know lot more about ADD than our parents ever did. Do we know enough? Do we know right? These are the questions I discuss here.