Dr. Adam L. Front, Psychologist


Dr. Adam's Blog

Attention Deficit Disorder

Posted on May 17, 2010 at 12:45 AM

      One example of the "medicalization" of human unhappiness is ADD (Attention Deficit Disorder) or, as it is now referrred to in the diagnostic manual, ADHD (Attention Deficit Hyperactivity Disorder). I do think that Attention Deficit Disorders exist, but I believe that they are not half as common as many people (including doctors who treat such disorders) think they are.  I have become acutely aware of this "disorder of the month club" selection.  It has been at the top of the charts for way too long. About 700% more prescriptions are written today for stimulants than were written 20 years ago. In 1991, approximately 5 million U.S. prescriptions were written for stimulant medications. In 2007, there were 35 million.  Attention Deficit is a neurological condition. It seems unlikely that seven times as many people now have this brain disorder than did only 2 decades ago.  

      Yet many people seem to think that they have ADHD these days. I believe that this misconception comes from the fact that ever since Bill Gates coined the term "multi-tasking," everyone thinks that it is something that we should be able to do. So we all accept responsibility for keeping far too many balls in the air, more than any one person can really handle. When the balls begin to fall to the floor, when there is so much on our plate that things start dropping off the edge, we think there is something wrong with us.  We have been set up to believe that we should be able to do more than we really can. Because of this discrepancy between the beliefs and expectations we hold about what we should be able to do simultaneously,  versus what is reasonably possible for humans, either we tell ourselves (or someone else tells us) that we have Attention Deficit.

      The reality is that the human mind can only do one thing at a time. Even computers (which is the original source of the term multi-tasking) can only process one function at a time, unless they have more than one processor in the box. I don't know about you, but I have yet to meet anyone who has two brains in their skull.

      When we split our attention between things, we are actually switching back and forth between them, not actually holding them both in our mind simultaneously.  One of the results is that the quality of our focus on each of the things we are holding in awareness becomes less sharp.  In practice, multi-tasking is used as a concept in the business world to foster the assumption that we should all work more for less money. This idea seems good to business owners and managers who are dealing with shrinking budgets and pressures to produce more and sell it for less.  However, this is not realistic for those on the front line, delivering goods and services, who end up being expected to actually produce mroe with less. This may be a large part of the reason that the quality of many goods and services generally has fallen so dramatically over the last few decades.  The tyrrany of the stock market necessitates that short-term quarterly earnings reports become more important than long-term quality and service that would keep customers coming back and better serve the long term profitablitiy of a company.

     It is an appealing prospect to think that a medication can help with our problems with focus and attention.  And yes, anyone who takes stimulants (whether they have ADD or not) will function better and faster - for a while.  Methamphetamine addicts can be really busy and productive at first, in the early days of their drug abuse.  Eventually though, whether we look at meth addicts or patients who are prescribed medications for ADHD, tolerance sets in and the dosage must increase in order to maintain the effect.  Eventually what we have is addiction to the stimulants, and things start to fall apart.  Some college students who are prescribed Adderal, for example, report after a while taking it that they are unable to functiuon without it.

      Our ability to focus and concentrate can be affected by many things - anxiety, depression, family or relationship problems, boredom, substance abuse or dependence, addictive or compulsive behaviors, worries and stress about money or work, insomnia or other sleep disorders, poor nutrition or other lifestyle stressors. Stimulant medications that are prescribed for Attention Deficit will merely temporarily mask these other problems.

      It is often only by addressing these other issues directly that we can regain focus.  Psychotherapy that addresses our life in context can accomplish this.  By re-assessing our values, expectations, beliefs, behavior, and the way we deal with our emotions, we can clarify a perspective that is grounded in what is truly important to us in life, and then commit to action that affirms our values and goals.

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