Thursday, November 28, 2013

My thoughts on ADHD and other disorders of the brain and nervous system

I have been prescribed Ropinirole for Restless Leg Syndrome (RLS). This is in a class of psychotropic or psychoactive drugs which include dopamine agonists and dopamine reuptake inhibitors.

Especially note the typical and very frightening "precautions," "warnings," and "side effects" sections in the following notices to consumers for this class of drugs:
Ropinirole (Requip)
Pramipexole (Mirapex, Mirapexin, Sifrol)
These drugs are so dangerous, in the opinion of the National Institutes of Health, that I will not take it. The symptoms of RLS are far more acceptable.

Now, compare the "precautions," "warnings," and "side effects" sections for above RLS drugs with common drugs used to treat ADHD (Attention Deficit Hyperactivity Disorder):
Amphetamine (Adderall)
Dextroamphetamine (Dexedrine)
Methylphenidate (Ritalin)
You will note a troubling correlation between the mass shootings over the past several years and the the fact that most of the shooters were taking, or had stopped taking, these prescribed drugs. The warnings of violence as a side effect for these drugs and withdrawal therefrom is clearly based on tragic experience!

As much as 18% of America's children have been diagnosed with ADHD using a checklist of behaviors in the DSM (Diagnostic and Statistical Manual -- a book whose primary reason for existence is to enable mental health professionals to bill insurance companies). However, the DSM system fails to acknowledge the existence of temperament and how it differs. The current ADHD symptoms are not clearly distinguishable from normal behavior. There is no clear evidence that ADHD symptoms are related to medically-treatable brain malfunction.

Studies do not prove that ADHD is a disorder any more than they do with normal temperamental variations. Chemical testing and brain imaging techniques have not proven anything except that everyone is different. The associations demonstrated so far have been inconsistent and are not clear as to cause, association, or consequence of the symptoms. These studies generally lack appropriate controls, who must be the same as the subjects in every way except for the dysfunctional behavior. See:
Does ADHD Exist?
ADHD Is Over-Diagnosed
ADHD Mythbusters
The mortal human body (including the brain) is not perfect. Almost everyone has some level of imperfection in the brain due to genetics, injury, malnutrition, or bad luck. In most cases, those imperfections are never made apparent, are minor in their effect, or the person learns to ignore, suppress, or compensate for the imperfection. In a few cases, medication can be helpful or even necessary because the imperfection causes dangerous behavior.

But, there is no truly scientific evidence that ADHD is a real problem that any drug can or should fix. It seems to me that a good test of the validity of ADHD as a true condition is this: Put the child in front of a TV with age-appropriate programming. Can the child focus on the programming without being drugged? Almost invariably, the answer is yes. That shows that drugging is not needed to get the child to focus.

The bottom line is that parents and teachers simply want easily-managed children. If all the children behave exactly in the same compliant manner, it makes the jobs of parenting and teaching much more convenient. To answer that flawed expectation, the health care system has outlined a process in the DSM to label non-conforming individuals and drug them into conformity. Drugs seem to be the easy way out, but they are a dangerous cop-out. As one can see from the above links, the drugs they're using can be extremely dangerous and the long-term effects is unknown.

So, what is to be done about hard-to-manage children?

In my generation and before (before modern science invented ADHD and its purported "cure") we simply learned to behave ourselves. Being raised in traditional, intact families where Mom stays home to nurture the family certainly makes a difference for those children who don't fit the mold. Unfortunately, modern education theory is rooted in the industrial revolution of the late 1800s where schools are viewed as a factory which takes in standardized parts and assembles them into standardized products via standardized processes. Too many parents have the same expectation for their children. That is not an appropriate model for educating widely variable children of God. What really bothers me is when the state (school staff and child protective services) override the God-given rights, responsibilities, and authority of parents to drug, hospitalize, and confiscate children over this vaguely understood condition.
"True doctrine, understood, changes attitudes and behavior. The study of the doctrines of the gospel will improve behavior quicker than a study of behavior will improve behavior." — President Boyd K. Packer (Ensign, May 2004, p 79)
Nobody has a drug deficiency (although drugs sometimes might be necessary to control dangerous behaviors). But, we all need to learn better behavior as President Packer suggests. Children, like adults, simply need to learn how to channel their behaviors and attention appropriately. It's called self-discipline. The prophets outline what behavior is appropriate and how to get there.

Worthwhile activities (ie not TV or computer games) that a child enjoys and where he is only compared against self or an external, achievable standard (rather than against the performance of other people as happens with children is school or team sports) can be used as opportunities to learn how to focus attention. For interested children, marksmanship is an excellent example of an individualized activity where one can learn focus and self-discipline.
"Even the best psychiatrist is like a blindfolded auto mechanic poking around under your hood with a giant foam 'We're #1' finger." — Dennis Miller (One of the brightest men alive today who, I suspect, would be drugged into mediocrity for ADHD if he were a child today.)

"Of course, that's just my opinion, I could be wrong." — Dennis Miller

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