Final Project: ADHD Revisit

            Much has been covered throughout the semester in this course. Deviance has been examined from many different perspectives. We have focused on topics as broad as what is deviance, and the established theories behind the phenomenon, up to very specific topics; dissecting the deviance within sexual preferences and physical modifications of one’s self. One of the topics for a previous blog post examined what caused attention deficit disorder (ADD) and attention deficit hyperactivity disorder  (ADHD) to reach its “epidemic” levels that it is at today; as well as what it’s development was. This post will look at the same topic, but to a deeper level, and to apply how other ideas that were focused on throughout the course relate. The point is to so the effects that society has had on the development and diagnoses of this “illness”.

Taken From http://www.dcneuro.net/vertigo/treatment/add-adhd

            Hyperactivity was first connected to unbalances in the brain’s chemistry as early as the 1940’s. The following decades of the 1950’s and 60’s saw an extreme amount of growth in the pharmaceutical industry, and by the 1970’s hyperactivity had developed into a neurologic disorder. Drug companies had also developed several drugs to be used as “treatment”. With the existence of these drugs, pharmaceutical companies had a great amount of money to be able to fund further research into hyperactivity. By the 1990’s it had received the current term of attention deficit disorder and was included in the Diagnostic and Statistical Manuel of Mental Health Disorders (DSM). The “illness” had expanded beyond only children; it included adult ADHD. It also had become a hereditary neurological disorder that was passed from parent to child, and the best treatment was the use of psycho-stimulant drugs to correct the imbalanced brain chemistry (Goldin 2010). “Seventy to 80 percent of the individual differences in ADHD-related symptoms are attributed to genetic rather than environmental factors.”

Taken From http://neurolove.tumblr.com/post/17149616448/what-is-the-dsm-diagnostic-and-statistical-manual

The DSM-IV criteria for ADHD states that “symptoms of inattention and/or hyperactivity-impulsivity have been present for at least six months to a point that is disruptive and inappropriate for the development level”. It includes that they may have trouble staying focused on tasks, dislikes things that take lots of mental effort, is forgetful, is disorganized, fidgets in seat, and may blurt out answers. Personally, I do not see these as characteristics that are outside of typical childhood behavior. Also, the “development level” that these children are being measured to is nothing more than a social construction of how the children of a particular age should act. These social constructions also are commonly used in the development of mental disorders. What is a mental illness is generally what is seen as not being normal among the population. What is normal varies across time and place. The fact that the DSM is created greatly concedes with Howard Becker’s “Labeling Theory”. the conferences and meetings that are held to create, remove, or alter the definitions of mental disorders serves as a formal way that rules are made so that those that violate the rules can be labeled as “sick” and treated. The personal feelings and even political beliefs of those in the psychology field can affect what is and isn’t seen as a mental disorder. This can be seen in how homosexuality was actually in the DSM as a mental illness for quite an amount of time. Inclusion of a new disorder in the DSM can serve as the catalyst thatleads to an epidemic of diagnoses and cases.

The use of media to advertise these pharmaceutical drugs can also cause parents and other adults, such as teacher, coaches, etc., to self diagnose children as having ADD/ADHD, even though they lack the proper training. A self-diagnosestest can even be easily found on many websites, with many featuring less than 30 questions. Even though some state they are “not a diagnoses tool” they will often tell you take the results to a trained mental health professional. Some of the questions even seem as ridiculous as the DSM-IV definition. With all of this advertisement of the condition, as well as it being featured in popular culture, people can be largely diagnosing themselves, with the symptoms also being fairly common behaviors; extreme over-diagnosis is very much a possibility. The fact that the younger students in a grade are 60% more likely to be diagnosed than older students greatly supports this. The pharmaceutical companies of course do not mind the condition being over diagnosed. That means more people being prescribed their psycho-stimulant drugs, and more profit for the drug companies. This money can then be used for further research to expand the definition for ADD/ADHD and create new drugs to make even more profit off of “sick” people.

A perfect example of this phenomenon is the drug Intuniv, which states that “your child’s stimulant medicine may be helping, but some ADHD symptoms cans still get in the way.” Luckily, by taking Intuniv, along with the stimulant medication that is already prescribed to your child, they will have all of their symptoms taken care of. All they need to do is take one pill instead of two. This pills are taken just because a student may not want to sit still and listen to a teacher talk about uninteresting topics for six hours a day; when they can look out the window and see a beautiful day, and all they want is to go outside and act like a normal child. This again all comes back to a social construction that children are supposed to be properly socialized to act in certain ways in specific situations. When they don’t they become sick and need to take medications to act the accepted way.

Taken From http://www.zeitnews.org/nanotechnology/synthetic-synapse-mimics-dynamic-memory-in-human-brain.html

These psycho-stimulant medications work within the brain by affecting the transmission of neurotransmitters between synapses. The specific neurotransmitter that it affects is dopamine and noradrenaline. On a psychopharmacological level, these drugs work on the brain in very similar ways as methamphetamine and cocaine. These types of drugs inhibit the reuptake receptors in the synapses, which cause a rush of the neurotransmitters into the synapse; due to the inhibited reuptake inhibitors the synapses doesn’t know to stop firing. The effect of this can be increased alertness, cognitive performance, improved mood, increased libido, and a stemmed fatigue. However, this flood of dopamine and noradrenaline into the synapse, over time, can actually cause the receptors to decrease in number. Therefore when the synapses are firing normally, not stimulated by a drug, not enough dopamine or noradrenaline is received to properly pass the message throughout the brain. This is especially dangerous for a developing brain, and a human brain continues development into a human’s twenties. By taking these drugs children may result in becoming an extremely different person than if they never took the drugs in the first place. This was even examined in the film Generation Rx. It examined the interest that the drug and pharmaceutical companies have in the definition of ADD/ADHD, as well as the effects these companies’ drugs have on the children that are taking them. Ritalin and Adderall are some of the most prescribed stimulant medications for ADD/ADHD.

Taken From http://www.24-7pressrelease.com/press-release/prescription-drug-abuse-aggressive-marketing-116807.php

Drugs that have such high effects are not surprisingly used for recreational purposes. The fact that these drugs are so readily available makes it not surprise that prescription drug abuse rates are so high. According to the National Institutes of Health, Adderall is the most abused stimulant pharmaceutical drug among high school students. It comes at a close second to the pain reliever Vicodin. Of the 7 million people that admitted to taking psychotherapeutic drugs not in their medical capacity, 1.1 million admitted to abusing stimulants. Stimulants can become addicting and lead to seizures, psychosis and other cardiovascular complications. Government agencies have sponsored programs to help discard unwanted or unused medication so that they are not used and abused for nonmedical use. Abuse trends continue to be high and results in some very tragic results, as can be seen in Susan Donaldson James’s news article on the subject done for ABC News. In an audio clip in the aforementioned article it is stated that prescription drug abuse accounts for more deaths than cocaine, heroin, or gunshot wounds each year. In 2009 prescription drug abuse surpassed auto accidents as the leading cause of accidental death in the United States. There is now even a market of doctors that are selling the drugs illegally to make money. Doctors may even be in standing to profit from prescribing certain medication, due to the fact they may have holdings in that specific company. Dr. Jorge Martinez was sentenced to life in prison in 2006 for overmedicating OxyCotin and Vicodin to patients, which led to the deaths of two. The government is obviously taking prescription drug abuse very seriously.

With the changes in the diagnoses and treatment of ADD/ADHD since the 1990’s, there has been both a change in the rate that students have been diagnosed, and the increased reliance on standardized testing in public schools. A side effect of these standardized tests is making school duller for the students. When the subject is not engaging, then the student is more likely to not pay attention, or show some of the behaviors that have been categorized and stigmatized to mean the child suffers from ADD/ADHD. The resulting treatment is to medicate them, to make them fit into the mold of how we believe children should behave. When they do not fit perfectly into this roll then we, as a society, start looking for a way to change them. The use of psycho-stimulant drugs quite literally changes the brain to make the child more “normal”. Dr. Daniel Conner states one of the arguments perfectly, “[d]oubt and confusion as to where thisdisorder fits into the general spectrum of illness further feeds the general perception that ADHD is a socially constructed disorder rather than a valid neurobiological disorder.” It is estimated to affect 4-5% of children, and children of lower income families may also be more likely to be diagnosed due to the fact that their parents do not have the same amount of interactions with their children due to a less set and consistent work schedules among the demographic. Low-income households are also likely to have worse outcomes due to ADD/ADHD.

Taken From http://blogs.babble.com/strollerderby/2012/01/31/sensory-processing-disorder-adhd-ritalin-whats-a-parent-to-do/

It is hard to not see ADD/ADHD as more of a socially constructed disorder. There is some scientific evidence out there that supports is a neurobiological disorder, and due to this, there likely are some people that truly benefit from the diagnosis. They likely have great troubles overcoming their symptoms. With this said, there are likely much less damaging ways to help overcoming these difficulties than by taking medications that have already been stated to be dangerous and even brain altering. Unfortunately, some of these other options, such as support groups, have been “infiltrated” by the pharmaceutical companies already. The reason why people want to be labeled is because they want to get access to the resources they see may be beneficial to themselves. Peter Conrad and Deborah Potter address these in “The Emergence of Hyperactive Adults as Abnormal”. The three key factors that they identify are the effects that the development of Prozac had, genetics and the rise of managed care. Prozac was one of the first drugs that was seen to manage stress and other minor issues; it showed that there was a pill to fix the little things, and set the precedent that medication was going to move that way. ADD/ADHD is also believed to be genetic, and with more managed healthcare people are being more heavily medicated.

While many see ADD/ADHD as a fairly minor and common disorder, it has greatly restructured the society that we live in today. The behaviors that are associated with ADD/ADHD have been observed throughout history, but it hasn’t been until the last several decades that the behaviors became diagnosed as a mental disorder; thanks largely to the money and work done by the drug and pharmaceutical companies that stood to profit by corning a new market of child consumers. These profits have then led to further medication and marketing of the drugs. The drugs that are then prescribed to the “sick” children actually can greatly alter their growing minds, causing a different personality to develop than would have developed naturally, not to mention the potential and danger of recreational abuse. This is all do to the fact that a particular child does not fit perfectly into the socially constructed ideals of what a student should be, but with a newfound focus on standardized test in the recent decade or so does it really come as a surprise that students do not want to quietly learn six hours a day? I don’t think so and I think other approaches besides medication would be most beneficial to a “sick” child that used to only be labeled “hyper”.

Non Linked Works Cited

1.             Becker, H. (1991). Labeling Theory. ““Readings in Deviant Behavior: Sixth Edition.” (Pgs 39-41). Pearson Education Inc.

2.             Conard, T. & Potter, D. (2000). The Emergence of Hyperactive Adults as Abnormal. “Readings in Deviant Behavior: Sixth Edition.” (Pgs 138-144). Pearson Education Inc.

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