ADD/ADHD: Treatment Without Identification

A diagnosis of ADD/ADHD is a process that requires a significant amount of observation and, more importantly, a great deal of psychological and medical testing. However, the majority of individuals who have been diagnosed with ADD/ADHD were diagnosed on the reporting of symptoms alone; either self-reporting, or, in the case of a child, reporting from parents, teachers, and caregivers. Many people are being medicated solely on the rushed diagnosis of a family physician who really doesn’t have the time to discuss the condition in-depth and who likely fails to recommend the individual for further testing; testing that might rule out other common disorders, or that might even point to nothing more than undesirable behavior.

This means that people are being diagnosed as having ADD/ADHD when they do not, and others are not receiving an ADD/ADHD diagnosis in cases when they really should. This over/under-diagnosis is problematic for the medical community, the schools and parents seeking to manage behavioral problems in children, and, most of all, the people who are being misdiagnosed.

Many common disorders can mimic the symptoms of ADD/ADHD resulting in an incorrect diagnosis if adequate care is not taken to compare the symptoms of each individual carefully with every available condition rubric. The symptoms of ADD/ADHD are so obtuse that they can easily be attributed to depression, anxiety, specific learning disabilities, early onset bipolar disorder, Tourette’s Syndrome, food allergies, head injuries, fetal alcohol syndrome, dental problems (such as abscessed root canals or mercury toxicity from fillings), family dynamics issues, grief or trauma, and even simple poor parenting!

The likelihood that ADD/ADHD will be diagnosed correctly is extremely low.

The fact that symptoms of many conditions and disorders are so often mistaken for ADD/ADHD warrants a closer look at the way that diagnosis takes place.

The most success in correctly diagnosing ADD/ADHD has occurred with the use of a process called differential diagnosis.

Merriam-Webster’s Medical Dictionary defines differential diagnosis as “the distinguishing of a disease or condition from others presenting similar symptoms”. Essentially, the process takes place in the following manner:

A diagnosis is called clinical decision making. The clinician uses the information gathered from the history and physical examination to develop a list of possible causes of the disorder, called the differential diagnosis. The clinician then decides what tests to order to help refine the list or identify the specific disease responsible for the patient’s complaints. – Encyclopedia Brittanica

Perhaps the most important part of the process is when “the clinician then decides what tests to order to help refine the list or identify the specific disease”. In many cases, this refinement never takes place. Conditions such as food allergies, toxicity, and psychological issues are rarely investigated. There are several reasons for this. It is often difficult for a physician to confront a parent with what may be a display of symptoms due to poor parenting, abuse, or familial stress, and many physicians realize that the work involved in teaching everyone involved with someone diagnosed with a nutritional deficiency or toxicity is more than some families will commit to. Additionally, it’s ok to have ADD/ADHD, it’s not ok to be in the early stages of developing a major mental disorder.

It’s simply politically incorrect to challenge a parent’s ability to parent.

Most people don’t want to accept a diagnosis of mental illness.

Many people will not do what is necessary to ensure that nutritional needs are met, allergies and sensitivities are addressed, and that toxic substances are avoided.

It’s easier to medicate.

But, taking the easy way out means that most people are not correctly diagnosed. The only way to accurately diagnose ADD/ADHD is to identify what is causing the symptoms, not medicate them away. And, identification takes time, energy, and resources.