'I can't tell you how many times I've been approached by parents who complain that medication 'hasn't helped our child,' or that it 'helps, but my child is still struggling in school.' In most cases, the problem isn't the medication.'
I worry about the casual way in which many doctors pronounce an ADHD diagnosis. Attention deficit hyperactivity disorder iseasy to diagnose, and doctors who diagnose ADHD too hastily only perpetuate the problems that lead patients to consult them in the first place.
Clearly, Fred’s symptoms were neither chronic nor pervasive — so the problem couldn’t be ADHD. The pediatrician had jumped from description to treatment without making sure that Fred met the diagnostic criteria. Two years passed. Despite steady use of the medication, Marie continued to have problems in school and with her peers. At this point, with middle school looming, Alicia called me.I looked over the psychologist’s report. It included several rating scales, completed by Alicia and the psychologist, that seemed “significant” in indicating ADHD. It also included a computerized test that was “suggestive” of ADHD.
This helped convince me that Marie’s problems stemmed from a mood disorder and a sense of helplessness she felt about her family situation. I recommended that Marie go off medication and start psychotherapy.. Her problems were not chronic; they began only after her parents’ marriage began to break up.
But that wasn’t the end of my diagnostic workup. When someone has ADHD, there’s a greater than 50 percent chance that he or she will also have a learning disability, anxiety, mood disorder, OCD, or some other neurological disorder. Given this high probability of coexisting conditions, it’s essential to consider additional diagnoses.
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