It’s All In Your Head: The Logic of the A.D.D. Deniers

W e’ve got Holocaust deniers and global warming deniers so it’s not surprising that we have A.D.D. deniers.

The A.D.D. deniers follow an interesting logic:

The “Invention” of A.D.D. by the drug companies.

  1. Premise 1: Drug companies create drugs.
  2. Premise 2: Drug companies need a disease that will be “cured” by the drug.
  3. Premise 3: Drug companies find a bundle of annoying behaviors.
  4. Premise 4: Drug companies bundle the annoying behaviors into a “package” by giving it a name, such as A.D.D.
  5. Conclusion: Drug companies have created a market by “inventing” a disease which, coincidentally, is “cured” by the drug they already have in hand.

Now they need the public to accept this new disease as being real and, of course, to accept the “cure” that the drug companies have. So, here’s the next argument.

The “Adoption” of the drug companies’ definition of A.D.D. by the psychiatric community.

  1. Premise 1: Psychiatric community composed of sycophants.
  2. Premise 2: Psychiatrists adopt the drug company definition of A.D.D.
  3. Conclusion: Psychiatrists find A.D.D. everywhere using this definition. They prescribe the “cure” discovered by the drug companies.

Of course there are teeny tiny nuggets of truth buried in these arguments. You’ve got the effect of good ‘ol labeling theory from Sociology 101. You’ve got the tenuous symbiotic relationship between the drug manufacturing and drug dispensing community. You’ve got the shift in the psychiatric community to more pharmacologically-based “cures” [note 1] which almost always entails drugs.

However, despite these tiny nuggets of truth, none of this necessarily means that A.D.D. doesn’t exist. Ask anyone who has lived with A.D.D. for 20, 30, or 40 years (or more!) and who didn’t know they had it, what it was like to finally be able to explain a whole constellation of behaviors. Ask them about their daily struggles – with or without drugs. How can anyone deny the similar experiences of so many A.D.D. people?

So, what is it that these “deniers” are so afraid of that they refuse to see what everyone else sees? Are they afraid of the reductionistic nature of explaining psychical phenomena in physical biological terms? Are they afraid to admit that sometimes will power does not conquer all? [note 2] I’m not sure what their fears are but it’s something. Hopefully the drug companies will come up with a cure for their “disease.” ;)

Some choice quotes from the A.D.D. deniers:

“They made a list of the most common symptoms of emotional discomfiture of children; those which bother teachers and parents most, and in a stroke that could not be more devoid of science or Hippocratic motive–termed them a ‘disease.’”

“I’m possibly the only person involved in the ‘ADHD debate’ that I know of who has no first-hand experience of the problem whatsoever. For me, the subject is entirely to do with ideas and beliefs and how they compare with my own experiences and whatever facts I’m able to discover.”

“Attention Deficit Disorder (ADD) is a fake disease created by boring out-of-touch leaders who are pissed off that kids aren’t listening to them.”

“ADD is a ‘mood’ in which someone has a difficult time staying focused.”

“The Great A.D.D. Hoax”

YouTube – Audio from Michael Savage Radio Show – ADD/OCD are a hoax.

[Updated on Aug 6, 2007 @ 15:09]

And now…the alternate view.

Attention-deficit/hyperactivity disorder (ADHD) is a real disease linked to changes in production of the brain chemical dopamine, two new reports suggest.

See: Brain Studies Show ADHD Is Real Disease
[Updated again on Aug 23, 2007]

  1. As opposed to the traditional Freudian “talking cure.”
  2. Have they taken too many Dale Carnegie courses? ;)
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  • DrCharlesParker

    Hey Jeff,
    Happy New Year! – What a refreshing blog you have over here – and copious comments from my insightful good buddy Gina Pera!

    We are, my friend, much on the same path, – and I have found in both office practice and regular consultation with medical colleagues, that much of what your are reporting here does have to do with the limitations of the diagnostic parameters, and the frequent imprecision with medication dosing strategies.

    Said more simply: many are simply not paying attention to the necessary details. Paradoxical but true.

    If we don’t think and thereby practice more scientifically, we will continue to be accused of not knowing what we are doing!

    I look forward to following your work over here, and look forward as well to our future conversations.


  • Scott Hutson

    I know ADD is real. I think(uh-oh)..of telling someone about something funny that happened to me(not ADD stuff,just an event),and they have a look,as to say,;”Wheres the funny part?”. In frustration/feeling stupid, I can only say;”Ya had to be there.”

    Denier’s will most likely not “get it” in this comment I made.I bet you(ADDers like me)did’nt have to read to far before knowing what I mean.

  • Scott Hutson

    “Cogito ergo sum” is a way to explain or not.

    Have we landed yet?

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  • Robharvey

    The add/adhd debate has gotten out of hand. Often, a matter gets out of hand due to imprecise use of language. If “disease” is narrowly defined as a negative health condition which typically gets worse when not treated/cured, and which is caused by a bacteria, virus, or poison, then add/adhd does not qualify as a disease. If one throws into the criteria pool what are typically called “genetic diseases”, then add/adhd might qualify if it can be shown to have a very definate pattern of heritability, or if the gene mutation can be positively identified and linked to the symptoms in traditionall causal ways. As adhd/add do not have clear cut heritibility profiles, and as no gene mutation has been indentified, then the set of symptoms called add/adhd do not yet qualify as a disease, or the less severe word, disorder.

    A little reflection on what is typically called a human “trait” may offer a better understanding of what is being discussed, and which word in the lanuage might best and most precisely describe the matter being discussed. If we assume that the condition known as add/adhd is physical (brain), as opposed to idea (mind) then we can think about other aspects of the physical body and consider if this is only a matter of trait. It is clear to everyone that all people are not created equal: In India, only Sachin Tendulkar is referred to as a god of cricket. This is because his ability to play the game well is far in excess of every other player, not only in India, but in all of the cricket world. There are other very, very good cricketers in India, and some who are just very good, and some who are just good, and others who are average and poor. The average and poor cricketers do not claim to have a disease or disorder, but may say, both with humor and candor, that they lack the cricket gene.

    A scenario like sporting ability is likely a good template for understanding adhd/add – most of us do think that one must have a certain physical, and thus genetic profile to be a good athlete – and much research supports this notion, such as data that athletes have exceptional hand-eye coordination and effecient delivery of oxygen into the blood, as well as above average levels of certain hormones. Use of injected hormones has been shown to increase athletic performance. In the USA, in most pro sports, some players have reported increased performance with amphetamines and cocaine. From this data we can extrapolate a hypothesis that poor athletes could become average or good athletes with the aid of hormones and dopamine increasing drugs.

    So it seems to make more sense to view add/adhd as a description of the less desirable end of the spectrum of a trait. Then we can understand why drugs could move an individual to a mmore desirable place on the spectrum. We can also understand why non-drug “therapies” could also move an individual on the spectrum.

    In “the West” little emphasis exists on developing the mind, except the recommendation to “study harder” and “concentrate”. The methods to do so are virtually unknown. In “the East” there is a long tradition of how to study harder and concentrate, independent of any particular subject matter. In India, a Brahmin child attending a Brahmin school will be taught how to concentrate as part of the daily practice of meditation. Brahmins typically score near the top of all school children//teens worldwide.

    It is also interesting to note that the add/adhd symptom of students, callled “fidgetiness” is almost non-existant in India, possibly due to the long tradition of caning students for such behavior. Contrary to scenes painted by some Westerners, Indian children are not brutally caned by teachers as a rule – generally the cane is empoyed and a swatting manner that may sting briefely, but not cause a bruise or welt. Recently India officially banned corporal punishment, but did not allocate funds for implementation – it is thought the practice continues in many parts of the country. Parents are often supportive of corporal punishment. I am not taking a position on the morality of corporal punishment, but the lack of add/adhd type of “fidgetiness” symptom in India suggests that the mind or brain can be conditioned out of such behavior without drugs. Corporal punishment is also practiced in Indian homes and villages, and secretively at all – typically boys (girls tend to be better behaved) will get a slap to the back of the head when unruly or disrespectful to elders. . Spanking the bottom is not common in India.

    It could also be that Indians don’t have much of the add/adhd genetic anomaly, if it is a genetic anomaly. since Indian children are typcially disciplined from early age, and as the add/adhd genetic anomly is not yet identified (if it in fact exists) it is hard to be sure from the Indian example if the matter is nature or nurture.

    In conclusion, I do think it would be more sensible to view add/adhd as a trait, and to explore as much as possible non-drug trait-altering/improving strategies, and to use drugs ny as a last resort. Further considerations on the matter should include the idea that every person has a dfferent upper limit to their cognitive proficiency, and so a drug-only treatment may not raise that ceiling, thus an individual with a lower limit will still have that limit. With such individuals drug-only based therapies may not produce significant improvement in cogntional ability.

    • Jeffs ADD Mind

      I usually respond to comments quite quickly. However, your comment was so long that, at first, I wasn’t sure *how* to respond. After rereading it I realized that your entire theory rests on the following: “As adhd/add do not have clear cut heritibility profiles, and as no gene mutation has been indentified, then the set of symptoms called add/adhd do not yet qualify as a disease, or the less severe word, disorder.” This may have been true ten, fifteen or twenty years ago. But enough research has taken place to disprove your sociological explanation for ADHD. Here are links to two articles discussing the genetic basis of ADHD: and In addition, here is a link to Barkley’s “ADHD in Adults: What the Science Says” which pulls together an enormous amount of data from two longitudinal studies. Therefore, based on the latest information about ADHD, your conclusion that “it would be more sensible to view add/adhd as a trait, and to explore as much as possible non-drug trait-altering/improving strategies, and to use drugs ny as a last resort” does not hold water.

  • Robharvey

    correction to my previous post: I meant to say that corporal punishment in Indian homes and villages in NOT practiced secretvily at all.

  • Steve

    Damn this is a tough subject.

    Okay, I am a denier. I won’t say that any “ADD” case is bogus. But I think there is a systemic sociological problem. The problem is the expectations that society places on people, especially unwitting ones like kids.

    My daughter was diagnosed. We knew it was wrong. Rather than to drug her into submission to what school expected, we took her out and home-schooled her. Best move ever. She’s brilliant and will contribute to the world in a way the school could have never managed to accommodate, let alone help her with.

    I will continue to suspect the medical community and ADD subscribers until they begin discussing the societal context in which individuals suffer disorder. Modern society is different from our evolutionary basis.

    If future society were to require everyone to be, say, a software engineer, and children were raised with that expectation, how many would succeed? How many would want to? How many would be labeled as abnormal?

    Until ADD subscribers acknowledge that modern society provides the expectations within which people are made to look and feel broken, and that there are, alternatively, wide-ranging lifestyle CHOICES that can reset those expectations, I will say that you are still missing the denier’s point.

    Some of us frogs in the pot have realized that jumping out is an option.

    • Jeffs ADD Mind

      While I may quibble over certain details, I’d say that we’re nearly 100% in agreement. (See this post: ) However, I’d like to point out a few things. First, many deniers deny the existence of ADHD as something that is rooted in biology. Second, there are some who acknowledge that modern society makes ADHDers (and others….such as the LGBT community) feel like they are broken. However, it is not likely the entire psychiatric field will suddenly acknowledge the role of social forces so don’t hold your breath for that acknowledgement. Finally, you raise an even bigger issue, that of choice. Very few of us have the economic wherewithal to homeschool our children and/or be able to help them craft an “atypical” career. I would predict, and I think you would agree, that the ability to do this will continue to shrink as our economy shrinks. As should be obvious, those who will suffer most are those who are the square pegs in a society of round holes.

      • Steve

        To deny our biology as the root of all traits is to lack any objective understanding of ourselves as an organism. No argument.

        The key though is whether parents, doctors and teachers regard those traits as differences, or implicit disease.

        I am not holding my breath that the field will suddenly acknowledge the role of social forces. To the contrary, I think most are conveniently entrenched in the idea of a chemical remedy.

        As to economic factors, I don’t intend my comments as a prescription for treatment. I am commenting on the systematic discounting of this denier’s philosophical case. Millions of parents are told that their child “has” ADHD. This positioning, and all the language that stems from it, is a disservice to parents because it tacitly implies the child’s environment is correct and normal, but that something is wrong with the child. Consequently, the most obvious target for treatment is the child.

        Likewise, as a matter of public health and education, the discourse is resoundingly accepting of a medical explanation and cure. To me, economic factors notwithstanding, that is a woeful breach of public trust and scientific integrity. Many people, regardless of wealth, do not realize their choice. This is a systematic failure rooted in culture, philosophy, commerce and communication.

        So I agree that “It’s all in your head” is a terrible characterization. It’s too trite to be meaningful, and it’s tortuously insulting to a sufferer. At the same time, I believe your post’s cited “Invention” and “Adoption” explanations are essentially true, even if not the
        whole story.  And according to your other cited post (which I had not seen), I assume you do, in fact, sympathize with the

        I appreciate that your response and other blog post acknowledge a view I share. But this post seemed to me a wholesale rejection of
        *the* denier view, which I thought included mine. As a voice in this field, I think you could advance the dialogue further by instead embracing all “deniers”, if not only long enough to impart precise language capturing the varying views.

        Thanks so much for replying and the effort you put into this.

        • Jeffs ADD Mind

          Keep in mind that this particular post was written four years ago. My understanding of the issues has grown enormously over that span of time, and, perhaps I should revisit this issue in a future post.

      • Gforce27

        I may have done much better academically and subsequently career wise if I’d been home schooled, or if I’d gone to a arts school, but it wouldn’t have “cured” my ADHD! It just would have given me an environment in which I could have succeeded at the things I love to do. However, I’d still be losing my keys, forgetting to pay bills, and in the dog house with my husband for constantly forgetting to take out the recycling. It wouldn’t have helped me years down the road when I had a child, and became the person that holds down the fort at home. What a nightmare, trying to remember everyone’s schedules, bills, garbage, recycling, appointments, play dates, groceries–you get the picture.
        How the heck would homeschooling have helped me with any of that?!

  • Augie Weiss

    It has been my opinion that ADHD is on the continuum of normal. If we consider the percent of the population with ADD/ADHD both diagnosed and non-diagnosed probably falls in around 10% of the population (I believe it’s much higher) than it’s no longer abnormal. 
    As you say Steve: “The key though is whether parents, doctors and teachersregard those traits as differences, or implicit disease.”  I guess I call it “normal differences”What it can be is debilitating, and that’s what makes it a disease or a chronic condition. While I agree the language used for definition is lacking so I would submit is the diagnosis to begin with. Brain issues are much more difficult to evaluate than physical ones so that is to be expected. I would argue that when you say your daughters “diagnosis is wrong” that is (an natural reaction) more a fault of poor language than mis-diagnosis. I am not educated in the medical field or language arts to know precisely how to correct those wrongs but I do know that this problem befuddled me and most of those I know. In fact I would wager you couldn’t get a reasonable definition from a hundred random people. Mostly because it manifests itself differently to some degree in everyone. Until the definition gets broken down into the many taxonomies applicable (not that I think that would really help) it will be necessary for us to deal with the muddled definitions.The medical case is there. The deniers are probably a smaller percentage of the population than those with the “condition”.

    The fact that many do not want to medicate is also “normal differences” even among those of us who are “believers”. 

    By the same token, there are times that we have to fit in to society for our own selfish interests and that is good enough for me. There is no doubt in my mind had I been medicated in high school my life would be completely different. And who knows how many of the 70% to 90% of those incarcerated and addicted to something negatively affecting society wouldn’t be better off if they had been diagnosed and given appropriate care.

    Sure is a lot to contemplate.


    • Jeffs ADD Mind

      I was a philosophy major so there is a part of me that sees things from the perspective of “in the mind” but I also majored in sociology so I’m well aware of the role of socio-economic forces. That said, I’m essentially in agreement with you. Historically the definition of “normal” changes over time. The “however” is that we don’t live our lives within large historical time periods but within very short, circumscribed periods of time. Further, though we are all subject to the socio-political forces “out there,” we live our lives within our own heads so, regardless of shifting definitions of normal, we have to arrive at a definition that we can live with on a daily basis (I have an upcoming post that looks at this issue). So, you are correct to say that we have to fit into society and I agree with you that our lives – mine and yours – would be very different right now if we knew 20 or more years ago what the heck was going on inside our heads and if we had medication and appropriate therapy.

  • Augie Weiss

    I just received this relevant link from the ADD / ADHD GuideI thought you might find it interestingReframing ADHD Mooney spent most of his childhood sitting outside the classroom in the hallway or principal’s office feeling morally defective and discounted.

    • Jeffs ADD Mind

      Great link! Thanks for sharing this!

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