DR MAX PEMBERTON: According to the test, I've got ADHD too. Ludicrous!
DR MAX PEMBERTON: ADHD is the latest ‘must-have’ mental health condition. But according to the test, I’ve got it too – ludicrous!
- Brewdog boss James Watt disclosed last week that he has the condition ADHD
- Dr Max Pemberton explains how suddenly he has seen more patients with ADHD
- READ MORE: Why are so many adults now being diagnosed with ADHD?
You’d be forgiven for thinking that we’re in the grip of an ADHD epidemic. It seems that barely a day goes past without some celebrity revealing their diagnosis. Clearly, ADHD is the latest ‘must-have’ mental health condition.
Brewdog boss James Watt disclosed last week that he has the condition. Former Premier League footballer Jermaine Pennant announced the week before that he had been given the label. They join the likes of Johnny Vegas, Ant McPartlin, Justin Timberlake, Sue Perkins and Olivia Attwood, who have also talked of being diagnosed.
While I don’t dispute these diagnoses, I have to say that, after 20 years of seeing literally no one with ADHD in my clinic, I now come across it all the time.
The one thing these patients have in common? They’ve paid someone for a diagnosis.
A whole industry has sprung up in diagnosing people with ADHD. It’s very profitable for psychiatrists and psychologists and there’s a stream of people who will pay handsomely to get a diagnosis, says Dr Max Pemberton
Proponents of this new craze in adult ADHD argue that the sudden explosion in cases is thanks to increased awareness, meaning that more people are coming forward to get tested.
I’m afraid that — in many cases — I just don’t buy it.
Time and time again, I’ve seen adults claim to have ADHD to explain away the fact that they can’t concentrate, or focus at work — when what they actually need is to get off their phones and learn to tolerate frustration, boredom and tedium in life.
A whole industry has sprung up in diagnosing people with ADHD. It’s very profitable for psychiatrists and psychologists and there’s a stream of people who will pay handsomely to get a diagnosis.
Assessments can cost anything from £800 to several thousand; and then there’s the ongoing treatment, which often includes private prescriptions for medication (only a psychiatrist can prescribe and they typically charge £350 or more per hour) and ongoing specialist therapy costing £150 an hour upwards.
We are also seeing more and more people who are selfdiagnosing using online tests. It’s something that is worrying a lot of psychiatrists, who feel that the tests being used ask vague or leading questions. Before writing this, I did a test myself. And guess what? If the results are to be believed, I too have ADHD. It’s ludicrous.
Who doesn’t get distracted when there’s activity or music playing around them? (One of the questions.) Lots of people find their tasks at work are boring or repetitive (another question). The result is that the term is becoming meaningless.
Over the past few years, the criteria for meeting a diagnosis for lots of mental health problems, including ADHD, has been widened. It’s called ‘diagnosis creep’, and means that more people fall within the threshold for being classed as having the condition.
Many have pointed the finger of blame at pressures from the pharmaceutical industry, since the more people with an illness, the more people who need medication. But does this actually matter?
I think it does matter, for a number of reasons. Many point to the fact that childhood ADHD is an established condition. But they fail to appreciate that even this remains controversial amongst doctors, and research suggests it’s being wildly over-diagnosed.
It is undoubtedly a complex condition, with genetics, social factors and environment playing a part. Many of us view it as a problem with the family, rather than the child. The World Health Organisation states that a diagnosis of ADHD can represent family dysfunction rather than a problem with the child.
Dr Max Pemberton (pictured) said ‘mental health has been weaponised, and many fear opprobrium will be heaped on them if they question the validity of a contentious diagnosis’
Many worry that it’s easy to whack a label on a child, and medicalise their behaviour, rather than accept there might be a problem with parenting that needs to be addressed.
And rather than looking at an adult’s life and their struggles, you label it all with a diagnosis that removes the incentive to look at what could usefully be changed.
Labelling can have a serious effect on how people view themselves and on the effort they make to change behaviours. A diagnosis means that people too often feel they no longer need to take responsibility for their actions, or make an effort to change.
There’s something reassuring in being able to say that your behaviour is the result of a neurological condition like ADHD. It also means that if anyone criticises you, you then have the protection of a medical diagnosis as defence.
A few years ago, we had a host of celebrities claiming to have bipolar disorder. This seems to have fallen out of fashion now in favour of ADHD.
A number of highprofiled doctors including Sir Simon Wessely, former president of the Royal College of Psychiatrists, and Dr Iona Heath, former president of the Royal College of General Practitioners, have spoken out about how doctors must resist the drive to over-diagnose patients.
Yet mental health has been weaponised, and many fear opprobrium will be heaped on them if they question the validity of a contentious diagnosis.
I fear that giving people a label traps them. It tells them there’s nothing they can do to change.
Research suggests many of those being diagnosed do have a genuine problem — but it’s not ADHD. They have a host of things from emotional issues and complex psychological problems to substance misuse.
Ignoring their real problems and putting a convenient label on it is really not the answer
Why Kate’s right about gardening
Kate Moss (pictured) has found inner peace by meditating in fields and how her garden is where she feels happiest
Kate Moss has spoken about how she has found inner peace by meditating in fields, and how her garden is where she feels happiest. Thankfully, you don’t need to be a multi-millionaire supermodel with a country pile in the Cotswolds to enjoy the same. I often encourage patients to consider gardening as a way to improve their mental health. Many people struggle with mindfulness. Their minds are a whir and they have difficulties concentrating and pushing out the constant intrusive thoughts that crowd in when they are trying it. Gardening, or even just going for a walk in the woods or a field, means your mind is purposefully engaged. Communing with nature is calm, restful and reminds us that there is a world outside ourselves. It’s sometimes better than any pill that we doctors could prescribe.
Biotech tycoon Bryan Johnson, 45, was reported last week as spending $2million a year trying to reverse the ageing process. Reading about his schedule I was struck by the tedium of his routine. It seemed miserable. What happened to growing old gracefully? Someone should tell him: we get one life, live it well!
- Did you slip up with Dry January? If so, you were not alone. A large study into how effective commitments to drink less found that many people struggled keeping to it. And when they did slip up, there was no further difference in how much they drank compared to usual. It’s as though the initial mistake gives us ‘permission’ to stop bothering. I’ve seen this time and again in patients with everything from dieting and smoking to drinking and drug use. You set yourself a goal — then something comes along that means you can’t do it as you’d planned, and your mind uses this as a reason to give up. Be aware of this. If you slip up once, it doesn’t mean you have to give the whole thing up. Instead, sit down and try to learn from the mistake. Think about what went wrong — and, most importantly, how you can learn from it and do things differently next time.
DR MAX PRESCRIBES…
THE GOOD LIFE
The Good Life: Lessons from the World’s Longest Study on Happiness, based on the research he oversees at the Harvard Study of Adult Development
Harvard Professor of Psychiatry Robert J. Waldinger has written a new book, The Good Life: Lessons from the World’s Longest Study on Happiness, based on the research he oversees at the Harvard Study of Adult Development. His popular TED talk discusses the findings and what it teaches us about happiness. It’s a fascinating insight into what really matters in life. (Spoiler alert: it isn’t money.)
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