One feature of our work as spiritual care specialists is that we do not diagnose our clients with an illness. We listen, explore clients’ concerns, and seek to understand their values and beliefs. Once we know where their strength comes from, we assist them in putting a plan in place that aligns with their approach to life.
… When we argue that adult ADHD is not a scientifically valid diagnosis, we do not mean, of course, that the symptoms so attributed do not exist. Clearly, adult human beings can exhibit problems with attention, concentration, focus, memory, and related abilities. What we mean is that these symptoms have not been shown to be the result of a scientifically valid disease (adult ADHD) and are better explained by more classic and scientifically validated psychiatric conditions, namely diseases or abnormalities of mood, anxiety, and mood temperament.
What Causes the Symptoms Attributed to Adult ADHD?
Plenty of other psychiatric disorders exist that can cause ADHD-like symptoms, and in current practice, individuals with these symptoms receive misdiagnoses of adult ADHD. For example, 84% of patients with symptoms meeting criteria for adult ADHD also have symptoms that meet criteria for mood illnesses.
Using the concept of diagnostic hierarchy, poor attention is a symptom of depression, mania, and anxiety; thus, the occurrence of inattention while a patient has mood symptoms does not mean the patient has both an attention disorder and a mood disorder. This would be like saying every person with pneumonia also has a fever disorder. It is common to find that someone who thinks they have adult ADHD has another illness, such as a mood or anxiety condition, that causes the symptom of inattention.
Another underappreciated consideration is the concept of mood temperament. Unlike the symptoms of major mood disorders, mood temperaments do not come and go; they are present all the time as part of one’s personality. Conditions such as cyclothymia, hyperthymia, and dysthymia involve constant presence of mild manic and/or depressive symptoms. Since these manic and/or depressive symptoms are present all the time, they can produce inattention, poor concentration, and poor executive function all the time.
Concluding Thoughts
The history of psychiatry teaches us that the field has been vulnerable to a host of diagnostic fads. Adult ADHD is the latest of such fads, and a careful review of the scientific literature reveals that the range of ADHD-like symptoms in adults is more accurately explained by other empirically validated psychiatric disorders. This has significant ramifications for therapy, given the wide use of psychostimulants in the treatment of these patients.