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A review by alexisrt
ADHD Does Not Exist: The Truth about Attention Deficit and Hyperactivity Disorder by Richard Saul
1.0
This book is a mess.
It starts out from a reasonable premise: ADHD describes a symptom cluster and that it is already known to overlap with other disorders. People may jump to the conclusion that ADHD is the problem and stimulant meds are the answer without fully investigating.
The problem is, he doesn't have any good answers. The bulk of the book is comprised of brief chapters listing disorders or conditions that may present similarly to ADHD. Many of these are reasonable things to consider, and I would certainly hope that a child is checked for vision or hearing problems before jumping to ADHD. They don't, however, explain enough cases--sure, Tourette's or schizophrenia might have similar symptoms, but how common are they? The diagnoses he chooses are not all solid. He devotes a section to sensory processing disorder, another condition that is viewed by many clinicians as a symptom cluster and which is not in the DSM. He includes an example of a child with bipolar disorder--another controversial diagnosis (and if we're going to rail against the side effects of stimulants, lithium is no picnic either).
Then he throws the real curveball. No, ADHD doesn't exist, but a new disorder, NDI, does. What's the difference? Ah! This is neurobiological! We can explain it through neurotransmitter levels, and this will also explain why some people do better with stimulants and some with SSRIs! But he doesn't explain how that all works, and you cannot just invent a new diagnosis in 10 pages and fail to explain it. This one chapter may undo the entire book.
I wavered between 1 and 2 stars--because he is correct that patients need to be fully evaluated, some patients may well have something else, and if his statistics are correct, there's much to wonder about in the number of ADHD diagnoses and the number of stimulant prescriptions being written. Our healthcare system, and even more so our mental health system, is prone to seeing a prescription as a quick fix. Unfortunately, he treats it only as a categorization problem, without recognizing the social factors that are also driving this.
It starts out from a reasonable premise: ADHD describes a symptom cluster and that it is already known to overlap with other disorders. People may jump to the conclusion that ADHD is the problem and stimulant meds are the answer without fully investigating.
The problem is, he doesn't have any good answers. The bulk of the book is comprised of brief chapters listing disorders or conditions that may present similarly to ADHD. Many of these are reasonable things to consider, and I would certainly hope that a child is checked for vision or hearing problems before jumping to ADHD. They don't, however, explain enough cases--sure, Tourette's or schizophrenia might have similar symptoms, but how common are they? The diagnoses he chooses are not all solid. He devotes a section to sensory processing disorder, another condition that is viewed by many clinicians as a symptom cluster and which is not in the DSM. He includes an example of a child with bipolar disorder--another controversial diagnosis (and if we're going to rail against the side effects of stimulants, lithium is no picnic either).
Then he throws the real curveball. No, ADHD doesn't exist, but a new disorder, NDI, does. What's the difference? Ah! This is neurobiological! We can explain it through neurotransmitter levels, and this will also explain why some people do better with stimulants and some with SSRIs! But he doesn't explain how that all works, and you cannot just invent a new diagnosis in 10 pages and fail to explain it. This one chapter may undo the entire book.
I wavered between 1 and 2 stars--because he is correct that patients need to be fully evaluated, some patients may well have something else, and if his statistics are correct, there's much to wonder about in the number of ADHD diagnoses and the number of stimulant prescriptions being written. Our healthcare system, and even more so our mental health system, is prone to seeing a prescription as a quick fix. Unfortunately, he treats it only as a categorization problem, without recognizing the social factors that are also driving this.