ADHD Past and Present
When I was a kid back in the seventies ADHD as we know it now did not exist. Sure there were probably kids in my classroom who had this disorder but we just didn’t have the diagnosis or the name for it. This is much akin to the fact that I didn’t know people with autism existed until I was in my twenties and in college. Things have surely changed over the decades. There are now more acronyms than ever to describe a vast array of physical, emotional, and mental challenges. We have more education and information than ever about disorders such as ADHD. When an individual is diagnosed with ADHD it is possible to receive support, services, and treatment based upon the label.
Have we evolved to the point where ADHD does not carry a stigma? I am going to say that we are not there yet. As much as we have a greater awareness of this neurological disorder, there are still many people out there including relatives, teachers, and the general public who think this is a made up excuse for irresponsible behavior. I remember a conversation I had with my sister about her son who has ADHD. He was having difficulties controlling his behavior in a public place and a man came up to her to suggest that she beat some sense into him. Add to this a story one of my friends told me about how her son was told by a special education teacher no less to “Just get over it” when he was having trouble concentrating at school. Our Eileen Bailey adds to these stories with some of her own in her post entitled, “Myth: ADHD is Not a Real Disorder.”
Clearly there is a lot of work yet to be done to promote awareness and education about ADHD as well as other learning disabilities.
Despite the fact that the diagnosis of ADHD may still bear a stigma, we still have come a long way from where we began, in how we used to describe and label this disorder. Take a brief jaunt through history with me to discover the evolution of how this diagnosis as we know it today came to be. (Sources include “The History of ADHD” by Keith Londrie and “A short history of ADHD” by Whitney Hoffman).
ADHD may have first been described in medical terminology in 1798 by Dr Alexander Crichton as “Mental Restlessness.” It is said that his description closely matches the DSM diagnosis of today.
The literature also tells us that back in the late 1800’s ADHD symptoms were depicted in a book of German fairy tales with the character of “Fidgety Phillip” who could not sit still at the dinner table and rocked his chair back and forth like a hobby horse. Phillip’s parents were said to be chronically cross as a result.
In 1902 an ironically named Doctor “Still” documented the first disorder caused by impulsiveness. This doctor bestowed the disorder with the most unfortunate label of “Defect of Moral Control.”
In 1922 these same symptoms were given the label of “Post-Encephalitic Behavior Disorder.” It sounds strange but may be better than a defect of moral control.
During the decade of the sixties the diagnosis for these symptoms changed twice to "Minimal Brain Dysfunction and then to “Hyperkinetic Disorder of Childhood.”
By 1980 the American Psychiatric Association created the diagnosis of Attention Deficit Disorder with or without hyperactivity. I believe the separate diagnoses of ADD and ADHD still confuse many people today.
It was 1987 when the American Psychiatric Association ditched the ADD diagnosis and just called this disorder ADHD as we know it today. By this time ADHD was considered a medical diagnosis which could cause behavioral issues.
In addition to the name changes, the treatment for ADHD symptoms has greatly evolved over time as well. Once described as a moral defect, the most recommended strategy given to parents was to punish the child. But over time medication was postulated as a possible treatment for the symptoms of this disorder. Ritalin was first introduced in 1956 as a way to reduce hyperactive behavior in children. Then by 1996 the medication called Adderall gained FDA approval for the treatment of ADHD. This was followed by Concerta in 1999, Focalin in 2001, and Strattera in 2002.
Other medications soon were added to the list to help treat the symptoms of ADHD including Vyvanse and Daytrana. You can read up on the full list of ADHD medications here.
Today the research shows that the best methods to combat the symptoms of ADHD are usually a combination of both behavior management and medication. Awareness and education about ADHD continues to grow each year. Back in 1998 The American Medical Association called ADHD “one of the best-researched disorders in medicine.”
I hope you have enjoyed our little journey through time. Now it is your turn. If you have ADHD as an adult, was it ever called something else when you were a child? What treatments were provided for you? Do you feel that the research, greater awareness, and education about ADHD have done well to decrease any stigma attached to the label? Do share your opinions and insights. We want to hear from you