Recently I received an “open letter to Ned Hallowell” in which the author took me to task for stating that ADHD is not a disorder but rather a trait. She then went on to explain how much pain and suffering ADHD has caused her, and she criticized me for implying that she did not have a disorder (which I most certainly did not mean to do). She said that while ADHD may not have disabled me, it was certainly disabling her.
Her letter reflects a widespread misunderstanding of my position. Let me take a moment to clarify where I stand.
Whenever I say that ADHD is a trait, I immediately go on to state that it can indeed be a disorder, and that it can ruin a life. The prisons, the ranks of the addicted, the halls of the unemployed, the people who have been multiply divorced, the people who suffer from depression, and even the people who commit suicide are over-represented by people who have ADHD. It would be absurd to claim that ADHD cannot be a crippling, chronic, lifelong disability. I fully acknowledge how desperately painful life with ADHD can be. Short of the severe outcomes mentioned above, ADHD often leads to a lifetime of underachievement, frustration, unmet potential, and ongoing sadness, if not despair.
I know how terribly crippling ADHD can be. I’ve been treating it for over 30 years in people of all ages, so I have seen firsthand how devastating ADHD can be.
My point in calling it a trait, rather than a disability, is that ADHD, if managed well, can also be associated with success at the very highest levels. I have adult patients who are self-made millionaires and billionaires; who are CEO’s and successful entrepreneurs; who are Pulitzer Prize winners and Academy Award winners; who are professional athletes; who are brain surgeons and prize winning scientists; in short, I have patients who function at the very top of almost any field you can name.
I also have patients who are blissfully married, love their children, love their friends, and live full and happy lives.
This is what makes ADHD so interesting, if not unique. It can lead a person in one extreme direction or another: either great success or terrible disappointment. Indeed, both can happen. A person can lurch from triumph to disaster and back to triumph again. People with ADHD rarely give up, which is one of the many reason I love them so much.
The key to maximizing the chances of the best outcomes is to get skilled treatment. Unfortunately, few doctors understand ADHD, either in children or in adults, and so the care that’s meted out is spotty at best.
Great researchers like Russell Barkley, Thomas Brown, Sam Goldstein, Len Adler, Mary Solanto, Peter Jensen, and many more have devoted their careers to pinning down the various ways in which ADHD can impact lives, and we owe them a huge debt. It was not so long ago that people laughed at ADHD as if it were a moral failing, not a legitimate medical condition, much as people used to trivialize depression or anxiety.
Now, thanks to major advances in neuroscience, epidemiology, cognitive psychology, and various related fields we have a sophisticated understanding of ADHD. But the public, and much of the medical profession, does not understand ADHD. It remains shrouded in ignorance and stigma.
Stigma is one of the greatest obstacles to people getting the help they need. No one wants to be called disabled or disordered. The reason that I point out that ADHD need not necessarily always cripple a person is, aside from being true, that it instills realistic hope. I see all my patients as champions in the making. Hope leads to far better outcomes than despair.
This is why the positive psychology movement, let by Martin Seligman and his group at the University of Pennsylvania, have delivered such a profound and pivotal shift in how we regard mental health. No longer is it only about what’s sick, disordered, disabled, or pathological. It is also about what’s healthy, gifted, talented, and valuable. By recognizing both sides, the healthy and the impaired, we stand a far better chance of promoting health and limiting disability. That’s what I am trying to do with ADHD.
My goal is to educate and also to instill hope, hope rooted in science and true-life experience, that will lead to the best outcomes possible for a brave and resilient group of people subsumed by the cumbersome and confusing term, ADHD.
Please understand. I know how awful life with ADHD can be. But I also know how wonderful it can be. Working together, we can help everyone become the best they can be, whatever obstacles they may face, whatever conditions they contend with.
Our greatest power as people lies in connection, in working together. As I am fond of saying, “Never worry alone.” Worrying together we tap into each other’s resources and come up with solution after solution.
Let me say to the woman who wrote me that open letter, You are a brave and strong woman. You have suffered a great deal. I am sorry that someone over-simplified my position in such a way that it hurt you. I hope that this note corrects that, and makes clear what I actually do believe.
Working together, we will progress, we will prevail. And we will feel joy in doing so.