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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
Dr. Schwartz's Weblog

An Additional Comment About ADHD, It's Really Real

Allan N. Schwartz, LCSW, Ph.D. Updated: Nov 19th 2007

It was correctly pointed out that powerful ADHD medications can have potentially harmful effects on the developing brains of small children. The major point at the end of the ADHD post that I submitted was that there remain large numbers of adults who are not diagnosed with this disorder. This became easily confused with the central theme of the posting which was that ADHD is a real diagnosis and a real disorder and not that more medications should be used for children. In point of fact, too many parents, worried about their children, are too ready to listen to the experts and accept medication treatment without looking into all types of behavior modification programs.

Even with regard to adults, there are other alternatives than going straight to medication treatment. Behavioral training in the form of coaching, behavior modification and cognitive behavioral therapy are useful techniques to be used. Of course, when nothing else is working and a person is in danger of losing their job or marriage, and then medication becomes important as an adjunct to behavioral therapy.

The only conclusion to be drawn is that there is no panacea when treating ADHD in children, adolescents and adults. As a society, we tend to medication oriented and this may be due to the impact that powerful drug companies have in encouraging us to turn to new medications. On the other hand, we Americans tend to want quick fixes when there are lots of problems that require time, treatment and lots of patience before solutions are found.

Finally, ADHD is a real diagnostic category and not something to be scoffed at by people who tend to be skeptical and rejecting of new information. Increasingly, research is showing that there are differences in the brains of people who have and do not have ADHD. These differences are being revealed by brain scans. Very often, time and maturity along with training and behavior modification, make stimulate the brain to overcome these problems. I would add that ADHD is not a single entity but is made up of several sub categories that have not yet been revealed. Further research will give us greatly improved treatment techniques.

Because we know that ADHD is real and can be scientifically quantified, treatment is necessary for the youngsters and adults who are hampered by it. Too many adults complain about how they were made to feel when they were children and were "out of control" at home and in school. It is essential that parents take this diagnosis of ADHD seriously and get the appropriate treatment for their youngsters so that they can learn to master their behavior and the social skills necessary for success in school and society without being made to feel that they are "bad."

Your comments are encouraged

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

Reader Comments
Discuss this issue below or in our forums.

ADHD doesn't need medication instantly. - Kyle - Oct 12th 2009

We had our children on medication after their diagnoses, but since have take them off. We're sure it's on a case by case basis, but they have shown improvements with our alternate methods (and guidance from their doctor).

Risks with trying alternative? - Slattery - Nov 24th 2007

What are the possible risks of addictive-side effects with some of the ADD meds? I'm by no means a luddite, just largely unfamiliar with ADD. In fact, actually, I'm wondering if I may have adult ADD. I'm interested, concerned and looking for help.  Thanks!

Availability of alternatives - Calochilus - Nov 23rd 2007

Dear Allan

I concur to a large extent but locally there is a cartel of Psychiatrists who are luddites and the negative image of ADHD disuades many from arriving at a thorough diagnosis (all comorbidities included) . Without a diagnosis one is at the mercy of a large range of "Alternative Practitioners" whose heart may be in ther right place but lack an overview of the problems. There are very limited numbers of professionals dealing with ADHD by life skills coaching, behaviour management, neurofeedback or other techniques.

This is a problem for children but a massive barrier for adults who are expected to "grow out of it" by the time they have left school.

I am actually of the opinion, that for many adults, a brief stint on an effective medication gives more insight and thus tools to address ADHD than starting with alternatives . Given the difficulty of access to either, it is perhaps only wishful thinking.

There is a real difficulty in the concept of titrating an effective dose of an appropriate medication. Most prescribers will nominate a single medication at a single dosage and if that fails, then "Sonny, you are on your own". It is interesting to observe the different effects of brand name drugs and generics, everyone responds idiosyncratically. "One man's meat is another's poison"

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