Preface

Not another book on ADHD! This is perhaps the groan that will greet this publication. A quick look at Amazon.com indicates that this subject has been written about extensively. So – why another book?

The reasons are as follows:

In 1998 our first child was born. He was (and still is) a joy. However, after a couple of years we started to realize he was different. He had the energy and stamina of a superhero; he could walk for several miles by the time he was 3 (although running was his chosen form of movement). His activity was not a cause for concern, we would just accommodate his needs, and as new parents we considered this to be fine; we did not have a comparison. In fact we thought other children were inert and slightly boring! Excitement and activity were to be with us for sometime to come, shortly to be joined by stress and anxiety. But it was not just his zest for life and his activity that were noticeable; he was also starting to show signs of being impulsive and disorganized. He would react to others around him very quickly and often respond physically and sometimes aggressively. He would try to use physical force to get to his goal rather than thinking and problem solving. Although his behavior was not initially a problem in its own right (after all, boys will be boys), it was starting to become an issue not only with us as parents, but also with others who would occasionally care for him and eventually teach him. We became the parents the teachers always wanted to speak with after school.

In common with many others, but suffering in isolation – the loneliness that comes with differences can be acute – we realized that our son’s individuality, or, as they were to become, his difficulties, were preventing full participation and integration within the wider social world, and, more worryingly, were severely restricting his education. To cut a long, and possibly familiar, story short, we went through the multiple processes of evaluation and diagnosis. Eventually, his consultant psychiatrist awarded him the diagnosis of ADHD that we had suspected now for some time. It may appear curious that I use the word awarded as it may imply a prize or goal. But it was an award, and a reward for all the hard work that went into his evaluation. He is now an expert at the psychometric tests. Along with diagnosis came treatment. We had tried a number of behavioral techniques with him, but after the diagnosis came methylphenidate (Ritalin). Methylphenidate is a notorious drug with a controversial history. Stories of addiction and worse were never far away. If the drug works, that’s great, but how does it work? and what does it do? are important questions to resolve.

I am a psychobiologist by trade – that means I study the biological underpinnings of behavior. I am also a concerned parent, and as any anxious parent who has to make a decision about their child’s health, I wanted to find out more about ADHD and its treatment. I thought I would get a good book that would explain it all to me – wrong! I was greeted with a lot of books, none of which had the answers I required. Many were books about the demise of a past society and the creation of a modern fast-paced society full of bad parents. On the back cover of Angela Southall’s book in bold it states “This is not just another book on ADHD. This book tells the side of the story most of us are otherwise unlikely to hear.” However, Southall puts forward a similar set of arguments about ADHD that a great majority of other anti-psychiatry books do, she just does it in one entertaining and intuitively appealing volume [1]. These books did tell me about the horrors of methylphenidate and that parents and society are ultimately to blame. Many of the books are selective in their use of evidence – a criticism that the authors will no doubt direct at me.

As a result of my dissatisfaction with the available books, I went back to the original sources of information. This information is in the scientific and medical journals where new investigations on ADHD are published. This is not an exercise for the faint-hearted, As Ida Sue Baron points out, “the extensive literature regarding Attention-Deficit/Hyperactivity Disorder (ADHD) is often overwhelming, even to those most knowledgeable about this behavioural disorder” [2] (p. 1). Apart from the sheer volume of information that is available, anyone who has tried to read such papers will immediately know that they are often difficult to comprehend and focus on the small details of ADHD. This dissatisfaction with the accessible knowledge regarding ADHD prompted me to write this book. My intention is to inform parents, students, academics, clinicians, educators, and most importantly those diagnosed with ADHD with a clear account of this complex disorder and its treatment and dispel some of the erroneous assumptions that can be prevalent (e.g. [3–5]).

Like all people, I come with my own ideas and views on ADHD. As a psychobiologist, I approach the study and discussion of ADHD from a neuroscientific position: that is, a brain perspective or the medical model. Having admitted to a bias towards the medical model, I also have a view on the rapidly changing world around me, and I share the sympathies of those individuals who suggest these changes in our lifestyle have an impact. I do not subscribe to the notion that our environments and our biology are separate: nature and nurture cannot be untangled so simplistically (if they can at all!).

The simplistic notion that the world is too busy and there is an over-stimulation of the senses to which we react is an attractive hypothesis. We can all feel the bombardment of our senses and the stress that it can produce in western society (and beyond). But do these changes cause ADHD? Even if they do, why is it that most children (or adults) can manage within this changing society? Ultimately, why do some individuals get ADHD and others do not? Is there a common cause of ADHD? Is there a common change in the brain? Is there hope? And is there a cure?

The questions are endless, though many can attempt to be answered. But for every question answered, many questions still remain and even more are created in the fine detail of ADHD research. The pursuit of knowledge and understanding is therefore endless, and this is exemplified in the case of ADHD. Finally, the complexities of the brain are still as yet to be unraveled. It is surprising given the brain’s complexity that some people, many of whom are non-experts, will pass comment/judgment on the brain’s output (behavior). As Lyall Watson said, “If the brain were so simple we could understand it, we would be so simple we couldn’t.”

I hope that this book explains some of the science behind ADHD, as well as its limitations, and empowers people with the knowledge that will move them away from the bar-room debates and playground comments to a more educated and informed level.