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Some Lessons in ADHD

08 Sep Posted by in Students | 8 comments
Some Lessons in ADHD

You may know this, but my sense is the knowledge is not widespread: ADHD is an essentially contemporary disease, which means additionally that it needs to be explained (in part) historically.

My goal here is not a big history lesson, but a couple of particulars are essential. Hints of identifying hyperactive kids in school go back to Germany in 1856, but no real clinical interest developed before the mid-1920s. Effectively, in other words, before then the disease had no effective existence. Even then it did not take off: that would wait until the 1960s and 1970s, with U.S. parental advice, doctors, and increasingly parents and teachers themselves gaining a lead over the rest of the world. Why then? Possibly school was becoming more onerous, more probably patience with kids was wearing thin because of changes in parents’ lives, and even more probably the introduction of a new drug (Ritalin, 1955) helped open the floodgates. The history since then involves steady intensification: in 1980 estimates had 3% of all kids affected; that had risen to 5% by the early 1990s; actual diagnosis in the U.S. now hits 11%. And production of Ritalin has soared even more rapidly.

Two points here, related to two of my strongest professional interests. First, this is a history that is really relevant. Teachers and doctors, certainly, should know that ADHD, whatever its other features, is in part an artifact of contemporary history, and they should have some sense of historical explanation. (Some comparative knowledge won’t hurt, either). In these days when we question the value of the humanities, it is really vital to remind ourselves that, without history, we risk believing that every contemporary phenomenon is somehow inevitable, or just “there” for no apparent reason. History does not tell us exactly what to do about something like ADHD, but it is potentially liberating, authorizing us to consider alternatives to current models. (And by the way, history does provide wider knowledge, both useful and deeply interesting, about how diseases get invented and popularized.)

(The relevance of this kind of knowledge of the past means also, of course, that historians must still be urged to deliver a history, and even more a capacity to learn and understand historically, that is relevant to this kind of analysis. We don’t always, as a discipline, step up to the plate here.)

The second point, which anyone in college-level student life does know, but society as a whole may overlook: widespread medical treatment of ADHD is having a huge and problematic effect on college campuses, with growing numbers of students coming to college on medication (for many reasons, of course, not just ADHD), where they may lapse in diligence, or occasionally try to sell their prescriptive doses. Costs in counseling, personal disarray, and other issues are far higher than most people realize.

Again, neither the little history lesson nor the reference to the unexpected range of issues attached to childhood diagnoses gives us precise guidance on a growing problem area. But they do combine to suggest the desirability of wider discussion, and some sense of options – and greater resistance, perhaps, to copout diagnoses.