The Problem of ADD/ADHD Misdiagnosis (1): Why it Happens

Being diagnosed with ADD/ADHD can be one of the most life changing experiences imaginable. This is because this diagnosis will often lead to some very radical interventions (with medication on top of the list) being suggested as ways of managing the condition. Most people meekly accept this diagnosis and, with it, the costly and severe treatment suggestions. But what if the diagnosis was wrong to begin with? Surely such a thing cannot happen in a modern and sophisticated medical system?  The sad reality is that it can, and it happens much more frequently than most medical professionals would like to admit.

The fact that ADD/ADHD misdiagnoses do occur should, at the very least, convince all of us to make sure that any diagnosis that is handed down is accurate and based on the best possible information. Failing to do so could set you down a path characterised by huge financial costs and near incessant demands to medicate.

There are many possible reasons for the misdiagnosis of ADD/ADHD, and we will look at some of them in more detail over the next few weeks. It is often possible to spot some common factors behind the diverse forms of ADD/ADHD misdiagnosis. They are:

• Failure to investigate alternative explanations: There is an old saying that goes: “If you only have a hammer everything looks like a nail!” Unfortunately many professionals have come to regard an ADD/ADHD diagnosis as just about the only tool at their disposal when it comes to managing challenging behaviour or thought patterns. This leads to a lack of consideration of other probable causes. This problem is compounded by the fact that many professionals see the solution to the perceived problem as simple and straightforward: Just prescribe a dose of widely available medication. The pattern of ‘rapid diagnosis – rapid medication’ is very hard to break once it is established.
• Outside pressure: Many ADD/ADHD diagnoses happen after teachers (or other professionals who have to deal with the effects of behavioural problems) make a referral. Some teachers are, sadly, merely interested in having the problem ‘go away’ over the short term, without necessarily considering the long term effects of radical ‘treatments’. They also know that the quickest way for this to happen is through sedation! This situation is at its most dangerous when you have a kind of  ‘closed circle’ with teachers being very quick to refer students for suspected ADD/ADHD and the reference then being made to specific medical professionals who are usually very quick to supply exactly that diagnosis.
• Money: The big drug companies pump millions of dollars into the marketing and distribution of their flagship products. Some of this money is spent on incentive schemes to encourage professionals to prescribe certain products, instead of rival brands or alternative methods of treatment. It would, sadly, be naïve in the extreme to deny that this cold fact is not behind at least some erroneous ADD/ADHD diagnoses every year.

All of the above paints a disturbing picture but it should also leave us with hope. This is because it just reemphasises the fact that one doctor’s diagnosis of ADD/ADHD is not the final word on the subject and that, even where there are good reasons for this diagnosis, medication is not the only course of action open to you. Not even close in fact!

Over the next few weeks we will look at some specific reasons for misdiagnosis, some of which you might find strange and surprising. It would be good to, for the moment, concentrate on an immediate course of action once you do receive a diagnosis:

• Determine your professional’s diagnosis rates: It might be difficult to get this information but it is vital that you do! ‘Word of mouth’ could be very helpful in this regard. If you find out the professional to whom you have been referred does indeed have a very high ‘strike rate’ you should seriously consider your alternatives.
• Determine the ‘referral rates’ of whoever made the original referral: The same principle mentioned above should be followed when it comes to the referral behaviour of teachers and other professionals. Some are indeed ready to make an ADD/ADHD referral at the drop of a hat!
• Get a second opinion: It is vitally important that you do not make any final decisions on an ADD/ADHD diagnosis without at least taking steps to have the diagnosis confirmed or challenged.  It is obvious that you should seek such a second opinion from someone whose diagnosis rates are not ‘off the charts’.
• Investigate possible alternative causes: The symptoms associated with ADD/ADHD are certainly not unique to the condition. You should therefore continually ask yourself: Is there something else that could be causing this? Over the next few weeks I will do my best to help you to accurately answer this question.

The bottom line: An ADD/ADHD misdiagnosis could have a profound impact on your life and you should therefore protect yourself from it by getting as much information as possible and by exploring all the alternatives. You can begin by checking back next week as we continue to explore this issue.