Question: What exactly is ADHD? Why does it exist in the world? Why has it become the “diagnosis du jour”?
Answer: In most cases ADHD can be thought of as a part of personality. Personality is made up of temperament which is mainly genetic, and character which is mainly learned. Temperament includes:
Differences in temperament begin to show even in utero, e.g., high vs. low activity level. Anxiety proneness and hyperarousability can be detected by listening to the marked change in fetal heart rate in response to a stimulus such as a loud noise. The normal fetus will only have a slight increase in heart rate in response to the same noise. A small percentage of fetuses will have no increase in heart rate – they will become kids with low/no anxiety. Dr. Jerome Kagan of Harvard has studied individuals from womb to adulthood. The hyperarousable fetuses frequently become shy individuals who in my experience also are more likely to also be ADHD. The low arousable fetuses become the bold kids and sometimes become the antisocial personality frequently without anxiety or guilt.
Variations in temperament lead to the whole range of personality types including vigilant, mercurial, adventurous, self-confident, and dramatic, none of which is considered abnormal or pathologic. Each trait exists on a continuum from a little bit to marked in degree. Some people have one or two prominent traits. Others have several traits. Personality is defined as pervasive, enduring ways of feeling, thinking, and behaving in relationships, work, and the world in general. A personality disorder exists when one of the temperament traits is excessive and maladaptive and there are short comings in character.
Character includes:
The third character trait is self-transcendence-valuing beliefs, family, etc., as greater than oneself.
ADHD traits can be mild and even charming. ADHD individuals can be fun and frequently creative. ADHD focuses on the cognitive and behavioral aspects of personality, especially as they relate to how one interacts with the environment – which of course includes social interaction. The current diagnostic manual (DSM IV) does not include any mood or emotional symptoms as part of the disorder. For any condition (such as personality or ADHD) to be a disorder in the sense of an official medical diagnosis it has to result in significant distress to self or others and/or cause impairment in functioning such as school, work, relationships, recreation.
