ADHD Denial - Medical Ambiguity Creates Significant Problems

Medical Treatment Can Significantly Contribute Tostrategies are not used, and many do not practice
ADHD Denialspecific titration, the course of treatment is confounded
Denial and misrepresentation of ADHD difficultiesby ups, downs and inside outs. The treatment regimen
remains pervasive in spite of remarkable new science.itself becomes a disincentive for the long term medical
One of the most important reasons, other than somerelationship necessary to adjust medications. The
simply not wanting to have a problem or takeTherapeutic Window, discussed extensively in other
medications, is the fact that the basic new science isarticles here, is often simply overlooked as significant.
often overlooked. Most importantly, the psychiatric4. Belief Systems: Some docs simply do not believe in
labels have not kept up with functional brain science.ADHD, and they challenge the care given by other
The current labels are too superficial, too descriptive,more informed docs. Science does not count, - to
and lack functional biological significance.many ADHD is a character or personality disorder,
The unhappy result of these circumstances: medicalbased on will. This maladaptive belief is encouraged by
targets are imprecise, miss significant symptomthe cloudy diagnostic process - led by those who are
objectives, and often are simply used capriciously. Ifcorrectly challenging the vagaries of the diagnostic
docs don't have a precise target, it's almost impossibleprocess.
to hit the mark. Missing the mark directly correlates5. Antidepressant Thinking Applied to Stimulants: Some
with encouraging denial.docs who are interested in treating ADHD apply 24
These seven brief observations underlie some of thehour half-life thinking, such as is seen with
most challenging public perceptions regarding the useantidepressants, to these shorter half-life stimulant
of medications used to treat ADHD.medications - which often last less 12-14 hours.
First three basic points: Result from medical confusionStimulants must be adjusted quite specifically.
and inexact use of medications without specific6. Noncompliance: Patients take the stimulant care into
measurements - the key background word istheir own hands, using medications irresponsibly, have
iatrogenic - from my first posting 2 years ago at theside effects, then blame the doc, the diagnosis, or the
site below:medications. Capricious dosing results in capricious
1. Right Diagnosis: If the ADHD diagnosis is made withoutcomes, and ultimate dissatisfaction. The new longer
shallow observations, descriptively, not functionally, theacting medications offer significant improvements on
treatment targets appear vague, unconvincing, andthis process.
somewhat imaginary - as indeed they are with7. Previous Bad Experience: Older medications just did
description alone. Regrettably, medical practitionersnot work as well, proved too cumbersome and
struggle daily with these vagaries.subject to abuse, thus turning the public against all
2. Right Medication: While many understand theADHD intervention possibilities. Some of the most
pharmacology of stimulant medications, many simplyprofound denials come from those identified with
do not take the time. If the doc does not know theADHD as children, and were then improperly dosed
differences he/she will not address them, and if notwith what are now antique medications. Managed care
addressed with the patient, inevitable adverse effectscompanies regularly favor outdated drugs that provide
will be blamed on the diagnosis and the specificless predictable outcomes.
medication - and the client simply does not want to doPrecise dosing, careful selection of medications,
that again.knowledge of drug interactions, and appreciation of
3. Right Dosage: All ADHD medications require titrationmultiple possible comorbid conditions will significantly
strategies to dial them in specifically. If titrationimprove outcomes.