ADHD is a Spectrum and Why I Disagree With the DSM

I disagree with the Diagnostic and Statistical Manual of Mental Health Disorders (DSM)… yup I said it!

I disagree with it because I feel that the ADHD diagnosis should be considered a spectrum, not three individual diagnoses, much like the changes they made in the most recent DSM(5) with Autism. I do, however, appreciate that in the most recent update they change the criteria to be more reflective of what we are learning, ADHD doesn’t always show itself before the age of 7. 

What I disagree with broken down symptom by symptom:

Inattention-

•     Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities

  • It may look like this to the outside world but many ADHD inattentives actually pay very close attention to details they just may get distracted or forget

  • And oftentimes we’re very careful in the things we do. We may just not see the reason why the way we do something might not be right. Remember, our brains don’t work the same so we often don’t see the mistakes as careless but actually the opposite

•    Often has trouble holding attention on tasks or play activities

  • We actually have great attention, but the problem is we’re paying attention to EVERYTHING

  • And as for the tasks or play, yeah if we don’t care about it then we will have trouble but if it’s something we like then time doesn’t exist. We can spend HOURS doing one thing, it’s called Hyper-Focus

• Often does not seem to listen when spoken to directly

  • Ok so I do like that they included “does not seem” 

  • We will listen but if you take FOREVER or over-explain or don’t get to the point then we’ll struggle to follow

• Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked)

  •  Ok so I partially agree with this

  • However, one incident in my own life that stands out was in school when I never showed how I got my answer in math

  •  I never showed it for several reasons… #1 half of the time I had absolutely no idea how I got the answer but no I didn’t cheat and #2 we didn’t always get it the way you taught it to us but if we put that down we’ll still get marked down so why spend the effort showing it? 

•  Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework)

  •  No.

  •  Just no.

  • We LOVE things that take a lot of mental effort, the problem is the things you think “require mental effort” are actually VERY BORING

  • And I hate to say it but often times there doesn’t seem to be a point or if we don’t see the point, we aren’t invested and probably won’t do it

Hyperactivity and Impulsivity-

• Often leaves seat in situations when remaining seated is expected

  • Not always, especially as an adult or a female. We are afraid to upset those around us so we’ll mentally “leave our seat” when it’s expected

  • This could look like us daydreaming, doodling, checking our phones, etc.

• Often unable to play or take part in leisure activities quietly

  • Why in the world would we play or take part in leisure activities quietly? 

• Is often “on the go” acting as if “driven by a motor”

  • Isn’t this what society is preparing us to do as adults? If we aren’t multitasking, we’re lazy and unproductive, right? 

  • And as an adult, this is often screened for as having trouble “relaxing”… Well, I got news for you, relaxing is my jam! I’ll take a spa day any day of the week. I love relaxing, I will hyper-focus on that all day, every day! Because I LOVE it.

I was officially diagnosed as an adult with combined type because my psychiatrist to some extent agrees with me about the criteria not being reflective of everyone with ADHD. If we took the criteria literally, I would actually not even qualify for the diagnosis, I fall just short of meeting the minimum requirements as they are currently written. I also see this in my practice as well, I have a handful of patients who have never been diagnosed with ADHD because they do not meet the criteria minimum but it is very obvious that they struggle with executive functioning problems. But then again, I do not treat disorders, I treat the symptoms you feel are a problem. If it is causing a problem for my patients then we work on it, regardless of the DSM criteria. The only place I really see the DSM label being needed is for billing insurance and for medicinal purposes. 

If you’d like to learn more about how your executive functioning interferes with your quality of life, regardless of if you qualify for ADHD or not send me a message at Colleen@scatteredpotential.com, subscribe to my blog, or my newsletter by filling out the form below. Follow me on Facebook, Twitter, and Instagram.