Logo for kidsinthehouse.com, a parenting site with 9,000 videosI wrote an article, ”Why I Believe Attention Deficit Disorder is a Myth,” for the website The Kids in the House:  The Ultimate Parenting Resource, on August 29, 2017.   The Kids in the House is a site that offers 9,000 videos from experts and parents (who are the real experts!) on a wide range of parenting topics.  You can also watch a video on ADHD on this site, ”How to Thrive with ADD and ADHD” where I am one of the panelists.

The title of my new book is The Myth of the ADHD Child, Revised Edition: 101 Ways to Improve Your Child’s Behavior and Attention Span Without Drugs, Labels, or Coercion, and some people might get upset and think that I am saying that their disorder or their kids’ disorder simply doesn’t exist.  I say no such thing!  As a former special education teacher, I know that the symptoms associated with a diagnosis of ADHD—hyperactivity, distractibility, and/or impulsivity–are very real indeed!  So let me clarify what I mean when I say that ADHD is a myth.  I’m using the word ‘’myth’’ in its original sense of the term in Greek, which is mythos, meaning ‘’story.’’ So I’m talking about ADHD as if it were a story.  It’s a story that has been developed over the past three decades about why certain people are inattentive, fidgety, spacey, disorganized, impulsive and/or hyperactive.  The plain truth is that I don’t think it’s a very good story.  There are plenty of inconsistencies.  The main one, in my view, is the fact that professionals can’t seem to agree on how many kids have the disorder.  The DSM-5, which is the official manual of the American Psychiatric Association, says 5% of kids have ADHD.  The International Classification of Diseases, which is used instead of the DSM-5 in many parts of the world, uses an entirely different term – hyperkinetic disorder or HKD—and concludes that the prevalence is 1-3% of all kids.  The Centers for Disease Control in Atlanta, says 11%.  The prevalence also differs by state.  In Nevada 5.6% of all children are diagnosed with ADHD, while in Kentucky that number jumps to 18.7%.  That’s a lot of variation!

I think one of the reasons for the huge differences has to do with the fact that there is no objective diagnostic tool that can definitely say whether someone has ADHD or not.  Instead, the decision about who is ADHD relies mostly on subjective judgements.  The most commonly used tool—behavior rating scales—which are used in 90% of the diagnoses of ADHD, ask simple questions about behaviors, whether a child has sleep problems, whether he forgets his homework, and so forth.  The answers to these questions depend heavily on context.  A child might forget homework whenever he dislikes the assignment, or because the teacher gives the assignment at the start of the day instead of at the end, or because the dog ate his homework (sorry, just joking about this last one!).  The point is, that ADHD is a psychiatric diagnosis—that’s serious stuff—and to make this diagnosis hinge upon the subjective judgements of teachers and parents is very iffy to me.

Advocates of the ADHD story usually emphasize the gravity of the disorder by pointing out that there are thousands of studies indicating that ADHD is a brain-based disorder, probably of genetic origin.  I agree that there are brain differences between many kids diagnosed with ADHD and typically developing children, but the key word here is ‘’difference’’ not ‘’disorder.’’ Recent studies, for example, indicate that the brains of kids’ identified as having ADHD develop normally, but lag behind typically developing kids by two to three years.  This finding has huge implications for many of the other brain studies that have been done over the past twenty years especially those which have discovered problems in the executive functioning areas of the brain that govern planning, organization, inhibition, and goal-setting.  In kids diagnosed with ADHD, these areas of the brain (in the prefrontal cortex behind the forehead) are developmentally delayed and thus are apt to be less functional than so-called normal children.

Another issue related to brain studies is that these brain differences can be due to environmental effects such as early childhood trauma, adversity in the family, and even growing up in poverty (in fact several studies have suggested just that).  Advocates of the ADHD story also emphasize the genetic nature of ADHD, with the implication that this disorder is heritable and thus hard-wired into the DNA of ADHD-identified children.  Such arguments, however, ignore the fact that recent trends in genetics have focused increasing attention on how the environment can affect which genes are turned on and which are turned off (a phenomenon known as ‘’epigenesis’’).  In one study, a gene-environment interaction was noted where a child with a specific genetic mutation would develop behavior disorders under conditions of parental criticism.  That means if the child is in a family where the parents are supportive and helpful, this particular gene will not be expressed and the behaviors will not manifest themselves.

One final problem that I have with the ADHD story is that many kids with the diagnosis also have diagnoses with other mental disorders such as depression, autism, anxiety, and bipolar disorder—a situation referred to as ‘’co-morbidity.’’  In fact, one study in Denmark noted that 52% of all kids with an ADHD diagnosis had at least one other disorder.  The raises the following question in my mind:  if a child is both depressed and ADHD, where does the one disorder stop and the other one start?  How do we know for sure whether it’s not the depression alone which causes the inattention, impulsivity, and/or hyperactivity? These are also symptoms of depression in children.

All of these issues, to my mind, suggest that we should be critical in thinking about the validity of ADHD, and not rush to judgment in placing a label on a child and medicating him with a potentially hazardous medication (although medications can be helpful for some kids).  Yes, the symptoms are real, but is there really a ‘’thing’’ called ADHD that is responsible?  I have my doubts. (Note: all decisions regarding diagnoses and medications should be made in conjunction with your physician).

For more information about why I believe ADHD is a myth, plus 101 practical strategies to help kids with that diagnosis, get my book: The Myth of the ADHD Child, Revised Edition: 101 Ways to Improve Your Child’s Behavior and Attention Span Without Drugs, Labels, or Coercion.

This article was brought to you by Thomas Armstrong, Ph.D. and www.institute4learning.com.

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48 Responses
  1. Ian Ford

    Just a thought. ADHD has a herediatry component. ADHD is more prevalent in USA and Australia than in Europe. Maybe the reason is that the settlers who made the journey to the colonies a few hundred years ago either went out in chains because they had upset the ruling classes by refusing to conform to the social or religious norms, or else they needed to be a special personality type to face the risk of a long sea journey to an unknown future. In other word, the risk-takers and adventurers said farewell to family and friends for ever and started a new life. The risk-averse conformists stayed put in Europe, prayed in the esablished church each Sunday for the King and the lord of the manor, and watched the turnips grow.

  2. Kathy collins


  3. Navya Malik

    I think it is also important to consider the purpose of diagnoses in the first place. One of the biggest reasons diagnoses exist is so that patients can get the right treatment. If the symptoms of ADHD exist, and a patient is diagnosed with ADHD and their symptoms are targeted, I don’t quite see the point of discussing whether ADHD is a “thing”. Patients are diagnosed with ADHD when they display symptoms, and then those symptoms are treated. If the treatment works and improves the patient’s quality of life, then what is point of discussing whether ADHD is a “real” diagnosis? What constitutes as “reality” for you, if it is not the presence of symptoms that affect one’s daily functioning?

    PS – With all due respect, I believe that by calling ADHD a “myth”, you are spreading the wrong idea, since, as you noted in the first couple of sentences, you are not using the word its colloquial sense. This can be damaging since in today’s world, a lot of misinformation is spread and beliefs are formed due to articles and books titled such as yours, since many people do not take the time to actually read what the article says, which can negatively affect the lives of patients with “real” ADHD.

  4. Father

    “In one study, a gene-environment interaction was noted where a child with a specific genetic mutation would develop behavior disorders under conditions of parental criticism. That means if the child is in a family where the parents are supportive and helpful, this particular gene will not be expressed and the behaviors will not manifest themselves.”

    This is very interesting. Can the expressed gene be “turned off”. I.e. if the family becomes more supportive, could the symptoms disappear/improve drastically?

  5. (1=”kid with adhd” , 2=” kid without adhd” ) 100 % agree just think if 1 was messing about and 2 saw , but 1 got toys becuz 1 has adhd, but 2 has been good ,but 2 don’t get toys
    so he thinks that if 1 get toys by messing about then 2 will do the exact same as 1 ,so 2 will get toys , then comes the medication if you don’t need it it could cause death or serious brain damage then it carries on and on and a big circle of shit literal bullshit but that my apion ,adhd is purley apion there is no fact but on our side there is slight fact so no one is right but on apion im on the side of it doesn’t exist and i want to know


  6. Jaskiran

    I have ADHD and Panic Disorder, the argument that ADHD symptoms could be symptoms of the second disorder isn’t true because :
    1. I developed a panic disorder when I was 14 and I had symptoms of ADHD since I was 7
    2. my panic disorder meds don’t alleviate any of my ADHD symptoms

    It isn’t just that I cant focus even when I pay attention I still can’t retain information. the diagnosis was much more complicated than just a few questions I was visiting my psychologist for 3 months and she would run various tests and gave surveys for my teachers and parents to fill out.

  7. Randy Norton

    Correct me if I’m wrong. Wasn’t most of the research done on this disorder funded by pharmaceutical companies, the ones that supplies the drugs for it? And the authors of the books published were affiliated with these companies. If so that should say it all…

  8. Samantha

    That is exactly the point Randy Norton. If you have big pharma companies doing the “research”, that’s almost like the cops investigating themselves and find they did no wrong doing… Don’t get me wrong, I am not knocking cops, just making a comment.

  9. Bianca

    My son was struggling in reading comprehension. Teachers and the principal made suggestions that he may have ADHD. I did not think that was the case. I started to focus more on him and started to really look into what was going on in the classroom, which was over crowded. I started to request updates from the teacher. Needless to say his grade improved tremendously and no one is talking to me about him having ADHD anymore. If I would’ve listened to the principal my son would be taking medication that is not needed. Changing his diet also made a big difference.

  10. Yes, ADHD seems to be the ”default” response when a problem in school is identified. You did the right thing to work directly with the teacher – in my book The Myth of the ADHD Child: 101 Ways to Improve Your Child’s Attention and Behavior without Drugs, Labels, or Coercion, forging an alliance with the teacher was one of my 101 ways, and diet was a part of two or three other ways. Good going!

  11. K709rs

    Great article! There should be more talks and education about it. There is no need to overmedicating young kids with drugs that alter their brain development forever and Not giving it a chance to correct itself. Many of the “troubled” children just need more love, understanding, attention, and one on one work with caregivers. And really does every single child need to earn PhD? Can’t they be happy with the normal life instead turning them into zombies on meds?

  12. Logan

    I am a teenager with adhd. I have serious issues when it comes to focusing on things that are not interesting or challenging to me. I move around more frequently than my peers. I present all the symptoms of adhd. My parents are wonderful and are not controlling, and I’ve been this way since I was a very young child. I have a genetic link, that being my maternal uncle, to the disorder. Adhd is a very real disorder that is NOT a product of poor parenting, but is simply a different brain. It is a disorder because it interferes with the patients every day life. Kids who present symptoms of adhd are not treated correctly, however. I am on medication and it helps, however my desire is not to rid myself of this disorder. Despite it being a debilitating disorder, there are some definite positives to it. We are passion and challenge driven, which makes me an excellent math student. We crave adrenaline, making us good at sports such as skateboarding. We need to learn to accept the disorder and embrace its effects, as doing otherwise is an attempt to change the character of the patient, which is counterproductive and an awful idea. Trying to make a kid sit still is frustrating and makes the child resent the situation. Helping them accommodate and helping them based on their kinematic nature is the best option for helping adhd children. My point is it’s a very real disorder with genetic links that effects a vast number of people, where medication is helpful and treatment should consist of accommodation rather than getting rid of the symptoms all together. It is not a factor of parenting.

  13. Thanks so much for your comments. I don’t think I said anywhere that ADHD is due to poor parenting (this accusation is typically used by proponents of the deficit model of ADHD as a ”straw man” argument that can be easily knocked down by them). We’re actually not so far apart in our views. I believe ADHD is a difference or a form of diversity that can be disabling in certain environments (e.g. a teacher lecturing in a classroom) but as you note, can also be empowering in environments where creativity and high energy are required (e.g. skateboarding, composing music etc.). That’s pretty much what you said. And I believe that medications can be useful for some people but should also be accompanied by as you call them ”accommodations” or what I call ”niche construction” (building an environment where you maximize your assets and minimize your difficulties). So, here again we seem to agree. I appreciate your taking the time out to articulate your views in such a clear way. Thanks!

  14. Alex

    Hi Thomas,

    I believe that some of the comorbidities that you mentioned arise from the treatment of an individual with ADHD within society.

    A lifetime of being told that you are lazy and just need to try harder really fuels the old depression and anxiety.



  15. Jake

    There is some interesting new research about ADHD and prenatal nicotine exposure. The widespread adopt of smoking in the mid 1900s could have had a significant impact on the number of ADHD cases we are seeing today.

    Secondly, I would definitely agree that current diagnostics leave something to be desired. The symptoms have significant overlap with other conditions. Additionally, the diagnostic criteria have to be evaluated with a patient’s age in mind. A 10 year old that can’t read a book for 5 hours straight isn’t displaying an “Inability to focus”. A 10 year old that consistently can’t remember the content of lessons they just attended would indicate an “inability to focus”

    As for this statement regarding medicine: “potentially hazardous medication”, I would disagree. At initial, clinical doses, stimulants are typically very well tolerated and have minimal long term side effects. Obviously patients shouldn’t be on unnecessary medication but adhd medication is extremely safe, especially compared to other psychiatric medications (neuroleptics and benzodiazepines for example). Given studies have found untreated adhd leads to a significant reduction in lifespan, the hazards of not medicating could be significantly greater than medicating.

  16. Michael

    What I do not get about all those books and comments and studies about whether or not ADHD is “a thing”, what is actually done to help people with these symptoms?

    ADHD, or those symptoms or whatever it is called, are destroying my life.
    So, I can just laugh about people who think there are benefits or it is just a slight variation. I think this is because of it being severly overdiagnosed. If you are just a bit more forgetful or inattentive, you do not have a problem! If you only have those problems in boring situations, it is not ADHD!

    I wish you could live one day of my life and see how it is. I tried suicide two times already and the suffering is real. I am not able to live a normal life since I was a child. And there was no trauma (other than what was caused because of those symptoms!) or bad parenting involved. My parents tried everything and my siblings are normal.

    How come then, that I never was able to get a driver’s license? That I can’t remember stuff, no matter if it is important or not? I can’t have a normal Job or have normal relationships. I can’t use a calendar correctly because I keep making mistakes. Every day is a struggle. Every day activities are a challenge. Medication did help a bit, but it is too expensive where I live.

    What is it, if it is not a “thing”?

    What people like you are telling people like me is: “You are not sick, you are just not as good a person as anybody else! Try harder!”
    That is what I hear since childhood again and again. No wonder there is co-morbidity with depression and anxiety! You grow up seeing that what other people can do, you can not. No matter how hard you try, you keep failing.

    No one has understanding for someone who always forgets and misplaces stuff. What helps for normal people just won’t work for me. Everybody who actually knows someone with this problems would know.

    I am 35 years old. Since kindergarten my life is pain that only very few people understand. And to make it worse, now everybody thinks they have it and knows what helps. Everybody thinks they are entitled to an opinion. I say you have no idea about this problems.

  17. I’m so sorry about the suffering you’ve experienced in your life, and I certainly don’t want to add to it by negating all you have been through. There are no simple answers to the question of ADHD – it involves many different factors, and I agree that those who try to make it into a ”thing” are not helping matters. Regarding possible solutions, I believe that the more potential strategies there are to treat this condition, the more likely it will be that something will end up working, or at least will keep it from becoming worse. Thank you for your honest message. No, I don’t know what it’s like to have ADHD, although I do know about depression and anxiety since I have suffered from these conditions since I was twelve. I hope that you are able to find things that work for you so you don’t have to suffer so much. I know that medications, meditation, exercise, and therapy have worked for me.

  18. Thank you for enlightening us about ADHD. Some people may have this disorder and recognize it late . I believed these conditions affect the mental health of a person.

  19. Kitty

    In the past, if a student was easily bored and did not find their schoolwork challenging enough, they would have their IQ tested because it was likely they were simply smarter than their peers – or to put it another way, they learned easily and quickly, and their brains/intelligence level needed more challenging work for stimulation. Is this not something that is done anymore? It also seems that in many cases, environment plays a huge part. The old ways of teaching, with children sitting in neat rows and never allowed to speak until called upon, are finally dying out, and deservedly so. Learning is no longer a matter of memorization and listening to a teacher drone on, or copying things off the blackboard. Instead there is more interaction, more input, and learning is more active. I wonder if this might not serve to “correct” some of the behaviors associated with ADHD, such as boredeom and inability to focus. It also makes for interesting thought on why some children behave completely differently in one environment than in another, such as the child who “acts out” at home but never does at grandma’s house.

  20. Thanks for your comment Kitty. What you say is very true about the ”good” old days. These days, ADHD seems to serve as a mechanism that ”sucks in” all the cases of kids who don’t fit in. I was restless as a child, and they did exactly what you said, they gave me an IQ test, and I ended up skipping second grade. In today’s environment, it’s likely that I’d be labeled ADHD.

  21. Chris

    Hi Tom,
    Your title can be misleading and offensive. I am a 33 year old African male and was given the ADHD diagnosis a few months ago. Mental health is not something we discuss in my country. We use labels like cursed, lazy, unserious, stupid, reckless, foolish for people who don’t quite fit in but are capable of functioningto some degree. Those whose mental situation renders them incapable of functioning to any degree are called mad. I always felt a little off even as a very young child. My restlessness, over-sensitivity, angry outbursts, insomnia, forgetfulness, excessive daydreaming, chronic lateness, talkativeness, occasional hyperfocus, impulsiveness.. etc were always obvious to myself and others. I just always believed I wasn’t trying as hard as other people. Now an adult, nothing has changed but I did learn to act like other people when in public. It takes tremendous effort to bottle up the restlessness and monitor my emotions to mirror other people. My academic and professional life have been affected in the worst ways. Also my relationships. The ADHD label was not thrust upon me. I stumbled upon it after decades of wondering “what the fuck is wrong with Me?” My twin siblings, also in their 30s, have similar characteristics and have suffered in similar ways. I’m sure many “bored” kids have been misdiagnosed but maybe ADHD doubters should look into cases like mine before making statements such as “ADHD is fake”. I can’t wait for psychiatric diagnostic methods to improve in the near future. Currently there’s just too much guess work and assumptions.

    P.S. Reading opinions on ADHD from Psychology Today makes makes me want to stab someone. Very ignorant and hurtful nonsense.

  22. N M

    Just wanted to let you know that I had 65 out of 75 symptoms of ADD. I took up to 40 milligrams of Adderall for 22 years. In 2020, a doctor told me that even though my thyroid numbers were in the normal range, they could be made better. He says I was probably deficient in iodide. (Hypothyroidism). Miraculously, in less than a week after I started taking nature-thyroid all of my add symptoms had gone away. Now I can think clearly, stay awake, cook, clean, follow thru, etc.

  23. Thanks for sharing your story. The body is a complex organism, and so any easy explanations like ADHD, often obscure the medical reality. I’m so glad you got to the root of the problem and that you’re feeling much better. It’s great to hear success stories like yours! Much continued satisfaction!

  24. Dear Chris,

    Thanks for your response, and I’m so sorry if my use of the term ”myth” offended you in any way. I am certainly not saying the symptoms are imaginary – they most certainly are. The question is, what causes the symptoms – what sort of explanatory discourse best makes sense of them? I wish you had read more than just that one article, which was written earlier in my career – I still have the same viewpoint, but with I think greater sensitivity than before to the people who have suffered. . I’m sorry that things have been so difficult for you, and wish that in the future, you and your siblings bloom and prosper!

  25. […] it, and its “diagnosis” is completely based on the observer’s subjective judgments, as Dr. Thomas Armstrong thoroughly explains in his book, The Myth of the ADHD Child, Revised Edition: 101 Ways to […]

  26. Anonymous

    I have ADHD. Why did you post this? I thought this website was to “learn”. I am stuck living with it, and you are denying it exists. What is your problem?

  27. I’m not denying the symptoms of ADHD. They’re very real, and I don’t want to take away on bit from your experience. It’s the concept of ADHD that I take issue with – I think it’s in reality due to a complex interaction of genes with a rapidly changing environment (e.g. culture).

  28. Marek

    Dear Thomas,

    I’m a 31-year-old recently diagnosed with ADHD after years of sabotaging everything I had managed to achieve. I might be getting your point, and – to some extent – it seems legit to me, but it’s a quite complex one. Maybe these are my uncommon symptoms, or some philosophical/sociological background of mine, that made me getting your point, but truth is – not everyone’s been that lucky.
    Anyone who’s reading this must deal with the framing effect, an emotional one, as for many it might be unclear whether you’re questioning the ontology of ADHD. Many people with ADHD had to regularly overcome the overwhelming effect of ADHD myths (like, misconceptions) that they are lazy, unfitting or not socialized enough. That’s first. Then, your readers have to put lots of focus in understanding actual meaning of your words and that requires well-developed meta-cognitive skills. Just a quick reminder: we’re the ones with attention deficits, so it’s sometimes impossible to get to the fourth paragraph without being distracted 😉 Another thing – to understand the comorbity controversies you mention, one has to have quite a serious knowledge about psychiatry and/or psychology.
    Without these, it’s quite understandable that emotions might take over (in fact, they took over me at first as well). The substance of your idea here might be a valuable one, but the form is quite risky. It’s just really difficult to keep your emotions back, and when stereotypes are common, it’s important to focus on not creating false assumptions that these stereotypes are legit. Controversially sounding thoughts are a valuable contribution, but they can sometimes have an opposite effect than desired.
    But back to your point, have you heard about some attempts to introduce a better-fitting name, VAST? This can be a valuable answer to your text. I’d really love to see your opinion.

    All the best,

  29. Thanks for your well argued response to the complexities involved in questioning the ADHD paradigm. I think there’s always risk involved when one takes on a mainstream concept – but all my training, background, and intuition led me to the conclusions I came to. I suggest you look at the first few chapters of my book The Myth of the ADHD Child (new version published by Tarcher/PenguinRandomHouse), where I’ve updated my understandings and done I think a better job of teasing out the fine points involved.

  30. Raina

    As a research scientist, I find it strange whenever someone claims that something does not exist. It is almost impossible to prove a negative.

    Of course it is equally annoying when practicing medical professionals act as if they understand a condition like ADHD, when research medical professionals know that there are many unanswered questions about ADHD. Certainly this attitude leads to overconfidence in diagnosis and oversimplified treatment. So I understand where you are coming from.

    However, I do not think ADHD is a myth. My personal experience is that after 25 years of severe insomnia that has been resistant to any of the traditional treatments (behavioral modifications, bright light therapy, sleeping pills, antidepressants), my insomnia virtually disappeared after starting a tiny, 5 mg dose of Adderall. I also have all the symptoms of inattentive type ADHD, though these were not my primary complaint, but they helped lead me and my psychiatrist towards a workable diagnosis.

    Turning from my anecdote to the research, we find that 75% of adults and children with ADHD also self report sleep problems. For a long time, doctors thought this was simply a common co-morbidity/mis-diagnosis, or a side effect of stimulant medications (though sleep problems were originally in the diagnostic criteria for ADHD in the DSM-III).

    But more recently, scientists have proposed that ADHD is, at its core, caused by a malfunction of the circadian system. See “Is ADHD really a sleep problem?” from Science Daily.

    One of the pieces of evidence for this hypothesis is that sun intensity in different areas is strongly correlated with ADHD diagnosis rates, like that difference between Nevada and Kentucky that you note in your article. See “Geographic variation in the prevalence of attention-deficit/hyperactivity disorder: the sunny perspective., Biol. Psychiatry . 2013 Oct 15;74(8):585-90. This hypothesis would also explain why ADHD has become more prevalent over the years – people spend less time outdoors than they used to. (This would not necessarily mean that treatments like light therapy will fix everyone’s problem, though it seems like they are an excellent thing to try before medication.)

    Since you’re presenting yourself as a knowledgeable giver of advice about ADHD, which many desperate people are seeking, I hope you will remain up to date with new work in the field and open-minded about other possible explanations for the legitimate questions you ask in this article. (And of course, I hope practicing medical professionals will do the same.)

  31. Edward F.

    I am a student who suffers from Combined ADHD. I suffer from ADHD every day. This article is a misinformed guess at best, and a deliberate denial of truth. Here’s why.
    1: Childhood trauma is a symptom of ADHD because children with ADHD can feel lazy and be raised incorrectly (which can cause trauma) or be bullied by other students and sometimes even staff members (which I’ve experienced first hand) At school.
    2: Much like childhood trauma, Depression, Anxiety, and others are present in people with ADHD because they develop or are direct symptoms of ADHD
    3: ADHD is a very challenging disease and I struggle with it every day. My life has been filled with sadness that I wouldn’t of experienced if I didn’t have ADHD. How dare you.
    Please do better,

  32. I’m sorry that you were disturbed by my blog post, but I understand your frustration. I am not trying in any way to minimize the suffering that people have who are diagnosed with ADHD – I am simply trying to get people to think more clearly about the diagnosis, or at least to entertain other ideas about what might account for the symptoms (and trauma, depression, and anxiety are three things that I believe can account in part for the symptoms). It sounds like you also have depression, which I can relate to because I also have depression (unipolar) and know the immense amount of suffering it can cause. This blog post was written several years ago. In the meantime I’ve updated my ideas about ADHD and given them in the first few chapters of my book The Myth of the ADHD Child, in case you’re interested. Thanks for your honesty and my best wishes go out to you for suffering less and enjoying life more.

  33. Thanks for your comments. I’m glad that you were eventually able to discover the reasons for your chronic insomnia. I also suffered from insomnia for several years and discovered that antidepressants worked for me (I have unipolar depression). I’m aware of the sleep connection to ADHD, and in fact, wrote a blog post on this topic in 2017 (https://www.institute4learning.com/2017/09/04/is-adhd-really-a-sleep-problem/). And in the revised edition of my book The Myth of the ADHD Child I look at the issue of light in terms of circadian rhythms. So at least I am trying to stay up to date on these matters (the blog post you are responding to was written in 1996 – since then I’ve somewhat revised my ideas and added a lot of new information and research in my revised book The Myth of the ADHD Child). Thanks again for responding!

  34. Robert

    Hello Dr. Thomas Richard. While I’m not a doctor and I respect your opinion, I believe that it is incredibly short sighted, un useful, and actually damaging. It is damaging in that it is already incredibly difficult for many people with ADHD to receive treatment or diagnosis, and this further perpetuates the myths surrounding ADHD, one of the most studied and documented disorders in history. It’s un useful, because even if your theory is true(which it isn’t), what good does it do? Will people then disregard the effectiveness of the most studied type of medication in the world? No. Treatment would still remain the same as it is, using medication and cognitive behavioural therapy is still the most effective way to treat it’s symptoms.

    Now I am going to go through where I think your thinking is short sighted or illogical. While your book may be very helpful for improving behaviour and attention, this is nothing new. There are hundreds of books and articles detailing techniques(many of them similar to those in your books); directed at improving behavior and attention of those with ADHD without the use of medication. And they can be incredibly effective, so while I think your book can probably benefit many, treating ADHD without medication is not new at all. Furthermore, being able to treat ADHD without medication does not disprove the proven effectiveness of treatment with medication.

    Saying that the inconsistencies in the percentage of ADHD in the population is in any way relevant to how real the disorder is, is just wrong. Of course there is inconsistencies. Mental health awareness has exploded in recent times, leading to increases in diagnoses. ADHD in particular is believed to be one of the most underdiagnosed and misunderstood disorders, despite the amount of research surrounding it. You say that it is over generalized, yet fail to mention the three categories it is broken down into: Hyperactive, inattentive, and combined. Generally everyone fits into one of these three categories extremely well. And while you could try and argue that this is an example of three separate disorders, the treatment methods for them are all the same. Rather than being different disorders, these are simply the ways which ADHD presents itself in different individuals; ADHD could be considered a spectrum similar to Autism. The category which is most often underdiagnosed is the inattentive type, which is typically how females present ADHD. So there is two large populations(male and female) which generally present in different ways(hyperactive and inattentive), yet treatment for them remains largely the same and similarly effective. Does that make you think there are two separate disorders, one for each gender; or one disorder, which generally presents differently in each gender. While it is relevant to say that the diagnostic tools for being diagnosed are not the greatest, how else would you diagnose it besides psychiatric diagnostic? Yes, it’s probably a big factor as to why there is such variation, but that in no way points to ADHD not being real. And while it does lead to misdiagnosing, I would still argue that it is underdiagnosed. Of course it should not be diagnosed solely by teachers and parents, but anyone who wishes to get medication for treatment(what you seem to be so afraid of) would need a professional diagnosis anyways, so that point is irrelevant.

    As for the brain development argument, it would be much more helpful if you would actually link to these studies instead of just quoting them from memory. You yourself mention that these recent studies have implications for many other studies over the past 20 years, so why do you personally believe the new studies rather than the thousands of other studies conducted previously? You fail to link any of these articles here, let alone do anything to prove where the methodology could be wrong. In the next paragraph you try to point out that environmental factors could be a contributing factor. But correlation does not equal causation, and I think you could make the inverse argument but even stronger. ADHD is directly correlated with poor money management, impulsive spending, substance abuse, emotional dysregulation, and is known to be highly genetic. So children with ADHD could very well have parents with undiagnosed ADHD, meaning that children with ADHD are far more likely to be raised by parents with poor money management, substance abuse, and childhood neglect and trauma. So of course there is a correlation between these things and ADHD, any person with ADHD will tell you that stress can exacerbate their symptoms. And obviously children are less likely to present in families without these things, and there is less stress and more support for these children throughout their childhood. And then again, you reference studies without linking to a single one, and in the particular study you mention you simply say “behavioral disorders” instead of stating whether it looked particularly at ADHD, or a multitude of disorders, or something else entirely. And even if you consider everything in this paragraph to be accurate, it still doesn’t prove ADHD isn’t real, rather says that ADHD is something which can develop from environment, and people and studies claiming it is a brain disorder are simply incorrect. So even if it develops from environment and all these studies are wrong, if it still presents the same way, and reacts the same way to treatment, does that make it not ADHD?

    Your final problem is the most illogical and most shallow thought of all your points. The answer to the question in your mind: “if a child is both depressed and ADHD, where does the one disorder stop and the other one start?” can be answered by looking directly to something you had a problem with in your second paragraph, and directly provides reason for another problem you had in that paragraph. You argued that it’s a problem that there is no objective diagnostic tool- of course there isn’t, as you said in your final problem there is a high percentage of co-morbidities related to ADHD, so it must be judged on a case by case basis. I myself am a male with inattentive type ADHD. I went undiagnosed until I was 22. However, I was depressed from highs chool until then, and in high school I went to therapy for my depression, but it did not subside. However as soon as I started ADHD medication, my ADHD and my depression subsided. So if my depression was causing my ADHD like symptoms, treatment for my depression should have helped both. But since treatment for my ADHD like symptoms helped both disorders, I think its safe to say that ADHD was causing my depression. If my depression however remained after I started treatment for my ADHD Like symptoms, but my ADHD symptoms were reduced, you could assume they were either unrelated or somewhat related, but either way you would assume I have both depression and ADHD, and neither one is “causing” the other entirely, rather just exacerbating the symptoms of each other. This is exactly the answer to why there is no objective diagnostic tool, because it presents differently in everyone, and has high co-morbidity rates. And neither of these things are reason to believe ADHD “isn’t real” or is simply a misnomer. Autism also has many comorbidities and presents in many different ways; does this make you question the validity of autism?

    Lastly I will take issue with you calling ADHD medication potentially hazardous. This is perpetuating the myth that causes so many to go undiagnosed, or perhaps to even cause parents to reject the most studied medicines in history out of fear even if their child is diagnosed. ADHD medications are not dangerous. They are extremely well studied, and almost all of the risks can be greatly minimized with proper treatment and care. The most dangerous side effects are only high risk to those with pre existing conditions, which any doctor worth his weight in dirt should be considering before he prescribes any medication- for ADHD or other ailment. And with proper control, education, and monitoring, the risk of addiction and abuse is incredibly low. Those with ADHD literally don’t get high from proper dosing, and it takes them a much larger dose to get high than it does a regular person. They simply don’t have the same appeal to those with ADHD in the first place. Stimulants at low doses generally calm most people with ADHD, the opposite effect they would have on a neurotypical.

    In summary, you complain about teachers and parents diagnosing, and complain that there is no objective tool; yet complain that it’s hard to diagnose due to comorbidities. Either way, you literally cannot get medication(which is what you seem to dislike most) without a psychiatric diagnosis, so arguing that teachers and parents shouldn’t be diagnosing kids is irrelevant, they don’t diagnose kids, they see the symptoms and then take the kid in to a professional to receive a diagnosis. And because these comorbidities are so uncommon is why it is so hard to diagnose and why their cannot be an objective tool for diagnosis; anyone with their right mind will say that it should only be diagnosed by a professional on a case by case basis. The way to help reduce misdiagnosing is to teach doctors and psychiatrists; as well as the general population, more about the symptoms, not try make pointless arguments about what you call it. Most of your arguments involve circular reasoning which can be applied to a multitude of conditions, and you seem to be irrationally afraid of medication and against ADHD. You have a multitude of other works and articles which seem brilliant and I intend to look at much more of your work, however I can’t help but see this as a total miss fire. Thankyou for taking the time to read my reply, and I look forward to reading your other works.

  35. MEGAN

    If ADHD is a myth why does the medication I’ve been taking for over 20 years as I am 34 help me focus everyday and keep me from bouncing off walls? However I do think doctors are quick to assume a child having difficulty concentrating or what not to have ADHD with out further investigation

  36. Your symptoms aren’t a myth, and the medications successfully treat those symptoms. What I believe is a myth is the narrative that’s been told about these symptoms – I’d suggest that you get my book The Myth of the ADHD Child to read about my most current views on this subject. Thanks for writing in!

  37. No worries about the last name. I want to thank you for your reply. I admire the time and effort you put into your comments. The article that you’re responding to was written in the 1990’s and my views have advanced considerably since then. I am not against medications (I take medications myself for unipolar depression), but against their improper use (as you indicate, proper prescription and monitoring can solve most of this). In my latest book The Myth of the ADHD Child I include references to most of the claims that I make. I certainly believe that the symptoms of ADHD are real, but that the concepts used to make sense of them have some problems with them. I don’t think I’m contributing to misinformation (as some do who criticize ADHD), but rather providing other perspectives for people to consider. Progress occurs when different minds struggle to achieve a new synthesis. I wish you all the best in your life and hope that your depression and ADHD symptoms don’t serve as obstacles to all the things that you want and deserve out of life. Thanks again!

    Thomas Armstrong

  38. wendy

    How would you explain the brain differences in ADHD, without calling it a disorder? The dopamine transporter works backwards in ADHD individuals, causing an efflux of dopamine, which is corrected by the use of stimulants. Whereas, this transporter works correctly in ‘normal’ individuals. It won’t be long before you are faced with a dilemma of whether you want to appeal to the uneducated, and if so, why? I sound mean, but with all sincerity your arguments are flawed in logic (such as: if apples are not oranges, then apples cannot be pineapple). Apples must be compared with apples.
    Kind regards,

  39. We all have brain differences. No two brains are the same. Even if the so-called ADHD brain had dopaminergic abnormalities, these could be the result of stress, the media (rewiring the brain), the lack of play, and/or many other environmental factors. If somebody scares you, your adrenaline levels go up. If you came in not knowing the circumstances and measured that person’s adrenaline levels you must ascribe the high level as genetically caused, even though it was something that occurred in their personal experience. I suggest you look at my book The Myth of the ADHD Child and read some of the papers that I reference in it before you suggest that my work is only for ”the uneducated.”

  40. wendy

    I don’t think so. When they administer cocaine to a neurotypical person, the dopamine transporter is flipped, and there is a efflux of dopamine. But this is already the case in ADHD individuals, so when you administer the cocaine, or another stimulant, you get a flip of the flip – so to speak – so a more neuro-typical brain. I invite you to read Randy Blakely’s papers on Adhd and dopamine transporters in the brain 🙂

  41. Alex

    Dr Armstrong,

    The title of your book “the myth of the ADHD child” is hurtful to me as an adult with ADHD. No matter what your intention, it brings up painful feelings around having my symptoms minimized and misunderstood. I understand your explanation, that you mean mythos or story, but that does not change how I feel about it. And nothing in the book can undo the damage of that title for me.



  42. I am sorry about hurting your feelings with the title of my book. It was not my intention to minimize or misunderstand the life experiences of individuals with the diagnosis of ADHD.

  43. There are indeed brain differences, but they reflect a delay in brain development from 2-3 years in many areas of the brains of ADHD-diagnosed kids. So they have normal brain development, but have it later than neurotypicals. This makes the issue a developmental one, not a deficit one. I discuss this further (along with specific studies) in my book The Myth of the ADHD Brain: 101 Ways to Improve Your Child’s Behavior and Attention Span Without Drugs, Labels, or Coercion.

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