March 13, 2023The Sun It was boldly announced in a newspaper on March 4, “Prince Harry diagnosed by Dr. Gabor Mate with Attention Deficit Disorder” in a tell-all interview.
Mate said, referring specifically to the autobiography of the Duke and Duchess of Sussex, “Reading the Book, I Diagnose You with ADD.” Spare. “I consider it a normal response to normal stress and not a disease.”
Mate, author Scattered Minds: The Origin of and Healing of Attention Deficit disorder And The Myth of NormalDuring the live-streamed event of 90 minutes, which was described as both unconventional and reckless, he also diagnosed the prince with anxiety panic disorder, depression, posttraumatic stress disorder (PTSD), substance abuse issues, and panic disorder.
Mate made his diagnosis before he met the prince. He admittedly based his assessment solely on stories about grief, trauma, substance abuse, and other related issues. Spare. Mate said ADHD is a normal response to normal stress. He believes it can be treated without medication.
There is much to learn and so much misinformation about ADHD. Leading ADHD experts respond to Mate’s claims about ADHD and trauma, as well as fact-checking his treatment advice.
[Download This Free Guide to Debunking ADHD Myths]
All you need to know about clinicians diagnose ADHD based On a patient’s life story
The short answer is no.
“An accurate and complete ADHD diagnosis is a complex, multistep process that includes a clinical interview and a medical history review. Finally, loved ones, educators and/or colleagues must complete normed rating scales.” Thomas E. Brown, Ph.D., a clinical psychologist, has published six books about ADHD and served as the Yale School of Medicine’s clinical faculty for 21 years.
ADHD should only be diagnosed by a doctor, such as a psychologist, psychiatrist, or advanced practice registered nurse (APRN). Brown, who is the director of California’s Brown Clinic for Attention and Related Disorders, explains that an in-depth ADHD evaluation requires several components.
Brown says that the first step is to determine if the patient has ADHD symptoms. Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition, (DSM-V).. A patient must have displayed at least six of the nine symptoms (hyperactivity, inattention, and impulsivity) before age 12. Brown explains that the clinician will then interview the patient and, if necessary, refer the patient to a mental or medical health practitioner who is familiar both with ADHD and other psychological disorders that can cause similar symptoms.
He stated that a good clinical interview can take between two and three hours. This includes time explaining to the patient what ADHD means to them. ADDitude article, “The Building Blocks of a Good ADHD Diagnosis”
[Self-Test: Common ADHD Symptoms in Adults ]
To gather information from patients, parents, teachers, and partners about how they have performed in recent months, and in the past, as well as information from others who have observed them, the clinician should use standard ADHD rating scales such the Barkley, BASC and Brown, Conners or BRIEF scales.
Brown states that a doctor should also perform a complete physical exam in order to rule out any medical conditions such as pinworms or thyroid conditions. A physical exam can help determine if an individual is able to safely take ADHD medication.
A complete assessment can take several visits, and/or visits with an ADHD specialist.
Does Trauma Cause ADHD?
But it’s not exactly. Research shows that ADHD patients who have experienced trauma are more likely to be diagnosed. Research does not support the notion that trauma causes ADHD.1
“Research shows ADHD is a condition that is largely genetic and inherited.” Nicole M. Brown MPH, MHS, Chief Health Officer at Strong Children Wellness Medical Group in New York, Nicole M. Brown, M.D.
She stated that trauma affects the same brain areas, which can exacerbate ADHD symptoms. ADDitude webinar titled How Trauma and Stress Affect ADHD in Children All Colors – and How to Heal the Wounds. Her research was published in Academic Pediatrics (the official journal of Academic Pediatric Association).
“ADHD” is a brain-based disorder that is often diagnosed when a child has difficulty in school or later in life. Kerry J Heckman, LICSW, a licensed therapist specializing on somatic therapy for trauma treatment, is based in Seattle. Trauma can be caused by exposure to stressful events and experiences that can happen at any time in a person’s lifetime. ADHD may be caused by childhood trauma.
Epigenetics is a term that the Centers for Disease Control and Prevention defines as “the study how your behaviors and environments can cause changes in the way your genes function.” It sheds light on how trauma and other environmental factors may affect brain development. ADHD is not a result only of trauma.
Joel Nigg, Ph.D. is a clinical psychologist and professor at Oregon Health & Science University’s departments of psychiatry & behavioral sciences. “It all starts with genes,” he says. “But everyone is exposed at conception to different environmental toxins, advantages, and psychological inputs such as stress, adversity and even trauma. Epigenetics uses this input in order to alter how genes are expressed. This means that a gene’s output can’t be fully known until environmental and individual histories are taken into account. Nigg also explained how epigenetics affects ADHD. ADDitude webinar titled Genetics and the Environment: How Biology, Exposures and Genetics Contribute To ADHD in Children
Can ADHD be “Healed”?
There is no magic bullet or silver bullet for ADHD. It is a lifelong condition that can persist well into adulthood for most people with it.
Combining medication and behavioral parent training is the best way to manage ADHD symptoms in children. Adult ADHD is treated with stimulants (methylphenidate/amphetamine) as a first-line pharmacological therapy.2 ADHD symptoms can be treated with a variety of non-stimulants (second-line treatments).
Even medication can’t “cure” ADHD. Larry Silver, M.D., a psychiatrist and former Clinical Professor in Psychiatry at Georgetown University Medical Center, Washington, D.C., stated that there is no cure for ADHD. Insulin is a chemical deficiency that allows a person’s body to metabolize sugar. The person cannot metabolize sugar after the insulin wears off. We can’t fix the problem at this point, but we can compensate for it with medication. Silver was the former Acting Director, Deputy Director, National Institute of Mental Health (NIMH).
Adults should expect to work closely alongside their doctors to adjust medication dosage and find the best ADHD treatment combination.
Cognitive behavioral therapy, nutrition and meditation, as well as lifestyle and lifestyle changes, can help with ADHD symptoms such memory loss and poor focus.
Can individuals with ADHD self-medicate with marijuana and psychedelic drugs?
Mate and the Duke of Sussex spoke openly about the benefits of ayahuasca, a South American plant-based psychedelic.
Although some people with ADHD look for alternatives to first-line treatment, research doesn’t support the idea that illegal drugs can be used to treat their symptoms. Roberto Olivardia Ph.D., a Harvard Medical School Clinical Psychologist and Clinical Instructor in Psychology, says that people with ADHD are twice as likely to develop cannabis use disorder (CUD), which is a potentially dangerous pattern of cannabis use that can lead to clinically significant impairment.3
Contrary to popular belief, cannabis can be addictive and dependent on individuals’ mental and chemical functioning. Contemporary marijuana contains a higher level of THC than previously reported, which only makes it worse. He adds that people with ADHD are particularly affected by the adverse effects of marijuana.
Olivardia says that cannabis use can also increase paranoia, panic and mood disorders. Individuals with ADHD are at greater risk of suicide due to cannabis use than those without ADHD.4
Olivardia states that the substance’s most damaging effects are to developing brains. Numerous studies have shown that marijuana use before the age of 25 is associated with worse outcomes. One study found that heavy marijuana usage in adolescence was associated to a loss in intelligence of 8 points in adulthood.5 Another study showed that CUD is more common in children under 18 than in adults.6 Olivardia spoke out about marijuana and ADHD in the ADDitude Webinars titled The ADHD Brain and Marijuana: How to Identify & Treat Cannabis Use Disorder in Teens And Part 2: Young Adults and Marijuana, and the ADHD Brain
It seems that very low (micro-) doses of psychedelics such as LSD or psilocybin may be effective in treating symptoms of obsessive compulsive disorder, cluster headaches and ADHD. However, further research is needed and these treatments have risks, warn Ari Tuckman, Psy.D. They stated that psychedelics could worsen bipolar disorder symptoms or lead to psychosis, and that they are illegal unless administered in medical or research settings.
Why is a public ADHD diagnosis so dangerous?
Doctor-patient confidentiality is a restriction on doctors sharing patient’s medical information with others. Mate apparently ignored this and diagnosed Prince Harry with ADHD in public. Access to the interview required a $25 ticket. Ticket holders received a hardcover copy. Spare. ).
ADHD is not widely understood. There are many myths and misinformation that can be spread about ADHD, creating barriers to supporting and helping adults and children with the disorder. Many people believe ADHD is a fake disorder or an excuse for bad behavior. Although none of these statements are true, it doesn’t change that the enduring stigma affects how and if adults with ADHD share their diagnosis.
The UK didn’t recognize ADHD until 2008, when the NICE (National Institute of Clinical Excellence Clinical guideline CG72) was published.7 According to a 2022 study, BMC PsychiatryBefore that time, there was a lot of skepticism and almost no recognition of ADHD in the UK.8
The study’s authors wrote that “While the UK has seen a significant increase in adult ADHD clinical services over the past two decades, demand is currently outstripping provision by a long distance in many regions and nations.”
ADHD is considered a more “niche problem,”
The UK’s most prominent neurodiversity charity, the ADHD Foundation, tweeted: “Gabor Mate – it is neither ethical or appropriate to tell someone for first time — in a public interview — that they have ADHD. It is up to the individual to decide if they want to reveal their neurodiversity.
Debunking Prince Harry’s ADHD Diagnose: Next Steps
- Learn: The Brain Circuits That Link ADHD and PTSD
- Read: 21 Ignorant Comments (and Lyings) about ADHD
- Q: Who can diagnose ADHD?
- eBook: The Secrets of ADHD Brain
View Article Sources
1Brown, N.M., Brown, S.N., Briggs, R.D., German, M., Belamarich, P.F., Oyeku, S.O. (2017) Associations between Adverse Childhood Experiences, ADHD Diagnosis & Severity. Acad Pediatr.https://doi.org/10.1016/j.acap.2016.08.013
2Kolar, D., Keller, A., Golfinopoulos, M., Cumyn, L., Syer, C., & Hechtman, L. (2008). Treatment of Adults with Attention-Deficit/Hyperactivity Disorder. Neuropsychiatric Diseases and Treatment. 4(2), 389-403.https://doi.org/10.2147/ndt.s6985
3Lee, S. et. al. (2011). Prospective Association of Childhood Attention-Deficit/Hyperactivity Disorder (ADHD) and Substance Use and Abuse/Dependence: A Meta-Analytic Review. Clinical Psychology Review. 31(3), 328-341. https://doi.org/10.1016/j.cpr.2011.01.006
4Balazs, J., & Kereszteny, A. (2017). Attention-Deficit/Hyperactivity Disorder and Suicide: A Systematic Review. World Journal of Psychiatry 7(1), 44-59. https://doi.org/10.5498/wjp.v7.i1.44
5Meier, M, et. al. (2012). Persistent Cannabis users show neuropsychological decline from childhood to midlife. Proceedings of the National Academy of Sciences. 109 (40) E2657-E2664; https://doi.org/10.1073/pnas.1206820109
6Winters, K. C., & Lee, C. Y. (2008). Probability of developing an Alcohol and Cannabis Use Disorder in Youth: Relationship with Recent Use and Age Dependence on Drugs and Alcohol 92(1-3), 239-247. https://doi.org/10.1016/j.drugalcdep.2007.08.005
7NICE. Attention Deficit Hyperactivity disorder: The NICE Guideline for Diagnosis, Management and Treatment of ADHD in Children and Young People: The British Psychological Society & The Royal College of Psychiatrists. 2008.
8Asherson, P., Leaver, L., Adamou, M., et al. (2022) Mainstreaming Adult ADHD in Primary Care in the UK: Guidance and Practice. BMC Psychiatry. 22, 640 https://doi.org/10.1186/s12888-022-04290-7
Prev Post