Misdiagnosis and Dual Diagnoses of Gifted Children and Adults: ADHD, Bipolar, OCD, Asperger’s, Depression, and Other Disorders

Have you had multiple labels given to you by professionals? Do you love someone who has?

One of the well-kept secrets of the mental health community is that more than half and possibly up to 80% or more of the people who receive a diagnosis of ADHD, Bipolar, OCD, Asperger’s, PTSD, Depression, or a Learning Disorder are also gifted and multi-talented. Also, if you get any one of these diagnoses you are very like to get multiple diagnoses. They call this co-morbid or co-occuring conditions. They also may call you twice-exceptional.

 By definition, multiple diagnoses is a sign that we don’t really understand the full complexity of the underlying causes of human behavior. Is depression chemical? is it situational? is it reactionary? is it lifestyle? is it culture? is it the individual’s responsibility?

These are very disturbing questions. The truth is that all of these factors influence depression. Trying to pinpoint a single cause is a futile mission. Trying to diagnose your suffering and give it a single label can be helpful in understanding how you are feeling, but it can also mislead you into thinking that human suffering requires a label and a “treatment plan to fix” the suffering when really what’s needed is to change what’s causing the suffering.

It can also lead to assuming that suffering is being “caused” by an internal condition (something wrong with you) rather than by the environment you are in, or the lifestyle you are leading. For example, thinking that ADHD is the cause of your suffering, disorganization, poor grades or job performance etc. In reality, the causes are far more complex.  Suffering is not actually “caused” by ADHD.  If that were true, all people with ADHD would be suffering but it’s well known that many people with ADHD do not suffer from it any more than most people suffer from the problems of life. 

Thinking that how a person behaves in certain situations makes them disordered is a very dangerous assumption. If you are put in jail unfairly and you respond with anger, is that really inappropriate? Who is really to blame for the situation? What’s really disordered? The way we put people in jail? or the innocent victim?

Is it normal for an innocent person or victim to tolerate being put in jail? Is it normal to be in a courtroom knowing you are innocent and not have an emotional outburst?  Is it normal not to challenge or resist when you are being forced to do something you hate to do?

Any person who is naturally creative or has ADHD who is forced to endure a typical school environment is likely to have a negative reaction of some kind.  Just as a sun loving plant will suffer in the shade, creative kids and schools are usually a bad fit — because schools are designed to “standardize” achievement rather than to promote creative thinking.  

When creative, independent thinking kids with performance and behavior challenges (ADHD or not) are placed in alternative schools designed to make learning more democratic, cooperative and organic, the kids almost always perform better and become more cooperative.  The power of context and environmental design cannot be disregarded. 

ADHD in children is defined by the DSM IV in terms of how well they “control themselves and sit still in a classroom.” If a child who loves adventure, and prefers to learn by exploring, feels tortured by sitting indoors all day doing what people tell them to do in order to get an A, is that really a dysfunction child?

Is it really abnormal or disordered to prefer to learn things that are interesting or meaningful to you?  Isn’t it possible that the whole concept of school and education may be what’s in need of treatment and redesign? After all, our current model of schools has only been around since the beginning of the 20th century.  Why are we so sure we got it right? 

Granted…asking questions like this won’t solve the immediate suffering of parents, teachers and kids. But we can’t keep casting the questions aside either. Misunderstanding and intolerance of human neurodiversity (and the way we diagnose and treat people with ADHD) often causes more suffering than the actual brain wiring of ADHD itself. 

Our cultural norms, our schools and healthcare systems are in crisis because of our extreme bias in favor of the self-control mechanisms of executive functioning. What we have not be seeing is that the ability to challenge things when you see something is wrong, coupled with the drive to make it right, constitute a different kind of self-control.  You might call it initiative, leadership, courage, or the ability to speak up and advocate, or the ability to follow one’s heart.  These are not the same ingredients found in the recipe for the kind “self-control” that makes it easy for a person to sit down, shut up, and do what they are told in order to seek approval.

The ability to improvise (be reactionary) is another alternative to self-control that is an equally valid and necessary way of getting things done in the world. How might things change if we called everyone who is good at self-control born followers who are “disordered” because they are not as good at improvising, adapting or challenging? 

Just a thought.

[To learn more about the controversies behind this issue, see Misdiagnosis and Dual Diagnoses of Gifted Children and Adults: ADHD, Bipolar, OCD, Asperger’s, Depression, and Other Disorders by James T. Webb, et al.]  

2 thoughts on “Misdiagnosis and Dual Diagnoses of Gifted Children and Adults: ADHD, Bipolar, OCD, Asperger’s, Depression, and Other Disorders

  1. This is a book I refer and recommend to clients all the time. It is so useful especially with the homeschooling/unschooling/natural learning families I work with. Thanks for sharing and bringing your wisdom to the world.

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