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, the 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 the what’s causing the suffering. It can also lead to assuming that your 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 and are 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 here? What’s really disordered? The way we put people in jail? or the innocent victim? Is it normal for an innocent person or a victim to tolerate the process of jail and the courtroom without having an emotional outburst or challenging what’s happening to them? Similarly, a person with ADHD put in a typical school environment is likely to have a negative reaction of some kind, simply 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) is placed in an alternative school that is designed to make learning more democratic, cooperative and organic, the kids almost always perform better and become more cooperative.  The power of context 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 the to do in order to get an A, is that really a dysfunction child? Is it really unnatural or “disordered” to prefer to learn things that are interesting or meaningful to you?  Isn’t the whole concept of school and education really what’s in need of 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 witht the traits of ADHD can causes more suffering than the actual brain wiring we call ADHD.

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 may not be seeing is that the ability to challenge things when see something is wrong, and the drive to make it right are not the same ingredients found in the recipe for effective “self-control.” The ability to improvise (be reactionary) is whole other equally valid way of getting things done in the world. How might things change if we called everyone who is good at self-control “disordered” because they are not as good at improvising? 

[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.]