ADHD: Diagnosis or Description?

ADHD stands for Attention Deficit/Hyperactivity Disorder. It would be reasonable to assume from the name that everyone with ADHD has difficulty paying attention and staying still for any length of time. The label, however, is not accurate in this case.

Most people who have what is called ADHD can pay attention to what interests them, or to matters requiring their urgent attention, sometimes for extended periods of time. Not everyone with this "label" is hyperactive or restless, which makes the diagnostic category somewhat confusing. 

The terms "deficit" and "disorder" appear frequently in the diagnostic manual for psychiatrists and other mental health professionals, known as the DSM, currently in its fifth revision, to lend credibility to diagnostic categories through the "disease model," which is necessary for research and billing purposes. These terms do not, however, help real people to understand what they or someone close to them are dealing with. The DSM attempts to compensate for it's own deficiencies by offering three subtypes of ADHD: 1) primarily inattentive, 2) primarily hyperactive/impulsive, and 3) combined type.

A more accurate label for what most of the people with whom I meet struggle with is "Attention Regulation or Control Disorder (ARD/ACD)", which is sometimes accompanied by hyperactivity or restlessness. This name, which is my invention and not an officially recognized category, acknowledges the fact that, while it may be difficult for those with this set of traits to focus on demand, it is not impossible to do so when certain conditions (interest or urgency) exist. The presence of physical restlessness or hyperactivity is a "problem" depending upon environmental expectations. Typically difficult situations include classrooms, work meetings and cubicle settings.  

So, while our center is called ADHD Boston, we recognize the limitations of this diagnostic category. ARD or ACD Boston wouldn't get nearly as many Google hits.