This post is written for my daughter who accuses me of having Attention-Deficit Disorder (ADD). She is in nursing school now, and she is developing her medical mind, so I thought this would be a good post to help her distinguish between lay-diagnoses and medical-diagnoses.
My daughter observes that I forget where I put my phone, keys and wallet more than she would. She notices that my room is messy and I can be disorganized and for these reasons, she wonders if I have ADD. Admittedly her and I are different — indeed, my wife too is also much more organized and careful than me — but are these any reasons to label me with a DSM-5 disorder (see footnote).
I will now go through the DSM-5 (see pg 104 in this PDF) and show my kind readers why I probably do not have ADD.
A. First, it must per a PERSISTENT pattern of inattention with interferes with functioning.
[Well, hell, I have a job, I spent a concentrated 4 hours this morning reading about Bayes Formula etc. In some areas I am sloppy and it interferes with function a little, but I always get along OK. So no, I don’t have that criteria.]
Next, I must have 6 of the follow 9:
a) OFTEN makes careless mistakes. [not often, but I do]
b) OFTEN difficulty in sustained attention in lectures, conversations … [certainly not]
c) OFTEN does not seem to listen when spoken to [certainly not]
d) OFTEN does not finish duties in workplace [certainly not]
e) OFTEN has difficulty organizing tasks [certainly not]
f) OFTEN avoids tasks which require sustained mental active [well, only if I dislike the task]
g) OFTEN loses things necessary for tasks [well, maybe, but I always find them in short order]
h) OFTEN easily distracted by extraneous stimuli [well, not often, but I love stimuli]
i) OFTEN forget in daily activities [not bad here either]
So, I have NONE of these are OFTEN, unless compared to a meticulous person (and we know what we think of those folks). But even if you generously translate OFTENs to mean “occasionally“, I think I only have 4 out of 9 (not the 6 out of 9 required). I certainly have: a, f, g and h. BUT of those, the only troublesome one is perhaps “g”. Now my wife and daughter may disagree, but I am the scientist — what do they know!
So, my inattention moments are not persistent and I really only have one trait that OTHERS judge as “often” and it doesn’t bother me, and shouldn’t my opinion count.
So, to my daughter: OK, I agree, I may be an odd cookie, but no one has built an accurate little box for me yet in the DSM-5. It may be fun using lay-versions of psychiatric ideas, but let’s not forget that pathology is different from style. All that said, my wife also thinks I am a bit “different“. But then, I think they are all wrong, damn it!
PS: The DSM-5 also says, “Confirmation of substantial symptoms across setting typically cannot be done accurately without consulting informants who have seen the individual in those settings.” [well, don’t believe everything you read!] See, I don’t need medicine, just more love!
The DSM-5 is the Bible of Psychiatry and has gone under many changes, after all, it is #5 now. And each time, scientists gather more information, get rid of more of their prejudices and see through more of their blind spots. Yet the human mind remains far from understood and will probably remain so.
Nonetheless, the DSM-5 has been useful in some domains at some times. Truth, after all, is only our most recent approximation to Reality and Reality is what works from our perspective. But all this is a whole other conversation.