ADHD: The Brief History Of A Disorder

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The condition we call Attention-Deficit Hyperactivity Disorder (ADHD) has probably been with us throughout recorded history. Only recently, however, has the disorder become widely known and recognized—very widely. This is due to greater awareness of the condition’s symptoms and a better understanding of the problems experienced by afflicted children and adults (and, possibly, by a proliferation of the disease itself). The term ADHD was first used in 1987, but the condition itself has a recorded history that begins over 200 years earlier.

Early Identification

In the late eighteenth century, a German physician named Melchior Adam Weikard and the Scottish-born physician  Sir Alexander Crichton both described a disorder with symptoms that are now associated with ADHD: difficulty with sustained attention, compulsive nervous fidgeting, and the propensity for emotional excitement. These two perceptive doctors were the first to identify the disorder and its adverse effects on the sufferer. Just after the turn of the twentieth century, the British pediatrician Sir George Frederic Still gave a series of lectures in which he described multiple cases of what we now call ADHD. He termed the sufferers as morally defective—not because they were inherently driven to immoral acts, but because their conduct did not contribute to the betterment of society.

Confusing the Issue

The epidemic of encephalitis lethargica and the influenza pandemic of the late 1910s left many children with ADHD-like symptoms due to damage the diseases had inflicted on their brains. This led many scientists and doctors to believe that the ADHD condition was caused by undetected brain damage. As medical knowledge expanded, it became clear that ADHD did not exclusively stem from brain damage, and that other factors (such as genetics and environmental influences) contributed to the disorder’s manifestation in individuals.

Clinical Definition

The condition that would become ADHD was given various labels throughout the first half of the twentieth century, but it was first clinically defined in 1968, when the American Psychological Association released the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II). This volume used the term “Hyperkinetic Reaction of Childhood,” even though hyperactivity was not present in all cases. The 1980 DSM-III revised the diagnosis, changing the name to “Attention-Deficit Disorder,” noting that it may or may not be accompanied by hyperactivity. In the 1987 revised version of the DSM-III, the term “Attention-Deficit Hyperactivity Disorder” first appeared. In 1994, the DSM-IV first presented ADHD as it is commonly understood and still defined today. This definition of ADHD divides the condition into three subtypes: inattentive, hyperactive-impulsive, and combined. People with inattentive-subtype ADHD have trouble paying attention to details and focusing on tasks. People with the hyperactive-impulsive subtype tend to have excessive energy and poor impulse control, to the point that it adversely affects their daily functioning and interactions. People with the combined subtype suffer the effects of inattentiveness, hyperactivity, and impulsivity. Although some people still prefer to use ADD to describe inattentive-subtype ADHD, this is only a colloquial usage; it is no longer part of medical terminology, and no doctor will deliver a diagnosis of ADD. As knowledge about ADHD has grown, specialists as well as the general public have come to realize that the disorder’s appearance is not limited to childhood; it can present in adolescents and adults as well. Our expanded knowledge has led to the destigmatization of the condition and its sufferers, as well as to a variety of treatments. If you believe that you, a family member, or friend suffers from undiagnosed ADHD, you should consult a medical professional; they have the experience and the resources necessary to help you or your loved one lead a richer, more fulfilling life.