An unwitting aim of the just released book “ADHD Does Not Exist” might be providing controversy and sales more than balanced insight and help, according to Dr. Harold Levinson.
“Dr. Saul’s claims and book ‘ADHD Does Not Exist’ are unfortunately characterized by many misleading and invalid statements,” notes dyslexia/ADHD expert Dr. Harold Levinson. As a result, it appeared important to clarify vital issues concerning the wellbeing of 11% of the population with ADHD as well as their dedicated caretakers.
Based on the official American psychiatric diagnostic criteria (DSM), inattention is only one of many symptoms and conditions required for properly diagnosing and understanding the complex syndrome called ADHD. These otherwise normal individuals are also often chronically foggy-minded, forgetful, distracted, unable to transition, follow-thru and plan, impulsive, hyper, disorganized, failing, easily frustrated, defiant, oppositional, learning disordered or dyslexic, clumsy and uncoordinated, anxious and depressed, dumb-feeling, and prone to drifting into drugs and even crime without proper intervention and therapy.
Importantly, these very same officially recognized DSM- defining criteria of ADHD exclude all other coexisting, albeit important, known causal determinants of inattention (eg. insufficient sleep, visual and auditory difficulties, mental retardation, autism, etc.) mentioned by Saul so as to avoid contaminating diagnostic errors.
Despite this clear distinction within DSM, Dr. Saul uses the above non-ADHD causes of inattention to mistakenly conclude in his book interviews that ADHD does not exist.
“By analogy, that’s similar to an oncologist presenting examples of benign tumors and then publishing a sensational text claiming ‘Malignant Tumors Do Not Exist’ and treatment is dangerous,” notes Levinson.
Many of Saul’s unique convictions are summarized in a New York Post pre-book-release interview from January 5, 2014: “A doctor argues that attention deficit disorder is not real – and we’re medicating 11% of American children when we should be fixing their underlying problems.” Moreover, he is reported to believe that the incidence of children with ADHD is “Zero.” And that ADHD is merely a collection of symptoms, not a disorder.
Saul’s remarks that stimulants are dangerous also suggest he may be confusing the inevitable dangers due to improper management and unsupervised drug abuse with the tested, safe and often amazing benefits offered by low and slow incremental doses of therapeutic stimulants to the vast ADHD majority when properly monitored.
Perhaps the analysis of a few more of the author’s arguments may be helpful to those in need of additional clarity. Thus, for example:
1. “Who gains,” Levinson wonders, “the reader or the publisher, by Saul’s statements suggesting that a majority of physicians must be incorrect for too readily and rapidly diagnosing and treating the symptoms of a non-existent disorder called ADHD with stimulants instead of correcting its underlying causation? [However, the causation of ADHD remains unknown and distinct from the causes of inattention noted by Saul.] Many also believe that aggressive sales tactics from pharmaceutical companies also significantly contribute the higher incidence of reported ADHD and those treated.”
As noted by Levinson in Total Concentration, a significant percentage of patients with milder ADHD were previously excluded by a DSM error from proper diagnosis and treatment. By correcting this flaw within repeated DSM updates, Levinson believes the recognized incidence of ADHD has increased, no doubt facilitated by stimulant profit motives. However, the prevalence of this disorder is the same as before drug profit became a factor. Similarly, the recognized incidence of dyslexia has also dramatically increased over the past decades via enhanced insights without any drug profit interference whatsoever.
2. “Who gains by Dr. Saul’s failure to inform readers of the often devastating risks of non-treatment for ADHD?” asks Levinson. “Most research indicates that non-treatment of ADHD tragically results in a much higher probability of failure, drug abuse and addiction, as well as guaranteeing continuation of all the chronically devastating inattentive and non-inattentive symptoms described above.”
“Quite clearly, many more commentaries will be irresistibly drawn into this evolving controversy once the book is finally released 2/14,” Dr. Levinson predicts. “And two things are most likely to rapidly occur: more books will be sold, and more people in need of vital help will be frightened, conflicted and confused.”
Anyone willing to bet otherwise, please contact Dr. Harold Levinson.
About Harold Levinson, M.D. Formerly Clinical Associate Professor of Psychiatry at New York University Medical Center, Dr. Harold Levinson is currently Director of the Levinson Medical Center for Learning Disabilities in Long Island, New York. He is a well-known neuropsychiatrist, clinical researcher and author.