There has been controversy around the diagnosis of ADHD since the seventies.
And there should be that controversy until some issues are dealt with.
One issue that comes to mind is the fact that fewer women are diagnosed than men. It is likely a dismissive perception of women that still persists that makes the diagnosis less likely to be applied.
The still persistent idea that women are less, need less, do less, are less significant in our socioeconomic structure, despite the fact that, in these so called enlightened days, we publicly deny that, has made for much of that difference in numbers.
And the saddest thing is …
As if that in itself is not an outrageous issue, the thing that makes it worse, within the bounds of this discussion, is that this allows thousands and probably millions of women to slip through the cracks without diagnosis, and therefore without access to treatment, therapy, justifiably deserved help.
Let’s consider this. There are two categories of symptoms. In order to be diagnosed a subject must have five or more symptoms from the inattention category and/or five or more symptoms from the hyperactive category (don’t get me started on what happens if you have four from each …).
But that isn’t all. Those symptoms must have persisted for a minimum of six months. Additionally some of them must have been shown to have been present in the subject before the age of twelve.
Still not enough …
All of this is very relevant, but it still does not complete the diagnostic requirements.
All the above mentioned things must be in place, but additionally there must be a negative impact on the subject’s life.
And here is the rub!
The DSM says “There is clear evidence that the symptoms interfere with or reduce the quality of social, academic, or occupational functioning.” These are their words.
But the DSM does not identify who gets to decide that the symptoms “interfere with or reduce the quality of social, academic, or occupational functioning.”
Overwhelmed with information …
The subject of a diagnosis session may well be completely overwhelmed with the questions and possibly the answers.
But that does not mean that the subject should not have the opportunity to have a say in whether or not the symptoms impact their life negatively.
I submit to you that the idea of impact on a person’s life requires an assessment of that life and that assessment must not be biased by gender. And since there are many fewer women being diagnosed still, that gender bias must still exist.
And if anyone wants to say that it is not the impact on life that is being wrongly assessed because of bias, than we must accept that the symptoms are being ignored in women and they are not even getting to the assessment stage.
The bias therefore is in the idea that women with ADHD symptoms don’t deserve consideration?
Either way, it is wrong.