A Brief History of Time: ADHD Edition

I was going to make a quirky intro, but I haven’t had my coffee yet and my brain is refusing to generate something pithy and witty, so forget it. Here is your ADHD history, kids.

The History of ADHD

1798 — One of the earlier recognitions of what we now call ADHD. A Scottish doctor, Sir Alexander Crichton, noticed some people were easily distracted and unable to focus on their activities as others could. He reported that these symptoms began early in life.

1902 — The first name was given to describe ADHD, which was not all that flattering. The condition was first named by a British pediatrician named George Still, who used the term Moral Defect to describe a group of children who had difficulty paying attention and controlling their behaviour.

Moral Defect…charming.

1932 — German doctors Franz Kramer and Hans Pollnow described a condition called Hyperkinetic Disease. Children with this condition couldn’t stay still. Their difficulty following rules disturbed their school classes. And they had problems getting along with other kids.

Hyperkinetic Disease…better. We’re getting there.

1936 — The Food and Drug Administration (FDA) approved Benzedrine as a medication (the first stimulant on the market). Doctors saw the benefit it had on hyperactive kids concerning their school performance and overall behaviour.

1952 — The APA issued the first “Diagnostic and Statistical Manual of Mental Disorders (DSM). This is an official medically recognized manual that lists all possible mental disorders. We still use the DSM today.

1955 — The FDA approved the psychostimulant methylphenidate (Ritalin). It became more popular as an ADHD treatment as the disorder became better understood and diagnoses increased.

1968 — The second edition of the DSM came out and decided to include ADHD, but referred to it as Hyperkinetic Reaction of Childhood. We are finally in the DSM here!

Hyperkinetic Reaction of Childhood. Not bad, not great.

1980 — The DSM-3 officially recognized the diagnosis as Attention Deficit Disorder (ADD) with or without hyperactivity.

Attention Deficit Disorder. Better, but still not all-encompassing.

1987 — THE BIRTHPLACE OF THE CURRENT NAME — The DSM-3 changed the diagnostic name from ADD to Attention Deficit Hyperactivity Disorder (ADHD). There were no subtypes added at this point.

Attention Deficit Hyperactivity Disorder. Much better, but it’s still not totally accurate…

2000 — A new edition of the DSM was born. This edition (DSM-4) added the 3 subtypes under the ADHD diagnosis that we currently use today.

• Hyperactive
• Inattentive
• Combined

So there you have it. A mini class on the history of ADHD.

What’s ironic about this is that even after more than a century of trying to name this thing, they still haven’t come up with something accurate.

Allow me to explain.

ADHD is a misnomer because ‘attention deficit’ does not accurately reflect the total symptom picture. There is a common and well-documented symptom of ADHD known as ‘hyperfocus’.

This is when someone with ADHD has foud something of interest and focuses intensely on this particular interest for hours and sometimes days.

This focus is so intense that they can literally accomplish in hours what might take others days.

Those with ADHD have a strong interest-based motivation system. They need something exciting or novel to really grab their attention. Once something has their undivided attention, though, look out.

In my opinion, a more accurate description is attention dysregulation. An inability to regulate attention, versus an overt deficit in attention.

Well, there you have it.

From Moral Defect to Hyperkinetic Disease to Hyperkinetic Reaction of Childhood to ADD to ADHD.

I wonder what they will come up with next…

All the best space cadets — Megan