The History Of ADHD From Past To Present
Attention-deficit hyperactivity disorder (ADHD) is widely recognized by the medical community and the general public. Though there may be more room for more public understanding of ADHD, finding someone who has never heard of the disorder could be challenging. So, you may wonder how this reality came to be and what life was like for those living with ADHD before society had the language to name it. Below, learn more about the history of this condition and the ways it is treated.
Previous terms used for ADHD
Attention-deficit/hyperactivity disorder, also known as ADHD, is a somewhat new diagnosis for a condition that seems to have existed for as long as psychological research itself. Throughout history, both adults and children have been subject to a variety of labels attempting to describe the symptoms science now knows to be related to ADHD.
However, over time, stigma and a lack of information surrounding mental health have led to harmful and incorrect interpretations of the differences ADHD can cause. Examples of previous terms used include:
- Hyperkinetic Impulse Disorder
- Hyperexcitability Syndrome
- Clumsy Child Syndrome
- Hyperactive Child Syndrome
- Minimal brain dysfunction
- Organic Brain Disease
- ADD (Attention Deficit Disorder)
ADD is no longer a diagnosis as of the release of the DSM-5-TR. Instead, ADHD is divided into three subtypes.
The early years of ADHD research
Although its symptoms may not be anything new, the history of ADHD as a diagnosable condition doesn’t date back as far as you might think.
The earliest mention of a disorder that could later be categorized as ADHD is from the work of Sir Alexander Crichton from the late 18th century. In 1798, he documented a mental state with all the essential features of a subtype of ADHD, and his work concluded that there should be special educational accommodations necessary for children who exhibit these symptoms.
In 1902, Sir George Frederic Still, known to be the first practitioner of child medicine, concluded in a series of lectures built off the work of William James on moral control that children could experience a "defect of moral consciousness which cannot be accounted for by any fault of environment." At this point, an understanding that restlessness, an inability to sit still, and other symptoms were not due to external factors but instead the result of internal activity.
In the same decade, Alfred F. Tredgold conducted research focusing on children with behavior described as anti-school. Tredgold concluded that "high-grade feeble-minded" children experienced symptoms as a result of mild brain damage. While such a statement is far from the most sensitive framing of the disorder, work like Tredgold’s was an essential step toward the understanding of ADHD that exists in the modern day. This finding affirmed the idea of the brain playing a crucial role in shaping the symptoms we attribute to ADHD and was a move away from believing personal morality or deliberate decision-making to be the root of these differences.
ADHD medications
Just as the public understanding of what ADHD is and how it affects the human mind has changed, so too has the way providers attempt to treat symptoms. For decades, pharmacological solutions have been used to help adults, young adults, and children alike manage challenges related to ADHD.
In the late 1930s, one medication was being prescribed to children for severe headaches. Over time, one man, Dr. Charles Bradley, came to an accidental realization: many ADHD patients using the medication reported improved cognitive performance and behavior patterns. This discovery would mark a turning point. By 1967, there were several stimulant medications on the market.
This new type of ADHD treatment was not without controversy, though, particularly as the potential for substance misuse with these medications became more widely understood. Despite differing opinions about the efficacy of prescription medications for ADHD treatment, their rise in popularity has continued into the 21st century.
The BetterHelp platform is not intended to provide any information regarding which medication or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. Do not take any action (including starting, stopping, or changing medications) without consulting a qualified medical professional.
A brief history of medication for ADHD
Over the past century, the history of medication for ADHD has taken many twists and turns. The journey started in 1937 when the medical director of what is today called Bradley Hospital noticed that a specific stimulant led to better behavior in some children. Over 20 medications are now used to treat the condition, some being stimulants and others being non-stimulant medications. Do not start, change, or stop a medication for ADHD without first consulting a doctor.
The Diagnostic and Statistical Manual of Mental Disorders and official recognition
According to the Centers for Disease Control, estimates for how many children have ADHD vary widely over time due to the changes in how the condition is diagnosed and how diagnostic criteria are applied.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is often considered a guidebook of the human mind. This book outlines every psychological disorder accepted by the American Psychiatric Association and contains the diagnostic criteria most therapists and clinicians use to make diagnoses.
Several editions have been published since the original DSM-I was released in 1952. As of early 2022, the most recent publication of the DSM was released in 2013 and is referred to as the DSM-5 or DSM-5-TR. The DSM-I made no mention of ADHD or any disorder that describes ADHD-like symptoms. By 1968, “hyperkinetic impulse disorder,” a primitive form of the modern ADHD diagnosis, had been a term in use for over a decade and appeared in the DSM-II.
In 1980, the APA released the DSM-III, which featured a condition by the name of attention deficit disorder (commonly known as ADD). The DSM-III specified that the disorder could present itself with or without hyperactivity. Seven years later, a reissue of the DSM (not a major revision, so this was labeled the DSM-III R) contained certain changes with criteria that legitimately recognized attention-deficit/hyperactivity disorder. Regardless of which point you decide is the beginning, 1980 marks when ADHD was recognized officially by the medical community.
In the DSM-5, ADHD is not only recognized but has also been studied to the extent of allowing researchers to pinpoint more specific iterations of the disorder, like the predominantly inattentive type. What was formally diagnosed as ADD without hyperactivity is now ADHD-I (primarily inattentive type). One can also be diagnosed with the primarily hyperactive/impulsive type (ADHD-HI) or combined type, which involves symptoms of both subcategories.
ADHD-II is typically characterized by hyperactivity rather than frequent inattention or easy distraction. Individuals with ADHD-III, on the other hand, may experience hyperactivity and impulsivity but also present symptoms of inattentiveness, such as having a hard time focusing or forgetting things easily.
Moving forward in ADHD research, diagnosis, and treatment
The most recent major advancements occurred during:
The release of Clinical Practice Guideline: Diagnosis and Evaluation of the Child with Attention-Deficit/Hyperactivity Disorder (AAP 2000) guiding parents and pediatricians on how to assess and treat children with ADHD
Non-stimulant medication: The discovery and circulation of the first non-stimulant medication for ADHD, which was first approved in 2002
Medication changes: Warning labels were added to ADHD medication (2007) to include information about the possibility of cardiovascular risks and risks of adverse psychiatric symptoms (hallucinations, delusional thinking, or mania)
Support options
As public awareness of this mental disorder and its symptoms increases, there may be an uptick in the number of diagnoses received. The result may be further research and a shift toward discovering new and diverse ways to treat symptoms, particularly those unrelated to medication.
One opportunity to learn how to manage ADHD symptoms and understand how the disorder can affect behavior is through working with a licensed mental health professional. Options like online therapy through a platform like BetterHelp make connecting with a provider who understands your needs more accessible. You can connect with a therapist online via phone, video, or live chat and select a therapist with experience working with ADHD.
Online therapy is convenient and, based on current research, effective. One 2022 study noted that online therapy intervention can improve symptoms related to ADHD for adults and children alike. No matter your age or experience with ADHD cases, a licensed therapist may be able to offer problem-solving strategies, advice, and support.
Takeaway
ADHD is not a new mental illness, but it’s one that’s been misunderstood for centuries. It’s only within the past few decades that society has seen significant growth in understanding what ADHD is, why it develops, and how to best treat those who exhibit its main three symptoms: inattention, impulsivity, and, for some, hyperactivity. As the internet continues to educate and connect those with ADHD across the world, more discoveries may come to light and enhance the way people view this mental health disorder and others.
What was ADHD once called in the 1950s?
In the 1950s, some researchers used the term hyperkinetic impulse disorder or hyperkinetic disorder for attention-deficit hyperactivity disorder (ADHD). ADHD was long thought to be a result of minimal brain damage. However, symptoms were observed in children who hadn’t experienced brain damage or encephalitis. Today, researchers believe that genetics and environmental factors may play a role in ADHD.
What was the first type of treatment for ADHD?
In 1937, a specific stimulant was found to improve school performance and behavior problems of children, but as a side effect. Years later, another stimulant was used to treat ADHD. Today, some medications may help hyperactive children and adults to experience relief from their symptoms.
What was ADHD called in the 1900s?
For many years, ADHD was thought to be related to a brain injury. Then, in the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II), ADHD was referred to as hyperkinetic reaction of childhood. In the third edition (DSM-III), the term attention deficit disorder (ADD) was used. The DSM-III-R was the revision to this edition, where the term ADHD was first used. In the fourth edition (DSM-IV), the term attention-deficit hyperactivity disorder (ADHD) was used with sub-types.
When was ADHD first added to the DSM?
The term ADHD was first added to the DSM-III-R. In the previous edition (DSM-III), the term ADD was used.
What is the Starbucks syndrome for ADHD?
Starbucks syndrome is the term used to refer to overstimulation as a result of a dose of ADHD medication that is too high. This term is not the official terminology for an overdose of medication. If you have any concerning symptoms after taking your medication or after taking non-prescribed stimulants, reach out to your doctor. For emergency symptoms, visit the emergency room or call 911.
Why is ADHD considered to be a controversial diagnosis?
ADHD may be a controversial topic for some people due to the rise in prevalence. Some people wonder if ADHD is truly more prevalent or if there is more awareness of the condition than there was in the past. If you have questions about hyperactivity disorders or behavioral disorders in general, it may help to speak with a licensed mental health professional. They may be able to help you distinguish between symptoms of other mental health disorders, such as anxiety and major depressive disorder. If another person tells you they’ve been diagnosed with ADHD, believe them and support them. Each person has a right to their own story.
- Previous Article
- Next Article