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Richard Saul

ADHD Does Not Exist: The Truth About Attention Deficit and Hyperactivity Disorder Hardcover – February 18, 2014

by Richard Saul (Author)

173 ratings

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In this groundbreaking and controversial book, behavioral neurologist Dr. Richard Saul draws on five decades of experience treating thousands of patients labeled with Attention Deficit and Hyperactivity Disorder—one of the fastest growing and widely diagnosed conditions today—to argue that ADHD is actually a cluster of symptoms stemming from over 20 other conditions and disorders.

According to recent data from the Centers for Disease Control and Prevention, an estimated 6.4 million children between the ages of four and seventeen have been diagnosed with attention deficit hyperactivity disorder. While many skeptics believe that ADHD is a fabrication of drug companies and the medical establishment, the symptoms of attention-deficit and hyperactivity are all too real for millions of individuals who often cannot function without treatment. If ADHD does not exist, then what is causing these debilitating symptoms?

Over the course of half a century, physician Richard Saul has worked with thousands of patients demonstrating symptoms of ADHD. Based on his experience, he offers a shocking conclusion: ADHD is not a condition on its own, but rather a symptom complex caused by over twenty separate conditions—from poor eyesight and giftedness to bipolar disorder and depression—each requiring its own specific treatment. Drawing on in-depth scientific research and real-life stories from his numerous patients, ADHD Does not Exist synthesizes Dr. Saul's findings, and offers and clear advice for everyone seeking answers.

Print length

336 pages
Language

English
Publisher

Harper Wave
Publication date

February 18, 2014
Dimensions

5.5 x 1.09 x 8.25 inches
ISBN-10

006226673X
ISBN-13

978-0062266736
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Editorial Reviews

From Booklist

Roughly 11 percent of children and 4 percent of adults in America have been labeled with attention-deficit/hyperactivity disorder (ADHD). But is ADHD even an illness? Physician Saul proposes that ADHD is actually a collection of symptoms caused by other medical conditions: mood disorders (major depression or bipolar disorder), hearing loss, vision problems, substance abuse, hyperthyroidism, sleep problems, absence seizures, learning disabilities, and OCD. According to Saul, a false diagnosis of ADHD delays or prevents initiating appropriate treatment of the actual cause of symptoms like impulsivity and distractibility. Additionally, incorrect diagnoses of ADHD subjects individuals to unnecessary utilization of stimulants. Drugs like Ritalin and Adderall can produce side effects (notably sleep disturbance and decreased appetite) and be abused. Saul believes that medical practitioners, pharmaceutical companies, the media, and patients themselves have engendered an epidemic of misdiagnosed ADHD with serious consequences, including overuse of prescription medication. He writes that ADHD is too often a rushed, careless diagnosis or an excuse for behavior. Sure to ruffle some feathers, ADHD Does Not Exist is provocative and pensive. --Tony Miksanek

Review

“Parents will be better armed to ask more of the right questions after reading Saul’s book.” — Publisher's Weekly

“Sure to ruffle some feathers, ADHD Does Not Exist is provocative and pensive.” — Booklist

“A provocative, valuable guide for parents, school personnel and medical practitioners who deal with individuals showing symptoms routinely attributed to ADHD.” — Kirkus Review

“…an accessible, detailed, and well-documented list of rule-outs for those who are exploring an ADHD diagnosis. VERDICT: Essential for parents and teachers.” — Library Journal

Product details

Publisher ‏ : ‎ Harper Wave; 1st edition (February 18, 2014)
Language ‏ : ‎ English
Hardcover ‏ : ‎ 336 pages
ISBN-10 ‏ : ‎ 006226673X
ISBN-13 ‏ : ‎ 978-0062266736
Item Weight ‏ : ‎ 14.3 ounces
Dimensions ‏ : ‎ 5.5 x 1.09 x 8.25 inches

Best Sellers Rank: #422,844 in Books (See Top 100 in Books)
- #489 in Sociological Study of Medicine
- #867 in Parenting Books on Children with Disabilities
- #1,527 in Popular Psychology Pathologies

Customer Reviews:
173 ratings

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Richard Saul

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Dr. Richard Saul is a professor, clinician, researcher, and radio personality. For more than fifty years Dr. Saul has incorporated his clinical and academic experience into the practice of behavioral neurology and development. He served as the chairman of the department of pediatrics at Highland Park Hospital, and the medical director of an HMO in North Suburban Chicago. While working with the Health Systems Agency, a federal program, he was responsible for containing healthcare costs in Illinois.

Dr. Saul has been a Castle and Connolly Best Doctor in Chicago for the past ten years. His work has been applauded in US News & World Report. He is a member of the American Academy of Pediatrics, the American Academy of Neurology, and the Society for Behavior and Development. He earned his M.D. at Chicago Medical School. He lives with his wife outside of Chicago.

Customer reviews

5 star		46%
4 star		14%
3 star		15%
2 star		8%
1 star		17%

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Top reviews from the United States

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Gabrielle Zdep

The Good: Dr

Reviewed in the United States 🇺🇸 on November 10, 2014

Verified Purchase

From my book review blog, which you can find at http://gabbyecho.blogspot.com

Hi readers! My next review is on "ADHD Does not Exist" by Dr. Richard Saul. It was going to be on Stephen King's "Light and the Glass", but this book was a quicker read. Also, I have ADHD.

Here's a link to look at "ADHD Does Not Exist" on Amazon. I'm really torn on this book. I'd give it 2 or 3 out of 5 stars, but again, it was a complicated book to read / review.

Dr. Saul draws on about 50 years of experience as a physician and develops the conclusion that ADHD is not ACTUALLY a real condition. Instead, he argues, the symptoms of ADHD may be the symptoms of as many as twenty other disorders, illnesses or conditions. These include, among other things: hearing or vision problems, "not getting enough sleep", substance abuse problems, bipolar disorder, Aspergers disorder, giftedness, among others such as allergies and vitamin deficiency, such as iron, which can be common. He uses anecdotal evidence from different patients he's seen over the years who did not, in fact, have ADHD.

I'm going to split this entry into what I did not agree with, and why, and what I did agree with, and why. And then a part about the not-great writing.

The Good:

Dr. Saul does recognize that ADHD is HIGHLY overdiagnosed and its almost a go-to label to slap on a kid and throw stimulants at him sometimes. It happens all the time. It might be happening to someone I know, which I am not thrilled about. I don't think that any kid under the age of 7 should be treated with something as strong as stimulants. THEIR BRAINS ARE STILL DEVELOPING FOR GODSSAKES. Give him a chance! Anyway...

On that note, I also agree with him that stimulants are hugely overprescribed. However....

The Bad:

there is little to no discussion in here about the kids (and adults) who have taken stimulant meds and who HAVE had it work for them. (Of which I'm sure a fair amount.) There is also no discussion of a possible cause for ADHD, (why would there be, since Dr. Saul is convinced that all ADD things are just symptoms of something else?)

There are theories about its cause. For example, this study published in the New York Times discusses how a brain-scan of somoene with ADD will show differences in dopamine reward pathways. Surely Dr. Saul is aware of this? So why no discussion?

The book is somewhat disingenuous. Perhaps a different title would have been "ADHD Does Not Exist as Much as We Think It Does!"

But I doubt that would have caught as many peoples attention and helped it sell as well.

The Ugly:

The writing style is....difficult. Each chapter follows exactly the same format:

- Information about the disease and how it's related to ADHD

- Little Johnny comes in to see Dr. Saul; he's been diagnosed by his school shrink or another doctor as having ADHD, and they may have already started him on stimulants

- Oh noes! The stimulants aren't working, or they are making the problem worse!

-Dr. Saul sees Little Johnny and thinks that it may be Something Else

- Dr. Saul tests and treats Little Johnny for the Something Else

- Johnny gets better and ADD/ADHD symptoms improve or nearly disappear!

.....so this is EVERY SINGLE CHAPTER, one for each of the conditions that can masquerade as ADHD. These chapters do contain a wealth of information about the conditions ADHD can be confused with, and that is one of its good points. It also drew some thoughtful conclusions. But the writing style was repetitive, pedantic, and just kind of clumsy. It was a fast read, but not necessarily an easy one.

In conclusion: I think that this is, in some ways, a helpful book. It empowers parents and doctors to figure out what else might be going on with the child besides ADHD, and adults to ask the right questions as well. However, he accuses ADHD of being a "disorder" defined only by its symptoms and having seemingly no cause. This is really pretty incorrect, as the MRI studies mentioned above discuss a probable cause of the disorder. (From the NY Times article, read the studies about the genetic component, too.)

His strongest argument is that when you treat these other conditions, the ADHD symptoms usually fade or go away. But to say that EVERY CASE of ADHD is actually bipolar, or allergies, or lead poisoning, or fetal alcohol syndrome, when it may in fact be just a different neurological profile, seems to me a little bit irresponsible.

He also doesn't mention mixed ADHD (my type), and also, a patient's conundrum of "what do you do when you've tried treating for basically everything else and the ADHD "symptoms" still persist?" (like mine?)

And, while I agree with Dr. Saul that "treatment delayed is treatment denied", if I had to read that line one more time I was going to throw my kindle across the room.

Overall, a pretty decent book in the right situation. I'd recommend it to people who want to learn more about what conditions can look like ADHD.

Ok, my NEXT review will be "Wizard and Glass". :

Good evening readers ~

48 people found this helpful

Helpful

Avid Learner

Informative...& Misleading

Reviewed in the United States 🇺🇸 on May 6, 2022

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I'm now in my 70s, and finally had the diagnosis of ADHD in my 50s, when I began taking Adderall. The medication has been a godsend, after half a century of struggle!
I'm a clinical social worker, married to a surgeon, & we both found the book fascinating, as it encourages taking a look at other possible diagnoses, with clear descriptions of each. I believe the book should be required reading for any clinician who quickly diagnoses and treats for ADHD. HOWEVER, the title (and THEORY) is greatly flawed. I DO have ADHD, and resent this man making such a statement, since I have finally found relief, and plan to continue the medication (10 mg, timed-release daily) until the end of my life.
I've lost two siblings to suicide, most likely due to undiagnosed, untreated schizophrenia and/or bipolar disorder. I consider myself extremely fortunate to be dealing "only" with ADHD, and I'm grateful beyond words for the work I've done to recognize and address the disorder for the past 40 years (particularly by reading Drs. Ned Hallowell and John Ratey & a training with Ned) and the medication I've now taken for 15 years. Read the book for clarification, but please don't buy into this guy's theory!

9 people found this helpful

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Monnike

Misleading!

Reviewed in the United States 🇺🇸 on September 30, 2016

Verified Purchase

Despite the title, the author DOES conclude that ADHD exists. He just decides to call it NDI (Neurochemical Distractibility/Impulsivity); a term he invented and nobody else uses. This admission is buried in Chapter 17, right around the place in the book I was ready to call it quits on the whole thing and stop reading. That fact annoys me even more. You see, I have been recently diagnosed with ADHD, the inattentiveness kind. I'm 40 years old and even though the diagnosis is a relief because it seems to explain most of my life, as a smart individual with a high IQ, I was a little skeptical. That is, until I read this book!

As background, I have a graduate degree from MIT in Brain and Cognitive Sciences (Course 9, for my MIT peeps). I also went to law school and have been a lawyer now for about 15 years. Despite what others call an impressive resume, I have felt like a fraud most of my adult life. I was diagnosed with depression and anxiety in my early twenties and have been treated with antidepressants and cognitive behavioral therapy for most of my adult life. IT DID NOT WORK. CBT helped, yes. And the antidepressants took the edge off so I could at least fool everyone into thinking I was well-adjusted and doing well. Inside, I was always afraid I would be find out as a fraud. Why? Because even though my papers in college, my briefs in law school, my presentations and arguments were always great and a lot of times, excellent, they were always done the night before or at the very last minute. No matter how hard I tried, I could not sit down and start before then. And I tried, very hard. In college, professors praised the analysis and criticized the carelessness in the grammatical details or presentation. In life, those careless mistakes were dismissed as symptoms of a busy case load... but I knew better and I was terrified of being discovered as the fraud I was.

The first 16 chapters of this book (and the last 4) did not apply to me. At all. I was actually screened for a lot of those conditions in my twenties (including epilepsy) and treated for depression and anxiety. In addition, MIT should've 'cured' the giftedness condition the author mentions in this book. I had all the challenge I could manage there and then some! Nothing worked.

After reading chapter 17, I'm pretty certain the author would agree with my psychiatrist that I have 'NDI' as he chooses to call ADHD... And just like my psychiatrist, he would probably prescribe stimulants. I have tried several already and have seen an improvement in symptoms. We're still trying to find the right dose/medication. Because I went undiagnosed for so long, medications will not be the cure-all I had hoped after a lifetime of struggling. My psychiatrist also prescribed CBT with an emphasis on dealing with ADHD. And that's where I am right now.

This book is a waste of time. Instead of a book meant for the general public, the author would have served his patients better by publishing this information is a medical journal or magazine aimed at his peers. This book basically addresses how ADHD can be misdiagnosed and cautions doctors not to consider ADHD as the only cause when a simpler or better understood condition will explain all symptoms and serve the patient better. And for that, the author gets one star. Because even he admits that ADHD DOES EXIST.

A better title would be 'ADHD Misdiagnosis: How doctors can best evaluate patients displaying distractibility/impulsivity.' But, of course, that would not have sold as many books as a misleading title that plays into the perceived controversy surrounding ADHD would...

Do NOT buy this book. If you're curious, borrow it from your library, but be warned that you will waste your precious attention span on empty reading.

669 people found this helpful

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Top reviews from other countries

Meena

Self contradictory nonsense

Reviewed in the United Kingdom 🇬🇧 on August 18, 2022

Verified Purchase

The author claims ADHD is a symptom, not a diagnosis. He then says what’s been diagnosed as ADHD might just be “depression” as though depression satisfies the definition of “diagnosis” rather than “symptom” any better. There’s nothing remotely scientific or enlightening hidden anywhere in the rest of the book either.

6 people found this helpful

anjsh

A must-read for all SENCOs in schools.

Reviewed in the United Kingdom 🇬🇧 on April 30, 2022

Verified Purchase

This clearly and helpfully explains all of the possible underlying conditions which are often misdiagnosed as ADHD. As the author says, if you choose to treat ADHD symptoms and ignore the real underlying cause, this means appropriate treatment is delayed and denied. There is no point prescribing drugs to a child or adult for the wrong diagnosis and in fact it can make things worse or be dangerous. In all of his case studies, he is able to show how the patient improved by identifying the correct cause and giving the appropriate treatment. Why wouldn't you want this? Why do people insist on applying a useless label because it is currently 'trendy' or socially acceptable, when a thorough investigation can uncover the true cause? In only a few cases was it actually a chemical imbalance and the prescribing of 'adhd-type' drugs was appropriate. It's too easy for professionals to say, oh they've got ADHD, when a child is presenting with a list of symptoms, but it's always worth looking at those interactive factors of a child's life and environment in more depth to be able to apply the RIGHT plan of support.

2 people found this helpful

Amazon Customer

Just a list of differential diagnoses

Reviewed in Germany 🇩🇪 on January 4, 2022

Verified Purchase

I would sincerely hope that anyone on either the giving or receiving end of an ADHD diagnosis would be familiar (or quickly familiarized) with all these alternative explanations for distracted, forgetful or hyperactive behavior. If not, this is a quick read to summarize the differential diagnoses, but does not justify its provocative title or binding design.

7 people found this helpful

Daniel Zaitz

Great points raised by the author, however you don't need a whole book to understand them.

Reviewed in Canada 🇨🇦 on October 29, 2021

Verified Purchase

The author makes a strong point that ADHD is not diagnostic, rather is the symptom of other possible underlying conditions. In the book, he elaborates on why this is the case and what conditions are those. The points made are excellent, however, I feel that the content could be summarized in 50 pages, and as I result I think you might end up overpaying for the book. My advice is to still get educated about the authors' viewpoint, but instead, read a summary of the book.

André Hajjar

The truth

Reviewed in Canada 🇨🇦 on May 7, 2019

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He truth

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