Why a Gifted Adult Should Be Wary of the Mental Health System

 

What is normal for a gifted adult is the basis for a clinical diagnosis for non-gifted adults.  According to James Webb and his 5 co-authors of Misdiagnosis and Dual Diagnoses of Gifted Children and Adults, this is the reason gifted people who wind up in the mental health system are frequently given an incorrect diagnosis.  I don’t exactly know what to say about this other than to suggest you go back and re-read the first sentence of this paragraph and come to your own conclusions.

Those in the mental health field regularly refer to a book called the DSM or Diagnostic and Statistical Manual of Mental Disorders.  It’s a kind of recipe book for mental health which describes different behaviours associated with specific mental illnesses and mental health practitioners as well as family doctors refer to this manual to ascribe a diagnosis.  And, not incidentally, the DSM provides codes for mental health practitioners to bill insurance companies.  The authors of Misdiagnosis and Dual Diagnoses of Gifted Children and Adults contend that the lack of awareness of what it means to be gifted results in the misdiagnosis of gifted people since the criteria described for many mental health disorders in the DSM are similar to those experienced by many gifted people.  Each mental disorder has a list of typical behaviours; for example, here is the diagnostic criteria for Attention Deficit Hyperactivity Disorder:

A. Either (1) or (2)

1) Six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level.

Inattention

a) often fails to give close attention to details or makes mistakes in schoolwork, work, or other activities

b) often has difficulty sustaining attention in tasks of play activities

c) often does no seem to listen when spoken to directly

d) often does not follow through on instructions and fails to finish schoolwork, chores or duties in the workplace (not due to oppositional behaviour or failure to understand instructions)

e) often has difficulty organizing tasks and activities

f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)

g) often loses things necessary for tasks or activities (e.g. toys, school assignments, pencils, books or tools)

h) is often easily distracted by extraneous stimuli

i) is often forgetful in daily activities

2) Six (or more) of the following symptoms of hyperactivitiy-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level

Hyperactivity

a) often fidgets with hands or feet or squirms in seat

b) often leaves seat in classroom or in other situations in which remaining seated is expected

c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)

d) often has difficulty playing or engaging in leisure activities

e) is often on “on the go” or often acts as is “driven by a motor”

f) often talks excessively

Impulsivity

g) often blurts out answers before questions have been completed

h) often has difficulty awaiting turn

i) often interrupts or intrudes on others (e.g. butts into conversations or games)

 

B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.

C. Some impairment from symptoms is present in two or more setting (e.g., at school [or work] and at home).

D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

E. The symptoms do not occur during the course of Pervasive Developmental, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

Reading the DSM-IV description it’s easy to see how a gifted person could be given the label ADHD.  In general, Webb et al make the point that looking at the DSM-IV without considering a broader context, in this case, being gifted, can result in an incorrect diagnosis and possibly associated medication.  Misdiagnosis and Dual Diagnoses of Gifted Children and Adults provides guidance as to how to distinguish between the similarities of gifted behaviours and other behaviours described in the DSM-IV.  For example, someone with ADHD may not be able to sustain attention in almost all situations while a bored gifted person will not pay attention in specific situations. 

I picked up this book despite the fact it’s about psychology simply because it’s one of the few books out there that discusses gifted adults at all - and even this one is primarily about children.  I’m wary of what I perceive as a skewed emphasis on the pathology associated with being gifted.  Not that psychology doesn’t have it’s place or help people in need because I believe it does.  However, what little information is out there about being a gifted adult is predominantly focused on mental health issues.  As a result, psychology and education form the base of information about gifted adults even though most of us are no longer in school nor have a psychological problem.  I was surprised to find that the authors of Misdiagnosis and Dual Diagnoses of Gifted Children and Adults say exactly the same thing: not much is known about gifted adults and what is known is disproportionately weighted towards the psychological field.  The authors are clear that their book is aimed at a very specific audience and is not necessarily meant to be applied to the general population.  They aim to educate those who work in the mental health area, educators and those who have reason to interact with mental health environments about what it means to be gifted.  In fact, Webb et al suggest that gifted people are no more likely to experience mental disorders than the rest of the population with the exceptions of a slightly higher rate of Obsessive-Compulsive Disorder and eating disorders.

Webb et al contend that what is perceived as ‘disordered behaviour’ is a normal reaction by exceptional (but not mentally ill) people to their surroundings.  That appears to be the difference – people who experience mental disorders consistently display ‘disordered behaviours’ regardless of the environment.  For example, a gifted person, if stimulated, can pay attention and focus.  Someone with ADHD has difficulty regardless of the situation.  A fine line, particularly if a gifted person displays behaviour consistent with depression, or is in fact, situationally depressed due to their environment.  Some gifted people may not have ever experienced a supportive environment to know the difference.  Nevertheless, an interesting perspective.

Other Interesting Information from Misdiagnosis and Dual Diagnoses of Gifted Children and Adults

• gifted people may not be more likely to experience mental illness but gifted people who also experience mental illness are unlikely to have their giftedness recognized by the mental health community potentially compounding the situation
• gifted people often have a distorted yardstick for what is ‘normal’.  Most gifted people do not think they’re exceptional and expect others around them to have the same abilities.  Some of the potential for gifted people to be intolerant and impatient may be grounded in their inability to recognize what is ‘normal’ for them is not for most others.
• gifted people with an auditory-sequential learning preference (sequential, analytical, concrete and structures) tend to be serious and rule oriented.  This tendency can be misinterpreted as a mental health concern

If you are a parent and the education system or mental health system seems to be randomly applying labels (and maybe medication) to your child, I suggest you read this book.  If you are a gifted adult that has been ‘diagnosed’ by someone in the mental health community without awareness of what it means to be gifted – according to this book, the vast majority of the mental health community, Misdiagnosis will provide you with a different perspective.  For the rest of us gifted people, it is disturbing to see how easily giftedness can be interpreted as a mental health disorder

Tagged as: adhd, characteristics, Intellectual giftedness, James Webb, Misdiagnosis and Dual Diagnoses of Gifted Children and Adults