Diagnosis, stigma, treatments are all the main challenges. And no, ADHD is not a condition that ‘everyone has these days’
It was quite telling that during ADHD (Attention Deficit Hyperactivity Disorder) awareness month, allegations of mistreatment of students with ADHD hit the news.
Like most topics that fall under the umbrella of mental health, ADHD has its own uphill battle. In some ways, Cyprus reflects many patterns seen abroad (women getting diagnosed later, several attempts of people trying to abuse the system), but there are of course some country-specific problems – most notably in the education system, according to the head of Cyprus’ ADHD association Marina Georgiou.
While stigma is not unique to Cyprus, the way schools approach it, is “archaic” she tells the Cyprus Mail. And the crux of the problem lies in primary and secondary education.
“Universities are absolutely great. They can handle any adjustments, offer alternative ways of taking the exams, and really accommodate the differences. It’s at schools where our battle lies.”
The allegations of mistreatment, for example, came to the fore after a parent reported a high school principal to the education ministry and police. The student’s father claimed issues had been ongoing for a year, and his son was encouraged to keep a notebook documenting everything. A teacher allegedly grabbed the notebook off him, gave it to the principal who in turn refused to return it.
Though the ministry called it an isolated case, Georgiou said this is not the first time they have had issues with the specific school.
Cyprus’ current laws stipulate that ADHD students fall under the category of students with learning difficulties, and as such are termed “children with special needs”.
The problem first begins with diagnosis, Georgiou says. There is a lag in getting the system in place to spot the symptoms properly and then often a resistance from parents who view the label as a stigma they should try to resist.
But once that hurdle is crossed – if at all – many families are faced with the task of getting the necessary support that often comes with a financial burden and a challenge in the suitable support resources.
Several students diagnosed with ADHD in school are taken outside of regular classes and put into special units, she explains.
“Nothing is more stigmatising than this. Why single these children out?”
The battle Georgiou is trying to fight is for inclusion.
She argues that students who are disruptive and create an extra challenge in class are treated with an ‘easier option’ – the special unit. As such, they miss out on a lot of classes because they are given a more limited curriculum and often cannot graduate with an apolytirion (high school leaving certificate) due to their ‘special’ status.
“ADHD students aren’t dumb, though they are often left feeling that way. They just need more engaging ways to learn.”
This could mean more visual representation, a better breakdown of information, more room for engagement and less distractions. Effectively, it requires teachers to better understand ADHD.
According to the education ministry, the majority of students in fact attend regular classes and only join the special units if they have a serious comorbidity with ADHD.
In a statement to the Cyprus Mail, the ministry said it respects the diversity of all students, including those with ADHD.
“Schools support all children and recognise and fulfil the potential of every pupil, regardless of their learning difficulties. It is everyone’s wish that children feel safe, participate in the inclusive educational process and have the opportunity to develop their full potential in an inclusive environment.”
The education ministry conceded that it among the reforms it is addressing, there is stronger emphasis on prompt diagnosis and intervention.
There is also more focus on ‘nuclear knowledge’ for ADHD students and efforts to change the legislation surrounding special education.
According to Georgiou, while there has been progress across society with more knowledge about ADHD there are still roadblocks that need to be tackled.
Stereotypically, people associate ADHD with a hyperactive young boy. But in fact, there are three diagnoses. Hyperactive, inattentive and combined. And girls have it too.
The symbol for ADHD is a rainbow butterfly depicting the rapid mental movements of a person with ADHD. It aims to reflect the ability of people with ADHD to adapt and transform to life’s challenges, while the rainbow colours symbolise the diversity of thinking in people with ADHD.
And while associations like Georgiou advocate for inclusivity, they stress ADHD is not a quirky thing that “everyone has these days” but a disorder with crippling effects without proper support. Poor impulse control coupled with challenges in regulating emotions can affect personal relationships and put ADHD individuals at greater risk of danger.
Studies have pointed to higher risks of car accidents for ADHD individuals as well as higher prison rates. Poor time management and organisation can lead to a chain of events that individuals struggle with – meeting deadlines, paying their bills on time and getting projects started.
It’s not a matter of being unable to, Georgiou stipulates. It’s a matter of learning how to work with the brain you have. “ADHD individuals are brilliant under pressure, there are companies abroad that actively seek out people with ADHD.”
This is because the ADHD brain is short on dopamine – so situations of high stress bring out the best of ADHD individuals, she explained.
“We can multitask better than anyone.” And there’s no bargaining with the perks of an ADHD hyperfocus – where an individual can become so gripped with what they’ve become interested in that they can sit for hours uninterrupted working on a project that has fascinated them.
Often the ADHD students are branded as ‘the class clown’ or ‘daydreamer’ due to their challenges focusing – which may present in hyperactivity or inattentiveness. It is also important to note that hyperactivity is sometimes internalised for certain individuals – and therefore more likely to fly under the radar.
Add in the mix, the ‘gifted student’ ingredient and poor diagnoses at schools become rampant, particularly for females who face a different set of difficulties.
Research has shown that females often present ADHD symptoms differently – often due to societal expectations of them and more pressure on how they are expected to behave – and as such, often go undiagnosed.
The other challenge Georgiou explains is one mirrored across the globe – malingering. Where people deliberately try to fake ADHD symptoms to gain access to the medication.
ADHD drugs can be incredibly beneficial for individuals who are short on the dopamine. But for ‘neurotypicals’ the medication is either abused most often as a party drug or a performance boosting medication.
One expert in the field who did not wish to be named said he often had to deal with parents calling him asking him to give their children a diagnosis so they could obtain access to medication as they had exams coming up.
While the specific doctor refuses, he is aware that there are many who will hand out the diagnosis without much thought. Or they deem the individual fits the ‘ADHD box’ and do not question whether the symptoms could be fake or simply a presentation of another issue.
This results in people saying “Oh, everyone has ADHD these days” because of the ease with some which can get a diagnosis, Georgiou says. This is then compounded by the fact that it becomes harder to take ADHD seriously – when there are already so many challenges.
“We know this problem exists, and it’s a global one.” Georgiou points to an upcoming conference set to take place in Larnaca, where among many other topics it addresses the issue of malingering, as well as ADHD in teens, women and girls, university students and the financial impact of having ADHD.
The conference is called: Revolutionary solutions for ADHD – Transforming Lives and Unleashing Potential. It will take place between November 1 – 3 at Larnaca’s House of Arts and Letters.
