"The line between illness and art is blurred"

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Is that still sick or is it already art? In attention deficit disorder ADD, the boundaries are often arbitrary. In the conversation: ADS expert Prof. Alexander Münchau.
Prof. Münchau *, ADD is considered a disease. But apparently it can also have advantages. For example, innovative thoughts penetrate better into the consciousness of those affected. Are people with ADS particularly creative?

Often, not always. Many people with a predisposition to ADD feel the urge to cross borders and look for new things. That's why they're restless and jittery - but also creative. I think there are hardly any creative people who do not also have traits of ADD. Those who are not predisposed to these perceptual and behavioral patterns tend to sit on the sofa and prefer to leave things as they are. This can be beneficial. On the other hand, people who initiate something new, who are not satisfied with the given, who strive for new shores, feel impulses that drive them - this is the case with many people with ADD. Of course, this also has advantages.

That sounds like ADD is completely normal.

There are plenty of them! Almost ten percent of the population meet the criteria for ADS. I think that's a realistic number.

But not all of them are with the doctor.

No. In fact, those who do well in society never see a doctor. They become chief physician, manager or go on stage and become an actor. ADD is not necessarily a disease.

If creativity at ADS unfolds in a socially appropriate context, we call it art or innovation. If it takes place outside social boundaries, ADD can make you sick. This limit is not clear-cut. So far there is no reliable and unequivocal biological marker that indicates ADD. It is usually only noticed when this person comes into conflict with certain rules, makes a lot of mistakes or is too impulsive. It is often a fine line to walk between art, creativity, success and falling out of the ordinary or falling.

Many famous personalities are said to have had ADD, for example Wolfgang Amadeus Mozart or the writer Georg Büchner.

Basically, it is completely irrelevant to art whether a person has ADD or not. What matters is what an artist creates. Büchner probably had quite severe ADD, but that doesn't determine the value of his literature - it stands on its own. The question that seems more interesting to me is: what makes the artist create this kind of art?

Are you robbing a society in which many swallow Ritalin of its most creative minds?

I'm primarily a doctor, but I'm also an artist - so this question also concerns me. As a doctor, I am faced with the behavior of some children with ADD, which can be so problematic that things get out of hand. If a child is so impulsive that he or she has constant anger attacks, clashes with others, brings parents to the brink of despair, and threatens social isolation, Ritalin can be very helpful. However, this drug should always be combined with behavior therapy. Ritalin should not generally be given to anyone who is believed to have ADD. We always have to carefully consider why we are using a drug and what our goal is. If we try to treat any behavior that calls the rules into question, we deprive ourselves of important resources.

Why is Ritalin prescribed rashly today?

We live in social structures in which there is a great deal of freedom and opportunities. This does not make everyone happier, it can also lead to uncertainty.The need for control grows accordingly. This also plays a role in the school and educational context. Ritalin can make compliance easier. Children with ADD are less likely to adapt to given rules. However, if every child with a glimpse of ADD were given Ritalin, this would be problematic. We would probably rob these people, but also society as a whole, of many opportunities for further development. Ultimately, it's not about suppressing ADS, but rather channeling it to a certain extent. With appropriate caring care, you can live with it very well. It is part of being human not to always meet norms.

Prof. Münchau, thank you very much for the interview.

The interview was conducted by Christiane Fux

* The neurologist Prof. Alexander Münchau heads the work group Movement Disorders and Neuropsychiatry in Children and Adults at the Institute for Neurogenetics at the University of Lübeck

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