This piece, “Outliers," appeared on page 20 of the Holiday 2025 issue of Chicago Life Magazine.
The saying, “It take all kinds,” is usually delivered with a shrug, after dealing with a person we've judged to be peculiar. The more we learn about the psychology, biology, and even the evolutionary history of people whose behavior may make them a challenge, the better we appreciate how much more accurate is the response, "We’re all in this together.”
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My friend was melting down. His wife was scared. He'd been upset and shouted before. But he'd never thrown things. After a couple of frantic phone calls, the couple showed up at my door mid-afternoon. He was still pacing and shouting. Fortunately not throwing things. We drove him to the local mental health facility. There a competent and kind counselor interviewed him for two hours. The tentative diagnosis was attention deficit hyperactivity disorder, ADHD, a big surprise. The man was in his early 50s. ADHD is most commonly diagnosed in boys around 7 and 8 years of age.
In retrospect it made sense. My friend, a brilliant, funny man with a unique take on the world and encyclopedic knowledge of sports, had had a hard time holding a job. He'd get bored and frustrated and speak out when he should have held his tongue. This man with an advanced business degree turned go his wife to do their income tax filing because he couldn't get it organized himself. Missed appointments and lost car keys were regular features of his life.
There's a happy ending. Once diagnosed, my friend was prescribed a stimulant medication that he could take intermittently when he needed to get it together for a task at work or at home. He kept a regular job for years, where he excelled. And he took up cooking and gardening.
I have a string of stories to tell about patients whose lives turned around once they were diagnosed with ADHD and treated with stimulants. Almost all of them were boys who had been annoyingly disruptive and subjected to endless punishments and counseling with little result. We all have had to put up with kids like them in school. They suffered way more than we did. Shunning by classmates hurts far worse than time outs or visits with the principal.
But aren't stimulants speed? Yes they are. Isn't speed addictive? Yes it can be. How then can you give potentially dangerous drugs that are related to cocaine and methamphetamine to children? Because for those who respond, which are many with ADHD, especially children, their lives are much, much improved on drugs. They do better in school, with family and peers, and later on, in their careers. Studies have shown a 30%-40% lower incarceration rate. Drug addiction, including to speed, is way less than it is in their untreated peers because they don't need to resort to street drugs to manage the symptoms that previously caused them so much suffering. They function at a higher level. Most importantly, they are happier.
The report of the Make American Children Healthy Again Commission, released in May by Robert Kennedy, Jr.'s Department of Health and Human Services (DHSS), makes a valid point that in the U.S. ADHD is somewhat over-diagnosed and over-treated. The document suggests lots of ways to study ADHD and other health issues of childhood. I hope they come up with some good answers. In the meantime, I fear clinicians will come under great pressure to stop prescribing stimulants for children with ADHD, when there's still not much else to offer them. They will suffer.
The conduct of people with ADHD can lie pretty far from the average. They are not sick persons to be quarantined or repaired, but potentially valuable outliers. I cherish the opportunities to laugh and to think outside the box that my friend with ADHD has given me, in large part thanks to his diagnosis.
Every human brain is unique, even from the one that resides in the head of an identical twin. People with ADHD are wired in some ways more uniquely than most. If we know how to appreciate them, they may produce fabulous art or solve knotty problems by approaches that those of us who are closer to average would never have come up with.
How about schizophrenia? Since time immemorial groups have depended, for the sake of cohesion, on people who converse with the unseen world. Or in the case of folks with obsessive-compulsive disorder (OCD), what prehistoric band didn't need an accountant who could keep track of every last arrowhead and basket of grain? Robert Sapolsky, Stanford professor and author of Behave: The Biology of Our Best and Worst, has proposed that the genes for schizophrenia and OCD have persisted in our DNA because having a small number of individuals with these traits actually helped human groups to survive.
Today we tend to treat the symptoms of schizophrenia, OCD and ADHD plenty aggressively. At our best, we're motivated not by a need to control these outliers, but by compassion.
As humans have organized ourselves into ever larger societies, we have lost a good deal of the face-to-face intimacy that brings appreciation of those who lie farther away from the norm. Today, rather than being valued by the tribe as shamans, organizers, artists or entertainers, too often outliers come to be seen as disruptive weirdos. In a perfect society everybody would be appreciated and contribute according to their unique perception and abilities.
We owe it to these people who may be suffering because their behavior doesn't fit neatly into our world: to help them focus if they have ADHD; reduce their out-loud crazy talk if they have schizophrenia; and get on with their lives if they have OCD. Drugs are not ideal. However, too much of the time they're the best we have to offer, especially in the face of ever more constricted resources with which to address mental health closer to its roots.
We have all been challenged by people who are labeled outliers. The best thing you can do for such folks is to value them because they are different from you and also because, underneath it all, they are a whole lot like you.
