These days everybody has a child suffering from ADHD among their acquaintances. At least, that’s the diagnosis when kids are hyperactive and have difficulties concentrating. When only the latter (so without the hyperactivity) it’s called ADD, which is more common in girls. ADHD and ADD rates have exploded over the last ten years. The same holds true for prescription rates. In the old days a busy young boy was just loud, now he has ADHD. A girl that had difficulties to focus was called dreamy, now it has ADD.
Some experts worry that normality may be becoming an endangered species. Recent studies show that 25% of the US population every year qualifies for mental disorder. If you look over the course of an individual’s life, by the age of thirty-two 50% would have had an anxiety disorder diagnosis, 40% a depressive diagnosis, 40% a substance diagnosis. These are enormously large figures. You could argue that maybe people are that sick, but probably the diagnostic system has become much too loose.
A reason for this is that people who are experts in a given area are often worried about missing a case. They think that a person deserves diagnose and treatment. They are worried that if they don’t get the appropriate diagnosis or treatment, their life will be ruined. Experts usually don’t worry nearly enough about false positive cases (people who get the diagnosis, but don’t need it).
This doesn’t take away from the fact that ADHD is a crucial clinical problem that needs treatment. However, it is now getting over-diagnosed causing a false epidemic. ADHD used to be an uncommon diagnosis only given to very severe cases. The treatments were seen as powerful and to be reserved only to those who really need them.
With diagnosis rates also prescription rates for medication like Ritalin and Concerta have gone through the roof. These are trademark names for methylphenidate, a psychostimulant drug that increases levels of dopamine in the patient’s brains. Dopamine is a neurotransmitter that is naturally released in rewarding experiences and creates a feeling of pleasure. Chemically not unlike cocaine, methylphenidate is a powerful stimulant that increases alertness and productivity. In many ways it is actually similar to amphetamines like speed.
What is less known is that there is no actual scientific proof that medication has any effects on the long term. Only children who also got behavior therapy tend to do better in the long run. Still prescription rates go up every year. The use of ADHD medication has actually doubled over the last 5 years.
This shouldn’t be too much of a problem if it weren’t for the many possible side effects of ADHD drugs. There are both medical and psychiatric risks. Psychiatric risks are especially insomnia and hyperactivity. Medications can also be used in an addictive way and can contribute to anxiety disorders, depression and psychosis. Medically, the most severe side effects are loss of appetite and cardiovascular problems.
Of course a large group of children actually needs medication. These are the more severe cases that don’t function properly without it and would quickly fall by the wayside. But Ritalin should only be used as a last resort when other treatments like counseling or therapy have failed. In many cases the parents are the ones asking for alternative solutions like therapy or a special diet program because they don’t recognize their child anymore since it started using Ritalin. Many children become less creative and more withdrawn into themselves.
It is not always easy for parents to go in against the advice given by school or so-called experts. Schools often exert a lot of pressure on parents to test their child for ADHD because they like to work with calm and docile students and often don’t have the time and resources to pay extra attention to children who need it. In many cases teachers themselves already diagnose a loud child with ADHD. What they don’t always realize is that the label they put on a child also marks them as a patient suffering from a psychiatric disorder.
Another powerful force to be reckoned with is the pharmaceutical industry. With the expansion of the diagnosis many people have been treated who are fine on their own. This is very much pushed by the drug companies that want to sell as much medications as possible. As they cannot advertise their products, the industry is looking for different ways to reach the masses e.g. leaflets in waiting rooms or websites that contain self-tests and free information on ADHD. What many people don’t know is that many big informative websites are actually sponsored by drug companies and present ADHD as strictly caused by a biochemical imbalance, while there is no scientific proof for that. Of course they are quick to present their wonder dug: Ritalin.
To finish on a positive note, once there are no more products to market and everything will be generic, probably rates will go down again. This is important as over-diagnosing is not only bad for the false positives, but also for the severe cases of ADHD. They could miss out on the attention and care they really need.