New data from the Centers for Disease Control and Prevention shows that nearly 1 out of every 5 high school age boys and 11% of school-age children have received a diagnosis of attention-deficit/hyperactivity disorder (ADHD) — that's a 16% increase from 2007 and a whopping 53% rise over the last decade alone. These numbers alone are terrifying enough, but when one considers the amount of drugs that children as young as 4-years-old are prescribed to combat it, enough is enough. The United States needs to start taking mental illness more seriously, and this means the overdiagnosis of ADHD in children needs to stop immediately.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), people must meet 6 criteria in each category of "inattention" and "hyperactivity-impulsivity" in order to receive a diagnosis of ADHD. These are things like a failure to give close attention, not seeming to listen when spoken to directly, difficulty organizing tasks or activities, fidgeting, interrupting, and leaving one's seat when told to be seated. The symptoms must have appeared before age 7, be causing impairment in school, and there must be "clear evidence of interference" with daily tasks. Sound familiar? They should, because these are absolutely normal behaviors of growing children.
"There’s a tremendous push where if the kid’s behavior is thought to be quote-unquote abnormal — if they're not sitting quietly at their desk — that's pathological, instead of just childhood," said a Harvard professor of medicine.
But teachers who can't control their classes (this is where the "interference" claim comes from) and parents who need a break from their children's antics are now rushing to doctors demanding treatment for their child's undiagnosed ADHD. And because the American Psychological Association (APA) is planning to change the definition of ADHD for the next DSM to encompass even more cases — in part by raising the age at which symptoms must first appear to 12 — these numbers will continue to climb.
Dr. William Graf, a pediatric neurologist in New Haven and a professor at the Yale School of Medicine who described the new data as "astronomical," added that "mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy."
Two-thirds of children who receive an ADHD diagnosis are prescribed stimulants like Adderall and Ritalin. These are drugs that can pose a dangerous risk for cardiovascular issues and addiction, but when given to people who can actually benefit from them, are relatively safe.
"If your child has been diagnosed with ADHD and needs these drugs, they should be used for the shortest possible time and the smallest effective dose," said Dr. Steven Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic.
But how does one decides who needs the drugs and who doesn't? There's often talk of kids growing out of ADHD, when this is not the case at all. If a child actually has the disorder, they will have it forever — just like someone diagnosed with depression or anxiety. A child who appears to "grow out of" the disorder is simply demonstrating their maturation from a fidgety, "out of control" child to a mature teenager or adult. Or, the lack of ADHD "symptoms" could be hiding another disorder altogether.
"Some of these children may have other disorders or other disorders combined with ADHD," said Dr. Xavier Castellanos, professor in the Department of Child and Adolescent Psychiatry at the Child Study Center, NYU Langone Medical Center. "Even when it is ADHD, it doesn't necessarily get fixed easily. It's complex."
Castellanos went on to say that ADHD has become a rather "fashionable" diagnosis as a result of direct marketing to consumers by drug companies. Parents may hear about the latest ADHD drug or may be presented with a list of symptoms that could affect any child, but they always fill their child in the blank and run off to demand drugs from their child's pediatrician. And these doctors may just be proud that this mental illness is being recognized and combated, ignoring the fact that their patient may not actually have it.
There needs to be a massive overhaul in how ADHD is diagnosed. A simple checklist of symptoms is not enough to both diagnose those who actually have the disorder and weed out those who are just being kids. The APA also needs to change its criteria for diagnosis so the descriptions of each symptom do not refer directly to classrooms or schoolwork, thus eliminating the possible misleading of parents and teachers. People who actually have ADHD, those in whom it will never disappear due to age, deserve this change. If it does not occur, then their absolutely real diagnoses of ADHD may be swept under the rug in the future as people begin to realize the true instability of the current diagnostic process.