It seems like everywhere you look, there’s someone lamenting over the tremendous increase in ADHD cases in recent years. Just in the past few weeks, a variety of pundits and experts have put forward theories to explain the surge, from air pollution during pregnancy to over-stimulation of young minds.
But a recent study by Peter Conrad and Meredith Bergey points to an array of compounding factors that have caused an explosion of ADHD diagnoses both in the U.S. and abroad. They call it the “globalization of ADHD,” and there’s a great deal of evidence showing that the growth of ADHD cases is indeed a global phenomenon. Leah Burrows of BrandeisNow writes:
According to the study, in the U.K., diagnosis of the disorder in school-age children grew from less than one percent in the 1990s to about five percent today. In Germany, prescription ADHD drugs rose from 10 million daily doses in 1998 to 53 million in 2008.
While acknowledging the limitations in understanding a complex disorder like ADHD, Conrad and Bergey have identified 5 key trends as the primary drivers of this growth.:
1) Pharmaceutical companies are well-resourced and determined lobbyists, and have coaxed some countries to allow stimulants, such as Ritalin and Adderall to be marketed more directly to consumers.
2) Treating patients with counseling and non-medical therapies is becoming less popular than treating them with medicine. (Many insurers, including Medicaid, will pay for drugs but not for psychotherapy, for example.) This incentivizes the labeling of children with a specific disorder.
3) The Diagnostic and Statistical Manual (DSM), the bible of mental disorders, is gaining more traction in Europe and South America. The DSM has slightly broader standards for diagnosing ADHD than the system used by many other countries, the International Statistical Classification of Diseases and Related Health Problems (ICD), hence more folks are falling within the standard.
4) ADHD advocacy groups are raising awareness of the condition.
5) Because everybody is occasionally fidgety and distracted and nearly everybody despairs of not getting enough done, people turn to the internet for answers and find checklists put up by drug companies, with overly general questions like: “Are you disorganized at work and home?” and “Do you start projects and then abandon them?” and encourage people to ask their doctors about medication.
All of these trends seem like reasonable explanations of the growth in ADHD diagnoses. But the question remains, should we do something about it? And if so, what?
There’s an ongoing debate over whether or not this growth represents better identification of previously overlooked ADHD cases or mis-diagnosis of normal individuals (Conrad and Bergey seem to support the latter). But this debate does little to help the actual people suffering from attention deficits.
The fact is, no matter how “over-diagnosed” ADHD may be, these cases represent real people who are reporting struggles with inattention, hyperactivity, and/or impulsivity. We should be focusing on how to help these individuals instead of arguing about whether or not these deficits are severe enough to warrant a medical diagnosis.
The real debate should be about how we treat individuals with varying degrees of attention deficits. We can all agree that the status quo – prescribing stimulant medications, and only stimulant medications, in nearly 100% of cases – is unacceptable.
We at NEURO+ support individualized therapies that involve the integration of one or more tools (pharmacological included) for the treatment and management of attention disorders. It’s our mission to build products that offer a safe, effective, and affordable solution to help childreB and adults overcome attention difficulties.