How Real is the ADHD Epidemic?

By Kate Harveston

Attention-Deficit Hyperactive Disorder, or ADHD, is a condition often diagnosed in childhood and characterized by hyperactive behavior and an inability to focus, among other symptoms. For decades, it's been a common diagnosis for children who are having trouble in school or who can't sit still. In recent years, many parents and even young adults who spent their childhood on Ritalin and other ADHD medications are beginning to question whether or not medical professionals have been over-diagnosing this mental illness all along. 

How real is the supposed ADHD epidemic?

The History of ADHD

ADHD is not a new condition.  Doctors first made the first diagnosis in 1902, though they called it hyperkinetic impulse disorder. A British pediatrician described it as an ‘abnormal defect of moral control found in children.' In spite of this mention, it wasn't officially named or considered a diagnosis until the publication of the third edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders) in 1980. 

The FDA approved Ritalin as a treatment for ADHD in 1955, and it has been used as a successful treatment for many years. 

In the 1990s, diagnoses of ADHD in children started to climb, which could be attributed to a number of different factors.  Some say that the diagnostic techniques for ADHD were improving, allowing more accurate diagnosis, while others believe that more children were developing the disorder.  

Whatever the case, the 1990s had the highest number of new ADHD diagnoses, leading to many people wondering whether the children taking Ritalin and other similar medications truly had ADHD. 

Many news outlets started questioning whether ADHD was an actual diagnosis at all, calling it a hoax or claiming that doctors were drugging kids without reason. 

A Trend of Misdiagnosis 

Today, more than 6.4 million children have been diagnosed with and treated for ADHD. These numbers don't include those young adults who were diagnosed with the condition as children and aged out of the targeted demographic. While many of these diagnoses are accurate, as many as one in five of these may have been a misdiagnosis.

Why are so many kids misdiagnosed?

Part of it is due to public school systems.  Children are judged on their behavior, but their emotional maturity is not taken into consideration.  Instead, they are expected to perform the same as their peers, regardless of their maturity level. This can lead teachers, parents, and even medical professionals to misdiagnose them with ADHD. 

It could also be due to the school environment — many schools are excessively rigid, with a heavy focus on standardized testing and require kids to sit still and function for 6-7 hours a day.  For young children, whether they've been diagnosed with ADHD or not, this can be a trial. Add to that the fact that school districts across the country have eliminated recess or free play time and are just now starting to restore these breaks, it stands to reason that high energy levels could be mistaken for the symptoms of ADHD. 

The condition itself can be difficult to diagnose — like many other mental disorders, doctors can only diagnose it through observation of the child, and behavioral observations reported by the child's parents and teachers. No blood test can say definitively one way or another that a child needs to receive treatment for ADHD. 

Why are so many kids misdiagnosed?

Long-Term Effects of ADHD Medications 

The medications used to treat ADHD are, at their core, powerful stimulants. For children with ADHD, they can be beneficial — the stimulants act as a calming agent that allows the children to function in school and at home. Even with the benefits it offers, it is important to take into account the risks of putting children on such powerful stimulants.

Some studies have found that stimulant medication can stunt a child's growth, leaving them behind their peers in height and weight.  Parents can mitigate by establishing a ‘drug holiday' over the summer months where they stop taking the ADHD medication during the summer break. 

Stimulant medications also affect the brain's neurotransmitter levels. The number of dopamine receptors in the brain increases, allowing it to adapt to the increased levels of dopamine the body produces in response to the medication. This could also be why many children with ADHD require progressively higher doses of stimulant medications for their treatment to be effective over time. 

When it comes down to it, treatment of ADHD, whether it's with behavioral therapy, stimulant medications, diet changes, or a combination of the three, tends to be better for the child than non-treatment. Children with ADHD who go untreated or undiagnosed tend to have a higher instance of failure in school. 

Those that continue to show symptoms of the condition into adulthood have a hard time functioning in a traditional workplace. 

A Difference in Opinion

The children who have grown up with ADHD are becoming adults, and many have started looking at it as a difference in cognition instead of a mental disorder. Instead of taking stimulant medications to make it easier for them to focus, they find the things that they love — the things that make them hyper focus in a way that only individuals with ADHD can. 

It's entirely possible that the best way to treat ADHD is to let these students find the way that they learn best. Putting every student in the same box isn't going to work, whether the students are neurotypical or neurodivergent. While there isn't a lot of study following this train of thought yet, as the children with ADHD grow into adulthood, chances are there will be more curious minds looking into the different ways that we can embrace those who see the world differently than we do.  

ADHD is unquestionably a condition that requires treatment, though that treatment will need to evolve if it is to offer actual benefits — both in the long and short term — to those who are diagnosed. In the meantime, though, researchers and medical professionals need to focus on finding more accurate ways to diagnose ADHD, so fewer children end up misdiagnosed and those who do require treatment can get the help they need faster. 

Αbout the author

Kate Harveston is an online journalist with particular interests in social change, health, politics and news. She holds a Bachelors in English and enjoys reading and hiking in her spare time. If you enjoy her work, you can visit her blog, Only Slightly Biased.