ADHD -- Overdiagnosed in USA or what?

[Fiannan]

Interesting article:

ADHD among American Schoolchildren

And...

CNN - ADHD may be overdiagnosed, study says - September 1, 1999

There seems to be quite an emotional debate in education and psychology over issues like proper diagnosis of ADHD, treatments, etc. The rate of use of drugs like ritalin has grown geometrically in the last decade and a half and is causing concern as to long-term consequences.

Personally, I find it troubling that some areas of the country have huge numbers of young boys being diagnosed with this "disorder" and being put on stimulants that may have adverse side-effects (and which many of these kids now have parents swiping the ritalin and becoming addicted to it). I am also troubled that if you go to Asian nations or places like Sweden or Russia you don't find very many kids diagnosed with this and yet their schoolkids out-perform our's quite easily (maybe in Asia and Russia kids don't dare act up in school or else the penalties are quite severe -- and one wonders if that's a bad thing). Then again, in Sweden which is very non-punishment oriented there too one finds few kids diagnosed with "DAMP" and strict guidlines on how extreme cases should be treated.

Personally, if a kid needs a stimulant to be focused why not pack a Mountain Dew in his lunch? How about classrooms that don't bore someone to tears? And for once why don't we recognize that small children naturally need to burn energy off and it's not natural for them to sit quietly? Brigham Young condemned mothers who gave their little ones alcohol to quiet them down in church meetings. Wonder how he'd feel today with the drugs being prescribed for kids.

[Loudmouth_Mormon]

I think most people would agree that it's overdiagnosed in schools.

However, I strongly disagree with the notion that ADD/ADHD doesn't really exist.

LM

[Fiannan]

I think there are some kids who are so off the scale that intervention is needed but this guy seems to be more correct than not:

U.S. psychologist Dr. Bob Jacobs told the Youth Affairs Network Queensland conference that doctors and pharmaceutical companies had turned behavioral problems in children into a disorder.

He voiced concern that misdiagnoses resulted in youngsters being prescribed powerful drugs like Ritalin, which may affect their long-term mental and physical development.

In a radio interview afterwards, Jacobs - who is on the advisory board of the International Center for the Study of Psychiatry and Psychology - said his conclusions had been made as a result of his own observations during many years in practice, working with children and families.

He cited cases where parents reported that their ADHD-diagnosed children could not pay attention - but then those same children could play video games for hours without being distracted.

Sometimes where parents made changes in the way they were doing things, the symptoms would go away.

"A real disease doesn't go away when somebody else does something," he argued.

Jacobs said experts had put labels on different behaviors and called them a disease.

"There's no proof. Nobody has ever presented any evidence of a condition called ADHD, except to say all these children are hyperactive; all these children are inattentive, and therefore they all have the disease. It's the 'and therefore' that I'm concerned about."

Jacobs acknowledged that many parents would disagree with him. Parents tend to believe what has become the mainstream view, in part because the drugs prescribed for ADHD do work in that they make the child more docile and more compliant.

Ritalin Debate: Some Experts Doubt Existence of ADHD -- 04/18/2003

[Fiannan]

Very good reading:

PBS - frontline: medicating kids: does adhd exist?

[Canuck Mormon]

Originally Posted by Loudmouth_Mormon

I think most people would agree that it's overdiagnosed in schools.

However, I strongly disagree with the notion that ADD/ADHD doesn't really exist.

LM

I would agree. It seems that every time a child acts up in class or doesn't pay attention, they are diagnosed as ADD or ADHD. It's a hard call to make. My wife is a teacher and she sees kids that are ADD/ADHD and others that are diagnosed ADD/ADHD but really aren't. She thinks the next big "thing" for kids will be "slow processing speed". She has a few kids in her class that have psychologists notes stating this, but they do just fine when it's something that interests them (cartoons, video games, etc).

[CliffieDuckie]

I do agree that it is overdiagnosed/overtreated, but I do NOT agree that it isn't a real problem. It is a physical deformation of the frontal lobe of the brain.

Just because a kid acts up does not mean that he/she is ADHD. For a REAL diagnosis, it has to affect more than one part of your life. A common mistake with ADHD is that everyone thinks that it means the person can't focus at all and runs and jumps all over the place. Yes, that CAN happen, but one thing that is not associated with any other disorder is hyperfocus. With ADHD, you either can't focus at all, or you focus too much (like the other night when I sat down to do a sudoku puzzle and the next time I looked up it was 3 a.m.) and the hyperactivity can range from jumping around to a constant, involuntary shaking of legs or arms, twiddling pencils or rubber bands without realizing it, etc.

In response to the video game quote- That's hyperfocus. I couldn't carry on a conversation, do simple tasks like empty the dishwasher, or remember to put shoes on (or the days when I can't remember if I put socks on, so I put some on and later realize that I'm wearing two pairs) but I could sit for HOURS taking electronics apart, play music, or clean cages. It's an uncontrollable thing and you don't get to choose what you hyperfocus on... I once hyperfocused on brushing my teeth and half an hour later my gums were raw. That hyperfocus gets us in a lot of trouble because, logically, if we can focus on THAT thing and dont focus on other things, we're obviously just lazy.

Anyone who says ADHD doesn't exist needs to come meet me. The most common things I hear about it are: "You just choose to be that way." "You're just being immature." "You're just lazy." and my personal favorite: "You're just being rebellious." There are some people (like me... and I swear this has happened on more than one occasion) that it is so severe that they forget to go to the bathroom. I mean, not really "forget" but on the way to the bathroom get distracted with anything and everything so that an hour later you realize "WOW I really have to pee! THAT'S what I was going to do!" That sort of thing is not a choice, that's not immaturity, it's not laziness, and it's not rebellious behavior. It's a DISEASE.

I DO think that a lot of people use ADHD to rationalize their ill-behaved kids, but it is a real disease that causes a lot of problems for those of us who have it.

[CliffieDuckie]

Originally Posted by Fiannan

Personally, if a kid needs a stimulant to be focused why not pack a Mountain Dew in his lunch? How about classrooms that don't bore someone to tears? And for once why don't we recognize that small children naturally need to burn energy off and it's not natural for them to sit quietly? Brigham Young condemned mothers who gave their little ones alcohol to quiet them down in church meetings. Wonder how he'd feel today with the drugs being prescribed for kids.

I have a couple responses here... Soda + ADHD = Most irritating child you've ever met. First of all, the stimulant doesn't actually stop the hyperactivity part-it helps with the inattentiveness. Once you can focus on things, you actually NOTICE when you're twitching, fiddling with things, etc. so you can stop. So, yeah, the hyperactivity might be lessened a tiny bit, but all that sugar is going to make them go haywire. Diet has a LOT to do with the ability to focus so when you drink a soda, the sugar evens out the caffeine and you don't get any benefit (though your dentist likes those checks he gets for filling the rotting teeth!) PLUS if it's a small child, they think that drinking soda causes you to get hyper and this thought alone is enough to make them bounce off the walls. Also, a soda isn't enough for a lot of people. There are different degrees of ADHD. My sister just needs exercise and she's good to go... I on the other hand need LOTS of different kinds of therapy.
Classrooms are boring, BUT you don't get a choice on what you focus on. Even if it's interesting, I may not be able to pay attention, and the same goes with lessons. Also, any class that requires reading is out of the question. I couldn't read an entire book before medication because I would read a sentence, forget what that sentence said so I'd read it again...and again...and again... until I gave up and just went on.
Parents shouldn't give their kids medication because they are annoying... This is nothing like giving babies alcohol to quiet them down. Yes, I do take my meds partially because I annoy everyone around me (I can't help it) but it's also for ME. Part of treating ADHD with medication is to make the person with the disorder feel better. Imagine being frustrated every single second of every single day for your entire life because you know that you can't do even the most basic tasks a two-year-old could do. That's why depression and anger disorders usually come along with ADHD. That baby isn't bothered by the fact that he/she's annoying someone, someone with ADHD is very bothered by the fact that they KNOW everyone is annoyed by them and that they can't do anything about it.

[pushka]

Thanks for the insight on ADHD in these posts...I must admit to having been a little confused about the use of caffeine in the treatment of the condition, as I'd always just thought that ADHD meant a child was hyperactive and therefore caffeine would just increase the hyperactivity, thanks for proving me wrong

[ruthiechan]

THANK YOU Cliffie, and fent.

Having ADD is so much more than being hyperactive or messy.
My husband has ADD but he is not hyperactive, but he sure can do that overfocus thing, and forget about time, or what he does with his things, or whether or not he ate that day (unless he's at work, because they feed them free meals), when he organizes everything is still messy. I could go on.

I do agree Fiannan that we have a problem with teh school system. Children are NOT meant to sit at desks all day. So there are doctors and teachers who assume that disruption = ADD.

Depression and Asperger's Syndrome, OCD, and such things are often misdiagnosed as ADD (and even the other way around sometimes).

Ritalin is not the best drug out there for ADD. Adderall and others are better, and it also depends on the type of ADD you have. Many people with ADD can focus on things if they are interested in it, but the moment it stops stimulating them (basically not giving them the adrenaline they need to keep their brain going) nope it's out the window.

Another problem with caffeine is that it is quick release. There's no time delay, and no regulation. Thusly, over the long run caffeine makes ADD worse.

Cliffie is correct about the prefrontal cortex being the issue. The deformity lies in the fact that when someone with ADD tries to focus on something instead of the activity in the prefrontal cortex increasing it decreases. This is why stimulant medication makes it better, and why in the short term caffeine makes ADD patients feel better.

For more information on ADD: Clicky
Chapter 12 deals with ADD (they're mini chapters).

On the same site they have a test you can take to see if you have ADD and what type you have. My husband is Type 2. There's a link to the tests on this page: Clicky

[pushka]

You had to pay to take the online test in the link provided so I googled and found this site

Free Online ADD Test, Free ADHD Test Online

Don't know if it's reputable or not, I scored 35/90 which I thought was low, but it said many of my answers indicated possible ADHD symptoms and advised that I seek further advice from a doctor...(Don't know what the results are for others, would be good to compare perhaps?)

Btw, I don't think that I have ADD or ADHD and it was difficult to answer some of the questions in a simple 'yes' or 'no' format, for me anyway, lol!

Just thought I'd add another free online test for comparison...the site seems genuine (apart from the blatant plug for medications), and the list of possible symptoms of ADD/ADHD is exhaustive...

Attention Deficit Disorder Test / ADHD Test