It’s 2012. Odds are, you know someone who’s been diagnosed with Attention-Deficit/Hyperactive Disorder. Hell, the way things are looking, I wouldn’t be surprised if you were diagnosed with ADD or ADHD. Because over the past few decades, the rate of diagnosis for this family of disorders has grown shockingly, and it begs the question: Is ADD on the rise? Or is over-diagnosis to blame?
Today, according to the United States Center for Disease Control, approximately 9.5 percent (5.4 million children) 4-17 years of age have been diagnosed with ADHD, and that’s in the United States alone. Of course, that number has been rising. The CDC reports that rates of ADHD diagnoses increased an average of 3 percent per year from 1997 to 2006 and an average of 5.5 percent per year from 2003 to 2007. Those numbers in no way match up with the rising population or with an increase in the amount psychiatric professionals, and the data can mean one of two things: either ADHD is for some reason more prevalent than ever before, or professionals are diagnosing the disorder much more frequently, and possibly, much more flippantly. And of course, the scientific community is still out on that one.
Since the late 1990s, psychiatrists and psychologists both have been railing back at forth. Is ADD on the rise due to the increases in stress from modern life? Or is the modern counselor improperly trained in diagnosis, and prone to over-diagnosing? After all, the sentiment is good: a child is not up to speed, and if he is diagnosed with ADHD, he’ll be given special attention, training and classes for people with disorders. Unfortunately, this also attaches a dangerous stigma to the child; children labeled with ADD/ADHD are often treated differently throughout life and perform poorly due to self-fulfilling prophecy. Two American psychologists, Dr. Hartnett and Dr. Mika, have been firing back at one another for years, one journal article after another. Mika believes that ADD is on the rise, and that there is no trend of over-diagnosis. Hartnett, on the other hand, asserts that something needs to be done to stop the diagnosis of ADD. Hartnett even discovered that, in their early years, so-called “gifted” children display exceedingly similar traits to ADD children and the probability of misdiagnosis is quite high.
Another doctor, Thomas Szasz, M.D., wrote a book in 1961 entitled “The Myth of Mental Illness.” Szasz made a number of radical claims about the nature of psychological disorders but fought heavily against ADD, which was just emerging in popular diagnosis at the time. Szasz asserted that all diagnoses of ADD were misdiagnoses, and that ADD symptoms are the result of improper parenting and social issues. While Szasz’s claims are hotly disputed, even today, his stance on ADD has blazed a trail to combat over-diagnosis.
I’m sure that if you think back to your elementary school days, you can recall that one kid who was kind of spazz (unless it was you.) You might even remember when that kid stopped acting like a spazz. That kid was diagnosed with ADD or ADHD, and was medicated, with either Ritalin or Adderall, two medications that ensure your child will focus, be calm and not act out. And it’s because of these medications, even more than the stigma of ADD, that psychologists object to the over-diagnosis of ADD.
Ritalin, first synthesized in 1944, is a close relative of cocaine. It has a high potential for abuse, and can cause a number of adverse side effects, including anxiety, hypersensitivity, headaches and possibly, schizophrenia. Adderall is more recent and was developed in 1996. On a molecular level, it’s practically identical to methamphetamine. It can lead to drug dependence, behavioral changes, hypertension and, in some cases, more serious symptoms. Both are commonly sold as recreational drugs on campus, especially during exam time.
The scientific community is still debating. Obviously, it’s not a good thing to be pumping children full of heavy medication, but some still argue for the greater good. Yet, in so many cases, we have children who grow out of these symptoms and become better adjusted. If these children had been given Adderall or Ritalin, they might have developed a dependence on the drug and never adjusted properly. So, maybe it’s all over-diagnosis; after all, there has yet to be any established biological cause for the disorder. But even if ADD is a legitimate disorder, a problem to be fixed, these paranoid counselors prone to over-diagnosis are not the answer, and neither are dangerous stimulant drugs.
Ryan Cady is a second-year psychology major. He can be reached at firstname.lastname@example.org.