View Full Version : ADHD epidemic


K-Funk
09-30-11, 03:59 PM
The United States of Adderall?

snippet from thought provoking article on WHY we are seeing an ADHD "epidemic" now:

http://www.huffingtonpost.com/larry-diller/united-states-of-adderall_b_980238.html




A 60-year cultural trend (http://books.google.com/books?hl=en&lr=&id=rpv1cI7MI34C&oi=fnd&pg=PP11&dq=%22therapy+culture%22+F+Furedi&ots=tkulOceCgm&sig=ShYlVk7dKxKVYkxjbAHOveQ1soE#v=onepage&q&f=false) has made feelings more important in general. Pre-1970s parents simply didn't think about their kids as much. Parents worry about their children falling behind and feeling different and bad. Their concerns about their children drive them to professionals, who then offer medication. We are the only society that addresses sometimes minor differences in children's behavior or performance with drugs to such a degree.

There are items that are not on my list. I don't include sugar, processed foods, additives, TV, video games, Internet and cell phones. There is either no good research to support these factors or sometimes multiple studies that show no or very weak links at best (as with sugar (http://www.springerlink.com/content/kx10890h33351475/)). I know proponents of each factor will exaggerate its influence with at least one study that purports to "prove" a link. I anticipate many aggrieved disclaimers from readers (e.g., "My son stopped eating _______ and all his ADHD symptoms disappeared!").



I also believe there are no conspiracies to drug the children of America. Rather, a number of economic "invisible hands" (http://books.google.com/books?hl=en&lr=&id=I8KvaDNqpZ4C&oi=fnd&pg=PT9&dq=) work together to make children and families less able to cope and Adderall an attractive, efficient solution.

I welcome readers' comments. I am not denying the existence of ADHD/ADD or the value of Adderall for the particular child or adult using it. I am not presuming I "know" for certain why we are the "United States of Adderall." But I worry less about our children's chemical imbalances than their living imbalances, which may contribute to the ADHD/Adderall epidemic.
thoughts?

selita
09-30-11, 04:40 PM
I think it might have more to do with the decline in the value of college degrees. If you need high school to get ANY job and you need college/university to get MOST jobs, of course there's a higher emphasis on academics. There's too much competition. Education has become too attainable (I'm not sure I believe that, but that's a whole other story) and jobs have become less attainable.

But, having ADHD Dx'd and treated, for me, is more help against stress and future health problems... than help with achievement. So far. I am no longer in daily panic mode just to get things done. It's good.

I would have been treated all my life if I knew then what I know now, but I needed some education on ADHD before I would have accepted it. I couldn't take meds without understanding them. I guess that's just my hang-up, but it's true.

K-Funk
09-30-11, 05:10 PM
A related article from the Huff Post about ADHD:

http://www.huffingtonpost.com/daniel-goldin/deconstructing-the-adhd-e_b_462876.html

We have a research establishment at least partially co-opted by the pharmaceutical industry, reluctant to question assumptions about the hereditary nature of ADHD and the long-term effects of stimulants. We have a sizable number of pediatricians and psychiatrists paid to receive pharmaceutical company talking points. And due to the work of CHADD and other seemingly neutral groups, we have a population of parents and teachers open to interpreting impulsive behavior and spaceyness as symptoms of a brain disease.

Let the debate ensue! :D

KronarTheBlack
09-30-11, 07:40 PM
Larry Dillers article is an article based on his opinion that Society needs to change instead of managing problems through drugs as a first treatment. I agree with him.

ginniebean
09-30-11, 09:51 PM
The editor of the Huffington Post is one of those new agers who believes that you can 'positive think' you're way out of anything. The HP will print any tripe that happens to discredit mental illness and then suggest some snake oil will 'cure' it.

K-Funk
09-30-11, 10:35 PM
Interesting....although I didn't think the Dilller piece was that bad. He seemed to be saying "I think genes are involved, I think environment place a role, let's try to tackle this from both angles"

is that not your take?

The editor of the Huffington Post is one of those new agers who believes that you can 'positive think' you're way out of anything. The HP will print any tripe that happens to discredit mental illness and then suggest some snake oil will 'cure' it.

ginniebean
10-01-11, 02:59 AM
Kfunk, you caught me, I just saw huff post and spewed.. I'll go read the article :D

pechemignonne
10-01-11, 09:25 AM
I wouldn't apologize too fast, Ginnie. The Huffpost article is another stupid piece of junk.

The only interesting tidbit is this:

It is my guess that only a small percentage of children are correctly diagnosed with ADHD -- meaning they have biologically driven delays in frontal lobe development that prevents them from thinking before acting. Many of the misdiagnosed are probably mistreated children, as the behavioral symptoms of trauma and neglect are almost identical to ADHD. The well-known trauma researcher Jennifer Freyd, Phd. recently published a study indicating that teachers, responsible for the majority of ADHD referrals in the US, frequently identify children suffering from maltreatment and neglect as exhibiting ADHD symptomatology. The study goes on to warn that "we have a responsibility to investigate whether we are medicating abused or neglected children for misdiagnosed ADHD." The rest are no doubt children who lie in the mid-range of the spectrum, difficult, fidgety children with maybe more of a present-tense bias to their temperament, but unimpaired.
If you ignore the stupid part where Goldin makes a "guess" that ADHD is overdiagnosed (when actual studies, not "guesses" show that it is in fact underdiagnosed), there is a very good point there. There needs to be more study into the impact of trauma on children, more screening for child abuse, and more knowledge about links between trauma and ADHD symptoms.

I'm going to look into the Freyd study. I have a lot of respect for Freyd and while ADHD is not her area, trauma certainly *is*.

Update: Meh, I didn't read it properly. Her study only discusses teacher perceptions of children's symptoms. Kind of a no-brainer, and I don't think it's a bad thing that teachers are misidentifying children as having ADHD. It isn't a diagnosis and it can get them in for a psychological evaluation, which they obviously need anyway.

KronarTheBlack
10-01-11, 09:40 AM
Read the first article Peche. http://www.huffingtonpost.com/larry-diller/united-states-of-adderall_b_980238.html It is much more reasonable.

pechemignonne
10-01-11, 10:06 AM
I read that article as well, Kronar. I think it's bunk also, and I think that Diller is out of his mind. I am familiar with his writings on ADHD. He argues for corporal punishment. I don't think that anything he says about ADHD should be taken seriously, he is simply a general practitioner with a very loud voice and some culturally-acceptable opinions.

Fortune
10-01-11, 10:08 AM
Ah, yes. Lawrence "Spanking Might Beat Ritalin" Diller (http://health.usnews.com/health-news/blogs/on-parenting/2008/06/09/one-view-a-spanking-might-beat-ritalin).

pechemignonne
10-01-11, 11:48 AM
Response to the February 2010 article by Dr. Daniel Goldin

I realize that this article was published some time ago, but I still feel the need to respond fully to what I believe is a perfect example of the kind of misinformation commonly spread about ADHD in popular media. It continues to disappoint and infuriate people who have ADHD that the opinions of persons who are general mental health practitioners (such as Goldin) or physicians in general practice (such as Dr. Lawrence Diller) are given prominence in popular media over the actual studies and expertise of specialists like Dr. Russell Barkley.

To begin with, the statistics quoted at the heading of the article suggest that ADHD is over diagnosed. However, recent studies and statements by experts in the field suggest that in fact the primary concern of most people studying the disorder is the degree to which ADHD is underdiagnosed and undertreated. The fact that the general public (the audience for Dr. Goldin’s piece) may not be aware of this important contradiction makes the lack of mention of the expert consensus on the subject practically a willful misleading of the public.

The quoted story which follows only serves to highlight the difficulty in having a person who is unfamiliar with ADHD providing diagnosis and opinion on the subject. This mother, who wants information on a disorder that her child may have, is given quotes from the Diagnostic and Statistical Manual of Mental Disorders, a compendium designed for use by mental health practitioners to help them with diagnosis. This is not a book to be used to find a list of symptoms for self-diagnosis or for a parent to understand their child’s symptoms. The fact that Dr. Goldin felt the need to pull it off the shelf in conversation with a patient’s parent in order to explain the disorder is a string indication of his lack of familiarity with ADHD. Naturally the parent was confused by the definition provided. I can’t think of a less helpful reaction to a parent’s confusion than to quote the DSM at them.

As for the fact that nearly 10% of children have been diagnosed with ADHD, this only brings ADHD into the realm of common childhood disorders, on par with asthma. Are we going to start arguing that asthma is overdiagnosed and that we should change the criteria for diagnosis because so many children are presenting breathing impairments?

The next few paragraphs seek to link ADHD “epidemic” with increased use of pharmaceuticals for mental illness, generally. There are two problems with this thesis. For one, it presumes that medication of ADHD is a negative outcome, and one which parents are happy to consider. Neither of these are true. Since medication is part of the necessary treatment of ADHD, it is not any more alarming or sinister that more people should be taking ADHD medication than it is that more people should be taking heart medication or cancer medication. Neither is it the case that parents are “relieved” to be able to blame someone else and make the decision to medicate their children easily.

Of course, ADHD is highly stigmatized and parents of children with ADHD are very often blamed for their children’s symptoms, and the symptoms of ADHD do make parenting such children more difficult and more taxing. Also, parents often have a lot of worries about their children’s futures if their behavioral and other problems continue. So there is some element of relief in finding that there is a clear source for the problems that can be remedied. Parents don’t want to think that they are casing their children to be dysfunctional, and they want to know that their children will get better. That doesn’t mean that most parents of children with ADHD are enthusiastic about the idea of their child having a brain disorder or the idea of putting their child on powerful psychotropics. It is simply a blanket insult to parents of children with ADHD and all other similar conditions to suggest otherwise, and I fail to see how anyone could find data to support such a claim.

As for the idea that pharmaceutical companies are influencing ADHD studies and are plotting to put all of our children on drugs, there are several problems with this. In the first place, despite the constant decrying of the way that “drug companies” fund Barkley and CHADD and other ADHD research, I would like to see some evidence that this is in any way more significant for ADHD than for any other area of medical research, from cancer to heart disease to diabetes to depression. Of course pharmaceutical companies are interested parties. Of course it is problematic that they are the major source of financial support for medical sciences. It is also problematic that weapons manufacturers are the sponsors of so much of our technical sciences, and that so many of our biological scientists are being paid to try to find better wrinkle cream. However, if you are only going to trust studies that are not funded by interested parties, you will be practically unable to use virtually all of current science. That is a problem of our way of funding science in general, and therefore the results of ADHD studies are no more questionable than studies of any other disorder, and are held to the same scientific standards of accuracy and reproducibility, etc.

Furthermore, the entire thesis that pharmaceutical companies benefit from the treatment of ADHD with stimulant medication is flawed, because the data actually suggests that pharmaceutical companies and the medical industry in general make more money off of people with ADHD who are not being treated properly or treated at all. Over and over again the data shows that people with untreated ADHD have more injuries, ailments, and mental illnesses (particularly depression and anxiety) than they would if they were taking stimulants. So, in point of fact, pharmaceutical companies have more to gain by keeping people with ADHD off stimulants so that they will be on three other psychotropic medications instead.

This brings me to the conclusion, where Dr. Goldin states his “guess” that ADHD is overdiagnosed. He does not provide any basis for why his “guess” should be given more weight than the studies that show that on the contrary, ADHD is underdiagnosed and undertreated such that it causes severe life impairments in many people. Neither does he touch on the overall cost of these impairments to the people who experience them, or to their families, or to society as a whole. The cost of lost potential, the cost to self-esteem from being constantly told that you are lazy, careless, and dumb. The cost to relationships and the cost in dollars of having so many people unable to care for themselves on a basic level, as evidenced in the studies of Dr. Barkley and his team on long-term prognosis for adults with untreated ADHD.

And while Freyd’s study on teacher perception of children is interesting for the study of trauma in children and while it is certainly worthwhile to continue to study the diagnostic tools that can be used to differentiate between symptoms of trauma and symptoms of ADHD in children, ultimately it tells us nothing about the diagnosis of ADHD in children itself, because it is not a child’s teacher who will diagnose. It is in fact a positive outcome that teachers are on the lookout for ADHD symptoms and may be more likely to refer parents to seek psychological help for their children. Children who are reacting to trauma need psychological intervention, and if they are seeing a specialist because a condition is suspected that they don’t turn out to have, so be it, at least it got them into a psychologist’s office. A specialist can make the diagnostic differentiation that a teacher doesn’t have the skill, time or information to make. So, we need to work on making sure that diagnoses are being made by people qualified to do so, and that these people have the most information possible. On the whole, whether a child’s teacher or neighbor thinks that they have ADHD is not really an issue of overdiagnosis.

In conclusion, while ADHD may be sometimes misdiagnosed, as are all mental conditions and indeed medical conditions, there is no epidemic of overdiagnosis or overmedication. There is in fact a widespread problem of lack of access to diagnostic services and treatments, as well as a lack of education on the disorder in teachers, school staff, and physicians in pediatrics and general practice. ADHD is not a myth or a cultural symptom or a personality quirk, and a qualified specialist can tell the difference between the normal pressures of life and the biological condition that is ADHD. That medication is an essential component of treatment for most people with ADHD is not an invention of greedy pharmaceutical companies, any more than insulin or asthma puffers are an attempt to drug the nation’s children and adults. Finally, there needs to be more weight put to the information provided by the experts studying ADHD as a complex and debilitating disorder than in the guesswork and opinions of anybody and everybody who has a psychology or medical degree and happens to agree with the hand-wringing sentiment that is currently popular.

K-Funk
10-01-11, 10:59 PM
Fantastic point by point dissection and response!!!! Love it!!!!

I'm pretty impressed by what you wrote here, what do you do in your spare time when you're not on the ADD boards? :D

Response to the February 2010 article by Dr. Daniel Goldin

I realize that this article was published some time ago, but I still feel the need to respond fully to what I believe is a perfect example of the kind of misinformation commonly spread about ADHD in popular media. It continues to disappoint and infuriate people who have ADHD that the opinions of persons who are general mental health practitioners (such as Goldin) or physicians in general practice (such as Dr. Lawrence Diller) are given prominence in popular media over the actual studies and expertise of specialists like Dr. Russell Barkley.

To begin with, the statistics quoted at the heading of the article suggest that ADHD is over diagnosed. However, recent studies and statements by experts in the field suggest that in fact the primary concern of most people studying the disorder is the degree to which ADHD is underdiagnosed and undertreated. The fact that the general public (the audience for Dr. Goldin’s piece) may not be aware of this important contradiction makes the lack of mention of the expert consensus on the subject practically a willful misleading of the public.

The quoted story which follows only serves to highlight the difficulty in having a person who is unfamiliar with ADHD providing diagnosis and opinion on the subject. This mother, who wants information on a disorder that her child may have, is given quotes from the Diagnostic and Statistical Manual of Mental Disorders, a compendium designed for use by mental health practitioners to help them with diagnosis. This is not a book to be used to find a list of symptoms for self-diagnosis or for a parent to understand their child’s symptoms. The fact that Dr. Goldin felt the need to pull it off the shelf in conversation with a patient’s parent in order to explain the disorder is a string indication of his lack of familiarity with ADHD. Naturally the parent was confused by the definition provided. I can’t think of a less helpful reaction to a parent’s confusion than to quote the DSM at them.

As for the fact that nearly 10% of children have been diagnosed with ADHD, this only brings ADHD into the realm of common childhood disorders, on par with asthma. Are we going to start arguing that asthma is overdiagnosed and that we should change the criteria for diagnosis because so many children are presenting breathing impairments?

The next few paragraphs seek to link ADHD “epidemic” with increased use of pharmaceuticals for mental illness, generally. There are two problems with this thesis. For one, it presumes that medication of ADHD is a negative outcome, and one which parents are happy to consider. Neither of these are true. Since medication is part of the necessary treatment of ADHD, it is not any more alarming or sinister that more people should be taking ADHD medication than it is that more people should be taking heart medication or cancer medication. Neither is it the case that parents are “relieved” to be able to blame someone else and make the decision to medicate their children easily.

Of course, ADHD is highly stigmatized and parents of children with ADHD are very often blamed for their children’s symptoms, and the symptoms of ADHD do make parenting such children more difficult and more taxing. Also, parents often have a lot of worries about their children’s futures if their behavioral and other problems continue. So there is some element of relief in finding that there is a clear source for the problems that can be remedied. Parents don’t want to think that they are casing their children to be dysfunctional, and they want to know that their children will get better. That doesn’t mean that most parents of children with ADHD are enthusiastic about the idea of their child having a brain disorder or the idea of putting their child on powerful psychotropics. It is simply a blanket insult to parents of children with ADHD and all other similar conditions to suggest otherwise, and I fail to see how anyone could find data to support such a claim.

As for the idea that pharmaceutical companies are influencing ADHD studies and are plotting to put all of our children on drugs, there are several problems with this. In the first place, despite the constant decrying of the way that “drug companies” fund Barkley and CHADD and other ADHD research, I would like to see some evidence that this is in any way more significant for ADHD than for any other area of medical research, from cancer to heart disease to diabetes to depression. Of course pharmaceutical companies are interested parties. Of course it is problematic that they are the major source of financial support for medical sciences. It is also problematic that weapons manufacturers are the sponsors of so much of our technical sciences, and that so many of our biological scientists are being paid to try to find better wrinkle cream. However, if you are only going to trust studies that are not funded by interested parties, you will be practically unable to use virtually all of current science. That is a problem of our way of funding science in general, and therefore the results of ADHD studies are no more questionable than studies of any other disorder, and are held to the same scientific standards of accuracy and reproducibility, etc.

Furthermore, the entire thesis that pharmaceutical companies benefit from the treatment of ADHD with stimulant medication is flawed, because the data actually suggests that pharmaceutical companies and the medical industry in general make more money off of people with ADHD who are not being treated properly or treated at all. Over and over again the data shows that people with untreated ADHD have more injuries, ailments, and mental illnesses (particularly depression and anxiety) than they would if they were taking stimulants. So, in point of fact, pharmaceutical companies have more to gain by keeping people with ADHD off stimulants so that they will be on three other psychotropic medications instead.

This brings me to the conclusion, where Dr. Goldin states his “guess” that ADHD is overdiagnosed. He does not provide any basis for why his “guess” should be given more weight than the studies that show that on the contrary, ADHD is underdiagnosed and undertreated such that it causes severe life impairments in many people. Neither does he touch on the overall cost of these impairments to the people who experience them, or to their families, or to society as a whole. The cost of lost potential, the cost to self-esteem from being constantly told that you are lazy, careless, and dumb. The cost to relationships and the cost in dollars of having so many people unable to care for themselves on a basic level, as evidenced in the studies of Dr. Barkley and his team on long-term prognosis for adults with untreated ADHD.

And while Freyd’s study on teacher perception of children is interesting for the study of trauma in children and while it is certainly worthwhile to continue to study the diagnostic tools that can be used to differentiate between symptoms of trauma and symptoms of ADHD in children, ultimately it tells us nothing about the diagnosis of ADHD in children itself, because it is not a child’s teacher who will diagnose. It is in fact a positive outcome that teachers are on the lookout for ADHD symptoms and may be more likely to refer parents to seek psychological help for their children. Children who are reacting to trauma need psychological intervention, and if they are seeing a specialist because a condition is suspected that they don’t turn out to have, so be it, at least it got them into a psychologist’s office. A specialist can make the diagnostic differentiation that a teacher doesn’t have the skill, time or information to make. So, we need to work on making sure that diagnoses are being made by people qualified to do so, and that these people have the most information possible. On the whole, whether a child’s teacher or neighbor thinks that they have ADHD is not really an issue of overdiagnosis.

In conclusion, while ADHD may be sometimes misdiagnosed, as are all mental conditions and indeed medical conditions, there is no epidemic of overdiagnosis or overmedication. There is in fact a widespread problem of lack of access to diagnostic services and treatments, as well as a lack of education on the disorder in teachers, school staff, and physicians in pediatrics and general practice. ADHD is not a myth or a cultural symptom or a personality quirk, and a qualified specialist can tell the difference between the normal pressures of life and the biological condition that is ADHD. That medication is an essential component of treatment for most people with ADHD is not an invention of greedy pharmaceutical companies, any more than insulin or asthma puffers are an attempt to drug the nation’s children and adults. Finally, there needs to be more weight put to the information provided by the experts studying ADHD as a complex and debilitating disorder than in the guesswork and opinions of anybody and everybody who has a psychology or medical degree and happens to agree with the hand-wringing sentiment that is currently popular.

anonymouslyadd
10-01-11, 11:28 PM
The editor of the Huffington Post is one of those new agers who believes that you can 'positive think' you're way out of anything. The HP will print any tripe that happens to discredit mental illness and then suggest some snake oil will 'cure' it.

Do you mean Ariana Huffington?

pechemignonne
10-02-11, 09:42 AM
Fantastic point by point dissection and response!!!! Love it!!!!

I'm pretty impressed by what you wrote here, what do you do in your spare time when you're not on the ADD boards? :D
Um... I work in an office. Doing data entry and making photocopies.

Are you saying that I'm not living up to my potential?? :eek:

But thanks!! I sent a (slightly edited) copy to Dr Goldin, I'll keep you posted on the response. ;)

Oxycodone
10-02-11, 06:31 PM
Why is there more ADHD...let's see, in my opinion:

- Food Additives: sodium benzoate, potassium citrate, guar gum, Es, Polymers, phenylalanine, aspartame etc. It's not confirmed yet but it surely doesn't make you smarter or more focused.
- Videogames
- TV with 500 channels
- Internet

You can't really be serious about gaming, like Call of Duty or World of Warcraft and then start reading differential equations from a book without taking Adderall, that's just not possible. I am myself a gamer and the screen, the colors, the image movements animations etc. it sets the bar really high for other things that try to catch your attention like books or other stuff. After playing 3 hours of Call of duty or Diablo 3 beta, everything that surrounds you seems uninteresting, unexciting and not worth paying attention to.

TV, well that's obvious. Immediately after watching a movie you are as good as drunk for the next 5 minutes.

K-Funk
10-03-11, 04:58 PM
I'm saying you need your own office with a PhD after your name and a few articles under your belt ;)

Um... I work in an office. Doing data entry and making photocopies.

Are you saying that I'm not living up to my potential?? :eek:

But thanks!! I sent a (slightly edited) copy to Dr Goldin, I'll keep you posted on the response. ;)

mctavish23
10-03-11, 09:26 PM
NONE of the things you listed have a damn thing to do with ADHD.

NONE of them.

If there's been an increase in diagnoses it's due to education on the

disorder and improvement in the development of an evidence based

protocol.

tc

mctavish23

(Robert)

Old School MBD
10-04-11, 02:40 AM
I should have been the poster child for adhd in the 1970's

Before they started medicating us kids the docs would medicate
e the parents (valium)

The 1970's were also the era of spanking in school and taping mouths shut.....contrary to the one authors opinion, neither resulted in control of adhd