Thousands of Toddlers Are Medicated for A.D.H.D., Report Finds
nytimes.com
nytimes.com
A few specific quibbles:
The article says it's not a "disorder", but a "disorder" in psychiatry-speak means "Any pattern of psychological or behavioral symptoms that causes an individual significant distress, impairs their ability to function in life, and/or significantly increases their risk of death, pain, disability, or loss of freedom." ADHD symptoms may not represent a disorder for every individual in every situation. It's fine to say "change the environment" but that's not always an option.
Not to mention the "hunter-gatherer vs farmer" dichotomy doesn't explain the rise of ADHD diagnoses in the last 20 years mostly in the US vs other western countries, which are just as rich and just as regimented.
The other issue I have is with Thom Hartmann's description of ADHD which focuses on distractability and hyperactivity, but those are just two of the most common of the many symptoms that make up ADHD.
Finally, the woman apparently is familiar with abusing Adderall herself. Speaking as someone who has ADHD and benefits from Adderall, I don't experience it as "crack". Nor have I found it remotely addictive. Certainly it's less addictive than caffeine.
The general points are fine (schools and workplaces in the US have issues of their own that encourage ADHD-like symptoms), but the details are wildly wrong.
> It's fine to say "change the environment" but that's not always an option. ^ good point.
It's all wrong.
On the general "over-diagnosis" of ADHD, my problematic social-darwinist opinion: I believe that especially in the US there might really be more people with ADHD brains (in the end leaving your continent to settle on a new one is still perceived as something bold to do in 2014 - think of how much more risky this must have felt over the first couple of centuries after the discovery of America).
I can also think of many reasons why people are willing to take medication these days - all of them probably boil down to being profoundly desperate. I remember my grandfather who died last year at age 90, he clearly had all the traits of severe ADHD but he also had a secretary (cue "Mad Men" generation) and so didn't need to manage all the minutiae himself and was very successful at his job at a big company fully capitalizing his creative/impulsive side. This is a luxury most people with ADHD don't have any more as we are expected to do a lot more different, often detail oriented little jobs in-between - so to be able to do a somewhat acceptable job with those kinds of tasks it drives people towards drugs like Adderall, Ritalin etc (I'm constantly abusing caffeine myself, it doesn't help much but again I'm desperate). I can't tell you how devastating it feels when people who don't understand our different wiring shout at you to "simply just fucking do it" when you are really, really trying hard to do just that. It's terrible and drives a lot of people towards alcohol and heavy drug addictions. I've read somewhere that a very high percentage of the jail population actually has ADHD.
[^1]: https://en.wikipedia.org/wiki/Demographics_of_Georgia_%28U.S...
And its not only non-Europeans who came here other than as a result of boldly choosing.
I believe that especially in the US there might really be
more people with ADHD brains (in the end leaving your
continent to settle on a new one is still perceived as
something bold to do in 2014 - think of how much more
risky this must have felt over the first couple of
centuries after the discovery of America)
Also, just for solidarity's sake: I was also diagnosed in my 30s, and was called "lazy" (etc.) a lot when young. Bet we went through a lot of the same things.
I think that's more up to the individual than the institution. My own story is a typical "I didn't know I had ADHD until it was too late," and I do wonder if I would have a better life if I just went straight into the workforce instead of spending a couple extra years trying to finish college and not realizing why its so hard for me. I even had a decent IT job in college, but thought it so shameful not to have a college degree that I quit to continue my studies and, of course, get deeper into debt. Maybe some personality types just don't work well in those environments. Insert typical "higher education isn't for everyone" debate here.
>Not to mention the "hunter-gatherer vs farmer" dichotomy doesn't explain the rise of ADHD diagnoses in the last 20 years
Maybe because society has reached a point where we can discuss these things without the idea of punishment and without applying morality to it? ADHD kids in the past were beaten, called losers, call sinful, called stupid, etc. Society hit them as hard as it could, yet it didn't fix anything. We've moved away from that mode of thinking and realized that some kids just aren't going to grow out of it and its not their fault. The same way that Alzheimers has been part of the human condition for god knows how long yet we only "discovered" it 1906. Before that, we just thought it was part of getting old and didn't realize its actually separate from aging the same way ADHD is separate from being an energetic child.
> Certainly it's less addictive than caffeine.
Getting off caffeine is trivial. Adderal withdrawal can be very serious for many people. I consider most ADHD meds to be pretty serious drugs. I don't think that's very controversial.
Caffeine withdrawal is no joke either. Getting off caffeine is not trivial, and "can be very serious for many people" as well.
Whether or not your statement is controversial, your implication is not pharmacologically correct, in the sense that caffeine and amphetamines are both comparably serious drugs. It is not very meaningful to compare the addictive potential of two substances, but to the extent that we can, the two are roughly the same[0].
Contrary to public perception, it is not correct to say that amphetamines are inherently "more serious" than caffeine; the means of ingestion, dosage, and (most importantly) the individual's personal biochemistry vary enough that you cannot compare those two drugs directly.
[0] The reason it is not a meaningful comparison is that the actual chemical compound is only one small factor that influence substance abuse and/or dependence. The means of ingestion alone is far more significant than the actual compound being ingested, which often surprises people to learn.
Getting off caffeine is trivial. Adderal withdrawal can
be very serious for many people.
Quitting caffeine by the same method is quite a bit more difficult for me.
Speaking as someone who has ADHD and benefits from
Adderall, I don't experience it as "crack". Nor have I
found it remotely addictive. Certainly it's less
addictive than caffeine.
I find Adderall addictive in the sense that I'm severely "lagged" and sleepy if I discontinue it cold turkey. But, if I taper the dose to zero over 3-4 days, there is no problem.
The submitted article mentions a study published by the United States Centers for Disease Control and Prevention (CDC), and I see that the CDC has a homepage on ADHD[1] with numerous subpages.
Searching Google News for more news on the recent statement discovers stories[2] leading back to the 16 May 2014 report in the New York Times[3] mentioning statements by a CDC official at a recent conference (that is, not yet an official report from the CDC nor a peer-reviewed journal article). The conference presentation, according to the New York Times report, is alarming to many doctors who work with young children.
The bit about ADHD as an evolutionary adaptation is tacked on in reference to ideas from "Journalist Thom Hartmann," who doesn't seem to have any particular expertise in health reporting. There are better sources for the same underlying idea, that some of the behavioral signs characteristic of ADHD may not be maladaptive in all life circumstances.
[1] http://www.cdc.gov/ncbddd/adhd/index.html
[2] http://www.indianagazette.com/news/home-lifestyle/rise-in-ad...
http://www.the-leader.com/article/20140520/NEWS/305209955
[3] http://www.nytimes.com/2014/05/17/us/among-experts-scrutiny-...
Kids who have the hyperactive "subtype" of ADHD tend to move non-stop to the point where they injure themselves, and they also don't seem to listen to their parents. I'm not sure how much of this behavior shows for 3 year olds though...
Sounds like a quintessential 3 year old.
That doesn't mean it's not possible (or useful) to distinguish between a "normal" teenager and one who is depressed and needs treatment.
HOWEVER, "executive function disorder" is too general. Medically, it refers to a class of disorders that includes not just ADHD, but also Asperger's syndrome, Parkinson's disease, schizophrenia, and more[0].
I agree with your general sentiment; I just want to point out that we cannot use the term interchangeably, as many people who have executive function disorders do not have ADHD.
[0] https://en.wikipedia.org/wiki/Executive_dysfunction#Executiv...
Sometimes when a human being and society are misaligned, the society should adapt rather than the human being.
As a person with ADHD-Hyperactive-Impulsive type grows up, he will start showing less and less hyperactivity (the impulsivity is still there though).
http://www.nytimes.com/interactive/2013/03/31/us/adhd-in-chi...
D.A.R.E. - To keep kids OFF the streets (where they could engage in dangerous activities such as "play"), and to keep them ON drugs (where they are easy money).
Well, it turns out, these children often can't be helped by "good parenting" or non-pharmaceutical therapy. They are still destroying their homes, terrorizing their parents and peers. And even though they are the aggressors, they suffer immensely, let alone their parents.
Also, even in much milder cases it has been shown that beating or otherwise severely punishing children (emotionally might count, too), actually increases the behavioral problems in the long term. If ADHD medications helps these children to actually choose peacefulness, I'm not entirely against it.
They shouldnt have children.
Edit: 550am fat thumbed typing.
http://magarshak.com/blog/?p=158
ADHD is the "Hysteria" of the 21st century
Are there any material (video or similar) showing how an average ADHD kid behaves today vs. 20 years ago?
However, being disruptive isn't a particularly good proxy for "has ADHD" and someone without ADHD that is referred has a higher chance of being diagnoesd with ADHD than someone with that is not referred. This results in a lot of kids who end up being treated who shouldn't and plenty of kids who go untreated who could benefit.
A few years later I did try taking some Adderall, unofficially acquired from a friend, and in three days it caused me to start having all kinds of mental health problems (OCD and Tourette's type symptoms, fyi) that I'm still not fully recovered from. Admittedly I think I took a bit too high of a dosage, but I'm scared to even try again if only three days of something could basically turn me halfway insane. Maybe if I'd started on only a half dose it wouldn't have happened, but I'm worried about the fact that such people were trying so hard to push a drug that ended up having those kinds of effects in only three days from only a slightly elevated dosage.
So I definitely think this whole thing is a huge pharma scam at this point. I'd be highly skeptical of any ADHD diagnoses, especially when they're all based on self-reporting (notoriously unreliable) and a bunch of therapists, teachers, etc. who are quick to jump to whatever explanation fits with their prejudices about a person. It scares me that they're pushing these drugs on people, especially at such young ages, not to mention how it prevents the real underlying problems from being solved.
This is a controversial subject though, so I'm going to step out now. Just wanted to share the story of my negative experience with it.
Your experience is an indictment of bad psychiatry, which nobody here would defend. But you explicitly say you wouldn't trust them to diagnose you with anything (I wouldn't either), so I'm not sure why you then draw the conclusion you did:
> So I definitely think this whole thing is a huge pharma scam at this point. I'd be highly skeptical of any ADHD diagnoses
(FWIW, your comment is gray as I write this; I didn't downvote you, but I wanted to explain why I think someone might have).
A bipolar disorder would explain these symptoms. Also bipolar is a very common comorbidity of ADHD, with overlapping symptoms. At the very least, the social problems that come with ADHD predispose for bouts of depression.
Taking destabilizing drugs like Ritalin or Amphetamines is also known to trigger manic episodes or other psychosis. Which is one of many reasons why medical professionals won't tell you to start at the final dose for the first few weeks...
ADHD is a very tough condition to understand. The repercussions of deciding not to treat a child are severe and unequivocal. A child with untreated ADHD will be much less happy, much less social, much less successful (in every sense of the term) and less healthy than need be. Which is sort of the point of treating it.