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I've been suffering from ADHD all my life but only got diagnosed when I was 30. I still haven't taken any meds yet but a diagnosis alone in my childhood probably would have helped with preventing neurosis originating from a school-time worth of derogatory remarks by teachers like "you are a lazy, lazy boy" and "please be quiet, you are inferior anyways". Drugging kids (especially at the very low age of 2-3, no problems advancing in school yet etc) surely must be a function of the pharmaceutical industry trying to make money with overtly fearful parents ("Will my child be able to compete?").

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.

To say that this social darwinist opinion is problematic is the under statement of the week on HN. How bold of a decision was immigration in light of the Irish Potato Famine or African Slave trade? Why was the decision to go to Australia less bold and less defining than deciding to go to America? It is also worth pointing out that America was discovered 10,000 years ago. Is that the discovery you were referring to?

The article and video were about over-diagnosis of ADHD (in children) in the US if I'm not mistaken. About the discovery of America etc - my bad, yes I was referring to the historically rather recent influx of European settlers after the Columbus "re-re-discovery" to be "exact".

A large percentage of Americans are not of European descent. In Georgia specifically, 30% of the population[^1] are most likely descendants of individuals that did not "boldly choose" to cross the Atlantic and come to America.

[^1]: https://en.wikipedia.org/wiki/Demographics_of_Georgia_%28U.S...

> A large percentage of Americans are not of European descent

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)

I'd never thought of that before. Another possible reason for increased prevalence in the US is that we work more hours and have less vacation time than a lot of European countries, increasing the demands on our focus.

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.

>It's fine to say "change the environment" but that's not always an option.

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.

I've got the exact same history in terms of my academic career and being a "job-out" but I keep wondering about all the cool research work people like us could be doing if they would actually be able to study with discipline? I can't study, never been able to without out-of-proportion-huge investments in time and energy - I can't even finish books I really like anymore without brutally "hacking" my ADHD induced distractability and mind-wandering.

> 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.

This is obviously anecdotal, but I've discontinued Adderall (by tapering my dosage to zero over the course of 3-4 days) on numerous occasions with zero withdrawal or side effects.

Quitting caffeine by the same method is quite a bit more difficult for me.

Same. I've had no issues with 'addictions' to caffeine or to my meds, despite doctors worrying about it. I know my brain/body reacts to caffeine/stimulants differently than others due to my ADD.

I second what you've said, as I've had the same experiences in dealing with it myself. Adderall is not crack, but other people may abuse it as such. People without the disorder.

I'd imagine a lot of that increase has to do with fewer people going diagnosed, rather than more people having ADHD in the first place. People become more aware of the symptoms and realize they can get help, they're less scared of being called crazy, etc. Given how hard it is to tell mental conditions apart (I think I remember reading that somewhere around 40% of psychologists' diagnosis are later changed), there are probably some false diagnosis in there too, where the "true" diagnosis is something else that's less top-of-mind, or that hasn't been discovered yet, or is something other than mental disorder.

> It's fine to say "change the environment" but that's not always an option. ^ good point.

  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.

Similar experiences. Adderall is definitely not pleasurable in the sense that something like cocaine or meth (I don't have experiences with them) seems to be pleasurable.

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.