Is ADHD Overdiagnosed?

Posted on by Kevin.

ADHD is still on the rise. Researchers have not identified the underlying cause of this nationwide trend, however. Scientists from the U.S. Centers for Disease Control and Prevention found that between 2007 and 2009, roughly 9 percent of children between the ages of 5 and 17 were
diagnosed with the disorder. This compared with approximately 7 percent between 1998 and 2000. While this data from a reputable scientific agency seems compelling to me, many armchair scientists dispute the very existence of ADHD.

I talk about ADHD on a regular basis with folks at my local coffee shop. Many people are certain that increases in the incidence of ADHD relate to pharmaceutical companies and doctors pushing drugs. These folks cite Internet cures and assorted conspiracies. They reckon that the truth about ADHD is regularly squelched by drug companies and doctors, both of which “get rich from pushing pills.” “Nobody had ADHD when I was in school,” Gerard Carver plaintively insists every time I see him at the coffee shop. “This is a made-up disease.” Gerard’s friend, Bennett Morgan, adds in his deep suspicion of the medical establishment: “Do you know the leading cause of disease in the country?” he asks at least once a week. “Doctors! They kill more people than they cure. ADHD is another excuse for doctors to make money and slowly kill people with their toxic drugs!”

I try to share the neurological data with Gerard and Bennett, but science does not seem to appeal to them. I have brought in brain scan images that clearly show that the ADHD brain has certain areas that are underactive. I have brought in heritability tables that show ADHD is 90% related to the genes one inherits. I have tried to point out twin studies and adoption studies that offer powerful correlations between ADHD and one’s inheritance. They will have none of it. Gerard, who is slightly more reasonable, concedes that maybe ADHD exists for a small percentage of people. I even brought in a book by J.M. Fuster that shows that when certain parts of the brain are injured, ADHD symptoms start to appear. To me, Fuster’s book offers particularly potent proof of the neurobiological basis of ADHD. But some people are just not interested in science.

So, is ADHD overdiagnosed? I suspect it is not, but more evidence is needed. I know that a great many parents try to “protect” their children from such a diagnosis. I know that there is a tendency to not want to be labeled as disordered. I also think that our educational paradigms have narrowed and many social factors have shifted, making it harder in many cases for ADHD people to make it through the “system.” When I was in school, I got to come home for lunch every day. I had music and art classes, and played sports every day after school. My mother was over at the school and involved in activities a few times a week and was home when I returned from school. While I am considered ADHD now, no disorder was suggested for me when I was a child. However, understanding how education has changed, I am sure I would be labeled and on medication if I were growing up nowadays. I do not think there are any easy answers, but I do believe that ADHD is actually underdiagnosed.

12 Comments

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    Posted on by Nicky Hawkinson
  2. It has been said before, but i do believe that part of the rise of ADD diagnosis is the so called MTV age. We are constantly being bombarded with images and information at high speeds, making it so that when we are not continualy being engaged as in a class room or some work settings time seems to be standing still, making it easy to get bored.

    Posted on by Will E.
  3. Wow, Kevin, I just discovered you, your blog, and your intelligent book, from Twitter, which, by the way, I resisted adamantly for years in the name of a non-sound byte lifestyle.
    But I caved in a couple weeks ago when colleagues (other Learning Specialists and ADD Coaches) encouraged it.
    The Neurobiology of ADHD is REAL, and thanks for affirming it. Dr. Daniel Amen, Dr. Gabor Mate, and Dr. Ed Hallowell spell it out in their books, and my own body is a walking laboratory, plus the many clients I work with. Overdiagnosed? Not if you go to a doctor who is not a generalist. Overmedicated? Possibly, if parents are treating that like the be-all and end-all. (“Pills don’t teach skills”).
    But here is where the rubber hits the road: Homeless Shelters, Heroin Houses, and Incarceration facilities are filled with people whose histories reflect a pattern of ADD or ADHD, That is what you may want to insert in your conversations with the naysayers. Hope to have more communication with you about this. Thanks again for your blog.

    http://tamingtheoctopus-themanyarmsofwriting.blogspot.com/

    Posted on by Kendra Wagner
    • Kendra, thanks so much for reading, and I appreciate the affirmation. Yes, I have thought about the incarceration angle in terms of ADHD prevalence. I think Daniel AMen made that point in one of his books. Please keep coming back with your insight and keep fighting the good fight.

      Posted on by Kevin (Author)
  4. I personally prefer Thom Hartmann’s explannation for the increase in ADD diagnosis.

    He explained it as the world having two kinds of people, hunters and gatherers.

    Hunters have ADD. They can be charged with scanning the horizon for prey, daydreaming as they do it or keeping engaged by the passing scenery. They hyper focus as soon as they find the prey and pursue it with laser concentration.
    Put them in a field gathering berries and they will soon get bored and wander here and there collecting in a random pattern missing many berries.

    The Gatherer loves the field and can plan an organized and thorough plan to get every berry. Their focus on the berries stays constant throughout the task.

    In the classroom the Hunter is looking out the window or distracted by every movement and sound of his classmates and the Gatherer looks like the model student harvesting the berries of the academic environment.

    http://www.thomhartmann.com/articles/2007/11/thom-hartmanns-hunter-and-farmer-approach-addadhd

    Posted on by Kirk Tirakian
    • Kirk, I am very familiar with Hartmann’s hypothesis and have made extensive use of it myself. His book, ADD: A Different Perception, is one that everyone touched by ADHD should pick up.

      Posted on by Kevin (Author)
  5. I had to chime in on this topic…..I believe that the term “misdiagnosis” would be more accurate than over diagnosis when it come to ADHD. Besides premature dx for children younger than 6 years of age, I believe that other neurological disorders or delays due to poor executive function within the brain. These deficits are associated with many different types of psychiatric and developmental disorders such as ADHD, Schizophrenia, Autism, OCD, Depression, Anxiety Disorders and more. So, maybe that increase is based on misdiagnosis. Many symptoms overlap and a pediatrician may miss the subtle differences between ADHD and an Anxiety Disorder that an otherwise skilled psychologist would catch.

    Posted on by Bethie Frank
    • Beth, or should I say Bethie, yes a lot of disorders can look like ADHD. Some of the same atypical neuropathways are seen in a variety if disorders including ADHD, Bipolar, Asperger’s, and autism to name a few. And, as you well know, Beth, there is some pretty solid science behind these assertions. Thanks so much for weighing in and please weight in more often. Guest blog?

      Again, Joel Nigg’s Book, WHAT CAUSES ADHD?, is indispensable for anyone who wants to understand the neurobiological nature of ADHD, which is information that, as Beth pointed out, also helps to understand other conditions.

      Posted on by Kevin (Author)
  6. wow thats really intresting im glad its not like this in the UK
    Im still shocked that their still isnt much known about adhd
    Its been around for hundres of years with diffrent names
    most people could write what the know about adhd on the back of a postage stamp

    sorry if i went off topic but thats adhd for you lol

    Posted on by Ged Stevenson
    • Ged, it’s great to have someone from the UK reading the blog. In the near future, I will be writing in greater depth on the neurobiology of ADHD. Come back and read!

      Posted on by Kevin (Author)
  7. Kevin, as usual, you are my teacher. I would really like to learn more about the neurobiology of ADHD. What do you suggest as a good primer?

    Posted on by Jerry
    • Jerry, thanks for reading. A good place to start might be, “What Causes ADHD,” by Dr. Joel T. Nigg. It is an excellent book, although perhaps somewhat technical.

      Posted on by Kevin (Author)

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