Is ADHD Overdiagnosed?

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.