Recent growth of reported ADHD diagnoses and prescriptions, especially in adults, isnt simply due to an increasse in the number of people who have the condition, writes Brandeis University social science Professor Peter Conrad in a recent paper published in “Social Science and Medicine”
According to this study, the rate of diagnosable ADHD in the sample population of middle aged Australian adults was 6.2%. (My estimate as an ADHD aware clinician who has ADHD himself is that that would be in the right ball park at least).
I doubt that the rate of diagnosed ADHD in this population is more than 0.5%– it was about 0.2% a few years ago according to a survey done by the NSW health department.
So it is clear that in the middle aged population there is a great deal of undiagnosed ADHD. In this setting it is difficult to see whether there is any real increase at all in the last few years.
Actually I think there is- as the distribution of ADHD within the USA is not even- it clusters especially in very poor states with high rates of intrafamily trauma and also in Eastern seaboard states where kids live a more controlled and regulated life. It is lowest in more rural midwest states where children lead more active lives in more intact and healthy rural communities. Given Dr John Ratey’s observations about the overlap of the neurology of attention and movement it is clear that healthy outdoor play is essential to normal brain development- and that todays latchkey kids who spend more time on line and less time playing in the street may well be at risk of abnormal brain development.
Speaking as a clinician who was diagnosed at age 46, I see many cases of ADHD. After my diagnosis I realised to my alarm that I had, unknowingly been seeing ADHD adults for years- they were coming in with alcohol abuse, with habitual overeating, with chronic pain syndromes, with metabolic syndrome with marital and child rearing difficulties and with refractory anxiety and depression.
ADHD causes serious difficulties for those of us who have it, until we master it. Stimulant medication is only a part of the treatment regimen but it is a vital part for many of us. (My own personal treatment regimen is firmly anchored in mindfulness and I now practice largely in mindfulness and have a qualification as a meditation teacher. I could not have got there without access to dexamphetamine).
If it is true that the drug companies are playing a role in increasing ADHD awareness, I can only congratulate them, as my profession (especially in Australia) has abdicated its responsibility to the community in its regressive and incompetent attitude to the diagnosis and management of ADHD.
While my ADHD was diagnosed at age 46, I had had a strong clinical suspicion that I had ADHD based on my reading. However I was scared to seek diagnosis. I was afraid of being labelled eccentric or taking supposedly “dangerous medications”.
In the end I had to fire 2 psychiatrists before finding an individual competent to diagnose me, and that process took 2 years. By the time that process was done the damage to my marriage caused by my ADHD behaviours was irreparable.
People like Prof Conrad who focus on abstruse speculations about issues such as medicalisation cause real harms by scaring individuals away from seeking appropriate investigation and treatment and should be recognised for the menace that they are.