ADHD: Has this diagnostic fad run its course?
Like hysteria before it, ADHD has been a disorder of its time. And now it’s time to leave it behind and make a commitment to helping children be their best.
Murray, Ky.
The idea of Attention Deficit Hyperactivity Disorder (ADHD) as a credible diagnostic term has passed and it is time that we accept that and move on. Fads and disappointments are not new to the field of psychology nor is the need for people to get beyond them.
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Phrenology, hysteria, eugenics, compulsory sterilizations, shock therapy, and Thalidomide all at one time had some grounding in hope and reason. For awhile, each of them captured the imagination, but over time each led to more pain than good, and for that reason they all got left behind.
Like diagnostic fads before it, ADHD has been in many ways a disorder of its time.
Previous diagnostic fads
Hysteria found expression in a Victorian-era society that vigorously attempted to constrain the lives of women. The eugenics movement addressed societal concerns of the early 20th century relating to burgeoning minority populations.
ADHD became a popular diagnosis in the 1980s as more parents went to work and the role of schools and teachers changed. If we look at the history of our culture and the ailments that have plagued it, is not difficult to see why people in positions of authority told women that they were weak, minorities that they were feeble-minded, and children that they had a psychological disorder: It was easier for them than addressing the difficult conditions that women, minorities, and children faced.
At one time, ADHD appeared to be a reasonable theory that might help people address genuine concerns. Raising children can be hard, especially when adults are tired, frustrated, overwhelmed, and riddled with self-doubt. Beyond that, children can be annoying; They fidget, they interrupt, they don’t pay attention, and they don’t always do what they are told.
The behaviors of children and the difficulties of adults often lead to guilt, worry, and a sense of wrong that concerned adults feel a responsibility to address. The creation of ADHD as a psychological disorder was in part an attempt to deal with some of the difficulties of raising children. Unfortunately, that attempt has fallen short and led to new problems in recent years.
On a diagnostic level, ADHD is problematic. After generations of research, there is still no test for ADHD, nor is there a standard diagnostic measure within the profession.
A huge – and lucrative – market
What started out as a theory articulated by professionals is now an urban legend. Parents, teachers, talk show hosts, friends, neighbors and even the person you’re standing next to in the grocery store each believe that they can diagnose and treat ADHD. This superfluity of focused misinformation has helped fuel a pharmacological intervention that would have seemed absurd two generations ago. As of 2006, 4.5 million kids have been diagnosed with ADHD, with nearly half taking medication. In 2008, the ADHD pharmaceutical market was worth $4 billion.
Another problem with our fixation on ADHD is that it is not working. Again, even after generations of research there is no evidence that suggests placing children on Schedule II drugs such as Ritalin, Adderall, or Vyvanse improves their intellectual abilities over an extended period, or that these drugs affect children with ADHD any differently than they affect any other child. A stimulant is a stimulant is a stimulant. What we do know is that the use of these drugs can be debilitating, addictive, and deadly.
