In some parts of the world, record numbers of people are being diagnosed with attention deficit hyperactivity disorder (ADHD). In the United States, for example, government researchers last year reported that more than 11% of children had received an ADHD diagnosis at some point in their lives1 — a sharp increase from 2003, when around 8% of children had (see ‘ADHD among US boys and girls’).
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But now, top US health officials argue that diagnoses have spiralled out of control. In May, the Make America Healthy Again Commission — led by US health secretary Robert F. Kennedy Jr — said ADHD was part of a “crisis of overdiagnosis and overtreatment” and suggested that ADHD medications did not help children in the long term.
So what, exactly, is going on?
One thing that’s clear is that several factors — including improved detection and greater awareness of ADHD — are causing people with symptoms to receive a diagnosis and treatment, whereas they wouldn’t have years earlier. Clinicians say this is especially true for women and girls, whose pattern of symptoms was often missed in the past. Although some specialists are concerned about the risks of overdiagnosis, many are more worried that too many people go undiagnosed and untreated.
At the same time, the rise in awareness and diagnoses of ADHD has fuelled a public debate about how it should be viewed and how best to provide support, including when medication is required. The emergence of the neurodiversity movement is challenging the view of ADHD as a disorder that should be ‘treated’, and instead proposes that it’s a difference that should be better understood and supported — with more focus on adapting schools and workplaces, for instance.
Source: Ref. 1
“I do have a big problem with ‘disorder’,” says Jeff Karp, a biomedical engineer at Brigham and Women’s Hospital in Boston, Massachusetts, who has ADHD. “It’s the school system that’s disordered. It’s not the kids.”
But many clinicians and people with ADHD argue that it is associated with difficulties — ranging from academic struggles to an increased chance of injuries and substance misuse — that justify its label as a medical condition, and say that medication is an important and effective part of therapy for many people.
“I hear a lot of people talking about ADHD being a gift and a superpower, and I do applaud that,” says Jeremy Didier, a clinician specializing in ADHD who is president of Children and Adults with Attention Deficit–Hyperactivity Disorder (CHADD), a non-profit US group based in Lanham, Maryland, and who has ADHD herself. “But I do not want to downplay the impact that ADHD can have on someone’s life when it’s either undiagnosed or poorly managed.”
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