Why Are ADHD Rates So Much Higher in the U.S.?

It's high because overdiagnosis.

- TED Talk - Recommend one of the most-watched TED Talks of all time, by Sir Ken Robinson. Gems such as, "If you sit kids down, hour after hour, doing low-grade clerical work, don't be surprised if they start to fidget." And, "Children are not, for the most part, suffering from a psychological condition. They're suffering from childhood."

- Book - Also check out the book, "The Body Keeps a Score". The concept of "pseudocertainty" is a key takeaway: symptomatic labels can be helpful to a point, but they're not explanatory -- it offers a false sense of conclusion, but no root cause analysis. It conflates "diagnosis" with "syndrome". For example cancer is a specific diagnosis, and within it much specificity of dozens of particular types of cancer. Whereas ADHD is a "disorder", or a "pattern of symptoms". ADHD as a pseudocertainty is self-referential: "I have ADHD" "What does that mean?" "It means I exhibit symptoms of ADHD" "okay, so what does that mean?" "it means I have ADHD" "sure but what does it mean? And more importantly, why do you have 'ADHD'? "

- DSM - The DSM defines how ADHD is diagnosed by two lists of nine symptoms each, from which a practitioner chooses six symptoms from each, and qualifies them as having "persisted for at least 6 months". That's the definition of medical cherry-picking. Some of the descriptions are, uncomfortably, exactly what one would expect from a small child: "Often fidgets with or taps hands or feet or squirms in seat." "Often blurts out an answer before a question has been completed." "Often has difficulty waiting his or her turn." Scary.

- Conclusion - And that's how children in the US, by acting like children, get themselves drugged up and labeled as "having ADHD". Or the poor kids just have mild- to severe trauma, or residual emotional anxiety, and instead of parents/teachers owning up to their part in it, or educating kids on how to self-regulate, or offering children meditation classes, they just drug them instead. It's the kids that are abnormal, surely it's not the adults' faults!

$$$ Oh and don't forget, the ADHD therapeutics market size in the US is ~$10B/yr. Good luck stopping that party.

That's absolutely not true. It's like saying autism didn't exist before the 90s. It did, it just wasn't recognized.

I got diagnosed with ADHD a few years ago as an adult. I grew up without all of the things you mentioned and I've always had it, I just didn't know.

What I did know is I was having to put a lot more effort into things other people found easy, I was weird about certain things like watching movies without something to occupy my hands, and sometimes everything was too much.

Did I cope with it? Sure, by developing a lot of anxiety and drinking a LOT of caffeine.

I cannot express how much easier and more pleasant life is now that I have a framework to hang those behaviors on. Yeah, medication helps a lot, but it's being able to plan around potential problems that's the real winner.

Why? What's wrong with humans having variance?

I have a problem with the characterization of ADHD, because it just sounds like... children being children, or maladaptive adults not taking active control of their executive function. I acknowledge that the issues are real, but I suspect like many others that the issues patients have are ones that arise from societal requests and requirements.

I think the attempt to formally classify attention deficit disorder is mostly unscientific and one of care rather than something that can be objectively measured. The article and the professionals in it don't discuss any measurement of the condition, rather the lack thereof.

I think people who want care for ADHD should receive it, but I think the term is wildly out of date and we should have some sort of new term for the condition that doesn't have the same connotations, or just promote the societal idea that if you need nootropics to focus, that's OK.

Dr. Barkley's counterargument is essentially "it's preposterous to suggest that ADHD isn't well defined ... because clearly it is well defined," but that's a circular argument -- and still conflates "diagnosis" with "loose pattern of symptoms". He seems to get a bit emotional and take things personally; as if merely questioning the status quo of drugging kids implies that he is a bad person. Though we can't blame individual doctors for doing what they and the system institutionally thinks is best, it's still important to have critical, objective dialogue, even if it's uncomfortable. (Although my favorite de-motivational poster quote seems relevant here: "No single raindrop believes it is to blame for the flood".)

He also bristles that "They're only classified as Schedule II drugs!", etc. Let's be explicitly clear, they're amphetamine salts; we're drugging kids with amphetamine uppers.

Dr. Barkley is so (pseudo?)certain! Yet it all begs the question: How on earth did humanity survive back when cavepeople had such inadequate access to amphetamines?

Re: TBI leads to ADHD -- not saying that subcase is never true, but in the context of this thread, "why more US cases of ADHD vs. the world," unless children in the US suffer from proportionally more incidents of TBI to explain the uptick, then TBI isn't as relevant.