pills

Get ready for some real talk about ADHD.

In the past 25 years, the number of American children taking medication for ADHD has increased nearly six-fold. In France, however, children diagnosed with ADHD are more likely to be given counseling sessions, not drugs.

Is ADHD treatment in America turning to pills too quickly?

In a recent New York Times piece on “The Selling of Attention Deficit Disorder,Dr. Keith Conners, the original cheerleader to have this illness treated as a neurological problem, makes it clear that he is not proud of the fact that 15 percent of high school-aged kids are now classified as ADHD. Instead, he’s now calling the rate of diagnosis a national disaster of dangerous proportions.”

Why is it rising? Marketing. Lots of marketing. Drug manufacturers have succeeded in playing upon the fears of parents and the greed of doctors. Pills are being prescribed at an astonishing rate, while more and more kids — and now their parents, also — are being diagnosed.

Yes, that’s right. Not satisfied with the $9 billion in profits from the children’s market in 2012, pharmaceutical companies now have their sights on adult ADHD.

The Attention Deficit Disorder Association has been highlighting this new target market, as you may have seen in a recent commercial featuring Adam Levine of Maroon 5.

With marketing like that, it can be a tough sell to tell people that they don’t necessarily need to take medication for their level of ADHD, or even that their self-diagnosis of ADHD may not be “real.”

Commenters immediately took to the New York Times article with their opinions. “I’m sure it’s over-diagnosed, but for my daughter, who zones out in school, going from a 2.5 GPA to a 3.85 before and after medication (and extensive pre-testing) AND her leap in self esteem is proof enough in her case. As she put it, ‘After my pill, the world looks like HD!’” wrote Mtnman1963 on the NY Times article.

Now let’s not dismiss all ADHD. It is real. It does disrupt people from functioning at work or school, but the rate of classic ADHD in society is closer to 5 percent, not the 15 percent that are being diagnosed.

We could look to France to get insight into America’s ADHD treatment problem. While 9 percent of school-aged children in the US have been diagnosed with ADHD and are taking meds, in France, the rate is 0.5 percent.

It’s not that French doctors dismiss ADHD, they just look at treating it differently. While American doctors use a biological approach with medicine, French doctors take a social approach to ADHD treatment with family counseling.

Instead of treating children’s focusing and behavioral problems with drugs, French doctors prefer to look for the underlying issue that is causing the child distress—not in the child’s brain but in the child’s social context. They then choose to treat the underlying social context problem with psychotherapy or family counseling. This is a very different way of seeing things from the American tendency to attribute all symptoms to a biological dysfunction such as a chemical imbalance in the child’s brain.
[Psychology Today]

This different strategy has the French digging deeper to find the causes of the behaviour rather than immediately prescribing a pill to “mask symptoms.” They look at diet and watch how children behave after eating artificial colors, preservatives, or allergens.

There is no clinical test to accurately diagnose ADHD. It relies a lot on patient responses and doctor interpretation. Because of this, there is also a difference between the way French and American doctors diagnose ADHD. There simply aren’t as many children who qualify as ADHD under the French standards as those in America.

So when you see fewer French children being diagnosed, and subsequently fewer French children being medicated because of different treatment you have to wonder… are we doing it wrong?

What’s your experience with ADHD? How did you treat it?

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