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Attention deficit hyperactivity disorder is real. Don’t let anyone tell you otherwise. A boy who careens frenziedly around homes and busy streets can endanger himself and others. A girl who cannot, even for two minutes, sit and listen to her teachers will not learn. An adult who lacks the concentration to complete a health-insurance form accurately will fail the demands of modern life. When a
person of any age has a combination of these struggles—severely enough to impair his daily functioning—with no other plausible explanation for them, then he could very well have a serious, if still somewhat mysterious, condition that medicine has decided to call ADHD. No one quite knows what causes it. The most commonly cited theory is that the hyperactivity, lack of focus, and impulsivity of classic ADHD result from some sort of dysfunction among chemicals and synapses in the brain.
A person’s environment clearly plays a role as well: a chaotic home, an inflexible classroom, or a distracting workplace all can induce or exacerbate symptoms.
Unfortunately, as with many psychiatric illnesses, such as depression or anxiety, there is no definitive way to diagnose ADHD, no blood test or CAT scan that
lets a doctor declare, “Okay, there it is”—all one can do is thoughtfully assess whether the severity of the behavior warrants a diagnosis. (After all, we all are distractible or impulsive to varying degrees.) One thing is certain, though: There is no cure for ADHD. Someone with the disorder might learn to adapt to it, perhaps with the help of medication, but patients young and old are generally told that they will deal with their abnormal brains for the rest of their lives.
As for medications—for a long time Ritalin and now primarily Adderall, Concerta, and Vyvanse—they quite remarkably improve concentration and impulse control. Not unlike the painkiller OxyContin and antianxiety agents like Valium, they are powerful drugs that can be dangerous and addictive, particularly when taken improperly. All told, however, they have done considerably more good than harm; they are not the Devil’s work. If a diagnosis of ADHD has been made by a qualified and responsible health professional then the decision to seek treatment through medication, either for yourself or your
child, is not unreasonable.
The American Psychiatric Association’s official description of ADHD, codified by the field’s top experts and used to guide doctors nationwide, says that the condition affects about 5 percent of children, primarily boys. Most experts consider this a sensible benchmark.But what’s happening in real-life America?
Fifteen percent of youngsters in the United States—three times the consensus estimate—are getting diagnosed with ADHD. That’s millions of extra kids being told they have something wrong with their brains, with most of them then placed on serious medications. The rate among boys nationwide is a stunning 20 percent. In southern states such as Mississippi, South Carolina, and Arkansas, it’s 30 percent of all boys, almost one in three. (Boys tend to be more hyperactive and impulsive than girls, whose ADHD can manifest itself more as an inability to concentrate.) Some Louisiana counties are approaching half—half—of boys in third through fifth grades taking ADHD medications.
ADHD has become, by far, the most misdiagnosed condition in American medicine. Yet, distressingly, few people in the thriving ADHD industrial complex
acknowledge this reality. Many are well-meaning—they see foundering children, either in their living rooms, classrooms, or waiting rooms, and believe the
diagnosis and medication can improve their lives. Others have motives more mixed: Sometimes teachers prefer fewer troublesome students, parents want less
clamorous homes, and doctors like the steady stream of easy business.