The Rise of ADHD

What's really behind the rising number of ADHD diagnoses among children and adults? Is it a reflection of pressure from pharmaceutical companies, or simply a way for parents to shirk their responsibilities? Read the theories.

You probably know at least one child who has been diagnosed with ADHD — attention deficit hyperactivity disorder. You might even know a few adults who believe they have the condition. ADHD seems to be everywhere: among our children, among our peers, and in the headlines constantly.

About 9.5 percent of American children have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention. ADHD is now one of the most commonly diagnosed mental ailments among children and adolescents, and researchers estimate that 4 percent of adults have it too.

Given the rise in ADHD diagnoses, it's not surprising that sales of the medications used to treat ADHD have nearly doubled over the past five years, from $3 billion in 2005 to $5.9 billion in 2009, according to IMS Health, a health care information and consulting company.

Is ADHD just a fad, the disease du jour of a society accustomed to medicating itself for every conceivable symptom? Or is it a serious condition that, like depression, is just beginning to be well understood?

Defining ADHD

To make sense of the numbers, it helps to understand the disorder itself. ADHD, when properly diagnosed, is not just an inability to focus and sit still, though those are two of the most common symptoms. “ADHD is a complex mental disorder that affects a person’s ability to regulate cognition and emotions,” says Stephen V. Faraone, PhD, a professor of psychiatry at SUNY Upstate Medical University who has been studying ADHD for two decades.

Those who have the disorder have difficulty coping with complex environments and following tasks through to completion. Because of these symptoms, “people with ADHD are at increased risk of academic failure, substance abuse, depression, divorce, driving accidents, and other negative outcomes,” notes Guilherme V. Polanczyk, PhD, an assistant professor of child and adolescent psychiatry at the University of São Paulo Medical School and an expert on ADHD. “People don’t understand how debilitating ADHD can be,” adds Dr. Faraone.

ADHD was first recognized as a mental disorder in the early 1980s, but researchers say the syndrome had been seen and noted much earlier. “It didn’t just appear magically,” says Ronald C. Kessler, PhD, a professor of health care policy at Harvard Medical School.

Then what brought the disorder to national attention? “Maybe it wasn’t a big deal decades ago,” Dr. Kessler theorizes. “As society becomes more complicated, the deficits that come with ADHD become more obvious. We place a premium on being able to get things done.”

Scientists also know a lot more about mental illnesses. “Child psychiatry as a discipline is a recent phenomenon, dating from the last half of the 20th century,” says Dr. Polanczyk. “Mental disorders in general — such as bipolar, including in children— have been increasingly identified because we know more about these conditions.”

Skeptics, though, worry that the label of ADHD provided a way for parents and others to shirk responsibility. “ADHD became a popular diagnosis in the 1980s as more parents went to work and the role of schools and teachers changed,” wrote Stephen R. Herr, EdD, in an online opinion piece in the Christian Science Monitor in August 2010. Dr. Herr, an assistant professor at Murray State University, went on to say: “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.”