[DerpDerpDerp]

Your response doesn't actually address the article, which acknowledges that ADHD is a real condition, but suggests that fewer than 1 in 5 boys have it, and that a large number of misdiagnosed cases is bad, considering that they're given serious drugs because of it.

In fact, the only number it suggests as being inaccurate (based on an old study) is 25% of cases - that 1 in 4 cases is misdiagnosed. However, given the number of total cases, that means something like 5% of boys are being given serious drugs for potentially no reason.

I think that deserves serious consideration, and not your knee-jerk, strawman response.

[gress]

Also it's worth pointing out that if 1 in 5 boys have it, it's not a disorder. It's part of the normal range.

[joeyo]

I'm not sure if it's that black and white. Roughly 25% of deaths in the US are due to heart disease. Should we not intervene because heart disease is part of the normal range?

[amirmc]

I agree that it's probably not that black and white but a comparison with heart disease isn't a fair one.

The grandparent post does make a point. If such a large proportion of the population has a 'condition' is it really a condition or perhaps just how we (as a species) are? Especially in the case of something that's psychiatric/psychological.

For example, I've heard estimates that around 10% of the population is homosexual and for many years people wanted to 'fix' them. Around 10%-12% of people are left-handed and (I believe) that historically this was also something that people tried to 'fix'. I doubt many of us think twice about these anymore.

To a sibling comment that suggested what if 1 in 5 boys were born deaf, I'd say that the world would be a vastly different place. So different that we may not even entertain such a question. If, instead, 1/5th of boys were beginning to be born deaf, there would be a medical emergency. Unfortunately, in the case of things like ADHD it's difficult to know if we've always been this way or if there's really been a change.

[aianus]

Being gay or left-handed doesn't inherently impact your quality of life. Not being able to concentrate on anything does. So even if it were part of the normal range we should work on fixing it, like we do for myopia.

[amirmc]

Being gay or left-handed doesn't inherently impact your quality of life.

It does if everyone else is telling you that you're abnormal (and need to be 'fixed'). That was the point of using those examples.

Not being able to concentrate on anything does.

Only if society has defined as valuable the ability to do only one thing, without distraction, for whatever period of time. Therefore, anyone who cannot do this must be 'broken' somehow.

So even if it were part of the normal range we should work on fixing it, like we do for myopia.

The first part of your sentence doesn't make sense. If it's 'normal' then by definition it isn't broken (and therefore doesn't require fixing). For the myopia example, most people 'fix' it by wearing glasses or contacts, which are non-permanent and do not mess with brain chemistry. Indeed, some people I know with myopia only bother with glasses when driving and cope just fine without for the rest of the time. Of course, measuring the degree of myopia is very easy so drawing a line between 'has some difficulty' vs 'severely impaired' is a lot more clear cut. In one case, we can consider glasses as an augmentation to something that is normal, whereas in the other we've fixing something that's broken.

I'm not suggesting that ADHD isn't a problem. Merely that we should exercise some caution before we label some things (people?) as broken, when perhaps they are not.

[aianus]

It does if everyone else is telling you that you're abnormal (and need to be 'fixed'). That was the point of using those examples.

That's why I used the word 'inherently'. People telling you you're abnormal is not inherent to those conditions.

Only if society has defined as valuable the ability to do only one thing, without distraction, for whatever period of time. Therefore, anyone who cannot do this must be 'broken' somehow.

ADHD doesn't interfere with your life because other people are making fun of the fact you can't sit still. It interferes with your life because it's very difficult to be productive in any way if you can't concentrate for whatever period of time and being productive is what's valuable to society.

I have mild myopia and I don't feel any resentment to my optometrist for labeling me broken. I'm just happy he augmented/fixed me so I can read signs at a distance. And unless/until we have proof that prescribing Adderall is so dangerous that it's not worth the gains, then I don't see a problem treating it the same as contact lenses.

I'm not suggesting that ADHD isn't a problem. Merely that we should exercise some caution before we label some things (people?) as broken, when perhaps they are not.

Well, clearly they thought they were broken somehow when they went to the doctor with concerns about their attention spans, no?

[gress]

You're affirming the consequent.

[pantalaimon]

What is a normal death?

[rtpg]

three-quarters of Americans need vision correction, does that make it 'normal'?

[nsxwolf]

We need vision correction to meet a universal standard of visual acuity in the modern world - so that we can all read the same road signs, etc.

Normal vision could be interpreted as a range much larger than our arbitrary standard of "perfect", 20/20 vision.

[gress]

Yes, and well understood. Do you understand ADHD?

[rtpg]

As someone who has gone through tests and been diagnosed with ADD, I think I understand the frustrations, and it definitely does not "feel" normal.

Not being able to hold onto a thought for more than 3 minutes, or having to deal with potentially being distracted by every little thing that happens around me does not feel like the normal state of affairs. Trivial tasks can take me hours instead of minutes in some situations.

Unfortunately I'm currently in a country that doesn't allow me to get medication for this (and previously I was in a country that believes that ADD/ADHD magically disappears when you turn 18), but I still have good memories of how much it helped me get through middle school and high school (I went from almost never finishing my math homework to being able to finish everything in class in only half the allotted time).

[gress]

For sure - there is a wide variety of human experience, and each of us understands our own. By understanding ADHD, I was talking about the causes and the nature, not the experience.

If drugs are the only way someone like you can lead a happy life, then you should be able to use them.

[jonah]

Did 1 in 5 have it 50 years ago? 100? 500? If not, why now?

[chimeracoder]

Would you say the same if 1 in 5 boys were born deaf?

[harshreality]

Can deafness be treated in any other way?

What effort is being made to determine whether the etiology of ADHD is primarily biochemical (chemical/genetic), or primarily psychological (environmental/human-interaction)? Drugging to counteract ADHD symptoms makes sense only if it's the former.

[torkins]

So given that ADHD is, in actual fact, a neurobiological diagnosis, not a psychological diagnosis, then I guess you're stating your support for treating it with drugs?

[harshreality]

Neurobiological sounds like psychological to me. Unless you're saying doctors are measuring things like dopamine activity or doing brain MRIs to diagnose ADHD.

There's no good evidence that ADHD is not the result of psychological conditioning. For that matter, even if you measured abnormal neurotransmitter activity or brain scans in suspected ADHD patients before diagnosing them, if you looked at animal psychology studies where pathological behavior has been induced by conditioning, I'd be surprised if there weren't abnormal brain scans and neurotransmitter activity there, too. The neurochemical/neurophysical measurements that might provide "evidence" of a non-psychological etiology are invalid if those physical aspects of the brain are themselves affected/modulated by neurological conditioning/development.

If your solution to any problematic "neurobiological" symptom that responds well to a certain drug is to prescribe that drug, because if it responds to a drug it must be a chemical/genetic problem, then everyone will be on a drug eventually. Probably several.

[torkins]

These are easy problems for you to solve on your own, but since you don't feel like it I'll give it a shot.

1) You don't need to speculate what neurobiological means using phonetics, it's a real word with a definition you can just look up if your actual interest is in the facts. Neurobiological actually means related to the nervous system of the body. ALS is also neurobiological, and I'm guessing you wouldn't say it "sounds" psychological.

2)If you'd bothered to look, you'd find there is actually quite a bit of study of D2 and D4 availability correlated with ADHD symptoms. Like virtually all medical diagnoses both psychological and physiological, differential diagnosis is done by combining probabilities with presented symptoms, and not with exhaustive testing. Your requirement of diagnosing ADHD with a brain MRI is the equivalent of requiring endoscopy to diagnose an ulcer.

So what you say is factually incorrect, there's plenty of evidence. That's why the scientific body of many countries including the US has classified it as neurobiological (not psychological) for years, and the bulk of the scientific community believes pharmaceutical treatment is necessary in the same way that a broken arm needs to actually be set instead of telling the patient not to be lazy.

If you want to use scare quotes and insist on unfalsifiable assertions "prove the negative 'not' the result of psychological conditioning" then you are placing your argument in the same category as climate change deniers and anti-vaccers - anti-science, anti-rigor, pro-scare quotes.

[prutschman]

The literature on depression (last I looked, which was a while ago) suggests that drugs and therapy, separately, are roughly equally efficacious, with a synergistic benefit in combination.

Is there similar literature for ADHD?

[gress]

What are the biochemical markers for ADHD, and how are they tested for during diagnosis?

To my understanding, they are not, which makes ADHD a psychological condition.

[gress]

Yes, unless there was evidence of a contemporary cause, in which case I'd investigate it.

Have boys changed, or has society?

[epx]

Chebychev inequality!

[eruditely]

Your response is vague apologism for irresponsible journalism justified on a minor technicality. The articles is so stupidly charitable to it's own worldview(in the sense of lying) and omitting so much from the other side that it is ridiculous.

You are wrong to think that these people deserve "serious consideration", when the article is written itself to produce knee-jerk reactions "The drugging of the american boy....", as if we had IV Heroin plugged to these kids. Article allows for the opposition, most people who have random opinions about ADHD for no apparent reason other than to have an opinion.

http://www.ncbi.nlm.nih.gov/pubmed/23382575 (Is ADHD a Risk Factor for High School Dropout? A Controlled Study.) tells us that " Conclusion: Participants with ADHD were significantly more likely to repeat a grade"

Do you know the cost of high school drop outs or grade repeats to society? What about to the kid, who suffers massive self-esteem loss and under-values himself? Why is the author not more responsible? The modern era brings us new journalism-contrarian-chic, stylstic articles that irresponsibly lend fuel to very harmful world-views(such asADHD is not serious)

What drugs, exactly, and to which boy? Is the cost of not-treating much greater than the cost of treating? The article is merely an appeal to pop-trash trendy world-views, and does not deserve much of a response at all

[gress]

The loss of self esteem resulting from how school treats kids is due to a fault with school, not with the kids.

[eruditely]

You're right, as long as we fix the schools and the parents. Of which the majority have little scientific background, will use vague inprecise heuristics such as you are not disciplined enough, as opposed to the much easier solution of providing drugs so that these kids not crash their vehicles.

Irresponsible apologism over and over while not demanding the same from the author. Anti-medication pop-trash.

[gress]

It sounds as though you are seriously promoting using drugs to control children's behavior to solve the problem of poor schools.

Downvotes? Am I misreading the parent?

[DerpDerpDerp]

No one is saying we shouldn't be giving drugs to some kids.

It's saying we're over diagnosing, and giving drugs to kids who don't need them.

Giving 1 in 20 boys amphetamines for no reason is not a good thing - it's a dangerous and bad thing.