ADHD: Mental Disorder or Disease on Immaturity?
In a classroom, a young boy dangles in his chair, his shoes with untied laces swinging up and down, drumming his pencil on his desk while his eyes skim the room. He shifts in his chair to look out the window, spotting birds flying, leaves blowing, squirrels racing up tree trunks and pointing at the cars driving by. All of a sudden, a loud bell rings, interrupting his observations. The boy realizes class had just ended as he glances down onto his blank paper staring him in the face as a twinge of guilt pangs in his chest. These are symptoms of the well-known disorder of ADHD, Attention Deficit Hyperactivity Disorder. As rates of ADHD have increased across the country, this alleged mental illness has been put in a new light as nothing but the result of bad parenting and typical immaturity of children where it is used as an excuse to easily medicate away annoying behavior. Is this disorder nothing but a disease called childhood or perhaps just overdiagnosed based on loose standards and inaccurate interpretation?
Despite recent criticism and questioning of the disorder, ADHD is still considered a real mental illness with significant symptoms and disabilities. For example, Dr. Ronald Pies highlights drastic differences in brain activity, stating “Studies of brain activity have shown that in ADHD children, the frontal regions of the brain are actually under active. [This] may mean that these regions are not “keeping the lid on” disruptive behaviors.” This is visually represented in brain maps from the St. Louis Neurotherapy Institute, where the affected brain shows the red region of underactivity in the frontal-lobe compared to the consistent green regions of normal brain activity. This altered brain activity is correlated with inattentiveness and disruptive behavior that is often labeled acts of immaturity and a result of bad parenting; however, these behaviors are burdens of ADHD. Although diagnosis cannot be solely determined by brain scans, this illness has clear differences in brain activity independent from plain immaturity.
Similarly, ADHD results in many common symptoms that are very distinct from those without the disorder. People with ADHD often suffer from inattention, hyperactivity and/or impulsivity. For example, one may struggle maintaining focus and finishing tasks as well as remaining seated without fidgeting or squirming (American Psychiatric Association). Although some of these symptoms may be seen in most children, “the hyperactivity and inattention of those with ADHD are noticeably greater than expected for their age and cause distress and/or problems functioning at home, at school or with friends” (American Psychiatric Association). Hence, there are distinctions between “kids being kids” and children struggling with their mental illness to concentrate and maintain calm for long periods of time. Therefore, ADHD can significantly alter the behavior of a child or adult and cannot be disregarded as immaturity or a result of bad parenting.
Moreover, individuals with ADHD respond to medication differently than those without the illness. Dr. Glickman confirms that research patients show that behavioral treatment and/or medication improve their symptoms. Dr. Glickman continues to explain how ADHD medication stimulates those without the disorder with effects of hyperactivity, while the same medication reduces ADHD hyperactivity to increase concentration. This distinction is not a sole factor in the diagnosis; however, it is additional proof that ADHD exists as a real mental disorder that has different results from treatment. Thus, ADHD is an illness independent from immaturity and the victim’s environment.
On the contrary, many fall under the belief that symptoms of ADHD are due to immaturity and will be lost over time. Dr. Pies refutes this belief with the claim that adults can also suffer from this disorder. For example, he states, “the last 20 years have made it clear that kids with ADHD do not always “outgrow” the disorder. Between 4 percent and 30 percent of ADHD children will show symptoms in adulthood, depending on whether we count only the full-blown disorder or even a few ADHD symptoms.” Clearly, this mental illness is also prevalent in adults as the result of biological alterations, independent of childhood behavior. Thus, ADHD is a mental disorder that can carry into adult life separate from the individual’s environment and development.
Under the conclusion that ADHD is a real mental disorder, widespread skepticism begs the question: is ADHD overdiagnosed? There are many factors leading to the criticism questioning the escalation of the illness across the country. For instance, the rate in the United States has skyrocketed from 3–5% of children to 15% (Frances). Similarly, a graph provided by the ADD Resource Center shows the rise of ADHD in both genders of children. For example, in 1998 less than 10% of boys had been diagnosed with ADHD; by 2009 it had increase to over 12%.
Furthermore, Dr. Wedge states, “In most European countries, you don’t see children diagnosed with ADHD anywhere near the rate that American kids are.” All of these statistics and comparisons prompt the question: why are the American rates increasing; are more children becoming prone to ADHD, is it overdiagnosed or is there another answer? One point of view claims that as our world has advanced and time has passed, there has been more awareness of ADHD, a possible cause of the increase. In addition, within the last few years, the guidelines for diagnosis did officially change in order to help more children overcome their disabilities (Pagán). However, Dr. Frances discusses the results of a study regarding ADHD diagnosis and found that younger children were more likely to be diagnosed with the disorder. Dr. Frances concludes, “The studies converge on the inescapable finding that we are turning immaturity into disease. Being the youngest kid in the class clearly puts you at great risk to be tagged with an inappropriate ADHD diagnosis.” In each study the younger children that demonstrated immaturity had higher percentages of ADHD diagnosis, conveying that immaturity played a role in diagnosis. This study certainly questions the overdiagnosis of the illness, for many children may be diagnosed with the disorder simply due to their youth and lack of development. Due to the difficulty of diagnosing this disorder, with no way to be 100% accurate, ADHD may be overdiagnosed within the United States. Many of the symptoms of hyperactivity and inability to maintain attention can be seen in younger children, unrelated to this disorder. The challenge of diagnosing ADHD also suggests flaws in the quantity of children diagnosed in the United States; however, it may be more important to recognize the disorder in too many children than ignore unhealthy and threatening symptoms of this serious mental illness.
As the rates of ADHD have escalated to new heights, the skepticism of overdiagnosis has also expanded questioning of who is to blame: parents wanting to medicate away their children’s bad behavior? Doctors misinterpreting a child’s symptoms? Drug companies pushing production and sales of ritalin? It’s hard to point a finger at a specific target, but these questions are missing the importance of this issue. While it may be overdiagnosed in younger children simply acting out based on their immaturity, this disorder has significant impacts and can lead to severe consequences if ignored. ADHD is a real mental illness that is very prevalent in the world today, seen in both children and adults, demanding attention in order to treat the disabilities of struggling individuals, regardless of age. It cannot be overlooked or exclusively associated with immaturity nor considered a result of bad parenting. Therefore, it must be seriously considered for individuals that display the common symptoms and may need treatment for their potential disabilities.