“ADHD Nation”: Are Cases Rising Into An American Epidemic?

The book "ADHD Nation" by Alan Schwarz generally investigated the potential reasons behind the increase in diagnoses in children, questioning whether ADHD could be considered an American epidemic. Based on the typical definition of the word “epidemic”, ADHD is generally not classified as one, although its prevalence appears to have increased quite a bit in recent years. Treatment for ADHD often involves a combination of therapy and medication prescribed by a doctor or psychiatrist. Online therapy may be helpful for parents of children with ADHD, as it may help them learn about ways to support their children and manage their own potential feelings of stress.

What is ADHD?

Although the symptoms of ADHD may be specific, how they display themselves can be unique to the individuals affected. Some children may have trouble with socializing, as their ADHD may show up in the form of social deficits, such as talking over others, ignoring requests, and bossing other children around. Others may socialize without challenges but have major difficulties focusing their attention on tasks in school. Some children may experience difficulty in all areas of learning.

Whom does ADHD affect?

ADHD is typically diagnosed in childhood once a child has reached school age. Because it largely influences the types of behaviors responsible for success in school (and eventually the workplace), it is frequently unnoticed or not a source of worry for parents until the deficits impact a child's grades or social habits.

Although ADHD is usually diagnosed in childhood, it can also be carried over into adulthood, and adults can receive a first-time diagnosis after reaching the age of eighteen. Issues with work, relationships, and personal care are usually the reasons for seeking a diagnosis, as many adults with ADHD may find themselves lacking the skills that seem to come naturally to others.

Taken literally, ADHD may not be considered an epidemic; however, it may qualify as having similar rate increases.

There are generally two sides to the debate. On the one hand, never before may there have been so much to distract, titillate, and lure children away from academic pursuits or other culturally "appropriate" behaviors. The incidence of diagnoses may rise as a result of the potentially distracting environment. 

The other side of the debate usually argues that it may not be a matter of increasing toxins, poor diets, and increased media to blame but a simple recognition of symptoms in hyperactive children and adults that did not exist previously.

In general, ADHD is not recognized as an epidemic in the United States. Epidemics normally necessitate government intervention and a crackdown on the potential cause of the disease or disorder in question. ADHD may not have a definitive cause and may not be eradicated or treated in quite the same way as a virus, bacteria, or another form of disease. Therefore, it generally cannot be regarded in terms of an epidemic or pandemic. 

Instead, statistics from the Centers for Disease Control demonstrate that the incidence of ADHD may be consistently on the rise in the U.S., and treatment methods and modalities should follow suit to keep children as healthy, strong, and well-adjusted as possible.

ADHD Nation: The book that sparked the discussion

ADHD Nation is a book written by a New York Times investigative reporter Alan Schwarz, who sought to uncover the roots of ADHD and its proliferation in the U.S. In his book, he proposed that ADHD could be a product of pharmaceutical marketing, as the non-stimulant and stimulant medications currently used to treat ADHD appear to have predated the condition itself. According to Schwarz, medications may have been developed prior to there being a need for their use, potentially resulting in the current use of Ritalin and Adderall as treatments.

Although this alone may not be a conclusive response to whether it is overdiagnosed and overmedicated, the book raised various questions regarding the characterization of ADHD and the likelihood of young children displaying tendencies toward hyperactivity, impulsivity, and aversions to attending to single tasks, as many young children may not develop the maturity and drive to sit still for extended periods until they are as old as seven to 10. The author questioned whether it might not be a wise or accurate diagnosis in children ages three to seven or 10, as some children seemed to grow out of the symptoms as they grew older.

The biggest question from ADHD Nation generally asks what the reason for the rise in rates could be. Are there several factors? Might it be exposure to environmental toxins, constant overstimulation, or a stressed-out sensory system?  

According to a review in Child Psychiatry Hum Dev, “ADHD is a complex, heterogeneous disorder with a range of genetic and environmental factors that contribute to its behavioral expression and different developmental trajectories.” While the possible causes may be endless, and there is generally no definitive answer regarding its origin and the best way to treat it. Instead, doctors have primarily focused on alleviating symptoms.

The book argues that perhaps too much credence has been given to a host of pharmaceutical treatment options before exploring all of the therapeutic options, as many forms of therapy have demonstrated efficacy in treating some of the most intense and disruptive symptoms of the disorder.

Schwarz, the author of the book, is not believed to have aimed to discredit the existence of ADHD. Rather, his goal may have been to urge readers to acknowledge and understand that it can be a legitimate disorder and should be considered problematic at its current rates of diagnosis. Schwarz seemed to be curious about how ADHD should be treated, what its true prevalence is, and how much childhood and personality have been assigned the status of the disorder rather than being given a chance to evolve.

Treatment typically falls into two camps: psychotherapy and pharmaceutical intervention. Psychotherapy often involves all types of talk and behavior therapy, although the most commonly suggested form of psychotherapy is usually cognitive behavioral therapy, which generally seeks to replace negative thoughts and associations with positive, more functional, and fact-based ones, which tends to automatically produce more positive feelings and actions.

Treatment may also include various forms of medication. Some doctors may want to move forward with a prescription for these interventions immediately after giving a diagnosis, while others may focus primarily on therapeutic methods before introducing pharmaceutical stimulant drugs. Choosing a practitioner that is right for you, your family, and your needs can be essential in selecting the best form of therapy, the best medication regimen, and the best partnership for both. Never start or stop any form of medication without the guidance of a licensed medical professional.

ADHD can be a confusing disorder to navigate, as children may show varying symptoms throughout the course of a day and over extended periods. 

Online therapy often has several advantages over in-person therapy. You may schedule appointments with your therapist at any time and from any location with an internet connection, potentially making it easy for two parents to work together in developing an action plan for their child with ADHD. Licensed online therapists are typically also qualified to treat symptoms of anxiety or depression, which some parents may experience while supporting their children.

Online therapists may use various methods to help parents of children who may be experiencing these symptoms. Cognitive behavioral therapy (CBT) has generally proven to be as effective in treating patients online as it has in person. In contrast, forms of family therapy have often been shown to improve a child’s ability to manage ADHD within the family system.