The Demand for Drugs and the Misdiagnosis of ADD

Friday, December 20th, 2013

boy on playground“One appointment, one 30-minute talk session, and one prescription of 120 pills later, and I was set,” says Ruth Friedlander in Elle. “I could write a book on the rush of emotions I experienced prior to taking my first pill: a vivid mixture of fear and excitement…It took about a month for me to get hooked.”

The pill was Adderall, and Ruth now realizes that her lack of focus and need for naps were likely due to depression, not attention deficit hyperactivity disorder (ADHD). Ruth told her story in response to a recent article in the New York Times, which notes that the number of children diagnosed and medicated for ADD and ADHD has risen dramatically, from 600,000 in 1990 to 3.5 million today. Some believe this is likely due to the marketing blitz that drug companies have aimed at both doctors and parents. These ads – some of which the FDA has called false, misleading, or exaggerated – promise things like, “Better test scores at school, more chores done at home, an independence I try to encourage, a smile I can always count on” or “Schoolwork that matches his intelligence.”

I’m a mental health counselor, not a doctor or a schoolteacher, but with the help of medical and other professionals I diagnose and help treat ADD and ADHD.  Have I seen an increase in the number of kids diagnosed with these disorders over the past few years? Yes, but we don’t know how many are misdiagnosed.  It’s not difficult to properly diagnose ADD, but doing so requires time, careful and skilled observation, and—critically—accurate and objective collateral information from teachers and parents. It is of utmost importance that this diagnosis be correct—not just  because some ADHD medications may have potential for dependency and abuse but also because there are immense consequences for not treating your child’s ADHD. Repeated failures at school, self-medication, and disruptive behaviors can turn into a whale of a situation that can ruin a child and family’s life.

I recommend always that parents bring their children to a child and adolescent psychiatrist because the proper treatment for ADHD is a combination of medication and behavioral therapy. Not all pediatricians are specialists in this type of condition, and ADD is best handled by a specialist. At our adolescent outpatient programs, we combine the services of child and adolescent psychiatry with substance use/addiction and mental counseling. Our staff works with the child, the teacher, and the parents in a coordinated effort to provide care that allows kids with ADD to manage their condition and thrive.

As the Times notes, the ADHD education courses available to doctors are often subsidized by drug companies, and the ads are based on research funded by drug companies. Given the potential conflict of interest, it might well be useful to have other research and education options that are not sponsored by those who have a big financial stake in the outcome.

Along with ADD, the medicating of many other conditions seems to be increasing. I believe this is due to our country’s “culture of comfort.” We have become absolutely intolerant of any discomfort, whether it’s back pain or sleeping too lightly or wanting better erections. We are becoming a nation of people who seek instant relief in a bottle of pills.

Of course the pharmaceutical companies have a part in it. If the companies didn’t advertise, of course people would still be able to find and access information about these drugs—but they might not be as inclined to jump on the pharmacological bandwagon. As several people argued in a New York Times debate on the topic, I think we should consider regulating the advertising of medicine and prescriptions.

Between drug companies’ advertising and consumers’ expectations that everything needs to be perfect, we’ve decided that the answer is in a bottle of pills. But as Ruth notes, the easy answer isn’t always the right one: “Easier is no longer what I want in my life, and that knowledge came from taking the time to learn about myself the right way. Cheesy, maybe. Honest, yes.”

Jack Feinberg
Vice President and Clinical Director
Phoenix House Florida

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