Children are using psychostimulants medications everyday unnecessarily for ADHD that they might not even have leading to controversy between doctors and parents. In my family, ADHD affects me and my younger brother. As a camp counselor and a nanny I have seen first hand the effects that psychostimulants have on children especially when they forget or choose not to take it. While holistic alternatives aren't as popular in treating ADHD, they should be considered initially because not everyone who is diagnosed with ADHD actually has the disorder. The prevalence of ADHD is too great in this generation and doctors are jumping to conclusions in the diagnostic process without a full context of symptoms. Other disorders manifest similarly to ADHD and can be easily mistaken, therefore I believe we need to change the diagnostic criteria of the disorder to be more specific. 

ADHD is so common in todays generation that doctors are worried if it actually exists. 

ADHD or Attention Deficit Hyperactivity Disorder is a condition that causes children difficulties with controlling their behavior. This disorder is broken down into 3 symptom groups: hyperactivity, inattention, and impulsivity. ADHD can be Hyperactive/Impulsive, combined with all Three symptoms, or inattentive only ("Understanding ADHD ... ", n.p.). 

When the process of diagnosis begins, it usually starts with the parents and people closest to the child as well as their teachers or childcare providers. Parents usually are asked to evaluate how their child is doing in school, if they are happy at school, if the teachers have mentioned any issues at school, if the child have issues with completing homework or work in class, and if there are any concerning behavioral issues with friends, at school, or at home. If a doctor or pediatrician gets certain answers to these questions they will then move on to determine a diagnosis. ADHD is diagnosed as a mental disorder using the Diagnostic and Statistical Manual of Mental Disorders (DSM). The process of diagnosing ADHD is very crucial because of the way that ADHD is treated and managed with medication as well as being a complete lifestyle change. To put that on a child who may not even have ADHD would be difficult and unnecessary. Doctors are supposed to work very hard to confirm and give an accurate diagnosis of ADHD by following a checklist including: symptoms starting before the age of 7, significant impairment of daily life, symptoms occurring in multiple situations, and lasting more than 6 months ("Understanding ADHD ... ", n.p.). This criteria is very important because a lot of other mental disorders and health issues have similar symptoms. This causes ADHD to be misdiagnosed and leads to ADHD being too frequently diagnosed but also leads to a child being on unnecessary medication for life with significant health risks.  Pediatrician's should partner with mental health specialists to compare signs and symptoms and their context to accurately diagnose ADHD. ADHD can be commonly mistaken for or paired with anxiety, depression, aggression, a sleep or seizure disorder, developmental disorders, or mental retardation. Other conditions that can coexist with Attention Deficit Hyperactivity Disorder are oppositional defiant disorder, mood disorder, depression, anxiety disorders, and learning disabilities ("Understanding ADHD ... ", n.p.). Throughout the years, there have been many theories about a specific test for ADHD. Scientists and doctor's have disproven several tests including high lead levels in the bloodstream, continuous performance testing, brain imaging, brain wave tests, thyroid tests, etc. ("Understanding ADHD ... "). 

ADHD comes with lots of issues in parenting. Parents may wonder if they should instantly medicate their child with psychostimulants or work with lifestyle changes and holistic remedies to solve the issue. Most doctors recommend medication for long-term benefits of the child. Recent ADHD research completed at the Boston Children's Hospital and Mayo Clinic have shown that ADHD, a common childhood disorder, is starting to continue into adulthood therefore the diagnostic technique for ADHD needs to be adjusted to represent the new generation and new strains on children (Walton, n.p.). It needs to be very specific in order to differentiate between ADHD and other disorders that are commonly mistaken for it. Doctors need to figure out what is considered ADHD and what is not. Anxiety is most commonly mistaken for ADHD because it also causes kids issues with focusing. Anxious kids are "worried, preoccupied, and restless, but they're not really hyperactive" (Walton, n.p.). This behavior may present itself the same way as ADHD; leading to a mistaken diagnosis. This is why the diagnostic process of ADHD needs to be made more unique and specific; therefore, allowing children more accurate medication and treatments. Children may have attention problems but also have no ability to control their emotions and behaviors, this places them in a separate category and opens up a new diagnostic possibility. The symptoms need to be assessed as a whole instead of the few symptoms that match the ADHD symptom list picked out of context. Improper care for someone with ADHD can lead to many problems at school, inadequate treatment, mis-medication, and insufficient parenting (Walton, n.p.). In a Ted Talk, Dr. David Sousa addresses the idea that "misbehaving and not paying attention does not mean that something is wrong with a child" ("ADHD - A Case of over Diagnosis", n.p.). Recently doctors have been jumping to conclusions and assuming children have ADHD; however, there are ways that children behave that are not necessarily ADHD. Dr. Sousa believes we need to look at other possibilities such as diet, caffeine intake, stress, school-induced ADHD, and other issues that may cause the same irritability and hyperactivity as ADHD. In addition, some children just may not know the rules of how to behave in certain situations because they have not had enough time with their families or have been on technology for long periods of time. In order to prevent children from being medically diagnosed with a serious attention disorder they don't have, we should "make sure that before we put a medical diagnosis on a kid and say you have to go on medication, we are sure of all other possibilities" (("ADHD - A Case of over Diagnosis", n.p.). ADHD is widely mistaken for other disorders and simple things such as sleep deprivation leading to elevated numbers in prescriptions and numbers by the CDC.  

The Center for Disease Control (CDC) has reported elevated rates of ADHD in the years since 2003. In 1980, ADHD was only prevalent at a rate between 3-5%. More recently it is has increased almost 35% between 2003-2011  (Newmark, n.p.). Doctors are unsure if this many children have always had ADHD or if something has shifted causing a larger prevalence in the disorder. Others are convinced the diagnosis has become more common due to insufficient diagnostic techniques. ADHD is "the most prevalent childhood disease second only to obesity" (Newmark, n.p.). There are two large issues at hand: ADHD is over-diagnosed because doctors aren't adequately assessing children; society is pressuring them to diagnose ADHD, as well as children are being demanded to do more than they were 30 years ago (Newmark, n.p.). Attention Deficit Hyperactivity Disorder may depend on the child's environment socially, and educationally. The context of the diagnosis is important which is why pediatrician's need to get a full understanding of what the child's environment consists of including the school and family situation that the child is in. Pediatrician's don't have enough time to go through an entire lifetime of criteria an accurately diagnose ADHD in the typical 30-minute well visit. "One-Third of children or more are reported to be taking psychostimulants because of the academic pressure to succeed" (Newmark). Teachers and parents add an extra burden on children that goes back to cause them to do anything to succeed. If children are going to doctors who are not accurately diagnosing ADHD, complaining of the typical symptoms, a doctor will immediately give them medication allowing them to abuse it to succeed in school and get into a great college. The diagnosis is so important to regulate the disorder. The numbers are elevated because not everyone who is on ADHD medication actually has ADHD by the specific Criteria found in the DSM. Doctors need to be consistent across the board with their diagnosis and take the time to evaluate the children to the fullest extent (Newmark). 

Health insurance is a main factor in why primary care physicians aren't doing in-depth testing for ADHD. Doctors are unable to receive authorization to do the psychological testing that is required for a accurate diagnosis and end up making an "educated guess" from what they are told by parents. One step they can take to better the diagnostic process is to obtain a psychiatric history from both parents of a child to better understand what the spectrum holds for the child (Walton, n.p.). This allows doctor's to treat children properly until the proper evaluation can be done and can be started at the child's first ever visit to the doctor to get be on the lookout for any issues down the line. 

The article "Is ADHD being over diagnosed? An Indian perspective" addresses the concern that the rise is ADHD rates is a global issue. 
Netherlands

This Table Shows the rates in increased ADHD medication in developed countries (Argawal). 

There are many possible issues for this change in rates of ADHD, but the most supported is the idea that the "changing diagnostic criteria in DSM" affects how doctors and mental health specialists treat and diagnose ADHD; this leads to inconsistencies over time (Argawal, n.p.). A less supported argument that is more sociologically supported is the idea that pharmaceutical company's commercial interests are causing health professionals to mis-diagnose to sell medications, to support the economy. There is little evidence to support this theory, however it is widely speculated in many cases of medication and diagnosis not just the ADHD controversy (Argawal, n.p.). 

Further addressing the global impact of this ADHD epidemic is an Australian Study completed in 2014 that surveyed the general public to determine their views towards using drugs to treat ADHD as well as depression. The study went even deeper to ask participants if they believed ADHD and depression, two of the most easily handed out diagnosis, are over-diagnosed (Partridge, n.p.). The results of the survey showed that 78.3% of the surveyed public believed that "children are diagnosed with ADHD when they don't really have it" (Partridge, n.p.). There is a global concern in the publics mental health literacy; meaning mental health is not as widely accepted and treatment for mental health is not taken as seriously because the public is unaware and uneducated. Therefore, when it comes time for your child or family member to receive treatment for a mental health disorder, parents are very quick to listen to the primary care physician instead of getting all the information from a mental health specialist to make sure they have an accurate diagnosis before putting their child on possible life-long stimulant medications (Partridge, n.p.). 

In the last 10 years, ADHD has become almost as common as obesity while in  "1950s America, ADHD did not exist" (Stolzer, n.p.). Once it was introduced it was mostly seen in boys and the first and only treatment was parental behavior modification. In 2006, almost 10 million children were diagnosed with ADHD. It is not possible for a disorder to evolve this quickly and ADHD has become too common with no biological evidence to support a diagnosis this frequent. Doctors tell parents that "ADHD is the result of a chemical imbalance within the brain in spite of the fact that there is no scientific evidence" (Stolzer, n.p.). A diagnosis of ADHD almost always leads to putting children on psychostimulants like Methylphenidate commonly known as Ritalin, or amphetamine commonly known as Adderall. These are classified by the FDA as schedule II drugs, which are in the same category and have the same risks for addiction as morphine, amphetamines, opium, and barbiturates (Stolzer, n.p.). Children do not need to be on highly addictive medications for a disorder they may not have. Not to mention the many side effects that come with these heavy medications. Methylphenidate has very serious withdrawal symptoms including "irritability, suicidal feelings, headaches, and Tourette's syndrome" (Stolzer, n.p.).  Even the company that produces Ritalin, Novartis, has acknowledged that they are unaware of the long-term effects and safety of putting children on Methylphenidate. In addition, children's developing brains are more susceptible to chemical toxicity than others and the unknown long-term consequences of the addictive medications they are on could be detrimental (Stolzer, n.p.). "There are no physiological, cognitive, or metabolic markers that would indicate the presence of ADHD" (Stolzer, n.p.). 

Some critics state that there is no evidence to support the ADHD epidemic. Lisa Horan writes in her article "Report Concludes ADHD is Not Over-diagnosed" that the increase seen in the past decades of ADHD diagnosis is due to an increased ability to recognize the disorder and believes that a "conclusion of over-diagnosis cannot be drawn from this data" (Horan, 1). She believes that the increase in methylphenidate use is due to doctors believing this is the best solution. This is untrue because data from previous studies have shown that ADHD is not biologically traced and cannot be seen this quickly in such a short time period. Children are now required to do more, such as reading and writing, counting and logical problem solving, at a younger age than in years before. Children who in previous generations were only required to nap and play at the age of 5 or 6 and are now required to do higher demanding tasks may seem inattentive but are just young children without the maturity to sit still (Newmark, 2). Horan also says in her article that journalists and layman are questioning the ability of medical professionals to accurately diagnose, which has lead to an explosion of the idea that ADHD is diagnosed incorrectly. She believes that this has lead parents and others to question doctors as well, when the disorder is not truly an epidemic. She is false in these claims against journalists and parents have every right to be alarmed. Children are very much being misdiagnosed and parents should get multiple opinions as well as wait until children have had a chance to adjust to a school setting at a pace that is right for them before accepting a diagnosis and adding medication to the picture. 

Just by introducing more specific diagnostic criteria for ADHD, we can save lots of children and families from the long-term effects of psychostimulants medication and lifestyle changes. Children who are properly diagnosed will avoid being treated for a disease they do not have, or being placed on medication they don't need. The prescription rate of psychostimulants medications will go down therefore reducing the rates of abuse by students by limiting access to these medications. The diagnostic criteria needs to be adjusted to separate what is ADHD and what is not ADHD to avoid altering the lives of children and giving other inadequate treatment to those who were falsely diagnosed and suffering from a different disorder. 

