As the world continues to develop and progress at such rapid rates, the standards of the twenty-first century have only risen. In every aspect of life, such as school, sports, extracurricular activities, jobs, and so on, the children, teenagers, and young adults of this evolving century are being demanded to go above and beyond all expectations. Success has become less attainable and therefore the competition surrounding it has increased. Of course, there are many beneficial factors that stem from this development, such as increasing portions of strictly goal-oriented and career focused individuals. Conversely, the ones who cannot necessarily read and understand as quickly as their peers or who take a little longer to pick up on certain skills have been disregarded and put into a corner where, in order to keep up with a more productive and acclaimed lifestyle, they must be labeled with the condition “Attention-Deficit/Hyperactivity Disorder,” or “ADHD.” They are then prescribed medicine that may mute their personality and possibly drain them of excess thoughts and energy, in order to remain focused on the tasks of their future and the future of our society. The topic of whether or not ADHD is being over-diagnosed has become quite controversial in recent years. Some may ask if this disease is being diagnosed to simply excuse the lack of higher test scores within schools or are the beings of this generation simply surrounded by too many distractions. This paper will explore how both play a large role and how ADHD is being heavily misdiagnosed as well as over-diagnosed.

Before we dive into the controversial discussion of whether or not ADHD is being over or misdiagnosed, I think it is very important to define and understand exactly what it is that we are arguing. ADHD, or Attention-Deficit/Hyperactivity Disorder, is defined as “a chronic condition marked by persistent inattention, hyperactivity, and sometimes impulsivity” on WebMD. ADHD symptoms can appear as early as age 3 and can continue through adolescence and adulthood. Symptoms of ADHD can be mistaken for emotional or disciplinary problems or missed entirely in quiet, well-behaved children, leading to a delay in diagnosis. Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult and failed relationships. According to the Centers for Disease Control and Prevention statistics underlined in the Healthline article, as of 2011, 11% of children, ages four to seventeen, have been diagnosed with ADHD. This statistic shows the increasing prominence of this disorder in our society. 

Growing up, I had a wild imagination and the most dynamic train of thought. Not too long after I enrolled in elementary school, my mother was contacted by my teacher and told that her talkative and absent-minded six-year-old should be examined for Attention-Deficit/Hyperactivity Disorder. The doctors only confirmed what my teacher believed, and my mother was given a prescription of Ritalin and instructed to immediately begin me on a daily regimen. My mother, however, believed that this medicine would only mute my loud and outgoing personality and, eventually, turn me into someone I was not. So, instead of starting me 

on the regimen prescribed by the doctor, my mom started me on a regimen she designed all on her own. She began to schedule every portion of my life: when I ate, when I attended extracurricular activities, when I did homework, and even when I went to bed. She felt that precisely organizing my schedule would limit the distractions surrounding me. Now that I am in college, and away from my mother’s planning, I have begun to realize that this disorder affects me a lot more than I initially realized. 

Much like myself, there are many adults who do not quite realize the depth of the role ADHD plays in their life until they grow older. In Eugene Arnold’s article, a vast number of methods are listed and discussed that deal with treating ADHD. These treatments consist of vitamins, diet changes, supplements, and even physical therapies. None of these treatments include prescription drugs, which is surprising considering the most popular treatment options for ADHD are Vyvanse, Adderall, Focalin, Methylin, or Ritalin. Alan Schwarz, author of A.D.H.D Nation: Children, Doctors, Big Pharma, and the Making of an American Epidemic, has no doubt that ADHD is a valid disease that causes real suffering and deserves real treatment, as he makes clear in the first two sentences of the book: “Attention deficit hyperactivity is real. Don’t let anyone tell you otherwise.” (Schwarz, 4) But he believes that those who are disabled by the condition deserve a wider range of treatment options than an endless litany of stimulants, much like Eugene Arnold.

       Alongside the vast amount of prescribing that is taking place within the ADHD realm, misdiagnosis has also become a fairly large issue. In “The Most Common Misdiagnosis in Children,” Dr. Linda Spiro addresses many common psychiatric symptoms easily misinterpreted in children that eventually lead to a misdiagnosis. The main claim in the article concerns the most common misdiagnosis of all, ADHD. Dr. Spiro states that “many common symptoms occur for a variety of reasons, and can reflect several different diagnoses.” She discusses all of the other diseases, disorders, or even simply characteristics of adolescence that share the same signs, and how they can be commonly mistaken for ADHD. Dr. Spiro says, “Inattention that is outside the typical range is one of the three key symptoms of ADHD, along with impulsivity, and hyperactivity. So when a child seems unusually distracted, ADHD tends to be the first thing parents and clinicians suspect. However, there are many other possibilities that can be contributing to inattention.”  Dr. Spiro has been a psychiatrist in New York for several years and has also been a member on several boards that advocate for the mental health of children. In this article, she aims to raise awareness to those who have been misdiagnosed and those who may experience this diagnosis in the future.

       We are exposed to a more extreme point of view from Dr. Breggin. He opens his article with a strong statement—“The drugging of children for ADHD has become an epidemic.” He then follows by detailing all of the reasons kids are diagnosed with ADHD and showing how they are just purely antics of a child. He goes on to explain how extremely harmful it is to prescribe medicines without proper assessment to kids and determining what actually needs to be done. Dr. Breggin ends by declaring, “In all cases of so-called A.D.H.D., the diagnosis is harmful. The child instead needs a real medical and psychosocial educational evaluation, and usually the child will quickly respond to improved teaching and parenting. We are diagnosing and drugging millions of our children instead of providing them the improved educational and family life that they truly need.” Dr. Breggin wants parents, teachers, and doctors to realize that these kids need proper testing and treatment to live rewarding lives.

       When it comes to ADHD, the main consensus is that it is “commonly over-diagnosed.” However, Daniel Lavelle seeks to challenge that misconception and wants people to realize the suffering that ADHD people who remain undiagnosed experience. He tells the story of a woman who wasn’t diagnosed until much later in life and explains how she “feels that going undiagnosed until adulthood was pretty harmful.” Daniel Connor, a renowned psychiatrist who has a vast background in mental health research, holds a very similar opinion. In, “Problems of Overdiagnosis and Overprescribing in ADHD: Are They Legitimate?” he provides an in-depth description of the disease and everything it encompasses. As he states, 

“The public’s fear that ADHD is overdiagnosed and that stimulants are overprescribed is not generally supported by the current scientific research. Reasons for the continued controversy include fears of stimulant abuse and diversion, physician overprescribing, limited payer resources to support evidence-based standards of ADHD evaluation and treatment, and continuing unease as to the legitimacy of the ADHD diagnosis. Comprehensive physician ADHD evaluation practices are essential to accomplishing evidence-based stimulant prescribing and to reduce unwanted variation in stimulant prescribing rates that should, in turn, reassure the public that management is accomplished consistently and with due expertise.” (Connor, 6)

Connor is arguing that ADHD is unknown to people. Not unknown in the sense that they’ve never heard of the disorder, but more in terms of what ADHD actually entails. Society isn’t fully aware of all the symptoms, diagnostic patterns, prescriptions, and scientific research that ADHD includes and are therefore, suspicious and curious about its continuous spike. Connor wants people to realize that as time goes on, more is to be learned and understood about this disorder which can lead to the recognition of the disease in more and more children and adults.

Other experts have defended the diagnostic patterns of ADHD, arguing that it is invalid to label ADHD “overdiagnosed” because all over the world it is being underdiagnosed in many different minority cultures. In “Children Left Behind,” Devon Frye notes that - “Thousands of kids are being underdiagnosed and undertreated for ADHD — due in large part to their race or ethnicity. Why is this happening, and what needs to be done to fix it?” The article shows how people of color — black and Latino in particular — are much less likely to be diagnosed with ADHD, even though they show symptoms at the same rate as white people. It also discusses how if they are diagnosed, they aren’t as likely to receive treatment, even though many studies show that it can dramatically help kids and adults manage symptoms. Frye argues that when it comes to changing the racial disparities in ADHD diagnosis and treatment, society must promote education and outreach, push back against the stigma, dismantle bias, and find more invested doctors.

       It is extremely interesting to compare and contrast the vast amount of opinions on the diagnosis and treatment of ADHD. Varda Epstein once stated, 

“As awareness of ADHD grows, more people than ever before are being diagnosed with ADHD. It sometimes looks as though just about everyone has it but because of this new awareness there is also a knee-jerk tendency to diagnose and medicate children for ADHD without careful examination, when they act out in class. At the same time, research shows that ADHD is also under diagnosed among girls and minorities. In conclusion: ADHD is both over and under diagnosed.” (Epstein, 3)

 She concedes and shows understanding of both sides but I highly believe that one holds more weight than the other. Understanding the conflicts and complexity of the evolving world, and how we must fit and develop to be successful is a big step towards determining how ADHD should be diagnosed. After all of this thorough research and exploration, I can confidently say that I believe ADHD is being heavily misdiagnosed as well as over-diagnosed. 
