Is ADHD overdiagnosed? As a doctor who treats ADHD and as the mother of a child with ADHD, this topic hits close to home.
For many, the answer often depends upon their worldview and where they obtain their information, but let's take a closer look at the evidence in order to get a clearer picture.
A 2011 report released by the Centers For Disease Control and Prevention (CDC) indicated a 27% increase in the prevalence of ADHD compared to the previous ten year period.
While this may lead some folks to conclude that the over diagnosis of ADHD is clear, the authors of the report state that the likely reason for this increase is most likely due to today's more advanced diagnostic tools and greater societal awareness of the condition, particularly among parents, teachers, and mental health professionals.
Examining The Belief That ADHD Is A Myth
Some folks believe that ADHD is a manufactured or made-up condition from which pharmaceutical companies earn enormous profits. They often believe than ADHD diagnoses are freely given to any child who displays exuberance.
But is ADHD overdiagnosed in children who are naturally active? It is important to understand that there is a distinct clinical difference between overactive children and children with ADHD as evidenced by clear difference in brain scans.
Specifically, brain scans of those with ADHD indicate that the right frontal lobes of children with ADHD are smaller and less active compared to children without ADHD.
The frontal lobe is responsible for executive functioning including attention, problem solving, reasoning, and advanced planning - areas in which those ADHD experience deficits.
Further, most non-mental health professionals do not understand that an ADHD diagnosis is only given after multiple, specific clinical criteria are met. (Learn how ADHD is diagnosed here: Diagnosing ADHD.)
Similarly, these clinical criteria must significantly impact one's ability to succeed in academic or work settings, and significantly inhibit social functioning.
In other words, Attention Deficit Hyperactivity Disorder goes way beyond merely overactive children.
Making The Case That ADHD Is Actually Underdiagnosed
Conversely, one could easily make the argument that ADHD is under-diagnosed. Because many folks believe that ADHD is a myth and that most people are not taught to recognize ADHD symptoms, millions of children and adults continuing to go untreated.
For example, the evidence suggests that ADHD is under-diagnosed in girls. The primary reason is that ADHD manifests differently in females. Boys tend to exhibit the hyperactive symptoms of ADHD which immediately garners the attention of school officials, and usually results in assessments, testing, and ultimately treatment.
On the other hand, girls with ADHD tend to exhibit the ADHD symptoms of inattention. They struggle doing homework, and are often labeled "daydreamers" who simply do not apply themselves. Because girls with ADHD are less likely to be disruptive in class, they can easily fly under the radar and remain undiagnosed and untreated.
As a result, some researchers suggest that as many as 50% to 70% of girls with Attention Deficit Hyperactivity Disorder may be undiagnosed.
In returning to the original question, "Is ADHD overdiagnosed?" I think the true answer is more nuanced and too complex to warrant a simple yes or no response.