Probably over diagnosed by people self-diagnosing. Probably significantly under diagnosed officially/clinically.
And the above is true for a LOT of conditions, not just ADHD.
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I don’t have numbers but my personal experiences tends to show me what it’s over diagnosed, at least in California. Got many people around me that are diagnosed, with meds, and they take it as part of their identity, bringing it up all the time.
My kid talked to a therapist a few times for some minor anger issues, and he’s already talking about getting him diagnosed for ADHD. He’s the top student in his class, can focus for hours building anything he wants, is outgoing, and gets along with all his friends. He just has a few emotional outbursts at home, which don’t affect his functionality or happiness. I don’t understand the point of a diagnosis. It feels like a label would just follow him around and box him in, so we decided not to pursue.
He’s the top student in his class oh no. He’s gifted? Get ready for potential burn out in teen years or college years. These problems can change over time, and its impossible to predict how these conditions will play out, but I’d like to warn a parent your kid might need special attention / support considerations apart from a neurotypical child.
“He’s the top student in his class”
With studying, or without?
In my experience, being top of the class without working for it is a great way to wind up crashing and burning as soon as one gets to college and suddenly isn’t the smartest in the room
That’s kind of what happened to me. Never needed to study in grade school. Had to scramble and learn how to study in college.
Still didn’t register why I had so much trouble focusing or remembering stuff until the last year or so.
As medicine advances, most diseases or conditions will be diagnosed more often. With the extreme increase in technology in the past 50+ years I wouldn’t say that cancer is being over diagnosed just because we can find it better. While mental health science is arguably far behind traditional medicine, I wouldn’t say that ADHD as a whole is over diagnosed. Is it probable that there are some bad doctors that will simply hand wave kids away with an ADHD diagnosis? Sure but those cases are far less common than you might think. As someone with ADHD I have seen the sentiment that it is over diagnosed arise in my life as people claiming that what I suffer from isn’t real and I need to pay attention better, or that I’m just “abusing the Adderall to get ahead in life.” So no I don’t think it is over diagnosed and people around the world need to have a better understanding of how mental illness truly affects the people that suffer.
I’ve always been fascinated how ADHD is the disorder that gets singled out for over diagnosis but not ASD.
AFAIK there’s not much in the way of pharma treatments for ASD so public policy couldn’t care less about it.
There’s money to be made in demonizing ADHD.
Forgive my naivety, how do you get rich off demonising adhd? It would stand to reason that bucks are made by over diagnosing and selling superfluous treatment, what would I sell you after adhd is demonised?
You gotta think diabolically.
My psychiatrist here in Australia cautioned me when doing online research into different ADHD medications to check the country of origin and avoid American sources where possible, as there is a huge anti-drug bias in US public and medical literature, and to stick to European/Australasian/other resources for more accurate information on mechanism of action and potential side-effects.
Boy, he was not wrong. If you go on many American websites that talk about the pros and cons of one stimulant or another, it’ll overemphasise its propensity towards abuse and extensively list the side effects without bothering to explain how the drug actually works in the body.
You’ll think it’s an unbiased source, at first, because the website itself only seem to contain basic drug information (at a cursory glance) only to scroll to the bottom and find that the website is owned/sponsored by a rehab facility, of all places.
It’d seem like there’s money to be made off of dx and prescribing ADHD meds, but we all know how fucking hard it is to dx’d in the first place, let alone prescribed something that works. It’s not wildly profitable to prescribe drugs with heavy federal restrictions on it.
What is profitable, however, is to give someone 6 other psychiatric medications to treat ongoing mental health issues from undiagnosed ADHD, and the half dozen other co-morbid issues like substance abuse disorders, PTSD, anxiety/depression, bipolar disorders, body dysmorphia, eating disorders, and so on- none of which you’ll get much traction in treating without also addressing ADHD, and some of which may be misdiagnosed or more effectively treated when identifying the core disorder.
Why treat 1 condition when you can treat 7 ¯_(ツ)_/¯ Better yet, you can do that in an inpatient facility that their insurance can pay for, where you can convince them that their substance abuse issues are due to moral failing rather than an attempt at self-medicating a (widely speaking) treatable disorder, yet hypocritically prescribe them a cocktail of other psychiatric medications for their “moral failing”.
That being said, I’m not saying all rehab facilities are bad or operate in this manner, but it is just one of many ways that the medical and pharmaceutical industry inadvertently or directly discourages appropriate ADHD treatment, additionally fuelled by the government’s bigotry-fuelled war on drugs.
Jesus man. Thanks for the reply.
They’re selling another product.
Conmen like Tate and their ilk would love to sell you on the idea that Adderall is evil.
You’re just abusing adderal to get on par with NTs
The scientific, peer-reviewed answer is that it is significantly under-diagnosed in adults as well as in those AFAB of all ages. Most sources say up to 80% of adults with ADHD are undiagnosed and/or untreated.
May I have this source? Being genuine here, I don’t doubt this but I may use it to show people and maybe put a bug in their ear to get diagnosed.
I found these citations in a paper on the first page of Google. I apologize but I have not verified them.
Fayyad J, De Graaf R, Kessler R, et al. Cross-national prevalence and correlates of adult attention-deficit/hyperactivity disorder. Br J Psychiatry. 2007;190(5):402–409.
Retz W, Retz-Junginger P, Thome J, et al. Pharmacological treatment of adult ADHD in Europe. World J Biol Psychiatry. 2011;12(suppl 1):89–94.
Newcorn JH, Weiss M, Stein MA. The complexity of ADHD: diagnosis and treatment of the adult patient with comorbidities. CNS Spectr. 2007;12(suppl 12):1–14. quiz 15–16.
Thank you!
No problem, hope it was helpful. I will review further when I have time.
What does ASAB mean?
It was a typo that has been corrected to AFAB. The edit may not have federated to your instance yet.
Don’t know. I’m on a 2-5 year waiting list to find out 😵💫
Dang, that’s a long wait time. I hope you get some answers soon.
Cheers. Me too
Username coming through here
Say more please!
Mental health issues since I was 14. Diagnosed with schizophrenia and depression in my 20s. Been on so many medications which don’t work. Now in my 40s my wife see’s a self diagnostic for ADHD and says “you have every single one of these traits, perhaps you should mention it to your shrink” Ask my shrink who says of course we can refer you but the NHS has a waiting list of 2-5 years for an adult referral unless I go private. I’ve been waiting for a year and a half so far.
Dude, that really sucks. I wish you all the best! And thank you for sharing!
I’m not sure what the diagnosis process is wherever you’re at but here is a series of questionnaires for people in your family and yourself and your boss/teacher (depending on age) and that’s it. Super simple. I swear anyone with a photocopier and a pocket calculator could do the diagnosis.
When I had myself and my kids inspected I was shocked.
Thanks dude
I mentioned my adhd diagnosis in a post earlier today so you may be the same inquirer. Regardless here’s a little bit more of my story.
I was born in 1986 and not diagnosed with ADHD until 2021 (I was 35). I didn’t do anything about about my diagnosis until 2023 when my career started going off the rails. I sometimes fantasize about what my career would have been like if I’d been diagnosed (and acted on the diagnosis) 15 years ago when I started to suspect something was up.
For me it mostly manifests as struggles to initiate tasks unless they’re interesting or urgent.
Is it over diagnosed? Maybe. Our brains evolved to hunt, collect berries, and work collaboratively with our clan. If we struggle do so TPS reports so that shareholders know how their incomprehensible riches are being used, is it fair to call that a mental disorder?
Is paying money to the pharma-man so we can be a better money machine for your bosses shareholders kinda fucked up? Yes.
But will it also help me better support the things I value? My family? My community? My interests? Yes.
I think if you want to know if ADHD is over diagnosed you need a scholarly resource, not an internet forum.
The other thing that makes it tough is that we don’t really have a good grasp of what it is. At least, last i checked.
Like, are we just pathologizing people on this or the other side of a fuzzy threshold of executive function? Or is there a population that really is physiologically/genetically different? Either way, is there something wrong with society where people within a previously normal range of executive function are now unable to keep up?
Well its like they said, for 200,000+ years humanity was out foraging berries and hunting gigantic beasts to survive out in the wild and now were expected to sit still and focus while being trapped in a gray cubicle with florescent lighting and a fake plant on a desk doing who knows what boring task 8 hours a day every day 5 days a week 50 weeks a year for 50 years. Out in the wilderness itd be useful to be the one in your tribe that finds new food sources and needs to be physically active and alert often later at night. But in a gray cubicle in some soulless office building? not so much
Oh my gosh, similar to my story and you’re exactly right. Yeah I could totally be happier running around the forest all day but that’s not feasible when I’ve got kids getting off the school bus who need encouragement to do the things and who need to be fed more than the handful of berries that are likely smashed in my pockets because I was more interested in collecting several cool rocks. Now the kids are crying because it’s stone soup again for dinner. It’s just a damn mess.
Do you have any idea how hard it is to be diagnosed with ADHD?
I was diagnosed when I was 32. In order to be diagnosed, I had to go through a series of screening tests that measured intelligence, executive function, behavioral assessments, interviews with family that knew me when I was a kid, “testimony” from my therapist and other tests meant to rule out alternative explanations. eg. sleep deprivation, health issues, depression, anxiety etc. And it was expensive. Thousands of dollars and many hours. Its essentially designed to mentally tax you until the ADHD is detectable through any masking that you do.
Yes, and no. This is an unanswerable question.
Negligence, ineptitude, and mistakes happen in every field and medicine, education, and parenting are no different.
There is pain in being diagnosed correctly just as much as there is incorrectly. The question we should be asking instead for both sides of the aisle is how do we best deliver knowledge, support, and care in the correct format to those who need it?
Probably under diagnosed with people who actually have it.
Definitely not in women - the opposite is true.
Thinking about disgnosis reminds me of some of my experiences on LSD.
Several times I had these relevatory moments where the ephemeral nature of the universe and its gradual slipping into entropy over time became intimately tangible. When this would happen, I’d usually find it terrifying. I’d feel like the world was falling apart around me, because it literally always is.
But in these moments, I was so focused on seeing that entropy in a way that felt new that it would take some time to realize it had always been this way. It seemed like the end of the world, but the reality was that it was just a normal day and I was examining aspects of my world that I didn’t normally and making connections. That’s all.
Some of those connections were silly psychedelic-fueled nonsense, with whatever meaning that might lie beneath lost in some cryptic and half-undestood internal symbolism, while others were perhaps a bit more useful, but none of them were new.
To me, though, these revelations felt apocalyptic in the moment, and of dire urgency. It felt as though the realization itself presented a dire threat, as if it itself was entropy, but in reality the only thing that had changed was my awareness.
Diagnosis, to me, is a similar beast. We’re attempting to peel back the falsely self-protective veil of ignorance about our own internal workings, and we see these things as though they were new and should somehow define us. The reality is, though, that we’re just learning how to classify and examine what was already there. We’re not describing something different from what we might have assumed otherwise, we’re looking at the guts of what’s made us who we are.
For some people making those connections may lead to things that can help improve their lives. For others it can be a way to divorce a person from themselves. We’re taking the huge variety of human experience and trying to pigeonhole it just based on people that share various sets of common characteristics that some of them have found difficult to cope with or to make work with the expectations of their social context. If we’re focused on mental health only in terms of disfunction, that’s all we’re going to see when we start classifying it.
It can be both overdiagnosed and underdiagnosed! Both these things can be true at once:
- Some people who would benefit from ADHD treatment do not receive it.
- Some people receive ADHD treatment who would be better off without it.
One contributing factor is that people are treated differently in the contexts where ADHD is likely to come up (e.g. in schools) due to things like race, gender, and family income.
A black boy and a white girl having the same “brain stuff” going on are likely to be treated differently by teachers and parents — not only due to overt sexism and racism, not only hormonal and developmental differences, but also different cultural experiences with medicine (and medical mistreatment), different parental fears, etc.
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Professor of cognitive neurology here
There is research into using gaze behavior (eye movements during targeted cognitive assessments) to develop an objective test of attention symptoms, but otherwise no. The screeners (questionnaires) are all very subjective, and a true diagnosis requires an extensive interview which is also subjective as it requires accurate recognition of one’s past behavior. Which is difficult, because the things you don’t pay attention to often don’t get remembered.
My main focus is on using gaze and speech behavior to diagnose Alzheimers disease and other dementias, but I am planning to expand my research to ADHD in the next few years.
I also have ADHD, and I’m motivated because my kids will probably have it as well.
Most definitely but also poorly defined which leads to the former
Over diagnosed, probably. Over medicated, most definitely.
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