ADD/ADHD is either over diagnosed or misdiagnosed.
Dear Dr. Fournier:
Hi my name is Angela, I am a 12th grade student. I am currently writing a research paper about ADHD and is Ritalin over prescribed. I just finished reading your article “ADD/ADHD Pills Can’t Teach Difference in Reading for Content Versus Pleasure”. I just wanted to ask you, do you think Ritalin is over prescribed? Also what are your opinions on Ritalin?
The short answer to your question is yes, I do believe that Ritalin is over prescribed. This is not to say that Ritalin itself needs to be labeled as the problem, because I believe that the real problem is that ADD/ADHD is either over diagnosed or misdiagnosed.
A quick search of the Internet will reveal that when compared to other countries the majority of diagnosed ADD/ADHD cases appear in North America. Are we to draw from findings such as these those children in North America appearing to have a higher rate of ADHD than the rest of the world? Is it because we have the facilities and resources to conduct testing for disorders that go unchecked in other parts of the world? Is it because pharmaceutical solutions are so readily available in the United States that they are over prescribed? Is it a combination of these?
The first thing I want to address about your question is simply the spectrum of what we are talking about when we say “Ritalin.” I want to be clear that I also include all of the other pharmaceuticals that are used to treat the same problems, like Aderall, Concerta, Focalin, Vyvanse and the rest, and that when they are used appropriately and in those cases where they are legitimate solutions, they are helpful.
I have worked with children for thirty years. In the last twenty years of that time, I have encountered children who have been diagnosed ADD/ADHD around ninety percent of the time. During sessions, I usually find that testers, educators, occupational therapists and/or parents pushed the diagnosis. In many of these cases, I would argue that this conclusion was settled on in order to avoid the possibility that the problem may be educational in nature, not a medical question. However, the lure of instant gratification sometimes proves to be too strong, and pharmaceutical remedies are pushed at the expense of a child’s ingenuity, creativity, sense of exploration, initiative and other psychological attributes that may not fit the cookie cutter mold where a child sits like a statue in his or her chair in a trancelike “focus.”
WHAT TO DO
We are a society that tends to look for the short route, or the immediate resolution. Unfortunately, sometimes the right solution takes time, and cannot be found through a magic pill. Just as the advertisements promising heavy weight loss while doing nothing prey upon those who want to get results without putting in any effort, so too does the idea that pharmaceutical remedies will produce immediate, lasting, and healthy results. Unfortunately, I have found that this is rarely the case, and can be potentially dangerous. Ritalin and comparable medications are merely variant names for amphetamines, which are often addictive. Some of the alternative medications that seek to avoid amphetamines instead choose to block dopamine function, which can and has led to suicides by the users. Sometimes, when parents give in to the perceived quick solution, it may not prove be what their child wants or needs, and can cause a lot of heartache and family strife along the way.
The question I ask a parent when I find that they have their child on one of these medications is simple: “If your child were not in school, would he/she still be taking the medication?” The answer is the first step toward determining if the problem is indeed a medical issue, or may instead be a circumstance that demands an educational solution.
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