ADHD and Ritalin: The Problem of Unnecessary Diagnosis

Excerpted from an article in and titled "ADHD and Ritalin: The Problem of Unnecessary Diagnosis"

In 2005, the Center for Disease Control released a report stating that 4.4 million children aged 4 to 17 years had been diagnosed with ADHD. Of those cases, 2.5 million (56 percent) were taking medication for the disorder.

With roughly 10 percent of children in the United States estimated to have Attention Deficit Hyperactivity Disorder (ADHD), there is growing concern about the label's credibility and related prevalence of kids being prescribed Ritalin. Due to the debatable criteria for diagnosing the disorder, many are skeptical of the label's prevalence in society. Naturally, skeptics are also troubled by the high number of children being prescribed Ritalin for ADHD.

Ritalin is the familiar brand name for the drug methylphenidate-a powerful amphetamine. It is known to improve focus by manipulating levels of dopamine and serotonin in the brain. Studies confirm that Ritalin can help some children stay on task, but the drug is extremely controversial because of its side effects and its relationship with other amphetamines like speed.

According to Dr. Russell Barkley at the association Taking Charge of ADHD, between 3 and 10 percent of children have ADHD. Some estimates even suggest that one out of every six boys, or 16 percent, has the disorder. But the nature of ADHD is at the center of fierce debate.

The American Psychiatric Association's lists the criteria of ADHD diagnosis as follows: Warning signs include disorganization, forgetfulness, impulsive behavior, being easily distracted, and being fidgety or disruptive in class; the symptoms should have been apparent in both school and home environments before the age of seven, and should impair academic performance and social functioning.

It is undoubtedly a common scenario among children, but many question the legitimacy of the condition because a diagnosis is based solely on behavioral symptoms, which some people attribute to other causes. For example, poor academic performance and disruptive behavior can be caused by a lack of discipline or poor study habits. Some kids have emotional issues stemming from problems at home, while others are simply young for their grade and not yet as mature as their classmates.

ADHD is classified as a mental disorder, and some worry that having young children slapped with such a label can profoundly affect their self-image. Feeling inadequate or otherwise "different," some kids may suffer from low-self esteem, and a damaged self-image can detrimentally affect their future choices. Since having such a condition can shape a child's sense of identity, critics disapprove of the diagnosis's frequency, especially when it leads to a Ritalin prescription. Others accept ADHD as a condition but don't acknowledge Ritalin as a preferred treatment.

The long-term dangers of Ritalin remain something of a mystery, but the short-term effects are well-known, ranging from anxiety, insomnia, and weight loss to seizures and, in rare cases, sudden death. Considering that some children as young as preschool age are taking the medicine, there is substantial concern regarding its effects. The drug is also frequently abused, often by middle-class high school kids, and young people with drug problems typically have some history with it.

Despite the widespread caution and controversy surrounding ADHD and Ritalin, most doctors still consider both the diagnosis and prescription to be valid in many cases. In fact, some doctors argue that ADHD is under-diagnosed, especially in girls. Nevertheless, many remain convinced that the disorder is either over-diagnosed or lacking credibility, and that Ritalin is often prescribed unnecessarily.