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Do all these people REALLY have ADHD?
Olivia_WebMD_Staff posted:
The CDC reports that, as of 2007, 5.4 million children in the U.S . between the ages of 4 - 17 had been diagnosed with ADHD. And the National Institute of Mental Health reports that 4.1% of U.S. adults also have ADHD .

A recent shortage of ADHD medications in the U.S. led to a lot of debate around whether all of those folks diagnosed with ADHD really do have the disorder.

Do you think everyone diagnosed with ADHD has it?

Why or why not?

(If you have ADHD or think you may have, you can get support and expert answers on our ADHD community here at WebMD.)
An_241873 responded:
I dont think 100% of the children that are diagnosed actually have ADD or ADHD. My husband was thought to have bipolar since he was having so much trouble concentrating and having mood swings at 20 yrs old. Well come to find out he had ADHD. He was a typical hyper kid but the symptoms didn't show up until later on in life for him. Some kids are just hyper. I guess every case is different though. I just hate seeing so many kids on these ADHD drugs that are a "controlled substance." Its surprising their little systems can stand it!
phoenix31674 responded:
I don't think it's as high as is diagnosed. We have changed the academic environment so that 4 year olds are in a rigorous learning environment and not a play environment. Preschoolers are learning what was once taught in the first grade. And more schools are doing away with recess, gym and unstructured play so kids who do not have the proper attention spans are being forced to sit and focus for long periods of time rather than being eased into academics like they once were.

It just seems so odd that there has been such an increase in the number of folks diagnosed. Yes, you can say that we are just learning more about human behavior and identifying people who were slipping through the cracks, but how many kids act up in school because they just need a few minutes of the day to run around and be kids? Many of these kids also attend structured after school programs and are involved in sports with their siblings to the point where they don't have any time to play at home either.

I have no doubt some people really do suffer, but how many are just a product of an environment that teaches the 10 second attention span and doesn't teach people to focus or are a product of a learning environment that doesn't give them the tools to succeed.
An_241873 replied to phoenix31674's response:
I think that is great that there is more structure instead of mindless 1-2 hour recess for kids. I mean kids do need to blow off some excess energy outside but not an excessivly long recess. Especially all the way into middle school! My hubby was homeschooled so I dont know how long he had to pay attention and stay focused. Maybe it wasnt regimented enough to help him develop those skills as a child. So now as an adult his ADHD is worse.
Mathchickie responded:
I believe that most people who have been diagnosed with ADHD after a proper workup do in fact have it. I believe that there are some people who could benefit from treatment but have never been diagnosed.

I was diagnosed at age 19. It changed my life dramatically for the better. I currently do not take medications, but I know many people who need them to function at home, work and school.

So. the FDA and manufacturers need to get their act together and supply these legal medications to patients legitimately prescribed them!
phoenix31674 replied to Mathchickie's response:
The biggest problem is that so many do not get a proper workup. There are websites out there that tell you what to say and how to behave at the doctor's appointment to get the diagnose so people who want them can get the meds. They have found a legal and cheap way to get access to amphetamines. But with today's HMOs that have low reimbursement start forcing doctors to cram in as many patients as possible and some doctors feel pressured to make the patient happy and diagnose them with something. When a patient presents with the classic symptoms, it's going to be very hard for a doctor in a matter of 10-15 minutes to determine if it's a charade or someone with a legitimate need. This isn't like a bacterial infection where you can take a culture or thyroid problem where blood tests will show there really is a problem.

That said, there needs to be a better system in place for drug manufacturing as a whole. There are a record number of drug shortages because so many of the off patent drugs out there are vital for treatment of various illnesses, but generics turn so little profit, the manufacturers don't feel pressured to ensure their supply.

For many ADHD/ADD patients it is only the generic that is in short supply. There is plenty of name brand, but how many patients can afford their copay jumping from $10 to $200?

For anonymous, true ADHD/ADD is a chemical imbalance in the brain. I don't know that the learning environment would have an effect on that. But honestly, giving elementary kids 2 15 minute recesses during the day would probably make things easier. When I was in school we had recess and then time after lunch to play before going back to class. Not to mention unstructured play is good for a child's mental development. Gym is great for exercise and will help, but so many schools are getting rid of gym or decreasing it's frequency. And of course kids aren't getting exercise at home in some cases, which makes things worse.
seeit2 replied to phoenix31674's response:
Phoenix, I think you are right on about all of this. If I could still give posts "stars" I would give you 5.

I was in the lobby of an elementary school a year ago, waiting on my then-4 yr old daughter to finish speech therapy. The kids in first grade were being herded into the gym at the time for a new program that involved learning while moving - wish I knew the name - but skills were practiced while the whole body engaged in the activity, (like climbing a ladder while naming the picture or concept on each rung, that kind of thing). The principal, standing near the entryway, said that previous "wisdom" was that letting kids run around first thing in the morning would make them hyper and unmanageable throughout the rest of the day - but she was amazed to find that the exercise actually contributed to their learning and settled them down to learn the rest of the day. I wanted to to say "duh"... we need more free play (unstructured learning) to better focus our kids for the structure of their school day.
Gina_Pera responded:
Are you asking if the CDC (and a large body of published literature) is correct in its estimations of percentages? Or are you asking if physicians and other diagnosing mental-health professionals sometimes make mistakes?

If the former, yes, the epidemiological research has been exhaustive and conclusive. In fact, most experts quickly conced that the numbers are most likely conservative, especially the 4.1% figure for adults.

As I write in my book (Is It You, Me, or Adult A.D.D.?). that 4.1% figure is based on diagnostic criteria that was developed for children's ADHD symptoms, most specifically boys. That means many Adult ADHD-related challenges weren't even included in the criteria. The experts I interviewed put the more accurate figure at closer to 15% of adults having ADHD.

To me, it is extremely easy to see this likelihood. Just look at the percentage of the adult population in the U.S. who has dropped out of high school, is un- or under-employed, suffering substance abuse problems and obesity, in bankruptcy, and more. These are all risks of untreated ADHD. And the numbers are shockingly high.

If the latter question is what you mean -- do diagnosing professionals make mistakes? Well, of course. Especially with psychiatric syndromes, it can be difficult for the non-expert to distinguish one condition from another (for example, ADHD from bi-polar).

But this is not limited to psychiatric conditions. Modern medicine has become the domain of specialists who often do not understand physical systems beyond the one they have studied (e.g. cardiovascular). They often do not understand the intricate interplay of all physical systems, especially when it comes to the effect of going without exercise, proper nutrition, etc.

All that said, in my experience, most people who have read carefully about ADHD and developed a strong suspicion that they have it have usually been right. Sadly, this often comes after years of misdiagnosis and ensuing treatment that often exacerbated their condition. I am thinking primarily of adults with ADHD who were diagnosed and long treated for "depression" or "anxiety" and their ADHD symptoms completely missed.
Gina_Pera replied to An_241873's response:
You make a good point, phoenix. I've heard of many children with ADHD being homeschooled because they could not participate in regular schools without extensive problems. Some parents see homeschooling as the solution....until the child grows up and has to function on his/her own.

That's not to say that homeschooling isn't a viable option for many. It's when it's used as an "escape" from dealing with ADHD-related challenges that it proves problematic, in my opinion. It simply prolongs the opportunity to receive real and lasting help.
Gina_Pera replied to phoenix31674's response:
It's true. Some of the generics are in short supply. And, for many, leaving them behind might be a good thing. Generics are often NOT the same as the brand and can cause many more side effects. Until consumers try the brand, though, they will not know how much better the effect can be.

Also, the newer, sustained-action formulations are delivered into the system in a much less disruptive way than the old formulations are, often with a jagged roller coaster throughout the day. Not to mention the inherent irony of asking forgetful people to take 2-3 doses throughout the day.
Gina_Pera replied to seeit2's response:
seeit2 --

Actually, some research has shown children with ADHD experience more stress, not less with unstructured time. One study showed that these kids experience more stress on the weekends (unstructured time) than during the school week. And I can assure you many adults with ADHD are the same way.

What that teacher was doing sounds like a different thing entirely -- activating the body to activate the mind. That's very structured.

As for exercise in the morning, Dr. John Ratey documented the increased academic success that one Naperville, IL school enjoyed by implementing structured exercise each morning.
Olivia_WebMD_Staff replied to Gina_Pera's response:

Thanks so much for coming over from the ADHD board and chiming in with your wisdom!

chatley64 replied to An_241873's response:
I am sorry, but don't you think it's odd that so many children are diagnosed with add and adhd? As is the world being diagnosed as bi-polar, manic depressive, etc, etc ... You need to go online at and view "Making A Killing". You might open your eyes some after watching it. Things that make you go hmmmmmm. Most kids do not have ADHD or ADD .. they only need behavior modification or diet modification. Most parents are to lazy to be structured and disciplined with their children to do this. They find it much easier to drug their children instead, never mind the damage they could be doing to their children's organs.

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