Attention deficit hyperactivity disorder (ADHD) is a medical condition characterized by symptoms like inattentiveness, hyperactivity and impulsivity. According to the Centers for Disease Control and Prevention (CDC), ADHD is one of the most common neurodevelopmental disorders of childhood. It can persist into adulthood and affect a person’s social, academic and professional life.
The cause of ADHD is unknown. ADHD is linked to genetics and brain biology, but these factors don’t explain the dramatic rise in ADHD diagnoses over the past 2 decades. A 2018 study found that the estimated prevalence of ADHD in children and adolescents in the United States (US) rose from 6.1 percent in 1997 to 10.2 percent in 2016. That means 1 in every 10 children in the US has now been diagnosed with ADHD.
Researchers continue to debate what has caused this trend, but these are some of their key findings on what may be contributing to the rise in ADHD diagnoses.
1. DIFFERENT CLINICAL DEFINITIONS
ADHD has no known cause or biological markers to assist with diagnosis. This has caused different definitions of the condition to arise, which can affect the number of diagnoses. A 2015 study found that the estimates of ADHD prevalence vary greatly depending on what definitions and criteria for ADHD are used.
Another study found that the definition of ADHD in the US is different than internationally. Psychiatrists and doctors in the US use the Diagnostic and Statistical Manual (DSM) for diagnosing psychiatric disorders. Whereas, the International Classification of Diseases (ICD) is preferred internationally.
The ICD has a much narrower definition of ADHD than the DSM, which may be one reason why ADHD is diagnosed less often in other countries. Although, the study found that the DSM definition is catching on, which may be fueling a rise in ADHD diagnoses globally.
2. FOOD ADDITIVES
No evidence exists that any food additives cause ADHD, but research has shown a few that may increase hyperactivity and make the condition worse. These are some food additives to watch out for:
- Artificial sweeteners
- Artificial colors and dyes
- Caffeine
- Sugar
- Pesticides
- High-fructose corn syrup
Most of these are added to junk foods and soft drinks, which are best avoided whether you have ADHD or not. A well-balanced, whole foods diet is consistently recommended by health professionals for everyone, and it has also been shown to be helpful for those with ADHD.
3. LACK OF EXERCISE
Children in Western countries are getting far less exercise than they did a few decades ago. This lack of exercise may contribute to the rise in ADHD. When you exercise, the neurotransmitter dopamine is released. Among other benefits, dopamine enhances attention and focus. Medications used for ADHD do the exact same thing—they increase the amount of dopamine your body produces.
Research has shown that children with ADHD who exercised regularly did better on attention tests, and had less impulsivity and aggression. This was true even for children who weren’t taking medications. Other studies have discovered that exercise also improves working memory, academic performance and flexibility when switching between tasks.
4. DIGITAL DEVICE USE
A 2018 study concluded that teens who are heavy users of digital devices are twice as likely to show symptoms of ADHD. The study followed nearly 2600 teenagers for two years and focused on the mental health consequences of modern digital diversions, such as social media, streaming video, text messaging, music downloads and online chatrooms.
Researchers chose to study teenagers because adolescence is a common time for ADHD diagnosis, and they specifically started with teenagers who did not have pre-existing ADHD symptoms. Considering that 43 percent of high school students use digital media three hours or more per day, the study’s findings could highlight a concerning trend that’s contributing to the rise in ADHD symptoms.
5. GREATER AWARENESS & PROMOTION
ADHD advocacy groups spread and promote information about ADHD, as well as pharmaceutical companies that produce medications for ADHD. This is helpful for raising awareness about the condition and encouraging those who may have ADHD to seek professional help and get properly diagnosed.
Providing public information about ADHD and possible treatments is important, but experts warn that this wide spread promotion could have a downside. Now you can easily fill out a self-test online that may falsely conclude you already have ADHD. Or you may read an advertisement that suggests you can simply take a drug and ADHD symptoms will disappear.
Some doctors are concerned this could trivialize a serious condition and lead to unnecessary diagnoses. Extensive drug advertisements may also promote the use of medications instead of other treatment methods. In addition, research has found that the current abundance of information, and sometimes misinformation, may put pressure on doctors to diagnose ADHD more often.
ADHD is far more complex than a simple online quiz can tell you. If you have any concerns that you or someone you love has ADHD, speak to your doctor or a psychiatrist who specializes in ADHD. And keep in mind there are many other effective treatments for ADHD to try before medications.
6. MODERN EDUCATIONAL STANDARDS
In his book The A.D.H.D. Explosion: Myths, Medication, Money, and Today’s Push for Performance, Dr. Stephen Hinshaw’s research suggests that the US education system and government-dictated academic standards may contribute to the country’s higher rates of ADHD diagnoses.
For example, when the US introduced the No Child Left Behind Act in 2001, education funding suddenly became dependent on collective student test scores in each state. Dr. Hinshaw found that there was a surge in ADHD diagnoses soon after the Act was introduced.
Research has shown that treatment of ADHD can improve academic performance. Dr. Hinshaw believes many schools pushed for more ADHD diagnoses so children could receive treatment, which could boost test scores and local funding. After 2007, when the Act was changed, the rate of diagnoses tapered off in the same schools.
ADHD is a serious medical condition, but we need to be careful that we aren’t over-diagnosing ADHD simply because a child is not performing well in school. Perhaps we need to look at other ways of educating children who naturally have more energy and creativity.
Sir Ken Robinson gave an excellent TED talk discussing how important it is to build an education system that encourages all children to flourish, rather than trying to fit everyone into the same mold.
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