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Whether it’s unfiltered TikTok influencers or formal public awareness campaigns, it’s been hard to miss the growing media coverage of ADHD, or attention deficit hyperactivity disorder.
There are a wide range of views about ADHD. To many parents of affected children, it is a condition that is going under-recognised and needs better resourcing. NHS waiting times for assessment can be over two years.
US health chief, Robert F Kennedy (RFK), recently called for an inquiry into the rising numbers of children taking ADHD meds over the past few decades, as part of his Make America Healthy Again campaign.
ADHD is in the news this week because of a press conference held about a study into whether cases really are on the up. Their results have been published in the Journal of Affective Disorders.
That lack of a recent rise made some headlines but a previous study found that ADHD diagnoses increased in the UK from 2000 to 2018. By 2018, the highest rates were in boys aged 10 to 16 – 3.5 per cent had been diagnosed and 2.4 per cent were on medication. Back in 2000, those numbers were 1.4 per cent and 0.6 per cent.
Story of an adult diagnosis
The UK study found that, while teenage boys have the highest rate of ADHD overall, the biggest relative increase in medication use in the past two decades was in adults. The stimulant medicines don’t just help schoolchildren but can also help adults focus in work and everyday life.
“Everyone goes to the supermarket and forgets what’s on the list, but I can go to the supermarket with a list, cross things off the list and come back and still not have a key ingredient.
Caroline Williams was formally diagnosed with ADHD at 48
After a six-month-wait, Williams was assessed through an NHS pathway, which confirmed her suspicions, and the doctor suggested she try the standard ADHD medication. At first she tried using it only when needed but has found herself more productive when taking it daily.
“It can be so overwhelming, I just don’t do anything and I end up completely paralysed. For me, the medication has been the best way to get through that.
Other studies that have tried to find how common it really is – by giving the same behavioural tests to large numbers of children, whether diagnosed or not – suggest that true figure is about 5 per cent of children.
So the current long waiting lists for assessments, for both children and adults, may just reflect more people coming forward. “The most likely explanation is simply that we’re playing catch-up,” said Professor Shaw.
Broader definition
Like most conditions affecting mental health, there is no blood test or brain scan that can give a definitive diagnosis of ADHD. Instead, doctors go through checklists to see if people’s symptoms reach a certain level of severity based on what’s usual for their age, but this can be subjective.
“It means that the margin between ADHD and non-ADHD becomes more arbitrary, more subjective,” he said.
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Cultural differences between doctors in different countries could explain why diagnosis rates vary so much globally.
It may also explain why ADHD isn’t necessarily a lifelong condition. In fact, recent research found that of children who had been diagnosed, within five years, a quarter were no longer classed as having it, while in another quarter, the diagnosis came and went.
“There’s a great degree of interest in the possibility that the constant dividing of attention and multitasking online is creating the distracted generation,” said Professor Shaw.
“We don’t know if social media is driving some symptoms of inattention, or is it that kids who are a bit distractible are the ones who are going online and multitasking,” he said. “What’s the chicken, what’s the egg?”
Lockdown disruption
But the latest study did not find evidence that diagnosis rates had changed markedly over the pandemic years in Sweden, Canada and the US.
But all the experts called for more research to find out how ADHD rates have been changing in the UK in recent years. “Our study has shown significant gaps in the tracking of ADHD prevalence, resulting in a frustratingly unclear picture,” said Dr Martin.
She said her diagnosis was “validation that I wasn’t just making this stuff up and I wasn’t just lazy. There was something actually making it more difficult for me than it necessarily should be. This has made a huge difference to my life.”
But manufacturers have already designed vapes that get around the new law, because while technically reusable, they look like disposables and are priced just as cheaply.
I’ve watched
Wes Anderson’s new black comedy, The Phoenician Scheme, is, by parts, moving, exciting and surreal, but always entertaining. I didn’t quite manage to follow all of the complicated plot – about a crazy plan to make huge profits by building transport infrastructure in a desert – but it didn’t matter one bit.
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