- Mental Health
ADHD: An Over Diagnosed Mental Health Issue Among Children
As a child and family support worker I have seen far too many cases of children who have been diagnosed with ADD or ADHD. Most of the parents that I work with have severe parenting issues that have led to concerns of abuse and/or neglect. That's when I become involved with the family to help improve the home environment and family system by providing education and parenting skills.
Brief History of ADHD
The symptoms attributed to a diagnosis of ADHD have been around since the mid 1800s. Since then it has been known by various different names, such as Hyperkinetic Disorder of Childhood or Minimal Brain Dysfunction Disorder. Around 1980 the ADHD diagnosis rate started to rise. The diagnosis of ADHD is based on criteria from the DSM-IV. The primary criterion for a diagnosis of ADD/ADHD is often attributed to either inattention, hyperactivity, or impulsivity. In most cases the child will exhibit a combination of of all three.
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My take on ADHD...
As I mentioned earlier I work as a child and family support worker in the child welfare system. I work closely with child protectives services and family preservation services. I also have a B.S. in Psychology, so of course I did have a chance to study ADHD in depth during my academic career. I am in no way an expert in the matter, but I believe that my knowledge and first-hand experience have helped me formulate a realistic take on ADHD, which I believe is an over diagnosed mental health issue. Over the past two years I have worked with many families. Among those families, would say that about 2 out of every 3 families that I worked with had a child who had been diagnosed with ADD or ADHD. The families that I worked with also have severe parenting concerns that have led to issues of abuse or neglect, or a high risk of either of these occurring. When I met these families and the children who had been diagnosed with ADHD, I realized that there was a high comorbidity between ADHD and other mental health disorders, especially bi-polar and oppositional defiant disorder.
Majority of children who are diagnosed with ADHD are put on medications, such as Ritalin or Adderall. These medications are considered stimulant drugs which have an effect on the neurotransmitters in the brain. Medications prescribed for ADHD increase the levels of dopamine (a neurotransmitter) in the brain, which is said to have a calming effect on those who struggle with ADHD. Almost all of the children that I met who had a diagnosis of ADHD were on medication to help control the symptoms.
After talking to a lot of the parents I work with, I've realized that after they participated in parenting education and improved their skills in regards to effective discipline, positive praise and encouragement, and building family relationships, they often came back and told me how much of a difference they had seen in their child's behaviors, including those directly related to the ADHD. Many of the parents told me that their children's behaviors had improved greatly even if the child had already been on medications for the ADHD prior to participating in parenting education. This statement often raised a question in my mind, "Why are doctors and psychiatrists not first trying to provide therapy and other services, such as parenting education, before turning to medications to control the child's ADHD symptoms?" In the very least the child should also be undergoing therapy while taking the medication, but in my experience about 80% of the children who were taking ADHD medications were not in any therapy or counseling. It seems to me that the use of medications has become the primary solution (if not the only solution in many cases) to control the symptoms of ADHD.
Concerns about ADHD medications...
It is widely known that stimulant medications are highly addictive and prone to being abused. As mentioned before, they increase dopamine in the brain which creates the calming effect. What I often wonder is whether or not there are any long-term effects of these medications, specifically when taken by a child on a long-term basis. Young children who are diagnosed with ADHD are often still growing and developing in many ways, so is it safe to give them a stimulant medication that alters the chemicals in their brain? To me this seems like a legitimate question. Many people that I know who have had a child on ADHD meds or have been on ADHD meds themselves have said that it has a zombie-like effect. Some parents have told me that it turns their child into a totally different person. So, is it still safe to say that there are no long-term effects on a child who is taking these medications? Logically I would think that if a child is no longer acting "themselves" it will have a long term effect on how that child develops, whether it be socially, emotionally, cognitively, or even physically.
My advice for parents of children with ADHD...
Most parents who have children that display symptoms of ADHD have a hard time controlling their child's behavior, so the parent may grasp at any hope of "normalizing" their child's behaviors before they end up going crazy themselves. Unfortunately parents often forget to ask about alternative options, or even correlating services to accompany the medications used to control the symptoms. If a child is taking medications for ADHD, there needs to be other efforts in place as well. In my opinion it is not logical to completely rely on an ADHD medication to be the end-all solution to the problem. Parents need to learn techniques that will help them in controlling their child's behaviors as well, not just rely on the medication to do it for them.
Parents also need to really look at how they parent their child. Do they give in too often? Do they not follow through with discipline and consequences? Do they constantly yell at and demean the child? If so, these parenting issues alone could be enough to have an influence over a child's behavior, which could also result in a possible simulation of ADHD symptoms. Unfortunately there is no fail safe test for ADHD that will give a 100% answer, so it's left up to parents, doctors, and therapists to work together when it comes to a possible diagnosis of ADHD in a child. Unless all aspects are considered and analyzed, you may end up with a misdiagnosis of ADHD on your hands.