4 ms·

Why Are ADHD Rates So Much Higher in the U.S.?

26 points by rntn 1y ago

Pulcinella 1y ago
In comparison to other places in the world (especially Asia), there is somewhat lower stigma regarding ADHD in the U.S. I would add the UK to the stigma list as well. The UK government and NHS are pretty rabidly ADHD-denialist and make it incredibly difficult to get a diagnosis.
- collinfunk 1y ago
  > I would add the UK to the stigma list as well. The UK government and NHS are pretty rabidly ADHD-denialist and make it incredibly difficult to get a diagnosis. Don't you also have to wait years on a wait list for an evaluation? I feel like I remember hearing that a few years ago.
  - xdfgh1112 1y ago
    NHS waiting list is a few years but they will pay for you to use a private clinic, my waiting list is 5 months.
- xdfgh1112 1y ago
  They literally pay for you to use a private clinic to ensure everyone can be assessed quickly. ADHD is legally protected and recognised. Lumping it in with most of Asia is ridiculous.
  - ck425 1y ago
    Where in the NHS is that? Maybe just an English thing. I had to go private on my own dime and thankfully my GP took over prescribing, which is uncommon and becoming increasingly so. They also put me on the NHS waiting list, back when you could still get on it without being severe, and it was only last week I had my appointment almost 4 years after being put on the list.
    - xdfgh1112 1y ago
      It's called Right to Choose and it may be England only. The NHS waiting list here is also over 3 years!
- chrismeller 1y ago
  I was surprised when I moved to Europe that at least several (many?) EU countries don’t even authorize any ADHD drugs to be prescribed. So sure, maybe the doctor knows you have it, but even if they say you have it… so what, what can they do about it? As someone with some horrific environmental allergies, I see it as similar. The US has a ton more allergy medications available (both RX or OTC) than any of the other countries I’ve lived in or visited, so of course there are more people who have a diagnosis. In Finland they just stared at me wide-eyed and shook their heads when I asked if they had Sudafed. “Oh no, very strong…”
akomtu 1y ago
> ADHD is a complex condition characterized by symptoms like a constant inability to pay attention, impulsiveness, trouble sleeping, and mood swings. This looks like the very condition that's being promoted by reddits, reels, shorts, tiktoks, facebooks, even by news that aim to enrage as much as they can. Solid attention that's under your control is the #1 enemy of the attention based economy.
letwhile 1y ago
Over 10% of children? That sounds like a flawed testing method or toxic environment, not a disease.
- resoluteteeth 1y ago
  Can you explain why it being over 10% of children would make it not a disease?
  - deleted 1y ago
    [deleted]
  - garylkz 1y ago
    But really, if like more than 50% of children has ADHD, maybe it's not really a "defect" but rather a "trait" of some human. Unless you're implying that half of the humanity that has ADHD are defective humans. Just a thought
- deleted 1y ago
  [deleted]
- habinero 1y ago
  Why? What's wrong with humans having variance?
homeonthemtn 1y ago
Likely a combination of isolation (small families, no outside time) combined with tech designed to over stimulate. To me ADHD is an adaptation to an overflowing amount of stimulation and information. The brain skips around very quickly until it finds something very valuable and then mines the hell out of it (hyper focus) i would be very curious to find out the rate of ADHD in the Amish. Theyre an American population but without technology. Seems like a fascinating study.
- spicymaki 1y ago
  You are incorrect. ADHD is not caused by isolation or addictive tech. ADHD is passed down genetically and is caused by a difference dopamine regulation. People with ADHD have low baseline dopamine (A neurotransmitter that plays a role in reward, motivation, mood, etc.), that is why they hyper focus when they are in the zone. The brain is starved for dopamine and when there is spike in dopamine it causes an intense reaction. ADHD may have been useful preindustrial societies, but today it is maladaptive. Excessive use of addictive tech can mimic ADHD symptoms, but is not the same. People with ADHD are adversely affected by addictive tech. The symptoms mimic “bad behavior” so some skeptics think you can just beat it out of them or yell at them to just stop. That might mitigate the problem for very short time (perhaps due to a short dopamine rush), but they fall back into a low dopamine state afterwards.
  - homeonthemtn 1y ago
    Funny that the rise of ADHD runs parallel to the advent of the Internet, and only evidently striking Americans. Perhaps what you're describing is one form of it, and if so, we should develop a better naming convention to get rid of the ambiguity. Or go the cop-out approach and say it's a "spectrum" so you're never truly wrong, and never truly accurate.
    - yladiz 1y ago
      It could also be due to a better understanding of the causes, among other things. As always, correlation does not equal causation.
deleted 1y ago
[deleted]
wesleyd 1y ago
I have a slightly crazy theory that neurodivergent folk have historically been less inclined to “stay put”, and more likely to migrate, and the US - built out of immigrants - has selected for neurodivergence. (This assumes that neurodivergence is somewhat heritable.)
abbadadda 1y ago
There’s bound to be tons of ignorant stuff posted in this thread. Please support strong opinions or claims with scientific evidence. Personal anecdotes are not a license to spout vitriol one way or the other or to spread ignorance more generally. You don’t have to comment. Thanks!
tdpvb 1y ago
It's high because overdiagnosis. - TED Talk - Recommend one of the most-watched TED Talks of all time, by Sir Ken Robinson. Gems such as, "If you sit kids down, hour after hour, doing low-grade clerical work, don't be surprised if they start to fidget." And, "Children are not, for the most part, suffering from a psychological condition. They're suffering from childhood." - Book - Also check out the book, "The Body Keeps a Score". The concept of "pseudocertainty" is a key takeaway: symptomatic labels can be helpful to a point, but they're not explanatory -- it offers a false sense of conclusion, but no root cause analysis. It conflates "diagnosis" with "syndrome". For example cancer is a specific diagnosis, and within it much specificity of dozens of particular types of cancer. Whereas ADHD is a "disorder", or a "pattern of symptoms". ADHD as a pseudocertainty is self-referential: "I have ADHD" "What does that mean?" "It means I exhibit symptoms of ADHD" "okay, so what does that mean?" "it means I have ADHD" "sure but what does it mean? And more importantly, why do you have 'ADHD'? " - DSM - The DSM defines how ADHD is diagnosed by two lists of nine symptoms each, from which a practitioner chooses six symptoms from each, and qualifies them as having "persisted for at least 6 months". That's the definition of medical cherry-picking. Some of the descriptions are, uncomfortably, exactly what one would expect from a small child: "Often fidgets with or taps hands or feet or squirms in seat." "Often blurts out an answer before a question has been completed." "Often has difficulty waiting his or her turn." Scary. - Conclusion - And that's how children in the US, by acting like children, get themselves drugged up and labeled as "having ADHD". Or the poor kids just have mild- to severe trauma, or residual emotional anxiety, and instead of parents/teachers owning up to their part in it, or educating kids on how to self-regulate, or offering children meditation classes, they just drug them instead. It's the kids that are abnormal, surely it's not the adults' faults! $$$ Oh and don't forget, the ADHD therapeutics market size in the US is ~$10B/yr. Good luck stopping that party.
- viraptor 1y ago
  It's both over and under diagnosed. But you're overplaying some areas like people have no idea what they're doing. For example: > Often fidgets with or taps hands or feet or squirms in seat This is not describing typical kid behaviour, but self-stimulation. They're massively different. There's normally a follow-up discussion about the answers to that basic questionnaire. If you watched that talk, take a moment to follow up with this one from Russell Barkley which addresses what's wrong with Robinson's views https://youtu.be/5jOwjbwU41o https://youtu.be/5jOwjbwU41o > And more importantly, why do you have 'ADHD'? Genetics and occasionally brain damage from accidents. That much has been proven in many studies - it's very much inherited.
garethsprice 1y ago
As someone who grew up in the UK and emigrated to the US then got an ADHD diagnosis in my late 30s, and seeing how my friends’ kids in the US and UK differ in support, it is because in the UK you are just considered an absent-minded student who should apply themselves better, but in the US there’s a whole (albeit profit-motivated) network of resources. It wasn’t even raised when I was a kid in the UK I may have ADHD, and I wish it had been.
andrewmcwatters 1y ago
I have a problem with the characterization of ADHD, because it just sounds like... children being children, or maladaptive adults not taking active control of their executive function. I acknowledge that the issues are real, but I suspect like many others that the issues patients have are ones that arise from societal requests and requirements. I think the attempt to formally classify attention deficit disorder is mostly unscientific and one of care rather than something that can be objectively measured. The article and the professionals in it don't discuss any measurement of the condition, rather the lack thereof. I think people who want care for ADHD should receive it, but I think the term is wildly out of date and we should have some sort of new term for the condition that doesn't have the same connotations, or just promote the societal idea that if you need nootropics to focus, that's OK.
- viraptor 1y ago
  > children being children Children do not behave like the higher end of the typical diagnosis questionnaire. It may seem like that if you read it the first time, but professionals are expected to know the baseline. This claim is an unhelpful meme at this point. > or maladaptive adults not taking active control of their executive function And that's up to the follow-up chats to figure out if someone has the ability to control, but doesn't for other reasons, or if they're unable to control them. Just like lots of other physical and mental issues - this is not something new.
  - andrewmcwatters 1y ago
    Yeah, well I would know since I was diagnosed with it.

26 points by rntn 1y ago

In comparison to other places in the world (especially Asia), there is somewhat lower stigma regarding ADHD in the U.S. I would add the UK to the stigma list as well. The UK government and NHS are pretty rabidly ADHD-denialist and make it incredibly difficult to get a diagnosis.

collinfunk 1y ago
> I would add the UK to the stigma list as well. The UK government and NHS are pretty rabidly ADHD-denialist and make it incredibly difficult to get a diagnosis. Don't you also have to wait years on a wait list for an evaluation? I feel like I remember hearing that a few years ago.
- xdfgh1112 1y ago
  NHS waiting list is a few years but they will pay for you to use a private clinic, my waiting list is 5 months.
xdfgh1112 1y ago
They literally pay for you to use a private clinic to ensure everyone can be assessed quickly. ADHD is legally protected and recognised. Lumping it in with most of Asia is ridiculous.
- ck425 1y ago
  Where in the NHS is that? Maybe just an English thing. I had to go private on my own dime and thankfully my GP took over prescribing, which is uncommon and becoming increasingly so. They also put me on the NHS waiting list, back when you could still get on it without being severe, and it was only last week I had my appointment almost 4 years after being put on the list.
  - xdfgh1112 1y ago
    It's called Right to Choose and it may be England only. The NHS waiting list here is also over 3 years!
chrismeller 1y ago
I was surprised when I moved to Europe that at least several (many?) EU countries don’t even authorize any ADHD drugs to be prescribed. So sure, maybe the doctor knows you have it, but even if they say you have it… so what, what can they do about it? As someone with some horrific environmental allergies, I see it as similar. The US has a ton more allergy medications available (both RX or OTC) than any of the other countries I’ve lived in or visited, so of course there are more people who have a diagnosis. In Finland they just stared at me wide-eyed and shook their heads when I asked if they had Sudafed. “Oh no, very strong…”

akomtu 1y ago

> ADHD is a complex condition characterized by symptoms like a constant inability to pay attention, impulsiveness, trouble sleeping, and mood swings. This looks like the very condition that's being promoted by reddits, reels, shorts, tiktoks, facebooks, even by news that aim to enrage as much as they can. Solid attention that's under your control is the #1 enemy of the attention based economy.

letwhile 1y ago

Over 10% of children? That sounds like a flawed testing method or toxic environment, not a disease.

resoluteteeth 1y ago
Can you explain why it being over 10% of children would make it not a disease?
- deleted 1y ago
  [deleted]
- garylkz 1y ago
  But really, if like more than 50% of children has ADHD, maybe it's not really a "defect" but rather a "trait" of some human. Unless you're implying that half of the humanity that has ADHD are defective humans. Just a thought
deleted 1y ago
[deleted]
habinero 1y ago
Why? What's wrong with humans having variance?

homeonthemtn 1y ago

Likely a combination of isolation (small families, no outside time) combined with tech designed to over stimulate. To me ADHD is an adaptation to an overflowing amount of stimulation and information. The brain skips around very quickly until it finds something very valuable and then mines the hell out of it (hyper focus) i would be very curious to find out the rate of ADHD in the Amish. Theyre an American population but without technology. Seems like a fascinating study.

spicymaki 1y ago
You are incorrect. ADHD is not caused by isolation or addictive tech. ADHD is passed down genetically and is caused by a difference dopamine regulation. People with ADHD have low baseline dopamine (A neurotransmitter that plays a role in reward, motivation, mood, etc.), that is why they hyper focus when they are in the zone. The brain is starved for dopamine and when there is spike in dopamine it causes an intense reaction. ADHD may have been useful preindustrial societies, but today it is maladaptive. Excessive use of addictive tech can mimic ADHD symptoms, but is not the same. People with ADHD are adversely affected by addictive tech. The symptoms mimic “bad behavior” so some skeptics think you can just beat it out of them or yell at them to just stop. That might mitigate the problem for very short time (perhaps due to a short dopamine rush), but they fall back into a low dopamine state afterwards.
- homeonthemtn 1y ago
  Funny that the rise of ADHD runs parallel to the advent of the Internet, and only evidently striking Americans. Perhaps what you're describing is one form of it, and if so, we should develop a better naming convention to get rid of the ambiguity. Or go the cop-out approach and say it's a "spectrum" so you're never truly wrong, and never truly accurate.
  - yladiz 1y ago
    It could also be due to a better understanding of the causes, among other things. As always, correlation does not equal causation.

deleted 1y ago

[deleted]

wesleyd 1y ago

I have a slightly crazy theory that neurodivergent folk have historically been less inclined to “stay put”, and more likely to migrate, and the US - built out of immigrants - has selected for neurodivergence. (This assumes that neurodivergence is somewhat heritable.)

abbadadda 1y ago

There’s bound to be tons of ignorant stuff posted in this thread. Please support strong opinions or claims with scientific evidence. Personal anecdotes are not a license to spout vitriol one way or the other or to spread ignorance more generally. You don’t have to comment. Thanks!

tdpvb 1y ago

It's high because overdiagnosis. - TED Talk - Recommend one of the most-watched TED Talks of all time, by Sir Ken Robinson. Gems such as, "If you sit kids down, hour after hour, doing low-grade clerical work, don't be surprised if they start to fidget." And, "Children are not, for the most part, suffering from a psychological condition. They're suffering from childhood." - Book - Also check out the book, "The Body Keeps a Score". The concept of "pseudocertainty" is a key takeaway: symptomatic labels can be helpful to a point, but they're not explanatory -- it offers a false sense of conclusion, but no root cause analysis. It conflates "diagnosis" with "syndrome". For example cancer is a specific diagnosis, and within it much specificity of dozens of particular types of cancer. Whereas ADHD is a "disorder", or a "pattern of symptoms". ADHD as a pseudocertainty is self-referential: "I have ADHD" "What does that mean?" "It means I exhibit symptoms of ADHD" "okay, so what does that mean?" "it means I have ADHD" "sure but what does it mean? And more importantly, why do you have 'ADHD'? " - DSM - The DSM defines how ADHD is diagnosed by two lists of nine symptoms each, from which a practitioner chooses six symptoms from each, and qualifies them as having "persisted for at least 6 months". That's the definition of medical cherry-picking. Some of the descriptions are, uncomfortably, exactly what one would expect from a small child: "Often fidgets with or taps hands or feet or squirms in seat." "Often blurts out an answer before a question has been completed." "Often has difficulty waiting his or her turn." Scary. - Conclusion - And that's how children in the US, by acting like children, get themselves drugged up and labeled as "having ADHD". Or the poor kids just have mild- to severe trauma, or residual emotional anxiety, and instead of parents/teachers owning up to their part in it, or educating kids on how to self-regulate, or offering children meditation classes, they just drug them instead. It's the kids that are abnormal, surely it's not the adults' faults! $$$ Oh and don't forget, the ADHD therapeutics market size in the US is ~$10B/yr. Good luck stopping that party.

viraptor 1y ago
It's both over and under diagnosed. But you're overplaying some areas like people have no idea what they're doing. For example: > Often fidgets with or taps hands or feet or squirms in seat This is not describing typical kid behaviour, but self-stimulation. They're massively different. There's normally a follow-up discussion about the answers to that basic questionnaire. If you watched that talk, take a moment to follow up with this one from Russell Barkley which addresses what's wrong with Robinson's views https://youtu.be/5jOwjbwU41o https://youtu.be/5jOwjbwU41o > And more importantly, why do you have 'ADHD'? Genetics and occasionally brain damage from accidents. That much has been proven in many studies - it's very much inherited.

garethsprice 1y ago

As someone who grew up in the UK and emigrated to the US then got an ADHD diagnosis in my late 30s, and seeing how my friends’ kids in the US and UK differ in support, it is because in the UK you are just considered an absent-minded student who should apply themselves better, but in the US there’s a whole (albeit profit-motivated) network of resources. It wasn’t even raised when I was a kid in the UK I may have ADHD, and I wish it had been.

andrewmcwatters 1y ago

I have a problem with the characterization of ADHD, because it just sounds like... children being children, or maladaptive adults not taking active control of their executive function. I acknowledge that the issues are real, but I suspect like many others that the issues patients have are ones that arise from societal requests and requirements. I think the attempt to formally classify attention deficit disorder is mostly unscientific and one of care rather than something that can be objectively measured. The article and the professionals in it don't discuss any measurement of the condition, rather the lack thereof. I think people who want care for ADHD should receive it, but I think the term is wildly out of date and we should have some sort of new term for the condition that doesn't have the same connotations, or just promote the societal idea that if you need nootropics to focus, that's OK.

viraptor 1y ago
> children being children Children do not behave like the higher end of the typical diagnosis questionnaire. It may seem like that if you read it the first time, but professionals are expected to know the baseline. This claim is an unhelpful meme at this point. > or maladaptive adults not taking active control of their executive function And that's up to the follow-up chats to figure out if someone has the ability to control, but doesn't for other reasons, or if they're unable to control them. Just like lots of other physical and mental issues - this is not something new.
- andrewmcwatters 1y ago
  Yeah, well I would know since I was diagnosed with it.