According to the Centers for Disease Control and Prevention (CDC), about 11% of children aged 4-17 have been diagnosed with ADHD, as of 2011.
The American Psychiatric Association (APA), however, claims that the diagnosis for Attention Deficit Hyperactivity Disorder is given in 15% of cases when only 5% of children actually suffer from this disorder. And this number is steadily increasing from 7.8% of children in 2003, going up to 9.5% four years later.
The Pharmaceutical industry, or Big Pharma, wants parents to know that this disorder is common in America and it needs to be medically treated, but in other countries, ADHD is defined, diagnosed and treated quite differently.
Doctors in France, for example, diagnose this disorder in less than 0.5% of cases, maintaining that the disorder is the result of psycho-social and environmental or situational factors and not a biological disorder to be treated with medication.
Child psychiatrists in France use a system known as Classification Française des Troubles Mentaux de L’Enfant et de L’Adolescent(CFTMEA), which classifies childhood emotional problems differently to Americans.
The APA’s system was originally created to ‘provide French psychiatrists an alternative to DSM-III’ because it differed greatly from the practices of child psychiatrists in France.
The French CFTMEA focuses on finding the underlying issues leading to the child’s behavior and on taking a psychopathological approach to target them.
In France, doctors define ADHD as a disorder which is sociological and the result of a set of situations, whereas in the U.S. it is regarded as a neurological disorder caused by a chemical imbalance or biological dysfunction in the brain.
This is due mainly to the fact that, in the U.S., the pharmaceutical industry helped to define ADHD, which is why there is also such a dramatic difference in its treatment in the two countries.
ADHD Treatment Methods in France
When children in France are diagnosed as having ADHD, doctors look for underlying causes, with psychiatrists investigating the child’s distress and comparing it with their social situations.
Because the disorder is regarded as a social context problem, it is usually treated with family counselling or psychotherapy and medications are considered unnecessary and almost never prescribed.
The patient’s diet is also investigated, looking at possible causes such as unhealthy eating habits. They believe consumption of food with artificial colors or flavors, sugar, preservatives, allergens may have a negative effect on the child’s behavior.
One study conducted in 2011, reports a rate of ADHD as low as 3.5%
Dr. Wedge, a family therapist and the author of the book: A Disease Called Childhood: Why ADHD Became an American Epidemic, believes this could be the result of cultural differences in raising children in the two countries.
She notes that French parents often opt for more structured lifestyles for their children and tend to emphasize strict schedules, self-discipline and letting babies and infants ‘cry it out’ instead of giving in to children’s whims. Another difference is that spanking and moderate corporal punishment is not considered child abuse in France but as acceptable behavior to discipline children.
However, the effects of the different methods in treating ADHD in France are probably owed to the holistic approach which takes all the different factors in consideration, including behavioral and social context and diet.
On the other hand, the huge pharmaceutical companies in the U.S. have the main role in the definition of ADHD and in its treatment and many doctors and researchers are funded by them to emphasize the risks and promote the use of medications for ADHD.
Even some renowned universities, such as John Hopkins and Harvard, have been connected with such practices, and the general public is not aware that the studies are paid for by the companies benefitting from the sale of the drugs.
The fact is that the medicaments can be put in the same category as morphine and oxycodone for the risk of addiction and abuse and that they can result in various adverse health issues.
Dr. Irwin Savodnik is an Assistant Clinical Professor of Psychiatry at the University of California and he says that the pharmaceutical industry is now the one that defines the very vocabulary used in psychiatry at all its levels.
Another cause of the high rates of ADHD in the U.S. are the advertisements for drugs that result in parents’ hearing claims that ADHD medication can improve behavior and even test scores.
An example of controversial advertising is one from 2009 in which a child dressed in a monster costume takes off his mask and shows a calm, smiling face, with the caption reading – There is a great kid hiding in there.
The FDA has given repeated warnings for such ads, labelling them as misleading, exaggerating the effects of drugs, and simply false. There is no such propaganda like that in France.
We could learn so much from the way the French define and treat ADHD, their holistic approach and the way they do not immediately reach for medications, a practice which is damaging to children’s self-esteem and unethical.
Even children who could simply be uninterested in some subject, or have heightened energy and creativity, or be emotionally traumatized, are treated with medication.
However, there are many doctors in the US who do not treat ADHD as a disorder and believe in treating it in an alternative way.
According to Daniel J. Carlat, M.D, Associate Clinical Professor of Psychiatry at Tufts University Medical School, there are many diseases in psychiatry that can be treated equally well with therapy or medication, but guidelines are usually biased in favor of medication.
Dr. Tyler Woods, a Holistic Mental Health Practitioner, additionally notes that the DSM has a tendency to pathologize normal behavior, and that some rather normal and healthy anxieties are labelled as ‘anxiety disorders’ and treated as mental illnesses.
Even simple shyness can sometimes be viewed as ‘social phobia’ and children who are spirited and strong willed as having an ‘oppositional disorder’. Many psychotherapists, consequently, tend to follow DSM, no matter their own theoretical orientation.
Richard Saul is a neurologist who works with patients struggling with difficulties in focusing and short attention spans and he believes that ADHD shouldn’t be viewed as a disease but rather as a set of symptoms. He believes that the American Psychiatric Association’s Diagnostic and Statistical Manual should not list it as a separate disorder.
Another dissenter with medication is Dr. Sanford Newmark, a leading pediatrician and the author of ‘ADHD without Drugs: A Guide to the Natural Care of Children with ADHD’, who has been treating ADHD naturally for 15 years.
He believes that the conventional treatment with medication can have adverse effects on children’s health and should only be used as a last resort.
Instead, his own treatment methods include family counselling, positive behavioral and social changes, healthy nutrition with zinc, iron, and Omega-3 supplementation, as well as homeopathic treatments and Traditional Chinese Medicine.
And the number of doctors and experts in the U.S. that feel ADHD should be approached in a way outside the conventional treatments is growing.
The pharmaceutical industry, of course, is mainly responsible for the way ADHD is misdiagnosed and over-diagnosed in the U.S., while many now believe that it is necessary to provide alternatives to medication.