
When starting school, younger children are more likely to be diagnosed with ADHD - Reedx
https://news.harvard.edu/gazette/story/2018/11/when-starting-school-younger-children-are-more-likely-to-be-diagnosed-with-adhd-study-says/
======
WhompingWindows
ADHD researcher here, this was already known. ADHD is a neurodevelopmental
disorder, the key is that developmental disorders occur over the time-course
of typical development. To have a diagnosis of ADHD, there must have been
symptoms before the age of 7, and furthermore, it's much more likely to occur
in younger children because their executive functions are less well developed.

On the neurological level, there are different dopaminergic systems developing
throughout childhood, such as the motor cortex, the prefrontal cortex, and the
dopamine-based reward system. If the motor cortex develops too quickly before
the PFC, which controls/regulates behavior, well you'll have hyperactivity
that's unregulated. With less developed EF's comes getting out of the chair,
losing things, daydreaming, hyperactivity, and all of the diagnosable symptoms
of ADHD. Naturally, those who are 6-9 months younger (which might be a 10% age
difference in kindergarten) are going to be in very different developmental
stages. Requiring younger children to sit still and pay attention may be a
much more challenging task since their brains are actually less developed.
Thus, they more easily get pushed over the diagnosis line compared to their
older classmates.

There is another wrinkle here beyond age, which is gender: boys are around
2.5-3X as likely to be diagnosed because they are more hyperactive naturally,
i.e. their neurological systems develop at different rates than girls. This
sort of behavior in the classroom is much more disruptive than what girls
exhibit. Girls tend to be diagnosed with primarily inattentive subtype, since
their motor cortex is not usually as over-active, but they still may suffer
underdevelopment of the EF that helps them to focus. A girl daydreaming is
much less disruptive than a boy standing on his chair, rolling on the floor,
or wandering the classroom (all of which happened multiple times in my own
classroom).

~~~
snthpy
Thank you for your informative comment.

I was as sceptical of ADHD as most of the commenters here and have been
resisting sending my son for an assessment for about a year because I guess
what the diagnosis will be. However the more I've been looking into it and
observing him, the more I'm coming to the conclusion that it seems to be
something physical that he can't control. Just this evening we were in a
restaurant and he was standing in his chair, climbing up a pole. etc... When
he eventually knocked something over and I sternly reminded him to sit down,
he started hitting himself on the head, apparently rueful that he's
disappointed me again. It seems to be something he can't control and his
repeated failures to do so seem to be affecting his self-esteem.

What would you recommend as the best interventions to explore? I would prefer
something behavioural but am opening up to considering medication if the will
make him feel better about himself and facilitate smoother interactions with
his peers.

~~~
tcoff91
Does your child have enough outlets to burn off his excess energy? It seems to
me that kids really evolved to be outside running around with friends and
siblings extensively.

I would bet if he was getting his heart rate up for 3-5 hrs a day he would be
way way calmer the rest of the time.

It seems to me that the real problem is that we have constructed a world that
is fundamentally at odds with our biology and then when people cannot function
within it, we diagnose them as having a disorder.

~~~
openasocket
> It seems to me that the real problem is that we have constructed a world
> that is fundamentally at odds with our biology and then when people cannot
> function within it, we diagnose them as having a disorder.

I don't know if you meant it this way, but this certainly sounds like you are
implying that people with ADHD (or some portion of them) don't really have
anything wrong with them, they just need to exercise or something. As someone
who has lived with ADHD for their whole life, I find this attitude really
offensive. I have a medical disorder, there's a chemical imbalance in my brain
that has been diagnosed by doctors. I can't just walk it off.

It's not a case of the modern world being at odds with how we were evolved, I
would be struggling in the ancient world too. Without my medication I have
real trouble remembering things, making plans, and following directions.
Moreover, if the modern world is so at odds with our biology, why does the
overwhelming majority of the population have no problem functioning in it
while I do? And I don't mean to come off as hostile here, but I find it
insulting to be told by someone who presumably has no problem functioning in
the modern world that my inability to function in it isn't really a problem.

~~~
sxg
I don’t believe that’s what the OP is saying. I understood his comment to mean
that ADHD can be considered more of a “bad fit” for the person’s environment
than an objectively diagnosable disease. Perhaps by changing the environment,
ADHD’s symptoms may be mitigated. Maybe it’s not a 6-year-old’s fault that
he/she cannot sit still and quiet in a room for 8 hours with maybe a 30 minute
break for recess? Maybe it’s our expectations that are at fault.

~~~
Spooky23
You can really see developmental differences at 5-7. My son is 6, his
kindergarten last year had kids between 4-6 on the first day of school and
they vary substantially. Their lives vary a lot as well... how do you expect a
6 year old in early day, school and aftercare from 7-5 to behave?

------
eatitraw
I am really surprised at all the skepticism about ADHD in this thread.

1) Attention (or executive functioning in general) is normally distributed,
just like a lot of other human traits. If you don't doubt that intelligence is
normally distributed (and that some people are smarter than other), what makes
you think that there is no variability in executive functioning / attention?

Executive functioning also improves as brain develops, and that's why problems
of younger kids are probably more noticeable.

2) Re: diagnosing using checklists and interviewing. That's literally how
every other psychiatric disorder is diagnosed. Depression? Checklists and
interviewing. Anxiety? Checklists and interviewing. Schizophrenia? Also
checklists and interviewing.

Studies show that there are measurable differences between ADHD brains and
normal brains. People complain that these are not used for diagnosis. The
reason these scans are not used for diagnosis is because the resolution of
common brain scan methods is not high enough, and these differences are seen
on the population level.

3) Some graphs on brains differences: [https://adhd-institute.com/burden-of-
adhd/aetiology/neurobio...](https://adhd-institute.com/burden-of-
adhd/aetiology/neurobiology/)

~~~
nitwit005
I suspect the rather poor diagnosis situation is going to naturally produce a
lot of skepticism. Anyone is going to start questioning things if they see
kids with a diagnosis who seem basically normal. And, unfortunately, that does
seem to be happening quite often.

~~~
eatitraw
> Anyone is going to start questioning things if they see kids with a
> diagnosis who seem basically normal.

How do _you_ know if they are normal or merely seem normal though? What is
your definition of normal here?

~~~
nitwit005
Is the diagnosis situation poor? Yes. Do people pick up on that sometimes? Of
course. How do I, personally, define normal? Who gives a shit?

~~~
eatitraw
> How do I, personally, define normal? Who gives a shit?

If you care enough to leave a comment on HN, please also explain _why_ you
think it is poor. Because right now your comments add no substance to the
discussion.

~~~
nitwit005
We are in a discussion about an article providing strong evidence that
diagnosis is poorly done. Do a little research yourself, and you'll find it's
hardly the only evidence. Feel free to peruse a good New York Times write up
from a while back: [https://www.nytimes.com/2013/04/01/health/more-diagnoses-
of-...](https://www.nytimes.com/2013/04/01/health/more-diagnoses-of-
hyperactivity-causing-concern.html)

------
caymanjim
My birthday is in November, and the cutoff when I started school was October
31st. I was always the oldest kid in my grade, all the way through highschool.
Back when I went to school, ADHD didn't exist as an identified condition. If
it had, I may have been diagnosed.

Everything was way too easy for me, and I acted out a bit, perhaps out of
boredom, or simply because I had way too much free time. I've always been
"book smart", even among people my age, and it was particularly true when I
was six months older than the median student in my class and nearly a full
year older than some.

I'm highly skeptical of ADHD as an actual condition. Some kids clearly have
learning and behavioral problems, but I've got plenty friends and family whose
kids were diagnosed as ADHD and they are now medicating them into submission.
I think most of them are more like me; they're not being stimulated enough at
school, or stimulated properly. These kids need better schooling and better
parenting. They don't need to be drugged up.

~~~
WhompingWindows
Anecdotal evidence isn't enough. There is actual neurological evidence that
those with ADHD have mismatching development of their motor cortex and their
PFC which controls the executive functioning of the brain. Most meta analyses
of the diagnoses in recent years do not support your skepticism, in fact, some
researchers believe the condition is properly or even UNDER diagnosed.

~~~
andrewla
Let me unpack what you're saying here. Note that I have not surveyed the
literature, but I am slightly skeptical of ADHD as a diagnosis, having seen
"early detection/intervention" results amongst the children of my peers that
seem patently ridiculous.

> There is actual neurological evidence that those with ADHD have mismatching
> development of their motor cortex and their PFC which controls the executive
> functioning of the brain

That is to say that the set of people diagnosed with ADHD correlates to the
set of people who have mismatching development. But the tests for ADHD
(especially in early childhood) do not undergo any sort of PET or fMRI scans
for mismatched development; they typically have a set of questions that they
ask with a threshold for the number of "wrong" answers. I suspect (without
evidence) that as the testing moves earlier in age, there is more "success"
with early intervention simply because the condition is transient.

In situation where intervention is recommended, I think overreactions are
common and doing large-scale studies to determine how effective the
questionnaires are at rooting out both positive and negative findings of
"mismatched development" through directly measurable means like fMRIs or PET
scans, which are contraindicated in non-acute cases for children of the ages
in question, so we have to have longer-term survey studies before we can begin
to evaluate effectiveness.

The age-related results referenced in the article (thought I haven't read the
study) seem to indicate that at least some of the ad hoc testing is just
measuring normal childhood development milestones rather than serving as a
useful indicator of ADHD.

~~~
jonhendry18
" But the tests for ADHD (especially in early childhood) do not undergo any
sort of PET or fMRI scans for mismatched development;"

That's not the entirety of the diagnostic process.

Also, you may be putting more faith in PET and fMRI than they deserve.

[https://harvardneuro.wordpress.com/2016/01/21/tbt-the-
lesson...](https://harvardneuro.wordpress.com/2016/01/21/tbt-the-lessons-we-
learned-from-a-dead-fish/)

------
baryphonic
I'm a bit surprised I haven't seen any comments (admittedly, I got too
distracted to read them) about the decline of children's free play and the
increase in adult-guided activities in America over the past 50 years.

I was diagnosed with ADHD when I was 15 and have intermittently suffered
through it over the years. I took meds for a while, but I felt like an amped-
up zombie and stopped some time during college.

Kids have not always gone to school for full 7 hour days starting at age four
or five, where they have been subject to strict rules that emphasize obedience
to adults and "sitting still." In fact, some research indicates that children
at a young age learn best how to regulate themselves through play with other
kids, including through games (that they themselves create) and role-playing.
Kids figure out how to regulate themselves from each other, not from adults.
(This could explain why increases in ADHD, bullying and teen suicide seem to
be happening at the same time.)

I look back and think that at least in my case, this might explain a bit of my
issues. In my case, I think there are probably underlying causes that are only
now, years later, being looked at, including pretty serious trouble sleeping
and some hormone problems. But I also think that I lacked the child-oriented
play that kids really need, and was wound up in adult-guided activities where
I didn't learn to govern myself.

I'm not anti-schooling, but I do think that the schools have gotten too high-
stakes at earlier ages, and we should probably limit younger kids to shorter
school days and allow them to engage in relatively hands-off free play with
each other. (Of course, this is much easier said than done - teachers unions
and the lawyers' guild are quite powerful, and we moms and dads love the free
babysitting we get at the public expense.)

------
sudosteph
It's interesting because one thing about ADHD, and Autism Spectrum disorders
too, is that diagnosis is very dependent on people having a base point to
compare against. That's why for most of these disorders, you're more likely to
be diagnosed if you're 2nd born and 1st born doesn't have it. The parents are
familiar with how the first child developed and can see the discrepancy
sooner.

Meanwhile, in cases like my family, where me, my sister, my Dad, some cousins,
and probably my mom's siblings too all fit the criteria for ADHD (we're a
family of troublemakers) - my parents couldn't tell anything was off. When my
cousins got a diagnosis through school, my parents were skeptical of the whole
thing. But the treatment they got for it early on helped a ton and those
cousins turned out better adjusted in many ways than my sister and I who
didn't get diagnosed til adulthood.

It's funny though because now I have a step-niece (no biological relation) and
my mom keeps commenting on how crazy well behaved she is, because she doesn't
run around every time they go to a restaurant or talk incessantly or
constantly run into things... So from her perspective, children without ADHD-
behaviors are the abnormal ones. Go figure.

------
ravenstine
I don't dispute that ADHD is an observance of a real phenomenon, but maybe the
prevalence of the diagnosis is a result of society overoptimizing human
productivity? Having ADHD, especially now that ADD is ADHD-PI, seems very
normal these days, but it we treat it more like an affliction than a common
behavior the modern world needs more compassion towards.

If I have a child and they seem to have ADHD, I would pull them out of the
public school system so as they don't have their time wasted and their esteem
destroyed. If the system doesn't become more understanding, then it's up to
me. At least then my child can be brought up to learn good coping mechanisms
they'd be lucky to otherwise learn before it's too late.

~~~
WhompingWindows
I researched ADHD and was a teacher to boot. You wouldn't think it's about
human productivity when you have ADHD children standing on their chairs,
shouting, wandering the classroom during examinations. It's a serious
neurological disability and it's not just down to societal pressures for
productivity.

Some sad facts: Those with ADHD are much more likely to be friendless, to have
fights with parents, to abuse alcohol, nicotine, marijuana, and cocaine, and
to develop mental health problems like depression, anxiety, and conduct
disorder. The brain of those with ADHD is not "normally" developed and that
leads to a lot of issues.

~~~
all_factz
Another sad fact: medicating such kids is often a problematic solution. ADHD
drugs make one lethargic and just feel "off" (according to my sister, who was
on them for a long time).

What we need are more vocational schools to give the "hyperactive" among us a
realistic, career-oriented outlet.

~~~
2trill2spill
I got "diagnosed" with ADHD and tried taking the medicine for two weeks and it
was terrible. What's the point of doing better in school if you feel terrible,
lose your appetite, and have problems sleeping?

~~~
snerbles
Compliance.

You're more easily molded into an economically productive little cog for the
workforce.

~~~
cowboysauce
Tell me, how do stimulants make someone more compliant? Why is it that when
someone comes to the hospital in an agitated state, they aren’t given
adderall? Why isn’t ritalin given before surgery? Why are people with
schizophrenia given antipsychotics instead of vyvanse? This type of attitude
is as ridiculous as it is cynical.

People act as if the idea of a Ritalin zombie is the goal for ADHD medication.
It’s not. I’m not going to deny that stimulants do make some people lethargic,
but that’s the exception, not the rule.

Do you want to know what it’s like to take medication for ADHD? For the first
time in my life I can make choices. I can choose to clean up my desk without
something deep inside me rising up to stop me. I can sit down and read a book
and not feel the tensions building up inside me until it feels like a rubber
band about to snap. I can wait at a restaurant without feeling the need for
stimulation itch over me. My mind no longer jumps from idea to idea until I
get lost in my own head. I can speak without stumbling over words because my
mind is three sentences ahead. I can read a paragraph and actually remember
what I just read.

The notion that I’m just some lobotomized zombie shuffling to the strings of
my corporate masters is frankly insulting to everyone that struggles to live a
normal life with ADHD.

------
povertyworld
Anecdata, but this was my experience. I have a November birthday, and the
school district in Massachusetts gave my parents the option of having me start
a year younger than everyone or wait a year. My parents opted to send me to
school a year earlier. I performed poorly, and at one point was labeled with
ADHD. On the standardized tests they gave in 6th grade I scored at the 12th
grade level, so I don't think my problems were cognitive as much as
behavioral. Also, in high school having some peers who have been held back a
grade being 15 years old while one is just turning 13 can lead to some rather
unpleasant physical bullying. I often wonder how those early experiences may
have limited my life.

I was so tempted to send that article to my mom, but I didn't know how she
would take it.

~~~
jonhendry18
I was born in September, so was usually younger than most of my grade peers.
Did fine in K-6. Behavior was never an issue.

But I was diagnosed with ADHD in college.

~~~
povertyworld
By behavior I mean not doing the class work.

------
Reedx
This is a striking statistic: "...children born in August in those states are
30 percent more likely to receive an ADHD diagnosis, compared with their
slightly older peers enrolled in the same grade."

~~~
Oletros
Is there a cut for date for starting school?

Here in Spain, everyone born in the same year goes to the same class, is it
different in USA?

~~~
dudul
As per the article itself, many states implement the "1st of September cut
date". A kid born in September has to wait an entire year to start school
compared to one born on 08/31.

~~~
throwaway123032
And in Switzerland, 1st August. Retardness.

------
bigpicture
In my area, it is very common for parents of boys that will be "young" when
starting kindergarten to hold them back a year. They call it redshirting (a
reference to US college athletics).

Our local school district prohibits the practice, but really can only enforce
it at the kindergarten level. So many parents continue to enroll their boys in
private preschool for two additional years and then enroll them in first grade
when the school district can't say no. It is very rare for girls because of
the assumption that emotional and behavioral development is far ahead of boys
at that age.

~~~
corpMaverick
I want to do this with mine. He is younger, short and very active.

------
DoubleCribble
The September 1st cutoff for Kindergarten is treated as a distinct milestone
when it really should be treated as part of a developmental window. As far as
California is concerned, if you have a kid born on September 1st, they get 2
years of Kindergarten (TK + K). If their sibling happens to be born on August
31st, they get 1 year of Kindergarten (K only). And that 1 day distinction
could be the difference between a childhood of grade appropriate behavior
(older, more mature) or being labeled as ADHD (younger, less mature) with many
years of drug treatment to look forward to.

------
dgzl
My best mate in college started using Adderall when he was about 11 and abused
it through college. He's growing up to be a high functioning lunatic. My best
analogy of him would be a Bender from Futurama, but with a few STEM degrees.

------
WeAreGoingIn
There has always been ADHD around. When my normative group were kids, we
climbed trees, played Indian and cowboys and had a lot of outdoor fun. There
were some kid or two who was more risky or over the edge, but hey, we had fun.

Today, looking back, I would consider some of my childhood friends to have
ADHD or some kind of other diagnose.

Yesterday, these ADHD-kids, was not a great deal. There were also a lot of
local jobs and other opportunities as well that didn’t demanded a high
education.

Now kids don’t play outdoor and it’s easier to single out the ones with ADHD.
Further more people have moved to the cities and there is a greater pressure
to study. Today it’s hard to find a decent job for a supporter of a family
without a good education.

Hence, without a diagnose, these kids would not stand a chance. They need all
the help, support and understanding they could get.

~~~
jonhendry18
Even in the old days when there were good jobs for people without high school
educations, I'm sure the jails were full of people with ADHD. As they probably
are today.

~~~
ts1543636885
Indeed. [https://add.org/undiagnosed-adult-adhd-a-high-cost-for-
socie...](https://add.org/undiagnosed-adult-adhd-a-high-cost-for-society/)

------
dudul
My kid was born in September and I remember my wife doing a little research
around that "for fun" (yeah, that's how she has fun) a while ago, how kids far
and/or close to the cut off do.

She found a few studies mentioning that older kids (like born between
September and February or something) were doing way better in terms of the
academics as well. Which in a way makes sense, but maybe indicates that either
children start school too young or that programs are too agressive.

~~~
gizmo686
I don't think it indicates that students start too young, as much as 1 year
increments is too granular for grouping young children.

~~~
pbhjpbhj
This. My older kids have birthdays later in the academic year but have ended
up in groups for more advanced students.

Mind, nursery was a complete wash when it came to academics -- learning to
count to 3 when you can already count to 20 is rather futile. Public schools
just can't tailor to individual students.

Socially though, nursery was well timed for them IMO.

------
bayesian_horse
They don't really talk about the harm that could be done by "overtreating".
Between treatment options being quite safe and there being a continuum of
maturity/impulse control I would guess it is relatively low. Especially
compared to the consequences of ADHD not being treated (lower academic
success, lower social abilities, more violence, maybe even addictions later
on).

------
wnevets
"Fun" fact in the not so distant past lobotomies were used to treat
hyperactivity in children.

I wonder if the next generation will look back at the massive drugging of
children for ADHD in a similar light.

~~~
bayesian_horse
Probably not, because the benefits and side effects of appropriate ADHD drug
treatments are completely reversible and the scientific evidence for treatment
being positive is extremely strong.

~~~
Amezarak
Everyone benefits from taking stimulants. That’s why we drink coffee. The
efficacy of ADHD medication is not limited to people with ADHD. Should we all
take them?

The long-term effects of taking stimulants from childhood onward are not well
understood, let alone completely reversible. We’re performing uncontrolled
experiments- but that’s nothing new.

Not sure creating a situation where people are incentivized to get a diagnoses
giving them access to performance enhancing drugs is a great idea, though.

~~~
bayesian_horse
The line between disease/disorder and "unsatisfactory performance" is drawn
somewhat arbitrarily. But in general, those patients with an ADHD diagnosis
have much more to gain from "stimulants" than those who do not have this
diagnosis.

The potential for abuse of a drug should not limit its appropriate use, though
this happens all the time. Also, the safety of ADHD medication is quite well
understood, and even the long-term effects seem to be less than the
disadvantages of the disorder itself. There may still be a lot of room for
exact quantification, but at the moment it looks like ADHD medication is a
"good deal" in general.

------
roguecoder
It is surprising to me that people are so dubious of ADHD when for people with
the disorder who metabolize caffein normally diagnosis is remarkably simple:
give a six year old a cup of coffee. If they settle down or go take a nap,
they quite likely have ADHD. Give a neurotypical kid a cup of coffee and then
live with the results because no way are the parents going to thank you for
helpfully demonstrating how normal their child is.

------
epmaybe
Actual paper (paywall but abstract available):
[https://www.nejm.org/doi/full/10.1056/NEJMoa1806828?query=fe...](https://www.nejm.org/doi/full/10.1056/NEJMoa1806828?query=featured_home)

One part out of many that interested me in the discussion: "data from
insurance claims do not allow us to determine when a child starts school.
Parents may delay school entry for children born in August, which would mean
that those children start school at 6 years of age rather than 5 years of age.
Because we did not directly observe children’s ages when they entered school,
we cannot know how often this occurred"

There are other confounds, but suffice to say that this is not a very well
controlled cohort study. It is however interesting for guiding further
research.

------
crazy1van
This first part of this article about the realities of diagnosing ADHD is
worthwhile reading: [http://slatestarcodex.com/2017/12/28/adderall-risks-much-
mor...](http://slatestarcodex.com/2017/12/28/adderall-risks-much-more-than-
you-wanted-to-know/)

One particularly interesting quote:

"Trust me, no matter how unsuitable a candidate you are, no matter how bad a
liar you are, somewhere there is a psychiatrist who will give you Adderall.
And by “somewhere”, I mean it will take you three tries, tops."

~~~
roguecoder
Ironically, having ADHD makes it much harder to do all those things required
to get Adderall.

------
agigao
[https://m.soundcloud.com/instituteofartandideas/e123-minds-m...](https://m.soundcloud.com/instituteofartandideas/e123-minds-
madness-and-medicine-lucy-johnstone-david-nutt-david-healy)

------
swsieber
PSA: If you have ADHD symptoms, the first thing you should do is see if
getting enough sleep makes them go away. I'm not saying all ADHD is sleep
related, but bad sleep spawns ADHD in otherwise non ADHD people.

~~~
bayesian_horse
The first thing you should do if you see symptoms of virtually any
disease/syndrome/disorder is to see a doctor ;-)

------
ende
Get rid of a single long summer break and the entire concept of a “school
year”. Divide the year into quarters. Students can start in summer, spring,
winter, or fall.

~~~
rtkwe
> Students can start in summer, spring, winter, or fall

That's much harder to do than it sounds because now you have 4 groups 3 months
apart in the curriculum. The only way to really do it would be to segregate
the kids from the different start times into separate classes otherwise it'd
be pretty impossible to teach. There will also be a slight variation in class
size depending on the quarter it's for. as August and September are over
represented as birthdays.

I do think year round schools probably make more sense overall so there's not
such a huge gap where kids forget so much.

~~~
bigpicture
My local elementary school has 3 classrooms per grade. If we broke the year
into quarters and made each student attend 3 out of 4 quarters, what you'd end
up with is more efficient use of school facilities making up for a slightly
higher teacher cost. Probably.

~~~
rtkwe
I think before we do rolling quarters moving to a year round schedule would do
more to improve student performance than the more granular age groupings.
Could also just group the kids into however many classrooms are in each school
to do both.

------
TangoTrotFox
FiveThirtyEight ran an article on ADHD prescriptions [1]. It's getting pretty
silly. If people don't know ADHD was not recognized as a disorder until 1968.
And the popularity of drugging people for it didn't really take off until the
90s when a pharmaceutical industry astroturfing group called CHADD (Children
and Adults with Attention Deficit) started marketing ritalin hard. Since then
the use of using various pharmaceutical stimulants has become extremely
widespread - jumping up by multiple orders of magnitude.

I'm unsure what the latest numbers are but they offer the data to 2013. And
just between 2008 and 2013 adult usage of ADHD medication doubled. It was at
2.8% and has likely continued to rapidly increase. That's completed dwarfed by
what we're now doing to kids and particularly boys. In 2013 we were up to 9.8%
of all boys 12-18 years taking ADHD drugs. And those numbers again were, and
presumably still are, rapidly increasing.

I have this likely decreasingly controversial view that history is not going
to look back so kindly on psychology and our decision to start pretending we
can create a pill for everything. I mean what could possibly go wrong getting
10%+ of boys setup with stimulants, and increasingly often other sorts of
psychotropics as well, from their earliest and most critical developmental
years?

\-----

Of course I'm sure people will now respond with how these drugs saved their
life and without them they'd be homeless, in prison, etc. To these people I
have a simple logical question. Let's assume this is true that you would
indeed be homeless, in prison, etc without these drugs. We now see these drugs
numbers are absolutely skyrocketing to the point that sizable chunks of our
entire population are on them. So if we go back in time, why don't we see
skyrocketing prison/homelessness/etc as a consequence of people not being able
to have these drugs? Given the exponential increase in prescribing rates you
don't need to go back far. We should be able to see huge and causably linked
differences just over the last decade or two.

[1] - [https://fivethirtyeight.com/features/dear-mona-how-many-
adul...](https://fivethirtyeight.com/features/dear-mona-how-many-adults-take-
adhd-drugs/)

~~~
RickS
The realities are a lot more mundane than your last paragraph tries to paint
them. I was 29 when I finally got treatment (therapy + low dose of adderall).
I had been making 100k for years. It's perfectly possible to have an okay life
with ADHD.

But stuff falls through the cracks. You forget to brush your teeth. To pay
your bills. There was a year when I was making over 150k and every single
quarter, as often as was possible, my water got shut off to my house. I had to
shower at the gym and call the company with my tail between my legs and pay
over the phone and it was turned on 2 days later. I had the money. I had the
desire to pay the water bill. I just... couldn't. It was stupid. I felt like a
caveman, scared that a coworker in my open office would overhear this frantic
call and wonder WTF was wrong in my life that I couldn't pay my water bill.

I turned down promotions onto the manager track because it felt ethically
dubious to manage people when I couldn't even manage myself. Do you want a
person who can't remember to pay their water bill to be pulling the strings of
your career lader? I stayed on the IC Principal track to try and localize the
logistical fallout of my inabilities.

It's a little better now. It's not the difference between homelessness and
elon musk. It's the difference between a guy who pays his bills on time, has a
clean dishwasher, and goes to the dentist, versus a guy who is constantly
browbeaten by everyday life as the shit that most people think of as routine
and invisible derails you over and over in tragicomic ways.

I'm not sure what statistic would capture that. On paper, barring a decrease
in collections notices and faster email response time, I appear to be exactly
the same person.

But my life is better now. There are still cracks in the sidewalk – my life is
still pretty scattered, but you're not as likely to lose a leg when you trip
on one.

~~~
togedoge
This is my experience being diagnosed with ADHD at 29 as well. Things seemed
fine from the outside. Well paying, stable work. However, I had an incredibly
difficult ability to do anything that needed intrinsic motivation, and my
self-image began suffering as a result. I was constantly finding motivation
from external factors and/or fear of rejection/failure and/or adrenaline to
accomplish anything.

The first time I took a central nervous system stimulant (Modafinil as a
nootropic) I could suddenly book my dentist appointments, and book a doctor's
appointment to talk about mental health, and book holidays I'd been putting
off. And read several chapters of a book in one sitting. And make my bed and
remember to brush my teeth. And check in with friends I hadn't heard from in a
while. Normal life stuff. Is this what neurotypical people can do!? I wish my
frontal lobes had more activation and bloodflow by themselves.

My GP didn't understand how I could think I had a problem since I could
maintain a 9-5. My family compared me to my less "obedient" ADHD older brother
and never had me tested. I am pretty sure my mother has it but is in denial.

Dr. Russell Barkley has some great videos explaining how ADHD is an intention
disorder, and how knowing and doing are separate parts of the brain.

Thanks for sharing! There's a lot of misinformation about ADHD out there. I'm
glad that there are treatments that help right away (unlike most psychiatric
conditions).

------
LiterallyDoge
Can we stop drugging children and just give them a little more recess?

~~~
black6
When we sit children down to do low-grade, menial clerical tasks for eight
hours a day with minimal breaks, what do we expect?

~~~
vibrio
When we sit _adults_ down to do low-grade, menial clerical tasks for eight
hours a day with minimal breaks, what do we expect?

------
dawhizkid
Listen to Jordan Peterson on this topic...

~~~
x220
Why don't you quote him? I'll go ahead and summarize it for others: Jordan
Peterson, among other things, thinks that we are using drugs to alter the
brain structure of little children because they can't sit still for 6 hours a
day. He thinks it's harmful and we over-diagnose ADHD in children who act
naturally.

~~~
cma
Don't forget the part about lobster dominance structures apply to human
society.

