Stephen Hinshaw, professor of psychology at the University of California at Berkeley and UCSF, and a global expert on Attention Deficit Hyperactivity Disorder, and Katherine Ellison, a Pulitzer prize-winning journalist and author who was diagnosed with ADHD at 48, have teamed up to write ADHD: What Everyone Needs to Know. The book is an authoritative and engaging look at one of the most controversial health issues of all time, affecting an estimated 6.4 million children (one in nine) and close to 10 million adults.
Hinshaw and Ellison explain the brain chemistry that causes ADHD, how a parent can get a diagnosis, and why it’s important to diagnose ADHD early. They take an impassionate approach to the question of taking drugs, but also discuss other approaches to controlling it, such as counseling and exercise – all in an easy to understand Q&A format.
The dedication gives a hint at the sense of humor that also pervades the book:”We dedicate [the book] to anyone who has ever wondered whether the occasional joy of spontaneity are worth the annual costs of replacing lost sunglasses, keys, and cell phones, and to everyone willing to make the effort to understand, appreciate, and occasionally forgive the blessings and challenges of neurodiversity.”
Hinshaw and Ellison will be talking about the book and ADHD at Books Inc. at 1491 Shattuck Ave. on Thursday, Feb. 11 at 7 p.m.
Berkeleyside: Isn’t ADHD just an excuse for bad parenting, lazy, bratty kids, and pill-poppers?
Hinshaw and Ellison: This is a prevalent myth — and one we spend a lot of time debunking in our book, in interviews, and in our public talks. Despite the skepticism and the stereotypes, substantial research has shown that ADHD is a strongly hereditary neurodevelopmental disorder. The quality of one’s parenting doesn’t create ADHD — although it can influence a child’s development — and children with this condition are not lazy but instead handicapped in their capacity to focus attention and keep still.
Well, is it then a ploy by pharmaceutical firms to sell more stimulants?
Pharmaceutical firms have worked hard to expand awareness of ADHD as they pursue profits in a global market last estimated at $11.5 billion. But they didn’t create the disorder. Moreover, studies have shown that stimulant medications — the most common treatment for ADHD — can be quite helpful for many people with the disorder and are generally safe when used as prescribed. Our position on medication boils down to this: there is no “magic bullet,” and medication should be used with caution, due to potential side-effects and valid concerns about dependency. But you shouldn’t let Big Pharma’s sometimes remarkably aggressive tactics dissuade you from trying medication if a doctor says you need it.
Is modern society’s obsession with checking Facebook and Twitter giving us ADHD?
Everyone in modern society is facing a new world of devices, social media, and demands for rapidly shifting attention. It’s quite possible that the evolution of technology is moving faster than our brains’ capacity to adapt. Still, it’s important to make a distinction between distraction that can be controlled by turning off your email versus genuine ADHD, which arises from the brain’s inefficient processing of important neurochemicals including dopamine and norepinephrine. While most of us today are facing environmentally caused problems with distraction, people with ADHD are at a significant disadvantage.
How fast have US rates of ADHD been increasing, and why?
The short answer is: really fast. U.S. rates of ADHD were already high at the turn of the millennium, but since 2003, the numbers of diagnosed children and adolescents have risen by 41%. Today, more than 6 million youth have received diagnoses. And the fastest-growing segment of the population with respect to diagnosis and medication treatment is now adults, particularly women.
The current numbers are staggering: For all children aged 4-17, the rate of diagnosis is now one in nine. For those over nine years of age, more than one boy in five has received a diagnosis. Among youth with a current diagnosis, nearly 70% receive medication. U.S. rates are significantly higher than anywhere else in the world.
What might be causing some of the high rates in the United States?
One issue that seriously concerns us is the likelihood of overdiagnosis in some parts of the country. The danger of over-diagnosis is heightened by the fact that determining whether someone has ADHD remains a somewhat subjective process, in that, like all mental disorders, there is no blood test or brain scan that can decisively determine it.
“Gold-standard” clinical processes, which include taking thorough medical histories and gathering feedback from family members and teachers, can guard against overdiagnosis, but all too often the diagnosis is made in a cursory visit to a doctor.
What danger might there be of underdiagnosis?
The same quick-and-dirty evaluations that fuel overdiagnosis can also lead to missing ADHD when it truly exists. That is, the clinician who insists that he or she can detect ADHD in a brief clinical observation may overlook the fact that children and adults may act quite differently in a doctor’s office than they do at school or in the workplace. This is equally concerning, because whereas over-diagnosis may lead to over-treatment with medication, underdiagnosis means children who truly need help aren’t getting it.I keep hearing that ADHD is a “gift.” What does that mean?
Some people are now characterizing ADHD as a “gift.” What does that mean?
Celebrities including the rapper Will.i.am, and business superstars such as Jet Blue founder David Neeleman, have talked about the advantages of having ADHD in terms of creativity and energy, and many ADHD advocates have championed the idea that the condition is a “gift.” We support the idea of ADHD as a kind of neuro-variability that in some contexts, and with the right support, can offer advantages. But do look this gift-horse in the mouth: ADHD can also be a serious liability, and needs to be managed throughout a lifetime. Consider the Olympic swimmer Michael Phelps, who rose to stardom only to be embarrassed by drug and alcohol problems. Longitudinal studies show that people with ADHD on average suffer significantly more problems with addiction, accidents, divorces, and academic and employment setbacks than others. ADHD is serious business.
Listen to a KPFA podcast with Hinshaw.
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