Four times as many people as almost twenty years ago currently use ADHD medication, according to figures from the CBS (Netherlands Statistics Agency) on Monday. Should ADHD always be treated with medication and is the diagnosis even always necessary?
ADHD, or attention deficit hyperactivity disorder, is a term that is widely used, including on social media. But it is important to realize that not everyone actually has the condition. One in twenty people in the Netherlands has ADHD, Professor Sandra Kooij tells NU.nl. “Not everyone actually has a diagnosis. And many people are not treated.”
Clients who do receive treatment are mainly people who are severely affected, says Kooij. She is a professor of ADHD at the Vrije Universiteit in Amsterdam. “Many also have relationship problems, sleep problems, mood swings or depression.”
Furthermore, more and more research shows that ADHD is also a medical condition, says Kooij. It turns out that people with ADHD are more likely to have, among other things, obesity, cardiovascular disease, migraines, allergies and dementia. “So it’s much more than just busy and impulsive behavior.”
For these people, the ‘label’ ADHD is therefore a means to get help. “For many, it is a recognition,” says psychiatrist Menno Oosterhoff. Kooij agrees. “People with ADHD have a harder time.” According to her, the increase in medication use is due to better treatment and recognition and more knowledge about the condition.
‘Labeling is getting out of hand and is not always beneficial’
According to Oosterhoff, it is important that a diagnosis becomes a recognition and not a conviction. “Psychiatry is not there to put a label on everything, but to signal problems.”
Yet that labeling sometimes gets out of hand, according to Carolien Hooijmans. She is an educational expert and focuses on the development and education of children. “The bandwidth of what we consider ‘normal behavior’ has been narrowed by various factors.”
According to Hooijmans, social media and the design of education have influenced the vision of ‘normal’. “For example, there are increasingly larger classes, which means there is less room for deviant behavior. Moreover, teachers are under greater pressure.”
Diagnosing children and young people with ADHD does not always work to their advantage, according to previously published research from the University of Groningen. Researcher Laura Batstra criticizes the so-called ‘disorder thinking’, in which she states that a child with “challenging behavior” is labeled and thus becomes a ‘problem child’. That can be stigmatizing.
Hooijmans recognizes that and has difficulty with the term ‘disorder’. “A diagnosis can have an impact on your self-image, among other things.” According to Hooijmans, it is important to look at what a child needs. She believes that mental health care should be more cautious and restrained in classifying. “To prevent us from problematizing behavior in children who are fully developing.”
Medication and more understanding
There is a lot of discussion about the term ‘disorder’. Kooij also understands that the term is unpleasant and sees that it can be stigmatizing. Yet she sees no real added value in removing labels. “We can do without those labels, but society simply does not accept busyness, being late and other impulsive behavior.”
Oosterhoff believes that the discussion overlooks the problem. “People with ADHD can suffer a lot from their condition and medication can greatly improve their well-being and functioning.”
Kooij agrees, but states that there is more than medication. Therapy also helps people with ADHD to better deal with additional problems.
Hooijmans recognizes that people can certainly benefit from medication. But she also thinks that we should have more understanding for behavior that may be “different than usual”. And that’s where the experts meet. Kooij: “We must stop seeing people’s conditions as a mistake or weakness and be a little gentle with each other.”