Is ADHD Real?

More than any other disorder, the legitimacy of a ADHD as a mental health diagnosis is questioned by armchair experts everywhere. Anyone who has ADHD themselves or has a child with ADHD has encountered family members and friends who are more than happy to share their belief that ADHD doesn’t actually exist – “I was hyper when I was a kid too, but I didn’t have ADHD. It’s just kids being kids.” “Kids are too coddled these days, so they don’t respect their teachers.” “If parents would just discipline their kids, then they wouldn’t behave this way.” “If kids didn’t spend so much time watching TV and playing videogames, then they wouldn’t have ADHD.”

Hearing these messages is especially difficult for parents of kids with ADHD. Parents face the challenge of not only having to cope with their child’s ADHD, but also having to defend their parenting choices and the very existence of the ADHD symptoms. For many parents, dismissive comments from friends and family also plant seeds of doubt, leading them to quietly wonder whether their parenting is in fact the problem, or if they did actually cause their child’s ADHD by allowing them to play too many videogames. In addition, these comments perpetuate the stigma that too often surrounds ADHD, and ultimately discourages people from seeking help for themselves or their child.

While public opinion about ADHD varies widely, the science behind ADHD is actually quite specific: ADHD is a real, brain-based disorder that manifests as difficulty with concentration, organization, impulse control, and hyperactivity. Through brain imaging studies scientists are now able to identify parts of the brain that develop and function differently in individuals with ADHD (see my previous post on brain differences in with ADHD).

What causes ADHD?

Researchers are continually developing a more sophisticated understanding of why some people develop ADHD and others do not. The science shows us that the number one factor contributing to the development of ADHD is not watching too much TV or playing too many videogames, or parenting style or the food someone eats. It’s genetics. A person’s genes make up about 80% of their risk for developing ADHD. The other 20% likely comes from other “environmental” or health-related factors, like exposure to nicotine in utero, being born prematurely, being exposed to lead, etc. While factors like screen time, parenting style, teaching style, and diet don’t cause ADHD, research show that they can affect the severity of ADHD symptoms. So, growing up in a structured home environment, attending high quality schools, spending limited amounts of time playing videogames and watching TV, and eating a healthy diet can all help with the management of ADHD symptoms. These protective factors may even change the way the brain develops over time, leading to a less severe course of ADHD overall.

With so much evidence showing that ADHD is real, why do people question the diagnosis?
For starters, ADHD symptoms exist on a spectrum, and everyone as moments or days when they are less focused than they’d like to be or find themselves struggling to sit still. So, on an individual level, people without ADHD don’t fully understand that their periodic symptoms are far less severe than the chronic symptoms experienced by those with ADHD. As a result, they struggle to comprehend why it is that a person with ADHD can’t simply “make themselves” focus or stop fidgeting. On a societal level, we believe that parents and teachers should be able to control a child’s behavior. And, we fundamentally believe that all children and adults can be focused and organized when they choose to apply themselves. Individual weaknesses in these areas are rarely discussed or accepted as valid challenges faced by people with ADHD.

There may be times when it seems like everyone has a different opinion about whether or not ADHD really exists – but the scientific evidence doesn’t waiver. ADHD is a brain-based disorder that has a very real impact on the lives of children and adults, as well as their families. Parenting and teaching styles, screen time, and diet don’t cause ADHD to develop, but intervening in these areas can have a positive impact on symptoms and the trajectory of ADHD over time.

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