If you’re unfamilar with The New York Times “Room for Debate” series, the paper floats a question to a panel of experts around a topic. Then, each expert addresses the question based on their research, position & perspective in the field.
“Are Americans More Prone to A.D.H.D.?” is a recent “Room for Debate” question.
ADHD rages as a topic among educators, parents, and researchers. The experts’ responses in “Room for Debate” makes clear that ADHD diagnosis and treatment is far from a settled issue.
Is it a legitimate disorder? Is it even real? How come it skews in populations whose parents can afford a diagnosis? Are some mental illnesses social constructs? Suffice to say there are experts on all sides of the issue.
The NYT frames the discussion this way:
“For some conditions, perhaps wealth explains the disparity: in developing nations, more people are focused on pressing needs like food and shelter, making depression a “luxury disorder” in wealthy nations like the United States.
But are there other factors at play for conditions like attention deficit/hyperactivity disorder, that may be “culture-specific”? Maybe the condition is more common in the United States because the high-energy, risk-taking traits of A.D.H.D. are part of America’s pioneer DNA. Or maybe the same behavior is common elsewhere, but given another label? Some critics would argue that American doctors, teachers and parents are simply too quick to diagnose A.D.H.D. and medicate children. Do the American medical and educational systems inflate the numbers?”(NYT)
The NYT discussion includes views ranging from the true believing (Ned Hallowell), to the skeptic (Peter R. Breggin), to the race, gender and class lens (Donna Ford), to the nuanced (Ethan Watters).
I have to say I’m partial to the work and views of Ford and Watters. I really like the way that Watters works to get at the root of the issue:
“…The really mind-bending fact — the one that Americans can rarely seem to grasp — is that just because these disorders are culturally shaped does not make them necessarily less real. Those Victorian-era women really did faint and experience the paralysis, tics and fainting spells found in their symptom pool. Their unconscious learned, in short, to speak the language of suffering for their time.
In certain historical moments, a given diagnosis will hit such a resonant cultural note that it catches fire. This, I believe, is the story of A.D.H.D. Parents, teachers and mental health healers are critical parts of a feedback loop by which a child unconsciously apprehends their symptom pool. This is not to lay blame at anyone’s doorstep — a similar dynamic is in play with all mental illnesses. We won’t fully understand these illnesses until we add this knowledge to the mix, but that new understanding won’t magically make the disorders disappear.
Unfortunately, the debate about the “realness” or universality of a disorder like A.D.H.D. often distracts from a discussion of what might have given rise to the need for so many children to express distress. The underlying disquiet in the children of our time is more important than the symptom cluster that we declare as legitimate…”(NYT)