Why Does Everyone Suddenly Have ADHD?

Summary

The video script discusses the significant rise in ADHD diagnoses, particularly among adults, with a 123% increase from 2007 to 2016 and a 30% increase in prescriptions from 2020 to 2022. It highlights concerns over technology startups offering quick diagnoses and the potential over-prescription of ADHD medication. The script also addresses historical biases in ADHD research, focusing on hyperactive boys and overlooking groups like women and ethnic minorities. Changes in diagnostic criteria have improved inclusivity, but the video raises questions about the role of technology in mental health and the need for comprehensive healthcare over tech-driven solutions.

Takeaways

• 📈 Between 2007 and 2016, ADHD rates in adults increased by 123%, and ADHD prescriptions rose by 30% from 2020 to 2022.
• 💊 Multiple countries have reported shortages in ADHD medication, indicating a growing demand.
• 🌐 The internet plays a role in the perception of ADHD, with some content suggesting that viewers might have ADHD.
• 👨‍⚕️ ADHD was first described by Dr. George Still in 1902 and officially defined in the DSM-III in 1987, with subsequent updates changing its understanding.
• 🔄 ADHD is categorized into three subtypes: inattentive, impulsive, and a combination of both.
• 🤔 Having ADHD symptoms does not automatically mean one has ADHD; a medical professional's assessment is necessary.
• 🚫 Tech startups offering online ADHD assessments have faced criticism for overprescribing medication and prioritizing customer retention over health.
• 💼 Cerebral, a tech startup, was sued for allegedly focusing on prescribing stimulants to retain customers and for privacy violations.
• 👩‍⚕️ Historical ADHD research has been biased towards hyperactive boys, leading to an underrepresentation of other groups like women and adults.
• 📚 The DSM-5 updated the age threshold for ADHD symptoms to appear, allowing for more accurate diagnoses, especially in adults.
• 🌐 The internet may exacerbate ADHD symptoms in individuals, but there's little evidence that it directly causes ADHD.

Q & A

What was the increase in ADHD rates among adults between 2007 and 2016?

The ADHD rates among adults increased by 123% between 2007 and 2016.

How much has the rate of ADHD prescriptions increased from 2020 to 2022?

The rate of ADHD prescriptions has gone up by 30% from 2020 to 2022.

What is the role of Dr. George Still in the history of ADHD?

Dr. George Still, a famous pediatrician, described ADHD symptoms in 1902 as a 'morbid defect of moral control', marking an early recognition of ADHD-like symptoms.

What is the DSM and how does it relate to ADHD diagnosis?

The DSM (Diagnostic and Statistical Manual of Mental Disorders) is a book used by psychologists and psychiatrists to diagnose mental disorders, including ADHD, which was officially defined in its third version in 1987.

What are the three subtypes of ADHD?

ADHD is divided into three subtypes: the inattentive kind, the impulsive kind, and a combination of both.

What are some symptoms of ADHD?

Symptoms of ADHD include difficulty sustaining attention to tasks, being easily distracted by extraneous stimuli, forgetfulness in daily activities, excessive talking, blurting out answers, and reluctance to engage in tasks requiring sustained mental effort.

Why is online diagnosis of ADHD potentially problematic?

Online diagnosis of ADHD is problematic because it often lacks the comprehensive assessment by a medical professional and can lead to over-prescription and misdiagnosis, as seen with companies like Cerebral.

What concerns have been raised about the practices of some tech startups in ADHD treatment?

Tech startups like Cerebral have been criticized for over-prescribing stimulant medications to retain customers and for selling patient data to advertisers, raising ethical and privacy concerns.

How has the understanding and diagnosis of ADHD changed over the years?

The understanding and diagnosis of ADHD have evolved significantly, with the DSM-5 updating the age threshold for symptom onset to 12 years old, recognizing ADHD in adulthood, and allowing co-occurrence with other conditions like autism.

What is the gender dynamic in ADHD diagnosis?

Women are still less likely to be diagnosed with ADHD than men, with a current ratio of 2:1, despite evidence suggesting no significant biological difference predisposing men over women to ADHD.

What is the relationship between the internet and ADHD?

While there is a link between ADHD and internet addiction, it is not causal. The internet can exacerbate symptoms that appear in everyone, but there is little evidence to suggest it directly induces ADHD.

Outlines

00:00

📈 ADHD Trends and Concerns

This paragraph discusses the significant increase in ADHD diagnosis rates among adults between 2007 and 2016, with a 123% rise, and a 30% increase in ADHD prescriptions from 2020 to 2022. It highlights the extreme nature of the issue, leading to medication shortages in multiple countries. The paragraph also touches on the potential over-diagnosis facilitated by online platforms, which may not provide comprehensive assessments, and the ethical concerns surrounding tech startups in ADHD treatment, such as Cerebral, which has been accused of prioritizing customer retention over patient health.

05:02

👩‍⚕️ Gender and Ethnic Disparities in ADHD Diagnosis

The second paragraph delves into the gender dynamics of ADHD diagnosis, noting the current 2:1 male to female ratio despite a lack of clear biological differences. It discusses the historical focus of ADHD research on hyperactive boys and the recent shift towards understanding adult ADHD. The paragraph also addresses the under-diagnosis of ADHD in women, particularly those with inattentive ADHD, and the challenges faced by intelligent individuals and those from ethnic minorities in receiving a diagnosis. It mentions the changes in DSM-5, which expanded the age criteria for symptom onset and acknowledged ADHD's persistence into adulthood, potentially leading to a more accurate diagnosis rate.

10:03

🌐 The Impact of the Internet on ADHD Perception

The final paragraph explores the relationship between internet use and ADHD, suggesting a correlation between internet addiction and ADHD rather than a causal link. It critiques the notion that the internet is causing ADHD, instead arguing that it may exacerbate existing symptoms in individuals. The paragraph emphasizes the importance of accurate ADHD diagnosis and treatment, advocating for healthcare over tech-based solutions. It also discusses societal changes that have influenced the perception and diagnosis of ADHD, drawing a parallel to the historical increase in left-handedness acceptance. The speaker expresses concern over technology companies' involvement in healthcare and the need for comprehensive treatment options, concluding with a call for more open discussions on mental health.

Keywords

💡ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms such as inattention, impulsivity, and hyperactivity. In the video, ADHD is central to the discussion as it explores the increase in diagnosis rates, the role of technology in diagnosis, and the societal implications of these trends. The script mentions that ADHD rates have increased by 123% in adults between 2007 and 2016, and there's a concern about the over-prescription of ADHD medication.

💡DSM

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a publication by the American Psychiatric Association, which provides a common language and standard criteria for the classification of mental health disorders. In the video, the DSM is mentioned as the authoritative source that officially defined ADHD in 1987 and has since undergone updates, affecting how ADHD is understood and diagnosed, including the recognition of adult ADHD and the change in the age criteria for symptom onset.

💡Inattentive type

This refers to one of the three subtypes of ADHD characterized by symptoms such as difficulty sustaining attention, being easily distracted, and forgetfulness. The video discusses how the inattentive type of ADHD is often overlooked, especially in women and intelligent individuals, and how societal changes and diagnostic updates have led to an increase in diagnoses, particularly among women aged 23 to 49.

💡Impulsive type

This subtype of ADHD is characterized by symptoms such as talking excessively, blurting out answers, and avoiding tasks requiring sustained mental effort. The video script uses this term to illustrate the different presentations of ADHD and how they are perceived and diagnosed differently, contributing to the broader conversation about the complexities of ADHD diagnosis and treatment.

💡Combination type

This refers to a subtype of ADHD where individuals exhibit a combination of inattentive, impulsive, and hyperactive symptoms. The video script mentions this subtype to highlight the diversity in ADHD presentations and how the understanding of ADHD has evolved over time, leading to more comprehensive diagnostic criteria.

💡Technology startups

The video discusses the role of technology startups in the diagnosis and treatment of ADHD, raising concerns about their practices. It mentions companies like Cerebral, which have been criticized for prioritizing customer retention over patient health and for allegedly over-prescribing stimulant medications. The script suggests that these companies may be contributing to the rise in ADHD diagnoses and medication prescriptions.

💡Gender dynamic

The video addresses the gender disparity in ADHD diagnosis, noting that women are historically less likely to be diagnosed than men. It discusses how societal perceptions and research biases have historically focused on hyperactive boys, leading to an underdiagnosis of ADHD in women and other groups. The script highlights the importance of recognizing and addressing these disparities to ensure equitable access to diagnosis and treatment.

💡Ethnic differences

The video script points out ethnic disparities in ADHD diagnosis, such as Black children in the US being historically less likely to receive a diagnosis despite showing symptoms at similar or higher rates. This keyword is used to illustrate the systemic biases that can affect who gets diagnosed and treated for ADHD, emphasizing the need for more inclusive and equitable healthcare practices.

💡Internet addiction

While not directly causing ADHD, the video suggests a link between ADHD and internet addiction, where individuals with one condition are more likely to have the other. The script discusses how the internet can exacerbate symptoms that are common to everyone, such as attention and focus issues, but cautions against simplistic conclusions that the internet is causing ADHD.

💡Co-occurring conditions

The video mentions that before 2013, it was impossible to be diagnosed with both autism and ADHD, as they were seen as mutually exclusive. However, the updated DSM-5 acknowledges that ADHD can co-occur with other conditions, leading to a rise in diagnoses. This keyword is used to discuss the complexity of mental health diagnoses and the importance of recognizing that individuals can have multiple conditions.

💡Mental health awareness

The video concludes with a call for more open discussions about mental health, including ADHD. The script suggests that while the widespread use of the term ADHD can lead to overgeneralization, it also opens up conversations that can lead to greater understanding and inclusivity regarding mental health issues.

Highlights

ADHD rates have increased by 123% in adults between 2007 and 2016.

ADHD prescriptions have risen by 30% from 2020 to 2022.

Multiple countries have reported medication shortages due to increased ADHD diagnosis.

The internet is filled with content either diagnosing or seemingly promoting ADHD.

ADHD symptoms have been known for centuries, but the term ADHD was officially defined in 1987.

ADHD is categorized into three subtypes: inattentive, impulsive, and combined presentations.

A medical professional's assessment is required for an ADHD diagnosis, not just the presence of symptoms.

Technology startups promise ADHD assessments in under 30 minutes, raising concerns about accuracy and ethics.

Cerebral, a tech startup, was valued at $4.8 billion but faced lawsuits over unethical practices.

Some virtual health platforms have been accused of over-prescribing stimulants to increase customer retention.

Traditional healthcare providers do not show the same over-prescription issues as tech startups in ADHD treatment.

Gender dynamics play a role in ADHD diagnosis, with women historically underdiagnosed.

Historically, ADHD research focused on hyperactive boys, neglecting other presentations and demographics.

Recent years have seen a significant increase in ADHD diagnosis among women aged 23 to 49.

Changes in DSM-5 have expanded the age of symptom onset and acknowledged ADHD in adulthood and co-occurrence with autism.

The rise in ADHD diagnosis may be due to better recognition rather than an actual increase in prevalence.

The internet is linked to ADHD and internet addiction, but there's no evidence that the internet causes ADHD.

Concerns about technology companies filling healthcare roles and the potential over-prescription of medication.

The importance of discussing mental health and ensuring access to comprehensive treatment options.

Transcripts

between 2007 and 2016 ADHD rates have

increased by

123% in adults the rates of ADHD

prescriptions have gone up by 30% just

from 2020 to 2022 and this problem is

getting so extreme that multiple

countries have actually reported

shortages in medication and like to be

honest if you spend 15 minutes on the

internet you'll either find a video that

tries to convince you that you've got

ADHD or a video that feels like it's

trying to give you ADHD so it can feel

like maybe everyone has ADHD today but I

do want to investigate this because

there are some great successes that

we've made in the last few decades but

also some areas of concern some things

that worry me and some things that you

should probably be aware of first of all

I mean we need to start with like what

is ADHD depends who you ask right we've

known about ADHD like symptoms for

hundreds of years but I think a useful

place to start is 1902 with Dr George

still who was a really famous

pediatrician he described ADHD symptoms

as a morbid defect of moral control

which is so extra not exactly the most

like comprehensive description but if we

fast forward to 1987 ADHD became like an

official term in this book the DSM the

DSM is like the book that psychologists

and psychiatrists use to diagnose people

and in the third version it was

officially defined it's since gone

through two more updates and each of

these have progressively changed how we

understand ADHD today it's divided into

into three different subtypes three

different presentations the inattentive

kind the impulsive kind and a

combination so this is obviously you

know not medical advice you should

actually see a doctor if you want

medical advice but these are a few of

the symptoms of ADHD has difficulty

sustaining attention to tasks or play

activity is easily distracted by

extraneous stimuli is forgetful in daily

activities talks excessively blurts out

an answer before a question is been

completed or avoids dislikes or is

reluctant to engage in tasks that

require sustained mental effort all of

which uh you know somewhat relatable and

here in is where we have our our first

problem right because simply having

these symptoms doesn't mean that you

have ADHD typically you need to also

have an actual assessment by a medical

professional who can tell you whether or

not your case is legitimate that is

unless you decide to to go online

because people are struggling to Access

Medical Care in actual hospitals they're

turning to these technology startups who

are promising to be able to do that in

just under half an hour however the

promise that they make is actually not

not great and you'll see quite quickly

that these guys are like the poster

child for everything wrong with ADHD

treatment at the moment if there's one

thing we know about technology companies

is that they have the Public's best

health interests at heart I just want to

talk to you about this company cerebral

this company has actually been valued at

around $4.8 billion they've also been

sued by their own vice president of

engineering who alleged that the CEO was

tracking whether giving people stimulant

medication would keep them as loyal

customers this is crazy this is a direct

quote from this lawsuit when cerebral

determined that the patients who were

prescribed stimulants were more likely

to remain customers the CEO directed

employees to find ways to prescribe

stimulants to more ADHD patients to

increase retention unsurprisingly this

same company was also finded $7 million

over careless privacy violations which

means that they were selling patient

data to advertisers d health another

virtual prescriber has been in similar

trouble the founder and CEO has been

arrested and is on trial with the

Department of Justice in the USA so this

is another quote from this lawsuit that

was filed by the American government the

CEO and president allegedly obtain

subscribers by targeting drug Seekers

and spending tens of millions of dollars

on deceptive advertisement on social

media networks they also allegedly in

intentionally structured their platform

to facilitate access to adol and other

stimulants including by limiting the

information available to the prescribers

instructing their prescribers to

prescribe adol and other stimulants even

if the member didn't qualify and

mandating that the initial encounters

would be under 30 minutes interestingly

enough you'll see that if virtual Health

appointments are carried out by actual

hospitals then they don't have the same

problem of over prescribing medication

it's purely a problem with tech startups

That masquerade as healthcare companies

but ADHD rates have been rising for long

before this it's been a trend for

several decades whereas these companies

have simply Arisen in the last few years

and if we do consider this this question

from a few different other angles we get

a conclusion that feels a lot more

comprehensive and that reveals a lot of

a lot of big positives actually in the

space it's really important to consider

the gender dynamic because the reality

is women are still today far less likely

to be diagnosed than men currently the

ratio is 2:1 and yet there seems to not

be too much evidence that there's

actually a biological difference that

predisposes men towards ADHD than women

and if we look at what you know

researchers say about this we find that

there's a really big problem in how

we've actually researched ADHD over the

last few decades this is Dr Kathleen

nedu the director of the Chesapeake

Center on ADHD learning and Behavioral

Health and she talks a about the the

history of ADHD research and the changes

that have happened pretty significantly

over the last few decades she says that

historically research on ADHD has

focused almost exclusively on

hyperactive little boys and only in the

past six or seven years has any research

focused on adult

ADHD and this kind of tracks a lot with

what we think of as the general

perception or the general stereotype of

what ADHD looks like the hyperactive

little boy in a classroom and this isn't

just like a social stereotype it's

something that affects actual research

in clinical studies the male to female

ratio is actually around 4 to one so

even if men men are twice as likely to

have ADHD in general in actual research

men are even more over represented which

has had kind of like a a

self-reinforcing effect right this

tracks with the fact that a lot of this

rise is especially amongst women the

percentage newly diagnosed between 23 to

49 has nearly doubled just between 2020

and 2022 a few days ago I made a

community post asking members of the the

community what their experience was

getting diagnosed and I just copied one

comment from Ruth who described her

experience and she says that I got

diagnosed at 24 it took me 3 years of

seeking help and failing College to

finally get diagnosed because the nurse

practitioner was refusing to believe me

she kept telling me that I just had

childhood trauma and depression as if I

can't have those things and ADHD

eventually I had to seek out someone

else and pay out of pocket to get

diagnosed I fit the diagnosis for

inattentive ADHD almost completely but I

think it was missed because I never

caused any problems at school as a kid

and my parents didn't know enough or

care I'm not on any medications at the

moment but I'm hoping to within the next

couple of months we've had this huge

problem for decades where certain groups

have simply been ignored by medicine

effectively one of those groups is just

women in general who are more likely to

have the the inattentive kind of ADHD

the education system is really bad at

spotting inattentive ADHD or ADHD in

people who are more intelligent because

it's less likely to be a problem when

they're younger and much more likely to

be a problem once they're older and we

have a similar problem when we look at

ethnic differences so for example black

children in the US are historically 70%

less likely to get a diagnosis even

though they seem to show symptoms at at

least a similar rate if not more

frequently but there there's also been

some some changes in our definition of

ADHD and it's been able to capture a lot

of people who would have been otherwise

missed out by by doctors so in 1994 the

DSM 4 was published and this was the

guide book for psychologists for almost

20 years and one of the Key conditions

for being diagnosed is that symptoms

needed to appear first before the age of

7 years old and there were a few

problems with this well first of all if

symptoms need to appear before the age

of seven then it almost certainly needs

to be a parent or a caregiver that first

notices

because I think the average person can't

really remember how they behaved that

well before the age of seven this meant

that people who didn't have strong

support systems at home or retentive

teachers would be completely ignored

they physically couldn't be diagnosed

with it however in 2013 almost 20 years

later this diagnostic manual was updated

the threshold for when symptoms need to

first appear was increased to 12 years

old this is a like a really good change

because it means that people who might

not have a stronger support system could

still be diagnosed with ADHD because a

lot more of us remember our lives before

the age of 12 than we do before the age

of 7 this dsm5 also acknowledged the

fact that ADHD could continue into

adulthood for a long time it was simply

believed that it was something you could

grow out of and the diagnostic manuals

seem to kind of reinforce this idea some

people learn coping strategies some

people learn masking techniques but

adult ADHD rates are rising much more

quickly than childhood ad ADHD

and importantly before 2013 it was

actually impossible to be diagnosed with

both autism and ADHD you had to have one

or the other autism and ADHD have a

strong tendency to co-occur so a lot of

people who have one have the other as

well there's a there's a really strong

chance that this rise in diagnosis is

something similar to the rise in the

rate of left-handedness between the

early and mid 1900s nothing changed in

human genetics but there were simply

some huge societal changes it could be

very possible that we're just actually

Bridging the Gap between the actual

percentage and the under reported

percentage that we've had for all of

human history thus far but we we do have

to talk about the internet as well

because it is clearly affecting our

minds and it's clearly affecting our

attention spans even anecdotally but

yeah is the internet giving us ADHD well

there is a link between ADHD and

internet addiction this is not a causal

link right it doesn't say that ADHD

causes internet addiction or that

internet addiction causes ADHD simply

that if you have one you're more likely

to have the other it seems like there's

very little evidence to suggest that the

internet is inducing ADHD one of the

problems with the internet though is

that it can induce symptoms which can

appear in anyone if we go back to some

of the symptoms we can see that these

are things that to some extent everyone

struggles with right everyone struggles

at some point with attention focus

yapping but to suggest that the internet

is giving people ADHD is different than

suggesting that it's exacerbating the

symptoms which appear in everyone the

real question we're asking here is will

people get better if they just stop

using the internet whereas if you are a

person who has ADHD even not engaging

with the internet will still not cure

all of those symptoms what ADHD shows is

that the definitions are constantly

changing and so this feeling that

everyone has ADHD is I mean

categorically not true because there are

huge groups of the population that still

being left behind today and that don't

have access to the treatment that they

need and where I personally have

concerned

is in the fact that we are letting

technology companies fulfill the rule

that healthcare companies should be

doing I'm not anti medication or

anything I just think that people should

have access to the full spectrum of

possible treatments that a qualify

Doctor Who can give them the time and

attention that they deserve would

provide in general we have to accept

that ADHD has been adopted into our

vocabulary at large and the difficulty

is really you can't control how and when

people use words but more generally I'm

always going to pick the path that leads

to more people talking about mental

health because that path is more

inclusive and more likely to get people

to actually investigate

[Music]