The number of children and adults in Australia using ADHD medication is on the rise. But questions are being raised about the controversial condition, with one US doctor saying it doesn't even exist.
The number of children and adults in Australia using medication for attention deficit hyperactivity disorder – ADHD – has steadily risen in the past five years, at a time when questions are being raised about the condition and how it is treated. One US doctor has gone as far as declaring the controversial condition 'does not exist'. So what is life really like for those living with ADHD?
When Rosie Mansfield was in her early twenties, she tried everything to relieve the excessive amounts of adrenalin she felt coursing through her body every day.
"I used to drink quite lot," Rosie, now 27, tells SBS. "I used to take quite a lot of drugs.
"When you go out on a night out, your friends are high energy. I went out quite a lot and I really went for it.
"My friends would feel out of control and I would feel normal because everybody was on my level.
"But they’d get to wake up in the morning while I’d still be on that level."
Rosie went to numerous doctors and psychologists to find out why she had so much energy. When she finally got an answer it came as a relief.
"When the psychologist confirmed it was ADHD, I understood what the problem was," she says.
A radical view
Attention Deficit Hyperactivity Disorder (ADHD) – as defined in the US Diagnostic and Statistical Manual of Mental Disorders (DSM) – is an attention disorder causing a functional impairment in its sufferers.
There are three sub-categories of the condition: inattentiveness, hyperactivity, or a combination of the two.
But despite growing rates of ADHD diagnoses around the world – there was a 26 per cent increase in the use of ADHD medication in Australia between 2009 and 2012 – there is still scepticism about the condition among some members of the medical community.
US behavioural neurologist Dr Richard Saul caused controversy this year with the release of his book ADHD Does Not Exist.
In the book he claims doctors are too quick to prescribe ADHD medication without investigating the true cause of their patients' symptoms.
"I don't believe ADHD is an actual medical condition. I believe it's just a bunch of symptoms," he tells SBS.
"ADHD is a great excuse for trying to get out of things: get out of doing homework, get out of doing your job correctly, explain why you’re having emotional problems."
"It's much more acceptable for a doctor to say ‘You have ADHD’ than to say 'You're psychotic,' or that you're depressed and look at whatever emotional condition might be behind that."
Dr Saul is also critical of the diagnostic process for ADHD, which is based around a checklist of symptoms set out in the DSM.
"There is not one condition in medicine for which we use a checklist and make a diagnosis. This one shouldn't exist either," he says.
Sydney psychologist Marika Donkin, of the Sydney Cognitive Development Centre, rejects the idea that ADHD isn't real.
"I don't understand how you can say that if someone can’t pay attention, can't sit still and can’t focus, and this is affecting their grades and affecting their family it’s not a problem or a disorder," she says.
Ms Donkin says she understands why there is confusion about the condition but says there are risks around rejecting its validity.
"If ADHD isn’t picked up early, I think the risk is that the person with the condition gets classified as the 'naughty' kid, the 'dumb' kid – so people aren’t really picking up what the core problem is, she says.
Sydney mother Kim Forrester has two children with ADHD and both take medication every day.
She says the decision to put them on medication was difficult but necessary.
"I don't want to medicate my children. I don’t feel comfortable medicating my children. But at the moment it seems to be the only way they can go to school and interact with the teachers and interact with the other children in a way they feel accepted," she says.
She acknowledges there is a definite stigma around the condition.
"That's the [one] thing I’m not overtly open about – the fact that my children take a tablet every morning just to 'fit in' during the day.
"I'm not ashamed of it but sometimes I just can't be bothered dealing with whatever that reaction is going to be."
Daughter Sarah, 11, says taking Ritalin has helped keep her focused at school.
"Before I took medication it was really bad," she says. "I got pretty bad with my reports. My tablet made it be all better."
Rosie Mansfield was also told to go on medication after her diagnosis.
"When I was diagnosed and then encouraged to go on medication, I was extremely resistant. I was always anti-meds," she says.
"But I got to a point where I was so low – to the point of wanting to take my own life – because the condition became too much for my body and mind and I needed help, so medication was most definitely the next thing.
"When you're in that frame of mind, you’ll welcome anything that will apparently help you and I’m so glad that I did it."
But Dr Saul is adamant that the majority of people being prescribed such medications do not need them.
"Medication for ADHD is a disaster, a total disaster," he says. "During the last year there were one million new prescriptions of stimulant medication for children. One million.
"Is it that the doctors really feel they need it? Or are their parents feeling they need a leg up, so to speak, with their focus to help them learn better?
"Or is it really because the drug companies are advertising so heavily and make billions and billions of dollars a year on these stimulant products?"
For Kim Forrester, the debate around ADHD is casting a shadow over the vulnerable people at its centre.
"I actually have no issue whatsoever with what it's labelled with," she says.
"My concern is that I’ve got two children who are loved and understood in the home, but they have a lot of trouble in school and they have a lot of trouble in society."
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