The ADHD Myth: A Selection from Johann Hari’s Stolen Focus (2022)

“Everyone being diagnosed with ADHD has a real problem. They aren’t making it up or faking it. Whatever the cause, if you or your child is struggling to focus, it’s not your fault; you’re not incompetent or undisciplined or any of the other stigmatizing labels that might have been applied to you. You deserve compassion and practical help to find solutions. Most experts believed that for some children, there can be a biological contribution to their poor focus—though they disagreed on how large a contribution that is. We should be able to have a calm and honest conversation about the other aspects of the ADHD controversy while holding these truths in our minds. . . .

With each passing year, the number of kids identified as having this problem has soared, to the point that in many parts of the South in the United States, 30 percent of boys are now diagnosed with ADHD by the time they turn eighteen. As I write, it is swelling even further—huge numbers of adults are now being told they have this disability, with over three million of them already being prescribed stimulants. The market for prescribed stimulants is now worth at least $10 billion. . . .

The huge rise in children being diagnosed with attention problems has coincided with several other big changes in the way children live. Kids are now allowed to run around far less—instead of playing in the streets and in their neighborhoods, they now spend almost all their time inside their homes or school classrooms. Children are now fed a very different diet—one that lacks many nutrients needed for brain development, and is full of sugars and dyes that negatively affect attention. Children’s schooling has changed, so it now focuses almost entirely on preparing them for high-stress testing, with very little space for nurturing their curiosity. . . .

When people hear a child has been diagnosed with ADHD, they often imagine this is like a diagnosis of, say, pneumonia—that a doctor has identified an underlying pathogen or illness, and is now going to prescribe something that can deal with that physical problem. But with ADHD, there are no physical tests a doctor can carry out. All she can do is talk to the child, and to people who know the child, and see if the kid’s behavior matches a checklist drawn up by psychiatrists. That’s it. Sami says: ‘ADHD is not a diagnosis. It’s not a diagnosis. It’s just a description of certain behaviors that sometimes occur together. That’s all it is.’ All you are saying, when a child has been diagnosed with ADHD, is that a child is struggling to focus. ‘It doesn’t tell you anything about the ‘why’ question.’ It’s like being told that a child has a cough, listening to the cough, and then saying ‘yes, the child has a cough.’ If a doctor identifies a child with attention problems, that should be the first step in the process—not the last. . . .

For years, lots of parents were told that you could figure out if your child has ADHD in a straightforward way, related to these drugs. Many doctors told them that a normal child would become manic and high if they were given these pills, whereas an ADHD kid would slow down, focus, and pay attention. But when scientists actually gave these drugs both to kids with attention problems and kids without attention problems, this turned out to be wrong. All children—indeed, all people—given Ritalin focus and pay attention better for a while. The fact the drug works isn’t evidence that you had an underlying biological problem all along—it’s just proof that you are taking a stimulant. . . .

In 2015, Aussies were in the middle of a severe spike in methamphetamine addiction. For a while, doctors weren’t sure how to respond. With heroin, there is a drug they could legally prescribe to addicted people that’s a reasonable substitute, methadone—but with meth, there didn’t seem to be one. So Nadine—along with a group of other doctors—was part of a crucial experiment, licensed by the government. They started to give people addicted to meth a stimulant that is prescribed over a million times a year in the U.S. for kids with ADHD . . . .

When they are given these stimulants, the people addicted to meth seemed to feel less craving, because it scratched some of the same itch . . . . She compared it to giving nicotine patches to smokers. . . . When Adderall and meth were given in similar ways in the lab, these people with long-standing meth addictions responded in almost identical ways.

Nadine’s program is a thoughtful, compassionate way to treat people with meth addictions—but I felt unsettled to learn that the drugs we give kids turn out to be a reasonable proxy for meth. Sami told me: ‘It’s a bit bizarre when you start realizing that we are prescribing legally the same substances that you are saying on the other hand are very dangerous to take if you take them illicitly. . . . They’re chemically similar. They work in a similar way. They work on very similar neurotransmitters.’”—Johann Hari, Stolen Focus: Why You Can’t Pay Attention—And How to Think Deeply Again (2022)