“[It’s] like having the Library of Congress in your head, but with no card catalogue.”
This is what it feels like to have Attention Deficit Hyperactivity Disorder (ADHD), according to one sufferer. Melissa Orlov, an author of two books on the subject, writes about this response in an article for Psychology Today. The statement, she suggests, shoots a hole in the common myth that people with ADHD are just lazy. “Think about how hard it would be to get organized—a Herculean task!” she writes.
The idea of 838 miles of bookshelves in your brain without a roadmap is terrifying, and it’s an issue that, according to a new study from the Journal of Clinical Psychiatry, more kids than ever are facing. Published Tuesday afternoon, the study found a 43 percent increase in ADHD diagnoses among kids aged 5 to 17, with sufferers now making up 12 percent of the school-aged population.
The data in Cleary’s study came from the National Survey of Children’s Health—a CDC-sponsored survey to catalog the “physical and emotional health” of kids under the age of 18.
Lead researcher Dr. Sean D. Cleary, a professor of epidemiology and biostatistics at George Washington University’s Milken Institute School of Public Health, said it was the spikes among subgroups that were particularly compelling—namely: girls and Hispanics.
According to the science world, ADHD has been around for centuries. An early pioneer on the condition was a British doctor named Sir George Frederic Still. Known as the “father of British pediatrics,” Still gave lectures in the early 1900’s on what he referred to as an “abnormal physical condition in children.” Characterized by an inability to self-regulate, he described symptoms ranging from “outbursts of rage” to an “abnormal incapacity for sustained attention.”
It wasn’t until 1968 that the American Psychological Association officially recognized the disorder, which it then referred to as “hyperkinetic impulse disorder.” With the publishing of the DSM-III in 1980, the condition was renamed ADD (Attention Deficit Disorder). Seven years later it was given the name still in use today: attention deficit hyperactivity disorder (ADHD).
Today the APA defines ADHD as “a behavioral condition that makes focusing on everyday requests and routines challenging.” Doctors generally recognize three different types: the predominantly inattentive type, predominantly hyperactive-impulsive type, and combination type.
As of 2011, 6.4 million kids in the United States had been diagnosed with ADHD, with an average age of diagnosis of 7 years old. According to the Centers for Disease Control and Prevention, boys are 13 percent more likely to be diagnosed with the disorder than girls—which, if Cleary’s study is any indication, is not indicative of how many girls actually have it.
According to Cleary’s study, the increase in ADHD diagnoses among girls and Hispanics surpassed the overall population. Over the course of the 8 years, the number of girls diagnosed with ADHD increased 55 percent—from 4.3 percent to 7.3 percent. In the Hispanic population, the number increased a staggering 83 percent.
Dr. Stephanie Sarkis, one of the first to study girls with ADHD in depth, says the implication that because boys are more likely to be diagnosed means they are more likely to have the disorder is false. “Girls tend to be seen as not having it or having less of it when it’s really just as prevalent,” she tells The Daily Beast.
In the mind of some experts, the lower rate of diagnosis in girls reflects a difference in the way the disorder manifests in each gender. In other words, boys with ADHD are more likely to be carrying on antics in the classroom and girls are more likely to struggle with concentration.
While it’s true that the condition can look differently in girls and boys, Sarkis believes that the issue is more nuanced than a “boy version” and “girl version” of ADHD.
“There is no one dominant type per gender,” she says. If anything, Sarkis suggests the way ADHD manifests differently in boys and girls—and thus is often missed in the latter—boils down to societal norms. “When girls speak out in class they're told not to do that,” she says. “When boys speak out in class, or are otherwise disruptive, their peer group reinforces it.”
That’s not to say that ADHD in boys and girls is identical; studies on the brain makeup of male and females with ADHD have found marked differences. Girls with ADHD, for example, have quicker connections of neurons than boys with the disorder. Whether or not girls are more prone to a certain type or are more likely to exhibit less-noticeable symptoms is unclear.
What research has clearly shown is a dangerous link between ADHD in girls and social issues. A recent paper Harvard University’s Dr. Joseph Biederman—one of the most studied on this topic—found girls with ADHD to be more susceptible to mood disorders such as depression and anxiety, as well as low self-esteem.
Another study from UC Berkeley found that girls with ADHD between the ages of 17 to 24 to be at higher risk to self harm and attempt suicide. Due to these dangerous potential links, Sarkis and others are working to help the science world get a better grasp on how the disorder affects women—and why.
Until then, Sarkis says the best treatment remains stimulants and cognitive behavioral therapy, which are more effective when done in tandem. The new research, she says, is promising in terms of awareness, but does not signal the end of the road. “ADHD is still under-diagnosed,” she says. “There's a lot more that we want to know.”