We’re supposed to believe the stunning rise in rates of ADHD diagnosis is simply a result of better detection methods and growing awareness
Every now and then, when I think back on my school days, distant memory though they may be, I ask myself, “What would I have been diagnosed with if I had been at school today?”
It’s not an idle question.
School life for my mates and me was blissfully untroubled by diagnoses of any sort. None of us had depression, anxiety, autism, ADHD or anything you’d find in a medical textbook or a TikTok PSA.
Of course, the full range of human experience was on display during those years. We skipped lessons and scrapped and chased girls and did our best to pay attention to anybody except the teachers, but none of us was ever taken to a doctor because our parents or teachers thought we needed to be medicated.
Which isn’t to say that there wasn’t some pretty worrying behaviour on display. For example, there was a boy who had such bad anxiety about his final exams—he was due to go to Oxford—that his parents had to take away the lightbulbs in his bedroom to prevent him from revising through the night. So he got a flashlight…
I suppose you could class that as pretty bad anxiety, but he got through it, in the end, without medication, and went off to the dreaming spires of Oxford.
Actually, now I think about it, there was a boy who joined later on, when I was about sixteen, who apparently did have an autism diagnosis. He really was like the Rain Man—not that any of us had seen that film, of course. When this chap wasn’t demonstrating his mathematical or IT wizardry, he was jamming his fingers in his ears and singing at the top of his lungs or windmilling punches through the changing rooms after sports practice. But as far as we were concerned, he was just a weird kid: somebody who might help you with your maths homework in exchange for a couple of slices of toast from the canteen, but not somebody you’d otherwise associate with.
One kid in a thousand.
How things have changed today.
A new study that I reported on earlier today shows that one in nine American children have now received a diagnosis of ADHD. That’s seven million children. What’s more, approximately a million more children aged 3-17 received a diagnosis in 2022 than in 2016. The rate of diagnosis is increasing—drastically.
The results of the new study were taken from analysis of the 2022 National Survey of Children’s Health. They show that the estimated prevalence of ADHD is significantly higher in the US than in other countries.
According to the study authors, increased awareness of the condition is probably the cause of the increase in diagnoses. That means there’s no reason to worry. We’re just discovering kids who have the condition but wouldn’t have been picked up five or ten or twenty years ago.
“Public awareness of ADHD has changed over time. ADHD was historically described as an externalizing disorder with a focus on easily observable hyperactive-impulsive symptoms, and was thought to primarily affect boys,” the authors say.
“With increased awareness of symptoms related to attention regulation, ADHD has been increasingly recognized in girls, adolescents, and adults. Moreover, ADHD has previously been diagnosed at lower rates among children in some racial and ethnic minority groups. With increased awareness, such gaps in diagnoses have been narrowing or closing.”
The authors also say that the pandemic is likely to have brought the condition into focus—which would explain the massive jump in diagnoses in 2022 as compared to 2016—because parents were forced to have their children at home and manage their education themselves. It was only then, the thinking goes, that parents realised their children had problems concentrating and motivating themselves while mummy and daddy work remotely from the room next door.
Forgive me, but I’m not convinced. For one thing, the conditions and stresses of the pandemic were unique and we can’t assume that any behaviour displayed by children during that unprecedented period of, well, mass psychological warfare was typical.
Of course young children, locked up in their homes, isolated from their friends, told they’re at risk not just of catching a deadly virus but spreading it to their loved ones and maybe killing them—none of which they could ever have hoped to understand—are going to act up. And most children, especially boys, don’t want to be in a classroom in the first place, let alone on the end of a six-hour Zoom call with their female teacher—whom they probably hate, with good reason—when the comforts of home are all around them.
If children suddenly appeared incapable of learning during the pandemic, it wasn’t because they had lost their minds: it was because the world around them had.
But even without the extraordinary events of the pandemic, which we know were a disaster for children’s mental and physical health across the board, it’s clear that the rise in rates of diagnosis of ADHD and other similar conditions is not “normal.” There is no reason to believe, as the new study’s authors want us to, that we’re simply diagnosing more people because diagnostic procedures and public awareness have improved.
I realise that this is a complex problem. I don’t think there’s a single explanation for the shocking rise in mental-health conditions among young people, or indeed for the rise of any form of ill health in the Developed World. But one place we could—and should—look is food.
American children between the ages of two and five now get 58% of their daily calories from ultra-processed food. The only place where young children eat worse is the UK, where a full two-thirds of calories for toddlers come from processed food.
This garbage, which some food scientists believe shouldn’t even be classified as food but instead as a “food-like substance,” has been linked to every single one of the prevailing diseases of modernity, from diabetes and obesity, to cancer and Alzheimer’s.
Barely a week passes without some new study warning us of the terrible effects of consuming even small quantities of processed food. One study I like to quote shows that lab rats fed processed food for just four weeks lose their memory and stop displaying “anticipatory fear” in response to danger cues, such as the scent of a cat.
Simply put, these foods are toxic to whatever animal has the misfortune to eat them.
Studies are now substantiating a clear link between processed-food consumption and autism and ADHD, mainly through disturbance of the gut microbiome, the vital ecosystem of microorganisms that populates our guts. Exactly how vital you can judge from the fact that experts now call the gut and its microbes “the second brain.” The microbes in our gut don’t just help digest our food: they regulate our hormones, including testosterone, and they release neurotransmitters that directly affect our moods and thought processes.
If you disturb the gut microbiome, you’re in for trouble, brain and body. And that’s exactly what processed foods, with their myriad additives and novel ingredients, do. Common colorings and anti-caking agents, for example, are extremely toxic to beneficial bacteria.
Studies show that children with disturbed gut microbiomes are more likely to display the symptoms of autism and ADHD. A large-scale study of 16,000 children in Sweden, for example, showed that disturbances to gut flora early in life are linked to later onset of both conditions. Another study shows that overgrowth of a common fungus in the gut, Candida albicans, again as a result of gut dysbiosis, may be implicated in ADHD.
Like I say, this is just one potential factor, but given the quantities of processed food children now eat, I’m prepared to say it’s likely to be an important one. There are probably a wealth of other factors contributing to this mess, not least of all the process of diagnosis, which isn’t anywhere near as objective as your average physician would like you to believe. Another recent study suggested that the youngest children in a school year are 80% more likely to be diagnosed with ADHD, probably because, being the youngest, they have a much harder time keeping up than the oldest, and so their failure to learn is interpreted as a condition. This is a pattern that’s visible in diagnosis of a wide variety of conditions among children, including depression, anxiety, psychosis and even insomnia.
In response to RFK Jr.’s presidential announcement last year and the challenge of an explicitly health-focused campaign, Donald Trump announced that, if he wins the election, he will launch a presidential commission into chronic diseases, to investigate precisely why so many Americans are now so sick. Such an investigation is now long overdue, and whether it will ever materialise remains anybody’s guess, but we owe it to ourselves, and most of all to our children, to get to the bottom of the problem, one way or another. This is not normal.
