GRSJ224/Medicalization of ADHD

The Medicalization of ADHD

Conrad et al. addresses the social production of the notion of “deviance” that occurs through the way certain behavioral attributes are perceived within a societal context. In relation to ADHD, which is defined by the British Psychological Society by tendencies of impulsivity, hyperactivity and inattention (2.1.1.), the social context within which it is perceived as deviant appears to have contributed to its Medicalization as a neurological syndrome.  

History of ADHD

The earliest documentation in the medical field of what is now known as ADHD is believed to date back to journal entries by Melchor Adam Weikard in 1775 (as cited by ). Such longstanding history has warranted academics to claim that the syndrome is not the product of modern societal pressures , yet the medicalization of ADHD as a problematic phenomenon may correlate with the rise of industrialization in recent centuries. Between 1993 and 2003, it was found that funding for medication to treat ADHD increased by 900% and coincided with its usage by the 5 to 19 year old demographic to increase to 3 times as much compared to previous year. What was notable, was that countries who yielded higher usage were more industrialized and globalized countries such as Canada, the US and Japan ( pg. 6). If the environment created by industrialization itself is not the cause for the rise in diagnosis and treatment, then these finding suggest that this correlation is indicative of the imposition of pharmaceutical institutions in the categorization and stigmatization of ADHD as a medical condition.

Environmental Factors of Identification

While the industrialization of society may not be the root cause of the behavioral tendencies associated with ADHD, it presents a context in which these behaviors appear more disruptive and out of place. While noticeable signs of hyperactivity are often present throughout infancy, the diagnosis of ADHD in children frequently aligns with their emergence into the controlled environments created by institutional education (, pg 6). Structured environments appear to expose hyperactivity more clearly, and participation in a group setting often exacerbates its effects to the point that they are perceived as problematic (, pg 7). Through the process of socialization, which is largely influenced by environmental and cultural factors, hyperactivity as a natural attribute of ones personality and temperament is reconstructed as an encumbrance to proper sociability.  

Alternative Treatment

The medicalization of this condition and recommendation of treatments has steered focus away from lifestyle choices that yield improvements in a natural way without having to rely on medical resources. Yehuda et al. conducted studies of ADHD children and the effects of sleep deprivation and iron deficiency. By experimenting with the supplementation of essential fatty acids, it was concluded that increased levels of hemoglobin in participants resulted in better sleep and overall wellbeing due to improvements in factors commonly proved troublesome for individuals with ADHD such as concentration, mood regulation, and social interaction (, pg. 1168). It was further noted that sleep deprivation was also correlated to changes in dietary preferences when it comes to macronutrient breakdown. While it is unknown whether poor nutrition is the cause or the effect of inadequate sleep, the diets of sleep deprived children were found to consist primarily of lipids with small doses of carbohydrate, which contrasted to the opposite findings in children maintaining adequate levels of sleep (, pg.1169). While this information was relatively easy to procure with the access to an online database with extensive medical research and documentation, individuals without access to similar educational tools may not be privy to such knowledge, and suffer limited agency when dealing with ADHD.  

Racial, Cultural and Economic Implications of Medicalization

Chronis et al. acknowledges the benefits of Behavioral parenting training (BPT) as a means of treating behavioral issues associated with ADHD (1) as well as pinpoints factors that have proved detrimental to the accessibility and continuance of medical intervention. It was found that children of parents who were minorities, or of low economic status, were among those who were likely to deviate from suggested treatment plans (7). In addition to BPT, the behavioral challenges that are not targeted by these traditional practices often require the employment and help of a personal therapist (519), for which the time and resources are also not universally accessible. Through the medicalization of ADHD and the subsequent need for treatment for what has been categorized as disruptive behaviour the racial and economic implications of health care become prominent.

Social Diagnosis

ADHD’s identification as a medical condition is reliant on the social perception that it’s associated behavior signifies ”defective moral control” , or maladaptivity . It is only after the creation of a set or social norms or rules that behaviors can be deemed as abnormal or disruptive. Such identification also holds certain geographical and cultural contexts, as the creation of social norms vary place to place. Depending on a multiplicity of contributing factors such as population, economy, industrialization, and religion, cultural norms are globally diverse, so the identification, contextualization, and treatment of ADHD may vary greatly worldwide. In this way, the medicalization of ADHD can be seen as a first world construct as it relies on the industrialization and institutionalization of medical discourse as well as the economic domination of large pharmaceutical industries. The creation of a medical diagnoses also creates a need for treatment plans and practices, which not only work to rectify behavior to be congruent with social norms, but also reinforces racial, economic, and cultural hierarchies implicit within the process of medical intervention.