How could that be? The ADHD diagnosis is sometimes assigned too casually. People think it is a simple explanation for what they see. But the treatment for ADHD can actually aggravate other problems, such as bipolar disorder.
According to Dr. Demitri Papolos and Janice Papolos, children with bipolar disorder can sometimes react very badly to stimulants or anti-depressants. In their book, The Bipolar Child: the definitive and reassuring guide to childhood’s most misunderstood disorder, they report instances of bipolar children, who were wrongly diagnosed, or wrongly medicated.
“Antidepressants and in many cases stimulants given without the benefit of a mood stabilizer (possibly even with the protection of a mood stabilizer) can cause havoc in a child suffering from a bipolar condition, increasing anxiety states, potentially inducing mania, more frequent (mood) cycling, and increases in aggressive outbursts and temper tantrums.”
Parents may believe that ADHD is a relatively benign diagnosis, with a potentially manageable outcome. But if you overlook something more serious, and medicate the wrong disorder, you can make your child much worse. If your child is not responding to the medicine prescribed for ADHD, or if his behavior is becoming worse in some areas, consider getting a more thorough diagnostic work-up.
These brings me to my theory about why the children of the poor are more likely to be medicated for ADHD. Better off parents may be more persistent about getting an accurate diagnosis. Children of the poor may simply accept the opinion of the first authority figure who tells them their child needs medication.
It is also possible that there truly is more attention deficit disorder among the poor. Some researchers believe there is a genetic component to the disorder. If that is the case, then untreated and undiagnosed ADHD could account for some of the problems in living that plague the parents, problems that lead to them having lower incomes, or to their kids landing in foster care. I am at least willing to consider this as a hypothesis.
One other possible explanation: better off parents may be able to come up with non-medication strategies for managing their kids’ behavior. We have found it helpful to simplify the child’s life as much as possible. We have often stripped an easily distracted child’s room of all toys and unnecessary decor.
We keep the toys anywhere but in his room. He can dress himself in the morning, without being drawn off-task by all the stuff in his room. We also limit the use of anything with a screen. We don’t even own a TV; we seriously limit video games. Often, the birth parents think we’re being mean. They have a tough time understanding why we’re doing these things. But eventually they get the point that it can be in their child’s interest to have fewer things and less screen time.
These strategies are not panaceas. They won’t cure every hyperactive kid. But these strategies will improve the quality of life for almost any kid. The fact that the children of the poor are more likely to have an ADHD diagnosis may just mean that their parents need more and better information.