It's Not a Pharmacy Scam

"ADHD is just a fake disorder being pushed by big pharma."

"It's all the pharma companies trying to sell Adderall."

"ADHD is nothing but a scam, a hoax perpetuated by Big Pharma and the psychiatric industry."

These are all real comments I've heard or read about ADHD when doing research or talking to people about ADHD. Before I knew about my diagnosis, every time I heard about the disorder, there would always be some flavor of "big pharma" and "fake disorder" accompanying. This caused me so much confusion when I found out I have ADHD because there's a crazy amount of stuff on the internet saying it doesn't exist, and we're just lazy and looking for an excuse to get meds. So what I want to do in this post is to tackle these statements with facts and science. So let's start!

"It's overdiagnosed."

Maybe. In countries like the US, some school districts receive extra funds if they have kids with medicated ADHD, so there is some incentive to overdiagnose. I've had teachers in elementary school push my parents to get me on medication after my diagnosis, even asking me about it in class. So it's definitely possible that it is overdiagnosed. However, this doesn't mean it's a fake disorder or that everyone with a diagnosis doesn't have it. The majority of people who have diagnoses fit the symptom descriptions and are impacted by ADHD in ways many neurotypicals don't realize. A lot of people with ADHD-PI actually get passed off as lazy in their childhood and get diagnosed as adults, when there is no incentive to overdiagnose. It's also important to note that there are hardly any reliable statistics on this, just ballpark estimates by people who believe ADHD is overdiagnosed.

"It's propagated by big pharma."

The phrase 'big pharma' seems to be a recurring favorite among downplayers of ADHD. So why do they think pharmaceutical companies are to blame? There are many medications available to treat ADHD, so it seems plausible that pharma companies benefit from ADHD diagnoses. However, not every person with ADHD takes medication. In the US, about 62% of diagnosed kids take medication, and only 30% use medication as their only treatment form. There are other approaches to treating ADHD, and they include CBT and using strategies such as the Pomodoro technique or limited use of technology to help with inattention and focus. Depending on the severity, some people with ADHD can get by fine without medication, but many need it to focus on the same level as neurotypical people.

I think a lot of the stigma and mistrust comes from a misunderstanding of medications and how they help with ADHD. Essentially, ADHD stems from a combination of genetic, environmental, and neurological issues. Scientists aren't sure what causes these factors to lead to ADHD, but they have been able to identify the biological and genetic contributing factors, and a lot of it has to do with brain chemistry. The brain uses chemicals called neurotransmitters to allow neurons to communicate. There are many neurotransmitters, and each is responsible for different things. The important ones concerning ADHD are dopamine and norepinephrine. Norepinephrine is made up of dopamine, and dopamine is made from a chemical called dopa. People with ADHD have a deficiency of dopa, meaning we have less dopamine and norepinephrine in specific brain regions where they are essential. The brain area where these deficiencies occur vary, but they result in more or less the same symptoms. When there are deficiencies of norepinephrine in the frontal cortex, high-level functioning and attention are affected, in the limbic system, a deficiency causes emotional dysregulation, a deficiency in the basal ganglia is associated with inattention and impulsivity, and deficiencies in the reticular activating system can cause inattention, impulsivity, or hyperactivity. These brain regions are connected and frequently interact with one another, so no symptom occurs in isolation.

What medications do is adjust the levels of norepinephrine to the baseline. There are three ways of doing this: by introducing norepinephrine, by blocking its catabolism (breakdown), or by blocking its reuptake (when neurotransmitters are taken back into the neuron without being sent across). Stimulant medications raise the level of norepinephrine by introducing more of it into the brain, while non-stimulant medications block reuptake or catabolism of existing norepinephrine. Many people who bash ADHD medications don't realize that while some can function without them, many people need their medications to focus and do things that neurotypicals can do easily. So it's wrong to blame the pharma industry for ADHD because people need their medications, and all this accomplishes is further stigmatizing the use of medications for brain disorders.

"Kids just want Adderall."

Again, this view comes from a lack of knowledge of what medications do and how they help. It could also come from the legitimate concern that kids without ADHD will get their hands on stimulants, which is, unfortunately, a big problem. There are many instances of kids with ADHD being forced into giving their medications to other kids who want to get high, but as I said before, the people who take medications for ADHD need them for legitimate reasons.

"There's no evidence that ADHD exists."

This is the problem with many disorders of the mind and brain: they're hard to see physically. It's easy to tell when someone has a broken bone because you can see the fracture and bruising, but you can't tell as easily if a person has a mental or neurological disorder just by looking at them. The symptoms of these disorders are often invisible and hard to explain to people who don't experience them, meaning many people end up having to 'justify' or 'defend' their disorder. The good news is that scientists have clearly determined that norepinephrine deficiencies, grey matter volume differences, and specific genes are linked to ADHD, so there is now substantial evidence. Besides, while the name has changed over time, ADHD symptoms have been described as early as the 1700s.

"People with ADHD can't be successful."

Michael Phelps, Justin Timberlake, Michael Jordan, Richard Branson, Jim Carrey, Simone Biles, Solange Knowles, all have ADHD. People with ADHD are just as capable as neurotypicals at success in their careers. Studies have shown that traits such as hyperfocusing, hyperactivity, and impulsivity may make ADHD-ers better suited to entrepreneurial jobs than neurotypicals. In fact, people with ADHD are three times more likely to run their own business. ADHD doesn't mean you won't succeed, and your symptoms absolutely do not sentence you to failure.

"Everyone's a little ADHD sometimes."

Sure, everyone is forgetful or impulsive once in a while, but that doesn't mean everyone has ADHD. There's a big difference between showing a symptom occasionally and actually having the condition. Saying everyone's a little ADHD is like saying everyone has depression because we all get sad sometimes.

Why is there so much stigma and denial of ADHD? My guess is people don't know enough about it. This was true for me too. Before I found out about my diagnosis, I thought also it was about hyper kids and pharmacies. I didn't realize it's not all hyperactivity, adults can have ADHD too, and that there are so many biological causes for it. So the next time you hear someone dismissing any disorder or catch yourself making assumptions, do a fact check. Google it, or if there are too many conflicting articles on Google, find someone with the disorder and ask them. It's that easy to do and makes the lives of those continually having to defend their disorder or condition so much easier as a result!


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