I just came across a study done by researchers at the Washington University School of Medicine in St. Louis that disproves the popular belief that ADHD is overdiagnosed and kids are overmedicated. The exciting thing about this research is that it was not conducted by a pharma with a vested interest in proving the value of ADHD medications.

“What we found was somewhat surprising,” says Richard D. Todd, M.D., Ph.D., the Blanche F. Ittleson Professor of Psychiatry and professor of genetics. “Only about 58 percent of boys and about 45 percent of girls who had a diagnosis of full-scale ADHD got any medication at all.”

One of the most important conclusions of the study (which was also reported on World News Tonight with much more hyperbole) was that girls are more likely to go undiagnosed. It didn’t come as any surprise to ME, but it might to a lot of people who have this idea that a girl should be as physically hyperactive as a boy to qualify for the diagnosis.

It doesn’t work like that. Girls’ hyperactivity tends to be more in the arena of internal turmoil. It’s an inward thing. It can look like anxiety (because we are working so hard to process everything going on around us), flightiness, or just what appears to be intentional disorganization. As a kid, I talked all the time because the distractions around me were overwhelming. Talking was one way to reassure myself I was really where I thought I was instead of flying out the window, lost to whatever distracted me at the time. Of course, that meant that every teacher I had sent home reports to my parents that I was perfectly capable of doing the work, BUT….

Always the BUT…in big flashing red failing letters.

Because ADHD in girls doesn’t look like what ADHD is supposed to look like, it’s easily overlooked. I spent well over half my life believing that I was just doomed to disorganization and half-finished projects. I’d look at friends who were finishing major projects easily — like college, for example — and assume that I was just not as smart as they were.

For all of the flap, past and present, about how we are overmedicating our children and all the hyperbole about that, what this study proves is that too many children are not receiving any treatment, medication or otherwise. That puts them at risk, just like I was at risk.

Someday when I’m feeling really brave I’ll write about my father. He was a scary person when I was growing up. For purposes of this particular entry, it’s enough to say that he instilled enough fear in me as a child that I didn’t fall into some of the traps that other girls with untreated ADHD have. But I’m here to tell ya that when I started smoking at age 18, all sorts of things changed for me. I could focus on the task, get it done! When I found out what coffee and a cigarette could do in the morning, the world was good again. But I suffered from depression, made some awful life choices (including an impulsive marriage at age 19*) and spent a long time with a psychologist who never even considered ADHD as a possibility, meaning that the walk through overcoming depression was a lot spikier than it might otherwise have been.

On smoking — Nicotine is one of the most common self-medicating substances for ADHDers and it was socially acceptable at the time, too. Today, taking stimulant medications or giving your children stimulant medications for ADHD is only slightly more socially acceptable than smoking. Only slightly. I really wish the folks who are so anti-medication and willing to launch deceptive national campaigns about ADHD, depression and medications (see this post) would see what damage it does those kids and adults who truly stand to benefit from them.

As parents, we’ve had to fight all of the accusations about being rotten parents. As an adult, I get the sideways glance that seems to imply I’m imagining a need or a benefit from medication. Hey folks, lose the bias and get educated, because here’s what happens when you try to ignore ADHD in kids and not seek treatment, medication or otherwise (yes, I do believe in alternative and/or concurrent non-medication treatment).

They fail. They get constant negative feedback. They get stuff like “You’re very bright, BUT…” (Fill in the blank).

If they’re hyperactive, they are rejected more and more often by their peers as they get older. They get angry. They get depressed.

In girls, that anger can turn inward and they can turn to cutting, drugs, eating disorders and other behaviors that carry far higher risk than any stimulant medication does.

This study is a landmark study for a number of reasons, and the researchers are only beginning. I’m so glad to see that independent researchers are addressing important questions about ADHD, treated and untreated.

Technorati Tags: ADD, AD/HD, Ritalin

*I regret the marriage but not the result — The Eldest was and is a happy reward for an otherwise disastrous choice.