Imagine the scene. The specialist - call it a psychologist or a psychiatrist - gives you a blunt:
“Your son has signs of Asperger”(Change here 5 years ago for ADHD, ten years ago for schizophrenia, ago 15 for bipolarity… etc.). "It is likely that he will need to be medicated." And all the alarms in your father's head start to sound.
The overdiagnosis (overdiagnosis, by its original name) has resulted in a incredibly lucrative business for many, but especially for pharmaceutical companies that maintain a fierce battle to position in the minds of consumers the "advantages" of using their products to offer a better quality of life to them and -particularly- their children.
Take for example the boom - almost pandemic - of the increase in the number of diagnoses of children with Attention Deficit Hyperactivity Disorder (ADHD). In reality and despite being included in the psychiatric “bible” (the DSM or Statistical Diagnostic Manual of Mental Disorders), is a condition with unclear causes and in which it is believed that environmental factors as well as genetic factors are involved. That is, a lot is known but at the same time little.
The risk of the latter is the speed with which a diagnosis can be established and, consequently, treatment. Most specialists agree that drug treatment is essential and that 70% of children diagnosed with the condition will have to use doses of drugs intended to control it. This means that 7 out of 10 children will be using Ritalin, Focalin or any derivative of methylphenidate, immediately after diagnosis. Of course this is fine, isn't it?
Of course I am not saying - for the record - that it would not be inadmissible for a small accurately diagnosed with ADHD does not receive their dose of the appropriate drug. It would be stupid of me. However, what is already beginning to sound worthy of consideration is that the other side of the coin must be taken into account: that a good part of the drugs approved for use in ADHD have a high addictive potential.
I am not against the use of drugs, in fact in my practice I work together with psychiatrists because sometimes it is evident that the simple use of psychotherapy is not enough. However, what I do maintain is that the use of these should be taken with great care and this begins with the diagnosis of specialists.
About ten or fifteen years ago the Disorder Bipolar, Closely linked to ADHD and now in the new DSM-V is called Disruptive Regulation of Mood Disorder. This condition, which like ADHD has an unclear origin, is characterized by extreme changes in the condition from cheer up and that in general terms it causes one to go from excessive happiness to the most absolute depression without adequate causes (if there can be adequate causes for both).
Therefore, many children are now diagnosed with this recent Disruptive Regulation of Mood Disorder and therefore also begin to be medicated with antipsychotics that are not recommended for them (a very notorious case occurred in November 2013 when in Spain, specifically in Aragon, some parents refused to subject their son to these drugs because the Ministry of Education demanded it as a “psychiatric guarantee” so that he would not be excluded from school. The case went to court and ruled in favor of the family).
He said that everything begins with the diagnosis of the professionals and this is directly proportional and, therefore, disturbing with the ethics thereof. Figures collected from schools in the United States indicated until the end of last year that 11% of school-age children were diagnosed with some type of mental disorder, particularly ADHD. This means that 6.4 million children have received this diagnosis during the last decade at least. And the number keeps growing.
The question that arises - at least it arises for me - is these rising figures due to a real emergency or does it have to do with an urgency by doctors and mental health professionals to get out quickly? You have to take into account something that can be scary and that is not well known: in the case of ADHD or bipolarity, diagnosis is discretionary, that is, it depends on the personal and therefore subjective evaluation of the professional who is treating the child.
This means that there is no exact measurement of it and its diagnosis depends on various factors present or not in the professional: updated knowledge, analytical skills, therapeutic experience, professional ethics and specialization in the disease. There are many and more and more frequent cases in which health professionals not specialized in the disorder are encouraged to draw lapidary conclusions that squeeze -and of course-, the heart of any parent.
Then the thing must be careful. And if in addition to this it is added that not even the parents are saved from influencing the diagnosis, everything can get complicated. For example, the doctor Jerome Groppman, of the University of Harvard and renowned columnist on medicine for the New York Times, stated in an interview something very revealing: “The truth is that there is tremendous pressure if a child's behavior is perceived as, so to speak, abnormal: if he does not sit quietly at school, he thinks he has some pathology instead of to think that it can only be that, a child ".
This can generate that parents and even teachers wish internally (although this will not be openly recognized and of course it is understandable), that the child be diagnosed and treated with drugs that allow having it more controlled so that it is more appropriate for the control of grown ups.
A final but decisive factor is that which has to do with advertising and marketing about pharmacological products and their power in this or that disorder. Pharmaceutical companies spend trillion dollars a year so that your product is positioned in the mind of the parent as the best option for their child's condition. And one of the best means to achieve this is by convincing professionals of its effectiveness - and sometimes without it - to use your medicine over another..
They also do it through the mass media, especially television.
To conclude, it is evident the determining role of the mass media, especially television, play in all this matter. The latest "hit" of this fashion is the Syndrome from Asperger or as the DSM-V now named it (you know what they like with bombastic names) by including it with other autistic disorders: Autism Spectrum Disorders. Basically Asperger's is a mild form of autism characterized by social clumsiness, inability to identify emotions -particularly foreign-, and a certain degree of failure in motor self-control..
And it is not at all gratuitous that the increase in the indiscriminate use of the Asperger diagnosis goes hand in hand with an increase in the number of characters in film and television that fictitiously represent this syndrome, the syndrome being probably the most identifiable of all. Dr. Sheldon Cooper, interpreted by Jim Parsons On the most successful comedy series of the last decade on American television: The Big Bang Theory (Big Bang Theory). Hence the term "fashion".
Finally, it is important to clearly establish that -as I said above-, the issue of the "fashion for disorders" is taken more seriously by professionals, but particularly by the parents of these children.. It is not a question of systematically refusing the pharmacological option, but rather of stopping for a moment before blindly agreeing with the diagnoses made.. My recommendation is the oldest in the world: do something even after having several and diverse professional opinions about it, verify and compare the diagnoses of psychologists and psychiatrists but also cross them with that of neurologists and professionals in the study of human behavior. Perhaps this way you will also be able to help your child in a responsible way. Until next time.
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