Attention deficit hyperactivity disorder, known simply as ADHD, is characterized by difficulty paying attention and controlling compulsive behavior. In the U.S., ADHD is commonly diagnosed in children and is managed using medications. According to the Centers for Disease Control and Prevention, about 9.4 percent of American children ages two to 17 have ADHD — that means about 6.1 million children are being treated with drugs like stimulants and antidepressants. On the other hand, in France where ADHD is classified differently, clinicians are finding success in managing childhood symptoms through a holistic approach. Compared with the U.S., less than 0.5 percent of children in France are diagnosed with the disorder. So why the difference?
The psychosocial approach versus the pharmaceutical approach
Clinical psychiatrists in the U.S. consider ADHD a biological disorder with biological causes, so the preferred treatment is with psychostimulants. In France, however, instead of classifying ADHD as a biological dysfunction and pathologizing what is normal childhood behavior, clinicians choose to address the underlying causes of a child’s distress — not in the brain but in a social context. Hence their preferred methods of treatment are psychotherapy and family counseling.
American psychiatrists use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to classify childhood emotional problems, while French psychiatrists use their own system called The French Classification for Child and Adolescent Mental Disorders (abbreviated CFTMEA in French). CFTMEA focuses primarily on psychosocial causes of children’s symptoms, but DSM disregards these causes and encourages medical treatment. This leads American clinicians to give the ADHD diagnosis in a large number of cases and prescribe pharmaceutical interventions.
Aside from considering contributory factors in the environment of symptomatic children, the French holistic approach also allows clinicians to look at nutritional causes. In particular, foods that contain artificial coloring, certain preservatives, and allergens can cause ADHD-type symptoms in children. Fully aware that dietary interventions can sometimes help resolve a child’s behavioral problems, French clinicians prefer working not only with the children, but also with their parents. This minimizes the diagnosis of ADHD in French children….
In the 1970’s, psychiatry was on the rocks economically, it was losing out in competition with social workers and psychologists and non- medical therapists. Women were becoming increasingly aware that they’d be better off going to say a woman social worker than a male psychiatrist if they want to be understood or helped.
And at that point, and I trace this in “Toxic Psychiatry” – at that point psychiatry, at an organized level, including in the actual annual board meetings of the American Psychiatric Association, made a decision first to “re-medicalize”. To convince the public and the congress, which provides a lot of money to psychiatry and to convince the country that personal suffering is medical and biological, and, they made at the same time, after some debate, a decision to take more money from the drug companies, so the psychiatric association went from being broke to being wealthy within in a few years as a result of the support of drug companies which just pours in now. They won’t even open up their books to their own members. — Peter Breggin, psychiatrist