Big Pharma has played a significant role in manufacturing the ADHD epidemic in the U.S., convincing parents and doctors that ADHD is a common problem amongst children and one that should be medicated. However, many countries disagree with the American stance on ADHD, so much so that they have entirely different structures for defining, diagnosing, and treating it. For example, the percentage of children in France that have been diagnosed and medicated for ADHD is less than 0.5%. This is largely because French doctors don’t consider ADHD a biological disorder with biological causes, but rather a medical condition caused by psycho-social and situational factors.
France defines ADHD as a sociological disorder that’s caused by a set of social situations, whereas the U.S. sees ADHD as a neurological disorder whose symptoms are the result of biological disfunction or a chemical imbalance in the brain. France’s definition of ADHD drastically differs from that of the U.S., which is in part because the pharmaceutical industry helped define ADHD in the U.S. (you can read more about that here). France’s treatment methods, therefore, also greatly differ from those practiced in the U.S.
Treatment Methods for ADHD Used in France
Once a French psychiatrist diagnoses their patient with ADHD, they hone in on the behavioural problems by searching for the underlying causes. Psychiatrists will study the child’s distress and compare it to their social situations. France views ADHD as a social context problem; therefore, ADHD is often treated with psychotherapy or even family counselling. Very rarely do French psychiatrists prescribe medications to treat ADHD, as it’s usually rendered unnecessary after taking a more holistic approach.
It’s important to note that French psychiatrists also consider a patient’s diet when searching for the causes of behavioural symptoms associated with ADHD. Poor eating habits such as consuming foods with artificial colours or flavourings, preservatives, sugars, and/or allergens may worsen a child’s behaviour. This isn’t difficult to imagine; even as adults we can feel the effects certain foods have on our mood, energy levels, and thought processes.
Why There Are Fewer ADHD Cases in France Than the U.S.
A study conducted in 2011 stated that the amount of youth in France with ADHD may be as low as 3.5% — a far cry from the 11 to 15% estimate in the United States. Family therapist and author of A Disease Called Childhood: Why ADHD Became an American Epidemic Dr. Marilyn Wedge suggests that this may be as a result of the cultural differences between the U.S. and France in regards to raising children. According to Wedge, French parents will often impose more structured lifestyles onto their children, such as enforcing strict meal times and using the “cry it out” method with babies and toddlers. Children are taught self-discipline at a young age, which is why Wedge feels they don’t need to be medicated for behavioural issues.
Unfortunately, spanking is not considered child abuse in France, so this practice is used fairly often to encourage discipline. In March 2015, the Council of Europe, an international human rights organization, faulted France over the country’s lack of legislation regarding corporal punishment of children. As The New York Timesexplained, “Child abuse is illegal in France and is punished with long prison sentences, but it is not uncommon for French parents to slap or spank children, or for the French courts to view such actions as acceptable under a customary ‘right to discipline.’ “
As Dr. Wedge points out (although neither she nor Collective Evolution support spanking or any other form of child abuse), this simply adds to the discipline they’re encouraged to practice throughout their childhood (source).While Wedge makes some interesting points regarding discipline, I don’t think that’s the underlying reason why most French children don’t need to be medicated for ADHD. Rather, because ADHD is largely a behavioural issue, it rarely requires pharmacological intervention. I believe that these treatment methods are successful in France not because of their parenting culture, but rather as a result of their holistic approach in considering diet and behavioural and social context.
I believe France does not have an issue with over-diagnosing ADHD in the same way the U.S. does because pharmaceutical companies have not targeted them as heavily. Pharmaceutical companies play a substantial role in defining ADHD and deciding treatment methods in the U.S. For example, doctors and researchers in the U.S. have been paid to overstate the dangers of ADHD and the benefits of taking their drugs and understate the negative side effects.
It’s easy for people to believe this misguided information when it’s affiliated with well-known universities like Harvard and Johns Hopkins. Many people don’t even realize that these studies are funded by the very companies that profit from the drugs’ sale because that relationship is hidden in small print (source). These drugs can have significant side effects and are actually considered to be within the same class as morphine and oxycodone due to their high risk of abuse and addiction. You can’t just blame all doctors, either; many of them genuinely believe they’re helping these children because of the information they’ve been given in these studies and by Big Pharma.