What Can the US Learn From France When it Comes to ADHD?
For any parent with elementary-aged children (and even younger), ADHD is a hot topic. The condition is so prevalent in modern American society that playground discussions frequently center on diagnoses, medications, and how the behavior affects Johnny’s grades in school.
For parents – especially parents of boys – any demonstration of hyperactivity, raucous behavior, or short attention spans automatically earns that boy an ADHD label, even before the official diagnosis comes from a medical professional.
As a mother to two boys, I can certainly tell you that they are FULL of energy. But isn’t that what the power of youth is all about? It seems
that ADHD is on the rise, especially in young American boys, but is it really?
When compared on a global level, ADHD diagnoses and treatments vary dramatically. For instance, the way France defines, treats, and prevents ADHD not only sheds light on how to better treat the condition here in America, but it also hints at elements in our society that could be causing other problems.
First things first: What is ADHD?
To really understand ADHD and why it appears more in American society, first let’s take a look at the actual definition of the disorder. It is important to note that it is not defined the same way globally.
French doctors define ADHD as a sociological disorder caused by social situations. French doctors do not use the DSM (Diagnostic and Statistical Manual of Mental Disorders). Rather, they rely on the Classification Française des Troubles Mentaux de L’Enfant et de L’Adolescent
(or CFTMEA for short).
This manual was created by the French Federation of Psychiatry because French doctors wanted more than what the DSM-III offered. The CFTMEA “encourages psychiatrists to identify the underlying issues that cause a child’s symptoms and to address them using a psychopathological approach.”
This ideology shapes the entire way in which the French culture interacts with ADHD.
According to the DSM, ADHD is a neurological disorder that stems from biological conditions.
Even though France and the United States define the causes of ADHD very differently, the main signs and symptoms do align:
Diagnoses around the world
Even though the two countries disagree on the causes and treatments for ADHD, the fact remains that ADHD exists and affects the quality of life of those afflicted.
Incredibly, only .5 percent of children in France are medicated for ADHD. That period is not a typo. I repeat, only .5 percent of children in France are medicated for ADHD.
This statistic has everything to do with their definition and treatment of ADHD.
Contrasted with the near non-existence of children medicated for ADHD in France, American stats illustrate more of an epidemic. Depending on the source (CDC or APA), medicated cases in America range from nine to 15 percent of children.
The American Pediatric Association, however, believes that only five percent of those diagnosed are actually true sufferers.
How a disorder is defined affects how the treatment course is planned, and ultimately makes a statement about our culture.
Because the diagnostic manual in France encourages doctors to look for an underlying cause, the treatments then focus on treating the cause, usually of an environmental nature. French doctors first take a holistic approach, using medication only as a last result when holistic approaches do not solve the problem. The most common treatments for ADHD in France are:
- Time spent outdoors
- Diet changes
In the United States, ADHD is treated as a neurological disorder, which means that a heavy emphasis is placed on altering the child’s mental state through medication.
The .5 percent of medicated kids in France indicate that holistic approaches do not solve 100 percent of cases. Still, the vast majority of cases are
successfully treated without medication. This is important to keep in mind when considering whether or not ADHD is spurred by social or neurological conditions.
Children in the UK who exhibit these symptoms are also typically listed as having a conduct disorder – not a neurological one.
Spending time outdoors
While French doctors routinely examine the quantity of a child’s time spent outdoors and its effect on mental health, American doctors are slowly beginning to examine the multitude of positive effects the outdoors can have on mental and emotional health.
It is well-known that being outdoors improves physical health and sleep patterns, but the effects on mental and emotional health are just as numerous. A study
published in the “Applied Psychology: Health and Well-Being Journal” revealed that children (diagnosed with ADHD by a physician) who spent time outdoors reported a lessening of ADHD symptoms.
This validates what the French have known all along: Situations and environments can affect ADHD.
The diet factor
When examining how French doctors treat ADHD, it may seem surprising at first to see “diet changes” listed as an actual treatment plan. It’s actually more than just a treatment option; it is also a preventative measure. Why?
Food may contribute a great deal to ADHD, or at least ADHD symptoms. Studies show that there are at least nine food additives that affect ADHD and/or mimic its symptoms. These foods additives include:
- Red no. 40: The most commonly used dye, used in everything from packaged cake desserts to frosting to chips to yogurt, and even oatmeal products.
- Red no. 3: Listed as Carmoisine, this dye is used in candy and cake icings.
- Green no. 3.
- Yellow no. 5: The second most used dye, it appears in chips, waffles, cheese dips, puddings, and mac and cheese.
- Yellow no. 6: Used in the same products as Yellow no. 5.
- Blue no. 1: Frequently used in brightly colored cereals, ice cream, hard candies, certain yogurts, and chips.
- Blue no. 2: Used in pet foods and sugary, brightly colored cereals.
- Sodium benzoate: A preservative used in pickles and carbonated beverages.
- Orange B: Used in the casings of sausages.
According to a report
from ABC News, these additives are banned in many European countries, including France. This fact alone speaks volumes about the disparity between the number of cases in these two countries.
It also begs the question: If American diets were revolutionized, would ADHD cases dwindle?
What does this say about our culture?
None of these facts should be used to devalue someone’s (especially a child’s) experience with ADHD. As the pop culture saying goes, “The struggle is real.” For those diagnosed with ADHD, their symptoms are real.
However, in the spirit of expanding how we think about mental disorders, what if we did question the status quo and follow the lead of the more holistic doctors around the globe? What if these children didn’t need to suffer anymore because we decided to implement some of the holistic treatment options used in France?
Looking more closely at the relationship between the food we eat and it’s effect on our brain, the quality and quantity of outdoor time, and our overall social environment could make a world of difference for children suffering from ADHD.
While mental disorders are nothing to take lightly, as a country, we should embrace a more holistic approach to our daily lives. Perhaps other treatment options could help minimize the need for medication.
My comparisons between French and American cases are not to dismiss the disorder as purely American. Indeed, ADHD occurs globally. A study
from “World Psychiatry” pointed out that 19 percent of children who lived near Chernobyl were later diagnosed with ADHD. (But even this statistic begs the question regarding environmental causes of ADHD.)
What is the takeaway?
While conflicting reports of the number of diagnosed cases, varying definitions, and radically different treatment options may be enough to make a parent’s head spin, there’s a light at the end of the tunnel.
A diagnosis is not a defining characteristic of a child’s personality. A diagnosis means that considering a range of treatment options makes sense, and implementing some holistic practices regardless can improve a child’s emotional and physical well-being – not to mention the well-being of the whole family.
Reexamining how you define ADHD – as well as what effect a label has on a child – will make you better equipped to help your child through a diagnosis. If nothing more, questioning the status quo will make you more confident in any decision or treatment plan that you make.