The Rise of ADHD Diagnoses in America

Disclaimer: The following information is for educational purposes only and should not be taken as medical advice. This information should not be read to recommend or endorse any specific products. Dietary supplements are not intended to diagnose, treat, cure, or prevent any disease.

ADHD is the most common neurobehavioral disorder in childhood¹; an estimated 7.1 million (11.4%) U.S. children aged 3–17 years old have ever been diagnosed with attention-deficit/hyperactivity disorder (or ADHD), according to a 2022 national survey of parents.

The number of ADHD diagnoses in America has seen a dramatic rise over the past few decades, raising questions about what’s fueling this surge and how we understand this condition. Here, we explore the associated factors, from telehealth to TikTok.

But first, a look at how we interpret the rise in diagnoses, examining both prevalence and incidence to paint the full picture.

Prevalence refers to how many people have ever been diagnosed with ADHD at a given time. For example, prevalence data collected in 2022 shows that approximately 1 in 9 U.S. children have been diagnosed with ADHD at some point in their lives.² It’s a snapshot of how widespread diagnoses are in a population at a point in time.

Incidence, on the other hand, refers to how many new cases of ADHD were diagnosed within a specific time period. In 2022, the incidence rates rose with an additional 1 million U.S. children aged 3-17 years having received an ADHD diagnosis (compared to 2016).² This rise in new diagnoses over the years reflects a growing trend and increased recognition of ADHD, particularly in children.

Beyond diagnoses, the use of stimulant medications has also surged, as depicted by numerous stats:

• Over the last decade, the projected number of stimulant prescriptions dispensed increased by 57.9%, from 50.4 million in 2012 to 79.6 million in 2022, with the highest annual increase from 2021-2022.

• In another study, the percentage of children 4-17 years old with an ADHD diagnosis increased by 42% between 2003 and 2011, along with a 28% increase in ADHD medication therapy.¹

• What’s more, there’s also been an increase in polypharmacy —the simultaneous use of multiple drugs by a single patient, for one or more conditions. A 2020 study in Pediatrics found that 40.7% of people ages 2-24 who were prescribed a drug for ADHD were also prescribed a drug for depression, anxiety, or another mood or behavioral disorder.¹

With the statistics on rising stimulant prescriptions and ADHD diagnoses in children, we can infer an increase in ADHD diagnoses overall. What’s causing this rise? 

Increased Awareness

In a lot of ways, ADHD is still stigmatized, but it’s becoming more commonplace. Celebrities, like gymnast Simone Biles and director Greta Gerwig, have spoken about their diagnoses. “Neurospicy” has over 106.6M tagged posts on TikTok. Campaigns like ADHD Awareness Month promote education, advocacy, and support.

Greater public awareness can lead to more people recognizing symptoms and seeking evaluations. Now, a parent can search their child’s symptoms on a social media platform and be met with a vast amount of relevant information (which, due to the nature of social media, can sometimes be informative and other times be misleading). This rising awareness has contributed to earlier diagnoses in children, with ADHD becoming the most common neurobehavioral disorder in childhood, as mentioned above.¹

Historically overlooked populations, like women and older adults, are also benefiting from greater ADHD awareness. From 2012 to 2021, adults, particularly women, between the ages of 31-40 years and older patients between the ages of 71-80 years had the highest increase in prescription stimulants dispensed.

Public and professional awareness of ADHD symptoms and treatments has grown, leading more and more people to seek help and receive diagnoses (inferred by the increase in stimulant prescriptions and childhood diagnoses).

Expanded Access to Healthcare & Telehealth Services

Before the COVID-19 pandemic, prescriptions for stimulants were already on the rise—but when the pandemic began, policies were enacted designed to minimize barriers to healthcare access, like expanded telehealth series, allowing more people to obtain a prescription virtually.³ As a result, the percentage of both adolescents and adults receiving prescription stimulant fills increased significantly during 2020–2021, amplifying a trend that had already started in 2016.³

In tandem, there are now more ways of getting a prescription that no longer rely on booking an appointment with a psychiatrist. For the first time in 2022, nurse practitioners accounted for a larger share (23.4%) of stimulant prescriptions compared to psychiatrists (21.8%).

While the ease of obtaining diagnoses and prescriptions can be life-changing, helping people better understand their brains, it’s not without worries—like overprescription, health concerns, and misuse.⁵ (A 2020 survey states that more than five million people are estimated to misuse prescription stimulants.⁶)

In response to concerns about over-prescription and misuse, the Drug Enforcement Administration (DEA) began working on new rules that would tighten these new flexibilities by requiring in-person evaluations for Schedule II medications after an initial telemedicine prescription. These new rules were expected to be finalized by the end of 2024, but both patients and providers have been pushing for an extension.⁴

DSM Diagnostic Criteria

In the U.S., the ADHD diagnosis often uses the Diagnostic and Statistical Manual of Mental Disorder (more commonly known as DSM) criteria, which recognizes all three types of ADHD: impulsive/hyperactive, inattentive and distractible, or combined. While diagnosing, a healthcare provider will focus solely on observable behavior. Do you often have difficulty sustaining attention in tasks or play activities? Do you often fidget? Do you struggle to wait your turn?

This broader classification, especially with the inattentive type, means more people can be diagnosed, even if they don’t show hyperactivity. As a result, this can make the numbers seem higher in the U.S. compared to other countries that may only diagnose more extreme cases, like Hyperkinetic Disorder (HKD).⁷ On a positive note, because the DSM criteria allows for more people to obtain diagnoses, it can help more people better understand their brains and find pride in their differences as a result.

An increase in diagnoses, inferred by an increase in stimulant prescriptions and especially as it relates to children, women, and older adults, suggests a need for additional education and guidelines. Stringent guidelines can help ensure prescription stimulants are in the hands of those who benefit from them most, and more education around behavioral and lifestyle interventions can help address the root cause of attention issues, allowing some to avoid prescription stimulants.

While it can be easy to view the rise of diagnoses as a negative thing (especially when it relates to overprescription, misuse, health concerns, etc.), it can be just the opposite. An ADHD diagnosis can feel freeing; ADHD is not a flaw but rather a reason to learn more about one’s brain and how it works.

A diagnosis can bring about the help and resources one needs to make sense of their brain and show up as their best. It can help teachers better understand their students and how they learn; it can help parents tailor their child’s routine to work for their brain; and it can help society better understand and celebrate neurodiversity and all the wonders it brings to the world. 

1. Heather L. Girand, Szymon Litkowiec, Minji Sohn; Attention-Deficit/Hyperactivity Disorder and Psychotropic Polypharmacy Prescribing Trends. Pediatrics July 2020; 146 (1): e20192832. 10.1542/peds.2019-2832
2. Danielson, M. L., Claussen, A. H., Bitsko, R. H., Katz, S. M., Newsome, K., Blumberg, S. J., Kogan, M. D., & Ghandour, R. (2024). ADHD Prevalence Among U.S. Children and Adolescents in 2022: Diagnosis, Severity, Co-Occurring Disorders, and Treatment. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 53(3), 343–360. https://doi.org/10.1080/15374416.2024.2335625
3. Danielson, M. L., Bohm, M. K., Newsome, K., & et al. (2023). Trends in stimulant prescription fills among commercially insured children and adults—United States, 2016–2021. MMWR Morbidity and Mortality Weekly Report, 72, 327–332. https://doi.org/10.15585/mmwr.mm7213a1
4. Mazur, L., Dimick, G. I., Greco, J., Stauffer, R., Jackson, M. E., Jr., Callaghan, S. L., Enyeart, A., Zanayed, P., & Van Demark, D. C. (2024). Pending DEA extension on prescription of controlled substances via telemedicine. Morrison & Foerster LLP Insights. https://www.mwe.com/insights/pending-dea-extension-on-prescription-of-controlled-substances-via-telemedicine/
5. Moran, L. V., Skinner, J. P., Shinn, A. K., Nielsen, K., Rao, V., Taylor, S. T., … Ongur, D. (2024). Risk of Incident Psychosis and Mania With Prescription Amphetamines. American Journal of Psychiatry, 181(10), 901–909. https://doi.org/10.1176/appi.ajp.20230329
6. Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/
7. Faraone, S. V., Sergeant, J., Gillberg, C., & Biederman, J. (2003). The worldwide prevalence of ADHD: is it an American condition?. World psychiatry : official journal of the World Psychiatric Association (WPA), 2(2), 104–113.