One in every 15 youth suffers from ADHD: Here’s what you need to know about this mental health difficulty

The Covid-19 pandemic has brought mental health to the global radar. But several years ago, the Bollywood blockbuster, Taare Zameen Par, brought the mental health difficulties of children into sharp focus. The movie, released in 2007, transmitted an indelible message. The mental health concerns of children are often overlooked, and we need to keep the discussion current. In the rat race of life, the most vulnerable among us are easily forgotten.

In Taare Zameen Par, eight-year-old Ishaan tugged at our heart strings, as he (and his mother) struggled with schoolwork. His art teacher, Nikumbh (played by Aamir Khan) won our hearts with a role that emphasised the importance of recognising and adapting teaching methods for children with mental health difficulties. The movie highlights Dyslexia, a problem that frequently co-occurs with an issue even more common in children of school-going age: Attention-Deficit/Hyperactivity Disorder, or ADHD. Studies conducted around the world have shown that about 6 per cent of youth suffer from ADHD. An International Consensus Statement reported that there was no significant difference in the rates of ADHD between North America, Europe, Asia, Africa, South America, and Oceania.

ADHD is a brain disorder caused by the confluence of many genetic and environmental risk factors. Doctors define ADHD using three types of symptoms: inattention, hyperactivity, and impulsivity. Boys and girls show this by having trouble keeping their attention focused on the matter at-hand, and being unable to complete tasks, like homework. Some kids, like Ishaan, might simply stare off in the distance, not paying attention while their imagination runs wild.

The impulsivity of ADHD leads kids to blurt things out before thinking through their thoughts, or to act irrationally based on impulse rather than what’s appropriate for the social setting they are in. Finally, kids with ADHD can be hyperactive. Fidgeting, restlessness, and larger whole-body movements, like swinging their arms and legs, disrupt classrooms and distract the child with ADHD, as well as the people around them. How a child presents their ADHD is complex, and can be missed completely, especially for girls who are less disruptive than boys, yet also suffer academically. The temptation might be to dismiss these symptoms as ‘kids being kids,’ but that is wrong.

This is relevant in the Indian context, where there is resistance in accepting a diagnostic label, like ADHD, and medication options. These kids are merely labelled as ‘very naughty’. Often, it’s stated as a matter of pride that the same was seen in the grandparent and great- grandparent. They didn’t turn out too bad, so this child too ‘will outgrow the same’; or they often approach socio- religious methods to ‘cure’ the same.

Untreated ADHD can lead to difficulties in life, such as poor performance at school, and even failure. Adults with ADHD tend to be more accident-prone and can have trouble holding a job. More seriously, many untreated adolescents and adults self-medicate through substance abuse, and are at higher risk of sexually-transmitted diseases and premature death. It is important to let kids be kids, but ADHD will get in the way of having a happy childhood and can make it difficult to live a fulfilling life in adulthood.

In Taare Zameen Par, children with these difficulties are often taunted and teased. They are stigmatised by others, even adults, who call them “duffer, idiot, lazy, crazy!” Teachers see them as a ‘waste of time’ especially when they are focused on nurturing the talent of a select few who have a chance to be school toppers. Kids with ADHD suffer in silence and lose their self-esteem; a stark consequence that can last a lifetime.

The film Taare Zameen Par has an important message, which is that children with learning difficulties, like dyslexia and ADHD, do not need to suffer like Ishaan.  There are many ways a child with ADHD can be supported, both with and without medicine. Most children respond well to a combination of treatments, which include stimulant and non-stimulant medication, therapeutic supports, and lifestyle adjustments, like diet, exercise, and strategies that prop up boys and girls when they fumble, so they do not feel the sharp loss of their self-confidence. In Taare Zameen Par, Ishaan stares out the window, his imagination taking him to places that are serene and beautiful. As scientists, we share the vision of a beautiful life for children who struggle. We know there are many strengths in people who have ADHD, and imagine a future where ADHD is not a life-sentence of struggle and failure.

This article was written in collaboration with: Prof Stephen V Faraone, president of the World Federation of ADHD and Distinguished Professor, SUNY Upstate Medical University, USA; Dr Mantosh Dewan, Distinguished Service Professor, Department of Psychiatry, and President, SUNY Upstate Medical University, USA; and, Dr Alka Subramanyam, Associate Professor, Topiwala National Medical College and BYL Nair Hospital, Mumbai.

Mel Lefebvre is Communications Director; Sarojini M Sengupta, PhD, is CEO, AIMH (www.aimhinc.com). Views expressed are personal.

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