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Mhmm...! Okay.
额……！好吧。
So, there’s this question that I’ve been asking myself a lot lately.
是这样的，最近我一直在问我自己一个问题。
I’m constantly distracted...
我经常走神……
"Wait... wait... wait. Umm... I wasn't listening."
“等一下……等一下……等一下。嗯……我刚刚走神了。”
My room is a mess.
我的房间也是乱七八糟的。
"I cleaned this yesterday."
“昨天才收拾的呀。”
And I keep forgetting my keys everywhere.
而且我总是到处忘钥匙。
Do I have ADHD?
我不会有多动症（ADHD）吧？
And it seems like a lot of people on the internet are asking the exact same question.
貌似很多人都在网上问过一毛一样的问题。
But the thing is...diagnosis can be a bit tricky.
问题是……多动症诊断起来比较麻烦。
And the ADHD community is divided into two sides:
而且ADHD圈也分化成了两派：
People who think ADHD is being over-diagnosed, and people that think it’s being underdiagnosed.
一派认为ADHD已经被过度诊断了，另一派则认为当前的ADHD诊断力度根本不够。
A key criteria for Attention Deficit Hyperactivity Disorder is that, it shows up at a very early period of life.
判定一个人是否患有注意力缺陷及多动障碍有一个关键标准：患者是否幼年就已表现出有关症状。
And that's according to the DSM, a manual published by the American Psychiatric Association.
这是美国精神病学协会出版的DSM手册说的。
It’s essentially a huge guide with standardized criteria that doctors use to diagnose mental disorders.
这本手册部头非常大，参考的也都是标准化了的医生诊断精神障碍的标准。
And according to the latest edition,
最新的版本显示，
there are 5 big things that need to be checked off to determine if someone has ADHD.
要确定某人是否患有多动症，可主要考察5个因素。
First, you need to show persistent patterns of at least 6 symptoms from at least one of two categories.
其一，他需要持续表现出两大类症状中至少一类症状的至少6点具体症状。
And these symptoms had to exist before the age of 12.
其二，这些症状开始出现的时间必须是12岁以前。
Be present in two or more different settings.
其三，时刻处于两种甚至更多种状态之下。
Interfere with your social, academic, or professional abilities.
其四，症状已经干扰到了你的社交、学术或专业能力。
And not be "better explained by another mental disorder".
最后，“用其他精神障碍并不能更好地解释”其症状。
If you do meet these criteria, the good news is that ADHD medications are super effective.
如果你确实符合这些判断标准，那有一个好消息要告诉你，ADHD药物的效果是非常明显的。
You might be familiar with Ritalin.
你可能听说过利他林了。
It was introduced in back in 1955,
这种药是1955年引进的，
and since then more pharmaceutical companies developed new types of ADHD medication.
之后，其他制药公司也开发出了新型的ADHD药物。
Today, about 75% of ADHD patients respond to 1 of 2 types of stimulants.
到目前为止，两种主流刺激剂对大约75%的ADHD患者都是管用的。
Methylphenidate—which is in brands like Ritalin and Concerta;
一种是哌醋甲酯——利他林和专注达等品牌的刺激剂含有的成分；
and Amphetamine, which is found in Adderall.
另一种是安非他命，阿德拉里发现的刺激剂。
But not everyone thinks this boom in drugs is a positive thing.
不过，不是所有人都觉得这种用药热潮是件好事。
"First of all, it's weird that a diagnosis that used to be applied to about 3% of the population to 15%.
“首先，过去诊断比例只有3%，现在一下子提高到了15%，不奇怪吗？
An enormous increase in the diagnosis."
诊断比率出现了大幅度的上升。”
This is Dr.Allen Frances, and he believes that ADHD is being over-diagnosed.
这位是艾伦·弗朗西斯博士，他的观点是ADHD被过度诊断了。
"This is coincident to the drug companies coming out with new and very expensive products.
“诊断比率的上升和制药公司相继出现并推出各种昂贵的新产品的操作可以说是不谋而合的。
That give them both the method and means to aggressively market ADHD as a disorder--
提高诊断比例能够方便他们把ADHD当作一种障碍来营销——
selling the ill in order to sell their pills."
方便他们出卖患者的健康来出售他们的药丸。”
According to a number of studies done in the US, Taiwan, Iceland, and Canada—
美国、台湾、冰岛和加拿大等地开展的一系列研究显示，
the youngest kid in the classroom was way more likely to be diagnosed with ADHD than the oldest kid.
教室里年龄最小的孩子被诊断出ADHD的可能性比年龄最大的孩子被诊断出的可能性大得多。
"What this means is that immaturity is being turned into a mental disorder and being treated with a pill."
“这就意味着不成熟正在被当成一种精神障碍来进行药物治疗。”
In 2013, the DSM’s criteria broadened to include children who had symptoms by age 12.
2013年，DSM将出现症状的年龄标准扩大到了12岁以前。
Where previously, it required symptoms before the age 7.
之前的年龄标准是7岁以前。
This looser criteria could possibly increase the risk of more children being misdiagnosed for ADHD and put on drugs.
放宽标准可能造成更多的儿童被误诊为ADHD继而被迫接受药物治疗。
And all drugs have side effects—even the effective ones.
而且，所有的药物都是有副作用的——即使是治疗ADHD药效非常明显的那些药物也不例外。
Studies have found that ADHD medications increase heart rate and blood pressure.
研究发现，ADHD药物会导致心率和血压升高。
Other side effects include strokes, depression, and addiction.
还存在引发中风、抑郁和上瘾等其他副作用。
In rare cases, misdiagnosis can mean treating the wrong problem altogether.
极少数情况下，误诊还可能造成治疗方案南辕北辙。
"If you make a misdiagnosis of ADHD in an adult who has bipolar disorder and give him stimulants,
“如果你将一位患有双相情感障碍的成年患者误诊成了ADHD患者，然后给他服用刺激剂，
you become much worse."
那你不仅不是在给他看病，反而是在给他火上浇油。”
On the other hand...
另一边……
"There is a pattern in psychiatry.
“精神病学界有个现象。
If you go back to schizophrenia 60 years ago,
如果我们回到60年前精神分裂症盛行的时候，
people used to say schizophrenia wasn't a psychiatric disorder--it was a choice of lifestyle.
你会听到人们经常说精神分裂症并不是一种精神疾病，而是人们自己选择的一种生活方式。
We don't have that conversation anymore.
这个话题现在我们已经不讨论了。
30 years ago, same argument was applied to depression.
30年前，抑郁症也有个同样的经历。
We don't have that discussion anymore.
这个话题我们现在也不讨论了。
And in 20 or 30 years from now, we will no longer be having this discussion about ADHD."
二三十年后，估计我们连ADHD也不会讨论了。”
This is Dr. David Goodman and he thinks ADHD is being underdiagnosed.
这位是大卫·古德曼医生，他的观点是，目前对ADHD的诊断还远远不够。
"In one survey, they found that 4.5% of adults in the United States likely have ADHD.
“有一项调查发现，美国有4.5%的成年人可能患有多动症。
But what's really striking are two important facts.
但真正让人触目惊心的是两个非常重要的现实。
One was that 75% of the adults who presumably have ADHD have never being diagnosed,
一个是有75%的可能患有ADHD的成年人从未接受过ADHD诊断，
and of those with ADHD, 45% were receiving mental health treatment but not for ADHD."
另一个是已经诊断为ADHD患者的人群中，有45%的人接受的是精神健康治疗而不是ADHD治疗。”
And this is a big problem, especially for women.
这个问题就严重了，特别是对女性而言。
Women are generally harder to diagnose because while hyperactivity is more common in men and boys,
通常情况下，针对女性的ADHD诊断更为困难一些，因为虽然多动症在男性和男孩子中间更为常见一些，
inattentiveness is more common for women and girls.
心不在焉的问题却在女性和女孩儿中更为普遍。
Boys are twice as likely to be diagnosed with ADHD as girls are.
男孩被诊断为ADHD的可能性是女孩的两倍。
But many argue that it’s not necessarily because it’s more common in boys.
但许多人都辩称，这并不一定是因为ADHD在男孩中本来就更常见的缘故。
According to psychologist Ellen Littman,
根据心理学家艾伦·利特曼的说法，
studies of ADHD were based mostly on hyperactive young boys,
ADHD研究主要是在活跃过度的男孩子身上开展的，
leading to a distorted understanding of the disorder.
所以就造成人们对这种疾病的理解产生了一些误区。
Dr. Goodman also argues that media portrayals of ADHD can add to a stigma that keeps people from seeking treatment.
古德曼医生还认为，媒体对ADHD的渲染可能会增加人们的羞耻感，影响他们寻求治疗。
"Hi there! What’s your name?
“你好！你叫什么名字？
My name is Abernathy Darwin Dunlap, but you can call me ADD…
我叫阿伯纳西·达尔文·邓拉普，不过你可以叫我ADD…
on the count of the fact that I have ADD."
因为我确实得了ADD。”
"Wow. You were just the worst student in the world, weren’t you?"
“哇，你真是全世界最差的学生，不是吗？”
"They said I have AD… something. Can we have class outside?!"
“他们说我得了AD…什么的。我们能到外面上课吗？！”
An extensive study has shown that ADHD patients who get treatment
一项大规模的研究表明，从长远来看，接受治疗的ADHD患者
have much more beneficial academic and social outcomes in the long run than those who don’t.
在学习和工作中的表现远比不接受治疗的患者出色。
So the real problem here isn’t really whether there are too many or too few people diagnosed with ADHD.
所以，真正的问题并不是被诊断为ADHD的人究竟是太多还是不够，
It’s...are the right people, getting the right treatment.
重要的是……病人是什么病就给他诊断成什么病，该怎么给他治就怎么给他治。
And that’s something you’re not going to find on the internet.
而具体要怎么治疗，你在网上找是找不到的。
