Nearly 1 in 5 high school boys and 11 percent of all schoolchildren have been diagnosed with attention-deficit/hyperactivity disorder, or ADHD, according to The New York Times. This represents a 16 percent increase since 2007 and a 41 percent rise in the past decade.

The newest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM V) is likely to support the upward trend because it expands the diagnostic criteria for ADHD by casting a wider net and lowering impairment criteria. Some argue that this expanded definition is driven by the pharmaceutical industry. Two-thirds of the 6.4 million children diagnosed with ADHD now take stimulants such as Ritalin or Adderall, driving up sales to $9 billion as of 2012. Advertising campaigns play on parental fears by displaying students who are failing in school in an apparent effort to push parents to have their own children diagnosed and treated.

Wealth disparity is another reason for the rapidly increasing numbers of patients with ADHD. The economic gap dividing rich and poor has never been this big; the least wealthy 80 percent of the U.S. population holds only 7 percent of the country’s wealth in contrast to the wealthiest 1 percent of the population with 24 percent. Since ADHD is more common in children living in adverse environments, poverty and stressful early life events appear to be partially responsible for the steadily growing ADHD population.

A third contributing factor is the modern-day digitalization of our lives. We spend so much time online, interacting with computer displays, phones and the real environment simultaneously. Multitasking has even become a valued trait when seeking employment. However, in children this type of behavior may promote dysfunctional interactions and arrest development of important characteristics such as patience and the ability to concentrate.

The annual societal cost of illness for ADHD is between $36 billion and $52 billion, according to the Center for Disease Control and Prevention. However, as these numbers are based on a prevalence of 5 percent, actual costs may be much higher. A new study estimated numbers to be as high as $143 billion to $266 billion annually and include not only medical costs, but also education resources and lost productivity and law enforcement.

Stimulant medications used to treat ADHD are also subject to misuse and illegal diversion. Known for their ability to increase attention span and enhance performance, drugs like Ritalin provide a misguided solution to meet the ever-increasing demands of a highly competitive, intellectually focused society. Studies have shown that 10 percent to 30 percent of college students taking ADHD medication have misused or diverted their pills. They also reveal that a diagnosis of ADHD is an "easy out" for certain parents who are afraid their children will not excel in school without extra help.

On the other end of the spectrum, some parents are told by school that their children are not performing well and need to be seen by a psychiatrist who, after one visit, recommends amphetamines. As there is no definitive test to confirm the diagnosis of ADHD, some parents feel forced to choose between harming their children through noncompliance versus placing their health at risk from long-term use of amphetamine medications. Many parents wonder if their child’s behavior is really ADHD or simply part of growing up.

Clearly, ADHD stimulants, if given to the right patients, can make a huge difference, by enhancing the ability to concentrate and succeed at school and at work. However, taking these pills is not without risk. Such medications can cause weight loss, irritability, dependence and growth problems in children.

To identify those who truly suffer from ADHD, we need better means to render a responsible diagnosis. Making a diagnosis of ADHD should be a multistep process based on a complete medical and neuropsychological evaluation. In addition, the Food and Drug Administration recently approved a tool called the Neuropsychiatric EEG-based Assessment Aid, or NEBA, a noninvasive test that measures brain waves designed to make an objective diagnosis. Combined with the medical and psychological work-up, the NEBA may be an effective tool.

Treatment options are not limited to stimulant medication. Research has shown that neurofeedback therapy and behavioral training are effective in treating the attention and hyperactivity symptoms of ADHD. In fact, treatment combination of medication and behavioral training has proven to yield the best outcomes. A multifocal approach involving parent, teacher, therapist and child might be best the way to go.

Fortunately, ADHD is less common in the sunny states and correlates with melatonin levels. Sunlight has actually been shown through studies to improve ADHD symptoms. So, without abandoning sun safety, take your children to the beach and let them play. It could do wonders.

Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.