Myth busting ADHD
Researcher
If the Government is serious about its ambition to shift to a preventative health system, they need to take improving the diagnosis and management of Attention Deficit Hyperactivity Disorder, usually known as ADHD, far more seriously.
ADHD – a neurodevelopmental difference impacting a person’s ability to regulate concentration, impulses and emotions – is shrouded in a host of myths, confusion and misunderstandings.
As a result, ADHD has been a frequent flyer in news headlines for over a decade now. These stories predominantly debate whether the rise in ADHD diagnoses is the symptom of some societal or personal issue – for example is it a fad driven by social media, the result of an over-medicalisation trend or due to the failure of lax diagnostic tools.
And this sentiment is not exclusive to publications known to be provocative, it is widespread and mainstream. In March, Health Secretary Wes Streeting, claimed mental health conditions are over-diagnosed, and a recent New York Times article argued ADHD is over-diagnosed and overmedicated.
The validity and seriousness of ADHD is also widely disputed. Many claim it doesn’t exist, everyone has it or people are just using it as an excuse for their personal failings.
Chris Packham’s BBC Two documentary, Inside Our ADHD Minds, reveals a starkly different reality. Airing on Monday evening, Packham lets us into the lives of two very different-to-each-other people with ADHD and disproves some of the most persistent myths around the condition. The documentary successfully shows the vast and detrimental impact ADHD can have on people’s lives, especially when undiagnosed and unmanaged.
Packham’s documentary is a more-than-welcome contribution to the ADHD conversation, but it is also clear widespread understanding of ADHD is still muddied by myths. So, let’s do some ADHD myth busting.
Myth 1: ADHD is over-diagnosed these days. There was none of this ‘ADHD’ business back in my day.
Yes, the number of ADHD diagnoses has risen dramatically in recent years. But no, this is not the result of overdiagnosis. In fact, only 0.32 per cent of adults in the UK are diagnosed with ADHD – given it is estimated 3 to 9 per cent of adults have ADHD, only a tiny fraction are diagnosed.
The increase in ADHD diagnoses is a correcting of long-term underdiagnosis of the condition, especially underdiagnosed in women and girls. Inside Our ADHD Minds highlights this gender inequality in diagnosis, with women sharing their personal experiences struggling to get diagnosed. The documentary explains it is thought this gender imbalance in diagnosis is the result of diagnostic criteria based on men and boys, along with misconceptions about the prevalence of ADHD in women and girls. Given it is now understood ADHD often presents very differently in women, it is no wonder so many women have gone, and still are, undiagnosed.
Myth 2: Is ADHD real, or is it just an excuse for poor behaviour?
ADHD is very real. Although the symptoms – things like inattention, procrastination, time management issues, acting impulsively or difficulty managing emotions – are problems everyone struggles with from time to time, people with ADHD struggle with these issues constantly. This is the result of physiological differences in their brains.
Dr Tony Lloyd explains in Packham’s documentary, the brains of people with ADHD are structurally and functionally different. They have lower levels of dopamine and noradrenaline in their brain, neurotransmitters vital for enabling people to regulate their concentration, initiate tasks and control their emotions. Brain scans show that different parts of an ADHD person’s brain lights up when they try to concentrate on something, compared to a neurotypical person’s brain, indicating their attention is being pulled towards multiple things at the same time, likely to lead to distractibility.
Myth 3: ADHD is not that serious. There’s no need to even get diagnosed.
ADHD really is that serious. NICE have found that ADHD is associated with poverty, lower family income, and unemployment. And a recent study found significantly lower life expectancy for adults with ADHD – over 8 years less for women and nearly 7 years less for men.
Depression is three times more prevalent in adults with ADHD, compared to without. It is estimated nearly 50 per cent of those with ADHD will have anxiety disorders, compared to less than 20 per cent of the general population experiencing anxiety (which includes those with ADHD). And those with ADHD are at a greater risk of a broad range of physical health issues, from obesity, to sleep disorders, to epilepsy.
The brains of those with ADHD work and are structured differently, so knowing a person has ADHD, i.e. diagnosis, is a core component of prevention, treatment and management of any health issue for them.
Myth 4: There’s no reason a neurotypical person should care about any of this.
First and foremost, undiagnosed or unmanaged ADHD has detrimental impacts on those with it. For far too long, this group has had to struggle and suffer without support or even knowing why they are struggling. There is a moral obligation for the NHS and the State to step up and far better meet the needs of people with ADHD.
Secondly, improving the diagnosis and management of ADHD – given the associated broad range of medical and social issues faced by those with ADHD – perfectly aligns with the Government’s commitment to shift to a preventative health system. This shift would be a far more cost-effective approach, for both the health system and the economy.
Policymakers and the general public alike need to start taking ADHD far more seriously. Despite the sharp increase in diagnoses, the vast majority of those with ADHD remain undiagnosed. And improving the diagnosis and management of ADHD will only have positive impacts – for the individual with ADHD, for the health system and for broader society. With the 10 Year Health Plan due next month, now is the time for the Government to take action.