The article challenges the prevailing understanding of Attention Deficit Hyperactivity Disorder (ADHD), questioning whether the current diagnostic criteria and widespread medication use are justified. It cites a New York Times report indicating an "empirical crisis" regarding ADHD's scientific basis. The article suggests that ADHD is not solely a brain-based disorder, but rather influenced by both biological and environmental factors, existing on a continuum rather than a binary.
The author argues that biological explanations are often overemphasized, leading to an oversimplification of complex conditions and potentially an over-reliance on medication. The article points to statistics showing a significant increase in ADHD diagnoses, particularly among adults, noting the substantial use of stimulant medications like methylphenidate and amphetamine. It questions the long-term effectiveness of medication and its impact on academic performance.
The author draws parallels to other instances of medicalizing behavior, such as the classification of shyness as social anxiety disorder. The author suggests the pervasiveness of mental health discussions on the internet, coupled with the shorter attention spans induced by social media, may contribute to the rising number of self-diagnosed and diagnosed cases of ADHD.
The article concludes by advocating for a more holistic approach, encouraging self-awareness and personal responsibility. The author emphasizes that while addressing mental health concerns is crucial, it shouldn't come at the expense of acknowledging that common struggles with focus and attention are not necessarily indicative of a mental disorder. The article encourages a more balanced perspective that avoids oversimplifying complex issues.
A startling report in New York Times Magazine has brought to light how the scientific consensus on attention deficit hyperactivity disorder has changed. According to one of the scientists interviewed for the piece, the concept of ADHD is facing an “empirical crisis.”
ADHD’s hallmark symptoms of inattentiveness and restlessness present in a variety of ways. Individuals are easily distracted, forgetful, and impulsive. They have difficulty staying organized and lose or misplace their belongings frequently. Severe symptomatology can interfere with not only productivity at school or work, but the ability to complete mundane tasks associated with daily life.
ADHD was originally thought to be caused by deficits in the brain, such as smaller structural volumes. As a result, medication was deemed the appropriate solution, and biological explanations were promoted as a way to destigmatize the disorder.
Contemporary findings, however, suggest that ADHD results from both biological and environmental (or situational) factors. It is conceptualized as existing along a continuum, without a clear line differentiating between someone who has ADHD and someone who doesn’t. Symptoms are also believed to be context-dependent, fluctuating over the course of one’s lifespan. In some cases, psychological comorbidity exists (that is, other mental health diagnoses are evident, in addition to attentional problems), such as depression, anxiety, learning disorders, or autism spectrum disorder.
According to the Centers for Disease Control and Prevention, 7 million children in the U.S. have been diagnosed with ADHD, which translates to approximately one in nine children. On top of that, 15.5 million American adults have ADHD, and nearly a third report taking stimulant medication for it. The stimulants used in these medications can include methylphenidate and amphetamine.
Although 10- to 14-year-old boys are the demographic most likely to be prescribed ADHD medication, the largest increase has been among adults. By 2022, 18 million prescriptions had been written for Americans in their 30s.
Although these medications can improve one’s ability to focus and enjoy otherwise mind-numbing activities, these effects don’t last long-term, nor do they improve academic performance or learning ability.
In my view, biological and brain-based explanations are frequently used to prop up erroneous narratives. Recent examples include the use of brain scans to justify the nightmare known as gender ideology, and the claim that polyamory is a sexual orientation.
Although scientists and academic institutions today lean more toward dismissing biology in favor of social constructionism, when biological explanations are overextended, this is equally unhelpful. In the realm of mental health, it can lead individuals to embrace an overly deterministic outlook, believing their decisions are outside of their control, or that their conditions will forever define them.
Society has a history of pathologizing and medicalizing behavior to justify medicating people. Remember when shyness was upgraded to the mental illness we now know as “social anxiety disorder”?
There are indeed individuals who fear social judgment so intensely they are unable to attend gatherings or step outside of their homes. But every instance of nervousness in a social setting is not indicative of an anxiety disorder. In many cases, nervousness can be healthy and adaptive. This overuse and exaggeration of mental health lingo comes at the expense of those who are genuinely suffering.
In the realm of attentional difficulties, everyone struggles with paying attention, feeling overwhelmed, and fidgeting once in a while. With the normalization of therapy and discussing one’s mental health issues ad nauseum, especially on the internet, many will happily claim a diagnosis of ADHD or some other form of “neurodivergence,” whether or not they experience legitimate impairment in their functioning, or any symptoms at all.
ONE IN 4 ADULTS SAY THEY SUSPECT HAVING UNDIAGNOSED ADHD
Some may argue that the popularity of short-form content on social media, and constant interruption from smartphones, has attenuated everybody’s attention spans. I would agree, but if everyone is experiencing the same problem, it isn’t a mental illness — because this reflects a population norm. In this case, it’s not that everyone has a pathological inability to filter out distractions, but that we could all benefit from being on our phones less often.
Instead of taking pride in possessing signs of a mental illness, should we not be encouraging each other to be healthy? This doesn’t require going backward and re-stigmatizing conversations about mental health. It is, instead, a form of strength and self-awareness.
Dr. Debra Soh is a sex neuroscientist and the author of The End of Gender. Follow her @DrDebraSoh and visit DrDebraSoh.com.
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