ADHD misrepresentation: harmful and damaging

Written by Dr Sinead Rhodes (Senior Research Fellow) and Ailbhe McKinney (PhD researcher), University of Edinburgh

The last post I wrote about the representation of ADHD in the media highlighted clear improvements with coverage of this neurodivergent condition over the last couple of decades. It is then extremely disappointing to see a new post in the media that mocks the condition. The article is so bad that I am really hoping it is withdrawn and the media source learns a stern lesson from responses like this as I am assuming people with ADHD will be highly offended by it.

We have written a lot on Research the Headlines about sensationalist or misleading headlines but this one definitely tops all of them – ‘I may not be a doctor….but I’m almost certain you have ADHD: Welcome to the new stage of your life, where everyone seems to have the same neurological condition’.   Even more concerning is that the headline matches the full article. We often post about ‘Don’t stop at the headline’ as the article is usually informative with the headline acting as click bait. In this case though, the ridicule continues throughout the article. This is very disheartening to see this for what is a clinically diagnosed condition that can cause those affected significant difficulties in everyday life.

Ironically, I clicked on this post as I was waiting on some final information to press submit on a grant application I have been writing to fund a study to ensure more appropriate assessment of mental health in neurodivergent young people. To read an article that refers to ‘the ever increasing explosion in adult ADHD diagnoses’ at a time when we know that ADHD is still massively under-diagnosed is frankly alarming.  ADHD is under – not over- diagnosed (at least in the UK where this article was published). Many of those who have not been diagnosed, for whatever reason, typically have significant difficulties in how they function. This often extends to their mental health. Also, the article claims receiving a ADHD diagnosis can be achieved with “stunning ease” yet, in Scotland (and the UK), waiting lists for neurodevelopment condition assessment are lengthy, typically 18 months upwards with some children waiting up to 3 years (Crane et al., 2018), see for example NHS Tayside but has been up to seven years for adults.

Children and adults who are neurodivergent, including those with ADHD, have a much higher risk of mental health difficulties than their peers. They also show these difficulties much earlier in life – often in childhood. Mocking the usefulness of a diagnosis and the process is simply appalling.  We know that psychoeducation – understanding a condition you may have – is extremely important for positive outcomes. This is indeed recognised in the NICE (National Institute for Health and Care Excellence) guidelines (NICE, 2018) where understanding ADHD is recommended within the treatment plan for those with ADHD.         

It is difficult to read this article and not get the impression that the author thinks this will come across as some kind of banter – the whole piece is written as if it was to be interpreted as a joke. They even refer to the outcome of their assessment as ‘plus this way I get drugs!’ We know that for many young people and adults with ADHD stimulant medication can be a lifeline – it can facilitate them to stop and think and plan and remember what they need to do in any given situation. Coupled with appropriate supports within their environment – whether they are a child at home or school or an adult in employment – it can be an extremely important component of navigating their day in what many with ADHD perceive as a ‘neurotypical world’.

I would worry about someone who recently got an ADHD diagnosis coming across this article which belittles them. They may be at a point in their life where finally things are starting to make sense and may even be building the courage to tell friends, family, and co-workers. This article will then stop them in their tracks to do so and make them feel like a joke. They might think if I tell people I have ADHD they’ll just think I am a silly “ultra-online zillennial” looking for an excuse to not to work. After beginning to realise why their life has been harder than everyone else’s, this article will invalidate the years of suffering they have endured, because, as the article says, it is ‘so commonplace’.

The most concerning part of the article was the reference to women undergoing ADHD assessment. The article refers to ‘the reassessment of who’s been chronically overlooked (read: women)’ in the context of describing the new world they think we live in of an ‘explosion of adult diagnoses’. My work has involved considerable engagement with girls and women with suspected ADHD –the non-diagnosis due to having been on a long waiting list, hiding their ADHD (called ‘masking’ or ‘camouflaging’), being overshadowed by depression, anxiety, or eating disorders or delays caused by looking a little different to males with ADHD in their behaviours. Not having a diagnosis – being misunderstood and the mental health consequences that often come with that – just because you are a woman is not a laughing matter. The consequences of not having a diagnosis when you are experiencing those difficulties can be devastating.  Ailbhe McKinney, who is a PhD researcher working with me, has recently completed extensive work with female adolescents and adults with neurodivergent conditions about their priorities for research and the overwhelming response relates to wanting research to focus on masking and fitting in as these are thought to have a huge impact on mental health outcomes. Undermining the importance of diagnosis for women alongside a narrative about how easy it is to get a diagnosis is harmful and damaging to yes what quite frankly are a chronically overlooked group.