If I were to accept the premise of Channel 4’s documentary The Great ADHD Myth?, then I have spent years labouring under a false belief. The diagnosis I received for my so-called ADHD is apparently just an arbitrary concept, invented by popular consensus and promoted by publications like New Scientist.
National Health Service doctor Max Pemberton presented this idea in a documentary that aired in the UK last night, and in the less than 24 hours that have passed since, many articles and columnists have commented on why it’s so offensive. While I have my own thoughts on that – and trust me, I’m offended – the most urgent issue to address is the show’s wilful misrepresentation of the scientific consensus that ADHD is a real condition.
Read moreWhy many women with ADHD feel overwhelmingly controlled by their hormones
One claim is that ADHD is a new condition, dreamed up to force square pegs into the round holes of modern life. This is simply not true. An early documented medical description of what we now call ADHD dates from 1798 when Alexander Crichton from the Royal College of Physicians described people who had problems paying attention for long enough to complete tasks, saying they had “the fidgets”.
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Since then, the condition has been medically described and renamed (who can forget “abnormal defect of moral control in children” in the early 1900s?) many times. While Pemberton is right to note that rates of diagnosis have soared in recent years, diagnoses in the UK are still below estimates of population prevalence from around the world. Studies that screen large groups of people for symptoms consistently put rates of ADHD in the general population at around 5 per cent in children and 2 to 3 per cent in adults.
But the results of an analysis published in The Lancet this month found that just 1 per cent of the population is diagnosed overall in England. Even among boys and young men, the group most likely to be diagnosed, the recorded rates are 2.9 per cent and 3.6 per cent, respectively. If anything, ADHD is underdiagnosed on these shores.
Autism and ADHD are on the rise due to widening diagnostic criteriaA study of 140,000 people suggests that a broadening of the diagnostic criteria for autism and ADHD explains the sharp rise in diagnoses, but that doesn’t mean too many people are being told they are autistic or have ADHD
Then there is the claim that ADHD is a social construct, not a neurodevelopmental condition. This is something Pemberton concludes after talking to neuroscientist Katya Rubia at King’s College London. Rubia says that while there is evidence of differences between the brains of people with ADHD and neurotypical people at the group level, it isn’t possible to diagnose ADHD from a brain scan.
She is right, of course. You can’t diagnose ADHD from brain scans. The same can be said for most, if not all, psychiatric and neurodevelopmental conditions. Most of these, like ADHD, are diagnosed by assessing symptoms and the effect they have on a person’s everyday ability to function. “My interview was hours long and they cherry-picked the bits that suited their push for presenting ADHD as a myth,” Rubia told New Scientist. “Biased programs like this one that push their view of ADHD as a mythical entity are irresponsible and will have detrimental effects.”
Pemberton proceeds to seek out a diagnosis for ADHD via an online assessment, despite thinking he probably doesn’t have it. In reality, ADHD is diagnosed via a lengthy process that includes multiple questionnaires and an interview. To get a diagnosis, ADHD traits have to be causing significant problems in two or more settings, such as at work or with managing bills. If it doesn’t affect your life, mental health or relationships, you don’t qualify for the second D of ADHD: disorder.
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The person carrying out his diagnosis isn’t identified. All we hear is that Pemberton apparently has ADHD and is handed a prescription for drugs that are described as “basically cocaine”.
At this point, the scaremongering about drugging our brains, particularly those of children, really begins. Yes, there is an argument that we need more data on the effects of long-term medication use for ADHD. We don’t have this yet, partly because, despite claims of the addictiveness of these medications, people with ADHD are notoriously bad at sticking to their medication in the long term.
What we do have is evidence that treatments, whether drug-based or not, improve quality of life and self-esteem, and that undiagnosed and untreated ADHD increases the risk of mental and physical ill health, substance abuse, criminality and suicide.
Thought-provoking photographs capture what it feels like to have ADHDThese unusual images were created by visual artist Daniel Regan by submerging Polaroid photographs in his ADHD medication, to represent his experiences with the condition through art
All of which will hopefully be of some comfort to the parents of Mason, a young boy in the documentary who is taken off his medication in favour of yoga, nature walks and zero screen time. It seems to help a bit, but his schoolwork and behaviour decline, so his parents reluctantly put him back on the meds.
The documentary makes that seem like a failure. But the real failure is the way the programme-makers chose shock tactics over scientifically accurate reporting, letting Mason, and the rest of us, down.
Channel 4 declined to comment and Pemberton didn’t respond to a request for comment.
Need a listening ear? UK Samaritans: 116123 (samaritans.org); US Suicide & Crisis Lifeline: 988 (988lifeline.org). Visit bit.ly/SuicideHelplines for services in other countries.