For this month’s post I am going to talk a bit about the title topic, ADHD. As mentioned previously ADHD stands for Attention Deficit Hyperactivity Disorder, and todays post is actually about that name and what I think about it.
The main point is that in my personal opinion, ADHD is a bad name. This is largely due to two main factors: I feel it is not accurate, and it is not fully inclusive of what the condition actually involves.
Firstly, the inaccuracy gripe stems from the fact that ADHD is not a deficit or hyperactivity, as this description implies that someone with the condition simply has too much of one thing and not enough of the other. This in my opinion is not true and this perception of the condition is, I believe, actively detrimental to both diagnosis and support of this condition. Misconceptions around ADHD can lead to issues such as people not getting referred to specialists for diagnosis, receiving insufficient support in education and even the people themselves not understanding their own diagnosis.
In my opinion, and from what I have read about ADHD as part of my research, it is a regulation issue rather than cut and dry too much and too little. To clarify, I am not referring to the brain chemistry that is behind ADHD, as that is not an area I have a good enough understanding of to talk about. However, when it comes to the impacts and symptoms, I believe attention and activity shouldn’t be described as either a deficit or hyper but instead should be described as poorly regulated. This can be seen in how some studies seemingly suggest that symptoms of hyperactivity fade as people get older, however I think this could be a change in regulation. So, if for example, young people are naturally more energetic, then it could be suggested, that people who have issues regulating their energy, are more likely to skew towards the hyper end of the scale at younger ages. While when they get older, people with ADHD find that hyperactivity is just as common as hypo-activity, where they struggle to generate energy and motivation. With the attention side of things, this is again more a regulation issue, people can be easily distracted or struggle to focus on things yes, however this can also manifest as bouts of hyper-focus where people can be completely shut off from the world due to developing an intense and often out of their control level of focus.
The second main aspect of my opinion on this is the fact that the condition name does not actually cover all aspects of ADHD which causes issues in some symptoms not being used for diagnosis or considered when providing support. A lot of people just consider ADHD to manifest as someone who can't pay attention or someone who is constantly fidgeting; however this is by no means a fair description of the condition. Issues such as time blindness, decision paralysis and difficulties with emotional regulation are all common symptoms in people with ADHD but because they don't fall into the stereotypical categories, they are often dismissed. Because these other symptoms are not as well known, due to the name being too narrow, the support that is provided is also often not enough. It can often be focused exclusively on helping someone reduce their fidgeting or trying to improve their focus, while ignoring other issues, which can at times be much more detrimental.
This means research around ADHD is often missing out on massive factors, especially when you take into consideration issues around co-morbidity and under-diagnosis. It's also likely that societal factors impact diagnosis, such as the apparent gender disparity in diagnosis. Currently diagnostic criteria itself states that ADHD is a condition more common in male children, over female children, and this factor is reflected in the diagnosis rates. However, an important factor that seems to be ignored in this is that when looking at the stereotypical symptoms of ADHD, it can be noticed that they hold potential for bias in regard to gender. When looking at society, it is easy to see that over the years different standards have been applied to male and female children, such as phrases like being ladylike, or boys will be boys. This leads to female children being far more heavily pressured not to display behaviours which would stereotypically be associated with ADHD, meaning they are more likely to mask these symptoms, as discussed in my last blog post. This coupled with the diagnostic advice that male children are more likely to have ADHD, creates a vicious cycle in which the diagnosis of ADHD, especially in female children and adults, becomes much more unlikely and stigmatised due to misconceptions.
As a result of this, ADHD is very much misunderstood by many people, which is a major issue, that has even been highlighted by leading researchers in the field. However, institutions like education and health care, still have fundamental misconceptions, that lead to people being left behind and not receiving the support they need.
An alternative name could be executive function deficit disorder, which has been suggested by Dr Russell Barkley who researches ADHD. This name would give a more honest view of ADHD, that rather than describing it as something effecting just focus or energy, it has an impact on overall executive function. Such a name change could be incredibly beneficial to people with ADHD and help expand the diagnosis to those who would benefit from the support and improve the exiting support of those who are already diagnosed.
I hope this post has helped people expand their own understanding of ADHD, and possibly even helped undo some of the misconceptions surrounding it.
An Article by Dr Russel Barkley about ADHD and executive function: https://www.additudemag.com/7-executive-function-deficits-linked-to-adhd/
Blog post explaining terms used: https://lukehalpin.blogspot.com/2023/03/what-is-masking.html