DEN Chairs Blog

ADHD Awareness Month

by Jack Hellberg, DEN co-chair

Hello everyone. Increasingly, I have seen discourse online and the media turn its focus on rising diagnostic rates for neurodivergence. This is a significant and important topic, as diagnostic services are under significant strain and medication supplies are often unable to keep up with demand. Around the diagnostic process, our understanding of neurodivergence is certainly incomplete and diagnostic criteria will undoubtably continue to change over time. However, there is a common attitude that I encounter that “everyone is just neurodivergent now” or “anyone can get an ADHD/Autism diagnosis”. Anecdotally, people often ask me something along the lines of “what do you think about all these people claiming they are neurodivergent on TikTok” when they learn that I work for an adult autism assessment service. In response to this, I would like to outline my thoughts on why ADHD diagnostic rates in adults specifically are on the rise:

1. Changing diagnostic criteria

The DSM-5, published in 2013, outlines the diagnostic criteria clinicians use to evaluate someone for ADHD. These criteria require a variety of traits which broadly fall into one of three varieties (predominantly inattentive, predominantly hyperactive-impulsive, and combined) and some evidence of traits prior to 12 years old. However, this has not always been the case. From 1994-2013, ADHD-type categories were not only more rigidly defined, but there must also have been proof of traits prior to 7 years old. Due to these changes, we are finding many people were not eligible for ADHD diagnosis until the past decade.

2. Greater consideration for women having ADHD

There is a significant gap in diagnostic rates between women and men (3.9:1 according to one study). However, this gap used to be much larger and is in the process of shrinking. We can therefore see increasing ADHD diagnoses as a bit of “catch-up” as the artificially created gender gap in ADHD diagnosis begins to level out. This gap can be understood as a product of two primary factors. Firstly, historically ADHD was understood as a condition which was exclusive to pre-pubescent boys. However, even when girls became eligible for ADHD diagnosis, they often did not demonstrate traits in the same way. Non-boys/men are more likely to mask or suppress signs of hyperactivity or impulsivity, therefore not showing the “disruptive” behaviour typically looked for by educators and clinicians. While there is greater awareness of these gender differences, on average men might still have an easier time getting diagnosed than women. In any case, there is likely a large population of AFAB (assigned female at birth) people with undiagnosed ADHD who are now seeking an ADHD assessment now that they are more likely to be considered.

3. Wider knowledge of ADHD traits and a sense of neurodivergent community

Lastly, I would like to acknowledge the role of the internet and social media in the increased discussion of ADHD. Firstly, yes, I have no doubt that discussion of ADHD online has led to more people seeking an ADHD diagnosis. However, in my personal experience this has not resulted in waitlists clogged with people not fitting diagnostic criteria. Rather, I mostly encounter people who found social media content validated their long-standing observations about themselves to the point that they felt comfortable to pursue a diagnosis. Social media content about the experience of ADHD helps normalise ADHD traits and gives people the tools to advocate for their health. Additionally, content on social media has led to the rise of the neurodivergent community. People who are or suspect they are neurodivergent understandably want to engage with people who have similar experiences to them, especially when you consider the exclusion many of these people face in other settings. In this way, social media content surrounding neurodivergent experiences likely does increase demand for assessment services via increased awareness and confidence to pursue a diagnosis for those with lifelong neurodivergent traits.

I have only outlined a few of the factors contributing to higher rates of ADHD diagnosis. Neurodivergence generally is an area of rapidly evolving understandings and we will continue to see things change in the coming years. Due to recent changes, diagnostic criteria for ADHD is more equitable than ever before and more people have a general awareness of ADHD than ever before. Groups who have historically been excluded from accessing the healthcare services they need are now increasingly being considered by professionals. Overall, ADHD assessment services are effectively working through decades of backlog as people dismissed in their childhood are now being given the second look they deserve.