The ADHD Explosion

In this episode of A Doctor’s View, Dr Polyvios explores the dramatic rise in ADHD diagnoses and asks a difficult question: are we finally recognising a condition that has always been there, or are we beginning to medicalise the chaos of modern life?

From social media and dopamine-driven distraction to private clinics, self-diagnosis and the growing use of terms like “neurodivergent”, this episode examines the cultural, psychological and medical forces behind the ADHD explosion.

Why do so many ADHD symptoms now feel relatable to almost everyone? Has modern technology conditioned our brains to behave as if we have ADHD? And where is the line between genuine disorder and ordinary human struggle?

This is not an attack on people living with ADHD. For many, diagnosis and treatment can be life-changing. Instead, this episode is a deeper conversation about attention, identity, overstimulation and the world we’ve built around ourselves.

As always, this podcast reflects personal opinion and is intended to encourage discussion, not replace professional medical advice.

Thank you for listening!
email: adoctorsview@gmail.com
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twitter: @DrPolyvios

Transcript

Hello everyone and welcome to Doctor's View. I'm Dr Polyvios. In today's episode I want to talk about Attention Deficit Hyperactivity Disorder or ADHD for short.

Recently I came across a BBC News article that caught my attention, shall we say. It said that specialist ADHD services for adults in England are now stopping new referrals because they simply can't cope with the demand and it made me wonder why? Why is the demand so high all of a sudden? It feels like everyone knows someone who's recently been diagnosed with ADHD, be it a colleague, a friend, a partner or maybe even yourself and ADHD has gone from being this really niche childhood diagnosis to a mainstream cultural talking point. Social media is flooded with ADHD trait list videos, things about hyper-focus, forgetfulness, distractibility and there's even online quizzes that promise these instant clarity whether you've got diagnosis or not.

And I even saw an advert once for a course describing symptoms that literally anyone could relate to. Things like, do you have difficulty concentrating on difficult tasks? And it then led you to their ADHD diagnosis thing. And of course you do, it's human nature.

Why do you think it takes me so long to produce one podcast episode? ADHD has become part of our everyday vocabulary. I can't concentrate on anything, maybe I've got ADHD and this really raises a difficult question. Has ADHD truly become more common or have we simply found a new way to view ourselves? Are we finally recognising something that's always been there or are we actually just medicalising the chaos of modern life? So in this episode I just want to unpack that and discuss the rise in the ADHD diagnosis, what's driving it and what it really means and what it says about the world that we live in.

So what is ADHD? Well as I said it's attention deficit hyperactivity disorder and it's a neurodevelopmental condition that affects the brain's ability to regulate attention, impulses and also motivation. So it's not about intelligence or laziness, it's about regulation, the ability to focus, to plan, to resist distraction and to control impulses. And there are three types of ADHD that are recognised in the DSM-5TR and that is the Diagnostic and Statistical Manual of Mental Disorders 5th Edition Text Revision.

I had no idea what this was, I had to look it up. Essentially it's the standard diagnostic guide for mental health professionals and I think that's in the United States. But anyway there are three types like we said, you have the predominantly inactive, so these are people that have forgetfulness, losing focus, are easily distracted.

You have the predominantly hyperactive or the impulsive type, so people that are restless, they talk excessively and they act without thinking. And then you have the combined type which is essentially a bit of both. Biologically ADHD involves irregularities in dopamine and noradrenaline signalling within the prefrontal striatal circuits in the brain.

And these areas of the brain are responsible for the decision making part, the planning, then the focus bit. It's important to remember that ADHD exists on a spectrum. Not everyone experiences it in the same way and it often looks quite different in adults for example compared to children.

And there's also a notable difference between boys and girls. In one large UK survey of children aged between 5 and 15, around 3.6% of boys and 0.85% of girls met the diagnostic criteria for ADHD.

So that's a roughly 4 to 1 ratio. Boys tend to show more of a hyperactivity, whereas the girls tend to often be quietly inattentive, which means they're more likely to go unnoticed and undiagnosed, which could explain some of the discrepancy here. But at the same time, there's also a bit more of a theory as to why there might be such a discrepancy too.

So ADHD is real, it's complex and for many it's a life-changing diagnosis. But the recent explosion in adult diagnoses just suggests there's something bigger happening. So why the rise? Well when I was younger, it was almost unheard of for anyone to have an ADHD diagnosis.

It was seen as a bit taboo. And if you had this diagnosis or there was someone in the class with this diagnosis, they were seen as the weird kid. Fast forward to now, you know, that's not so much the case.

Now there are several possible explanations for the surge and not all of them are cynical. This is my podcast, so a lot of them are. But firstly, awareness has improved and we now recognise ADHD in adults, in women and in people who never fit the old stereotype of people that would be diagnosed with ADHD.

Secondly, the stigma has fallen. It's no longer something to hide. People talk very openly about being neurodivergent, in air quotes.

And that's actually something else I wanted to question. I'm not particularly fond of the term neurodivergent, and it may be my ignorance, but to me it often feels like a bit of a cop-out. And it's something we use to excuse behaviour or to justify something about ourselves that we don't want to confront.

The word neurodivergent began as a well-intentioned concept. It was a way to promote understanding for people who had genuine neurological differences like autism, ADHD, dyslexia. But over time it's become so broad and so loosely applied that it just feels like it's lost meaning.

So it was originally a social concept, not a medical one. And the idea that brain differences shouldn't be automatically labelled as disorders, that's essentially what the concept was. And that's fair.

But today it's almost anyone who feels slightly different, distracted or misunderstood, people now begin to self-identify as neurodivergent without any formal diagnosis or any neurological evidence. Or you diagnose someone else as neurodivergent. And this creates two problems.

So this creates two problems. Firstly, it dilutes the term. So if everyone who struggles to focus or dislikes crowds, for example, calls themselves neurodivergent, the word stops distinguishing people who have that real neurological condition from just normal human variation.

And secondly, it shifts responsibility. So everyday challenges, disorganisation, procrastination, impulsivity, they get turned into identity statements. So instead of addressing behaviour, people rebrand themselves as an unchangeable trait.

And sometimes it even bleeds into relationships. For example, you might hear, I can't communicate with my partner because they're neurodivergent or we're neurodiverse couple, whatever they say. And it becomes a way of sidestepping the hard work of actually having a deep and meaningful conversation and resolving issues, which, let's be honest, is very, very difficult.

So neurodivergent has effectively become a self-soothing label. And it sounds scientific, but in reality, it isn't. It's not a diagnosis.

It has no clinical definition, no biomarkers, no measurable criteria. And it's, you can argue it's sociology dressed up as neuroscience. So I'm not a neurologist or a psychologist.

And I have to make that very clear. And I'm sure there's plenty of people that would tear me apart for saying the things that I say and my opinion, but that's the beauty of this podcast. It's simply my opinion.

People can choose to listen to it. They don't have to. I might be wrong.

I might be right. But the point is that we can actually have a conversation. We can have common ground or at least have a different viewpoint of a different way of looking at things and opposing views are a wonderful thing.

Your life would be incredibly dull if we all just lived in echo chambers, everyone around you saying the things you want to say and, you know, all singing to the same hymn sheet. And sadly, a lot of people are very happy to do that nowadays. And I find that a little bit upsetting.

But anyway, back to ADHD. So the line between cultural diagnosis and cultural identity is blurring quickly. And access to diagnosis has also changed and not often the way people think.

So the NHS still technically offers ADHD assessments, but the system is absolutely overwhelmed. The waiting times to be seen by a psychiatrist can be years. And as I've said earlier, there are some regions that this service actually stopped taking in any new referrals altogether just because the demand is so high.

They have to deal with the backlog. So what that means in practise is that the NHS just isn't an option for a lot of people. So thousands of people are turning to private clinics where you often get an assessment within days and sometimes even hours, and often it's entirely online.

So while it might look like there's been a massive surge in demand, that's only part of the story simply because there's actually a bottleneck in the system. And you have the private sector stepping up to fill the gap for a price of course. And it's this ease of getting diagnosed where things start to blur a little.

Getting an ADHD diagnosis used to be a long drawn out process. It involved referrals, questionnaires, feedback from family or teachers, and often involved more than one appointment. Now, it's as simple as filling out a form online, booking a quick video call.

And if you Google, do I have ADHD, you'll find the same questionnaire all over the place. It has questions like, how often do you have difficulty concentrating when people speak to you directly? How often do you misplace things at home or at work? Are you easily distracted by activity or noise around you? Do you have difficulty waiting your turn? Things like this. And you have to answer each one with rarely, often, never, all the time, sometimes, etc.

There's like a drop down box of five different options for each question. So these were initially designed as screening tools. They're not diagnostic tools.

But the problem is, so many people can relate to these questions. It can literally take a half hour conversation in a text box form, and you've suddenly got this lifelong label. And sometimes you'll have a prescription to match with that label.

So when you look at these questions, most of us could easily answer them in a way that would make it appear that we have ADHD. You know, you could easily say, are you distracted by noise around you? Yes, of course you are. Often.

You'd be superhuman not to be. I know, at least I can't focus with music in the background or TV in the background. So it's not that ADHD isn't real.

It absolutely is. It's just the diagnostic threshold for being diagnosed. It's just dropped so low that we've gone from identifying an impairment to identifying an inconvenience.

And this is what's known as diagnostic inflation. And it forces us to ask, are we really uncovering the hidden ADHD or are we manufacturing it? And then there's the social media effect which adds to all of this. So as I said earlier, if you open up TikTok or Instagram, ADHD is absolutely everywhere.

You know, you'll see videos titled things like 10 signs you might have ADHD. The list is always the same. As we said before, they list a bunch of symptoms.

Are you forgetting what you're saying? Are you losing your keys? Are you starting projects and not finishing them? You know, these signs aren't necessarily signs of a disorder. They're part of a normal everyday life. And these videos spread really fast because they're relatable and the algorithm rewards relatability and engagement.

But then here's the irony. Social media itself actually mimics ADHD. It's constant novelty, constant dopamine hits.

It's an endless stream of microwaves every time you scroll. You know, and we've trained our brains to literally expect stimulation every few seconds. And you notice it now.

If you don't feel engaged within the first literally two seconds of opening a reel or a video, you just swipe to the next one. It used to be that you had a 30 second window, say when YouTube first started, to engage your audience. You know, you gave the video benefit of the doubt for 15 seconds, 20 seconds, 30 seconds.

And then you'd be like, actually, this isn't for me. You'd actually have that patience to see if it got a bit better. Whereas now we just don't have that.

And it's not that we've suddenly all developed ADHD. It's just we've conditioned ourselves to behave as if we have. So you have these platforms like TikTok flooding your brain with these dopamine bursts.

And we scroll, we get rewarded, we scroll again and another reward. And over time, you adapt to this rhythm and it's digital conditioning. That's why time goes so quickly when you doom scroll, for want of a better term.

And as a result, the tasks that used to, and as a result, the tasks that used to feel engaging, things like reading a book, watching a film, even just having a conversation, just begin to feel really slow. You sit down now to watch a movie and within five minutes, you are already scrolling, you lose track of the plot and you think, why can't I focus anymore? Maybe I've got ADHD, but often it's not ADHD at all. It's just that it's the dopamine balance that we've disrupted ourselves.

We are a by-product of overstimulation and we've built a world that rewards this distraction. So then we begin to wonder why we can't focus. We've trained our brains to novelty and now we mistake that conditioning for a disorder.

So while awareness and compassion are good things, there is a more cynical undercurrent behind the surge of the ADHD diagnosis. And as I said, I do share a little myself of that viewpoint. We've entered an era where personal responsibility feels very uncomfortable and emotional validation feels rewarding.

And a diagnosis like ADHD offers both. It removes guilt. It tells you it's not that I procrastinate, it's just how my brain works.

And for many people, that's completely genuine. But for others, it's a shield. It's a way of reframing your ordinary struggles as a medical inevitability.

It's in a way, part of a broader cultural shift, something I say is a victim-based identity. And the idea that experiencing struggle automatically gives you moral authority. And you can see it beyond ADHD too, in mental health, self-diagnosis in general, or in movements like the fat acceptance movement.

These movements started with good intentions, compassion, self-worth, dignity. But in some circles, they've drifted away from health and accountability and towards defensiveness against any critique at all. It's become movements of, I'm not the problem, you're the problem.

If you don't accept me for who I am, you are the one with the problem. And by doing that, you take away any responsibility that you have for those conditions. And we've even gone as far as people claiming they have Tourette's syndrome on TikTok.

They create whole accounts as if they have Tourette's and they amass thousands of followers. And they don't have Tourette's at all. They're literally riding off the moral superiority and the empathy of others to fulfil their narcissistic channels.

And so instead of asking what can I do to improve this, we just say, this is who I am. And while that might feel comforting, it's quietly corrosive because if nothing is your fault, then nothing's your responsibility either. And when we reward the label more than the effort, we build identity around being unwell.

And so instead of actually just striving to get better, when I was younger, as I said, if you even mentioned mental health or ADHD or dyslexia, you were seen as the odd one. It was a bit taboo. Now, obviously, that wasn't good either because kids genuinely suffered from these conditions and you were seen as a bit of an outcast.

But we somehow swung from one complete extreme to the other. So now, instead of hiding our issues, we showcase them like they're a badge of honour. And in doing that, we sometimes lose sight of progress.

And I'm not saying that people should be ashamed of these diagnoses. Absolutely not. But I feel that there is a huge number of people who are perhaps incorrectly diagnosed, shall we say.

And instead of wanting to treat it or try and get out of this situation or see what can be done, it feels like it's become part of their identity. So there's also a financial side to potentially the rise in diagnosis, which whether we like it or not, always seems to find its way in there. So the private ADHD assessments, they can cost anywhere from 500 pounds to 1500 pounds.

And so they're not cheap. They're quick, they're convenient. And let's be honest, probably sometimes a bit too generous with their diagnoses.

Because when there's a demand, there's a supply that will always rise to meet it. And every new diagnosis doesn't just create a new patient, it actually creates a new customer. So it's not just the clinics, but there's a whole broader ecosystem.

You've got prescriptions, policies, support systems that follow. You've got follow up appointments. It's a thing.

And we saw something similar during COVID. If you at the time, remember trying to fly, you had to get these fit to fly certificates. And the only way to get them often in time for your flight, because it had to be within, you had to get the result within I think it was 24 or 48 hours of your flight, something like that, you end up having to pay a couple of hundred pounds to some random clinic that you found online, these pop up labs that just appeared overnight.

And they'd email you a document that looked like it had been made in Microsoft Word and probably was. And they were just capitalising on that moment in time. And it feels like there's a softer version of that now with ADHD.

Now, for parents is even more complicated. In the UK, if a child is diagnosed with ADHD, parents can then may qualify for disability living allowance, carers allowance, or even educational support. And to be clear, many pursuers for a genuine, loving reason, they want to help their child and rightly so.

But it does create a subtle incentive, because the support depends on the diagnosis, and then the diagnosis itself then becomes the goal. So once a system starts rewarding the label, people understandably start to chase that label. And I think there's something that really frustrates me.

And that's what I believe this is that there's an element of parenting substitution. And what I mean by that is it's easier to label a child than to discipline one. So a boy being boisterous in class used to just be called a boy being boisterous.

That's literally where the word comes from. And now that boy has a problem. He's neurodivergent, or he's got ADHD.

And I get it, teachers are under pressure, parents are exhausted. And a diagnosis feels like progress, something that you can use to explain the chaos. But sometimes, there just isn't a neurological issue, sometimes an environmental issue, you know, giving a child an iPad for 20 hours of the day, and then taking it away, and then they throw a tantrum.

Yeah, that, you know, you can't then label that that kid with a with diagnosis of ADHD, because they're not behaving. But it's not that the child may not have ADHD, it's just that they sometimes they just need structure. And sometimes they don't even need that much.

Sometimes they're just being children. And, you know, it is easier to medicate a child than is to mental one. And unfortunately, I just don't understand why there's such an urge to label children with ADHD or neurodivergent.

And I get I'm not taking it away from genuine diagnoses. But it just feels as I said, it just feels like there's this bit, it's got more momentum to it, it's something that has become almost as easy to throw out there as a potential diagnosis for why your child's misbehaving as, you know, as they might be hungry used to be. So if we move on to the treatment side of things, we we then see also another incentive.

So treatment with ADHD is usually a multimodal thing involves medication, therapy, and structure. And many of these medications are stimulants. So drug drugs like methylphenidate, which is better known as Ritalin.

And these work by increasing your dopamine levels and your noradrenaline levels in the in the in the brain's attention circuits. And these help you improve your focus, it helps you improve your control. And for many people, this is genuinely life changing.

But like any drug, there's always side effects. And some of them can be quite serious, can have cardiovascular effects, mood changes, even psychotic episodes. And that brings us to the crux of why I'm bringing it up, which is, these drugs can be misused.

So if someone feels like they want an ADHD diagnosis to obtain these medications to have this hyper focused effect, so someone without ADHD then takes it, they may feel more productive. So it's often misused by people at universities or people in high pressure jobs just to try and boost their performance. But whilst you feel you're being productive, in reality, you're not.

So you might write your 10,000 word essay in one sitting, and you think you've nailed it, but the essay might be absolutely rubbish. And it does carry risks as well, you know, and you're taking those risks for essentially a productivity that isn't actually real. So what's the truth? Are people chasing ADHD? Or are we finally just seeing it more clearly? Honestly, I actually think it's a bit of both.

I think ADHD is probably undiagnosed in some groups, especially in women and adults who are overlooked as children. But it's also being over diagnosed in others, particularly in some corners of the private sector. And when you think about it, modern life looks like ADHD, where we're constantly bombarded with notifications, where we're juggling multiple tasks, we're sleeping less, we're living in this state of perpetual distraction.

And so even neurotypical people are really struggling to concentrate here. And there is also an element of we're pathologising being human. We're trying to function in a system that was never really designed for sustained focus.

It's not that we're having, at least to me, it's not that we're having this epidemic of ADHD, it's just that there's this epidemic of environmental overload. And instead of changing that environment, we're trying to medicate our way out of it. So sometimes the answer isn't a pill, it's just putting down your phone.

We've turned this overstimulation into this lifestyle we call the fallout of this disorder. So to summarise, ADHD is real. For those who truly have it, the diagnosis and proper treatment is absolutely life-changing.

And for some, maybe ADHD isn't really about attention deficit, maybe it's actually about meaning deficit. Because when life feels overwhelming, the search for an explanation really can easily become a search for identity. And maybe that's also part of the story here behind the ADHD surge.

So take a breath, step away from the scrolling, and remember that not every struggle needs a label, sometimes it just needs space.

As always, please look after yourself. 

I'm Dr Polyvios.

Goodbye.