Are you struggling to focus? Finding it hard to concentrate on one thing or read for more than 30 seconds without picking up your phone? Do you feel like you don’t fit in, like you can’t do bills, taxes or keep up with the pace of society? Are ADHD memes circling online resonating with you? You’re not alone.
Hundreds of thousands more women are being assessed for ADHD than ever before, especially Black women. According to data from 2014, 19.3% of Black British women had been recently diagnosed with ADHD, compared to 9.4% of white British women. On top of this, many people are self-diagnosing: videos with the hashtag #ADHD on TikTok have 2.4 billion views and more young people are visiting doctors to report they have ADHD based on a TikTok video.
But are those of us experiencing difficulties with attention really mentally 'disordered' or are we experiencing understandable responses to a distracting and overwhelming world? And what additional harm is caused by telling those who are struggling that they are 'disordered' rather than normal?
What is ADHD?
ADHD (attention deficit hyperactivity disorder) is a description of a group of experiences, not an explanation. These very real and sometimes debilitating experiences include difficulties with concentration and focus, forgetfulness, restlessness, hyperactivity and impulsiveness, which show up in very different ways for different people.
In adult women, the most commonly reported experience is inattention. Charmaine, a British-Jamaican woman in her 30s, told me that she’s experienced challenges with her attention and navigating social rules throughout her life. "I really struggle with getting practical stuff done," she said. "I’m self-employed and never felt able to sort out things like bills, invoices, insurance." Charmaine sought out a private assessment to avoid the long NHS waiting lists and was given an ADHD diagnosis. But if a diagnosis is just a description of a collection of experiences, what is causing them?
There is a popular myth that ADHD is caused by our individual brain chemistry, or can be genetically inherited. There is no reliable evidence to prove this. The Royal College of Psychiatrists has acknowledged that there is no such thing as a chemical imbalance. Dr Gabor Maté, esteemed specialist and author of Scattered Minds: The Origins and Healing of Attention Deficit Disorder, states: "The rise in people being diagnosed with ADHD over 30 years in itself disproves the genetic 'disease' model. Genes don’t change over ten or even a hundred years, which means our rising attention difficulties are a response to our environments."
A fixation on our individual brains obscures the real problem: our environment. Dr Akima Thomas, the founder of Women and Girls Network, explains: "Babylon [a term used to describe the oppressive aspects of white culture] will always put the emphasis on the individual, saying you have got ADHD – the problem is located in the individual and never located in the social and structural violence that is driving it." All psychological distress is a response to our environment, including our experiences of trauma, but the way this shapes our lives isn’t always clear-cut or linear.
Is it any surprise that so many of us struggle with focus given that we’re bombarded by technology, particularly social media, which is literally designed to invade our attention?
In his book Stolen Focus, Johann Hari tells us that we’re touching our phones approximately 2,500 times a day and the impact of this constant switching is detrimental to our focus. The tech companies behind this design want to seize our attention because they can turn it into data, and consequently money. Notifications suck us into a candyland of empty, addictive rewards designed to steal our focus. This constant chasing of dopamine hits augments how pleasurable everyday life feels and diminishes our baseline capacity to enjoy and focus on simple things.
It’s not only these powerful forces of surveillance capitalism and ‘technoference’ which make us sleep less and tire our focus, it’s the attention-degrading influences of systemic oppression. Studies have shown that people who are poor in the UK, in precarious social housing, raised by single or unemployed parents and exposed to stressful or traumatic life events are much more likely to experience difficulties concentrating. The same people have less access to food security and nutritional diets, which further impact capacity to focus. Those of us who have experienced traumatic childhoods have grown up constantly scanning for threats in our environment, making it hard to maintain focus. You have to trust that your environment is safe in order to settle into a state of concentration. But for many of us our environment isn't safe, especially if we are navigating the sharpest end of multiple oppressions.
Toni Morrison said that the function of racism is distraction, forcing people to repeatedly explain their reason for being. Her words ring loud considering the most recent government data on rising ADHD diagnoses among Black women. Racism has always existed, and Black people are often excluded or harmed by mental health services. Dr Thomas explained: "There’s a need for Black, minoritised and LGBTQIA+ communities to create meaning of our suffering. We’re so often categorised by the other – as the outsider. ADHD becomes another one of those categories imposed upon us but it maybe offers a preferable meaning to combat the usual harmful narratives of us as 'aggressive' or 'psychotic'."
Eve*, a 33-year-old mixed Black-British woman, described ADHD as "not being able to fit into society". Under capitalism and the false hierarchies of racism, we are all desperate to fit in as a means to survive. Fitting in often looks like constant productivity, working extensive hours and conforming to social norms. The term 'masking' is sometimes used to describe the ways in which people with ADHD try to adapt and hide their attention-related responses.
When some of us simply can’t pay attention, are forgetful, can’t concentrate, be productive at work, organise ourselves, meet deadlines or express ourselves in ways that mainstream society deems appropriate, we’re considered 'disordered' and encouraged to take psychiatric drugs. Stimulants like Ritalin are often the recommended intervention and can offer temporary relief. Many of us desperately need that relief and that’s completely understandable – we are all doing our best to survive with the tools we can access. What drugs can’t do is transform the unsurvivable demands of life that cause our suffering in the first place. Psychiatrist Dr Sami Timimi said: "These stimulants work in ways similar to cocaine on the brain and the long-term consequences on our health are unclear. Pharmacological companies also profit: it's an industry worth billions."
Eve received an ADHD diagnosis in January and has been on stimulant drugs for five months. "Having medication helped me get back to work for a bit in the beginning but I don’t know if it’s making a difference anymore. I’m still burnt out. Doing this amount of work and being a single parent isn’t sustainable for anyone."
Diagnosis and disorder: what’s the 'order' of society?
For many people, an ADHD diagnosis is a validating experience. Charmaine is one of them: "Before my diagnosis, a lot of things had happened in my life that I thought were because I’m just shit, like I’m just bad at life." Diagnosis can affirm that you’re not alone or at fault, and in our mental health system it is often the only way to access support, therapy or benefits. Charmaine said: "The reason I wanted the diagnosis was to see if it would make me eligible for something like Access To Work. I was thinking if I have a diagnosis then maybe I can get money to pay for a support worker, someone who can keep on top of my invoices and my bills, the stuff I’m really bad at keeping on top of."
What if people could access all of those things without being told their brain is defective? As a clinical psychologist I recognise that people need and deserve validation and support but I take issue with the labelling and pathologising of understandable human responses to a traumatising world as a 'disorder'.
Disorder will always be contextualised in opposition to what society deems 'order'. 'Disorders' and 'mental illnesses' have historically been used to describe marginalised people who have resisted societal norms. Women expressing emotion in a society where subservience was mandatory were diagnosed with 'hysteria'; Black people seeking freedom from slavery were said to be suffering from 'drapetomania'. The diagnostic system of 'disorders' is rooted in white and western ideas, often delegitimising any other cultural understanding of suffering.
The origins of ADHD can be traced back to research conducted in 1902 by British paediatrician George Frederic Still. He was studying kids who were fidgety, restless and couldn’t quite focus, and described them as having "abnormal defects of moral control". Maintaining focus and attention may have previously served the order of upholding a capitalist society, to engage us in labour. Now, as consumerism is the order of the day, we’re compelled to scroll, compare and click on ads.
Is scrolling one way we tune out from overwhelming environments? Dr Maté says that tuning out is a hallmark of ADHD but we all tune out under stress, and our environments are becoming increasingly stressful. It’s unfair to tell someone who is being bombarded with information, navigating where they can feel safe, that they are disordered for trying to keep up with it all.
It is understandable to want to avoid difficult emotions and distract ourselves from pain. All this time spent scrolling on our screens, performing successful versions of ourselves and being fire-hosed with often threatening and fragmented information exhausts our attention and depletes our capacity to feel our own emotions.
The feelings we most want to avoid, consciously or subconsciously, are often those associated with death (e.g. our own mortality, endings, grief, despair). Social media offers the appeal of immortality, of being 'seen' after we die – our profiles memorialise us so that we might never be forgotten. The irony of it is that we have become like the living dead in the process, sleepwalking through our lives. The opposite of death is wakefulness and we are less awake to our lives than we have ever been. The quality of our relationships is deteriorating through no fault of our own.
What are we actually seeking from these powerful media platforms? We’re longing for connection, relief from loneliness, to feel seen and loved. The compulsive tapping of a heart on Instagram or Twitter, of counting hearts or likes, may hold deep significance, symbolising a longing for our hearts to be touched and to touch the hearts of others.
What can we imagine differently?
Many of us will continue to struggle with inattention, impulsivity and hyperactivity while navigating this painfully distracting and traumatising world. Some have found day-to-day techniques to cope with these difficulties (e.g. using daily planners/reminders, time in nature) as well as therapy, meditation, embodied practices, stimulants and the arts.
It is a very understandable human desire to want clear answers and solutions to our problems, especially debilitating attention difficulties. On the surface, diagnosis may look like an answer. But there may not be a quick fix or solution to the complicated ways our pain and survival responses show up, to an oppressive world. Most importantly, it’s not us that needs fixing but the conditions around us.
What would a world where we could show up maskless look like? A world where we might turn to each other for support, embrace each other’s madness, inattention, excessive talking, interrupting, losing or forgetting things, restlessness, fidgeting – whatever the idiosyncrasy – without being pathologised or excluded. If we removed the unachievable standards of society and what it means to be successful according to capitalism, whiteness and other social norms, our struggles might be less of a problem.
The most therapeutic thing would be transforming the conditions of threat and the stressful environments that are causing our distress and distraction. Charmaine gave an example of this: "If we had universal basic income, or if we could afford a plot of land somewhere and still have our friends and communities nearby, I’d probably be okay. To know that if we don’t succeed, then we don’t have to starve."
We also need increased access to affordable nutrition to nurture ourselves on a cellular level, anti-racist and liberatory practices embedded into our institutions, exciting school and work environments that allow freedom, embodiment, connection, creativity and play rather than upholding target-driven hierarchies and rampant individualism.
When it comes to big tech and social media, Johann Hari highlights how urgently we need a collective movement to ban surveillance capitalism, to hold big tech companies to account and demand regulation so that we can reduce our screen time and recover our stolen attention. This gives us space to reconnect with our bodies, our emotional worlds, and reinvest in being present with each other in person. For our attention and focus to survive it needs to be nurtured, with the light, water and fertile conditions we deserve. As psychologist Tara Brach reminds us: "It is survival of the nurtured, not survival of the fittest."
The diagnosis of individual 'mental disorder' can make us believe there’s something wrong with us rather than the world around us, and that healing happens in isolation. It doesn’t. Already, many people who have received an ADHD diagnosis are building community through organisations like A Disorder For Everyone and ADHD is Over, collectively reframing their suffering as a survival response to a traumatising world.
To recover our individual and collective attention is hard to imagine in a world of rising speed, distraction, injustice and economic growth. What we need most is a culture of love and justice where we are seen and understood in our wholeness and where our needs are met so that we can feel some semblance of safety, belonging, acknowledgement, compassion and support, and be held by our communities. Maybe then we might be more awake to and accepting of each other’s imperfections, and to this one imperfect life, which is rapidly passing us by.
*Name changed to protect anonymity