As a doctor I’m often asked for my view on the soaring number of people seeking treatment for ADHD. Figures have trebled in the past decade and waiting lists for NHS assessments are so long it will take eight years to clear the backlog.
To be blunt, yes, I do believe ADHD is being wildly overdiagnosed. I also worry that the surge in cases is starting to have a damaging impact on the day-to-day lives of everyone.
Earlier this month IT executive, Bahar Khorram, successfully sued her employers, Capgemini, for not promoting neurodiversity training among staff. Ms Khorram complained her ADHD meant she could not multi-task or meet deadlines and that adjustments needed to be made to meet her needs.
I accept that Ms Khorram won her case but I do hope it doesn’t open the floodgates for more like it. Why? Because it’s starting to feel like some people think they shouldn’t have to make an effort to change their behaviour.
Surely ADHD shouldn’t mean that people no longer have to fulfil the basic requirements of their jobs? It’s not unreasonable or discriminatory for employers to expect people to hit deadlines or have more than one task on the go?
Isn’t it common courtesy to your colleagues to not cancel meetings at the last minute as Ms Khorram is said to have done? Where will this end?
Can I, as a doctor, suddenly not show up for clinic and blame my ADHD when patients in need are waiting to see me?
What if I, and some of my medical colleagues, started cancelling consultations, resulting in patients not getting the care they needed? Would those patients just have to suck it up?
‘I worry that the surge in ADHD cases is starting to have a damaging impact on the day-to-day lives of everyone,’ says Dr Max Pemberton
Earlier this month IT executive, Bahar Khorram successfully sued her employers, Capgemini, for not promoting neurodiversity training among staff
I am not disputing that many of those diagnosed with ADHD have problems and need help and support, but the whole workplace cannot be inconvenienced and made to adapt to their behaviour just because someone has a label.
It’s easy to see the appeal in seeking a diagnosis if it means you don’t have to put in the same effort and commitment as your colleagues.
ADHD has gone from being something that was once considered a relatively rare condition, affecting mostly children, to something affecting every school neighbourhood and workplace.
Ten years ago, I rarely saw anyone in clinic with this condition. Now, I see at least one person a day with the diagnosis and there have been occasions when every single patient I have seen in a day had ADHD! It is staggering.
Typically, in medicine, when the number of cases suddenly explodes it triggers rapid inquiries into why.
If clinics were suddenly overwhelmed with people diagnosed with a previously rare type of cancer, serious questions would be asked and urgent studies conducted.
Yet the medical and psychiatric professions seem to have just taken the ADHD epidemic in their stride, blindly accepting that all of a sudden, vast swathes of the population can no longer pay attention.
Instead of questioning why this is, too many of them seem happy to just whack people with a diagnosis and send them off with a prescription for Ritalin or something similar.
In rushing to label and medicate, we are failing to see the wider issues, especially when it comes to the rise of social media and online technology and the impact this is having on our ability to concentrate.
For me, it’s no coincidence that the rise of diagnoses coincides with the rise of platforms like TikTok and YouTube. These platforms bombard us with rapid-fire snippets of information in a never-ending stream of content specifically designed to keep us mindlessly scrolling.
I am convinced that what we’re witnessing is the consequence of technology evolving far quicker than our brains. Yet when we label what are normal struggles due to societal and environmental shifts with a medical diagnosis, it has far wider implications.
Several high-profile doctors including Sir Simon Wessely, former president of the Royal College of Psychiatrists, and Dr Iona Heath, former president of the Royal College of General Practitioners, have spoken out about how it is a doctor’s responsibility to resist the drive to over-diagnose and over-treat patients. Needless to say such comments are seen as uncaring and usually lead to a backlash. But it makes perfect sense.
In the industry we talk about something called ‘labelling theory’, when a patient starts to feel they no longer need to take responsibility for their actions, struggles or difficulties.
Giving people a label traps them. It removes any sense of autonomy and agency. It tells them there’s nothing they can do to change.
I believe that the human brain is full of possibilities and, when given the right support and guidance, people can change and adapt.
Surely this is a better message than expecting the world to adapt to them?
DR MAX PRESCRIBES…
WHY WE SLEEP By Professor Matthew Walker
Many books have been published on sleep but this is the most compelling. Written by a neuroscientist, he researched every aspect from the importance of it to our physical and mental wellbeing to the reason our sleep patterns change as we age.
Jewish comedian Philip Simon has been barred from an Edinburgh Fringe venue after attending a vigil for victims of the October 7 atrocity.
The venue claimed it cancelled his show because it has ‘a duty of care to customers and staff’. A nearby venue cancelled another show by Simon and fellow comedian Rachel Creeger. It claimed bar staff had expressed fears of feeling ‘unsafe’.
What possible risk could two Jewish comedians pose? I loathe the idea that being confronted with someone you might not agree with somehow makes you ‘unsafe’.
I work with victims of violence and persecution who really know what it is to be unsafe and it’s grossly offensive to use this term to silence people with views you simply don’t like.
MEN NEED TO NURTURE FAMILY TOO
Brooklyn and Nicola Peltz Beckham spotted in St. Tropez
I feel sorry for Victoria and David Beckham. It must be devastating for them to have fallen out with their eldest son, Brooklyn and his wife, Nicola.
More wounding still is that Brooklyn now seems to be spending all his time with his in-laws.
The pictures of him shopping in New York with his mother-in-law this week must have been particularly painful for Victoria. There is an old proverb about how ‘a son is a son until he gets a wife, a daughter is a daughter for life’. I’ve seen this play out many times: sons seem to think nothing of drifting from their family once they marry.
Sometimes there’s a falling out, other times they just gradually lose touch. This doesn’t seem to happen so often with daughters and I wonder if that is because women tend to nurture and cherish close relationships in a way that men don’t. I think this attitude is the reason rates of depression are so much higher in men.
