Paying attention to ADHD– is it really just a fad?

Media fixation with ADHD caught Henna Cundill’s eye, so she decided to investigate its struggles and superpowers.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

From a darkly shadowed face, a single illuminated eye stares.

Brands&People on Unsplash.

In a feat of irony, attention deficit hyperactivity disorder (commonly known as ADHD) is now getting a lot of attention. For example, between 28 and 31 January The Times newspaper published one article per day about ADHD. Intrigued, I looked back over the past few months, and I found that The Times has averaged 8 to 10 articles per month which are either partly or exclusively about this topic. These range from celebrity diagnoses to handwringing over the “troubling rise” in incidents of the condition, to concerns about parents gaming the system to get their children disability payments or extra time in exams.

With all this media hype, it is little wonder that some commentators are inclined to dismiss ADHD as a fad. Scroll through the comments beneath each article, and you will reliably find the rallying cry of, “We didn’t have ADHD in my day!” followed by the patient responses of those who try to correct this fallacy.

While the high public profile of ADHD is new, the condition itself is not. As early as the mid-1700s a Professor of Medicine called Melchior Adam Weikard was describing patients who were “unwary, careless, and flighty” – behaving in ways governed by impulse, and showing poor skills in punctuality, accuracy, and having an inability to complete tasks, to the detriment of their mental health. His description is of its day. For example, and somewhat amusingly, Weikard (himself German, but at this point living in Russia) also described his patients as follows:

Compared to an attentive and considerate person such a jumpy person may act like a young Frenchman does in comparison to a mature Englishman.

Even so, Weikard did not unconsciously adopt all the prejudices and stereotypes of his context: he broke firmly with existing medical consensus when he diagnosed these patients as having a “dysregulation in cerebral fibres” – rather than attributing their difficulties to astrological misalignments or demon possession.

By characterising ADHD as a brain-based condition, Weikard was ahead of his time, and we’ve come a long way since then. This is not the place to chart the whole biography of ADHD, suffice to say that when someone rolls their eyes and declares dismissively, “We didn’t have ADHD in my day…” – they are either over 300 years old or not talking like a mature Englishman, even if they read The Times.

The negative side of the condition as being in a constant fight with one’s own thoughts and senses – these are doughty opponents, they always know where to find you, and they only sleep when you do.

Another thing that is not new, despite what cynical commentators might seek to imply, is the treatment of some aspects of ADHD with medication.

Doctors have been prescribing amphetamines to patients with ADHD since at least the 1950s. Yet now those medications are in short supply. Contrary to the media hype, fewer than 1 in 10 people with an ADHD diagnosis take prescribed medication, but for some of those who do it can be a lifeline – calming down a washing machine mind that is stuck on constant spin.

One acquaintance of mine has taken to anxiously touring the local pharmacies, driving to neighbouring towns and villages, desperate to get her prescription filled.

Another is passing her own tablets on to her son, whose prescribed supply ran out sooner. Sharing prescription medication is, I am duty-bound to add, an illegal practice – but it is hard to expect a parent to medicate themselves whilst seeing their own child struggle to attend school, to complete exam papers and to just generally feel (and I quote) “like a normal person.”

People who have ADHD sometimes describe the negative side of the condition as being in a constant fight with one’s own thoughts and senses – these are doughty opponents, they always know where to find you, and they only sleep when you do.

This is not to overlook that there are positives to ADHD too – it is often pointed out that the condition entails a degree of “superpower.” A person living with ADHD may have an incredible ability to focus on one difficult problem to the exclusion of all else, and thus solve it, perhaps devising creative solutions that elude those with a more pedestrian style of thought.

Also, it is common for people who live with ADHD to be dynamic conversationalists, with high social intelligence and empathy, priming them for success at tasks like broadcasting and debating. Many elite athletes also live with ADHD and say that they able to strive for excellence due to their restless energy and resilience in the face of tough training regimes.

Given the mixed bag of struggles and superpowers, there is a raging debate about whether ADHD should even be considered as pathology, or just as a neurodivergent way of being human. I suspect there is no right or wrong answer to this – for each person who lives with ADHD it depends on their own experience and how they feel it helps or hinders them to live the life they choose. Neither is it a binary choice: more than one of my own acquaintances who live with ADHD has described themselves as being in a “love-hate relationship” with their neurodivergence.

ADHD challenges me to unfold my mind too – to become ever more aware and appreciative of the fact that there are many ways to be human.

Neurodiversity, like any kind of diversity, challenges the way we live to together in communities, choosing or refusing to show empathy towards those who are perceived as ‘other’. There are several places in the Bible where human interconnectedness is likened to the human body – made up of many different parts, with each member dependent on the other for the wellbeing of the body as a whole. In one of his letters, St Paul wrote, “If the whole body were an eye, where would the hearing be? Or if the whole body were an ear, where would the sense of smell be?” Society needs problem solvers, communicators, high achievers, even while society also needs people who can structure, plan and maintain consistency – and above all, society needs these different neurotypes to work together with a certain amount of mutual understanding and trust.

Reflecting further on the body metaphor, Paul also wrote this: “If one part of the body suffers, the whole body suffers with it.” It is estimated that about 5 per cent of people in the UK has ADHD, so it is likely that includes someone you know. The majority don’t take regular meds, but if you are connected to someone who is usually reliant on these, the next few months may be a time of particular stress and anxiety, as the current medication shortage is expected to continue into late spring. This affects not just those living with ADHD, but all of us, as we live together in our families, communities, and networks. Not everyone chooses to be open about having an ADHD diagnosis, but if they are, now might be a good time to ask them how they experience this condition, both with its positives and negatives, and how you can support them if they are managing without their usual prescription.

The body metaphor, and Paul’s teaching around it, reminds us that diversity is no accident, God has always been attentive to those who feel divergent or far from the centre, as Jesus affirmed when he announced his ministry would be for the poor, the prisoners, the disabled and the oppressed. The psalmist too, observes that God’s attention and concern for us is so complete, that one is “…hemmed in, before and behind” – even if one strays to the very ends of the Earth, or drives to the pharmacy in the next village. Thus, while the media circus may be new, we can be sure that God has always been attentive to those with ADHD, and wider society is called to be likewise.

Writing for The Times, Esther Walker describes ADHD as “…the health story that keeps unfolding.” Well, certainly every time I unfold my newspaper, there it is again. But ADHD challenges me to unfold my mind too – to become ever more aware and appreciative of the fact that there are many ways to be human: usually complex, sometimes difficult, often brilliant, and always interconnected.

Explainer

Creed

Psychology

18 September 2023

5 min read

Should you be ashamed of yourself?

Shame powers cancel culture, yet its historic role is guarding community boundaries. Henna Cundill takes an in depth look at shame - and empathy.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

The word 'SHAME' spray painted onto a grey hoarding in lime green paint.

Anthony Easton/flickr: PinkMoose, CC BY 2.0, via Wikimedia Commons.

“Put on this dunce’s cap and go and stand in the corner!” cries the teacher, and immediately we are transported to a scene that takes place in a schoolroom of centuries past. Likewise, if nowadays we were to see a woman being led down the street wearing a scold’s bridle, we might assume that there was a very odd sort of party going on; we might even intervene or phone the police. Why? Because these are not the scenes of 21st century Britain. We don’t do public shaming anymore – at least, we like to think we don’t.

But the truth is we very much do; in fact, shame is essential, at least to a certain degree. For a group to survive with any sense of collective identity and purpose, something has to prevent each person within that group from becoming too greedy, or too lazy, or too dishonest. That something is often the fear of being shamed, not even punished – just shamed. It doesn’t feel nice to be judged and found wanting, or to fear that you might be.

Think back to the last windy day when your recycling bin blew over – did you experience a passing moment of concern about the public pavement acrobatics of your wine-bottles, cake boxes and ready-meal trays? No need to blush – your neighbours probably rushed out ahead of you to hide their own multifarious sins. Studies have long shown that installing self-checkouts at supermarkets dramatically increases the purchase rates of “stigma items” such as alcohol and unhealthy foods. Oh, the things we do when we think no one is watching…

So, shame is, on one level, a functional tool which does the essential job of guarding the life and boundaries of a community. Perhaps one or two of us still eats a little too much and drinks a little too much, but shame is one of the things that keeps most of us from going too far, too often – or at least the threat of shame tends to discourage. As Graham Tomlin has recently explored – we still live in a society that equates over-indulgence with a lack of virtue.

It’s one thing for shame to guard certain moral boundaries (as long as we can all agree what they are) but we’re in a troubling place with the social ones.

However, when an individual does step out of line, then the shaming process has two modes of presentation: exposure or exclusion, sometimes both. This is most clearly seen in a court of law, where an offender is first ceremonially declared to be guilty (exposure) and then is subsequently sentenced (exclusion) – often “removed” from society, at least for a while, via a custodial sentence or a curfew. In this very clear way, shaming plays a functional role for the well-being of society as a whole.

But these two prongs of the shaming process can also happen in rather dysfunctional ways, some of which are dangerously subtle. We fear the recycling bin disgorging its contents because there is a certain social shame in being seen to consume too much junk. Fine. But what about the teenager who is compelled into a cycle of disordered eating because a schoolfellow has pointed the finger and said the dreaded word, “fat”? Likewise, many people love a chit-chat, and the fear of being excluded from a social group usefully prevents most of us from being too fixed on one topic, or from appearing inattentive or impolite. But in my research with autistic people, some have shared that they feel shamed out of social groups entirely simply because “chit-chat” is not right for them. Some have a language processing delay, others find “small talk” a bit confusing and inane and would rather talk about something specific. It’s one thing for shame to guard certain moral boundaries (as long as we can all agree what they are) but we’re in a troubling place with the social ones. Some of this shaming doesn’t sound very functional, not if the wellbeing of society is supposedly the goal.

The inverse of shame is empathy. Where shame excludes, empathy shows attentiveness.

Perhaps the saltiest example of this problem is the now infamous “cancel culture”. I know – even I can’t believe I would risk bringing that up as a writer, that’s how charged this debate has become. But de-platforming, boycotting, or publicly castigating someone for the views that they express – these are shaming activities, an attempt to render an individual exposed and excluded. It can be a very tricky argument as to whether this counts as functional shame, guarding the wellbeing of society, or dysfunctional shame, guarding little more than social norms.

We ought to try and take it on a case-by-case basis, but even then, sometimes what one person takes as a moral absolute another person sees as a social choice. At the same time, those who hold dearly to certain moral absolutes sometimes lose sight of the societal impact of what they say. The result can be a strange kind of war, one where there is virtually no engagement between two opposing factions, and the only weapons are a string of press releases and a whole lot of contempt. Eventually, often regardless of there being no engagement and no progress, both sides vigorously declare themselves to be the winner.

Jesus once said a strange thing when he was talking to a crowd. He said: “Settle matters quickly with your adversary who is taking you to court. Do it while you are still together on the way.” In other words, “Just have a chat first,” says Jesus, “and see if you can’t come to terms.” It was part of a much longer discourse where he also told the crowd to “love your enemies” – and this with the kind of love called agape, a love which favourably discriminates and chooses someone – very much the opposite of shaming them.

For my own research I have looked in depth at the shaming experience, and one of the conclusions that I come to is that the inverse of shame is empathy. Where shame excludes, empathy shows attentiveness. Where shame exposes an individual, empathy draws them into discussion. To empathise with someone is not to agree with them, but it is to recognise they are human just the same, and that through openness and dialogue it is possible for people, even those who have very different experiences of the world, to explore each other’s perspectives. The end point of that exploration may not be agreement – it might still be everyone back to their corners. But in the process no one has been shamed, no one exposed or excluded, no-one othered or dehumanised.

Of course, it is far easier to point the finger, to expose someone to the court of public opinion, and then to turn one’s face away, nose in the air, mouth clamped shut in an apparently dignified silence. On the surface this seems like the elegant response – live and let live – but in fact it is not: to designate someone as not worthy of attention is to very publicly inflict shame. We might as well clamp them into a scold’s bridle and lead them down the street. And, as we do so, let’s hope it’s not a windy day – or if it is, let’s be sure that we have firmly tied down the lids of our recycling bins.