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.

Article

Change

Psychology

27 August 2024

5 min read

Recovery came softly

A vision of grace amid an eating disorder.

From Mockingbird

Mockingbird is an organization devoted to “connecting the Christian faith with the realities of everyday life."

Under a tree, backlit by a sun set, two people sit in chairs outside and talk.

Harli Marten on Unsplash.

This article, by Lindsay Holifield, first appeared in Mockingbird. Published by kind permission.

I turned sixteen years old in a lavender-walled bedroom on the eating disorder unit at Texas Children’s Hospital. Surrounded by eagle-eyed nurses watching my every move and whirring machines keeping me alive, I quietly transitioned to Sweet Sixteen. The unit’s charge nurse was a gruff woman named Lupe, and despite her job, she did not particularly like children. But it was my birthday, and in an uncharacteristic act of kindness, Lupe offered me a slice of cake. She must have briefly forgotten her surroundings, because I was not a normal teenager. I was a patient on a pediatric eating disorder unit, and I broke down sobbing at the mere thought of such a high-calorie food entering my body.

This was my first birthday in a clinical treatment facility for anorexia, but it would not be the last. After receiving the initial diagnosis of anorexia nervosa as a teenager, the doctor’s pronouncement sounding like a death-knell at the time, I would admit to twenty treatment facilities on separate occasions across a period of fourteen years.

The treatment staff began to greet me knowingly when I would re-admit after only a few months out, as though I was an old friend returning from vacation. “Welcome back, Lindsay,” they would say, as they took my luggage and inserted yet another nasogastric feeding tube. Over time, I began to be labeled “chronic,” and I internalized a belief that I was one of the sufferers who was fated to live the rest of my life under the oppressive weight of this struggle.

I would have to try harder. I would have to pull myself up by my bootstraps and willpower my way into recovery. After each attempt under this approach, I would fall flat on my face.

It seemed that no matter how much motivation I mustered up, this internal drive to self-destruct would not leave me alone. I desperately wanted to wake up each day without having to submit afresh to the hellish existence of self-starvation and running till my lungs felt on the verge of collapse. But I felt chained to this destructive cycle deep into my bones, despite my best intentions.

I was often berated by various treatment providers for not having enough motivation. I didn’t necessarily want to die, but I could not find the strength within me to fight off the voice in my brain that demanded self-destruction. Doctors and mental health clinicians made it clear that if I really wanted to get better, I would have to try harder. I would have to pull myself up by my bootstraps and willpower my way into recovery. After each attempt under this approach, I would fall flat on my face. The despair of my situation began to swallow me whole: there was no way out, because I could not yell at myself enough to make myself well.

Because of the lavish softness I was shown, I began to approach myself with greater softness.

I was twenty-six years old, and I was sitting in a green folding chair in the summer on a farm in Nashville, Tennessee. The woman in the folding chair across from me is decidedly in support of my recovery, but she isn’t yelling at me or giving me a stern lecture. Instead, she is explaining with great care and tenderness how much sense my struggles make in light of my previous life experiences. “Perhaps,” she says gently, “your brain was trying to survive great pain. Perhaps you were simply trying to make the ache go away the best way you knew how.” Her compassionate words break something open within me, and I start weep like a small child. No one has ever approached me with compassion like this; they are all afraid being too soft will simply enable me to further harm my body. But they are wrong. It is precisely this compassion and sense of being witnessed that softens my armored heart.

Recovery did not come overnight, but I can unhesitatingly say that the compassion of a woman on that farm in Nashville is what radically changed the trajectory of my life. Because of the lavish softness I was shown, I began to approach myself with greater softness. The voice of condemnation quieted, and I slowly turned from self-destruction to life.

Do you not hear the gospel ringing out here? My story of recovery is simply a zoomed in image of the grander story, the beautiful truth that makes up the fabric of our existence. Admitting powerlessness to destructive forces of sin and death is important, but the condemnation of the law will not save us. It is the extravagant, one-way grace of God that resurrects the dead.

I have heard similar fears in faith communities that I continually hear in my recovery communities: if we are too extravagant with compassion, we are enabling sin and destructive behaviors. But I am a living testament that compassion is what softens hearts of stone, armored up by self-protection and attempting to earn love through behavioral perfection. I would have died many times over save for the compassion that chased me down and embraced me, and being held in such tender kindness was the only thing that could have changed my fate. I believe this for mental health, yes, but more importantly, I believe this for the rescue of all of humanity. The grace of God is the sole agent of resurrection and change.

To the surprise of those who cling tightly to rigid, white-knuckling versions of recovery, my behavioral change occurred only after I was met with a grace without strings attached. This should not be surprising to Christians, however. Here again, the gospel glaring back at us, that repentance is a response to the kindness of God. This is the God who loved us while we were dead in our sins, while we were powerless to the forces of the world, the flesh, and the devil. Against our behavior-driven moral sensibilities, God offers us grace that is a free gift, compassion in its fullest expression, and it is the only thing that will bring renewal and healing to the inhabitants of this desperately aching world: minds, hearts, and bodies included.