Have your social media algorithms decided you have ADHD?? You may be starting to get familiar with terms like #adhdtiktok and #neurospicy but why are you suddenly being served up content related to this neurodivergent condition? Is it a sign or just a coincidence?

Back in the day, ADHD was pigeon-holed as “a schoolboy” condition, most commonly associated with disruptive, hyperactive behaviours that were noticed in and out of the classroom. But that is quite a poor stereotype of the condition and a very outdated opinion. We spoke to Dr Marielle Quint, Chartered Clinical Psychologist at The Soke in South Kensington to discuss not only the #adhdtiktok phenomenon but also why we need to have a broader, modern-day view of the condition, particularly when it comes to diagnosing young girls and women.

First of all, what does ADHD stand for and what is it?

ADHD stands for Attention deficit hyperactivity disorder and is classified as a neurodevelopmental disorder. ADHD is in essence a problem of executive functioning, in other words, people with ADHD tend to experience difficulties with the area of the brain that helps us to focus, organise, plan and regulate our emotions.

ADHD can be experienced in infinite ways for different individuals, but stand-out symptoms include difficulties with being disorganised and distracted, procrastination, misplacing or losing things, experiencing time blindness and zoning out of conversations. Children and young people can experience sensory difficulties, being extremely sensitive to the way particular clothes feel, light and sounds. There is no relation to intelligence and can be particularly creative, having a tendency to hyperfocus on things that are experienced as enjoyable.

ADHD has a prevalence rate of 2.5%, making it more common than autism and it is highly inheritable. Indeed, often when young people are being assessed for the condition, it often transpires that one parent has traits or meets the threshold for a diagnosis themselves.

We most commonly think of young, overly-energetic boys getting diagnosed in school. Can you explain why this is actually quite an outdated view of the condition?

Stereotypically there is a misconception of children, particularly boys with ADHD as overactive and behaving badly. This is because initially in the 80’s the manual used to diagnose was based on studies in relation to boys. Using the behaviour observed in these studies has of course yielded further boys with similar difficulties and behaviours and therefore diagnoses..

Girls and women tend to experience more of the inattentive subtype of ADHD (defined below), so symptoms such as daydreaming and internal scatteredness (likened to the feeling of having 42 opened tabs) aren’t naturally associated with cause for concern. Additionally, there are societal expectations, particularly of women to be seen as capable, multi-taskers and working mothers that both exacerbate and normalise this experience to a certain extent. 

Can you talk about the difference between “hyperactive” ADHD and “inattentive” ADHD?

There are three different types of ADHD

  • Predominantly Inattentive Presentation: It is hard for the individual to organise or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.
  • Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who are impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.
  • Combined Presentation: Symptoms of the above two types are equally present in the person. Because symptoms can change over time, the presentation may change over time as well. There used to be a separate diagnosis of ‘ADD’ which is now outdated. 

Is there a link between ADHD and dopamine?

Dopamine is the ‘feel good hormone’ and also plays a large role in aspects of attention and inhibition. This is further complicated for women, as monthly fluctuating hormones oestrogen and progesterone can both boost and deplete dopamine which can minimise or exacerbate the management of ADHD symptoms and associated mood. 

It seems more and more people are being diagnosed later in life, particularly women. Why do you think this is?

Thankfully, there are more conversations of shared experiences of ADHD, all the time. There are several public figures who have shared their diagnoses and experiences, such as Olympian gymnast Simone Biles and actor Emma Watson. 

Until recently, ADHD was a condition that was often considered to ‘grow out of’. There is better testing for ADHD available and there is more knowledge, conversation and information readily available. 

However there are still disproportionately more boys being diagnosed than girls. It is vital that we become more astute at recognising the signs of girls with ADHD to get them seen, diagnosed and appropriately supported and treated. The sequelae of undiagnosed ADHD can be serious; associated with poorer educational performance, increased risk of mental health difficulties, substance misuse and difficulties with employment. Girls and women are missing out and hopefully, we can continue to rectify this. 

How does one usually get diagnosed? 

Diagnosis is performed by a psychiatrist who will take a detailed history. Questionnaires looking at your current experiences and difficulties will be completed and if at school, these may also be completed by parents and teachers. More recently, a more quantifiable test looking at eye saccade movements has been developed to aid what is essentially a subjective experience with quantifiable data.

Let’s talk about the ADHD Tik Tok phenomenon… many people credit the Tik Tok algorithm for showing them ADHD-related videos which lead them to be diagnosed. What are your thoughts on this?

With the NHS being more squeezed than ever before, social media is having a phenomenal effect in increasing awareness and understanding of our health in a way that wasn’t available until now. Information is accessible, relatable and easy to find. With many celebrities disclosing their own difficulties, it can be so helpful in demystifying and destigmatising many conditions. However, it is important to be wary of the sources of information that you are looking at. There are vast numbers of widely available ADHD questionnaires that are not valid and no substitute for clinical assessment and treatment.

Helpful resources…

Mind.org – www.mind.org.uk/information-support/tips-for-everyday-living/adhd-and-mental-health/

ADHD UK- www.adhduk.co.uk/about-adhd/