Living with ADHD is like navigating a wild terrain, not only because of the symptoms but also because you're on a constant mission to enlighten folks that keep badgering you with stuff like: "Is ADHD real? Truly?". Cue the eye-rolling moments when you hear comments like, "You don't have ADHD - you just have bad organization skills" or "Kids are naturally hyperactive – it's not ADHD." Oh, the joy.

Even though the American Psychiatric Association stamped ADHD with the official "disorder" label in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there's a surprising number of doubters out there. 

You probably have a family member who claims that depression is a myth and believes in wild nonsense about the origins of COVID-19. And guess what? It’s not only fans of big pharma conspiracy theories who believe that ADHD is an invented disorder. Some medical professionals are also guilty of moonlighting as ADHD skeptics. 

So, why the skepticism? Why do even smart people have doubts about the validity of ADHD? And how on earth do you respond to those who insist you're just faking it? Today, we're diving deep into this ADHD mystery.

[Is ADHD Real?] The Big Question: Is ADHD Real?

Ehm… Duh!

If you have ADHD, you know how real it is and how significant an impact it can have on the everyday life of a person. The mainstream medical community, including the National Institutes of Health and the U.S. Department of Education, also doesn’t have any doubts that ADHD is an actual condition and not just a combination of symptoms. Its recognition as an objective disorder should be a no-brainer for many reasons. Let's break down the most substantial ones.

ADHD is rooted in brain chemistry. 

In the DSM-5 definition of ADHD, it’s said that it is a neurodevelopmental disorder. These disorders are related to developmental deficits or differences in brain processes and affect how people function in their personal, professional, and social lives. So, in simple words, the brains of ADHD folks march to a different beat. 

However, medical scientists still don’t have a conclusive understanding of the biological processes behind ADHD (as it happens with many other psychiatric conditions). They have only recently started researching the many ways the brains of ADHD folks differ from the normal brains. Yet, there are already some very intriguing findings.

There’s an imbalance of chemical messengers, or neurotransmitters, within the brains of people with ADHD that causes the disruption of activity and communication between four functional regions of the brain - frontal cortex, limbic system, basal ganglia, and reticular activating system. This imbalance manifests with symptoms like inattention, impulsivity, emotional dysregulation, and even, in some cases, hyperactivity (depending on which region of the brain it affects). 

There are also findings that show that children with ADHD often have slightly smaller brains, and their brains may take more time to mature than the brains of kids without ADHD. (1) Other studies that examined the brains of kids and young adults with ADHD have discovered that they had lower gray matter volume compared to the brains of kids without the condition (2,3).

We only mentioned a few studies, but there’s so much more! If you’re interested in the difference between ADHD and neurotypical brains, you can find more curious info in our more detailed article.

ADHD is hereditary.

Another reason to define ADHD as a valid disorder is its genetic nature - it's a family affair. We know it’s the same condition, not just a bunch of unrelated symptoms when passed from generation to generation. There are findings that show that the formal heritability of ADHD is about 80%. That’s a very high number. Moreover, it is higher than most other psychiatric diseases (4).

Scientists are now working on determining which genes, specifically, make an individual susceptible to ADHD. If they manage this, it would be much easier for the doctors to diagnose this condition and find effective treatment strategies accurately. That's the dream!

ADHD diagnosis has high reliability.

Though the doctors don’t have objective diagnostic tests that can 100% confirm or deny if you have ADHD (because let's be honest, that would be too easy), that’s true for many other psychiatric conditions. Even some medical conditions usually identified with objective laboratory tests can be hard to distinguish. But your doctor can still accurately diagnose you with ADHD. 

Moreover, ADHD diagnosis is considered quite reliable. Reliability of the diagnosis means the likeliness of several doctors coming to the same diagnosis after independently evaluating the same person.

Of course, misdiagnosing happens with ADHD, too. However, it’s understandable - the condition can manifest in so many different ways, and there is still so much scientists and doctors don’t know about it. 

Now, armed with all these reasons to declare ADHD as a valid disorder, you'd think everyone would be on board, right? Well, hold onto your ADHD-fueled energy because some folks are still raising their eyebrows and throwing shade. What's the deal with these ADHD skeptics? Let's find out!

[Myths about ADHD] Why do people think ADHD is not a natural condition?

Usually, ADHD deniers use similar arguments to support their claims; some of these arguments are even sprinkled with accurate facts about ADHD. Let's unpack these claims and see where they're taking a detour into the realm of misconceptions. 

Everyone has some symptoms of ADHD 

Some people claim that the majority of the population suffers from a bunch of symptoms enough to get diagnosed with ADHD while actually not having ADHD. And that, in moderate amounts, they’re a normal part of the human condition. 

Referencing the information from DSM-5 that only 5 symptoms of 18 needed to get diagnosed with ADHD, these people claim that is not enough to make an accurate assessment. Seems like a legit concern, no?

But they forget that the process of being diagnosed with ADHD is not as straightforward as just filling out the symptoms checklist. (We wish it were that simple!) Before diagnosing, your doctor will study your family medical history and have you undergo a thorough physical and psychological evaluation to discard other potential conditions. 

Also, the symptoms must be persistent and affect your day-to-day life. To get diagnosed with ADHD, your symptoms must be present for at least 6 months. Also, symptoms must occur in two or more settings, such as work and school. So you won’t get diagnosed with ADHD if you forget your bag at the cafe several times or can’t concentrate on a boring subject for a few hours.

Too many people get diagnosed with ADHD now 

Some ADHD deniers cry foul, claiming that the increase in the number of ADHD diagnoses that have been observed in recent decades is not natural. People of the past didn’t have ADHD, they say, and this disorder is probably some modern conspiracy of the medical and pharmaceutical industries.

Hold up! Even if the term ADHD only strutted onto the scene in the late '80s, doctors from yesteryear were describing hyperactive, inattentive kids who'd likely be candidates for an ADHD evaluation today. Just because we didn’t have a name for this condition doesn’t mean it didn’t exist.

As for the visible increase in ADHD diagnoses in recent years, more and more people learn about the existence of this condition and decide to get a proper medical evaluation. Also, the topic of having a mental disorder has become less stigmatized, so people are less afraid of getting a diagnosis.

Sure, there's a smidgen of truth in the allegation that ADHD can be overdiagnosed, but it's not part of some master plan by big pharma. Overdiagnosing mostly happens because of the poor diagnostic practices of the doctors - when they don’t consider other possible conditions or don’t use the necessary evaluation guidelines (5). 

Adults can’t have ADHD - it’s just a result of bad parenting

In the past, ADHD was considered a disorder common among children only, but more and more adults are diagnosed with ADHD now. It’s established that adult ADHD is more complicated and challenging to diagnose, as it presents differently than childhood ADHD (6). However, some people still deny the very existence of adult ADHD.

They often claim that the symptoms of hyperactivity and attention deficit persist into adulthood because of bad parenting and childhood traumas. They think that because of it, kids with ADHD grow up not knowing how to take responsibility for their behavior and just blaming their condition for the lack of self-control. Spoiler alert: they're wrong. 

These people don’t understand that the condition is based on brain chemistry, and discipline has nothing to do with it. Overly controlling parenting can make symptoms even worse.

This misunderstanding of how ADHD works also raises the claim that adults with ADHD can simply get themselves together and choose not to have the symptoms. Like they can simply stop being the way they are.

Though ADHD symptoms can become less intense or even disappear with age, adult ADHD is pretty much the real deal. And adults with ADHD are no less vulnerable - the condition makes it difficult for them to have successful careers and build meaningful relationships. They are more likely to have mood disorders to get involved in dangerous behaviors or dabble in the world of substance abuse.

[ADHD Deniers] How do you deal with ADHD deniers?

It’s hard to be calm and talk to people who are denying the existence of a real thing that complicates your life a lot and who are just calling you lazy and irresponsible. And it’s ok not to want to put your energy into proving them wrong. However, understanding their perspective might unveil different reasons behind their skepticism.

Many folks have trouble imagining having mental conditions like ADHD until they have close contact with a person who struggles with them. Having a heart-to-heart with someone who has ADHD could spark empathy and curiosity.

Sometimes, ADHD denial can be a genuine attempt to get more information about the condition. People just can not know about it. Maybe their child is struggling with something similar, and they are trying to make sense of what it is and may come off as rude, trying to get answers. If you feel that a person you know behaves like that, you can recommend some enlightening reading material to them so they can figure out how the condition works.

In some cases, denial might be rooted in fear. People who struggle with ADHD can also deny the existence of the disorder because they are afraid of being diagnosed with a mental condition. We talked about how more and more people are getting okay with admitting to having mental health issues, but it’s not a universal thing. This topic can be taboo in some communities, and the stigma around it is still pretty real. Talking to people like that can be complicated, as they can react unexpectedly. You may gently suggest they find an ADHD support group, as they may get the needed validation and understanding in such spaces and more easily come to terms with their condition.

But sometimes, people are jerks, and they deny your diagnosis just to make you feel bad about yourself. They can tell you that you can discipline yourself into not having ADHD symptoms or, on the contrary - that people with ADHD are just incapable of succeeding in anything. In such cases, don’t give them the satisfaction. Remember that ADHD is a real diagnosis, and though it can bring some unique struggles into your existence, it doesn't write the script for your entire life. Your journey can still be fulfilling, engaging, and uniquely yours!

Sources

¹ Lancet Psychiatry. Subcortical brain volume differences of participants with ADHD across the lifespan: an ENIGMA collaboration

² PLOS One. The brain anatomy of attention-deficit/hyperactivity disorder in young adults – a magnetic resonance imaging study

³ Journal of the American Academy of Child and Adolescent Psychiatry. Cortical Gray Matter in Attention-Deficit/Hyperactivity Disorder: A Structural Magnetic Resonance Imaging Study

⁴ Current Psychiatry Reports. Genetics of ADHD: What Should the Clinician Know? 

⁵ CJP. Is Adult Attention-Deficit Hyperactivity Disorder Being Overdiagnosed?

⁶ Drugs & Aging. Clinical Presentation, Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in Older Adults: A Review of the Evidence and its Implications for Clinical Care