IS ADHD EVEN REAL?

There is widespread scepticism that ADHD is even a real ‘thing’. Sceptics have decried what they view as the pathologising of normal human behaviours and experiences, as well as the needless medicalisation of naughty but otherwise healthy children and, now, adults.

Indeed, in this era of everdwindling attention span due to an incessant barrage of information and the relentless pace of technological advancement, who in their right mind would look at the collection of traits associated with ADHD and attribute them to anything other than the human condition?

Yet this belies a widespread misunderstanding of what ADHD is, and the wealth of evidence that exists to prove its existence.

‘In the age of constant distraction, distinguishing between the effects of external influences and ADHD can be challenging,’ Lance says. ‘While digital distractions can impact attention spans, ADHD involves persistent difficulties in sustained attention, impulse control and executive functioning. Individuals with ADHD often exhibit these challenges across various settings, affecting both personal and professional domains, and these challenges will have been with them in some form or another since early childhood. An anecdotal example might involve a client who struggled with work tasks due to persistent attention lapses despite implementing digital detox strategies.’

Differences in the brains of those diagnosed with ADHD have been well documented, specifically in the prefrontal cortex, which controls executive functions such as problemsolving, attention, planning and response inhibition. Research has found a link between ADHD and the abnormal function of a gene that regulates the neurotransmitter dopamine, causing people to behave impulsively in pursuit of dopamine producing activities( resulting in, for example, obsessive exercise, or addictive behaviours such as substance abuse). Mood swings and brain fog are also side-effects of deficient dopamine.

‘There is very clear scientific evidence for the causes of ADHD,’ Prof Schoeman says. ‘It’s a neurobiological disorder, and an euro developmental disorder, which means it’s present from birth. The most common risk factor for ADHD is genetic. It’s the most genetic of all psychiatric disorders, with up to 80% of patients having a family history of ADHD. But we have not been able to identify one single gene that causes it; rather, multiple genes are interacting to cause it, that affect key neurotransmitter systems in the brain, especially in the frontal lobe, which is responsible for attention, concentration, motivation, drive, the ability to focus and so on. But there are also other neurotransmitters involved, for example, serotonin, which contribute to emotional dysregulation, irritability and impulsivity. Being born prematurely is another big risk factor for ADHD.’