AFFIRMING PSYCHIATRY
Is ADHD Real?
In 30 years of psychiatry, I have frequently been in doubt about the true nature of attention-deficit/hyperactivity disorder (ADHD). Is it an illness? Is it simply a variation of normal? Is it a problem in our culture that might not be a problem in other cultures? The source of my doubt, I suspect, is that individuals just seem to ‘be wired that way.’ ADHD, it seems, is heavily influenced by genetics,1 and some individuals just seem wired to be more spontaneous, more distractable, more open to the next thing, and less able to keep themselves focused on things they find boring or tedious. It is just how they are.
Maybe ‘how they are’ would have been less of a problem in premodern times, when being open and exploratory may have been an advantage more than a hindrance. In premodern times, we did not ask children to sit in school for 6 hours a day doing work that would bore adults, nor did we ask adults to stare at screens and do mind-numbing tasks for 9 hours a day. Perhaps ADHD is just a mismatch between the demands of our current world and the nature of the world for which we evolved.2 Perhaps it is not a disease at all.
