Have you seen ADHD content pop up in your feeds? Are you getting a lot of it? In the past few years, there's been a surge in the number of adults diagnosed with ADHD, and at the same time more and more people online are going viral with "signs" that you might have it too. Whether with our doctors or friends, we're all talking a lot more about adult ADHD. Is this a perfect storm of online content leading to more diagnoses? Or is there more to the story?Brittany is joined by culture journalist Kelli Maria Korducki, who wrote about this for The Guardian, and Manvir Singh, assistant professor of anthropology at UC Davis, to get into it.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy
Chapter 1: Who are the hosts and guests discussing ADHD in this episode?
Hello, hello. I'm Brittany Luce, and you're listening to It's Been a Minute from NPR, a show about what's going on in culture and why it doesn't happen by accident. All right, y'all. This week, we are connecting the dots between TikTok, a neurological diagnosis, and that food molding in the back of your fridge. don't think these things are connected?
Well, Kelly, Manvir, and I are here to prove it to you. Kelly Maria Korducky is a culture journalist, and Manvir Singh is a professor of anthropology at UC Davis. Kelly, Manvir, welcome to It's Been a Minute. Thank you. Yeah, thank you so much for having us. I am so thrilled to have you both here. So to set the scene, let me share some videos that have been popping up on my social feed lately.
Rarely specific signs of ADHD. Your platter is trash. You can learn a new skill in record time. It will take me two weeks to pick my clothes up off the floor.
You can remember really weird, minute details from the past.
I can't remember why I've walked into a room.
These are all from the hashtag ADHD. And these kinds of videos from how to self-diagnose to how to manage a diagnosis are all over social feeds. And one study found that over a third of the claims about ADHD on social media weren't related at all to ADHD or even other diagnoses, but were instead just, quote, reflecting normal human experience.
Did you ever leave your laptop sitting outside by a tree? You might have ADHD.
all these online voices start to make it seem like anything could be a sign of a diagnosis. Now, I'm not trying to say ADHD looks one way or that it can't affect many parts of people's lives. Trust me, it affects many parts of mine. But this all has me wondering, what happens when a diagnosis goes viral?
And when people say, oh, that sounds like me, how do you separate personal identity from a diagnosable condition? So Kelly, Monvir, a lot to get into, but I wanna first focus on adults. Adult ADHD diagnoses have soared in recent years. Count me in that number. Kelly, your reporting showed that there was over a 100% increase. What's going on here? Why the increase?
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Chapter 2: Why has adult ADHD diagnosis increased so much recently?
You know, I think it's a variety of factors. One is simply awareness, increased awareness of ADHD characteristic symptoms during the pandemic in particular. Telemed was huge in the surge of prescription rates for ADHD medication, psychostimulant medications. These telemed providers came in just at the exact moment that many people expected
were noticing that they couldn't focus on their stuff when they were stuck at home and freaking out. That correlation has also fueled the speculation over a potential rise in misdiagnoses.
Yeah, well, I think one thing that I would add is that the rise that we see in adults... my understanding is one that you've also had a huge expansion of diagnosis in children. And I think across the spectrum is like a strong indication that there is kind of filling out the reservoir or people who have long lacked a diagnosis.
So there's better diagnosis of women, better diagnosis of people of color. But at the same time, I think there are all of these interesting indications that that in some directions that there is also like a potential pathologization of normal behavior or normal variation.
And so one example that you find in children is that like young children are much more likely to be diagnosed with ADHD than older children in a class. That's a general trend that you find where like younger kids are not only seen to have ADHD more, but are medicated more often.
Hmm. I definitely hear what you're saying about the possibility for kind of, this isn't an elegant term, almost like a market correction for people who maybe previously should have been diagnosed and were not. Like you said, women, people of color, check, check. That definitely, I think, was a little bit a part of probably what happened with me.
Like I had a teacher reach out to my mom about me having inattentive actually, not hyperactive, but like inattentive ADHD symptoms when I was like in kindergarten. We didn't come back around to that for about another 28 years, but it's all good. But what benefits do people see from getting a diagnosis?
Well, I think that, you know, the first and most important thing is it provides a sense of understanding for people who maybe have attributed their symptoms to, you know, personal failing. Low moral character. Low moral character. Yeah. Yeah. We really do tend to moralize these ADHD traits in particular as signs of laziness, as signs of arrogance, like you're too arrogant to try.
That's a big one. And people internalize that. Yeah. in a way, getting told, like, actually, this is a neurodevelopmental disorder that's a real thing in your brain, I think is very reassuring. It also can potentially provide people with an infrastructure to learn to better deal with their symptoms. And it provides access or opens up access to care and medication, potentially.
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Chapter 3: What benefits do people experience after an ADHD diagnosis?
Yeah. Like a lot of creators are making videos discussing their symptoms, and some of them are backed by science and others are not. There's a bigger list that clinicians use, but some of the recognized symptoms of ADHD include task avoidance, easy distraction, forgetfulness, and fidgeting. But I also saw, you know, a bunch of TikToks about how people with ADHD like...
have a hard time doing fridge management. Like that's its own symptom. You know, what food is in your fridge, how long it's been in there, making sure your nice produce isn't going bad and the takeout leftovers are moldering in the back. And I'll say that's not a problem for me. And I also know a lot of people who don't have ADHD who struggle with fridge management for whatever reason.
And one study found that over a third of the claims about ADHD on social media weren't related at all to ADHD or even other diagnoses, but were instead just, quote, reflecting normal human experience. This study, to me, suggests perhaps people are over-pathologizing aspects of their own lives. But what I really don't understand is what do they get out of this? Like, why do people...
What diagnosis and what does it add to their identity?
If I just look around at my table right now on my computers, I have one, two, three, four, five open windows. I have my phone next to me. I have like several books. I have checks. I have like so much going on here. I don't consider myself to have ADHD, but I think it's very hard for me not to be inattentive and distracted.
I think like inattentiveness and some degree of distractedness, maybe less so hyperactivity is, or just like common elements of the human experience at the moment. And so there is also, I think, something very familiar in that kind of content. You can kind of resonate with just the difficulties that everyone has in everyday life.
Now, I would say, though, that that is, I think, distinct from the question of what are the benefits that come from naming oneself. I mean, I think it can reduce these feelings of guilt or self-blame, but I think that also... Creates narratives about ourselves, creates stories about ourselves. You know, people write about the self-fulfilling prophecy that comes from diagnostic labeling.
You know, I've seen a couple of writers describe what's going on as quote unquote diagnosis culture.
And going off of what you just said about diagnosis becoming a self-fulfilling prophecy, I think some people might use it as a full explanation for what's going on in their lives at the expense of thinking about how their personal history might factor in or even thinking about some social or systemic reasons why people might find it hard to cope with their lives. What do you think about that?
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Chapter 4: How is ADHD portrayed and commodified on social media platforms?
Yeah, that's a very rich question. As an individual who has ADHD and who like just really has really spent, you know, I've spent my whole life trying to make it work. It's really wonderful for people to be able to explain and narrativize their experience through a formalized lens and through an official channel.
And so I think really the biggest challenge maybe for people who are receiving diagnoses is to kind of be able to locate their own agency and their own path within the frame of this diagnosis. You know, to understand that the diagnostic criteria are not predictors of their everyday experience and to recognize that they have agency and also accountability for their own decisions and actions.
Coming up, is the diagnostic system itself the problem?
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Chapter 5: What are common misconceptions about ADHD symptoms online?
Some researchers say that even with this increase in diagnoses, ADHD is still underdiagnosed specifically for people of color and women. And I think that that can be true, but there are also business incentives that go along with these cultural incentives to see ADHD in everyone.
You know, like there is one telehealth company accused of and another whose executives have been criminally charged with distributing Adderall and other ADHD drugs to patients who didn't need them in order to allegedly boost bottom lines and keep patient retention. Also, it bears mentioning that a lot of these drugs are addictive.
How do we balance getting people with ADHD the help they need with not allowing situations like this to arise?
Chapter 6: How do experts differentiate between normal human behavior and ADHD?
Well, the first step and maybe the most obvious one is just more widely available therapeutic care for a greater share of the population. And also, I would say that broadly speaking, there's a real over-reliance on pharmaceutical tools at the expense of behavioral tools, organizational tools, kind of a more like therapeutic toolkit.
Yeah. I mean, it's interesting that you pose that question because I think that is the question of psychiatric labeling. How do you design a diagnostic system that draws lines around people according to a checklist that is useful for them but does not end up harming other people, pathologizing other people, providing medication to other people that might get them addicted? And
I mean, it was Steve Hyman, the former director of the National Institute of Mental Health. He said something like the current DSM, this diagnostic system that we have for labeling psychiatric disorders is an absolute mess. It's because of issues like this. Right.
For people who don't know, the DSM is the Diagnostic and Statistical Manual for Mental Disorders, which is the book that doctors use to diagnose people for all kinds of mental health issues and disorders. Right.
But speaking to the issues with it, even after getting diagnosed myself, I noticed so many discrepancies between how that process happened for me and how that process happened for other people I know who got diagnosed with ADHD. I had to jump through way more hoops. That's kind of when I had an inkling that maybe the diagnostic tools that we have are not perfect.
Yeah, I would say that. So I think there are two issues that we can point to. One is the one that you're talking about where there isn't consistency in how each individual is evaluated. But the broader one is like, is it the best system to have... a, forgive me, but glorified checklist that practitioners use.
And I would say that many people argue that it's not the best system, that we are actually fundamentally are using the wrong system to catch people.
So what would a better model look like?
So one model is called HITOP, and it says we should throw out a system where you have diagnoses that you're labeled by, and instead we should think about everything as a system of dimensions or spectra.
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Chapter 7: What is 'diagnosis culture' and how does it relate to ADHD?
Yeah, I think that's a really good question. One thing that I have thought about and written about has been that once you have people who are labeled by a system, that creates an investment in the system staying around. I've written about the difficulty of Asperger's. When they were moving from one edition of the DSM to the other, they got rid of Asperger's.
They made it a part of autism spectrum disorder. And that created a lot of backlash because by naming people as having Asperger's, you created an identity, you created a community, you created a kind of person, essentially. And that, in turn, made it harder to revise the system.
When you have such a close link between psychiatric diagnosis and identity, you actually make it harder to reform psychiatric diagnosis to make it better capture human variation.
Thank you both so much for this conversation. I really appreciate learning from you. Thank you so much for having me. Yeah, thank you so much. That was culture journalist Kelly Maria Korducky and Manvir Singh, assistant professor of anthropology at UC Davis.
And I'm going to put on my influencer hat for a minute and ask you to please subscribe to this show on Spotify, Apple, or wherever you're listening. Click follow so you know the latest in culture while it's still hot. This episode of It's Been a Minute was produced by Liam McBain. This episode was edited by Nina Potok. Our supervising producer is Barton Girdwood.
Our executive producer is Veralyn Williams. Our VP of programming is Yolanda Sanguini. All right. That's all for this episode of It's Been a Minute from NPR. I'm Brittany Luce. Talk soon.
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