Paying attention to ADHD– is it really just a fad?

Media fixation with ADHD caught Henna Cundill’s eye, so she decided to investigate its struggles and superpowers.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

From a darkly shadowed face, a single illuminated eye stares.

Brands&People on Unsplash.

In a feat of irony, attention deficit hyperactivity disorder (commonly known as ADHD) is now getting a lot of attention. For example, between 28 and 31 January The Times newspaper published one article per day about ADHD. Intrigued, I looked back over the past few months, and I found that The Times has averaged 8 to 10 articles per month which are either partly or exclusively about this topic. These range from celebrity diagnoses to handwringing over the “troubling rise” in incidents of the condition, to concerns about parents gaming the system to get their children disability payments or extra time in exams.

With all this media hype, it is little wonder that some commentators are inclined to dismiss ADHD as a fad. Scroll through the comments beneath each article, and you will reliably find the rallying cry of, “We didn’t have ADHD in my day!” followed by the patient responses of those who try to correct this fallacy.

While the high public profile of ADHD is new, the condition itself is not. As early as the mid-1700s a Professor of Medicine called Melchior Adam Weikard was describing patients who were “unwary, careless, and flighty” – behaving in ways governed by impulse, and showing poor skills in punctuality, accuracy, and having an inability to complete tasks, to the detriment of their mental health. His description is of its day. For example, and somewhat amusingly, Weikard (himself German, but at this point living in Russia) also described his patients as follows:

Compared to an attentive and considerate person such a jumpy person may act like a young Frenchman does in comparison to a mature Englishman.

Even so, Weikard did not unconsciously adopt all the prejudices and stereotypes of his context: he broke firmly with existing medical consensus when he diagnosed these patients as having a “dysregulation in cerebral fibres” – rather than attributing their difficulties to astrological misalignments or demon possession.

By characterising ADHD as a brain-based condition, Weikard was ahead of his time, and we’ve come a long way since then. This is not the place to chart the whole biography of ADHD, suffice to say that when someone rolls their eyes and declares dismissively, “We didn’t have ADHD in my day…” – they are either over 300 years old or not talking like a mature Englishman, even if they read The Times.

The negative side of the condition as being in a constant fight with one’s own thoughts and senses – these are doughty opponents, they always know where to find you, and they only sleep when you do.

Another thing that is not new, despite what cynical commentators might seek to imply, is the treatment of some aspects of ADHD with medication.

Doctors have been prescribing amphetamines to patients with ADHD since at least the 1950s. Yet now those medications are in short supply. Contrary to the media hype, fewer than 1 in 10 people with an ADHD diagnosis take prescribed medication, but for some of those who do it can be a lifeline – calming down a washing machine mind that is stuck on constant spin.

One acquaintance of mine has taken to anxiously touring the local pharmacies, driving to neighbouring towns and villages, desperate to get her prescription filled.

Another is passing her own tablets on to her son, whose prescribed supply ran out sooner. Sharing prescription medication is, I am duty-bound to add, an illegal practice – but it is hard to expect a parent to medicate themselves whilst seeing their own child struggle to attend school, to complete exam papers and to just generally feel (and I quote) “like a normal person.”

People who have ADHD sometimes describe the negative side of the condition as being in a constant fight with one’s own thoughts and senses – these are doughty opponents, they always know where to find you, and they only sleep when you do.

This is not to overlook that there are positives to ADHD too – it is often pointed out that the condition entails a degree of “superpower.” A person living with ADHD may have an incredible ability to focus on one difficult problem to the exclusion of all else, and thus solve it, perhaps devising creative solutions that elude those with a more pedestrian style of thought.

Also, it is common for people who live with ADHD to be dynamic conversationalists, with high social intelligence and empathy, priming them for success at tasks like broadcasting and debating. Many elite athletes also live with ADHD and say that they able to strive for excellence due to their restless energy and resilience in the face of tough training regimes.

Given the mixed bag of struggles and superpowers, there is a raging debate about whether ADHD should even be considered as pathology, or just as a neurodivergent way of being human. I suspect there is no right or wrong answer to this – for each person who lives with ADHD it depends on their own experience and how they feel it helps or hinders them to live the life they choose. Neither is it a binary choice: more than one of my own acquaintances who live with ADHD has described themselves as being in a “love-hate relationship” with their neurodivergence.

ADHD challenges me to unfold my mind too – to become ever more aware and appreciative of the fact that there are many ways to be human.

Neurodiversity, like any kind of diversity, challenges the way we live to together in communities, choosing or refusing to show empathy towards those who are perceived as ‘other’. There are several places in the Bible where human interconnectedness is likened to the human body – made up of many different parts, with each member dependent on the other for the wellbeing of the body as a whole. In one of his letters, St Paul wrote, “If the whole body were an eye, where would the hearing be? Or if the whole body were an ear, where would the sense of smell be?” Society needs problem solvers, communicators, high achievers, even while society also needs people who can structure, plan and maintain consistency – and above all, society needs these different neurotypes to work together with a certain amount of mutual understanding and trust.

Reflecting further on the body metaphor, Paul also wrote this: “If one part of the body suffers, the whole body suffers with it.” It is estimated that about 5 per cent of people in the UK has ADHD, so it is likely that includes someone you know. The majority don’t take regular meds, but if you are connected to someone who is usually reliant on these, the next few months may be a time of particular stress and anxiety, as the current medication shortage is expected to continue into late spring. This affects not just those living with ADHD, but all of us, as we live together in our families, communities, and networks. Not everyone chooses to be open about having an ADHD diagnosis, but if they are, now might be a good time to ask them how they experience this condition, both with its positives and negatives, and how you can support them if they are managing without their usual prescription.

The body metaphor, and Paul’s teaching around it, reminds us that diversity is no accident, God has always been attentive to those who feel divergent or far from the centre, as Jesus affirmed when he announced his ministry would be for the poor, the prisoners, the disabled and the oppressed. The psalmist too, observes that God’s attention and concern for us is so complete, that one is “…hemmed in, before and behind” – even if one strays to the very ends of the Earth, or drives to the pharmacy in the next village. Thus, while the media circus may be new, we can be sure that God has always been attentive to those with ADHD, and wider society is called to be likewise.

Writing for The Times, Esther Walker describes ADHD as “…the health story that keeps unfolding.” Well, certainly every time I unfold my newspaper, there it is again. But ADHD challenges me to unfold my mind too – to become ever more aware and appreciative of the fact that there are many ways to be human: usually complex, sometimes difficult, often brilliant, and always interconnected.

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Loneliness

2 August 2023

6 min read

Why do we feel so lonely?

Re-reading some classics of English literature leads Graham Tomlin to wonder what lies behind our epidemic of loneliness.

Graham Tomlin

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

These days I can’t seem to avoid the spectre of loneliness. Bob Geldof recently described Sinead O’Connor as ‘full of a terrible loneliness’ in the weeks before she died. Elon Musk, who owns Twitter, one of the world’s greatest social networks, was recently described as a cutting a lonely figure. Even more widely, over a quarter of all Londoners say they often or always feel lonely - and that in a city where you can’t get away from people – all 8 million of them.

Loneliness is an epidemic these days. In the UK we even have a Minister for Loneliness and a Department of Government offering ‘Loneliness Engagement Fund’ grants for groups coming up with good ideas to combat it. Loneliness, as Roger Bretherton writes, causes psychological and social damage and is one of the main threats to mental health in contemporary life. I would hazard a guess that if you’re reading this there are times you feel isolated, and would love to have a greater sense of community where you live, or richer friendships. If you don’t, then count yourself fortunate.

Underneath our immediate sense of isolation, our social unease, the ache in the soul that comes with feeling out of connection with others, lies a deeper sense of cosmic loneliness.

During the pandemic, looking around for books that would shed some light on that strange experience of isolation as so many did, I re-read two novels: Daniel Defoe's Robinson Crusoe published in 1719, and Joseph Conrad’s Nostromo, published in 1904. In both stories, people get stranded on deserted islands. Somehow lockdown didn’t seem that different.

Everyone knows the story of Robinson Crusoe. You might have thought that being the sole survivor of a shipwreck, alone on a remote island, would lead to a crisis of loneliness and self pity. Well, he does have moments when he reflects on the possibility that he might die in that desolate place, and remarks how ‘the tears would run plentifully down my face when I made these reflections.’ But the self pity doesn't last long. He goes on to ask himself the question of why he alone was saved out of all crew of the ship that foundered. He sees some kind of providential design in this - that he has been saved, not just by chance, but for some wider purpose, which gives him a sense of comfort. In fact, the novel is the tale of a kind of spiritual awakening, as he gradually sees in his story something of the hand of God mysteriously guiding and preserving him through his trials. Seeing this enigmatic hand directing his affairs, and discerning some kind of purpose in his isolation, Crusoe sets about the tasks of building a kind of small civilization on his island, constructing increasingly sophisticated shelters, planting crops, capturing and taming animals, mapping the island, until his final rescue. He is alone (until Man Friday appears of course) but strangely not alone.

In Conrad’s Nostromo, it turns out very different. This is a story of attempts to protect a hoard of silver from revolutionaries in the troubled (and fictional) South American republic of Costaguana. In the course of trying to hide the treasure, alongside Nostromo, the main figure in the story, the politically ambitious and romantic journalist Martin Decoud, also finds himself stranded on a deserted island, albeit with the load of valuable silver for company. His experience however is totally different. He has no such belief in providence and so for him, the isolation bears more heavily: “solitude appeared like a great void, and the silence of the gulf like a tense, thin cord to which he hung suspended by both hands, without fear, without surprise, without any sort of emotion whatsoever…” Unable to bear the isolation, the aimlessness of his life on the island, and the apparent failure of his plans and projects, he fills his pockets with silver ingots from the treasure, rows in a small dinghy a short way out from the shore, shoots himself with a revolver and falls overboard, sinking slowly to the bottom of the sea. And so, as Conrad describes it, in a cold, yet superb turn of phrase: “the brilliant Don Martin disappeared without a trace, swallowed up in the immense indifference of things.”

Even though they both faced isolation and loneliness, the fates of these two characters are very different. One is a story of spiritual growth, learning, meaningful activity and ultimate rescue. The other is a tragedy of lost hope and potential. It touches the heart, yet remains a tragedy.

Is it surprising that when we tell ourselves that we are alone in the cosmos, that there is no-one there to hear our cries or heartfelt longings, that the aching hole in the universe finds its way into our own hearts?

Of course, both are novels not historical episodes, yet the two books, separated by nearly 200 years, operate in very different frameworks. The first operates in a world which assumes a kind of providential ordering of things. The working of a divine hand of providence is, as Crusoe (and presumably Defoe) realises, hard to discern and difficult to distinguish in any one moment, and so leads many to doubt it is there at all. Belief in providence has always been a choice - an act of faith rather than a scientifically proved theory. And yet the story is framed within the overall belief that in the strange twists and turns of life there is a deeper divine order that leads towards a distinct purpose of good and which makes human activity directed towards that purpose meaningful.

The other story has lost that sense of divine order, and is left only with the “immense indifference of things.” This is a world in which there is nothing beyond what we can see and feel, no objective purpose, direction or goal other than that dreamed up by us. Human activity, in this case, the search for wealth and riches, seems strangely pointless. All that is left is human love and relationship and when that becomes impossible, due to enforced loneliness, there seems little point left to life.

Richard Dawkins famously wrote: ‘the universe we observe has precisely the properties we should expect if there is at bottom no design, no purpose, no evil, no good, nothing but blind pitiless indifference.’ For the moment I'll leave to one side the question of whether the universe does point in that direction, but either way, if we tell ourselves that story, as we have so often been doing for the last couple of centuries, is it surprising that often we feel dreadfully alone? Is it surprising that when we tell ourselves that we are alone in the cosmos, that there is no-one there to hear our cries or heartfelt longings, that the aching hole in the universe finds its way into our own hearts? It doesn’t take much imagination to see that the ‘immense indifference of things’ leaves a hollowness in the heart of life and the pit of the stomach.

Such a deeper cosmic loneliness might explain why we can still feel alone even in a city, even in a crowd or even sometimes among our friends. It helps us see our loneliness not just as a tragedy but as a pointer towards our need from greater sense of connection than any human being could give.

In Matthew’s gospel, the very last sentence depicts Jesus saying to his perplexed but bewildered disciples, scarcely daring to believe that he has actually risen from the dead: “Surely I am with you always, to the very end of the age.” This simple promise is one that has held and sustained Christians for generations, in prison cells, through dangerous voyages, through purges, in times of persecution, misunderstanding and sickness and, yes, times of loneliness in modern western societies. Of course, we need a sense of belonging, and the company of others, as we are made for that. But underneath it we need a deeper connection, a bond with something, or someone at the very heart of things. Such a promise doesn’t remove loneliness, but it makes it bearable, even meaningful.