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.

Article

Comment

Morality

Sport

3 July 2023

6 min read

The day the Ashes caught fire

After the upset following Alex Carey’s controversial stumping of Jonny Bairstow at Lord's, Graham Tomlin reflects on the so-called 'Spirit of Cricket' and what it tells us about our innate sense of justice and morality.

Graham Tomlin

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

Illustration generated by Dan Kim using Midjourney

Unless you have a complete aversion to sport or wilfully avoid all reference to cricket, you can’t have missed the controversy over the dismissal of the English player Jonny Bairstow by the Australian wicketkeeper Alex Carey at Lords during the final day of the second Ashes Test. Bairstow let a ball go through to the keeper and, thinking the ball (and the over) was finished, wandered down the pitch to chat to Ben Stokes his fellow batter, at which point Carey smartly threw the ball at the wickets to get him out stumped. The Aussie captain, Pat Cummins felt it was a fair cop, as it was within the rules of the game, and on that level, most English players and fans agreed with him. But what the English went on to say is that it was not within the ‘spirit of the game’, and therefore sneaky and underhand. Hence the unremittent booing of the Australians for the rest of the game from the usually sedate Lords crowd, hostility which is only likely to ramp up for the rest of the five-match series with the notoriously partisan Yorkshire crowd at Headingly next in line.

According to the Laws of Cricket, Bairstow was out. He had left his ground before the ball was considered ‘dead’ – which requires both teams to consider it such. The Aussies still felt the game was live, Carey threw the ball as soon as he received it, and so the England batsman has little grounds for complaint. Yet the distinction between the Laws of Cricket and the ‘Spirit of the Game’ has been invoked often since the incident to suggest the Australians are dastardly cheats who will do anything, however underhand, to win a game of cricket, just like they once famously got a young teammate to rough up the ball with sandpaper (clearly illegal) but got caught.

Laws and rules, whether in cricket, a business or charity or within a legal system, are there to protect something else, something deeper than the rules. Our legal system exists to protect more important things like families, community harmony, innocence or human life.

So where does this distinction come from and what does it tell us about our deepest moral instincts? The Laws of cricket are a human invention. Like all sports, cricket is a game which emerged in past centuries and then developed a complex series of rules (in cricket they are always called ‘Laws’) to govern the playing of the game. Those rules develop and change over time. Recent changes include instructions on what you do when a dog invades the pitch, or banning the use of saliva on the ball to make it swing more. Changes even come even in the new format called the Hundred, where bowlers bowl units of five or ten balls at a time instead of the traditional six-ball over. Yet each of these rules are in a way artificial. They are invented and monitored by humans to develop and monitor a human construction called the game of cricket.

Yet we also sense that the Laws cannot do everything. There is this elusive and instinctive thing called the ‘Spirit of Cricket’, so much so that the phrase ‘it’s not cricket’ has seeped into common usage to describe something that just doesn’t feel right. The MCC even runs a lecture every year at Lord called ‘The Spirit of Cricket’ inviting a former player or journalist to reflect on something deeper about the game than the nuts and bolts of the laws, individual performances or team results.

Yet the Spirit of Cricket is more than just about cricket. It appeals to a deeper sense, shared amongst all of us, that some things, even though not codified in human law, just don’t feel right. They go against our deepest moral instincts. They just seem wrong. When Ben Stokes said he wouldn’t have wanted to win a game in the way that the Australians had just done, he was appealing to a deeper moral structure than could ever be codified in a written rule.

So what does all this tell us? Two things, I suggest. The first is that we humans have a deep moral instinct of fairness. We have a sense of conscience, that is not just a human construct, and appeals to something more deeply embedded in the human heart and mind – and conscience is not just a matter of individual preference or cultural difference. We sometimes talk about respecting individual conscience, yet in a more important sense, something called ‘the spirit of cricket’ or the spirit of any game or human enterprise for that matter, testifies that conscience has a universal dimension that is common across societies and cultures – so much so that the spirit of cricket is said to hold whether the game is played in England, Australia, India or Afghanistan. Spot-fixing, or manipulating a game to win a bet, even though it’s not mentioned in the Laws of cricket, is thought of as bad practice wherever you are in the world. There is something universal about Conscience. It may not always be easy to deduce exact rules from it, and in grey areas like the Bairstow incident, it doesn’t lead to straightforward conclusions, but it does nag away at us when we are doing something shady or devious - even when we get away with it.

Secondly, It points to the distinction between human laws, that try to codify our way of living together and regulate human relationships, and a deeper moral law, that individual laws try to protect. Laws and rules, whether in cricket, a business or charity or within a legal system, are there to protect something else, something deeper than the rules. Our legal system exists to protect more important things like families, community harmony, innocence or human life. You might say that the Laws of Cricket are there to preserve the nebulous, but more important and very real thing we call the Spirit of Cricket – to ensure the game is played in a sporting, respectful and generous way, so that it can be enjoyed and not endured, and the competitive instincts it draws on at its best are regulated and don’t get out of hand into open conflict and violence.

once you take away.. the deeper natural law that pricks our consciences ... all you are left with is power – the imposition of the will of some upon the destiny of the many.

In one of his lesser known books, The Abolition of Man, CS Lewis called this deeper moral structure the Tao, drawing on a concept in east Asian religions. He said it included things like duties to parents, elders or ancestors, the importance of justice, good faith & truthfulness, valuing mercy, magnanimity and so on. This natural law is embedded in us, he argued, and that all our value systems are but fragments of the Tao. Despite our ideas of progress, we can no more imagine a deeper or different Tao than we can invent a new primary colour. To try to live outside this Tao, leads, he argues, to the Abolition of Man - the ultimate unravelling of humanity, because once you take away the Tao, the deeper natural law that pricks our consciences, that God-implanted instinct for what is right and wrong, fair and unfair, all you are left with is power – the imposition of the will of some upon the destiny of the many.

St Paul once described what happens when the divine Spirit of God begins to work in a person – they begin to produce “love, joy, peace, forbearance, kindness, goodness, faithfulness,gentleness and self-control.” He goes on to say: “Against such things there is no law.” You cannot demand or legislate such things into life, yet individual laws exist to create the conditions in which they can flourish and grow. There is a moral law that we dimly sense underneath our human legal constructions and moral deliberations, which protects things that matter to us and to which we feel ourselves compelled to conform – unless that is we have silenced the voice of conscience, something we all feel is a dangerous thing to do.

Whether or not Bairstow should have been deemed out, whether or not the Australians were being unsportsmanlike or taking fair advantage, maybe a rumbling dispute over a fine point of cricketing practice can point to something profound about the nature of the world we live in after all.