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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Creed

8 May 2023

6 min read

Dialling down the drama in the science and religion debate

In the first of a new series, biologist and priest Andrew Davison explores the perceived tension between science and religion, and the role identities play.

Andrew Davison

Andrew works at the intersection of theology, science and philosophy. He is Canon and Regius Professor of Divinity at Christ Church, Oxford.

Vails containing growing plants sit in a lab's fridge.

Photo by CHUTTERSNAP on Unsplash

Evolution isn’t just an idea for me; thinking about it has changed the course of my life. I arrived at university in the 1990s having been a member of a house church, full of the kindest people, but fundamentalist when it came to the Bible. I thought that the world was made in six days, six thousand years ago. When I realised that the evidence is stacked against the idea – to say theleast – it almost cost me my faith.

I got through that crisis because friends introduced me to Christian thinkers from the Middle Ages, especially Thomas Aquinas (1224–1274). Far from representing an age of fear and ignorance (the ‘Dark Ages’), I found there an intellectual world that thrived on questions, with such philosophical sophistication that I was sure any of its chief exponents could have taken evolution in their stride. The struggle between faith and science lifted. Eventually, the sorts of questions that had previously kept me awake at night in worry, kept me awake in wonder. That was almost thirty years ago. Today, contemporary developments in evolutionary theory are one of the main strands of my work as a theologian.

In two further articles, I will describe some of what’s so interesting, and disputed, in biology and evolution at the moment. In one, I’ll talk about the shift away from the idea that we can reduce everything down to the working of genes. That’s sometimes called an example of ‘nothing-but-ery’: here, the claim that our destiny is ultimately about ‘nothing but’ genes. In the other, I’ll talk about some of the ethical repercussions that those contemporary evolutionary developments might suggest, on such practical matters as good housing.

In the rest of this piece, however, I will stick with the idea that it’s useful to see the idea of a tension between religion and science, not least over evolution, as being as much personal as intellectual. In particular, tensions over evolution in ‘science vs religion’ are caught up with questions of identity. Seeing oneself as a ‘religious crusader against science’ or a ‘scientific crusader against religion’ is an identity. It’s part of the story you tell about yourself, part of what you take pride in. Since these are also identities that define themselves in opposition to one another, they tend to extremes. Reconciliation involves renegotiating one’s identity.

Nor is money insignificant. There’s money to be made in writing shrill and divisive books, but in calm and conciliatory books, not so much. Angry books create interest on social media. They find to an already energised readership. Moderate books, and authors who try to dampen the flames of animosity, don’t sell that well; neither do books that are willing to say ‘actually, these questions are more complex, or nuanced’.

Evolution and economics

Crucial in these questions of identity is the gulf between those seen as the ‘elite’ and those who don’t see themselves that way (a common theme in politics today). Why is a denial of evolution more common in poorer communities? It’s not only that these are people without educational advantages. It’s also that they feel on the disadvantaged side of an economic and cultural system. In that situation, people are typically all the more invested in what the system can’t take from them, such as their ethnicity, their religion, and its culture. Good on them for that. People in that situation will be all the more unwilling for others – whom they perceive as an elite, who enjoy all sorts of worldly advantages – to tell them what to think about their biological origins, bound up, as they are, with dignity, faith, and self-understanding.

As an economically disadvantaged Muslim man once put it to me, ‘No one’s telling me that my faith’s stupid, or that I’m just some sort of monkey.’ There’s so much more going on in that statement than ‘being wrong about the science’.

Moreover, disadvantaged people, and especially the majority who don’t have white skin, have been on the receiving end of prejudice cast in evolutionary terms. Teaching the theory of evolution – glorious though it is as a work of science – has a checkered moral history. That brings us back to monkeys. The ‘Scopes Monkey Trial’ (1925) has achieved iconic status, as the triumph of science over superstition in rural Tennessee, but it’s more complex than that. The prosecution, with its anti-evolutionary stance, was wrong to dismiss evolution as a matter of science. They weren’t wrong to be repelled by the science textbook at the heart of the case, which was uncomplicatedly racist, and indeed racist on supposedly evolutionary grounds. Evolution, it claimed, had produced lesser (black) and more advanced (white) races. As historians have also shown in recent decades, evolution was a powerful inspiration, into the early century, for advocates of cut-throat economics and politics: winner-takes-all, survival of the fittest, let the poor go to the wall.

I’m not saying that every bit of opposition to evolution among poorer communities rests only on the ways that evolutionary theory has been used against them, but it is useful to remember that some of the religious opposition to evolution in the twentieth century came from a principled response to the unpleasant ethical, political, and economic positions to which – they were told – evolution gave support, including full-on advocacy for eugenic programmes of sterilisation of the poor, and contempt for the physically weak: all clothed in evolutionary garb.

Drama critique

The spectacle of a ‘science vs religion’ drama turns out to be about more than science, and also about more than theology or religious belief. It’s also about identity, advantage and disadvantage, about some deeply unpalatable economic and social positions, and even about making money out of writing books. There’s everything to be said for teaching biology well, and for arguing about the truth of evolution on scientific terms. I do a fair bit of that myself. There’s everything to be said for teaching theology well, and for arguing that it can take evolution in its stride. That’s even more my aim. But neither offers the full picture, and it’s not helpful to think that anyone who doesn’t believe in evolution is simply stupid or wicked. We won’t get very far, not even as advocates of science, unless are willing to listen. Unexpectedly, my experience is that the flagship scientific societies in the United States (where tension over evolution run so high) are better at this than they are in United Kingdom.

Getting trapped in one end of some mutually reinforcing antagonism is hard to shake. It’s difficult to get to a nuanced position when you’re dealing with positions that are defined against each other. Whether arguments about evolution are part of your experience or not, there’s a wider message here, which we might all do well to take on board, asking ourselves whether positions of animosity can become unhelpfully baked into our sense of ourselves.

Accepting evolution does not naturally, or inevitably, lead to brutal social Darwinism, but it’s been used that way in the past, more often than coverage of science today often lets on. We are by no means out of its shadow, even from under the shadow of eugenics. Being aware of that big, historical picture is useful, but it shouldn’t obscure the message from the beginning of this article, that these matters are fundamentally personal, and as much about how we see ourselves, and others, as they are about ideas. Reconciliation and understanding happen person by person, and person-to-person.

You might think the work I’d most relish as a priest and scientist, or think most useful, would be reassuring religious people that evolution isn’t their enemy. That’s a good thing to do, but I’m actually even more thankful for opportunities to reassure scientists that religion can be thoughtful, unafraid, and even downright passionate about science. Turning up to dinner in my college still in my cassock after evensong, sitting next to visiting scientists, and asking intelligent, enthusiastic questions about their science can do as much good as all the lectures I give in churches or to theology students about the irreplicable value of science.