ADHD: Understanding the Genuine Condition Amidst Rising Self-Diagnoses

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In this edition of my ‘Ask Me Anything’ series available on my social media channels, I explore the trend of self-diagnosing ADHD and the debate over whether ADHD symptoms are merely the result of stress.

“How much of the current ADHD fad is legitimate? I’m seeing a lot of self-diagnoses based on what seems like normal responses to stress.”

I can’t really say how much of the self-diagnosis stuff is legitimate, but ADHD itself definitely is. We have a lot of data showing that it has a significant genetic component related to dopamine signaling (and to a lesser extent, methylation and serotonin pathways) that cause the symptoms many people rely on to diagnose the condition.

The thing with stress is that it depletes dopamine, because the stress hormones noradrenaline and adrenaline are made from dopamine. ADHD symptoms are caused primarily by deficits in dopamine signaling. So, anyone under stress can start to “act” like they have ADHD since they will have lower than normal dopamine levels. With ADHD, however, these symptoms are occurring all the time, and stress just exacerbates them further.

So, yeah, you see these things as a normal reaction to stress. Yet, they aren’t stressed and it’s still happening. When they are stressed, the symptoms are much worse.

It’s estimated that somewhere between 5% and 10% of people have ADHD, but diagnoses are made exclusively based on clinical presentation. If someone is under chronic stress, they may be misdiagnosed as having ADHD, so having your genetics analyzed or having a comprehensive psychological examination is important to know for sure what the problem is.

Neither of those things seem to happen in the medical world. Doctors go through a 15-minute questionnaire, don’t have the psychological training to rule out other causes of symptoms, and ignore genetics. It’s basic bitch medicine.

Things aren’t better in the world of self-diagnosis, either. Genetics are often ignored despite their wide availability to the public, and psychological assessments are rarely if ever happening. Instead, you have a bunch of social media contagion that lead people to conflating normal variations in behavior and attention with ADHD. Maybe they’re right, maybe they’re wrong.

There’s also a huge issue with ADHD diagnoses in childhood, especially in boys. I won’t go into a lot of detail, but a lot of boys seem to be labeled as having ADHD and needing drug treatment rather than just being appreciated for their boyish energy and adventure. The entire modern learning environment is incompatible with childhood biology, and these boys are punished for our failings.

One final point I want to make is to question why a label is necessary. If you act a certain way and find that certain things help or hinder your ability to be the best version of yourself, who cares what the diagnostic label is? They can even be counterproductive given how often we start to associate with labels. Suddenly, the ADHD diagnosis becomes an excuse for behaviors that we don’t like.

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