Dani Donovan nearly didn’t post the illustration that changed her life: a deadpan visual gag that translated her ADHD-aided storytelling style into a 12-point flowchart.
When he released him Coming to the Twittersphere in December 2018, she thought very few people would see it. Instead the post went viral “almost immediately” with over 100 million views across social media channels. Exactly a year later, she left her corporate graphic design job to pursue ADHD Comics full-time.
Donovan, now 31, has become a grand doyenne among the broad spectrum of ADHD influencers, a space that didn’t exist when she shared her inaugural post nearly three-and-a-half years ago.
ADHD, or attention deficit and hyperactivity disorder, is having a moment. The video tagged #ADHD on Tiktok has been viewed more than 11 billion times. Most creators are 20- and 30-somethings who identify with executive function disorder, whose symptoms typically include difficulties focusing and regulating emotions. There are some clinicians who use their platform to clear up misconceptions (and discourage self-diagnosis). Overall, they post for an ever-increasing audience.
There is an increasing trend in adult ADHD diagnoses over a decade. The steady climb of teen ADHD was already a cause for concern (and eye roll). But between 2007 and 2016, the incidence of adult ADHD in the US increased by 123%, far higher than the rate increase in child and adolescent cases. In the mid-2010s, adults replaced children as the primary market for ADHD medication.
There are some anecdotal signs that this phenomenon has at least picked up pace during the pandemic and, more likely, has intensified. In a survey published in March by the magazine Edtitude, more than a quarter of the 2,365 adult readers of the ADHD-focused publication reported that they had been given a formal ADHD diagnosis within the past year. Online pharmacy SingleCare saw a 16% increase in prescriptions for generic Adderall, a popular ADHD stimulant drug, from early last year to early 2022.
Some attribute this pattern to social media. Donovan has directly confirmed that she has received more than 1,000 messages from people who underwent a diagnostic evaluation and received a diagnosis because of its content. The decade-old reddit page r/ADHD has grown from 643,000 subscribers in March 2020 to over 1.4 million today, neatly reflecting the rise in ADHD curiosity (if not necessarily diagnosing) that coincides with the pandemic Is. But the increasing prevalence of the disorder is driven not by excessive exposure to social media, but by a tangle of distinct cultural and clinical threads, each entangled in its own right. The era of ADHD is a clash of science and society, and each has its dissatisfaction.
It helps break things down. There is ADHD as a neurodevelopmental impairment with known structural correlates (think small amygdala and hippocampus in the brain), and ADHD as a clinical diagnosis with enormous profit potential for the pharmaceutical industry. Then there is #ADHD in the form of an algorithmic material incentive and confirmation of experience.
“One thing that makes ADHD a unique diagnosis, in some ways, is that there are social benefits to being diagnosed that you don’t always see for other mental health difficulties,” says Dr. Margaret, a clinical psychologist and researcher. Sibley says. in ADHD. “People are able to carry an ADHD diagnosis to a school or workplace and because of it have reduced responsibilities, or accommodations for testing, et cetera. When there are benefits like this, you have a variety of consumers. “
In other words, ADHD can provide people with a measure of grace for falling short of productivity expectations that would affect the baseline ability of most humans. To that end, the pandemic may have provided even more impetus for finding an ADHD diagnosis. With the onset of COVID-19, many people suddenly found themselves unable to read books or maintain basic email correspondence, their attention shot completely and unnaturally. The phenomenon has become so apparent and pervasive that it has fed a media sub-genre of psychological reassurance-interpreters, assuring readers that cognitive horsepower is to be expected to decrease, given the “unprecedented” challenges of the time. .
The striking overlap between ADHD symptoms and the garden variety “epidemic brain” only adds to a common misconception of the former. Simply, ADHD symptoms can look and sound like the conflicts that define many people’s everyday workflows, often fragmented by push notifications and digital dopamine hits. Who? Not there Having trouble multitasking or completing tasks? and that Not there Fighting the urge to impulse-scroll social media during particularly dull moments of any afternoon? Over the past two years, these difficulties have become more pronounced.
But whether or not ADHD is actively overdiagnosed is a different question, and without a simple answer. Two things are certain. For one, research suggests that ADHD isn’t a clear disorder that a person does or doesn’t have as a whole, but a combination of challenges that exist on a spectrum of impairments. According to Sibley, rigorous standards of psychiatric evaluation should be able to determine between the clinical presentation of the disorder and the presence of certain ADHD symptoms.
The second certainty is that the stimulant medications often prescribed to treat ADHD are highly controversial. Skeptics point out that drugs like Adderall and Vyvanse are, in effect, industry-regulated dosages of speed. Whether or not everyone diagnosed with ADHD has the disorder is a statement of the uncomfortable fact that most people’s productivity will see improvement from the medications prescribed to treat it.
The result is what Sibley describes as a “philosophical debate”, albeit often shrouded in the language of security.
“You might ask yourself a similar question about people using steroids in sports,” says Sibley. “People can exaggerate the pros and cons, but ultimately it comes down to what people value more than the issue of safety, because you can find stimulants safe in any person, even without ADHD. can manage.”
Debate aside, ADHD diagnoses – and the medications that treat the condition – have become much easier to obtain during the pandemic. Social distancing measures removed legislative barriers that previously prohibited remote providers from prescribing controlled substances, a class of drugs that includes many ADHD medications. This allowed several venture-backed telehealth startups to expand their provisions, and led some to focus on diagnosing ADHD and prescribing drugs to treat it.
No one has noticed the shift. The same algorithmic mechanism that fuels the visibility of #ADHD TikTok and Instagram memes also fuels ADHD treatment offerings from startups with tech-control names like Clarity, Dunn, and Cerebral. Promotional ads for these companies have become the inevitable window dressing of many people’s social media feeds.
But there is pushback going on. In late April, a former Cerebral executive launched a labor lawsuit against his former employer, alleging that by overprescribing drugs for ADHD, the company “severely put profit and growth before patient safety.” was” he was fired for expressing concern. In recent weeks, a growing number of online pharmacies and brick-and-mortar drugstore chains have stopped filling prescriptions for controlled substances such as Adderall held by telehealth providers.
The extreme uproar over stimulant drugs paints a misleading picture of what some patients really need or need. “The thing is, meds aren’t a panacea,” says Joy Hui Lin, a Southern California-based freelance journalist in her early 40s. “You need structure.”
Hui Lin was diagnosed about five years ago after recognizing her own struggles in an article about ADHD in women. She soon learned that because of gendered social expectations and social bias, ADHD is often misdiagnosed or overlooked in girls and women, especially girls and women of color.
What he internalized as character deficiencies became textbook symptoms of the disorder. She also felt that, while the medications provided a helpful support, she benefited most from the implementation of routines and procedures to help her stay on top of her daily responsibilities.
A similar vantage is echoed by “Cindy Noir,” the online personality of a 26-year-old social media content creator based in Dallas. Last summer, a licensed psychotherapist got in touch with Noir after watching a TikTok livestream in which Noir spoke about her difficulty completing household tasks and communicating ideas with her sharp-witted mind. The physician was unable to give Noir an official ADHD diagnosis from a phone call and email exchanges, but expressed the opinion that Noir likely met the diagnostic criteria for the disorder and recommended that she seek evaluation.
“Unfortunately, as a woman and as a minority, being diagnosed with ADHD is actually the biggest uphill battle because they will diagnose your symptoms as other things, not ADHD,” she said. Noir, which is black. He ultimately opted to follow a formal ADHD evaluation or pharmaceutical treatment path due to a lack of health insurance coverage, but he says his life has been improved by adopting the organizational strategies recommended for ADHD patients, such as to-dos. Creating lists and setting electronic reminders. She feels empowered, in control.
What is often overlooked in the mainstream debate is that most people are doing everything possible with the resources they have. Amidst the ethical landscape of the for-profit health care system, companies’ cynical exploitation of the deep vulnerabilities of individuals deserves scrutiny. But it seems unfair to dismiss the relief people get from an ADHD diagnosis, or social media content that validates and supports their efforts to live life to the fullest.
“I see relief and belonging from people who feel like they don’t fit in anywhere,” says ADHD comics artist Donovan. “They got this place, like, ‘Oh okay, these are my people’. These are my people.”