By Steve Ollington.
In recent years, workplaces have noted a clear increase in the number of adults disclosing or seeking a diagnosis for Attention Deficit Hyperactivity Disorder (ADHD). This rise within society more generally has sparked public debate, leading to questions in some media outlets, and among some public figures about whether ADHD is overdiagnosed, or perhaps no more than a “fashionable trend.”
People with ADHD have always been here, experiencing similar challenges – they just weren’t getting the diagnosis they needed and often were not even aware that ADHD was the source of the challenges they were facing. For many, they knew there was a problem and would wonder why they struggled in these ways, thinking they were the only ones. This will still be the case for lots of people now, even with the greater awareness.
The higher prevalence of ADHD diagnosis (or the growing queue of people waiting for diagnosis) is due to a combination of long-overdue clinical recognition, greater public awareness, and partially reduced stigma. But there is another factor, one which has only recently started to become clear – a growing mismatch between the ADHD cognitive style with increasingly process-orientated environments (particularly in businesses).
In an effort to address the question of “Why are there so many people with ADHD these days?” with the answers in one place, we will explore the major contributing factors, beginning with the most widely known.
Greater Numbers and Increased Clinical Understanding
The most obvious place to start when addressing the rise in diagnosed cases is the increase in the population size itself, alongside critical advancements in medical and professional understanding.
- There Are More People: A simple factor contributing to the greater number of people diagnosed is the overall increase in the global population – whilst this of course does not address per capita increases, it does factor into the numbers over-all.
- Greater Recognition by Experts: Experts have acquired greater understanding of ADHD, and are therefore more easily able to recognise the signs and symptoms. This of course means more referrals based on those signs and symptoms – but also, it is reducing the previous issues with misdiagnosis. Many people with ADHD would get diagnosed with other conditions that had overlapping symptoms, or with mental health challenges such as anxiety and depression. It is now better understood that untreated ADHD can be a root-cause for many of these cases.
- Greater Recognition in Educational Settings: Previously, traits often associated with ADHD in children-such as constant movement or failing to follow instructions, easily distracted, always forgetting things, etc… were simply seen as defiance or poor behaviour. Today, there is greater recognition in schools, with teachers and Special Educational Needs Coordinators (SENCO) being trained to identify symptoms. For many people in previous generations, these visible struggles led to being labelled as a disruptive, troublemaker, weird, etc… a significant number of these children would end up getting expelled.
- The Recognition of ADHD in Women: Historically, ADHD was predominantly associated with hyperactive young boys. The recognition that girls can also have ADHD came much later. This is because the hyperactivity sides of ADHD (when present, which is not always) is typically more common with boys – and that’s what would stand out the most. Speaking generally, ADHD girls would suppress this more and internalise it. Both boys and girls with ADHD, whether outwardly hyperactive or not, experience internal restlessness which goes significantly above the ‘normal’ threshold. It will manifest as being easily distracted but is often due to constant overthinking, and an anxious emotional intensity. This overlooked presentation resulted in many girls being missed or misdiagnosed – many of these girls are now women who are rightfully seeking the diagnosis they should have got years ago.
- The Recognition of ADHD in Adults: There was an incorrect belief that children simply “grew out of it” by adolescence or young adulthood. It is now understood that ADHD is a lifelong condition; adults learn to subdue or internalise hyperactive traits into subtle behaviours like fidgeting or pacing. They would also figure out coping strategies, and ‘mask’ themselves to try to meet the expectations of others and avoid judgment. The ADHD was still there, they just learned they had to hide it. This later recognition means a wave of people who have been trying to hide parts of themselves for decades (which in itself is a drain of cognitive energy) are now seeking diagnosis.
- Parents via Children: Lots of adults are learning about their ADHD through the diagnosis of their children. Now that ADHD is better understood, more children who show signs of ADHD are getting referrals for diagnosis. Their parents are then present during the diagnostic process, and it’s extremely common for them to be sitting and listening to the whole thing thinking “Oh… this explains a lot about me and my life, too”. This should not be surprising, given that the heritability rate for ADHD is 86.5%… that’s about the same as the heritability rate for height!
- More Scientific Understanding: Modern research has leveraged scientific tools to deepen understanding, including studies on genetics, medication effectiveness, and neuroimaging. These scientific advancements have confirmed biological differences in the brains of individuals with ADHD, enabling greater recognition of ADHD and providing objective answers for subjective experiences.
Social and Cultural Factors
The current social environment has directly impacted peoples’ capacity for self-recognition and their comfort level in pursuing a diagnosis.
- Greater Awareness by People Themselves: The visibility of ADHD-related content through platforms like social media has been a double-edged sword: while leading to plenty of misinformation, it has also provided essential, accessible information that resonates with people’s experiences, prompting many to seek a diagnosis. This greater awareness by people themselves, even with the risk of false positives, is a major component of the diagnostic surge. This factor has a lot to do with why some people think it’s a fashionable trend – because the social content often points to signs of ADHD without including the intensity aspect. For example, with the core trait of inattention you might hear people protest that ‘everyone gets distracted sometimes’, which is true – but the social content should make clearer that to meet the threshold of ADHD they would get a lot more easily distracted, a lot more of the time than what would be considered as a normal amount of distractedness for the average person. Either way, many of the people getting diagnosed with ADHD have seen that content, recognised it in themselves to the extreme extents that ADHD presents with, and sought diagnosis.
- People Feeling More Comfortable to ‘Come Out’: Along with much of the previously discussed social media, the rise of visible neurodivergent role models, successful entrepreneurs, and neurodivergent professionals has helped to challenge the stigma of ADHD. Coupled with legal protections, this growing acceptance makes individuals feel more comfortable disclosing their condition to their managers, employers, and colleagues. This collective effort attempts to reduce the stigma and demonstrate the potential positives of the condition.
- A Greater Willingness by Society to Do Something About the Impact: There is an increasing willingness by society and progressive organisations (Like NiB) to address the difficulties faced by neurodivergent individuals and to actively investigate why many people with ADHD “fall through the cracks” in conventional structures. The UK government has formed an ADHD taskforce, companies have created networks to improve neuroinclusion, there is more training being made available, and so on. All of this helps to spread awareness and understanding, and that means more people are finding their answers.
The Underestimated Missing Piece: Environmental Friction
A significant, but little-considered factor driving the rise in adult diagnoses is the growing mismatch between the way the ADHD brain operates and changes in expectations around working-styles. ‘Performing’ in many roles, now requires ‘conforming’.
- Society Has Become More Bureaucratic: Society in general, and the modern corporate world in particular, has followed ideas and theories, offering systems and strategies – there are also more rules to think about for compliance, etc… and people with ADHD tend to struggle with bureaucracy.
They often experience difficulty following rigid procedures and prefer to approach tasks via their own methods – they are typically outcome-oriented rather than process-driven. This is partly due to working memory issues and a cognitive style that processes information differently, which can lead to misunderstandings and communication misalignments with peers.
Having grown up navigating a world not built for their neurotype, people with ADHD have had to adapt, to develop workarounds, and to “figure out” novel ways to meet expectations. If the results are what matter, this can work out well. However, the modern emphasis on how a task must be done creates a barrier. It forces the individual to compromise their effective, alternative method to adhere to a mandated process, leading to underperformance, stress, and anxiety. It is no wonder then, that more people who are ADHD are discovering their condition, because as flexibility in approaches is reduced, more people with ADHD will face these barriers, struggle at work, and try to understand the ‘problem’. Many will then of course see that others have similar problems, similar experiences, and have discovered it comes down to ADHD.
The Environmental Fit
This model explains how the manifestation and impact of ADHD depends heavily on the environment’s fit with the person’s cognitive style. Let’s explore the concept a bit deeper…
There are many people out there with ADHD who might be tradesmen, drivers, farm workers, or other types of work that do not have office managers telling them “This is how it must be done”. These people may never realise they are ADHD or need a diagnosis for work-related reasons, because their environments are not demanding them to follow processes instead of results.
A real life example: I know of a boxing coach who runs their own gym – I would bet my house on it that this person is ADHD, but it does not matter to them – because they are their own boss and determine their own methods. They have never sought a diagnosis because their life is not spent having to try to interpret other people’s ways of doing things in order to succeed.
This factor contributes to the high over-representation of people with ADHD in entrepreneurship. They have ideas and like to pursue them, but they need to do so without others putting what they see as unnecessary obstacles in their way. These people then often have support such as assistants who look after admin for them, allowing them to focus on their goals.
At the other end of this, the same factor contributes to the high over-representation of people with ADHD in prison, or expelled from school. They cannot do things in the prescriptive ways put upon them, they cannot follow these rigid paths laid out before them that others can follow. So they must, out of necessity, carve their own paths – but this will not always be in healthy directions, since these paths are unguided.
This model also goes some ways to explaining why there is a higher prevalence of ADHD diagnoses in cities, like London. It’s because of corporate concentration. Cities concentrate a high number of the process-oriented and bureaucratic businesses that generate the peak friction described above – cities are where you find head offices of large bureaucratic businesses (and government of course) that employ large numbers of people.
There are other factors with the higher city ADHD diagnosis rates though, such as the tendency for people with ADHD to seek novelty and explore. Cities also often have more opportunities in creative fields, where ADHD people are commonly known to thrive. But also there is simply greater access to diagnosis in cities.
To conclude then, the rise in diagnosed professionals with ADHD is, in large part, a delayed validation of a complex reality – including an environmental mismatch between a results-oriented cognitive style and rigid, process-heavy systems. The future of business success depends on accommodating this diverse reality, because those people who think differently and need to do things differently, they are innovators, explorers, creators, and problem-solvers. Let them do their thing, and measure them by their results – not just by how they get there.
Article Author: Steve Ollington is a volunteer with Neurodiversity in Business, and writes about his ADHD research as part of his PhD with Swansea University.
