Dani Donovan barely published the life-changing illustration: an unreleased visual gag that translated his ADHD storytelling style into a 12-point flowchart.
When he released his drawing on Twittersphere in December 2018, he thought few people would see him. Instead, the post went viral “almost immediately,” garnering more than 100 million views on social media channels. Just over a year later, she quit her corporate graphic design job to make full-time ADHD comics.
Donovan, now 31, has become a big dean in the growing realm of influencers in ADHD, a niche that was virtually non-existent when she shared her inaugural publication just three and a half years ago.
ADHD, or Attention Deficit Hyperactivity Disorder, is happening for a while. In TikTok, videos tagged as #ADHD have been viewed more than 11 billion times. Most creators are people in their 20s and 30s who identify with executive function disorder, whose symptoms often include difficulty concentrating and regulating emotions. Some are practicing physicians who use their platforms to correct misconceptions (and discourage self-diagnosis). Taken together, they publish a constantly expanding audience.
The trend points to an increase in diagnoses of ADHD in adults for more than a decade. The steady rise of juvenile ADHD was already a source of concern (and rolled eyes). But between 2007 and 2016, the reported incidence of ADHD in adults soared 123% in the U.S., far exceeding the rate increase in child and adolescent cases. In the mid-2010s, adults replaced children as the primary market for ADHD drugs.
Photography: Kelli Donovan
There are some anecdotal indications that the phenomenon has at least kept pace during the pandemic and most likely accelerated. In a survey published in March by ADDitude magazine, more than a quarter of the 2,365 adult readers of the ADHD-focused publication reported that they had been given a formal diagnosis of ADHD over the past year. SingleCare online pharmacy saw a 16% increase in prescriptions for generic Adderall, a popular ADHD stimulant drug, from early last year to early 2022.
Some attribute the pattern to social media. Donovan testifies first-hand that he has received more than 1,000 messages from people who have performed clinical evaluations and received diagnoses thanks to their content. The Reddit r / ADHD page, a decade ago, went from 643,000 subscribers in March 2020 to more than 1.4 million today, clearly recording an increase in ADHD curiosity (if not necessarily diagnoses) which coincides with the pandemic. But the rising prevalence of the disorder is not so much a fad fueled by overexposure on social media as the intertwining of different cultural and diagnostic threads, each knotted in its own right. The ADHD era is a clash between science and society, and the discontent of each.
It helps to break things down. There is ADHD as a deterioration in neurodevelopment with known anatomical correlations (think of smaller tonsils and hippocampi in the brain) and ADHD as a clinical diagnosis with great potential for benefits for the pharmaceutical industry. Then there is #ADHD as an incentive for algorithmic content and affirmation of experience.
“One thing that makes ADHD a unique diagnosis, in a way, is that having a diagnosis that you don’t always see for other mental health difficulties has social benefits,” says Dr. Margaret Sibley, a clinical psychologist and specialist researcher. . and ADHD. “People can be diagnosed with ADHD at a school or a workplace and have reduced responsibilities because of it, or trial accommodation, and so on. When there are benefits like this, you have different types of consumers.”
In other words, ADHD can give people a measure of grace for not meeting the expectations of productivity that would put pressure on the reference capacity of most human beings. To that end, the pandemic may have provided an even greater incentive to seek diagnoses of ADHD. With the advent of the Covid-19, many people suddenly found themselves unable to read books or maintain basic email correspondence, their approach skyrocketing completely and unusually. The phenomenon has been so pronounced and widespread that it has been fueled by a media subgenre of psychological reassurance tellers, reassuring readers that a reduction in cognitive power is to be expected, given the “unprecedented” challenges of the time.
ADHD is not a clear disorder that a person has or does not have, but a combination of challenges that present themselves in a spectrum of deterioration.
The striking overlap between ADHD symptoms and the “pandemic brain” of the garden variety only exacerbates the common misconceptions of the former. Simply put, the symptoms of ADHD can sound and sound a lot like the struggles that define the daily workflows of many people, which are often fragmented by push notifications and digital dopamine successes. Who has no problem doing multiple tasks or continuing with tasks? And who doesn’t fight the urge to get around on social media during the especially boring moments of a certain afternoon? In the last two years, these difficulties have only worsened.
But whether or not ADHD is actively overdiagnosed is a separate question with no simple answers. Two things are true. On the one hand, research suggests that ADHD is not a clear disorder that a person has or does not have, but a combination of challenges that present themselves in a spectrum of deterioration. According to Sibley, rigorous standards of psychiatric evaluation should be able to determine between a clinical presentation of the disorder and the mere presence of certain features of ADHD.
The second certainty is that stimulant medications that are often prescribed to treat ADHD are extremely controversial. Skeptics are quick to point out that drugs like Adderall and Vyvanse are indeed industry-regulated speed doses. Whether or not all people diagnosed with ADHD have the disorder, it is an uncomfortable statement of fact that the productivity of most people would see an improvement with the drugs prescribed to treat it.
The result is what Sibley characterizes as a “philosophical debate,” though often surrounded by the language of security.
“You could ask yourself a similar question about people who use steroids in sports,” Sibley says. “People can raise pros and cons, but it ultimately comes down to what people value more than a safety issue, because you can safely manage stimulants in anyone, even a person without ADHD.”
Debates aside, diagnoses of ADHD and drugs that treat the disease have become much easier to obtain during the pandemic. Social distancing measures removed the legislative barriers that previously restricted remote providers from prescribing controlled substances, a class of drugs that includes many drugs for ADHD. This allowed several emerging telehealth companies backed by companies to expand their benefits and led some to refocus on diagnosing ADHD and prescribing medications to treat it.
The change has not gone unnoticed. The same algorithmic mechanisms that increase the visibility of #ADHD TikToks and Instagram memes also promote ADHD treatment offers from startups with control names such as Klarity, Done, and Cerebral. Promoted ads for these businesses have become the inescapable showcase of many people’s social media.
But the setback is underway. In late April, a former Cerebral executive filed a labor lawsuit against his former employer, alleging that he was fired for expressing concern that the company had “put profits and growth notoriously earlier. that patient safety “by over-prescribing ADHD medications. In recent weeks, a growing number of online pharmacies and brick-and-mortar pharmacy chains have stopped filling prescriptions for controlled substances such as Adderall placed by telehealth providers.
The pandemic removed the legislative barriers that previously restricted remote suppliers from prescribing controlled substances, such as Adderall. Photo: JB Reed / Bloomberg News
The great commotion over stimulant drugs paints a misleading picture of what some patients really want or need. “The fact is that drugs are not a panacea,” says Joy Hui Lin, a 40-year-old independent journalist based in Southern California. “You need structure.”
Hui Lin was diagnosed about five years ago, after acknowledging her own struggles in an article on ADHD in women. She soon learned that because of social gender expectations and social biases, ADHD is often misdiagnosed or overlooked in girls and women, especially girls and women of color.
What she had internalized as a lack of character turned out to be textbook shots of the disorder. He also realized that while medications provided helpful help, he benefited more from implementing routines and processes to keep up with his daily responsibilities.
A similar advantage is echoed by “Cindy Noir,” the online person of a 26-year-old Dallas-based social media content creator. Last summer, a licensed psychotherapist contacted Noir after watching a live TikTok broadcast in which Noir talked about his difficulty completing household chores and communicating ideas at the pace of his fast brain. The therapist was unable to give Noir an official diagnosis of ADHD from a single phone call and email exchanges, but expressed the view that Noir was likely to meet the criteria for diagnosing the disorder and recommended that he seek an evaluation. .
“Unfortunately, she said, as a woman and as a minority, being diagnosed with ADHD is one of the most important battles because they will diagnose your symptoms like other things and not like ADHD,” says Noir, who is black. Finally, he chose not to undergo a formal evaluation of ADHD or pharmaceutical treatment due to lack of health insurance coverage, but says his life has improved with the adoption …