By Liam Mannix
James Vivian thought he’d gotten used to his brain. His surging, complex emotions. His extremes of mood. His inability to relax. A personality that combined distractibility and daydreaming with obsessive organisation and hyperfocus.
When the pandemic threatened to kill his skincare business, he managed to pivot to selling his products online.
James Vivian was diagnosed with ADHD after emerging from COVID lockdowns – part of a growing cohort of people diagnosed post-pandemicCredit: Wayne Taylor
Vivian, 41, from the inner Melbourne suburb of Prahran, was thriving – until lockdown ended. “I was extremely overwhelmed,” he said. “When most people were celebrating or rejoicing I was super-duper overwhelmed, and not quite sure what to do.”
His carefully built world collapsed. “And so I went looking for answers,” says Vivian. He was, he says now, entirely unsurprised when his psychologist told him he most likely had ADHD.
Vivian is among a growing number of adults diagnosed with ADHD after the COVID pandemic.
In 2020, when COVID struck, everything changed. Millions of Australians found themselves stuck inside with their thoughts, and many did not like what they heard. In lockdown, we spent much more time online – just as an ecosystem of ADHD content creators was flourishing on social media.
These trends have coalesced into a dramatic increase in the number of Australians prescribed ADHD medications: prescriptions more than doubled between 2020 and 2023. Extend the data back to 2013, and there has been a 496 per cent increase in adult prescriptions.
Animation by Matt Davidson
A key driver of that increase was a remarkable reversal in gender and age prescribing patterns.
Psychiatrists have long known they are missing many young women with ADHD, who present differently from young boys. Girls tend to be more inattentive than hyperactive, making them less disruptive in the classroom and therefore less likely to get diagnosed early. They are half as likely as boys to receive a diagnosis before the age of 12.
This trend is now being upended. In 2022-23, 59 per cent of all new adult ADHD patients were women. For the first time, there are now more Australian women than men being treated for ADHD.
Government data shows a step change in prescribing patterns pre- and post-pandemic. In 2019-20, adults made up 33 per cent of all people starting treatment for ADHD. In 2022-23, that number had jumped to 45 per cent, with particularly pronounced increases in people in their mid-20s.
About 1 in every 100 adult Australians now receives treatment for ADHD (which is still below the true level of ADHD in the community). Given that untreated ADHD decreases productivity and increases the chances of someone encountering the criminal justice system, “This will have positive effects, not just on those individuals but on the community,” says Professor David Coghill, chair of developmental mental health at the University of Melbourne.
ADHD is among the most common ways in which brains differ from the norm: about 7 per cent of children and 2.5 per cent of adults have the condition.
It is caused largely by genetic differences that change the way the brain develops. Brain regions linked to executive control and emotional processing tend to be smaller and less active in children with ADHD, while the mind-wandering mode of the brain seems over-powered.
ADHD is mostly driven by genes, but its expression is often driven by environment. In the right environment, the symptoms can become almost invisible; in the wrong environment, they can be intolerable – for example, being stuck inside for two years. Evidence from around the world suggests people with diagnosed ADHD saw significant increases in their symptoms during lockdown.
“People with ADHD tend to automatically gravitate toward careers they can manage with their ADHD: the job has to have enough interest, it has to have activeness, and it has to have structures in place to help them concentrate,” says Alison Poulton, a University of Sydney researcher and adviser to ADHD Australia.
“Then, suddenly, [for example] they have to work from home, get up on time, sit at their computer at 9am. If they have got ADHD, that may well be when they are going to fall apart.”
Analysis of prescription data, published in Australasian Psychiatry this year, found those for ADHD medications jumped 23 per cent in 2021, 28 per cent in 2022, and 37.2 per cent in 2023.
The study also showed increases in ADHD search traffic and media coverage, which predicted an increase in prescriptions a month later. “We see so many media reports; it’s such a trendy topic on social media,” said Luke Woon, the study’s lead author.
Izabella Risteski, 26, runs an online ADHD coaching business. Many of her clients find their diagnosis – and her services – on social media. Mainstream information about ADHD “just isn’t hitting the mark”, she says.
“It’s filling this gap in ADHD treatment in general. People tend to lean towards online forums or TikTok [for ADHD information],” Risteski, from Sydney’s Paddington, says.
However, a 2022 study on popular TikTok ADHD videos rated more than half of the content as “misleading”.
Jacqui Gueye, 42, from Airport West in Melbourne’s north-western suburbs, was the third woman in her friendship group to receive an ADHD diagnosis, after she started to struggle to cope with life’s demands following the birth of her second child.
“I thought: ‘Surely, life can’t possibly be this hard’,” she says.
Seeking answers, Gueye turned to Instagram.
“I think in some ways, a lot of that was more useful than the DSM-5 or the official criteria,” she says. “Because it was people’s lived experiences, and they were very similar to mine.”
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