Why do so many women (and boys) suddenly have ADHD?

In the age of identity politics we think labels clarify, but too often they freeze us. The truth? We are all in flux all the time.

Does that 10-year-old boy really have ADHD? Or is he simply a boy whose energy levels aren’t suited to sitting in a classroom for hours each day? Picture: istock

“Mental health ideology may be the biggest and most powerful cause of mental health problems today,” is a typically punchy sentence from Searching for Normal, but this book was not written by an anti-science crank. It was written by Sami Timimi, a UK-based consultant child and adolescent psychiatrist of several decades’ standing.

Since the 1990s there has been a remarkable shift in Western psychiatry. Instead of operating on the Socratic principles of doctors talking with patients to find the emotional and historical source of their unhappiness, too many have pivoted to treating mental health like physical health. They diagnose their patients with a “disorder”, slap them with a pathologising label (ADHD, autism, etc) and medicate them.

Searching for Normal argues against the medicalisation of frustration and unhappiness.

In the UK, between 1998 and 2018, there was a 787 per cent increase in autism diagnoses. Between 2019 and 2021, there was a 3200 per cent increase in the number of British women taking online ADHD tests. And for all the labelling and medicalising, no one is getting happier – the opposite, in fact.

“I feel like having a John McEnroe moment and shouting, ‘You cannot be serious!’, for all the good it would do,” Timimi says.

He is not the only one. A slew of books are coming out by those who have refused to enrich themselves by accepting kickbacks from pharmaceutical companies, pointing out that this naked emperor is bad for us. The Age of Diagnosis by neuroscientist Suzanne O’Sullivan has just been published, and Abigail Shrier – who called out the damage that gender healthcare was doing to teenage girls in her book, Irreversible Damage – has written Bad Therapy: Why the Kids Aren’t Growing Up, which just came out in paperback.

Searching for Normal is so good I have been quoting its insights to friends ever since I finished it. For example, Timimi writes that depression and ADHD aren’t caused by low levels of serotonin in the brain, despite the repeated claim that they are.

Thus, antidepressants, which boost serotonin, aren’t correcting our chemical imbalances, they are causing them. The only people who benefit are the drug manufacturers as more people become dependent on their drugs.

He argues that politicians love mental health initiatives: because it suits them to pretend that it’s our broken brains making us anxious rather than the social conditions they have created. “It’s easier to rule over a population constructed as needing paternalistic care and sympathy than one made of people who are intelligent, capable and resilient,” Timimi says.

Why are so many women suddenly getting ADHD and autism diagnoses? Timimi writes that psychiatry has always been a paternalistic discipline, pathologising women and their understandable anger and frustrations. In the previous century it was “hysteria” and “moral insanity”, and now it’s ADHD and autism. As for the vogueish term “neurodiverse”, this creates a false binary that there are “neurotypical” people, which every good psychiatrist knows is nonsense.

“The mental health industrial complex”, as Timimi calls it, exploits anxious people’s fears that they are different and haven’t achieved as much as they wanted, by offering them a diagnostic label instead of reassuring them that everyone feels like that.

This shuts down the possibility for development, with people assuming they are uniquely fragile and need medicine to function.

Why are so many women suddenly getting ADHD and autism diagnoses? Picture: istock

Worse is when children are overdiagnosed. Parents are understandably desperate to help their distressed children, but when a doctor palms them off with a lazy label – rather than looking at the child’s history to understand what they’re reacting to – the parents then treat their child like a sick person, which confirms the child’s self-identity as helpless. “The problem becomes the problem,” Timimi says.

I admit bias: as a teenager I spent three years in hospitals suffering from anorexia nervosa. What helped me recover was cutting off contact with other anorexics, going to a new school where no one knew my past, and not just rejecting the label of “anorexic” but also (briefly) changing my name, so I no longer thought of myself as Hadley who didn’t eat – I was “Clare” who did eat. In the age of identity politics we think labels clarify, but too often they freeze us when the truth is we are all in flux all the time. Timimi doesn’t make this point, but I suspect one reason people are so desperate for a label is the demise of religion. We no longer talk about souls. Instead, we have a glowing, constant, core identity that explains everything about us to us.

The human tendency towards overcorrection is one of the few guarantees in life. But in trying to right the wrongs of underdiagnosing people in the past – dismissing soldiers with PTSD and mothers with postnatal syndrome as annoying and troublemaking – we are now, Timimi says, pathologising anyone “who doesn’t follow the narrow boundaries of expected behaviours, and to such an extent that we overlook histories that would obviously have an impact on their presentations”.

Does that 10-year-old boy really have ADHD? Or is he acting up because his parents have split up, or is he simply a boy whose energy levels aren’t suited to sitting in a classroom for hours each day? Given how boldly Timimi addresses these issues, his timidity in discussing the rise of gender dysphoria is disappointing.

He packs that brief section with much throat-clearing about how trans people deserve respect and kindness; surely people who believe they have ADHD do too? But I strongly suspect he knows the trans movement, with its insistence on pathologising feelings and medicalising people for life, fits in perfectly with his arguments.

That aside, this is a terrific book, timely and wise, thoughtful and thought-provoking.

The Times