Day dreaming and social "awkwardness". Have you also been diagnosed with ADHD or autism by the internet?
London as a Mecca for people with ADHD
Autism and Attention Deficit Hyperactivity Disorder (ADHD) have seen a recent increase in diagnoses, including in young adults. According to a study by researchers at University College London, the prevalence of ADHD among adults under 30 has increased 20-fold in recent years (from 2000 to 2018), and a 2021 study in the UK found (between 1998 and 2018) a 787% increase in autism diagnoses across all age groups.
This is a particularly widespread phenomenon in London. New research has shown that London has the highest recorded annual increase in prescriptions (for ADHD) in the UK, with a 28% annual increase in prescriptions for ADHD across the capital, compared to an 18% increase in prescriptions nationally.
This is generally considered to be a result of a better understanding of these conditions, a new found openness in mental health and a widening of diagnostic boundaries. So it doesn't necessarily mean increasing prevalence, but rather increased awareness.
Beware of TikTok 'diagnoses'
In my age group, debates about ADHD and autism in adults are particularly common. On TikTok, Generation Z's favorite social network, the ADHD hashtag has 47 billion hits and counting, while autism has around 49 billion. There are countless "test for autism" and "test for ADHD" videos, typically of dubious quality.
One study from 2024 found that 60% of the autism-themed videos examined on TikTok contained "misleading information," while a 2022 study found that 52% of the content about ADHD contained misinformation. Worrying, given that each of the ADHD videos studied had an average of three million views, while videos about autism averaged 750,000.
And while autism and ADHD were once associated with "troubled" boys, the increased prevalence of diagnoses in adults has produced some high-profile new "faces" popular among Generation Z.
Who among the famous is "on the spectrum"?
Barry Keoghan, SZA, Sam Fender, Greta Gerwig and Reneé Rapp are among the celebrities who have shared their ADHD diagnoses, while Mark Zuckerberg and Elon Musk, two of the world's richest men, have both spoken openly about their experiences with Asperger's Syndrome, an autism spectrum disorder.
On the one hand, this increased representation is invaluable because it shows that neurodivergent individuals don't have to be limited, and makes them feel seen. On the other hand, some psychiatrists argue that it may contribute to the perception that ADHD and autism are the diagnoses "du jour" .
Fashion in psychiatry is nothing new. Studies have shown that people have actively sought out diagnoses that conferred social status since the 18th century, when gout became a fashionable disease because of its association with wealth. Then came bipolar disorder in the 2000s. "Thanks to a number of celebrities claiming to have it, many more suddenly self-diagnosed. Good old 'depression' was boring," psychiatrist Max Pemberton recently launched into a memoir in The Spectator. "Now bipolar disorder is out, ADHD is in," he argued.
From "naughtiness" to creative "superpowers"
An article in the Australian Psychological Society similarly hinted at whether ADHD might be having its moment in the limelight, stating, "Historically negative associations such as 'bad boy syndrome' are increasingly reversed and now we have an increasingly positive identification that it is a 'superpower' of creativity and originality.' The conflation of autism with the powerful tech dudes who now occupy the ruling class of the world may have given it a similar gloss.
But the excessive "handing out" of diagnoses carries its own risks. "One of the main concerns with increasing mental health awareness is misdiagnosis," says Dr. "Symptoms of ADHD or autism can easily overlap with other mental health issues, such as anxiety or depression, as well as physical health problems."
Waiting lists are breaking records
Pickering, who is the director of Clinical Partners, a leading private mental health service, says that "comprehensive clinical assessment" is needed to properly diagnose and treat ADHD or autism. "As quick and easy as online tests and videos on TikTok may seem like quick and easy tools for self-diagnosis, they often lack the depth and accuracy needed to properly understand complex difficulties." Instead, Pickering recommends using any online tests as "a first step to understanding whether you may need a full, professional evaluation, or as a basis for discussion with your practitioner." But with an eight-year delay in diagnosing ADHD and a waiting list that reached record numbers for autism in 2023, it may not be as easy as it sounds.
This delay has led some prominent psychiatrists to announce an "over-diagnosis" of ADHD, including Professor Simon Wessely, former president of the Royal College of Psychiatrists, who recently noted that the trend is probably not "short of better recognition or help-seeking.' Wessely, a non-executive director of the National Health Service England, also argued that rising levels of awareness are now less likely to be 'beneficial' than in previous decades.
There are also concerns that growing awareness of a milder form of autism will overwhelm waiting lists and dilute the severity of the difficulties. For example, so-called low-functioning autism is characterised by severe social communication problems (30% of people with autism spectrum disorder are non-verbal) as well as extremely inflexible behaviour. Last June, Professor Patricia Howlin, founding editor of 'Autism' magazine, told The Guardian, " There are groups of parents who feel very abandoned because their children are so markedly different from people who are leading figures in the neurodiversity movement."
Unfortunately, increased "awareness" of autism doesn't always mean it's beneficial to discuss it online. When Elon Musk appeared to perform a Nazi salute at President Donald Trump's inauguration event, many online dismissed it as a consequence of his "autism." But, predictably, this was very poorly received by the autism community. "'Stop bullying Elon, he's just autistic,' No no no. Stop bullying autistic people by associating us with his behaviour," wrote one user of the X network.
Zdroj: Giphy
Will we all be neurodivergent eventually?
For anyone wondering if something has to break eventually: maybe not. For some psychiatric researchers, there is a world where this will simply continue - to the point where everyone admits they are on the autism-ADHD spectrum. "I think it will continue until everyone is categorised as neurodivergent," leading autism researcher Professor Ginny Russell told The Guardian last March. "As awareness and numbers of diagnoses grow, those with less severe symptoms are coming forward with their own stories of how autism affects them. Diagnostic criteria are being expanded to take these stories into account, which is again leading to a further increase in diagnoses."
Others see the onus on doctors to fight over-diagnosis and take the pressure off schools and the National Health Service, with Professor Wessely leading the fight against the "over-professionalisation or medicalisation" of conditions that may not actually be that serious.
At the moment, the numbers are still rising and the proposed content still makes me want to get tested for ADHD and autism. But as someone who straddles the line between the two, with only a handful of symptoms and none that demonstrably diminish my quality of life, I'm starting to feel like it's my civic duty to just let it pass unnoticed.
What are the symptoms of autism?
According to the UK National Health Service, the common symptoms of autism in adults are:
- Difficulty understanding what others are thinking or feeling
- High anxiety about social situations
- Difficulty making friends or a preference for solitude
- Apparent directness, rudeness, or lack of concern for others when it is not intended
- Difficulty expressing how you feel
- Taking things very literally - for example, you may not understand sarcasm or phrases like "break a leg"
- Keeping the same routine every day - and experiencing great anxiety if it changes
Common symptoms of autism in young children:
- Not responding to their own name
- Avoiding eye contact
- They don't smile back when you smile at them
- Get very upset if they don't like a certain taste, smell or sound
- Repeat movements such as waving their arms, shaking their fingers or rocking their body
- They don't talk as much as other children
- They don't play 'pretend' as often
- They repeat the same phrases
Common signs of autism in older children:
- They don't understand social "rules" such as not jumping in people's faces
- Avoiding eye contact
- Get too close to other people or get very upset if someone touches or approaches them
- They notice small details, patterns, smells or sounds that others miss
- Have a very strong interest in certain objects or activities
- They like to plan things carefully before doing them
What are the symptoms of ADHD?
According to the National Health Service, ADHD symptoms can be categorized into two types of behavior problems:
- Inattention (difficulty concentrating and focusing attention)
- Hyperactivity and impulsivity
In children , it can manifest as follows:
- Short attention span and easy distractibility
- Appearing forgetful or losing things
- They seem unable to listen to or follow instructions
- Unable to sit still, especially in quiet or calm environments
- Are unable to concentrate on tasks
- Excessive physical movement or talking
- Acting without thinking
In adults, this may manifest as follows:
- Carelessness and lack of attention to detail
- Constantly starting new tasks before completing old ones
- Poor organizational skills
- Inability to concentrate or prioritize
- Constantly losing or misplacing things
- Forgetfulness, restlessness and nervousness
- Difficulty staying quiet and talking when it's my turn
- Inability to cope with stress
- Risky behaviour in activities, often with little or no regard for personal safety or the safety of others - for example, dangerous driving
For more information, visit the National Health Service website.
© The Standard Ltd
Prepared for The Standard by Maddy Mussen.
