The UK's Health Secretary, Wes Streeting, has ordered a clinical review into the diagnosis of conditions like ADHD and autism, driven by concerns over a sharp rise in people claiming related sickness benefits. This move comes amidst an international surge in diagnoses, prompting a fierce debate: are we over-pathologising normal behaviour, or finally recognising a long-ignored reality?
The Personal and the Political: A Diagnosis Explosion
Globally, diagnoses of Attention Deficit Hyperactivity Disorder (ADHD) are increasing at a remarkable pace. In the UK, prescriptions for ADHD medications have risen by 18% each year since the pandemic. Similar trends are visible from North America to Germany, where rates increased almost fourfold in just over ten years, and China, where it is now termed "an increasing public health concern."
Author and retired physician Dr Gabor Maté, diagnosed with ADHD in his fifties, describes the label as a useful descriptor that explained his workaholism, emotional reactions, and impulsivity. However, he cautions that the diagnosis itself explains nothing, creating a circular logic: a person is inattentive because they have ADHD, and we know they have ADHD because they are inattentive.
Beyond Genetics: The Toxic Culture Debate
While ADHD is often framed as a highly heritable, biological brain dysfunction, Maté and other experts stress the profound role of environment. Genes provide a predisposition, not a predetermination, and are activated or silenced by life experiences. The core issue, they argue, lies in modern societal conditions that sabotage healthy brain development.
Neuroscience confirms the brain is a social organ, shaped by early relationships. The critical "mutual responsiveness" between caregiver and child, beginning even in the womb, builds its circuitry. Yet today's climate of rising inequality, economic insecurity, social isolation, and digital addiction places intolerable stress on families.
Stress, Development, and the Path Forward
Stressed parents, however loving, are less patient and attuned, which in turn stresses children. A child's coping mechanism to this overwhelm can be to "tune out" – mimicking ADHD traits. This cycle is exacerbated by the neurotoxic impact of excessive digital media exposure on young brains.
The solution, Maté proposes, is not more blame or stigma, but a societal shift. It requires supporting pregnant women and young families, creating empathetic institutions from preschool upwards, and helping parents address their own unresolved trauma. While this demands investment, the cost is a pittance compared to the economic and human toll of the current crisis.
The debate on ADHD is complex, caught between fears of overdiagnosis and the relief of validation. As the UK government's review begins, Maté's argument stands: empathy and a critical look at our toxic culture are the essential starting points for understanding this soaring phenomenon.
