Welcome Ben Fogle. Welcome Sheridan Smith. Two more public figures have joined the ADHD club, and while it does feel an awful lot like this has turned into an oversubscribed pity party, I can tell you from personal experience that more diagnoses can only be a good thing. Not just for those who have it, but for society at large. Allow me to explain...
It was a crisp winter day in Zurich six years ago and I was in rehab, following a bender in Budapest. No less than 10 minutes into my first session with the eminent psychiatrist Dr Thilo Beck, he asked me a fleeting question that was about to change my life. “You do know,” he said, head cocked to one side, “that it is highly likely you have ADHD?”
A test back in the UK confirmed Dr Beck’s supposition. I scored 9/9 for Attention Deficit and 8/9 for Hyperactivity, a result that, the report said, reflected “a lifelong pattern of symptoms and impairment in multiple domains of functioning.” It explained everything from my dismal school reports and dropping out of two university courses to my self-loathing and heavy drinking.
You might be rolling your eyes. Everyone’s got ADHD these days, you may surmise, or some other mental affliction that doesn’t need a label and serves only to give people excuses. To which I say: this label saved me. We humans need explanations.
This neurological condition (attention deficit hyperactivity disorder) is having its moment in the spotlight. Not because more people are developing it (it’s genetic and linked to innate dopamine dysfunction), but because until recently it was so underdiagnosed in adults, especially women.
“People with ADHD may have problems with organisation and time management, following instructions and focusing on tasks,” says the NHS website, as well as being “restless, impatient, impulsive and risk-taking”. And while yes, all people possess some of these traits sometimes and in moderation, try navigating life with all of them, all the time.
Miserable at school
You know that feeling you get when you walk into a room and briefly forget what you were looking for? Imagine that, but you live there and it’s not a quiet room; it’s a busy call centre with multiple people having different conversations simultaneously, plus there’s a giant screen playing a film, a brass band in the corner and several acrobats hanging from the ceiling. Oh, and there’s someone standing in the doorway with their hands on their hips telling you off because you can’t concentrate. Take all this into account, and you’ll see perhaps why my path mapped out the way it did.
While I was utterly miserable at school (the rules, the routine, the scoldings), I was also an academic success – something that surprised and quite frankly annoyed my teachers every time the exam results came in. My uniform was always wrong, I lost my textbooks, forgot about commitments, didn’t listen and never did my homework. That was when I showed up; during sixth form, I attended less than 30 per cent of my lessons, according to my final report. Instead, I was illegally driving my car to school without a licence, leaving it in the teachers’ car park and wandering beyond the grounds. I graduated with four As.
One of the main reasons that ADHD is so under-recognised in girls (boys are almost four times more likely to be diagnosed) is because it presents so differently. Males tend to be more physical and unrestrained in their hyperactivity whereas females generally internalise these traits. Indeed, I may have looked vacant while I was staring out of classroom windows but my mind was performing cartwheels. I used to burn off energy in solitude, shutting myself in my room and bouncing around on my bed in circles for hours every evening. True to the statistics, my brother Charlie, whose symptoms were more obvious, was diagnosed when he was seven and I was merely berated for how much time I spent away with the fairies.
At university, where there were far fewer constraints than school, my attendance was even worse. I can’t have averaged more than 10 lectures a year. Perhaps Edinburgh, where I was (or rather wasn’t) reading classics, didn’t suit me, I thought, and I moved to the University of Bristol after just two terms. Unsurprisingly, it was the same story – my professor threatened to throw me out unless I started turning up to seminars (more straight As notwithstanding), so I dropped out.
Thrive on panic
From there – accompanied always by too much alcohol and often cascades of cocaine – I worked as a model, then for an artist, then in advertising, before moving to New York on a whim in my mid-20s and taking a job in a bar, after which I finally found my way into journalism. I’m very fortunate I did, because it’s one of the few professions that complement the sort of brain I have.
I thrive on panic and short deadlines – it forces my mind into a state of hyperfocus, an ADHD trait which allows us, in somewhat of a contradiction, to concentrate intently for long periods on certain tasks, but only if they are very urgent or very interesting; to the point where we won’t even take a loo break if we need one or a sip of water if we’re thirsty.
It’s why I was always so good at cramming for exams and still perform best when I’ve got at least three articles to race through a day. I think of it as a superpower; the profound weakness being that I can’t switch it on at will. If I could do that, my house would be tidy, my holidays booked in advance, and I wouldn’t file my taxes every year an hour before the midnight deadline.
While the high-pressure nature of my job served me well career-wise and the frequent travel that accompanied it kept my itchy feet occupied, my relationships (both romantic and platonic) were always short-lived and messy, I was easily drinking a bottle of wine a night (it was the only thing that slowed down the mental circus) and by the time I reached that treatment room in Zurich I was exhausted.
I was there to do a story on the clinic – Paracelsus, a private £57,000-a-week rehab centre for the top 0.1 per cent – but Dr Beck, the company’s chief consultant psychiatrist, didn’t need me to be a real patient to spot the signs immediately, and that was before I’d disclosed to him how much I drank.
“Undetected ADHD often causes patients to self-medicate and develop substance abuse issues,” he says. “It’s a common comorbidity, but I’ve seen first hand the transformation so many addicts undergo when they get diagnosed and treated; not just in their addiction recovery but in every facet of their lives.”
I, for one, am proof. First and foremost, I take medication and it works. That, or it’s a total coincidence that since being on Adderall I have held down the same job, got married, started a family and hardly ever drink.
I no longer berate myself over the unconventional way I go about life. I do still leave assignments until the last moment (knowing I’ll go into hyperfocus when the time comes), but now, instead of tying myself in knots agonising over impending deadlines, I don’t fret about them. The diagnosis has also changed the way my loved ones treat me - they are less inclined to take it personally when I forget things and they get less frustrated with me when I’m failing to focus or follow directions.
One of the most helpful things Dr Beck told me was that meditating isn’t necessarily the right tonic for people with ADHD. People have been urging me my whole life to sit quietly or take up yoga in order to find peace from the goblins that dance inside my skull. In fact, I need noise and distraction to calm down. Ever since I was a child, I’ve insisted on having the television or radio on in the background to help me sleep, and was always told it was a bad habit. Today, I have an eye mask with built-in headphones so I can nod off to a podcast without disturbing my husband, and I don’t feel guilty or weird about it.
Would I take a permanent cure for my ADHD, if one existed? No, I wouldn’t, actually. When my psychiatrist first prescribed Adderall to me, she warned me it might “stifle my creativity” and she was right. I don’t take it on days where I’ve got a big story to write because it makes a discernible, dulling difference to my style. For all the problems that come with having the neurological set-up of a pinball machine, it does often lead to artistry and innovation; and explains why ADHD is much more common in musicians, actors and painters than bankers, administrators and insurance brokers.
In total about 5 per cent of the global population have ADHD, according to The Lancet. In the UK, that number is estimated to be around 2.6 million, yet as of 2020 there were only 120,000 diagnosed cases. Since then – probably prompted, in part, by the many celebrities who have gone public with theirs (Michael Phelps, Emma Watson, Richard Branson and Heston Blumenthal, to name a few) – there has been a 400 per cent increase in the number of adults seeking treatment, according to the ADHD Foundation.
Don’t deny its existence
Good for them, I say. If you still think of it as trivial and not worth naming, consider my brother. Our mother never told Charlie about his ADHD diagnoses when he was a child because she didn’t really believe in it (though she very much does now). His mental health was so bad that he attempted suicide several times from his teens onwards, flunked university, drank like a sailor and, like me, settled for working in a bar. Charlie found out only around the same time that I discovered I had it, when he was 30, and how he wishes he’d known sooner. Today, he has a job as a software engineer earning six figures and is more stable than any of us thought possible.
I’d argue that society benefits from identifying and treating ADHD, not denying its existence. And just remember – for this is true of all psychological illnesses – most people who have one aren’t faking it. On the contrary, they’ve probably spent most of their lives pretending to be normal instead. What a tiring game that was, and how relieved I am to have stopped playing it.