The ADHD Diagnosis "Epidemic" Isn't What You Think It Is

Something I've noticed, the more I talk about ADHD online, is that it tends to draw out a very specific type of comment. It usually comes from someone older. It usually involves the phrase "back in my day." And it almost always ends with some version of the suggestion that things have gone too far. Too many diagnoses. Too easy to get one. Too many people using it as an excuse.

I get it, in the sense that I understand where it comes from. I don't agree with it. But I get it.

Because from the outside, the jump in ADHD diagnoses over the last decade does look a bit suspicious. If you grew up in a time when ADHD was the thing the loud disruptive boy in class had, and now seemingly half of your TikTok feed is neurospicy women in their twenties talking about executive dysfunction, it probably looks like something has gone wrong. Like the bar dropped. Like everyone decided to rebrand their personality as a disorder.

Here's what actually happened.

ADHD was, for a very long time, understood almost exclusively through the lens of hyperactive young boys. Bouncing off walls. Can't sit still. Disrupting the class. That was the image, and that was largely who got diagnosed.

Girls, broadly speaking, present differently. The hyperactivity tends to be internal rather than external. The chaos is hidden. We learn very early to mask it, to compensate, to hold it all together on the surface while absolutely losing our minds underneath. We get called daydreamers, scatterbrains, too emotional, bright but unfocused. We do not, historically, get referred for assessment.

So what looks like a sudden explosion of diagnoses is, in a lot of cases, just the backlog. Decades worth of people, mostly women, who were missed the first time around because the criteria was written for someone who didn't look like them. The awareness didn't create new ADHD. It found existing ADHD that had been sitting undetected in people who'd spent years quietly falling apart and being told it was a character flaw.

I'm one of them. I got diagnosed because the conversation finally got loud enough that I recognised myself in it. Not because a doctor handed out diagnoses like loyalty stamps. Because I finally had the language to describe what had been happening in my brain my whole life, walked into an assessment, and was told yes, this is real, here is why everything has always been harder than it needed to be.

That is not the system being exploited. That is the system finally, slowly, starting to do what it was supposed to do.

There's also something worth unpacking in the idea that more diagnoses means the bar has been lowered. Because severity and validity are not the same thing. Someone with mild hypertension still has hypertension. We don't tell them they don't deserve a diagnosis because we once knew someone who had a stroke. ADHD exists on a spectrum, like most conditions, and the people at the more severe end and the people at the milder end are not in competition for who suffers enough to count.

What I think people are actually reacting to, sometimes, is the visibility. ADHD is talked about openly now in a way it wasn't before. People make content about it, write about it, discuss it with friends. And when something that was previously hidden becomes visible, it can look like there's suddenly more of it. There isn't. It was always there. We're just allowed to talk about it now.

More people getting diagnosed means more people getting support. More people understanding their own brains. More people being a little less hard on themselves for things that were never really their fault.

That's not a crisis. That's the point.