The ADHD Myth?

Over the past 10 years I’ve worked with higher education institutions, companies, and physical and mental health teams across the country, delivering training on neurodiversity. In the past year, however, something has changed. One set of questions I always ask during training sessions is: What percentage of people are dyslexic? What percentage are ADHD? What percentage are autistic? It's a bit of fun, but it's also revealing. Most groups get dyslexia roughly right. Dyslexia is generally estimated at about 10% of the population, with some research suggesting the broader spectrum may be closer to 17%, ranging from people requiring little support to those with higher support needs.

But what do people guess for ADHD? 30%. 35%. 45%. Sometimes even 50%.

The estimated prevalence of ADHD in adults is around 3%, yet public perception is that it is dramatically higher. Why? Because of documentaries such as The ADHD Myth?, alongside a steady stream of articles from Dr Max Pemberton in the Daily Mail and The Spectator. There is a constant barrage of media coverage from various talking heads suggesting that ADHD is overdiagnosed, not real, or somehow a threat.

Although this documentary was presented as science-led and supported by "expert" discussion, anyone familiar with Dr Pemberton's previous writing would have little doubt about where he stands. He is an ADHD sceptic, and he has not always been particularly sympathetic towards ADHD patients in his public commentary. To his credit, he comes across as somewhat more compassionate in the documentary. However, this sits uneasily alongside previous statements from him such as ADHD being "the latest 'must-have' mental health condition", "a convenient label", "just get off your phone and pay attention", and claims that ADHD "remains controversial amongst doctors" and is being "wildly over-diagnosed". That final claim cannot be reconciled with existing evidence. O'Nions, using NHS data, estimates that only around one in nine people with ADHD have actually been diagnosed. [1]

Is ADHD a "genuine developmental disorder"?

What struck me most was that the documentary repeatedly asked whether ADHD is a neurodevelopmental disorder, yet never seriously addressed the question. The programme simply asserted this conclusion without properly examining the evidence underpinning decades of research and clinical practice. I cannot overstate how little the documentary actually engages with the question it sets out to answer. ADHD has been recognised as a mental health condition since 1968 for children, and since 1994 for adults, with only relatively minor changes to the diagnostic criteria over time. Suggesting that ADHD is not genuine, or that most cases are not genuine, makes the work of clinicians trying to support ADHDers more difficult.

The fallout from a documentary like this is significant. It affects people who have fought for years to obtain an assessment. It makes it harder for them to speak openly about an important part of their identity. It creates additional barriers to seeking support, accommodations, and community. Rather than contributing to a balanced and productive discussion, this documentary reinforces stigma and makes life harder for a group that already faces considerable challenges.

I’m just a humble Occupational Therapist with another degree in Sociology, but what confused me further was the repeated discussion of social constructs by medical professionals, an area that is not their area of expertise. Unless we consider all physical and mental health conditions to be social constructs, the argument seemed to be: I don't consider this a medical condition, therefore it must be a social construct. If the programme wanted to have a meaningful discussion about social constructs, why were sociologists, philosophers, or researchers with expertise in the topic not included?

This documentary is unbalanced in all the wrong ways. It cherry-picks its experts. It cherry-picks its research. It cherry-picks its arguments. And ultimately, it cherry-picks the conclusions it uses its substantial platform to promote

Lots of really good experts, real people who work to make the lives of ADHDers better, have already commented on this. I just wanted to take a look at a few key sentences mentioned, and address them

Five Statements made in the Documentary

1. "Ten years ago it was relatively rare in children." – Dr Max Pemberton, NHS Psychiatrist

This claim is difficult to support with the available evidence.

Research from the United States [2] suggests ADHD prevalence among children in 2023  (the latest data I could find) was broadly similar to levels reported in 2016, at around 10%. A systematic review conducted by King's College London, examining 40 global prevalence studies, likewise found no conclusive increase in ADHD prevalence since 2020.[3]

The narrative of a sudden explosion in ADHD prevalence is not reflected in the research evidence.

2. "So I've discovered that there is currently no marker that distinguishes one brain with ADHD from another brain without it. And so you can't diagnose it from a brain scan." - Dr Max Pemberton

This claim is particularly surprising coming from an adult psychiatrist. Depression, Bipolar disorder and Anxiety disorders cannot be diagnosed through a brain scan either. These are among the most common conditions treated by psychiatrists working within NHS mental health services. Presumably, psychiatrists do not require every patient to undergo a CT or MRI scan before receiving a diagnosis or treatment. The reality is that these conditions, like the vast majority of mental health conditions, are assessed and treated according to national and international diagnostic guidelines, including the DSM. ADHD is no different. It is assessed and diagnosed using established clinical criteria, just like hundreds of other recognised conditions.

One can certainly debate whether ADHD, Autism, and Dyslexia should be considered mental health conditions. However, the fact remains that they are included in the Diagnostic and Statistical Manual of Mental Disorders and ADHD and Autism are routinely assessed and treated by qualified healthcare professionals.The diagnostic process for ADHD in adults and children is well established and has remained broadly consistent for decades. The suggestion that ADHD is somehow uniquely invalid because it cannot be identified through a brain scan demonstrates a misunderstanding of how most psychiatric diagnoses are actually made.

*Incidentally, Professor Katya Rubia, shown in the documentary  has since said her comments on brain imaging were taken out of context

3. "I'm now convinced that it's a myth that ADHD is a neurodevelopmental disorder. Actually, I think it's a set of difficult behaviours, a social construct, not a disorder of the brain." – Dr Max Pemberton

This was perhaps the most frustrating claim in the entire documentary. Throughout the programme, numerous professionals, not necessarily ADHD specialists, repeatedly argued that ADHD is not a medical condition or a neurodevelopmental condition. Instead, it was described as "a set of difficult behaviours."

Yet the same contributors also acknowledged that:

• The feelings, struggles, and experiences are real.

• People find many everyday tasks exceptionally difficult.

• Children may be significantly underperforming in education.

• They can be more disruptive, talkative, fidgety, disengaged, and unable to meet expectations.

• These behaviours cause genuine distress.

The documentary centres on Mason as an example, but Mason is not the only person with ADHD. ADHD is considered a neurodevelopmental disorder because similar patterns of difficulty emerge across countless individuals, cultures, and environments. The symptoms typically appear early in development and persist across different areas of life. In fact they must appear early in development for the diagnosis to be made, even in adults. That is precisely why ADHD has been classified as a neurodevelopmental condition.

What particularly frustrated me was how often valid observations were immediately followed by unsupported conclusions. For example, Dr Pemberton acknowledges that "these behaviours do cause people real distress," but then says, "To me it feels wrong that we are diagnosing kids for being kids." These two positions cannot be reconciled. Children experiencing significant levels of distress, impairment, and functional difficulty are not simply “kids being kids”. These are children who are being referred to Child and Adolescent Mental Health Services because their difficulties are severe enough to affect multiple areas of functioning.

Under established diagnostic criteria, ADHD requires impairment across more than one domain of life. We are not talking about ordinary childhood behaviour. We are talking about children and adults whose difficulties are substantial enough to be disabling

4. "In effect they work the same as a slow-release cocaine, which is quite shocking when you use that language."

- Sarah Warley, neurophysiological psychologist

Indeed, it is shocking when you use that language, Sarah. This was one of the most irresponsible statements in the documentary. Stimulant medication has been used with ADHD populations since the 1930s and is among the most extensively researched treatments in child and adult mental healthcare. Thousands of studies have examined its effectiveness, side effects, safety profile, and long-term outcomes.

For a “neurophysiological” psychologist who primarily works in non-medication interventions this remark was, at best unhelpful, and, at worst, likely to create unnecessary fear among families. Imagine being a parent who has spent months or years considering treatment options, discussing them with healthcare professionals, and carefully weighing potential benefits and risks. Then imagine hearing your child's medication described on national television as essentially equivalent to "slow-release cocaine." This language is inflammatory. It generates fear rather than understanding, and again, makes life harder for ADHDers, rather than smoother.

Sarah Warley also argued that "medication should be the last thing you try, not the instant knee-jerk reaction." She is absolutely right.

The NHS and NICE guidelines [4] agree with her! Medication is not the first-line treatment for children with ADHD, unless severe. NICE guidance recommends considering medication only when ADHD symptoms continue to cause significant impairment after environmental modifications and behavioural interventions have been implemented and reviewed.

This crucial context was absent from the documentary.  I believe viewers were left with the impression that medication is routinely handed out as a first response, when in reality, assessment, environmental support, behavioural interventions, parental support, child and parent preferences, monitoring, and review are all key parts of the process. The failure to mention this gives a distorted picture of ADHD care and undermines the work of professionals who support ADHDers every day. The documentary repeatedly alludes to the principle of "do no harm," yet several contributors then use highly emotive language that risks doing exactly that.

Multiple contributors argue that children should simply be "treated like kids," while simultaneously describing prescribed ADHD medication in terms more commonly associated with illicit drug use. This is factually misleading. Stimulant medications are among the most tightly regulated medications available. Prescribing is carefully controlled, and children receiving treatment are routinely monitored. Blood pressure, weight, growth, mood, and overall wellbeing are regularly reviewed. That reality is completely obscured by phrases such as "slow-release cocaine."

5. "So the truth about ADHD is it's not our brains that need fixing, but rather it's the system that we are expecting our children to survive in that does. That's what we need to fix."

Ironically, this may have been the strongest point made in the entire documentary. Dr Pemberton is absolutely right that our education system should do a better job of supporting all learners. However, I would argue that the ambition should be much broader than that. Why stop at education?

Every person has value. Every person has needs. Every person deserves support that enables them to participate fully in society and to live the best life they can.

We should absolutely improve educational systems and create environments that are more inclusive, flexible, and neuroaffirming. But we should also ensure that healthcare, social support, employment systems, and community services are capable of supporting people according to their needs.

What surprises me about this style of argument, and similar arguments made by figures such as Suzanne O'Sullivan, is how limited the proposed solution often feels. The suggestion is frequently that we should withhold support from those with lower support needs in order to focus resources exclusively on those with greater needs.

I think this is a very narrow way to think about care. Why should support be viewed as a zero-sum game? Why should the goal not be to improve support for everyone? One of the most striking aspects of this conclusion is that it unintentionally echoes the social model of disability.

The social model argues that disability arises not only from differences within individuals but also primarily from environments and systems that fail to accommodate human diversity. In that respect, Dr Pemberton appears to be endorsing a position that many disability advocates have argued for decades. Great!

But supporting people through better systems should be the starting point, not the end point. Education should be more inclusive. Society should be more neuroaffirming. Public understanding should improve. People should have access to healthier lifestyles and better opportunities to thrive. But why is a psychiatrist calling for modifications to the education system instead of talking about modifications to the health service to support all of his patients?

Why not both?

Why not both. We should have a better educational system, neuroaffirmative school and society. And for some medication is a life changer, and we should all eat better and move around more. AND ADHD is a real Neurodevelopmental difference.

1.       O’Nions E, El Baou C, John A, et al. Life expectancy and years of life lost for adults with diagnosed ADHD in the UK: matched cohort study. The British Journal of Psychiatry. 2025;226(5):261-268. doi:10.1192/bjp.2024.199

2.       Xu G, Strathearn L, Liu B, Yang B, Bao W. Twenty-Year Trends in Diagnosed Attention-Deficit/Hyperactivity Disorder Among US Children and Adolescents, 1997-2016. JAMA Netw Open. 2018;1(4):e181471. doi:10.1001/jamanetworkopen.2018.1471

3.       Alex F. Martin, G. James Rubin, M. Brooke Rogers, Simon Wessely, Neil Greenberg, Charlotte E. Hall, Angie Pitt, Poppy Ellis Logan, Rebecca Lucas, Samantha K. Brooks, The changing prevalence of ADHD? A systematic review, Journal of Affective Disorders, Volume 388, 2025, 19427,ISSN 0165-0327, https://doi.org/10.1016/j.jad.2025.119427.

4.       National Institute for Health and Care Excellence: Attention deficit hyperactivity disorder: diagnosis and management NICE guideline Reference number: NG87 Published:  14 March 2018  Last updated:  13 September 2019

https://www.nice.org.uk/guidance/ng87/chapter/Recommendations#managing-adhd