What is ADHD?
What’s the scale of the problem and what’s life like for people with ADHD - attention deficit hyperactivity disorder? Henry Shelford is chairman of ADHD UK and he spoke with Adam Murphy...
Henry - It's the worst named mental health condition: attention deficit hyperactivity disorder, and it's woefully negative talking about deficits, disorder. And it's wrong. It's not an attention deficit. It's an issue of controlling the attention. And not everyone has hyperactivity. That's not an essential part. And particularly as people become older in adults, the hyperactive part becomes much less prominent, leaving the majority with, inattentive combined, so there's three kinds of ADHD, hyperactivity, inattentive, and combined, which is a combination of the two.
Adam - It's suggested that like one in 20 people are affected. Does that sound reasonable to you?
Henry - It does, and there's a recent Lancet study that backs that up. So around 5%, so in the UK, that's 3.3 million people, and that's reaching the clinical standard where there's a significant impairment on someone's ability to function. If you take that wider, for people with ADHD traits, it's about 11%, so 7.3 million. And right now, obviously there aren't 3.3 million in the UK diagnosed. So we have a lot of people who have the condition who haven't been diagnosed and are really struggling.
Adam - And what about people like me? You know, the people who struggle and then end up getting diagnosed late. Is that a common story that you tend to hear?
Henry - Well, I was diagnosed in my forties. I know you're going to talk to Dr. Max Davie, and he's in the same position. The majority of the calls to our charity are adults. And one of the things that causes people to realise, is if they might be at a life point where they've got structures and they're doing okay, but something changes and they realise they really aren't. And this period of COVID has changed a huge number of people's way they work. And they've really realised that they have issues. And so we are seeing a lot of adults coming forward, thinking they've got ADHD. The record we know of in the charity of someone who's aged 73, that's the oldest. And we do get a lot of people who, when they realise, that they just say when they learn about it, just everything falls into place. It all makes sense now, how they are. And it shows how important shows like this are in terms of educating people so people can realise and get the help they need.
Adam - What kind of stigmas do you see out there for people making their way through the world with ADHD?
Henry - The biggest one is people not understanding that my actions are traits and not behaviors. So neurotypical familiarity, like the things we've talked about, being late or, bad timekeeping, missing appointments, struggling with deadlines, butting in on conversations, zoning out. It's not, you know, it's not me being rude. It means I've thoughts caught in my head, probably from something you've said, and I'm following it, but that neurotypical familiarity can equal contempt. So people, you know, a lot of people struggle with their to-do list or managing their day, but their struggle is very different from the impairment and absolute destruction of life and careers and jobs and relationships that's happening for someone with ADHD.
Adam - And what kind of fraction of the kids who have ADHD grow up to be adults with ADHD?
Henry - It's thought to be around 60%, take it, carry it on into adulthood. There's some discussion over that number, but I think that the clear point is the majority do. They do tend to, the hyperactive element becomes less prominent, and the less prominence is important because it's actually often better social skills and better controlling of self, that makes it less obvious. You know, you learn to sort of play with your fingers or play with the little thing in your pocket, rather than running around. You're still doing it. But the issues of control of attention, very much remained there. And actually when you're moving out of the structures of school or other education, it then becomes much more difficult. You're supposed to be controlling yourself and obviously you can't and so you can hit real problems there. And certainly as a charity, we get lots of calls in from people, you know, turning 18, going into their first job or into university or leaving university and into their first job, or changes in their workplace. And retirement actually is another big bump where the work structure goes away and suddenly people are struggling to know how to manage their day.