The number of people diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) is experiencing a dramatic and sustained surge, both in the United Kingdom and across the globe. This trend has prompted significant concern, including from UK Health Secretary Wes Streeting, who has ordered a clinical review into the diagnosis of conditions like ADHD and autism amid rising sickness benefit claims.
The Personal and the Circular: What Does a Diagnosis Explain?
Retired physician and author Gabor Maté, diagnosed with ADHD himself in his 50s, describes the initial relief a label can bring. It seemed to clarify a lifetime of challenges, from workaholism and emotional reactivity to simple clumsiness. However, he cautions that the diagnosis often becomes a tautological loop: a person is inattentive because they have ADHD, and we know they have ADHD because they are inattentive. While descriptively useful, this does little to uncover the root causes of the behaviour.
Despite a lack of consensus on its fundamental nature—or even its validity in some quarters—the diagnosis is proliferating. In the UK, prescriptions for ADHD medications have risen by 18% annually since the pandemic. In Germany, diagnosis rates increased nearly fourfold in just over ten years, while in China, it is labelled a growing public health concern. This pattern points to a widespread, international phenomenon affecting children and adults alike.
Beyond Genetics: The Social Environment's Crucial Role
While ADHD is frequently framed as a highly heritable, biological brain dysfunction, Maté and a growing body of research emphasise the pivotal role of environment. No specific gene has been identified that predetermines ADHD; at most, genetics may create a predisposition. As geneticist R.C. Lewontin noted, genes and environment are in constant dialogue, and when the environment changes, all genetic bets are off.
The core issue, therefore, shifts to what in our modern environment might be hindering healthy brain development. Neuroscience confirms the brain is a social organ, its circuitry shaped by early experiences and the emotional milieu. The Harvard Center on the Developing Child stresses that the interaction of genes and experience, influenced by responsive adult-child relationships, literally builds the brain's architecture, beginning in the womb.
A Toxic Culture for Developing Minds
Here lies the crux of the modern dilemma. The essential, attuned relationship between parent and child is under unprecedented strain. Maté points to a neoliberal context marked by rising inequality, economic insecurity, and social isolation. The erosion of community supports, the fraying safety net, and the addictive pull of digital media create intolerable stress for families.
Stressed parents, however loving, are less patient, responsive, and calm. Research shows that in such environments, children not only lose a protective buffer but may also experience stress-inducing relationships with their caregivers. This child stress directly impacts brain development, with ‘tuning out’ becoming a coping mechanism. The documented psychological impact of digital media adds another layer of risk to the developing mind.
The solution, Maté argues, cannot be found in a pill alone or in blaming parents. It must be rooted in a societal commitment to supporting families. This includes aiding pregnant women and young parents, providing empathetic support in all childcare institutions, and helping children struggling with ADHD traits. Crucially, it requires health professionals to compassionately address parents' own emotional stresses and unresolved traumas to foster a nurturing environment.
While such support carries a financial cost, Maté contends it is a pittance compared to the immense economic and human suffering caused by current social conditions that create a hostile landscape for raising children. The soaring rates of ADHD call not for scepticism or stigma, but for a profound societal reflection and a response grounded in empathy and systemic change.
