We hear the term ‘social construct’ and to clarify, they are societal norms, rules, ideas, concepts etc created and accepted by a society to help people to understand the world around them – they are changeable but are not factual and are different depending on which society you are in.
One way of thinking of social constructs is to imagine landing on earth with nothing in place that we know, a barren planet. Most of what we have then developed or agreed as rules, concepts etc are social constructs which are passed down to us by our primary caregivers/parents such as:
- Education
- Intelligence
- Money
- Behavioural rules e.g. ‘wrong and right’, ‘good and bad’
- Fashion
- Gender (created term, whereas use of word ‘sex’ relating to biological sex at birth)
- Race
The problem with asserting that ADHD is a myth/social construct is that it marginalised those who have or believe they may have ADHD. It basically asserts that ADHD traits are just part of being a human and given a label without clear measurable evidence of its existence. Suddenly people are accepting that you have challenges but with the belief that they do not in themselves count as a neurodevelopmental conditions. This flies completely in the face of the World Health Organisation which recognises ADHD in the International Classification of Diseases (ICD-11) and years of study and research in this area. Of course it is still early in terms of our acceptance and understanding of ADHD, the NHS only recognised it in adults in 2008, 2000 in children. This makes it all the more surprising or disappointing that it is a NHS Psychiatrist, Dr Max Pemberton, leading the charge in the documentary.
Some people will not believe in anything unless there is clear scientific evidence of it. Interestingly though we don’t seem to see the same focus on depression for example. It may also be that there is an anti-big pharma angle here, or anti-disability. It’s clear that the epidemic of awareness of neurodivergence is costing governments financially as they struggle to cope with the surge in requests for assessment.
A recent Channel 4 Documentary called ‘The Great ADHD Myth?’ could have been a thought-provoking in-depth look at neurodivergence but for many it was anything but. It makes headlines and many people only look at that level and it forms their opinions. This is how stigmas are maintained.
It is disturbing for millions of people who are bracing themselves for a potential public backlash and questioning their own version of reality, many people living with ADHD reported going into their workplaces with trepidation following the airing of this documentary worrying about how their work colleagues would react to them. This really isn’t fair.
Some experts quoted in the programme have come out since the airing of the programme stating that quotes attributed to them were cherry picked to suit the makers of the programme. It is this clear that those behind making the programme were keen to ensure that it strengthened the personal views of those involved.
Without going into detail there is much about the documentary that is sensationalist and flimsy at best and deeply damaging and stigmatising at worst.
The lack of empirical evidence and lots of overreaching to make connections between behaviours and medication versus lifestyle changes made it very subjective and lightweight. The arguments posed also unravelled right at the end before the closing credits.
Why should we care?
Many of us are already finding it hard to know how to talk about our ADHD experiences due to stigma and that feeling that everyone is getting a diagnosis. I work with GPs who admit that they are not well-placed to turn people away from a referral as they are not experts in this field. If a patient has self-assessed using the ASRS-1 form and goes to the GP it is hard for the GP to contest the appropriateness of a referral to a specialist service.
Some will argue that the lack of friction in the service pathway is part of why referrals are on the rise but in truth many of us feel that it is only now through greater awareness that we’re questioning our pasts. To get diagnosed through a reputable assessor there are other measures and evidence considered before deciding whether somebody meets the criteria for ADHD.
In the documentary, Max Pemberton took an online ADHD assessment privately and was diagnosed with ADHD which he disagreed with. He pointed out a few times that everybody experiences the traits that he was asked about and trivialised the process which did not appear to be thorough. It was a private assessment, the NHS mainstream services do not accept many of the private assessments to medicate and will often insist on joining the waiting list again if wanting to rejoin NHS care.
To say that ADHD is a social construct can only come from someone without ADHD or undiagnosed and denying the existence of it. People who find ADHD debilitating at times have no doubt and with the clear genetic inheritability, links to environmental factors and WHO recognition of it, it doesn’t feel like something that requires proving.
We may argue that ADHD as a term is unhelpful, personally I would prefer ‘Emotional Regulation Disorder (ERD)’ as it is the basis for so many of the extreme traits that we live with but we are where we are. For many of us, medication helps us to take the edge of the worst of our traits and improves executive function such as focus and attentiveness. This in itself hints heavily at a treatable condition that is much more than a social construct.
Read more around the evidence and explanation of what ADHD actually is here.
For more ADHD questions and answers click here…