ADHD: From stigma to superpower

ADHD finds itself at the center of mental health discourse, and some see it not as a disorder but as a strength. Danielle investigates the origins of this theory and questions who benefits from the rebranding of ADHD.

More on this story: 

• The myth of the ADHD “superpower”

Danielle: So, when she asked me to be her maid of honor…

That's me, giving the maid of honor toast at my sister's wedding, and my mom laughing as she records on her phone. It's May 2022, about four months after I was diagnosed with ADHD.

I'd love to say the diagnosis helped me get my life in order, but that would be a lie. Instead, it sent me down the rabbit hole of ADHD social media, learning all the ways the disorder has likely impacted my life. It all got overwhelming at a time when I was already overwhelmed. I didn't have an apartment, a partner, or a job. There was nothing grounding me in New York. So, I left.

I went to South America, told myself I could do whatever I wanted until the wedding, and after that, I'd fly back to New York and figure things out. Three weeks before the wedding, I flew into Dallas and spent the weekend with my sister. I bought a dress off a department store sale rack. Then I flew to Nicaragua to learn to surf. I know it sounds erratic, maybe like a 37-year-old refusing to grow up, but my choices made sense to me. Kind of. I mean, if you need dopamine, learn to surf.

Then came the wedding. I had to leave the welcome party early to pick up the dress from the tailors. I almost forgot, then got lost and missed most of the dinner. A little voice in my head kept telling me I'm an idiot, that I can never get anything right. And I never will, because I have ADHD.

The wedding would be my first time seeing extended family in more than two years because of the pandemic. I dreaded the questions about what I'm doing with my life. I figured I'd get ahead of it by standing up in front of a room full of people and starting the toast with the self-deprecating joke I'd written. I asked my cousins to laugh on cue, just in case the joke didn't land.

I scribbled notes and rewrites up until the moment the DJ called me to the front of the room. And as he handed me the microphone, and I looked at everyone staring back at me, something unexpected happened. For the first time since being diagnosed, I felt grateful for the way my brain works.

I thought, "If ADHD is the reason I don't have this kind of classic life, it's probably also the reason I still love last-minute travel and like challenging the ways we're supposed to do things, and why I have a career in three fields, not one." Insatiable curiosity makes my life possible. All of this raced through my head, and then I started my speech.

And while I'm only two years older, I've always absolutely loved giving pristine advice. So, I thought I would start there. There's just one problem: We are in a room full of people who have figured out the secrets to long and happy marriages. And I'm certainly not one of them. So, if anyone has advice, please find the bride and groom later. I'd also love to hear it.

I don't think I could have handled that laughter an hour earlier. I was in such a dark place. And then I wasn't. The speech became a turning point. I stopped resenting my ADHD and started appreciating it. I think it's made my life a lot more interesting. I'd love to claim this as an original thought, but it turns out, a lot of people were starting to feel the same way.

Over the next year or so, the idea of ADHD as a strength seemed to take over the public conversation about this disorder. By 2023, it almost seemed cool, or at least trendy, to have ADHD. I watched this happen on social media and heard it in conversations with friends. Friends who'd never mentioned mental health issues were starting to call to tell me they had ADHD. And in those calls, they used a specific word: superpower. It's like ADHD was somehow rebranded in less than two years. I was confused.

I still think of the stigma, and I've wondered two things. First, how'd this happen? I'd read that 84% of ADHD content on TikTok is misleading. Is all of this positivity and talk of superpowers driven by that 84%? My second question is about the impact. Is the rebranding of ADHD one of the reasons so many women are being diagnosed? If so, what's the connection? And what does it mean to rebrand a mental health condition? Who does that benefit?

As I started trying to answer these questions, I realized social media influencers didn't create this new way of thinking about ADHD. That, as far as I can tell, started at least 30 years ago and has been largely driven by a man determined to get the world to see ADHD through his eyes. For better or worse, I think he can now say mission accomplished.

This is "Climbing the Walls," a podcast where I try to figure out why so many women are being diagnosed with ADHD. I'm Danielle Elliot.

We made it! Hello, how are you?

Ned: Nice to meet you.

Danielle: Dr. Ned Hallowell opened the door with a giant smile on his face.

Danielle: Nice to meet you, too. Thank you. I love your doormat.

Ned: Ok. You noticed that. Most people don't notice it.

Danielle: Oh yeah. The doormat says, Home to Ned, Sue, the names of their kids, and the names of their pets. It ends with a question mark, as though they're not sure if they'll have more kids or get more pets. Ned ushered me into the living room. Inside, the walls are covered with photos, massive frames with 20 or 30 photos each, maybe more. The kids all look grown, so I guess that question mark is about pets. He walked into another room and stood in front of floor-to-ceiling bookshelves.

Ned: I've written 23 books, and by the way, the reason I write so many books, it's not that I'm ambitious to write books. If I don't have a book going, I get depressed.

Danielle: Writing is one of the ways he manages his ADHD. He stopped in the kitchen, and we sat down at a big table. I asked how ADHD became his specialty.

Ned: When I was in medical school, I'd never heard of it, and then I went through my residency in adult psychiatry, didn't hear of it. It wasn't until I started my fellowship in child psychiatry in 1981.

Danielle: Early in Ned's child psychiatry fellowship, a professor gave a lecture about attention deficit disorder, as it was known at the time, and what Ned still calls it. As he listened to the professor describe kids who struggle with boredom, he understood. At the time, the medical model didn't mention adults, but that didn't sit right with Ned.

Ned: The minute I heard that lecture, I saw it in myself. And then the more I kept my eyes and ears open and the more I heard what people were telling me, the larger it became.

Danielle: Over the next decade, Ned finished his training and started working at a hospital. He treated patients with severe cases of obsessive-compulsive disorder, depression, schizophrenia, and other mental health conditions. He also treated many adults, describing what he recognized as ADD. In his conversations with these patients, he became increasingly suspicious of the official diagnostic manual, the DSM, described ADD.

Ned: Because I knew the standard books got it wrong. I knew that the truth was in the patients and the people who have it, and in me, because I had it. And so, it was a combination of looking at myself and looking at the people that I saw. I majored in English at Harvard and graduated with high honors as a dyslexic with ADD and doing pre-med. And I'm small potatoes compared to the Nobel Prize winner who has it. I really do believe, and this is not propaganda, I really believe this is a marker of talent.

Danielle: He shared his suspicions with a colleague, Dr. John Ratey, and they realized they were reaching the same conclusions.

Ned: The three main symptoms of ADD, distractibility, impulsivity, and hyperactivity, turn each one of those on its head, and you get an incredible positive. The flip side of distractibility is curiosity. And that's what drives us. We're driven by curiosity. What's that? What's how is that? So, if you hear a noise out there, the dull person wouldn't care, but the ADD person "What's that? What's that?" And that how, you know, discoveries get made.

The second one is my favorite, impulsivity. That's what gets us all into trouble. Well, what is creativity but impulsivity gone right? You know, you don't plan to have a creative idea. They pop impulsively, disinhibition, and then the third one, hyperactivity, you get to be my age, I'm 74, it's called energy, you know, and I'm real glad I've got this little power pack on my back.

Danielle: Ned and John were the first to put all of this into a book, published in 1994. It's called "Driven to Distraction."

Ned: John Ratey and I thought we'd be lucky if it sold 10,000 copies. The next thing you know, that book, I mean, not to toot my own horn, but that book changed everything.

Danielle: "Driven to Distraction" helped Sari Solden recognize her ADHD. It helped Emily Mitchell understand herself. It sold more than two million copies, and it's still selling strong. It changes everything for people who read it, which, for a long time, meant it changed everything within ADHD circles or for people who were already diagnosed with ADHD and looking for more information.

I am not convinced it changed the public perception of ADHD, at least not at first. And it definitely did not change the minds of the ADHD gatekeepers. One prominent expert, a professor of psychiatry at the University of Massachusetts Medical named Dr. Russ Barkley, did not hide his dismay.

Ned: At first, people ridiculed it. Russ Barkley said to me, "Will you please stop writing positive things about this? Because we won't get any research money because they don't want to fund strengths."

Danielle: I reached out to Dr. Barkley. He told me he remembers this slightly differently. He said that, quote, "Championing ADHD as a gift risks losing the hard-won protections and entitlements that exist with the diagnosis because it is a disorder."

Over the next two decades, research started to support the idea that there are benefits to having ADHD. Granted, most of this research was conducted in other fields. Geneticists identified genetic mutations that were strongly correlated with ADHD.

Evolutionary scientists hypothesized that in the past, there could have been evolutionary advantages to having this type of brain. One psychiatrist told me that the benefits may not have always been experienced individually. He said ADHD exists because humans evolved in groups, and groups need risk-takers in order to learn anything new.

Someone had to light the first fire. Someone had to be the first to swim. Someone had tried eating different foods. And when they did, it didn't always go well. People lit themselves on fire. People drowned or got eaten by sharks. People ate poisonous berries. But someone else cooked food. Someone else caught a fish. And someone else discovered that we can eat strawberries. Whether they lived or died, the risk-takers taught everyone something.

Not all scientists agreed with the research on potential evolutionary benefits. At a 1999 CHADD conference, Dr. Barkley gave the keynote address. He told attendees he strongly believed that there is no evidence to support the idea of evolutionary advantages and that talking about them trivializes the disorder. He said that you cannot claim to benefit from ADHD and then want to call it a disorder. Ned agrees. Sort of.

Ned: It's not a deficit disorder. I mean, I have an abundance of attention. The challenge is to control it. So, to call it a deficit disorder makes it sound like a form of dementia, which it's not, at all. And I think of it as a way of being in the world, not a disorder or a, but a way of being in the world like being an extrovert. You know, it's a way being. And when you begin to realize that, then it's so liberating because then you see yourself.

Danielle: For years, this liberation came to those who happened to read Ned and John's books, or Sari Solden's, or a slew of others, written by people who treat adult ADHD. The strengths did not enter the medical conversation, but the evidence of potential advantages only grew.

In 2008, a pair of anthropology students traveled to northern Kenya to spend time with one of the few groups that still lives in the hunter-gatherer lifestyle. Many in the group carry a genetic mutation that is strongly associated with ADHD.

The researchers determined that when living nomadically, those with the genetic mutation exhibit better health than those who live a settled life. And when living in a more settled life in a village, those with a genetic mutation show greater

malnourishment. Conversely, people without the mutation are more healthy in a settled lifestyle and more malnourished when living nomadically.

Summarizing their findings, the authors of the study wrote, there is good reason to believe that in our evolutionary past, ADHD was often not much of a problem and was perhaps even an asset. Several studies have since supported their findings. The medical model continues to describe ADHD as a deficit, and it continued to carry a stigma. Ned sees this as a great tragedy.

Ned: People tend to be afraid of this diagnosis. I don't want to be fucked up like that. I don't want to be weird. Because it's classified as a mental illness, you know, in the DSM and people naturally push back on that, which is so ironic because they should embrace it. There's no diagnosis in all of medicine that can jack up your life better than this diagnosis, or can hurt your life more than diagnosis not made. The prison population is full of people with undiagnosed ADD. Halls of the unemployed, the addicted. ADD is a very common treatable cause of addiction.

So, all these at-risk populations, a lot of them, a big segment have ADD. If we treated the ADD, cut down on the recidivism rate, cut down the addiction, save relationships. And they're talented folks, they really are. Things can only get better once you have the diagnosis.

So, I come along and say, no, you know, my line is I don't treat disabilities. I help people unwrap their gifts. And that's the truth. But that shift in emphasis makes all the difference in the world. "Oh, OK, I'll work with you to unwrap my gift. I just don't want to work on becoming less crazy or less defective or you know."

Danielle: Ned spent more than 40 years attempting to rebrand ADHD. The idea never seemed to reach the general public. Then, sometime during the pandemic, ADHD transformed from a stigmatized disorder into something people casually refer to as a superpower. I've tried to dissect this transformation. ADHD content on social media definitely helped destigmatize the disorder. So did a general cultural shift towards accepting and understanding mental health differences.

But when I look at ADHD content that was posted to social media in 2020, I don't see much, if anything, about superpowers. I talked to a popular ADHD coach. She can't remember people talking about superpowers until about 2021. She suggested it might've been linked to media coverage of a new book, a new book written by, you guessed it, Ned and John. It's called "ADHD 2.0."

I read "ADHD 2.0 "shortly after my sister's wedding. My copy is full of notes, entire pages underlined, especially the part about a recent scientific advance in the understanding of negative self-talk. The type of self-talk that I was feeling before seeing extended family at the wedding. The authors described this type of rumination as creativity applied to the past. Of course, creative people also ruminate, pairs of opposites, and all that. Thinking about this helped me tame my inner critic in ways that I never thought possible.

So, the book's great, at least it was for me, but I'm not sure it shifted public perception. The positive reframing of ADHD still needed a boost, and then it got one, a big one. One of Ned's patients wrote a memoir, Paris Hilton. On the cover, she called ADHD her superpower. On the first page, she quoted Ned. Around the same time, she and a few other celebrities appeared in a documentary called "The Disruptors."

In the film, they talked about ADHD as the thing driving their success. Olympic gold medalist Simone Biles talked about her ADHD in media tours. Comedian Nicole Byer talked about it on her popular podcast. Filmmaker Greta Gerwig mentioned it as she was doing press for her blockbuster hit, "Barbie." As celebrities opened up about their ADHD, and did so without shame, the shift in public perception was rapid and obvious.

Ned: I mean, now, you know, it's rare that I'm greeted with pushback. It used to be a routine. People would say, "Isn't this just an excuse for being lazy?" And now people are very curious, and it's great because now they can use it. Their first reaction isn't skeptical. Their first is tell me more. And that's wonderful. I mean, it's just wonderful. And it's so liberating.

This diagnosis, if you have it, you find out you have it, you're laying claim to a whole new way of being in the world. And sometimes that's dramatically better, and sometimes it's marginally better, but without any doubt, it's better. Just how you look at yourself is better.

Danielle: All this positive talk around ADHD had started to lift some of the stigma, which likely led to more people getting a diagnosis who needed it. And that's great, but I had concerns. This rosy reframing in the last few years, it seemed like it appealed to everyone I know. That's what worried me.

Is there any chance some people are hearing that creative people have ADHD, and they want to be considered creative? That they hear career women have ADHD, and they identify with that? Where is the line between having ADHD, attention deficit hyperactivity disorder, and being a person who struggles to focus, or being a person who is extremely creative?

Ned told me I'm getting caught up in the diagnostic criteria. He doesn't want to throw out the accepted diagnostic criteria for ADHD. He just thinks it's flawed. He prefers what he calls a descriptive model, in which you describe the experience of ADHD and ask someone if this description feels familiar.

Ned: It's a description, this is what it tends to look like. We tend to be a dreamer, tend to a visionary, tend to an entrepreneur, tend to think outside the box, tend to impatient, tend be an inventor, intuitive, amazingly forgiving, credulous, ready to believe anything. And then the downside, yeah, we often, we have trouble doing things that are boring. You know, it's just that. I mean, we have no patience for boring stuff, and we bounce off of it.

That takes in quite a few people, and it's not, I'm not forcing a diagnosis on anybody. I'm just saying, "Here's a description. If you think it fits you, let's talk about what you could do about it to make it better, you know, or take advantage of the upside." Then you're not saying, "Do I have it or not?" You're saying, "Is this a good description of me? And what can I do about it? Is there something here that the stuff in that book might help me with, or not? "There's no controversy in that.

Danielle: I have a hard time with this because the description seems all-encompassing. I don't know many people who wouldn't relate to at least some of this description. Everyone gets distracted sometimes. Everyone feels low sometimes. And if anyone who relates to it should consider ADHD, would that not lead to overdiagnosis?

Reporters and experts debate over diagnosis whenever diagnosis rates rise. In the past, they focused on pharmaceutical marketing. They said it presented stimulants as a cure-all for basic human behaviors, that it stretched the definition of a mental health condition in pursuit of profits. Now, I wonder if some ADHD coaches, authors, speakers, and doctors have expanded the definition to the point that descriptions feel relatable to everyone.

Ned has books to sell. ADHD coaches need clients. Is it possible that, in an effort to sell these books and services, some experts are triggering overdiagnosis? And on the flip side of that, that they have painted such a rosy picture of ADHD that some people are led to believe it's not all that bad, or maybe not worth pursuing treatment. Ned told me he's not worried about overdiagnosis. He maintains that, if anything, ADHD is still wildly underdiagnosed.

Ned: It's so much more prevalent than we think. You know, the official numbers are five to 10%. But that's just because they're measuring people who meet the diagnostic criteria. The rest of us, you know, who are doing great, and we don't meet the diagnostics criteria, but we have definitely the trait. I think we're talking 30, 40%.

Danielle: I asked Ned to clarify his suggestion that 30 to 40% of the population has ADHD. And he reiterated that he does not think 30 to 45% meet the diagnostic criteria. Rather, he was talking about two distinct things. He was talking ADHD, a serious disorder, and ADHD, a trait. As in, there are people whose lives are truly disordered by ADHD who fit into the statistics on increased rates of incarceration, divorce, substance abuse, credit card debt, premature death, and the many other negative consequences associated with ADHD.

And then there are people who have some of the elements of ADHD, even if not the full disorder. Regardless of whether they have severe ADHD or mild symptoms that might not qualify as a disorder, Ned believes they would benefit from ADHD coaching or reading his books. What Ned was doing here, insisting on a distinction between the disorder and a trait, it helped me understand why so many people tell me they have a little bit of ADHD.

It seems to line up with the idea that ADHD symptoms occur along a spectrum, but it also left me with more skepticism because if everyone with, quote, a little ADHD is now being diagnosed with ADHD, the disorder, doesn't that indicate overdiagnosis? I'm not sure. It's a big question and an important question because the current rates of diagnosis have helped contribute to an unprecedented drug shortage.

If people are being misdiagnosed and that's limiting people with the disorder from accessing medications and treatment that they need in order to function, that's a huge problem.

Overdiagnosis is a riddle we'll never solve. This is a subjective diagnosis. People can lie. Other people can feel too much shame to ever seek help. Still more might relate to descriptions, even if the symptoms don't impair their lives. There are likely tons of people with undiagnosed ADHD and tons with misdiagnosed ADHD. We could circle it all day.

But while I had the ear of one of the leading experts on ADHD, I wanted to ask Ned a harder question, one that is less about his book sales and more about how he differentiates between the trait of ADHD and the disorder. What if the reason more people are seeking a diagnosis is actually because more people have moved from the trait part of the spectrum to the disordered part of the spectrum? Meaning, what if ADHD is actually becoming more prevalent?

Part of the search that I'm on is sort of why the rise, not just the rise in diagnosis, but Is there a rise in actual prevalence, and I'm curious if they...

Ned: I don't think so, I mean that's up for grabs, but I think it's that we've expanded our definition enough that what we're seeing now is pseudo-ADD, environmentally induced ADD. We live in a very ADDogenic culture now.

Danielle: As in a culture that creates ADD-like symptoms in people. Does this make your head spin? It made mine spin. I felt like he was saying no, ADHD is not more prevalent. But yes, you're right, it is, because we've expanded the definition of ADHD to a point that it encompasses more than ADHD. Ned continued.

Ned: And the two big causes are saturated with electronic media and deprived of what we're doing, human connection. And you take those two, too much electronics and not enough human connection, that's ADDogenic. It makes you short-attentioned, impulsive, impatient, hard to connect with.

Danielle: He told me how to tell them apart. He suggested something he calls the Vermont test. Leave them on a farm in Vermont for a few weeks.

Ned: And you come back in a couple of weeks, and if they're sitting on the porch reading a book, then it was not true ADD. And if they've turned the farm into an amusement park, then it is true ADD.

Danielle: He was only half serious, but his reasoning was completely serious. He said that a person with environmentally influenced ADHD will feel their symptoms ease now that they're in a quieter, less stimulating environment. They'll be able to relax. A person with true ADHD will continue to exhibit ADHD regardless of their environment. If their symptom is hyperactivity, for example, they'll spend their weeks in Vermont turning a farm into an amusement park. They won't be able to sit still. Maybe they'll hyperfocus on a book for a little while, but not the entire time.

Ned: It's an important point because people try to trivialize ADD by saying, "Oh, everyone's like that." Well, no, everyone is not like that, and it's important to make that distinction.

Danielle: I agree. It's important to make that distinction. The current rates of ADHD diagnosis are not making that distinction. What do we do about this? Before I could ask this question, the sliding door opened behind me.

Ned: Hello!

Sue: Still recording out there? Hi!

Danielle: Ned's wife, Sue Hallowell, was home from work.

Sue: Hi, how are you? Nice to meet you.

Danielle: She shook out her umbrella and wiped her feet on the mat, then walked to the fridge and pulled out a bottle of wine.

Sue: Is rosé OK?

Danielle: Rosé is great, thank you.

Sue: Friday night!

Danielle: I was about to stop the recorder when Ned turned and said...

Ned: She knows more about couples and ADD than anyone in the world.

Danielle: Sue is a therapist. When Ned's first book came out, couples started contacting her about ADHD. She moved around the kitchen as she explained this, then stopped to pour me a glass of wine.

Sue: How's that?

Danielle: That's perfect.

She said that back then, she had no idea how to offer couples therapy focused on ADHD.

Sue: And so, I've learned over the years — Cheers — how to do this. And I really enjoy it.

Danielle: Yeah.

Sue: Ned, what did you order?

Ned: I got two, we got two fishes and one chicken one.

Sue: Two what?

Ned: Two fish...

Danielle: Over dinner, we talked about ADHD and relationships, and trends Sue is seeing in her practice.

Sue: My caseload tripled.

Danielle: Really?

She said she's definitely seeing a rise in diagnosis in the last few years, and that so many people really don't understand how much ADHD impacts relationships. Eventually, Ned stood up. He carried our plates to the sink and started washing the dishes. Sue asked if I had plans for July 4th. I told her I'd be in Michigan visiting friends. She said she'd be there too.

She said you have a camp in Glen Arbor?

Sue: We have a camp at the ADHD family camp in Glen Arbor. It's so cool.

Danielle: This was news to me. My brain started firing off in a million directions. When people say I have shiny ball syndrome, well, this is why. Sue and Ned started telling me about their camp, and I was already lost in my head, figuring out how I could go.

How long have you had it?

Sue: This is gonna be our 19th year.

Danielle: When is it?

Sue: It's July...

Danielle: It would start while I was in Michigan. I was thinking that a camp for families with ADHD must be full of women with ADHD. Maybe women who were recently diagnosed. Maybe women don't even know yet that they have ADHD. And I could be there the moment they figured it out.

I mean, so often ADHD is everyone in the family, but did you started thinking as a way to educate parents about the future?

Ned: Yeah.

Danielle: And, do you have a lot of parents who recognize their ADHD?

Sue: Oh, so many people recognize their own ADHD in it.

Ned: And marriages get saved.

Sue: Yeah, it's really incredible. But, it's also…

Danielle: I finally just came out with it. I asked if I could go to their camp.

Sue: Yeah, you're welcome to come and see what it's all about, it's really...and there's some families now that have come back for years and years because and then there are new families every year.

Ned: It's only a week. It's amazing.

Danielle: That night, I extended my trip to Michigan. After seeing friends for the 4th of July, I'd drive north to their camp to see how much can happen in a week and how the women at the Hallowell camp might help me understand what's happened in the last four years. That's next time on "Climbing the Walls."

"Climbing the Walls" was written and reported by me, Danielle Elliot. It was edited by Neil Drumming. Sound design by Cody Nelson. Briana Berry was our production director. Ash Beecher was our supervising producer. And Diana White was our associate producer. Fact-checking by Mary Mathis. Research by Karen Watanabe. Our music was composed by Kwame Brant Pierce, with additional music provided by Blue Dot Sessions, and our mixing was done by Justin D. Wright.

The series was brought to you by Understood.org, a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia.

From Understood.org, our executive directors are Laura Key, Scott Cocchiere, and Seth Melnick. A very special thanks to Rae Jacobson, Julie Zeitz, Jordan Davidson, Sarah Greenberg, and Kathleen Nadeau. If you want to help Understood continue this work, consider making a donation at Understood.org/give.