Is ADHD Really a Deficit? It Wasn't Always Little Boys Bouncing off the Walls...

I am Sofia, a 21-year old university student and I was diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) when I was nearly 16. As someone who is currently doing a degree in Biology (with Education), I have always wondered where ADHD came from. ADHD in girls is often not diagnosed until later in life or missed completely as girls often do not meet the stereotype many people hold of ADHD. I attended a grammar school and I have always been very academically able. This meant that despite all my behavioural problems, my ADHD remained uncovered for much of my school career. My school reports are littered with comments like “Sofia could do so much better if she just tried harder” and “Sofia has interesting things to say but is unwilling to engage and prefers to disrupt lessons”. I spent years thinking I wasn’t good enough but when I was told I had ADHD it was like everything slotted into place. For the first time in my life, I understood myself but it left me questioning why I was the way I was and where it might have come from.

10,000 years sounds like a long time, and in terms of societal changes, it is, however in terms of genetic evolution, it is not. In 10,000 years our looks and genetics have largely remained unchanged but our lifestyles are drastically different - we no longer live as hunter-gatherers and instead of spending all day outside collecting food or materials for survival, we spend all day at work and pop to the supermarket for groceries. Given the mismatch in the speed between our genetic evolution and our lifestyle evolution, it stands to reason that some individuals are genetically better suited to the lives of our pre-historic ancestors.

ADHD is characterised by three main symptoms: inattention, hyperactivity, and impulsivity - symptoms that in today’s society are not always useful, but certainly could have been historically. The exact cause of ADHD is unknown and it is likely that both genetics and the environment have a role to play in its development but evidence suggests genetics can account for 70-80% of the probability of developing it (ADHD UK). Currently, ADHD has a global prevalence of 2-7% and this number is high enough to suggest that it has been selected for by natural selection; behaviours associated with ADHD would have been advantageous to our hunter-gatherer ancestors who would have outlived others and reproduced more successfully to pass on their genes to their offspring.

The three characteristic symptoms of ADHD are all labelled in ways suggesting they are detrimental to an individual but by reframing these, it is easy to see how they may have been beneficial historically. If inattention is thought of as having a rapid shifting focus of attention rather than an inability to maintain attention, the ways it could have been beneficial can be highlighted: to collect food, for example, hunter-gatherers must constantly scan their environment to notice any small movements from prey or identify plants to pick for consumption. Protecting a group from attack requires similar skills to notice predators. Hyperactivity can be thought of as excess energy or movement and this would have been invaluable in gathering resources for survival and travelling further afield to do so. Impulsivity can be reframed as having quick reactions to environmental cues, allowing hunters to quickly kill any prey or respond to attacks on habitations.

It is only with the rise of civilization that these symptoms are detrimental; being expected to sit at desks in school or in an office for 8 hours of the day doing the same task is not what people with ADHD, or people in general, are genetically adapted to. It is unfortunate that these differences are seen as inherently bad characteristics and it is unsurprising that individuals who are constantly told they are not good enough and need to try harder to succeed eventually become hostile and defiant. This results in school exclusions, adverse mental health outcomes and individuals being ostracised by a world not built to accommodate them. All of the behaviours that once were advantageous to survival are now deviations from societal norms that limit success in education and the wider world and cause harm to the individual. ADHD has not always been a “deficit” and labelling it as such will only ever serve to demoralise those diagnosed with it and perpetuate the harmful stereotype of the disruptive young boy in primary school. Stigma associated with ADHD is rife but understanding why it came to be can hopefully help change that and shine a more positive light on it.

By Sofia Carlisle-Bell

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