Is modern life causing ADHD?
Look beyond medication, says Dr Max Pemberton – and ask why our children are struggling
Channel 4
- Dr Max Pemberton
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In 23 years as an NHS psychiatrist, I’ve seen an extraordinary rise in a single diagnosis – Attention Deficit Hyperactivity Disorder (ADHD). From being rare in children and almost unheard of in adults, it’s estimated that around 2.5 million people in England now have it.
Up from around 21,000 in 2019, there are now around 270,000 children and young people waiting for an assessment for ADHD, described as a condition where people may find it difficult to concentrate or sit still. Prescriptions for medication have climbed since the pandemic by 18 per cent a year.
It’s shocking that we’re giving children powerful medicines that can fundamentally change their character and personality without a bigger debate. I and many colleagues are uneasy about it, but the subject has become so charged that speaking up in public has felt like picking a fight. My new documentary on Channel 4, The Great ADHD Myth?, is an outlet for those in the medical profession to raise concerns and to find out what’s going on.
We’re usually told that the brains of people with ADHD are wired differently. But talking to Katya Rubia, professor of cognitive neuroscience at King’s College London, I discovered that when you compare brain scans of people with the diagnosis to those without, the differences are very small, and no scan is able to reveal who has the condition and who doesn’t.
It's easy to reframe everyday struggles as illness rather than part of life
So, how is it being diagnosed? Via a checklist of behaviours that includes: often talks excessively, often fidgets and fails to give close attention to detail. So much of it is vague and subjective.
I wanted to see how that works in practice, so I paid £1,200 for a private online assessment. I was told I had combined type ADHD, which I don’t accept for a moment. It shows how easy it has become to reframe everyday difficulties and struggles as a medical illness rather than as a part of life.
I was also prescribed lisdexamfetamine, which is given to thousands of children in the UK. Taking the drug, it was as though someone had quietly turned me down from 10 to about 7.5. That missing couple of points is more or less what makes me the person I am. I could see how a child on the medication would sit still in a classroom but complain that they don’t feel themselves.
At the heart of our documentary is 10-year-old Mason, who had been taking lisdexamfetamine for two years but wanted to come off the medication. His mum, Shauna, had started to wonder what the drugs were doing to his personality. Under the supervision of an independent doctor, Mason came off the medication for six weeks, gave up screens and ultra-processed food and spent more time outdoors and playing sport. He was more of a handful at home but happier in himself. “I finally get to be myself,” he told me.
Dr Max Pemberton.
What none of us had reckoned with was school, where those six weeks became far harder than the family had expected. Shauna faced an agonising decision as to whether her son should go back on medication.
Watching her weigh up the decision, I kept returning to the same thought, that if a 10-year-old cannot cope with school unless he’s taking amphetamines, the problem lies less in his brain than in what society and school are asking of him.
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We ask children to sit still for hours in an education system built around exam results rather than personal needs. Outside school, we hand them phones that fragment their attention before they’re 10, and we live at a pace that would leave any of us restless and unable to concentrate. And yet, we’ve decided the fault sits inside the child’s head. My hope is that after watching this documentary, more people start asking whether ADHD is caused by modern life.
Authors
Dr Max Pemberton
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