ADHD - An Alternative Understanding

Author: David Schepkowski - Published (Original): 29.11.2024 - Published (English Translation): 02.12.2024

Despite all the advanced knowledge about ADHD, many misconceptions still persist today. From the belief that adults cannot be affected, to fears of medication turning individuals into "zombies," to unhealthy self-perceptions among those diagnosed regarding the advantages and disadvantages of ADHD—there is still much awareness to be raised. As someone with ADHD, who also observes the impact of these prejudices on clients and my own children, I hope to contribute to an alternative understanding and a healthier idea of humankind through this article.

Preface: This article stems from an informational evening I organized for parents at my son’s daycare. I would like to take this opportunity to thank the local educators for this chance, as well as all other professionals who contribute daily to the inclusion of our children everywhere.

Introduction

ADHD is a condition that affects more people than we might realize. It is often accompanied not only by numerous negative impacts on those affected and their families but also by just as many misunderstandings. While medicine and science strive to provide education and alleviate suffering, such efforts are tied to lengthy processes. Above all, a supportive society is needed—one that can provide individuals with ADHD a compassionate environment starting from childhood. This is not about excusing harmful behavior but rather about fostering responsibility on all levels.

The goal? To give affected individuals the same opportunities for a self-determined and healthy life, enabling them to contribute meaningfully to the very society in which they want to feel seen and supported. I myself received the diagnosis only in adulthood, after years of battling depression and social anxiety. Additionally, I face daily challenges as a single father of two children with ADHD. As an ADHD & Life Coach, I’ve made it my mission to promote awareness. 

In this article, I use some common assumptions about ADHD as a basis to enhance understanding of the topic and advocate for a compassionate perspective on humanity, fostering a sense of togetherness from which everyone can benefit.

Assumption #1 – People with ADHD Can’t Focus

ADHD stands for Attention Deficit Hyperactivity Disorder, highlighting the core elements that come to the forefront during a diagnosis. However, the term is misleading for most people, as not everyone experiences the same symptoms. A phrase like "Can you please put down your phone and listen to me!?" is not only a common refrain in many families and relationships, but it also shows that individuals with ADHD can very well focus their attention on other things—just not always on what is currently important.

Prolonged focus on an interesting topic or on internal negative emotions (also known as hyperfocus) is as characteristic of people with ADHD as the difficulty of breaking away from that focus. "Attention-shifting and self-regulation disorder" would be a term that better captures the actual symptoms, causes, and strategies for dealing with them. By the way, the aspect of attention deficit has nothing to do with affected individuals not receiving enough attention themselves. In fact, it is often the case that parents give excessive attention and thus power to the negative behaviors of affected children, which in turn amplifies the symptoms.

New Assumption: More awareness and collaboration between researchers, educational institutions, parents, and those affected are needed to truly address the condition. This includes rethinking terminology and diagnostic criteria.

Assumption #2 – Only Children Have ADHD

 Who doesn’t know the stereotype? The image of a schoolchild who can’t sit still, disrupts class, and forgets their homework. From personal experience, I can say not only that parents, with the right support, can counteract such consequences, but also that with a diagnosis and the accompanying assistance, these problems can be mitigated well into adulthood.

ADHD is also referred to as a neurological developmental disorder, which means that its symptoms generally improve with brain maturation throughout childhood development, typically into the twenties. This explains the statistics indicating that, depending on testing methods and diagnostic criteria, approximately 2-10% of children in Germany are considered affected, compared to only about 2-5% of adults. However, this does not account for the undiagnosed cases, which are estimated to be significantly higher due to infrequent diagnoses, and it contradicts the understanding that ADHD cannot be cured. Once you have ADHD, you always have ADHD!

The lower rate of diagnosis in adults, however, cannot be explained solely by brain maturation but is also related to the symptomatology of ADHD. Adults experiencing distress often struggle with self-doubt but barely manage to cope using unhealthy coping mechanisms. This prevents them from persistently seeking support. The result: those who did not receive a diagnosis as children are excluded from the statistics.

New Assumption: Traumatic experiences from childhood often lead adults with ADHD to either hide their condition or remain unaware of what is "going wrong." However, they also deserve appropriate recognition and support options.

Assumption #3 – Girls Don’t Get ADHD

 When imagining a schoolchild with ADHD, most people might first think of a boy. This reflects the gender distribution statistics: boys are said to be two to four times more likely to be affected by ADHD than girls. However, this discrepancy can also be explained by detection rates. Some symptoms manifest differently or in milder forms in girls compared to boys. Due to a natural developmental advantage in social skills, girls often adapt better to the expectations of school, parents, and peers. Despite this, girls also experience personal struggles and difficulties with concentration but are often overlooked.

It’s only when girls exhibit “typical” ADHD behaviors (such as hyperactivity or impulsiveness) that those around them take notice. I’ve observed these differences in my own children—a boy and a girl—as well as in myself. As a frightened boy who didn’t fit the typical ADHD profile, I was socially, and eventually academically, left behind.

New Assumption: Girls are also affected by ADHD and often suffer, often in silence, from its symptoms. Academic performance and social compliance should not be the sole benchmarks for fostering a healthy self-image in children.

Assumption #4 – There Are Different Forms of ADHD

Yes and no. In the past, a distinction was made between ADHD and ADD (a variant without hyperactivity), but this differentiation has since been abandoned. Currently, three main subtypes are specified: predominantly inattentive, predominantly hyperactive-impulsive, or combined. However, there are doubts as to how far hyperactivity can be considered a decisive diagnostic criterion.

Nevertheless, this approach brings us closer to a more individualized perspective, especially since it does not differentiate between genders. Beyond the basic symptomatology, treatment must be tailored to the level of individual characteristics, which do not always align with the concept of "ADHD types" and are often preferable to a strict subdivision into subtypes.

New Assumption: Statistics and typologies may be helpful for general treatment recommendations, but they do not always apply to individual cases. Individual traits, even those that go beyond ADHD itself, need to be given more consideration.

Assumption #5 – Today, Everyone Claims to Have ADHD

This dangerous assumption, which finds no support in reality, is accompanied by some of the most harmful prejudices, making it all too easy for many to ignore the suffering of their fellow humans. The fact is that the number of ADHD diagnoses has increased over the years. However, there are valid reasons for this. On the one hand, mental health issues are increasingly entering the awareness of our society. Records from ancient times already suggest that people with ADHD have always existed—just like individuals with autism or left-handedness, who until not too long ago were also treated as "disordered." On the other hand, greater awareness has led to more people seeking treatment, which naturally also increases the absolute number—though not necessarily the percentage—of misdiagnoses. Yes, there are individuals who self-diagnose, use it to gain attention, or use a diagnosis as an excuse for their behavior.

This can be explained, among other things, by the dynamics of social media, where rapid group formation influences perception, creating the appearance of a binary world of "normal" and "abnormal." This is a phenomenon that can be found in any trend. It is partly rooted in human nature and can only be addressed through increased societal awareness and individual accountability. And while, as someone affected by ADHD, I personally find it frustrating that a distorted image of ADHD is misused for sensationalism by certain parties, this is an expected cost of raising awareness. These tensions must be borne within a supportive community, and they simultaneously offer an opportunity to transform into productive cooperation.

New Assumption: The movement toward greater awareness of mental disorders is still in its infancy and is thus accompanied by growing pains. These do not reflect reality and must not allow a few opportunists to dictate the direction of progress.

Assumption #6 – Children with ADHD are just poorly raised

 The way children grow up and are raised has a significant impact on their future. Parenting guides and support benefit all families, but especially those dealing with ADHD, which often require additional assistance. For example, children with ADHD unintentionally challenge their parents to adopt an authoritarian parenting style. However, this approach exacerbates ADHD symptoms, leading to the classic vicious cycle known to nearly all affected families.

The results are often resignation from exhaustion and a loss of responsibility in a permissive parenting style, where the child is essentially left to fend for themselves, or a desperate attempt to regain control over the family. If at least one parent also has ADHD—highly likely given the 70–80% inheritance rate—uncontrolled outbursts of anger can make it nearly impossible to establish a structured, guiding, yet understanding (authoritative) parenting style.

A comforting thought: ADHD is not caused by poor parenting but is primarily genetic. However, a skilled approach on all fronts, adjusted to the child's developmental stage and supported with appropriate medication, significantly improves an ADHD individual’s future prospects. Without such support, the consequences can be devastating, including reduced life expectancy due to risky behaviors leading to accidents, heart and blood sugar diseases, increased susceptibility to addiction, and even personality disorders and depression with higher suicide rates. Parents can only do so much alone, and even with available support systems, finding the necessary expertise is often challenging.

New Assumption: Parents are not to blame for the existence of ADHD, but they can play a crucial role in helping their children pave the way for a healthy, independent, and responsible life. Recognizing one’s own potential diagnosis and learning to manage it is often the key factor.

Assumption #7 – ADHD Medications Turn Children into Zombies

This is a persistent notion. Medications remain the most effective treatment, particularly in childhood, before the brain has matured and therapeutic measures can take full effect. However, until relatively recently, the mechanisms of these medications were not well understood. This lack of understanding in the past led to doses that were too high, which indeed resulted in a sort of "sedation." Additionally, there is the phenomenon where parents, particularly those with ADHD themselves, perceive the behavioral changes in their child—even when the medication is properly dosed—as problematic.

One reason for this lies in parents’ identification with their child. Any behavioral change after taking medication is, understandably, observed with skepticism. Seeing one's own child from a new perspective is naturally challenging. While not downplaying potential side effects, it is worth noting that ADHD medications are among the most thoroughly researched psychiatric drugs. The positive impact of these medications is often best illustrated by statements from those affected, such as, "I paid attention today in school!" "I haven't forgotten my homework in a long time!" or "I finally managed to make friends!"

Moreover, these medications counteract the dopamine deficiency that underlies ADHD (and thereby partially address a deficiency in adrenaline and noradrenaline). This critical neurotransmitter activates mechanisms related to motivation, the reward system, and so-called executive functions (such as working memory, organizational skills, and self-regulation). Advances in brain imaging techniques and decoding human genetics increasingly demonstrate that while people with ADHD are not free from responsibility for their behavior, they are not to blame for its causes. This research also increasingly supports the hypothesis that ADHD has an evolutionary basis.

New Assumption: Medications should and must be critically evaluated, just as one's own opinions about them should be. In the end, each individual case matters, as there is a wide range of drugs that can mitigate the worst consequences of ADHD. If such measures, combined with other support options, create a solid foundation for life, a transition to other medications or even a complete discontinuation of treatments may be possible in adulthood.

Assumption #8 – ADHD only has Disadvantages

Among all prejudices, this one is most often propagated by those affected themselves. This is for more than understandable reasons when considering, alongside the previously mentioned consequences of shortened life expectancy, declining academic and professional performance, broken relationships and friendships, and the accompanying self-doubt and unhealthy coping strategies. Contrary to societal perception, many individuals with ADHD do indeed feel a sense of responsibility. They are often acutely aware of their behavior and its consequences, especially as adults, even if they do not understand its origins or how to address it. When this awareness meets misunderstanding or even hostility from others—starting in childhood, where they are labeled as “idiots,” “lazy,” or “nuisances”—the options often boil down to retreat, rebellion, or resignation.

Nevertheless, it is entirely possible to lead a good, self-determined life with ADHD, one built on personal values, personality, and interests. Achieving this requires the courage to take responsibility for one's behavior while also showing self-compassion. By doing so, individuals with ADHD can begin to harness the strengths inherent in their condition. Given the high prevalence of ADHD in the population, the historical documentation of its symptoms long before formal psychological classification, and its high heritability, one might conclude: ADHD should not be viewed solely as a disorder but as a product of evolutionary adaptation. When dopamine deficiency occurs, it not only produces the typical symptoms of a disorder but also leads to significant advantages.

This phenomenon can be explained by the less active internal filtering and evaluation mechanism in people with ADHD. This means that external stimuli—such as sounds, movements, and others' facial expressions—as well as internal stimuli like emotions, thoughts, and impulses, are more frequently perceived. As a result, individuals with ADHD may be more easily distracted or quicker to anger but are also more open to new experiences and more active. The same mechanism that leads to “disruptive” behavior in a modern world also contributes to behaviors that historically made people with ADHD valuable members of society:

• The daydreaming late riser becomes a vigilant watchman.
• The hunger-stricken slacker becomes a skillful hunter.
• The fidgety defiant becomes an adrenaline-driven warrior.
• The forgetful chatterbox becomes a creative problem solver.
• The curious klutz becomes a courageous  explorer.

Tribal groups, and humanity at large, could greatly benefit when curious individuals tried unfamiliar, potentially toxic food or when foreign tribes were conquered and mixed with. The fact that many of these “occupations” often led to a quick yet heroic end might explain why the ADHD gene did not become more widespread, yet remains preserved: in the end, the hero gets the girl - and the heroin gets the boy.

New Assumption: The modern world was not designed for people with ADHD. However, building a society on self-flagellation or self-pity by affected individuals, only to have them shatter at its foundation, cannot be the goal. A stronger focus on insights into the often neglected area of evolutionary psychology proves to be both worthwhile and necessary.

Conclusion

Even though I do not advocate for a return to the times of our ancestors, we all seek a place in society—a society that no longer considers the needs and strengths of individuals with ADHD. But those niches do exist for us. We are the elite athletes and emergency responders, the entertainers and artists, the founders and inventors. We thrive in society’s extremes, immersing ourselves in them—for better or worse.

So, my final appeal to all those affected: Don’t deny yourselves the opportunity to take control of your own lives. You stand to benefit the most by not defining yourselves through a diagnosis. To everyone else, I’d like to share an African proverb, whose author must have been talking about a child with ADHD: “It takes a whole village to raise a child.” I hope this underscores the shared responsibility we all carry.

P.S. Would you like to learn how to lead a self-determined life with ADHD or need support in getting a diagnosis? Perhaps you’re a family member or professional who could benefit from more information about ADHD? Feel free to contact me or book a free initial consultation, and let me guide you as your coach. See you soon!

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