Find a therapist to help with ADHD

Brain scans only show group averages, not a neurological marker that identifies an individual with ADHD.

High heritability does not show that ADHD—or any individual’s difficulties—is largely caused by genes.

Recognition and support do not require making diagnosis the explanation for people’s struggles.

Following the Channel 4 documentary The Great ADHD Myth?, which aired in August this year, the Royal College of Psychiatrists issued a statement about it in which it described attention-deficit/hyperactivity disorder (ADHD) as a “well-established neurodevelopmental disorder,” the legitimacy of which "should not be questioned." An accompanying statement went further, stating, "Whatever you think about ADHD, its scientific basis is not in doubt."

These responses, and others, cite evidence of genetic and neurological differences, responses to stimulants, and institutional consensus as establishing the diagnosis of ADHD as “real” and beyond scientific doubt, treated as though they establish it as a distinct neurobiological entity, substantially genetic in origin. These are scientific claims that very much depend on evidence. The crucial question, then, is what the cited evidence actually establishes.

In a recent BMJ response that I co-authored with Joanna Moncrieff, Lucy Johnstone, and James Davies, we distinguished among the “experiential reality,” “institutional reality,” and “ontological reality” of "ADHD is real." These are very different claims, and they are used interchangeably in a way that misleads.

Three meanings of “ADHD is real”

First, "ADHD is real" is used to refer to the reality of the experiences and behaviours that are diagnosed as ADHD—difficulty with concentration, organisation, impulsivity, restlessness, and the demands of everyday life, sometimes in the extreme. This is ADHD's experiential reality. These experiences and behaviours are undoubtedly real.

The second meaning refers to the institutional reality of ADHD. It is a recognised psychiatric diagnosis, used by clinicians and healthcare systems........

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