ADHD is no longer a subject confined to paediatric clinics and psychology practices. The disorder has seeped into mundane conversations, from social media checklists to those viral self-assessment videos. There is increase in awareness but it has also led to an opposite problem —many people interpreting normal behaviours such as forgetfulness or difficulty concentrating at school or work as ADHD.
The experts say the true challenge is finding a position that balances two profoundly opposing types of risk: falsely classifying genuine cases, and over-interpreting behaviours which may be explained by other means.
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ADHD is not simply about being distracted, restless or forgetful. These behaviours become clinically significant when they are persistent, occur across settings, begin during childhood and substantially interfere with functioning,” says Dr. Radhika Sharma, Consultant Child and Adolescent Psychiatrist. “A checklist can raise a question, but it cannot establish a diagnosis.”
Using Social Media as a Diagnostic Tool
Social media is flooded with ADHD content and many people are recognising symptoms they might previously have spent a lifetime ignoring. A person who constantly loses their keys, interrupts conversations, struggles to concentrate in noisy environments or feels mentally restless may watch a few videos and conclude they have ADHD.
But recognising a symptom is not the same as meeting the criteria for a neurodevelopmental disorder.
“Almost everyone experiences occasional forgetfulness, procrastination or difficulty focusing. ADHD is defined by a persistent pattern of symptoms that causes meaningful impairment, not by the presence of a few relatable traits,” explains Dr. Sharma.
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Self-tests available online can therefore be useful as a starting point for discussion, but they should not be treated as diagnostic tools.
Increased diagnoses: overdiagnosis or simply better detection?
Research by British scientist Samuele Cortese and coworkers, on 16 March 2022 in The British Journal of Psychiatry, estimated that worldwide prevalence of attention-deficit hyperactivity disorder (ADHD) is near to 5.4% amid children and youth. This is equivalent to around one in every 20 children.
At the same time, psychiatrist Anita Thapar has argued in Child and Adolescent Mental Health that the condition may still be under-recognised in some populations, despite the increase in diagnoses.
So, does a rise in diagnosis automatically mean overdiagnosis? Not necessarily.
The broadening of diagnostic criteria have too expanded the number who might fit the definition. In 2013, the DSM-5 raised the age at which some symptoms needed to have been present from before age seven years to before age 12 years. The number of symptoms criteria needed in certain presentations was also lowered from six to five for adults.
Dr Sharma says: “These changes led to detecting people who might have remained undiagnosed before, especially older children and adults.” “But wider criteria also make the careful clinique on evaluation even more imperative.
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Why ADHD Can Be Mistaken for Something Else
One of the biggest problems with ADHD assessment is that its symptoms are not exclusive to ADHD.
Poor sleep, anxiety, stress, learning difficulties, emotional problems and challenging family circumstances can all affect a child’s attention, behaviour and ability to regulate emotions.
A child going through significant stress, for example, may become unusually restless or distracted. Similarly, chronic sleep deprivation can produce irritability, impulsivity and concentration problems that may resemble ADHD.
“Before diagnosing ADHD, clinicians need to ask what else could explain the behaviour,” says Dr. Navin Kapoor, Developmental Paediatrician. “Sleep, anxiety, learning difficulties, hearing or vision problems, family stress and other developmental conditions should all be considered.”
Why a Five-Minute Diagnosis is a Problem
For this, note that ADHD cannot be diagnosed with a single questionnaire or by spending 10 minutes at the office with the child. An appropriate evaluation usually considers the child’s developmental history, symptoms across settings, academic and social functioning, reports from parents and teachers, and alternative diagnoses.
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Dr. Kapoor says, “Parent and teacher questionnaires are important pieces of the puzzle—not the whole puzzle. They should be diagnosing based on a comprehensive clinical assessment rather than a score on a form”
Awareness Without Overdiagnosis
There are increasing discussions around ADHD, the conversation itself is not a bad one. This can raise awareness and lead to adults and children finally getting the right help they need after years of struggling. The danger is when that awareness goes into self-diagnosis and every energetic, dazed or impulsive child gets assessed for ADHD.
Dr. Kapoor notes, ““We should neither label normal childhood behaviour as ADHD nor dismiss a child whose difficulties are genuinely affecting their education, relationships and daily life. The goal is not fewer diagnoses—it is more accurate diagnoses.”
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ADHD may be everywhere in the conversation. But that does not mean it is behind every moment of restlessness, forgetfulness or lost concentration.
