To Label or Not to Label
Is ADHD really a disorder, or just a different way of being normal (The Economist, 2024)? The Economist asked exactly this in an episode of its Babbage podcast, questioning why it's considered a disorder at all.
And yet, there it is in the DSM-5-TR, psychiatry's diagnostic manual, listed under "neurodevelopmental disorders." A disorder, by definition, is a clinically significant disturbance in thinking, emotional regulation or behavior: a dysfunction linked to significant distress or impairment. Put simply, it suggests something in us is broken. Is it?
I have children diagnosed with ADHD, and I strongly suspect that if I got tested today, I'd be diagnosed too, since I share many of their traits.
So is something in me broken? The word "disorder" carries a heavy negative connotation. And when roughly 6.5 million American children and 15.5 million American adults are living with an ADHD diagnosis, are that many of us really "disordered"?
Putting the Numbers Into Perspective
Around 1 in 16 Americans, children and adults combined, live with an ADHD diagnosis. At about 22 million people, that's roughly the population of Florida (23.5 million) or New York State (20 million).
Breaking it down further: children with ADHD alone would fill Los Angeles and Chicago. Add New York City, and you have all the adults.
And those are only the people who've been diagnosed. I'd argue the real figure is significantly higher:
Many adults, yours truly included, live with ADHD but have never spent the time or the considerable money to get diagnosed. Why bother, when the process is that expensive and exhausting?
I know what it took to get a diagnosis for my own children, and it wasn't easy. It was a fight. Unless a child has a parent with the knowledge and resources, or a teacher who spots the signs and pushes for an evaluation, they get overlooked.
I'd imagine we could add another big city or two to our ADHD population.
The Case for “Different”
Yes, a diagnosis can be helpful. It explains why someone can't focus or sit still, why their mind wanders, why they drift into daydreams and brain fog, and why they struggle with executive function and organization.
But (and this is a big one) what about all the great things that come with ADHD? Creativity. Thinking outside the box. And the two I value most: an almost superhuman hyperfocus that can border on genius, and the ability to get an enormous amount done, of course only when we're engaged.
Consider this:
What if society has got it all wrong?
Biologically and evolutionarily, we aren't built to sit still. We're meant to be outdoors far more than we are. We certainly weren't designed to drive everywhere, scroll through social media, outsource all of our thinking to AI, absorb a constant flood of information and have food delivered to our doorstep.
Is It Us, or the System?
And let's not forget sunlight. By high school, it becomes a rarity. Many high schoolers drive themselves to school: a quick walk to the car, a quick walk into the building. So when exactly are their bodies told it's morning? (Circadian rhythm, anyone?) Then they sit, and sit, with five-minute passing periods to move to the next room and sit some more. The only movement most teens get during the school day is the brief passing period or the occasional PE lesson. By the time school lets out seven painful hours later, the winter sun is going down, and they return to homework, test prep and yet more sitting. Am I the only one hearing alarm bells?
So do we really have ADHD, or has society set expectations that are unhealthy, unachievable for many, blind to individual ability, and at odds with how we're built?
Add to that the fact that diagnosis isn't always straightforward. ADHD symptoms can look a lot like seasonal affective disorder, too little sunlight, too little sleep, or simply an overworked teenager. With roughly 1 in 10 American children now diagnosed, I can't help but wonder...
As my professor, who specializes in what the field calls "exceptional children," put it:
"ADHD exists on a continuum. Society determines where the line for abnormal is drawn. Many of us have characteristics of ADHD." (Dr. John Forde, Loyola University Chicago).
I couldn't agree more. And exceptional they are: look at the challenges so many children face trying to fit into these strange societal norms, yet they go back every day and fight to keep up and do well.
Now imagine we took away the constant sitting and the lecture after lecture. Imagine children had room to explore, time to move, and time in the sunlight, which in winter has to happen during the school day or not at all. Imagine every student were offered the simple things that help (a short break, a walk to reset, access to the teacher’s notes, a little extra time on tests) without first needing a costly, lengthy evaluation. Would we find that many of us don’t need a diagnosis at all?
I'm living proof that ADHD can be a superpower when it's harnessed the right way.
When it isn't, it really can make you feel inadequate by today's educational and societal norms and expectations. But I'd argue that's only because we're all being squeezed into a box that doesn't fit. After years of not really loving school, I finally found my subject, psychology, and since then there's been little stopping me. My own family barely recognizes me. I love what I study. I can sit, read, focus and do incredibly well, because I've found my niche: something I'm good at, care deeply about and that makes complete sense to me. (Unlike the many math lessons where no one ever explained why we were learning calculus, or how it might ever matter in our lives.)
To Label or Not to Label?
Which brings me to Sir Anthony Hopkins, the celebrated Welsh actor (The Silence of the Lambs and Shadowlands, my personal favorite). He recently called neurodivergent labels "nonsense" and "rubbish":
I wholeheartedly agree that we shouldn't need a label. Just as we all look different, surely our brains are different too. These traits make us human and unique, and we should be celebrating individuality. Imagine a world where everyone is exactly the same. How utterly boring!
But, as much as I hate to disagree with Sir Anthony, a genius of his craft: when I think back to my own schooling, I wish there had been a label to explain my boredom and wandering focus.
For my own mental health as a child, I wish someone had given me a reason.
It wouldn't have changed much, except to let me know there was a reason and that it wasn't really my fault. And I could have learned strategies to cope with the constant distractions.
So here's my conclusion: Western school systems favor a particular kind of learner, one who can sit still for long stretches of time, focus, absorb what's being taught, and ideally look utterly fascinated while doing it.
What about the kids who need to move to focus, or use their hands? The kids who learn by doing? The kids half asleep in class because they've gone from room to room all day without seeing sunlight? The kids who need to act out vocabulary words rather than recite definitions? (That would be one of mine. Ask them a difficult word and they'll act it out while telling you all about it. They have to move while explaining.) None of that fits our Western model of sitting still to learn. But because of an ADHD label, everyone now accepts that this is how they learn and express themselves. In our house, that's just who they are.
So yes, Sir Anthony, I’m on your side.
We shouldn’t need a label.
What we desperately need is a way to educate children in the way that suits each of them best, and to give them the tools they need without first having to prove, at great expense, that something is “wrong” with them.
That means exposing them to all kinds of subjects so they can find what they love and care about, and maybe even telling them why on earth they’re learning calculus.
Sadly, society hasn't caught up to us yet. Maybe one day it will and realize we knew it all along.
Until then, I'll take the label.
In a one-size-fits-all system, it's the only way to stop being squeezed into a box that doesn't fit, and to get the individual plan (an IEP or 504 plan) that every child deserves, even if we still have to fight for it.
Citations:
Danielson, M. L., Claussen, A. H., Bitsko, R. H., Katz, S. M., Newsome, K., Blumberg, S. J., Kogan, M. D., & Ghandour, R. (2024). ADHD prevalence among U.S. children and adolescents in 2022: Diagnosis, severity, co-occurring disorders, and treatment. Journal of Clinical Child & Adolescent Psychology, 53(3), 343–360. https://doi.org/10.1080/15374416.2024.2335625
Jha, A. (Host). (2024, November 6). ADHD: Just a different way of being normal [Audio podcast episode]. In Babbage from The Economist. The Economist. https://www.economist.com/podcasts
Staley, B. S., Robinson, L. R., Claussen, A. H., Katz, S. M., Danielson, M. L., Summers, A. D., Farr, S. L., Blumberg, S. J., & Tinker, S. C. (2024). Attention-deficit/hyperactivity disorder diagnosis, treatment, and telehealth use in adults—National Center for Health Statistics Rapid Surveys System, United States, October–November 2023. Morbidity and Mortality Weekly Report, 73(40), 890–895. https://doi.org/10.15585/mmwr.mm7340a1
Wright, T. (2025, November 2). Anthony Hopkins calls mental health labels ‘nonsense,’ dismisses autism diagnosis from his wife. Fox News. https://www.foxnews.com/entertainment/anthony-hopkins-calls-mental-health-labels-nonsense-dismisses-autism-diagnosis-from-his-wife