Is it ADHD or is it modern-day life?

Because I, for one, have been finding it hard to tell.

Photo by Steve Johnson on Unsplash

It’s any given weekday morning and I’m at the kitchen bench, a headful of must-dos mounting.

Library day for my youngest. Make sure he’s got his books.

Homework due for my middle child. Check she has her glasses.

Dance this afternoon for my eldest. Remind her to get her gear.

As I’m doing this, I’m packing a dinosaur bento lunchbox with a kaleidoscopic range of foods cut into elaborate shapes. I never thought I’d be this sort of parent, but having a couple of fussy eaters can take you to some strange places.

Case in point, I’m now wondering what other foods I could buy or magical recipes I should try that might just do the trick. I feel tired just thinking about this but then another thought pops up cautioning me against labelling my kids as ‘fussy eaters’ – even in the privacy of my own mind. It's likely damaging them in one way or another, which reminds me I really should follow up on that paediatric referral regarding something else entirely unrelated.

My train of thought is interrupted by my husband checking in with me on afternoon logistics. My reply to him is interrupted by my eldest asking me where her school shorts are – even though I’m certain by now we both must know they are where they are nine times out of ten i.e. her wardrobe. My explanation – and let’s be honest, exasperation – is interrupted by my middle child asking me to do her hair just as my youngest attaches himself to my leg declaring he needs a mummy huggle. ‘Now!’

As I look between my husband and three children, all four of them simultaneously asking something to me or of me, I have to wonder, is it ADHD distractibility or is it the impossible demands of modern-day motherhood?

Things that make you go hmmmm…

The question of whether or not I have attention-deficit/hyperactivity disorder (ADHD) is something I’ve been sitting with for a good couple of years now.

Suspicions were first raised after a psychologist suggested it might be something we consider exploring for one of our kids. Going down a rabbit hole, I soon discovered the high heritability rate of ADHD, which studies suggest is around 80%. During this process I also learned more about ADHD symptoms, which broadly speaking include issues around inattention, and/or hyperactivity and impulsivity.

My next clue came after two close friends – from separate social circles – told me, unprompted, that they’d send me the adult ADHD self-report scale questionnaire following their own recent diagnoses.

Curious, I took a look…

Q. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?

An article I wrote for Mamamia on procrastination springs to mind.

Q. How often do you have difficulty unwinding and relaxing when you have time to yourself?

Well, um, only really… Every. Single. Time.

Q. How often do you feel restless or fidgety?

Wait, what? Restlessness is a symptom? I had long ago just accepted this as one of my annoying character traits.

It was at this point that I decided it might be sensible to go see a psychologist specialising in adult ADHD. Six sessions later, I was told that seeking a formal diagnosis would be advisable.

It’s complicated

Globally, it’s estimated that more than 366 million adults are affected by ADHD, suggesting it may be the most common mental health condition in the world right now. According to recent data from the Australian Bureau of Statistics, an estimated 1.5 million Australians currently have ADHD. Over the past five years, ADHD medication levels have more than doubled in Australia. So, what’s going on here?

Well, it’s kind of hard to say for sure. One school of thought suggests that it’s not so much the prevalence of ADHD that is increasing, but rather the number of cases being formally diagnosed that is rising. Largely, this is put down to greater awareness of ADHD symptoms – I see you TikTok and your 36+ billion views of #ADHD.

As Mimma Mason, cognitive scientist recently told news.com.au, “Diagnoses are on the rise because we know so much more about ADHD now. The more people learn about the symptoms of ADHD, the more they are seeking confirmation or diagnosis.”

However, according to others this is just one part of a much larger puzzle. For instance, Dr Gabor Maté, physician, author and renowned addiction, trauma and ADHD expert recently shared his thoughts on The Mel Robbins Podcast.

“Western medicine … tends to look at things purely from a biological point of view, so ADHD is considered a genetic disease that you inherited. Here’s the problem with that, if that's the case, why are the numbers going up? Genes don't change in a population over 10, 20, or 30 years. Something’s going on in the environment that’s affecting child [brain] development.”

“The brain is a social organ,” continues Maté. “It's interactive with the environment all our lives and therefore environmental conditions affect the brain.”

Dr Trenna Sutcliffe, a developmental behavioural paediatrician and director of the Sutcliffe Clinic in California concurs that environmental factors such as diet, pollution, toxin exposure, paternal age, maternal stress etc. are just some contributing factors in the rise of neurodivergence.

Sutcliffe recently theorised further on The Peter Attia Drive Podcast saying that epigenetics – which is how behaviours and environment can impact and change gene expression – may also be at play. Though as yet, this idea remains unfounded.

Whilst Maté doesn’t subscribe to ADHD being a purely genetic condition, he does believe there is a genetic component being passed through families that’s relevant.

“There is something genetic here and that’s sensitivity. The more sensitive kids are, the more they feel what's going on around them … then they’re told ‘You’ve got a genetic disease’. No, you don't, it's an adaptation. As with many childhood adaptations, later on they create problems. They served their purpose but now they are wired in.”

Or as Robbins reiterates, “The genetics loads the gun, but the environment pulls the trigger.”

Make it stop

It’s the last week of the longest school holidays in the history of school holidays (Australian parents, you know what I’m talking about). It’s nearing forty degrees Celsius out, the air-con’s not coping and quite frankly, neither am I. I’m sweating. Not just because it’s peak summer and I’m a woman in her forties, but also because I’ve got freelance work due, I've got a husband away for work, I’ve got washing to hang out, meals to make and I’ve got three kids at home with me while all this is happening.

When I’m on deadline and the kids are home, it generally means two TVs, not all that far from each other (thank you open plan living), are going at the same time – a war of incremental volume increases afoot. There’s also likely a washing machine tumbling, a dishwasher purring and a sibling squabble soon about to erupt, cue the high pitch squeals and blood-curdling screams. And, just for good measure, someone will likely decide now is the perfect time for a spot of impromptu recorder practice.

I’m trying hard to finish my article and get it filed despite three different people interrupting me every sixty seconds with requests for, I kid you not… MORE! SNACKS!! Clearly, I’m overstimulated AF, which is little surprise given I’m a person with functioning auditory faculties who’s barely had a day to themselves in close to seven weeks. Yet still, a part of me wonders, is it ADHD sensory overload, or is it a lack of community rife in modern-day nuclear family structures?

Sliding scale

One of the trickiest parts about diagnosing ADHD is that there is no conclusive way of testing for it. In a piece for The Sydney Morning Herald, aptly titled Why has everyone suddenly got ADHD? Amanda Hooton writes, “No genetic tests, no blood or biochemistry markers, no brain-imaging methods can tell you, categorically, that you have [ADHD].”

It also exists on a spectrum, as Sutcliffe points out, “We're all on a bell curve for all of these diagnoses.” This is where impairment becomes important.

In Australia, adult ADHD assessments are carried out via a formal interview with either a psychologist or psychiatrist to determine the prevalence of symptoms. The Diagnostic and Statistical Manual of Mental Disorders, currently in its fifth edition (DSM-5) provides a list of 9 inattentive and 9 hyperactive-impulsive symptoms.

For children, 6 of the 9 symptoms must be present to reach the threshold for diagnosis, while for people aged over 17 years, only 5 symptoms are required.

Additionally, what’s trying to be determined through a clinical interview is the overall impairment these symptoms present to an individual’s day-to-day life. Generally, this will take into consideration various aspects of life, such as relationships, home, work, school, mental health etc.

Impairment impact

When I consider my own potential impairment, at first glance, I wouldn’t say it’s all that high. Sure, I tend to run a bit late but I’m not the super-duper late type. I’m also generally pretty organised and our household runs as smoothly as can be expected with two working parents and three rambunctious kids in it. I’ve got two degrees and apart from taking stints out of my career for child-rearing purposes, I’ve always been employed. Likewise, I’m fortunate enough to have more than a few healthy, meaningful relationships in my life.

That said, there are some less obvious things. For example, my procrastination and rumination, which can act like fuel to my anxiety igniting other firestorms like insomnia. But is that ADHD related or is it a normal response to living in a fast-paced, uncertain world rapidly moving far beyond what our evolutionary wiring was made for?

Can I have your attention please?

It’s any night of the week and I sit down on the couch with my husband after we’ve eventually got the kids fed, bathed and into bed. I open my phone for some mind-numbing escapism and I’m instantly up to my eyeballs in unread messages I need to reply to across six different platforms or apps.

I open Instagram (because we all have our favourites) and before I know it I’ve seen cyclone warnings, destructive floods, shark attacks, war-torn countries, countless casualties, three different ADHD memes and Kylie and Timothée more times than I can count – yet somehow I’m still not sure how to pronounce his name properly. It takes me a good ten minutes or more before I realise, I haven’t even opened the inbox I specifically came onto this app for.

Coming as a surprise to literally nobody who owns a smart phone, research indicates that attention spans are shrinking. In 2004, attention spans on any screen averaged out at two and a half minutes. By 2012, this had fallen to 75 seconds and in the last five years it’s reduced further and is now believed to be an average of 47 seconds or less.

Begging the question, is it ADHD inability to focus or is it modern-day technologies, purposely built to be addictive teamed with a 24-hour news cycle promoting relentless information-overload?

Where to from here?

It’s today and I’m trying to gather my thoughts to finish this article, which is proving more difficult than I anticipated. The more I seem to learn about ADHD the more questions I have, even/especially with a formal diagnosis.

Turns out, I’ve got what is clinically described as mild to moderate ADHD combined type (meaning inattentive/hyperactive) even though, as stated in the report, my official criteria ratings are near threshold levels and are actually under for inattentive symptoms.

Informally, my doctor described me as a ‘borderline case’, which leaves me in a strange kind of no-man’s land with my diagnosis.

I don’t really identify with the life-changing revelations that many ADHD diagnoses have given people, especially women like me in their forties, who have – with less overt symptoms – historically slipped through the cracks. Part of me almost feels like a Johnny-come-lately, jumping on the bandwagon of a societal hot topic, despite having gone through all the proper processes.

Likewise, I’m left wondering, is my case severe enough to medicate? My doctor says yes. But should I be looking more broadly at environmental factors rather than relying solely on medication? It seems sensible.

If nothing else, one thing’s clear here… me and my busy brain have a lot more things to sit with and sift through yet.

How ‘bout you?

What are your thoughts on this very big topic of ADHD increases? What do you know to be contributing to it, and do you have any personal experience with this? I’m curious to know. Share your thoughts in the comment below.