Opinion

Readers react to Kate Woodsome’s column on ADHD ‘illness’

Is ADHD a condition, a disorder, an illness, a neurodivergence, a superpower? Each person with ADHD with whom I talked chose a different word depending on the severity of their symptoms, how it affects their executive functioning and whether they have access to coaching, medicine or a supportive family, and school or work. Our readers reflected this, too. Here’s some of what they had to say. Comments below have been edited for brevity, clarity and style.

From neurodivergentcoach on Instagram: It’s not an illness. It forms part of the natural neurodiversity of the human race. Implying otherwise does a great disservice to the thousands of people with ADHD.

OdeDoc: I like the term “neurofabulous.” :-)

Rascally Rabbit: I have a sibling with ADHD who does fine with medication. He’s not ill, he is the way he is and this society doesn’t permit that. He takes meds which makes him more acceptable to society. I love him whatever he is.

Anne H from the bay: I don’t call myself neurodivergent because frankly I think it’s a meaningless term; all of our brains are different. But I do know my ADHD causes me distress and requires treatment. Whether that means it’s a chronic “condition” or “illness” I don’t care. … I get treatment for my ADHD because without it, I am not able to do the things I want to do. I am not trying to be someone I am not, I’m just trying to enjoy my life without feeling terrible all the time.

Aaron El WaPo: It’s deeply offensive to me that so many — and especially those with “differences” who are high functioning — can be so dismissive of those for whom the “differences” are so severe as to be debilitating. Illnesses are not diagnosed based on “difference”; they’re diagnosed based on symptoms that substantially interfere with daily life, and many require treatment well beyond “sheer willpower” to live even remotely functional lives.

Tina C: I mean, our brains don’t work the way brains are supposed to work. That’s a disease/disorder. I don’t think that having a disease/disorder/disability is anything to be ashamed of. I actually think it’s helpful to have it recognized as a disability. That way I can say to someone who thinks I got special treatment because I got to pick my cubicle at work when we moved space so I was far away from the printer and the busy hallway that there was no difference between my tiny accommodation than putting someone in a wheelchair closer to the elevator.

Woodsome: ADHD is highly hereditary and scientists are examining other risk factors, including brain injuries and exposure to toxins such as lead as a child. In childhood, the brain of someone with ADHD develops differently and often uses inefficient routes to send messages, according to psychology professor Susan Whitfield-Gabrieli, director of the Northeastern University Biomedical Imaging Center. Some people grow out of ADHD, but many don’t.

ADHD manifests differently in each person, but people can have difficulty regulating attention, behavior and emotions. People with ADHD can be highly sensitive to rejection, and studies show they have higher rates of depression and elevated risk of suicidal thoughts and substance abuse. Some people can manage their condition with organizational tricks. Others have found success with coaching, therapy or prescription stimulants that treat deficient levels of dopamine and norepinephrine, chemical messengers in the brain. For those with severe ADHD and no access to care, it can be a chronic illness that hurts their health, their relationships and their ability to learn or keep a job.

CDL66: Out of control, ADHD is a disease or disorder. Under control … well, after screwing up my academic/profession career path, I was diagnosed with ADHD at age 30. The difference from before that and the 25 years since then has been remarkable. I still have days I struggle, but there are also days when I’m able to use my controlled ADHD to get multiple tasks done well. I’m fairly sure I would prefer my controlled ADHD to being neurotypical if I had a chance to experience the latter.

I am Sascha: I do see that my brain is different, and some things have made it a lot harder to be mentally healthy, but it’s also given me huge advantages. I do not think of it as an illness so much as something that can make me prone to illness if I am not careful.

Woodsome: My column is a window into how our fractured health-care delivery system and hyper-connected culture can make people feel simultaneously better and worse. To make clear that a person is more than their neurodevelopmental condition, I start the piece with a successful young woman whose ADHD, when managed well, is a small part of her experience. Then I delve into the forces making it harder for millions of Americans with ADHD to get the support and resources they need, as well as ways we can make it better.

Why? Because in the United States, mental health is still treated differently than physical health by insurance companies, the government and large swaths of society. As a result, it is often underfunded, workplaces skimp on behavioral health care plans and, despite parity laws, insurance companies don’t always reimburse treatments fairly. My column aims to make clear to the government, insurance companies and society that we need to take ADHD seriously, and that doctors need training to properly diagnose and treat it.

NanSku: I think using the term illness is to show ADHD isn’t a personal failure, the same with depression. This isn’t a choice, it is something happening to them. People need the resources to deal with it just the same as cancer patients need treatment to deal with their illness. If the brain is involved you wouldn’t deny someone treatment for a brain tumor or aneurysm. Treating ADHD is lifesaving.

JMEopinion: I was on meds for ADHD for years and the med worked wonderfully. I was a better person for it, better being a wife, mother and teacher. Then, I turned 50, and insurance would not cover it anymore saying that any woman in her 50s shouldn’t need it anymore. I couldn’t afford it out of pocket, so I quit taking them … one of the most difficult transitions in my life. This was quite a few years ago, and all I can say now us thankfully, I’m retired, and my kids have grown and are independent. My hubby still doesn’t understand how my brain works, or doesn’t, but that’s another story!

Woodsome: A challenge of covering mental health conditions and neurodivergence is honoring the heterogeneity of experiences while using language that triggers protections and care for people living with them. Our vocabulary, like our understanding of the brain, will evolve in part because of conversations such as this. What is important is that people recognize they are not alone on the journey, and that their route will depend on where they’re coming from.