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A new culture war is brewing over autism and ADHD

Prescriptions for children diagnosed with ADHD and autism have gone up significantly in the last three years. Credit: Getty

April 7, 2024 - 2:00pm

When the National Health Service was founded in 1948, the then Health Secretary Aneurin Bevan optimistically argued that expenditure would fall over time, as the population grew healthier and technology advanced.

Within a few years this early optimism proved displaced, as improved public health and medical innovations led to a population living ever longer and with increasingly complicated demands on a health service originally designed to stop people dying from pneumonia and tuberculosis.

As once happened in the realm of physical illnesses and disease, there is now a similar process underway with psychiatry and mental health, with a vast increase in diagnoses of autism, ADHD and related disorders, and a health service designed for a time, only a few years ago, when the prevalence of these conditions was believed to be much rarer.

According to new NHS data, the number of patients waiting for an autism assessment in England is at its highest level since current records began in April 2019, with over 172,040 people on waiting lists, compared with just 32,220 in December 2019.

There is plenty of debate around the reasons for this increase in diagnoses, and many people with autism or ADHD report that Covid-era lockdowns exacerbated their symptoms, whilst providing others with a great deal more time for internet research and self-diagnosis.

There has also been a wave of high-profile adult diagnoses among various celebrities, with barely a week going by without a footballer, model, or MMA fighter talking about their experiences with autism, ADHD, or both.

In fact, a new report from the Nuffield Trust has found that there had been a 28% increase in drugs designed to treat ADHD prescribed to 10-14-year-olds — but a massive 146% increase in such prescriptions for 30-34-year-olds.

It is this huge increase in adult diagnoses that has the potential to cause division among people with these conditions, and to make the issue increasing politicised. While such diagnoses can be beneficial in helping high-functioning adults make better sense of their life, they are considerably more important for children with very severe manifestations of these conditions.

As there are more and more people going undiagnosed and failing to receive treatment and advice that could be vital to their health, education and well-being, there will be increased resentment from the parents and carers of those with more severe forms of these disorders towards those less obviously impacted by their condition.

For their part, many of those with milder forms — and this is especially for a certain kind of Left-wing social media user — resent the use of terms such as “severe” or “profound”, and therefore the implication that they do not truly have the same condition.

The rise in people being referred for and putting themselves forward for diagnosis shows no sign of abating, all while there is a clear shortage of medical professionals and resources to deal with such an increase. It appears, then, that the discourse around who “really” has autism or ADHD will grow increasingly rancorous.


David Swift is a historian and author. His next book, Scouse Republic, will be published in 2025.

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El Uro
El Uro
1 month ago

Google autism, read three or four pages and you will find you have all the signs of mild autism. If you read ten pages, you will be sure that you have severe autism

Arthur King
Arthur King
1 month ago
Reply to  El Uro

There are many people like myself who are part of the Broad Autism Phenotype. Often the families of people with the classical definition of autism also have autistic traits. Your comment that everyone will find themselves to be autistic is absurd and dismissive. The definition is just widening and will include more people.

El Uro
El Uro
1 month ago
Reply to  Arthur King

These kinds of comments evoke in my memory the same feelings as the pestering of annoying beggars near the church, showing off their ulcers and deformities.
You feel a bit sorry for them until there are too many of them.
.
PS. Remember MeToo!

Endless Keys
Endless Keys
1 month ago
Reply to  El Uro

So, a group of people have ulcers and deformities- Your response is to not treat or aid? Your response is to call them annoying and dismiss them? Where did you learn this behavior? Because this is a behavioral response, not a logical one. It’s learned.

Are you implying that neurodivergent people just want to be felt sorry for? Empathy is not pity. The Oxford dictionary defines empathy as “the ability to understand and share the feelings of another,” while pity is “the feeling of sorrow and compassion caused by the suffering and misfortunes of others.” Heck, you don’t even need to empathize. It’d be kind and make the world a better place, of course. It’s just kind, not a requirement.

Why did you associate this with the Me Too movement? Was that choice to also dismiss sexual harassment and assault victims of the Me Too movement. A victim only means someone who has been wronged. A person who refuses to learn, wrongs themselves- that is self victimization. Even then, that person deserves care because that is what a good society does. It does good. It tries.

Therapy is a great treatment for people regardless of diagnosis. But, it works best when the person acknowledges they have a problem and seek it themselves.

Arthur King
Arthur King
1 month ago
Reply to  El Uro

I find your hyperbolic statements funny. Even if that isn’t your intent. Showing off deformities… lol … it is also ironic. I believe that BAP phenotypes are an evolutionary advancement. Social intelligence is shed in favor of higher rational and strategic intelligence. BAPs are found in high numbers in tech as are fully autists. I don’t share this view that autists are more evolved since it seems unnecessarily belligerent towards neurotypicals.

Tyler Durden
Tyler Durden
1 month ago
Reply to  Arthur King

Or that introversion and a modicum of social disconnect provide the basis for a skillset embraced as optimal by the tech industry.

Benedict Waterson
Benedict Waterson
1 month ago
Reply to  Arthur King

Is the definition of ASD vs ‘neurotypical’ really just ‘people who are less social’ vs ‘people who are more social’?
If so, what is the point of this definition?
What broad social purpose does it serve to impose a diagnostic term claiming to define people who are ‘less social’ – who might be ‘less social’ in a wide variety of ways not understandable via a general term?

Rasmus Fogh
Rasmus Fogh
1 month ago
Reply to  Arthur King

Well, but what does it mean that “the definition is widening”? If I can quote “The Incredibles”: “If everybody is special – nobody is”. At a guess I may well be part of the ‘broad Autism Phenotype’ myself – the ‘A’ word has been used about me – but what is it in aid of?

As I see it there are two alternatives: If you are mentally handicapped to the point where you are incapable of participating in normal life you have a right to special consideration, but you also have to accept you are not fully up to it. Alternatively, if you are capable of normal life, with more or less effort required on your part, you should compete on equal terms using the head you have got. Why would you deserve to get extra exam time for mild autism, any more than you would get additional added marks to compensate for a lower IQ?

It may well be helpful to see yourself as ‘successful but not neurotypical’, but is it reasonable or fair to expect the rest of society to not only validate your self-understanding, but to have the majority adapt to the minority?

Cantab Man
Cantab Man
1 month ago
Reply to  Rasmus Fogh

Rasmus – ADHD and Autism are tied to specific, overlapping genes (the studies are published in Nature). These differences in the genes are not in “everybody.”
This conversation reminds me of the medieval ages when people proclaimed with deep conviction that epilepsy was evidence of possession by the devil.
The scientific evidence is clear on Autism and ADHD being tied to specific genes, regardless of people’s emotional and dismissive biases and (perhaps heaven knows why) envy of the condition.

Rasmus Fogh
Rasmus Fogh
1 month ago
Reply to  Cantab Man

Everything is tied to some kind of gene in some way. Mostly through risk or propensity or how your body interacts with environmental factors. So ‘tied to a gene’ does not say anything about what accommodations, if any, society should make.

Cantab Man
Cantab Man
1 month ago
Reply to  Rasmus Fogh

In the US, providing “Accommodations” at work for autistic people is about things like obtaining a quiet place to work, if required. This is not necessary with all of the noise-cancelling headphones (especially in Tech).

Accommodations are not about hiring more autistic people (with a few small exceptions) or anything that could negatively impact neurotypical people who are worried about this.

Yes, Tech companies talk about it a lot for optics. But I was very leery about sharing my diagnoses because (1) neurotypical people (e.g. superiors and bosses) will always exponentially outnumber autistic people in the workforce, (2) neurotypical people are proven to make negative snap- judgments about autistic people in a matter of seconds, (3) these snap-judgments don’t change with time, and (4) the negative judgments are not based on substance – id est, competency for the job – but based on “style” (i.e. ‘this person is somehow not normal
like I am’). See my quote below from the studies published in the journal Nature in 2017.

Thus, sharing an autism diagnosis has the upside of maybe securing a highly-visible accommodation – like a quiet space to work – that peers, who possibly already judge you harshly because of your ‘style’, will use to beat you with because of their predisposed biases that are not going to change.

And sharing an autism diagnosis has the definite downside of becoming a prime opportunity for neurotypical superiors to hide in dark corners and say, ‘I always knew there was something off about that guy
he really shouldn’t be in this position considering he has autism. Let’s fire him so he can get the help he needs.’ I give these type of leaders points for their style
but substantially more negative points for their substance.

As an aside, this is also why – after my own diagnoses – my partner and I had my daughter tested for ADHD since she was struggling in school the same way that I did when I was young (executive function kicked in for me around 9th grade), but we didn’t have her tested for ASD just yet. ADHD has known treatments. But ASD is what I am
it cannot be treated by electroshock or anything else. If my daughter is also ASD Level 1 like me, she needs to learn how to adapt, hide and conform as best she can in this world so that her ‘substance’ (i.e. competency) shines bright enough to hopefully overweigh neurotypicals’ dismissal of her based on her ‘style’.

Rasmus Fogh
Rasmus Fogh
1 month ago
Reply to  Cantab Man

That all sounds rather sensible. I guess we do not disagree as much as one might have though to start with.

The one thing I might still quibble about is your putting the difference between neurotypical and neuroatypical down to ‘style’, and therefore something that should be irrelevant and make no difference. I find that a bit too strong. It may well be that if everybody was autistic the world would function just as well, only differently, once everything was optimised for the ‘new neuroypical’, But in the world we actually live in, people has an automatic and well-honed way of interacting with each other. Having to fit in someone who interacts in a completely different way is demanding, disruptive, an a lot of work. The question becomes which side has to do how much of the adapting. And in general (whether or not it applies here) I think there is too much of the argument that it is the majority that always has to adapt to the minority.

Endless Keys
Endless Keys
1 month ago
Reply to  Rasmus Fogh

So, your hang up is the term “special.” Do you not feel special? You also seem to think accommodations are bad? You have to admit you are not able to do something to get accommodations. Accommodations are not “easy” to get.

Everyone requires effort on their part. Needing more effort means they may qualify for accommodation.

Did you need more exam time? Why did you not seek accommodation? If you didn’t, what is the issue then? You didn’t need it. Someone else did. That’s all.

Yes, as a society were are to adapt. Accommodations are to adapt…

If you do not wish to interact with people who need accommodations, you do not have to. I believe the feeling would be mutual.

Rasmus Fogh
Rasmus Fogh
1 month ago
Reply to  Endless Keys

I do not need more exam time – I manage fine without it. So, I am sure, do a lot of the people who come with a diagnosis and demand extra help to get one up on their peers. Consider the (personal anecdote), Oxbridge student who was worried about not getting a first and asked his tutor which diagnosis would be most useful to get him some exam assistance.

Just to keep it simple: Should people get additional marks and preferential treatment on hiring to compensate for low IQ – which is after all genetically linked and not their fault? Or, if not, where is the difference?

Benedict Waterson
Benedict Waterson
1 month ago
Reply to  Arthur King

What is the definition?
It’s all just part of some big undefined, ever-expanding ‘spectrum’.

Endless Keys
Endless Keys
1 month ago

https://www.cdc.gov/ncbddd/autism/signs.html
https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd

A spectrum is: used to classify something, or suggest that it can be classified, in terms of its position on a scale between two extreme or opposite points.

Autism spectrum:
https://spectrumofhope.com/blog/5-different-types-of-autism/

Yes, as we find new evidence of the spectrum expanding, the spectrum classification would expand. That is how science works.

Benedict Waterson
Benedict Waterson
1 month ago
Reply to  Endless Keys

”That is how science works”
Definitions of human behaviour, psychology, or the manifold complexities of the brain and how it interacts with contingent social/cultural contexts (between different countries, different time periods), are not simply accessible to science in the same way that laboratory subjects are.
The extent they can be scientifically defined might be very limited.
There is a diagnostic culture, where ‘culture’ is the operative word

Matt M
Matt M
1 month ago
Reply to  Endless Keys

Psychology is not a science.

Cantab Man
Cantab Man
1 month ago
Reply to  El Uro

El Uro – ADHD and ASD have been tied to differences in a few specific genes as published in Nature in September 2022.
In other words, ASD and ADHD are not make-believe nor are they determined by wishful thinking. They are specific to our genes.

El Uro
El Uro
1 month ago
Reply to  Cantab Man

The scientific evidence is clear on Autism and ADHD being tied to specific genes, regardless of people’s emotional and dismissive biases and (perhaps heaven knows why) envy of the condition.
.
If you assume that I feel prejudice or, even more cheerfully, envy towards this kind of people, you are very mistaken. It’s just that sometimes I get tired of the sight of snot and tears, especially on the face of a male creature; but you amuse me with a reference to the journal Nature.

Cantab Man
Cantab Man
1 month ago
Reply to  El Uro

El Uro – You have every right to be personally tired of a verbal exploration of the flawed human condition, and you have a right to proclaim your condition of tiredness as far and wide as you wish on various fora.
But the flawed human condition – and the study and verbal exploration of the same – remains with us, regardless of any personal attitudes toward such things.
This is a gift (or a curse if one deems it to be for themselves) bestowed upon us by the Age of Enlightenment.
C’est la vie.

El Uro
El Uro
1 month ago
Reply to  Cantab Man

I think differently.
If you have urinary incontinence, please don’t explain to everybody what combination of genes is causing it, much less ask others to tolerate your smell.
Put on diapers and shut up.
The world doesn’t care about you

Cantab Man
Cantab Man
1 month ago
Reply to  El Uro

You and I do think differently.
I’m fascinated by the exploration of the human condition, both in scientific and experiential / anecdotal form. Without such, we would not have poetry, we would not have art, and we would not have Shakespeare. Nor any other literary achievements nor scientific advancement to treat urinary incontinence…or, more accurately, cancer.
If scientific studies are published on the flawed human condition, if public policy is geared toward addressing these scientific findings, and if people share their experiences on the same, I’m interested.
I do find it hard to resonate with the proverbial ostrich with its head in the sand. My curiosity is far greater than that.

El Uro
El Uro
1 month ago
Reply to  Cantab Man

I do find it hard to resonate with the proverbial ostrich with its head in the sand
It is impossible to communicate with a person who has absolutely no understanding of what I am talking about.
PS. For dislikers: Respect the people you are living with. They have enough problems of their own, and you shamelessly ask them to solve your problems. Stop playing helpless babies.

Cantab Man
Cantab Man
1 month ago
Reply to  El Uro

El Uro – Your difficulties in communication notwithstanding, I wish you well in your journey of discovery.

Dougie Undersub
Dougie Undersub
1 month ago
Reply to  Cantab Man

I don’t have the physique to be a pole-vaulter. That’s specific to my genes and causes me some disappointment. However, I’ve got over it and I’m not looking for my condition to be medicalised.
Most people with ASD and ADHD were coping well enough without medication until recently and I suggest we return to those times.

Endless Keys
Endless Keys
1 month ago

Pole vaulting and ADHD/autism are quite different. ADHD/autism are neurodevelopmental disorders, pole vaulting is not. ADHD and autism are different from each other as well.

Are you saying we shouldn’t treat conditions like ADHD? ADHD medication often helps with making people with ADHD more functional in their own lives and society. That’s all.

Autism on it’s own rarely has medication applied for treatment. Generally, autistic people want to be left alone by people who harass others. Harassment and denial of care has never helped people cope. So, I’m not too sure why you made that claim they were “coping well enough.” Why seek treatment if they were coping? Your point is like saying, “Diabetics were coping just fine without insulin.” They just died. “People with PTSD were coping just fine without medication and treatment.” They are often at risk with.. let’s just say, “dying.” So, no, people were not and are not coping just fine. Especially, when people who do not understand various conditions seek to deny, dismiss and invalidate the people who live with those conditions.

The real issue, for you, seems to be you just don’t want to hear about it. Given that you didn’t want to investigate this subject to self educate, you also have the ability to not investigate future content you don’t want to read about. You can, of course. In your case, it is a choice. Take care.

(edited for formatting.)

Matt M
Matt M
1 month ago

I think it is an infringement of your human rights to not to be able to be a pole-vaulting champion if you feel you should be one. I demand the Olympics commission reduces the maximum height of future vaults to 2’6″ to foster equity.

Cantab Man
Cantab Man
1 month ago

“Most people with ASD and ADHD were coping well enough without medication until recently
.”

Ah, yes. The ‘if we don’t see it or hear about it, then it definitely doesn’t exist so please stop talking about it’ crowd.

Arthur King
Arthur King
1 month ago

As someone who has autistic traits, I gravitate to others who are the same. I find most neurotypical types with their incessant social posturing and social concerns so boring.

El Uro
El Uro
1 month ago
Reply to  Arthur King

Whining on the Internet is like whining into eternity.

Lancashire Lad
Lancashire Lad
1 month ago
Reply to  El Uro

Stop it, then.

Cantab Man
Cantab Man
1 month ago
Reply to  El Uro

To be clear, what were the comparisons you chose to employ in your dismissive posts above, El Uro?
A person with Autism and/or ADHD who explores the topic is similar to…what was it? Someone who talks about having involuntary urination? And being Autistic or having ADHD and wanting to understand more about the topic on an article such as this is like being someone with “snot and tears?” And being Autistic and exploring Autism is like “annoying beggars near the church, showing off their ulcers and deformities?”
It seems that you are suffering from an extreme case of disgust for those who are different from yourself…perhaps wishing that neurodiverse people would just stay silent or be disappeared so you can feel that the world is your safe space?
By the way, why whine so fervently to eternity about a topic that you try so very hard to convince others that you care nothing about?

Endless Keys
Endless Keys
1 month ago
Reply to  El Uro

You are quite fixated on putting down on others. Your comment here is a bit ironic, you are complaining about complaining.
ADHD and autism obviously impacts one’s ability to function on tasks or socially. Medication proves affective to helping ADHD function in society. Education and awareness help those willing to learn how to improve acceptance of each other. These things have been documented. Why are you resistant to data?
When you said in previous comments, “Society doesn’t care.” It does care. And so do you. Otherwise, why are you fighting so hard against people with ADHD/autism? Wouldn’t you just move on and not care? No, you are emotionally engaged.
Why would it matter to you if someone else has a diagnosed condition? It is has no impact on you, specifically. You have invested yourself in divisive discourse with no solutions, only complaints and put downs.
Whatever personal bitterness you have towards the world and others is, indeed, your own responsibility. I hope you heal, sincerely. I believe in your capacity to grow as a person but only you can prove it.

Arthur King
Arthur King
1 month ago
Reply to  El Uro

Someone help me understand this comment. I understand that the poster has misunderstood my intent, which is fair enough, however I find is puzzling that one could think I am whining. I thought I was being a bit of a jerk for coming outright and saying what I’m confident is a common viewpoint of neurodivergent people.

Peter B
Peter B
1 month ago
Reply to  Arthur King

Your comment seems reasonable to me and there’s no evidence that you’re a jerk !
A lot of us find attention seekers tiresome. Although we may also be closet attention seekers by posting comments here …
I’d suspect that a lot of people posting here have autistic traits – as many have admitted (I may well be one too).
I think there is a distinction between diagnosis (this ought to be relatively quick and easy) and treatment (which may be slow, expensive and not always successful).
I suspect that a large proportion of diagnosed cases don’t require a lot of – if any – treamtment.
If you are not severely autistic and unaware of your autism, a diagnosis alone might be useful in understanding why your behaviours don’t always produce the results you expect in others. And you might be able to fine tune things you do and say – or at least be more aware of the effects you have on others.
At least, that’s what I’m telling myself.

Cantab Man
Cantab Man
1 month ago

I was designated as ‘gifted’ later in life, and within a few years following this I was diagnosed with Inattentive ADHD and Level 1 Autism. Being diagnosed at any age and with any level of autism is extremely helpful.
As Nature reported in 2017:
“…we find that first impressions of individuals with ASD made from thin slices of real-world social behavior by typically-developing observers are not only far less favorable across a range of trait judgments compared to controls, but also are associated with reduced intentions to pursue social interaction. These patterns are remarkably robust, occur within seconds, do not change with increased exposure, and persist across both child and adult age groups. However, these biases disappear when impressions are based on conversational content lacking audio-visual cues, suggesting that style, not substance, drives negative impressions of ASD.”
In short, having any form of ASD has very real-world implications for individuals who are trying to make a living because of the inherent biases (formed within seconds of meeting) of their neurotypical peers. Being diagnosed is the first step to understanding what seems to be irrational biases that one has faced since childhood, and being diagnosed also allows one to find ways to mitigate and/or cope with the biases. As the Delphic maxim goes: “It belongs to all men to know themselves and think well.”
Another reason it’s good for adults to be diagnosed is because these conditions are highly heritable. As published in Nature (September 2022):
“Attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are highly heritable neurodevelopmental conditions, with considerable overlap in their genetic etiology….
“Additional analyses revealed that individuals diagnosed with both ASD and ADHD were double-loaded with genetic predispositions for both disorders and showed distinctive patterns of genetic association with other traits compared with the ASD-only and ADHD-only subgroups. These results provide insights into the biological foundation of the development of one or both conditions and of the factors driving psychopathology discriminatively toward either ADHD or ASD.”
Now that autism and ADHD has been tied to a few genes and is proven to be highly hereditable, my own diagnoses meant that my partner and I were open to my daughter being tested for ADHD since it can be treated. With treatment she has quickly transitioned from being a child with many self-doubts at school due to neurotypical biases to becoming a self-assured child who is no longer afraid of being curious about the world in front of her neurotypical peers. For this gift, I am extremely, and will be forever, grateful. 
Knowledge is power.

Peter B
Peter B
1 month ago
Reply to  Cantab Man

Absolutely.
Diagnosis can help to explain why the world isn’t quite the way you always assumed it to be.
And that doesn’t necessarily mean you need treatment or that others need to change or treat you differently. It means you don’t need to feel upset or frustrated at not understanding things.
Autism and ADHD may be genetically heritable (I don’t know). But they might also be partially behaviourally heritable (children imitating parental behaviour).

Cantab Man
Cantab Man
1 month ago
Reply to  Peter B

“Diagnosis can help to explain why the world isn’t quite the way you always assumed it to be.”

I can attest that this is also quite true about anyone, such as parents and teachers and bosses, who know someone with autism but didn’t know they were autistic. Fitting a square peg into a round hole has never been an optimal strategy when it comes to genetic traits as significant as autism

You are also quite right that treatment isn’t always the answer. Autistic people will always attract some number of bullies who don’t like nonconforming ‘errors’ in their safe spaces. Learning how to adapt and hide via “masking” is an absolute must in my opinion.

“Autism and ADHD may be genetically heritable
.”

I provided the quotes from the scientific journal Nature that ADHD and Autism are genetically heritable
would you also like a link or the exact citation
or is your mind already made up to dismiss the evidence of nature playing a significant hand rather than nurture?

Peter B
Peter B
1 month ago
Reply to  Cantab Man

I wasn’t dismissing the fact that it’s genetically heritable at all. I used “may be” simply because I haven’t done the homework to educate myself like you have and it’s an accurate statement of where I am (perhaps that’s mildly autistic behaviour ?). It simply means I have an open mind on it while I remain relatively ignorant on the matter.
You’re doing a great job on educating people about autism and ADHD here. That really is the only way forward. You can’t blame people who haven’t experienced it first hand for not being aware and understanding about this.

TERRY JESSOP
TERRY JESSOP
1 month ago
Reply to  Cantab Man

“Highly heritable neurodevelopmental condition” = If your mother is a hysterical catastrophist, then it is likely will be too. Poor you. Have you ever thought of taking up meditation? You might find it helpful.

Benedict Waterson
Benedict Waterson
1 month ago

some of these diagnostic criteria have a similar level of definitional ambiguity to horoscopes
do you ever feel anxious in social situations? Wow!

Matt M
Matt M
1 month ago

Not only that but the treatments are non-existent. Quasi-amphetamines like Ritalin (which probably do more harm than good) and “talking cures”. Total quackery!
The reason ADHD and autism can’t be treated is because they are natural parts of the human condition.
The NHS should stick to broken bones and heart attacks.

Peter B
Peter B
1 month ago
Reply to  Matt M

You’re assuming that treatment is always required. Adn that treatments are always medical.
Neither is always the case.
Treatments often include talking therapies. Some of us have seen these work. Just be grateful you haven’t needed them.
Sometimes a diagnosis alone can be helpful as it allows people to understand better why they don’t quite fit in and either come to terms with it or make small adjustments.
According to your line of reasoning, we should immediately defund CAMHS and abandon any help for vulnerable young people here. That’s probably not what you intend, but it’s the way it’s reading right now. There are plenty of us who can explain why that’s not a great idea.

Entropy
Entropy
1 month ago

All behaviours and personality types, neuro architecture, sensitivity to certain neurotransmitters can be ascribed to genetics and epigenetics to a greater or lesser extent. Different phenotypes suit different professions and all are needed. But take any behaviour or personality to an extreme, you have an individual with extreme problems fitting into society. This is who psychological disorders were invented for. People with serious mental or behavioural problems who cannot fit into society. But due to big pharma and the psychiatry industry, the meanings of these disorders have been stretched so far with each iteration of the DSM, that they are now essentially meaningless as they have shifted disorders so far into the centre of the bell curve that a huge amount of normal range people who have barely more problems functioning in society than the average Joe are now classifiable with these once rare hefty labels. Which they would not have navel-gazed and Googled about then sought diagnosis for (knowing the criteria for a diagnosis, and having prepared to obtain a diagnosis in advance) just a few years ago. I don’t blame people for identifying with such labels as society has groomed them to accept them, and the new widened criteria fits a huge amount (me too I expect if I were to be tested). And the labels are trending, because since about 10 years ago or so, it has become a positive thing to be seen as weak,victim or marginalized.

Chris Milburn
Chris Milburn
1 month ago

Strange to see all the downvotes. I’m a doc, my wife is a psychiatrist. And you are correct! Psychiatric medicine has become so advanced that there are very few mentally well people left anymore.

AC Harper
AC Harper
1 month ago

The Trans Activists should be worried – Labour have usually shopped for the most fashionable ‘oppressed people’ to champion and switching support to the autism/ADHD set would be more popular with the general population and also a problem more amenable to solution.

Endless Keys
Endless Keys
1 month ago
Reply to  AC Harper

More access to care leads to more diagnosis. Trans people have always existed. Neurodivergent people have always existed. But, more access to information hasn’t stopped willful ignorance.

Thomas K.
Thomas K.
1 month ago

As there are more and more people going undiagnosed and failing to receive treatment and advice that could be vital to their health, education and well-being, there will be increased resentment from the parents and carers of those with more severe forms of these disorders towards those less obviously impacted by their condition.

I was diagnosed with severe Obsessive Compulsive Disorder twenty years ago, severe enough that I am considered disabled, and I quite apparently fell through the cracks of Canada’s much-vaunted social safety net (apparently those cracks are each the size of the Grand Canyon but don’t you dare ever point that out). And I learned very early on that the majority of people, doctors and specialists included, don’t give a damn. But that was twenty years ago, right? We’re so much more understanding and compassionate now, right? We’ve ‘progressed’ as a society, no? Wrong. People seem to care even less than before despite how much we go on and on about how much more we understand and how better we are than before. I’ve found the louder people claim to care, the more likely that they don’t. My identity isn’t fashionable enough to be marginalized, you see. My suffering isn’t in vogue, apparently. I should just be good and crawl back into my hole where I can safely be ignored. Even more, I should feel bad for them, ’cause they had a panic attack once or they’re real gung-ho about cleanliness, so clearly we have the same condition.

I genuinely didn’t start writing this comment intending it to be this hostile or bitter, but I think it might help get my point across. I apologize if I’ve offended anyone, but simply saying I’m ‘resentful’ is a bit of an understatement. Whether that resentment is valid or justifiable, straight up telling me it isn’t is not going to make anything better, especially when the presumed expectation is that others deserve my sympathy far more than I was ever deserving of any myself.

David McKee
David McKee
1 month ago
Reply to  Thomas K.

Well said, Thomas. You are right: much rides on what is fashionable. You have every right to feel aggrieved that the world’s attention is governed by who shouts loudest, not who has the greatest need.

Chris Milburn
Chris Milburn
1 month ago
Reply to  Thomas K.

Let me try to summarize your comment. “I’m a victim too!”.
I long for the times when people were embarrassed to announce their diagnoses publicly.

Prashant Kotak
Prashant Kotak
1 month ago

The majority of men are somewhere on the so-called autism spectrum and always have been through history, the vast majority of those at the mild end. On the other hand, the vast majority of women are not autistic, exactly the same as through history. There are obviously always exceptions around of both sexes, ever rarer as severity increases. This observation is independent of culture or race or era. So what is now being called autism, is just a label, currently in fashion. It’s just the way men and women are wired, no doubt for what will turn out to be perfectly explicable evolutionary reasons. You may as well make the label ‘autistic’ synonymous will ‘typically male behaviour’ and the label ‘not autistic’ with ‘typical female behaviour’, it’s all just labels for bog standard human behaviour.

Endless Keys
Endless Keys
1 month ago
Reply to  Prashant Kotak

Can you cite a source to support your claims? Or do you think you may be autistic?

Prashant Kotak
Prashant Kotak
1 month ago
Reply to  Endless Keys

I can cite six odd decades of interacting with all sorts of people across multiple countries and cultures, does that count? As to me being autistic, I’m a geek, so I imagine so.

David McKee
David McKee
1 month ago
Reply to  Prashant Kotak

“Everyone’s a bit autistic.” Yes, I had that thrown at me when I informed people I had been diagnosed with autism. Let me show you how you’re wrong.

Growing up, autistics learn very quickly never to ask for help. To do so invites incomprehension (How can you possibly find that difficult? Are you a complete idiot?) or ridicule (Hey everyone, guess what David’s just said now.)

We learn too, to reject offers of help. Advice from well wishers is either misleading…
(What the hell did you do that for?
It’s what you told me to do.
I didn’t mean like that. Haven’t you any common sense?
As common sense is the product of minds that think the same way, no, we don’t have common sense. And it’s our fault.)
…misleading, or just plain incomprehensible.

Is that what you experienced, or any of your friends experienced?

Growing up, you may well have known someone who was autistic. That was the weird kid that no one wanted to be friends with.

Prashant Kotak
Prashant Kotak
1 month ago
Reply to  David McKee

My response is straightforward, I don’t think autism is not real, I don’t think there are vast numbers of people suffering from the disabling variety of it, although there clearly are some in that category, I don’t think there are more people suffering from it now than in the past in proportion terms, I don’t think (and this is probably the contentious bit) it is any more fixable or changeable (with drugs or therapy) than, for example my race or gender is, at least for now.

But there is hope: your CRISPR home kit, orderable from amazon, is just around the corner.

Elizabeth Bowen
Elizabeth Bowen
1 month ago

They read books like ‘We’re All Neurodiverse’ and ‘The Highly Sensitive Person.’ Ralph James Savarese is my favorite.

https://blogs.baruch.cuny.edu/literatureandthebrain2019/files/2019/04/Savarese.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8992885/

David McKee
David McKee
1 month ago

The only thing we can say for sure is that everyone is groping in the dark. We have studied autism seriously for about 35 years. That’s an eyeblink. We know next to nothing about autism.

So it opens a door a mile wide, for every charlatan who wants to make a quick buck, and every dreamer who wants to remake society from top to bottom.

Autism exists. I know, because I am autistic. How we diagnose and treat is a subject of sharp debate. As yet, no consensus is forming.

Anthony Roe
Anthony Roe
1 month ago
Reply to  David McKee

We are going to need an other huge expansion of the NHS to diagnose and treat all who may or may not have autism ADHD (only ongoing treatment can confirm or not such an ever expanding and self referring disabilty and then provide lifetime support). The costs have already proved calamitous to Councils and the National Government.

Peter B
Peter B
1 month ago
Reply to  Anthony Roe

I’ve just made a comment in this thread that not all diagnosis (relatively cheap) will require treatment (relatively expensive). There is a spread of severity here and the most severe cases will need treatment. The milder cases may well not and people may be able to understand their interactions with others better and adjust a little.
Having some experience in this area, I doubt that the NHS is going to be the universal answer. Ultimately, these are very personalised services and you’ll get what you pay for when it comes to treatment. The NHS could be doing more on diagnosis.

Anthony Roe
Anthony Roe
1 month ago

I think Lionel may have missed another coming mania. Nobody is normal anymore, too dull. When the disabled reach 90% the normal will be the most disadvantaged.

Graham Stull
Graham Stull
1 month ago

We need less focus on Autism and more on Ought-ism. As in:
You ‘ought’ to do physical exercise, ideally outside in the sunshine.
You ‘ought’ to be physically tired when you go to bed.
You ‘ought’ to eat healthy food, with few or no ‘ingredients’ in it.
You ‘ought’ to be sceptical that the solution to human health problems comes out of a lab.
You ‘ought’ to let boys run around, hit each other and scrape their knees while building impossibly elaborate tree forts.

Hendrik Mentz
Hendrik Mentz
1 month ago

Diagnosis always intensifies stress, defines incapacity, imposes inactivity, and focuses apprehension on non-recovery, on uncertainty, and on one’s dependence upon future medical findings, all of which amounts to a loss of autonomy for self-definition. It also isolates a person in a special role, separates him from the normal and healthy, and requires submission to the authority of specialised personnel. Once a society organises for a preventative disease-hunt, it gives epidemic proportions to diagnosis. This ultimate triumph of therapeutic culture turns the independence of the average healthy person into an intolerable form of deviance | Illich, I. (2021:96) Limits to medicine: medical nemesis: the expropriation of health. Marion Boyars. London.

I purchased Illich’s book after reading Lias Saoudi’s review in Unherd: ‘Is modern medicine making us sick.

Tyler Durden
Tyler Durden
1 month ago

Individuals young now odd diagnosed with autism were simply called introverted in the past and chose different life paths to the herd. The ADHD hyperactivity thing seems to be over-excitation largely caused by video games if not the digital screens all on their own.

David Hyett
David Hyett
1 month ago
Reply to  Tyler Durden

So I am a 51 yr old male with adhd, I was totally hyperactive and indeed dangerous as a child, but, maybe surprisingly to you, never had a computer game and rarely watched TV. How does that fit in to your narrow assumption?

UnHerd Reader
UnHerd Reader
1 month ago

This really annoys me. ADHD is a made up problem by parents and teachers in America as an excuse for not socialising their children before they went to school.
I did research into this in the eighties and found, like the BPS at the time that these children wait, sit still and pay attention if they want to, which precludes it being an illness or a “syndrome”.
There is a problem usually caused by genetic damage to the baby in the womb by an alcoholic mother called hyperkinetic syndrome.
These poor children cannot stop moving or focus on anything no matter how much they want too even sleeping is difficult and it causes them enormous stress and upset.
As for autism, it is so over diagnosed that genuine autistic people are suffering because of it.
An autistic person cannot make cohesive sense of the world around them as they grow up and how to interact with it. If they do not have cognitive deficits as well, which unfortunately many do, they are constantly looking for clues as to how to “join in” to the world everyone else seems so good at navigating. When they hit on something they can understand, usually an inanimate thing like engines, cars, drawing etc, they obsessively focus on it so that they very quickly become very good!
The idea that just because you find socialising difficult or some things make you feel anxious means that you are “on the spectrum “, or none “neurotypical “ is as ridiculous as saying because you couldn’t be bothered to learn to read you must be dyslexic.
No one knows what causes autism, but because it is now labelled as spectrum, it has become the latest fad amongst the elite and media stars. After all to be able to label yourself as none neurotypical makes you stand out from the crowd and excuses any bad behaviour you may indulge in.
My old professor used today that if you can understand a joke and tell one in return you are not autistic; yet we have comedians labelling themselves autistic nowadays.
I have worked with genuine autistic children and adults and they would kill to be able to express themselves as the so called none neurotypical special group demanders do.
It seems that people will do anything to be seen as special nowadays, even at the expense of people who genuinely need help.

Peter B
Peter B
1 month ago
Reply to  UnHerd Reader

A little simplistic perhaps – surely there must be degrees of severity in autism (that’s all a “spectrum” is really, annoying though the phrase may be), but some excellent points.
I’d tend to agree that genuinely autistic people just want to be normal and fit in. And anyone who wants to be autistic probably isn’t. Not fitting in when you don’t understand why is usually painful. Choosing not to fit in is a luxury.

Cantab Man
Cantab Man
1 month ago
Reply to  Peter B

Well said and spot-on, Peter.

UnHerd Reader
UnHerd Reader
1 month ago
Reply to  Peter B

What you say is true and I was very cross when I wrote my last post. So many commenters showing off their special pleading in a way no truly autistic person could ever do.
Of course there is a “spectrum “, but it is much narrower than people would have you believe.
Asperger’s syndrome is the most common one.
Even children and adults who are lucky enough to get proper social training still find it difficult to operate socially with people they don’t know very well.
Many parents worry themselves to death about what will happen when their child hits middle age and they are too infirm to care for them.
Turning a serious disability into a celebrity fad makes my blood boil I’m afraid.

JĂŒrg Gassmann
JĂŒrg Gassmann
1 month ago

The phenomenon is real. Ask any grade school teacher who saw the changes from the 70s through the 90s. What we have today is neither normal nor sustainable.
We need to find out what in our environment is causing this. It’s probably not a single cause, but developments like these don’t happen without a cause. But there is zero interest in finding out. All the effort is in proving that the cause is genetic, which on the face of it cannot be right.

Paul Thompson
Paul Thompson
1 month ago

The attention span of children, and adults, and me, has been damaged by computers and TV. In the 80s, Sesame Street began the onslaught by using cartoons instead of people. Mr. Rogers, an old TV program, used people talking, and didn’t have magical cuts or endless stimulation. This is what Sesame Street did. It had a terrible influence on children.

Robert
Robert
1 month ago

“but a massive 146% increase in such prescriptions for 30-34-year-olds.”
First – HA!!
“While such diagnoses can be beneficial in helping high-functioning adults make better sense of their life…”
I’m confused. Why would a ‘high functioning adult’ need to take meds for ADHD? For anything? They’re high functioning!
I clearly don’t grasp the understanding of what is considered a ‘high functioning adult’. Does that make me a ‘low functioning’ adult? Undoubtedly.
Sigh. ‘Adults’ these days.
(And their diagnoses)

Davy Humerme
Davy Humerme
1 month ago

Read Abigail Shrier’s brilliant book “Beyond Therapy”. Maybe not yet in the UK but generations in the US are being raised by therapists. Many are under the vigilance of poorly qualified School counsellors, ideological teachers or nutty parents. However i would trust even the nuttiest parent not to fulfil Larkin’s observation of effing up as much as the other three. Little evidence exists for the efficacy of much therapy and Shrier surveys the literature . There is a separate issue of diagnosis shopping among attention seekers is implied. All must have traumas. This means those with deep problems being neglected, but all the while the therapy industrial complex welcomes them in.

Jae
Jae
1 month ago

Judging by the comments here, we’re in big trouble, everyone is ADHD. Self evident or self diagnosed, doesn’t matter.

Charles Wells
Charles Wells
1 month ago

I work as as the lead psychologist for several residential homes for Looked After Children and it has become very clear to me over the years that ADHD and ASD is being misdiagnosed. Children who have experienced trauma and abuse frequently display ADHD type behaviours which usually alleviate over time as the child stabilises in a safe environment. In my experience as a clinician the increase in adults being given a diagnosis of ADHD might be better understood as an increase in adults seeking a diagnosis. Once a diagnosis has been given (often by a consultant in private practice) a monthly prescription for Lisdexamfetamine (for example) can be issued. Lisdexamfetamine is a controlled drug and it is a strong stimulant and one can have access to it legally by convincing a psychiatrist that one has ADHD. This is an abuse of the medical system, as well as substance abuse and takes funding and resources away from those in genuine need.

Alex Stonor
Alex Stonor
1 month ago

There’s a shortage of the medications used to treat these conditions too.

Pamela Booker
Pamela Booker
1 month ago

Does this sudden explosion of people, especially public figures, defining themselves as on the autistic spectrum have anything to do with the fact that many geniuses are on it?