I know the unsettling truth about the rise in people being diagnosed with ADHD. I have spent decades treating patients... this is what's changed - and why I'm worried for the future: DR CHETNA KANG
Since I started practising more than two decades ago, the number of people being diagnosed with attention deficit hyperactivity disorder (ADHD) in the UK has soared.
In one year alone – between March 2024 and March 2025 – up to 20,000 people were newly referred to mental health services for an ADHD assessment, a rise of 13.5 per cent.
It's now estimated that nearly 2.5 million people have ADHD, according to the latest figures from NHS England. So what's going on?
While the figures do reflect greater awareness about the condition and more people coming forward for assessment, I believe a significant proportion of these people are being misdiagnosed.
Instead, they have what's known as 'pseudo-ADHD' – which I'm seeing more and more of.
It's characterised by similar symptoms to ADHD, including inattentiveness and difficulty concentrating, but only presents in adulthood. And instead of being caused by biological processes, it's brought on by excessive digital media use. In short, today's digital lifestyle and memory overload may be causing ADHD-like symptoms.
Other patients are told they have ADHD – or self-diagnose because of a lack of concentration and planning – which may instead be due to anxiety, PTSD or depression.
Five years ago, most people who came to see me were struggling with problems they had had for some time. Now, more and more are telling me what their diagnosis is and asking me to verify it.
But many who think they have ADHD don't – or actually have pseudo-ADHD.
Dr Chetna Kang says she has noticed that the number of people being diagnosed with attention deficit hyperactivity disorder (ADHD) in the UK has soared over the last 20 years
Although it mimics ADHD – leading to temporary lack of focus and distracted behaviour – it is easily reversed with a digital detox, yet people with pseudo-ADHD can end up needlessly on medication, which carries potential side-effects such as trouble sleeping and high blood pressure.
It's happening more regularly, especially since Covid, when so many day-to-day activities had to switch to online – from education to socialising and even fitness.
Gaming for hours and watching endless streaming videos while replying to social media posts has become a normal part of younger people's lives. Now many aspects of our daily lives take place virtually.
Research has found that people who spend more than five hours a day online may have digitally-induced problems which are interfering with their executive function (mental processes that help you set and carry out goals) and the ability to control their emotions, which also happens when you have ADHD.
Looking at a screen bombards your brain with thousands of stimulants in a few hours, and scrolling through social media can lead to more impulsivity, a key feature of ADHD.
According to a study published in 2014, Facebook use triggers impulsive parts of the brain in the same way as gambling and substance abuse. And digital time can eat into the hours when you should be asleep, leaving you tired and dysregulated. It can also lead to insomnia, irritability and poor organisational skills – hallmarks of ADHD.
But it's crucial that ADHD and pseudo-ADHD are tackled in very different ways – which requires an accurate diagnosis.
To do that involves a detailed history, including how much time people use screens for entertainment, gaming, social media, education and work, as part of a psychiatric assessment.
Many people who think they have ADHD don't. They may actually have pseudo-ADHD, which mimics ADHD
I want to look back to childhood, before the age of 12, with feedback from other family members and teachers, if appropriate, to rule out other potential issues such as mood disorders, including depression, PTSD or autism. Only then should someone do an ADHD assessment.
Unfortunately, an increasing number of private providers of ADHD assessments skip the first crucial bit of psychiatric assessment and do the ADHD part as a standalone.
They don't get the full picture and might misdiagnose someone or – as many clinics now offer a diagnostic service where a psychiatrist is not involved – those making the assessment may have limited training in mental health and may not recognise tell-tale signs of co-existing mental health problems.
Then there are people who self-diagnose from what they have seen on social media or using online tools – including a five-minute test called the The Adult Self-Report Scale (ASRS) Screener. This is useful for diagnosing ADHD among over-18s but should be used in conjunction with a clinical interview to provide additional information – it isn't a diagnostic test.
Social media can convince people they have ADHD when they don't and I see patients who have viewed multiple TikTok videos by neurodiverse influencers (whose brains develop or work differently) and are convinced they too have ADHD.
But lots of the information online is wrong.
In fact, a study in the journal PLOS One in March, found that popular videos on social media discussing ADHD may be misleading in more than half of cases.
It evaluated the claims (accuracy, nuance, overall quality as psychoeducation material) made in the top 100 #ADHD TikTok videos and fewer than 50 per cent of those made about symptoms were judged to align with the Diagnostic and Statistical Manual of Mental Disorders – the 'bible' of mental health problems drawn up by the American Psychiatric Association.
Yet these videos collectively amassed views totalling nearly half a billion.
Unfortunately, misdiagnosis can result in more problems, because medications for ADHD target specific neuro-chemicals that have key jobs in the brain.
Ritalin, for example, can improve concentration and focus if someone has ADHD – but if they don't, it just upsets the balance of chemicals in their brain.
A study in June 2023 in Science Advances found that in people without ADHD, the drugs may actually inhibit performance and productivity.
Researchers at the University of Melbourne looked at 40 healthy participants aged 18 to 35 without a diagnosis and monitored them while they attempted tasks with ADHD medication and without. After taking the drugs, people spent more time and effort solving the tasks, but were less accurate and efficient.
ADHD medications are safe but as with all drugs, they can have side-effects including sedation, drowsiness, and mood changes – so they should only be used by people who really need them.
And another reason for getting an accurate diagnosis is that people who have more than one issue, such as depression as well as ADHD, may need to take drugs in a certain order.
They might, for example, need to start with an antidepressant or an anti-anxiety medication to treat other conditions that may be exacerbating symptoms of ADHD before they consider taking a stimulant like Ritalin.
But for pseudo-ADHD you don't need medication.
A digital detox is a simple and effective treatment – and can also help those with genuine ADHD.
It doesn't mean throwing your smartphone away and never going on the internet again – it's more about limiting your time in the digital world and maximising your life in the real world.
The first step I recommend is to analyse your digital media use, looking at how much time you spend online, and why you do it.
Is it out of boredom, or to unwind and relieve stress? Is it because you are lonely? If so, arrange to meet a friend or join a club or a gym.
The important thing to do is make activities happen in real time. You need to balance digital media use with breath work, (breathing techniques that focus on the breath to improve relaxation) and enjoy outdoor exercise, spending time with friends and family in person, active spiritual practice, and going to the office rather than working remotely.
Some might opt for digital detox wellness retreats, where smartphones and digital devices are banned. But they can be expensive and there is always the question of what happens when you come back to normal life.
Activity tracking apps can also help you reduce social media use as well as motivate you, but the best thing is to swap the fast-paced virtual world for real experiences that match the circadian rhythm of your brain and body –instead of working against it.
No one is saying you can cure mental health problems by going for a walk or a coffee with a friend, but it is part of the solution.
Dr Chetna Kang is a consultant psychiatrist and an ADHD specialist at Central Health London.
Interview by THEA JOURDAN
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