By John Ely Senior Health Reporter For Mailonline
12:31 16 Feb 2024, updated 13:01 16 Feb 2024
Trendy apps, social media influencers and private clinics are contributing to a huge surge of ADHD in middle-aged women, an expert fears.
World-renowned University College London psychiatrist Professor Joanna Moncrieff fears the mental disorder is being over diagnosed.
As a result, thousands are needlessly getting powerful drugs designed to calm them down, she said.
Attention deficit hyperactivity disorder (ADHD) is a condition which affects people’s behaviour. It usually makes patients restless and causes them trouble concentrating and act on impulse.
Although typically diagnosed during childhood, clinicians have been taken aback by a wave of adults seeking help, and drugs, to help them with suspected ADHD.
Actress Sheridan Smith is the latest in a string of celebrities to share their diagnosis with attention deficit hyperactivity disorder.
The 42-year-old, who shot to fame on The Royle Family as Antony‘s girlfriend Emma, told Vogue that it has helped her ‘make sense of a lot of things’ in her life and better understand her ‘brain’s background noise’.
Other celebs to have been diagnosed with ADHD include Olivia Atwood, Sue Perkins, Johnny Vegas and Ben Fogle.
Influential figures coming forward have fuelled accusations that the condition has become ‘trendy’, suggesting it is being over diagnosed.
Asked about such claims, Professor Moncrieff said: ‘There are many doctors who’re extremely uneasy about this.
‘There is such demand for it from patients that doctors feel pressurised to give these diagnoses.
‘It’s now become so common I feel it’s actually become about peer pressure, people know other people with a diagnosis and almost feel that if they don’t get one they’re letting themselves down.’
Professor Moncrieff said older women were particularly vulnerable to some of these pressures.
She said: ‘It’s to do with a lack of confidence and therefore feeling a diagnosis might explain things and boost their confidence because it gives them something tangible to pin their anxieties about their inadequacies onto.’
NHS data, for the 2022/23 financial year, shows a massive surge in year-on-year ADHD drug prescriptions in women between their late 20s and early 30s, with rises of almost 60 per cent.
NHS statistics showed more than 230,000 people in England were now taking meds to combat their inattentiveness and hyperactivity.
Prescription rates jumped by a fifth in a year, in the biggest annual rise since modern records began in 2015.
Younger women saw the biggest annual increases, with rates jumping 50 per cent among those aged 25-39.
But older women, those between 40 and 60, aren’t immune to the trend either, with over 13,000 women in thus age group now taking ADHD medication, up from 9,000 the year prior.
In terms of what was driving the diagnoses, Professor Moncrieff told MailOnline that there were likely multiple factors at play.
She said private clinics, where people pay hundreds for an ADHD assessment, likely had a role.
Professor Moncrieff said a number of NHS mental health clinicians suspected these assessments, which can include questionnaires and a diagnostic interview, are less than thorough.
But one of the consequences was a number of these patients then sought out NHS care for their newly diagnosed condition.
‘People are going to these private outfits getting a diagnosis and then coming to the NHS wanting the health service to continue with the treatment so they don’t have to keep going privately,’ she said.
‘It is taking NHS clinicians by surprise and they’re not quite sure what to do about it.’
She added this extra case load was adding an extra burden on the already stretched NHS mental health services.
A damning BBC investigation earlier this year found patients could get diagnosed with ADHD and offered powerful drugs through unreliable video call assessments with private clinics.
Social media influencers promoting everyday problems as potential symptoms and trendy apps promising to help manage the condition have been blamed for sowing the idea among Brits that they may have ADHD, too.
Professor Moncrieff said social media platforms like TikTok had ‘a huge part’ to play in promoting ADHD to the masses.
Some accounts on the platform, with thousands of followers and millions of views, list common problems such as ‘not wanting to do dishes’, ‘procrastinating’ or being ‘messy’ as potential ADHD signs.
Other accounts feature stranger symptoms.
One seen by this website, a TikTok account run by American Katie Sue who says she was diagnosed with ADHD at 29, lists signs of the condition as including ‘mystery bruises’, ‘coming across as a flirt’, ‘having low esteem’ or ‘forgetting about food until it goes bad’.
None of these are listed as potential ADHD symptoms in adults by the NHS, although experts note that the condition can affect people in different ways.
Professor Moncrieff said everyday problems are unlikely to indicate someone has ADHD.
‘The diagnosis as it is set out is so woolly that anything can potentially fit into it,’ she said.
‘But no, on its own not wanting to do dishes or other repetitive tasks is not ADHD it’s completely normal, we all feel it.’
In fact, she said it was her opinion ADHD in adults was very rare and clinical signs requiring treatment were when aspects like inattentiveness and impulsiveness were having a massive impact on a patient’s life.
‘It’s not managing to work, or not being able to maintain relationships,’ she said.
Another potential source for the explosion in ADHD diagnoses is management apps, experts have suggested.
Some are advertised online, like the ADHD management app Effecto, which charges users just under $60 (£47.70) for a year’s access.
Effecto claims it allows users a ‘revolutionary way’ to manage their ADHD and doing so will ‘improve focus, manage disorganization and create your ultimate routine’.
But the app is also open to people who have self-diagnosed themselves with ADHD or even just suspect they might have the condition.
Professor Moncrieff said apps like this can act as a potential ‘gateway’ for people seeking more formal, and medicalised, help for their supposed ADHD diagnosis.
‘If you’re sucking more people into this idea that they have a medical condition you’re probably going to end up with more people on medication,’ she said.
Both Katie Sue and Effecto were contacted for comment.
Professor Moncrieff said it was crucial people remember that starting medication for ADHD was not a risk-free decision.
ADHD drugs take the form of various stimulants which, like any medical intervention, carry risks of side effects that vary in intensity.
Professor Moncrieff said we still knew precious little about the long-term effects of taking these drugs. Commonly taken ADHD drugs include methylphenidate (Ritalin), lisdexamfetamine (Elvanse) and dexamfetamine (Amfexa).
‘The widespread prescription of stimulants in adults is relatively new and they haven’t been widely tested for long periods of time, so we have very little good data on the long-term implications of stimulant use,’ she said.
‘We know that they can cause cardiac complications…and there is some evidence out there that adults who take prescription stimulants are more at risk of Parkinson’s or Parkinson-like disorders.
‘No one has any idea what the implications are for taking stimulants for life are.’
Smith is just one of several celebrities who have celebrated their ADHD diagnosis later in life.
Others include former Love Island star, Olivia Attwood who previously explained how the condition ’caused myself and people around me a lot of stress’ during her teens and early 20s ‘when it wasn’t managed’.
TV personality Katie Price has also discussed how her adult ADHD diagnosis explains why she has never felt there would be ‘consequences’ for her actions.
Ben Fogle, who has previously spoken about being dyslexic, revealed this week that he was recently diagnosed with ADHD after a ‘recent mental health storm’.
Former Bake Off host Sue Perkins last year shared that she had been diagnosed and that ‘suddenly everything made sense – to me and those who love me’.
Academics are still attempting to piece together how ADHD affects older people.
ADHD affects around 5 per cent of children in the US with rates in the UK about 3.6 per cent in boys and 0.9 per cent of girls.
But as many as one in 20 adults in Britain could have the condition, according to the ADHD Foundation charity.
Despite the sudden explosion of diagnoses among adults, ADHD is still more common in kids.
ADHD was only officially listed in the UK as a disorder that affects adults in 2008. Before then, it was only recognised as a childhood problem that kids grew out of.
As a result, rather than being over diagnosed, some experts argue that many adults now being told they have ADHD have gone years having their symptoms dismissed.
Others say that ADHD is on a spectrum, similar to autism, so it is arbitrary where to draw the line at what is ADHD and what isn’t.
What exactly causes ADHD is unclear, but it’s thought to involve genetic mutations that affect a person’s brain function and structure.
Premature babies and those with epilepsy or brain damage are thought to be more at risk.
ADHD is also linked to other conditions like anxiety, depression, insomnia, Tourette’s and epilepsy.
There is no cure, but a combination of drugs and therapy is usually recommended to relieve symptoms and make day-to-day life easier.