Issues with the Concept of Neurodiversity in ADHD

In this first of many Commentaries I will be providing to my viewers, I address the concept of neurodiversity or neurodivergence in the lay media and the problems inherent in the strong or extreme form of this view that claims there is no reason to diagnose or treat ADHD as a disorder when it is just part of typical human variation. One can acknowledge that ADHD represents the extreme end of a typical distribution of a psychological trait while at the same time acknowledging that those at the extreme lower end of this trait experience harm and impairment. It is therefore reasonable to offer them a diagnosis that grants them access to treatments, services, entitlements, and protections that, absent the diagnosis, they would not receive.

[@jopoole6848]

Hi Russell, I am an ND master's student in the UK and have been struggling to get my head around the whole 'drop the disorder' view of ND diagnoses. I know so many ND people for whom the diagnosis has been life-affirming. Recognising that there are genuine reasons why things are so hard for ND people allows us to find some self-acceptance when many of us spent decades blaming and hating ourselves. Thank you so much for this commentary, it has been illuminating. Jo (diagnosed with combined ADHD aged 52)

[@russellbarkleyphd2023]

Thank you! I could not agree more with your views on the self affirming nature of the diagnosis and acceptance of it. It’s hard to live with it until you own it. Be well

[@quemabocha]

I think the drive behind wanting to drop the "disorder" label comes from a similar place. As a newly diagnosed ADHD adult woman I have spent my entire life thinking that there must be something wrong with me because I just can't do things that other people seem to have no problem with. And yes. The diagnosis was incredibly validating. But also, it is very much saying "there IS something wrong with you" - a lot of people seem to believe that's not actually the case. That we are just not well suited for the way our current societies work, and that we would thrive in different environments. They say, there's nothing wrong with US. It's just that the world wasn't built for us, and so we struggle to function in it. And although I quite agree, that there are many things that could be changed in our cities, workplaces, education systems, etc. That would make life for neurodivergent individuals easier... I can't conceive of a way of life that would be suitable for me. Maybe I lack imagination. Anyways. What I meant was: people are arguing that they are not wrong, the world is wrong. They don't need medication, the world needs to stop expecting pears from apple trees.

[@francesasha]

Top notch explanation as usual. Appreciate your giving us your time and expertise Dr Barkley!

[@russellbarkleyphd2023]

Thanks!

[@aybikeanacali8414]

The reason why adhd people (including me) need neurodiversity perspective is because, especially if we're late diagnosed, we spend our whole lives thinking we're just lazy, irresponsible and selfish. And I know you disagree that all positive traits attributed to adhd is unrelated, and yes there are gifted people without any neurodevelopmental disorder, but usually that kind of giftedness comes with some sort of neurodivergence. We can see it clearly especially when we look at history of arts and science. Many inventions and art pieces wouldn't exist if it wasnt for some sort of neurodivergence. Speaking for myself while getting treatment and therapy I'm still trying to comprehend how adhd differs from other mental illness. And it's very exhausting when you can't totally understand an essential part of your identity. Maybe there is a middle ground where we can access to support and treatment but also accepting the human population need neurodiverse people.

[@Thesteadfast]

I've made this exact point many times. How can you ask for accommodations for something that's a "superpower"? I love seeing this backed by the biggest expert on the topic. I'm an ADHD Coach and I get very frustrated with people who make ADHD out to be a problem solely with the world. It's unmotivating and diminishes agency. Yes, the stigma can be harmful I've lived it but brushing over people's struggles just to protect their feelings does not help them improve their lives. It's biased but I suspect that the biggest proponents of this may be people with less severe ADHD or perhaps in the "symptomatic but not Dx" category but still got diagnosed. Superpowers aren't debilitating.

[@dgxdcoder8791]

From the fight on “Adhd does not exist, just try harder” To now “it’s a super power you lazy” 😅

[@Thesteadfast]

@@dgxdcoder8791 Yeah it feels like two extremes that are both harmful.

[@user-jy8zb2wc8l]

This is a really interesting observation. Perhaps it could become a self fulfilling cycle of sorts - those on the milder/less-impairing end may feel invalidated for not having "severe" enough symptoms for a diagnosis, but once diagnosed, they need to change the label to fit their experiences - aka it's not all bad of a condition. Of course when human abilities fall on a spectrum, the close you are to the threshold where you are labelled either "normal" or "impaired", the more it can understandably also feel like a bit arbitrary (and some context/environment-dependent).

[@Thesteadfast]

@@user-jy8zb2wc8l yeah I like your self fulfilling cycle description. From what I've read the nuerodiversity movement started within the autistic community. Once aspergers was not a separate label a people with very functioning autism started saying hey maybe it's not a disorder at all. Which is bizarre considering how debilitating severe autism is. Normalizing disorders should be the priority instead of getting defensive and trying to change the labels to protect feelings. I think it does damage and adds to the stigma. A name for subclinical or adhd light would also be useful.

[@dawnkeyy]

I think it's much simpler. It's coping. Given the nature of the disorder, ie it not being physical or immediately obvious negative effects like schizophrenia or things like severe depression, there's a lot of wiggleroom to cope with for people who don't want to carry a label of a disorder.

[@kateharl1383]

Thank-you I appreciate your work and your ongoing efforts. Here in New Zealand it is incredibly hard to get adhd acknowledged as a disability.

[@russellbarkleyphd2023]

I have heard that about Nz and Oz. What a pity. But that is yet another reason for this free public channel of information. Thanks so much. All success to you.

[@nicktefft6225]

Fantastic video. This channel has been super exciting, I've learned more/made more progress in the last year since finding your work than in over a decade with the diagnosis. It's hard to understate the positive impact you have had on the field, and on my life personally, so thank you. Looking forward to all your future videos.

[@russellbarkleyphd2023]

I am so glad it’s been of help to you. Thanks!

[@ZannaRussell]

Thank you, Dr. Barkley, for your channel. It's not a "gift" or a "super power." I may have some unique abilities because of it, but I'd gladly give those up if I could reduce or eliminate the problems that create the harm that ADHD has done to my life.

[@Othtsmlsgd]

Thankyou Dr. Russell! I love your no-nonsense approach and how clearly you articulate these complicated topics! Keep up the great work

[@russellbarkleyphd2023]

I shall try. Be well.

[@stellaglover6841]

Thank you Dr. Barkley for this concise and informative video. I have both ASD and ADHD and I wouldn't call it a gift as some might perceive. However, I am proud of myself to continue to learn and find ways to work with it. I have learnt so much from you. Thanks

[@inverbi]

Thank you for taking your time with us. Your information is tremendously useful. After 55-60 years I feel someone understand me and care. Also thank you social media.

[@HaShomeret]

With all due respect, it has been my personal experience that people who use the term nurodivergent tend to use it as an umbrella term for people who have neurological disabilities. It's inclusive specifically because it's being used for advocacy. Most people I personally know who use the term are using it to advocate for more rights and accommodations for the disabled, not to opt out of the disability label.

[@EdRolison]

In communities I am a part of neurodiversity is used inclusively. There's a lot of people who are subclinical, or not yet diagnosed with ADHD or ASD or other things that make them a bit "weird". And so a term that's a bit less pejorative than "fellow weirdos" is useful. But it's not used to exclude needs, rather just to recognise that amongst people with different cognitive function, acceptable, tolerance and accommodations are beneficial even when not strictly or medically necessary. Which doesn't preclude people needing treatment or legal protection, not least because here in the UK diagnosis timelines are hitting the decade mark. I have yet to find a better term of inclusiveness, but I am open to suggestions! But I do agree the danger of "oh but everyone is a little bit..." is perhaps technically correct, but potentially reductive, dismissive and harmful too.

[@gabrielladeass]

Thank you very much for advocating for us Dr. Barkley!! Thank you for your videos!!

[@matthewbarrett8859]

I got diagnosed at 39 only last week. I love that your videos don’t dumb anything down. I also love a bell graph! You mention that 30% of boys potentially developed ADHD from injury, is there any science that shows that subset display symptoms slightly differently then the 70% who are genetic? For example increased hyperactivity?

[@veilmontTV]

I really appreciate these videos. Im going through all of them. The more i know the better off ill be. I honestly feel like my emotional dysregulation is by far my worst symptom. I remember dates and appointments the vast majority of the time. I have been punctual all of my life. I do very often forget what i was talking about mid conversation. I used to get extreme anxiety when it happened and i got good at reacquiring the topic by just context clues. Usually those clues just refresh my memory though. I always wondered why i couldnt make my plans a reality. I joined the air force because i thought it would mature me. That was a hilarious joke. Ive felt an amount of shame that i wish upon no one with how i just always seemed to be on the edge of another crisis. I really feel good about my future for the first time at 34. I didnt realize how much i was actually suffering until it was gone. I also find it hilarious that im losing my hair right when im feeling in control for the first time. Thanks dad lol

[@emrys1976]

Thank you for this video. I get so mad at the “ADHD is my super power” nonsense.

[@inverbi]

Dr. Barkley no body is as interesting in the topic as you. You gave me the lion's share of my knowledge and it's keep on. On top of that, you also have a calming effect on me. Thank you very much!

[@user-yq1bs4is6y]

Not sure what you're talking about exactly when you say the "neurodiversity movement" (we may have different ideas about what this is), but my understanding of the concept is precisely what you said with the bell curve: the entire bell curve is the neurodiversity. Now, neurodivergence/neurodivergent, that is the line you drew for ADHD, and similar lines would be drawn for ASD, etc. Some people (mostly parents of neurodivergent children) say that ND is a superpower, true. From what I understand (*I do not claim to fully understand), mostly there is an embracing of disability and support needs. What IS said is that just because you are disabled does not mean you are less than human, and it discourage using disordered (monster, abomination, miscreant) to talk about human diversity (aka "different, not less"). Here is where, perhaps, you disagree with the "movement". It adopts the social model of disability that says that disabled people are actively disabled by a society that does not accommodate their needs, and upholds systems that disable some people because they are in the minority. Additionally, it says that the accomodations for neurodivergence in school/work/etc would be beneficial for society at large, and would reduce mental illness across the board and greatly improve quality of life for all people. After all, as you pointed out in the graph, 50% of people are deficient in self-regulation and EF. That means that 50% of all people would be "treated". That said, better self-reg/EF does not seem like it would negatively impact the top 50% and might make them even more "gifted", so win-win! However, this would cut into rich capitalist immediate profits, so it is obviously terrible for the economy and we should probably give them another tax break for even suggesting it.😂😭😭😭🤮

[@TheSamMcKeown]

This was very helpful and insightful, thank you.

[@russellbarkleyphd2023]

I am delighted it was helpful. Take care.

[@RalucaBojor]

Thank you for explaining it so well!

[@russellbarkleyphd2023]

A pleasure, Raluca

[@hubertbrychczynski9646]

Excellent video, thank you

[@freedbygsus]

I find it incredibly frustrating how often neurotypical people place the burden on me to make them feel optimistic about my disorder by talking about the "positives" of my ADHD. I wasn't built in some video game character creation engine where opting to debuff my executive function stat meant I got an equivalent buff to some other trait.

[@matsg2596]

Great video! ❤

[@pavlova717]

You have provided me with some important insights about these disorders, though it still doesn't totally add up for me and from my amateur perspective. Introspectively, I think I have evidence that my impulsivity and monotropic thinking is not exclusively a disorder but its own sort of cognitive style. I don't believe I would be who I am without them. I can sustain hyperfocus for hours if I'm highly interested in a task. My thinking is highly analytical and divergent. I don't sense it as being something ordinary or something I could have without my conditions. Are these traits bad? Well, many interesting people in history were born premature & the idea that they are interesting only in spite of that just doesn't seem always true. it seems possible to me as a general rule that unique successes come out of a diversity of circumstances even if these are mutations or limitations, and even if they're generally maladaptive in the population. Just take savant syndrome for instance. The extreme of any trait is likely to be maladaptive, but as you say, it's a bell curve in the population, so I am not sure exactly why to think of it as categorically disordered at one end and categorically functional at the other. Even in your other video, you present the correlation of psychopathy and creativity as an inverted-U. I'm not sure I would expect a bell curve if it was due to genetic drift. It just doesn't add up for me. I want to know who and what I am. I want to know what will help and hinder me. I mean, c'mon, surely school is actually just boring for many children. It is coercive for most children.

[@sonyaparkin7841]

God bless you Dr. Barkley 🙏💛

[@jophillipsillustration]

I would give it up in a heartbeat for sure!

[@Adrian-dl9nb]

I have to admit you changed my mind about this! You illustrated your points very well. It's not 100% clear to me if you're part of the ADHD community, but thank you for continuing to support us.

[@1966Svea]

Thank you very much for this informative video. What I would like to know about is the connection between the different neurodiversities to each other. Is there a correlation between gifted/ADHD/autism/transgender?

[@russellbarkleyphd2023]

Yes for some of those conditions. As my lecture here notes, ADHD has a significant overlap with ASD. Giftedness does not but those with ADHD can span the whole range of intelligence. So, yes, some are gifted but they are not linked. There is evidence that about 30% of those identifying as trans are also on the ASD spectrum. I have not yet seen any research on such an overlap with ADHD. Be well.

[@DLusby]

Thank you!

[@russellbarkleyphd2023]

My pleasure. Be well.

[@n.c.kupfermann1023]

I think I get your argument. It is somewhat similar to the argument if poker is gambling or not and if it should fall under the income tax. I poker player said once poker is not a form of gambling because in the end always the same player win. Which was used as evidence that poker is not a form of gambling and poker players who earned their living from poker should pay income taxes on their winnings.

[@Londubh]

I think an excellent parallel would be with height: a woman standing below 5' tall is unquestionably part of human variation (a 2nd percentile woman), but you can't say that her being shorter than 5' tall doesn't negatively impact her in our society.

[@shaneward_adhdreimagined]

I've struggled to find the right comment so bear with me on attempt number x. I want to agree, and disagree. The fringe elements of the ND movement are loud and militant, and inject intersectionality as their call to arms, but are not the representatives of ND. ND does recognise the extremes, and that there are different needs at different levels. But they recognise the role of empowerment over disorder. By advocating inclusivity we have an opportunity to have some control over our environment which reduces the stress of interaction with our environment. Diagnostic criteria are essential for access to medication and accommodations, but as you point out those who don't make the "cut" for having a major life impairment may never seek out a diagnosis but will be constantly frustrated by their interaction with a mismatched environment. We have to find a way to merge the needs of the Psychiatric fraternity with the ND movement because they both have a role to play. As a South African I've followed diverse arguments in the treatment of ADHD *because* we are not always in a position to treat everyone equally at a medical level - and so telling people they have to have a diagnosis, they have to take meds to alleviated their symptoms is not always possible. If I have to tell my prospects that their life is a disorder it makes it infinitesimally more difficult to find acceptance. I have to lean into empowerment over disorder. Which is why I've also found EPSIG and Professor Amanda Kirby's work to be just as useful allowing me to frame ADHD in a more holistic fashion. As a disclaimer I am an ADHD Coach so my focus may be different. My challenge locally is that whatever the US/UK/Canada "decide" is THE view of ADHD translates into unassailable dogma in our Psychiatric fraternity.

[@jigsaw4253]

Correct me if I'm wrong, but is this accurate? ADHD and Austim are exactly the same in terms of spectrum impairments? For example. Elon Musk is Autistic, but he's WAY more competent than not just ND but NT as well. Obviously, that's an extreme example, but there are many cases where they can live normal life's. I'd imagine this is the same for ADHD spectrum. And if so, why don't they call ADHD a "spectrum" disorder like autism?

[@brbndrnkr3766]

At the 430 mark you talk about biohazards causing injury to the brain, can you please expand on that? I'm looking more for what biohazards you mean.

[@russellbarkleyphd2023]

Any environmental substance or event known to produce damage to the developing brain. thanks!

[@DanniBby]

⁠​⁠​⁠@@russellbarkleyphd2023really would help if you could give examples for what environmental substances can cause biohazard to damage the developing brain?

[@vitulus_]

Thanks for the video. This was a similar conception that I discovered over-time which allowed me to understand ADHD much more. I think people look at ADHD the wrong way, like a traditional medical condition where there is a set cause. I also want to add that conceptually, it makes a normal-like distribution because there are many traits and factors that can cause ADHD. If we assign them some probability then you're going to get some kind of normal distribution -- as a normal distribution is the limit of a binomial distribution. I was wondering if you could cover IQ and intelligence and how that can impact ADHD, and how it may present or be diagnosed. I think in another interview you mentioned an interesting study where high IQ individual with ADHD had greater levels of creativty, something that is not observed for the average person with ADHD. It's an interesting topic, and there seems to be a paucity of people talking about the overall topic of intelligence and ADHD.

[@russellbarkleyphd2023]

Thank you as well

[@CJQuinn]

Interesting critique. Would I choose to stop having ADHD at the wave of a wand? Absolutely not. It's an impairment that has caused me and my family members a lot of difficulty and pain over my life; however, it's a key part of my personality and how I relate to the world and people around me. Diagnosis as an adult massively improved my life and my understanding of myself, in particular making me kinder and more forgiving to myself. I'm extremely glad that psychiatry offered the opportunity to identify the cause and mitigate the effects with medication. One thing that gets lost in the neurodiversity discussion is that it offers a means to come to terms with natural population variances in neuropsychology. Rather than insisting that "everything is fine", it's coming to terms with ourselves as we are and not seeing ourselves as defective or broken. That, I think, is the real power of neurodiversity; our existence is valuable and we aren't inferior to those in the middle of the bell curve.

[@russellbarkleyphd2023]

Agreed.

[@capgains]

Russel mentioned John (something) as the leasing expert on adhd. What is John’s last name if anyone knows ?

[@Shifterfire]

I think it is a shame that the discussion you are presenting is so polarized. I recognize that you might just be arguing against the extreme view that ADHD is not harmful and should not receive accommodations. I feel like this video is sketching a false dichotomy. ADHD comes with severe impairments, but that doesn't mean people with ADHD are broken. A disease centric lens tends to promote that view. I think that viewing ADHD just as a disease, something that needs to be "fixed", creates a lot of othering and ironically places blame on the people with ADHD. I think neurodivergence tries to address that, by trying to adjust society to better accommodate ADHDers. Moreover, that ADHD is a "normal" part of human variation does not mean that these people should not receive help or treatment. Being part of normal variation does not make you well adapted to current society, where very high amounts of self-regulation are required. Lower self-regulation abilities come with some advantages, but they do not outweigh the disadvantages and burden placed on the individual. Ultimately, I want to stress that the neurodivergent label does not need to interfere with seriously addressing ADHD. --- One more thing: Getting rid of ADHD is a bit of a vapid proposition. As you said, ADHD is dimensional, so what exactly would one be getting rid of? I'd love to have improved self-regulation abilities, sure, but I don't want to exchange my personality and interests for something else. P.S. neurodivergent ≠ neurodiverse

[@janetausig5805]

While I acknowledge that aspects of ND brains require support and mgmt I challenge this framing. First of all, many aspects of ND brains provide benefits along with challenges - so the "disability/superpower" argument is a false choice. Second, avg. EF brains may have other aspects that potentially cause harm but are inherently supported by cultural or societal practices: for example, watch wearing is normalized - people are not expected or shamed or labeled for not inherently being able to know what time it is. Finally, I don't think Dr. Barkley is addressing the harm of being labeled a "defective" i.e. lesser human on someone's self esteem or ability to advocate for their needs or rights or believe in their ability to achieve anything.

[@christpebbles]

What an odd bell curve. I was considered gifted and I have ADHD. Incompetent?!?!?

[@Dere2727]

Gifted in executive functioning, not generally gifted

[@jigsaw4253]

I knew u were going to make a video about this.