Despite everything I am normal

this is probably shaped by my limited frame of reference, but im really fascinated by witnessing the real-time development of adhd as a diagnosis. people attribute so many symptoms to it now or maybe they always did? i was wondering if you have any thoughts on what is the use of adhd specifically as a category within psychiatry. I'm esl so sorry for any confusing wording

no you're right imo; diagnostic categories are always somewhat in flux ofc but ADHD is one that has seen a particularly pronounced shift in the last couple decades. obviously this is multifactorial but my observation goes something along these lines:

'hyperactivity' has been dx'd in children since about the 1950s (also when Ritalin hit the market) but the ADHD dx doesn't really take off until the 90s (also when Adderall, a 2nd-gen reformulation of the 'obesity' drug Obetrol, hit the market). so, it's not all that surprising that 20 years later you see increased patient awareness of the diagnosis, increased popular interest in it, and shifting / expanding ideas of what it means and what ADHD 'is'. it's a relatively young dx.

part of the reason it's young is because it's basically a 'biopsychiatric' dx, meaning it diagnoses certain behaviours as being a 'brain problem' rather than having social causes or context. in practice this is complicated because psychs do use pharmacological approaches in conjunction with psychodynamic ones all the time; nevertheless, the central promise of DSM ADHD and its pharmaceutical treatments has consistently been that the ADHD subject has a physiological, neurological disorder / dysfunction / aberration, and that the drug treatments on the market fix it. that none of this is actually empirically supported is conceptually inconvenient and entrenched by the research process.

the biopsychiatric narrative is worth paying attention to because the context here is one in which it has become commonly accepted that behavioural 'disorders' and affective distress of various kinds can be, basically, either of pure biological origin, or else Your Fault. in the case of childhood hyperactivity, Your Fault historically also included Your Mother's Fault; part of the reason many mothers embraced Ritalin in the 50s and 60s was because the proffered pharmaceutical narrative explicitly challenged the idea that these mothers had done something 'wrong' to result in their (mostly) sons exhibiting disruptive and hyperactive behaviour.

this dichotomy of biology vs personal failing is very overtly present in quite a bit of discourse around ADHD today. if it's my brain being 'wrong' or different, then it's not something I've done wrong but a disease with a simple chemical fix. in this context I don't think it's surprising at all that a lot of popular and patient conceptions of ADHD have seen a considerable widening over the past few decades. often people like to blame this on pharmaceutical companies, and it's true that industry benefits from these discourses and frequently invests in them (eg, via instruments like ADDitude mag). however, that's a pretty simplistic explanation on its own and doesn't really account for the ways in which patients and potential patients also find this diagnostic category personally useful, for reasons ranging from identity-formation to the desire to access prescription amphetamines. ADHD increasingly shows up as a biologised explanation for behaviours ranging from 'eating too many sweets' to 'postural sway' and so on. you can see in such examples how invoking the idea of an aberrant ADHD brain is both reassuring to people who have been made to feel ashamed of certain behaviours, and provides a sense of shared identity and community with others.

all of this is to say: I don't find it surprising at all when I see a relative broadening of notions of ADHD, almost always expressed in biological terms (the 'ADHD brain' operates differently, 'seeks dopamine', causes this or that). ADHD is in some ways a particularly blatant distillation of this general trend in popular psychiatric discourses, for reasons relating to expectations about childhood and child behaviour, and the historical and present relationship between the ADHD label and the regulation of amphetamines. but much of what's happening with ADHD in terms of popular discourses about it can also be seen with many, many other psychiatric diagnoses, to varying extents and in various ways.

my experience writing about ADHD on this website leads me to close by explicitly stating the following: I do not think any ADHD behaviours / symptoms are people's 'fault' or an individual failing; I do not think using drugs for any reason is morally bad or needs to be justified; the fact that I do not think ADHD is a 'brain disease' does not mean I think people are 'making it up' or exaggerating wrt any difficulties they experience personally, professionally, emotionally, &c.