Unpacking ADHD: Part 7 - ADHD in Society: Familiarity vs. Understanding

The Science of ADHD: Why It's So Familiar (and Misunderstood)

ADHD isn't caused by one single thing; it's a complex puzzle with many pieces (Cortese & Castellanos, 2019; Kolar & Cortese, 2019). Our genes play a huge role—if you have ADHD, there's a 60-90% chance it runs in your family (Kolar & Cortese, 2019). This means many different genes, each with a small but important effect, are involved, especially those that control brain chemicals like dopamine (Kolar & Cortese, 2019; National Center for Biotechnology Information, 2020). So, it's not just one "ADHD gene" but a complex mix.

Environmental factors also play a part, working hand-in-hand with our genetic makeup. These can include things like certain infections, smoking during pregnancy, poor nutrition, or alcohol exposure before birth (National Center for Biotechnology Information, 2020; Kolar & Cortese, 2019). At the brain level, the main issue is often a glitch in how certain neurotransmitter systems, particularly dopamine (DA) and norepinephrine (NE), function. These chemicals are vital for attention, impulse control, and how we experience rewards (Kolar & Cortese, 2019; National Center for Biotechnology Information, 2020). All these genetic and environmental factors come together during early development, creating a predisposition to the disorder (Cortese & Castellanos, 2019; Kolar & Cortese, 2019).

ADHD is a household name, but this familiarity often comes with a lot of misunderstandings and unfair stereotypes (Visser et al., 2024). Its sheer commonness contributes to its widespread recognition; it is one of the most common childhood disorders, affecting approximately 8-12% of children worldwide (Cortese & Castellanos, 2019), and about 6% of U.S. adults are diagnosed (American Psychiatric Association, 2025). This widespread presence naturally makes it "familiar." However, this familiarity is a double-edged sword. While many people have heard of ADHD, this recognition often lacks accurate scientific understanding. Instead, it's frequently accompanied by myths, prejudice, and stigma.

Common misconceptions include the belief that "all individuals with ADHD are hyperactive" or that "ADHD is a fashion phenomenon" (Visser et al., 2024). These mistaken ideas and negative judgments contribute to both public stigma and the internalized shame people with ADHD might feel, which can unfortunately make it harder for them to get mental health support, stick with treatment, and generally thrive (Visser et al., 2024).

Research has shown a widespread lack of accurate information about ADHD among the general public, and even among some educators and mental health professionals. This deficiency leads to insufficient personalized approaches and limited accessibility of information and help (Visser et al., 2024). What's more, confusing messages about ADHD in online media and disagreements among professionals can make things even worse, making it challenging for the public to figure out what's true (Visser et al., 2024).

Despite these hurdles, there has been a recent increase in adult ADHD diagnoses from 2020 to 2023, partly due to more awareness and destigmatization (American Psychiatric Association, 2025). However, a significant number of adults, particularly women, still go undiagnosed (American Psychiatric Association, 2025). So, society's "familiarity" with ADHD doesn't necessarily mean informed understanding; it often means a superficial or even biased awareness, which creates significant barriers to effective support and care. This really highlights how crucial accurate public education is.

Finally, in Part 8, we'll wrap up with a conclusion that empowers understanding and support.

HC Telepsych NP

References

American Psychiatric Association. (2025, February 10). ADHD in adults: New research highlights trends and challenges. https://www.psychiatry.org/news-room/apa-blogs/adhd-in-adults-new-research-highlights

Cortese, S., & Castellanos, F. X. (2019). The neurobiology of ADHD: Still an enigma? Frontiers in Human Neuroscience, 13. https://doi.org/10.3389/fnhum.2019.00042

Cortese, S., Solmi, M., & Fusar-Poli, P. (2021). Neuroimaging of attention-deficit/hyperactivity disorder: A narrative review of recent findings. Current Opinion in Psychiatry, 34(2), 108–114. https://doi.org/10.1097/YCO.0000000000000674

Dutta, C. N., Christov-Moore, L., Ombao, H., & Douglas, P. K. (2022). Neuroprotection in late life attention-deficit/hyperactivity disorder: A review of pharmacotherapy and phenotype across the lifespan. Frontiers in Human Neuroscience, 16. https://doi.org/10.3389/fnhum.2022.938501

Kolar, A., & Cortese, S. (2019). The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): What every clinician should know. Current Psychiatry Reports, 21(10), 96. https://doi.org/10.1007/s11920-019-1088-7

National Center for Biotechnology Information. (2020). Attention-Deficit Hyperactivity Disorder. In StatPearls. StatPearls Publishing.

Neuroimaging and ADHD: fMRI, PET, DTI findings, and methodological limitations. (2013). Journal of Attention Disorders, 17(6), 455–469. https://pubmed.ncbi.nlm.nih.gov/23682662/

Visser, J., van der Meer, S., van der Heijden, P. T., & de Jong, J. T. (2024). Unmet needs and priorities for stigma reduction in ADHD: A qualitative study with young adults, parents, teachers, and mental health care professionals. BMC Psychiatry, 24(1), 847. https://doi.org/10.1186/s12888-024-05459-y

Wang, S. Y. A., Manza, P., Tomasi, D., Volkow, N. D., Wang, G. J., & Zhang, Y. (2023). Shared and distinct neurobehavioral phenotypes of child obesity and ADHD. Translational Psychiatry, 13(1), 74. https://doi.org/10.1038/s41398-023-02359-x

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