The Myth of ADHD Over-diagnosis: What the Evidence Actually Shows

“Everyone has ADHD nowadays”. It’s a phrase that has become almost unavoidable, repeated across social media, echoed by politicians and woven into everyday conversation. However, as a woman in my mid-twenties who has recently been diagnosed with ADHD and autism, it is one that I find difficult to accept. For many people like me, receiving a diagnosis is not a trend, but a long-overdue explanation for patterns of behaviour that we have spent years trying to manage and make sense of.

For much of my life, these patterns were easy to overlook from the outside. They looked like being highly organised - relying on multiple calendars, constant reminders, and rigid systems just to keep up with everyday tasks. But beneath that was a constant sense of mental overload: racing thoughts, restlessness, and a level of anxiety that came from trying to stay on top of things that never felt fully under control. None of this resembled the stereotypical disorganised, hyperactive and unmotivated image of ADHD, and so it went unrecognised.

When I received my diagnosis, it felt like a weight had been lifted. For the first time, I could make sense of why I struggled with things that seemed to come easily to others. Yet sharing that diagnosis was accompanied by an uncomfortable feeling—that I was somehow participating in a trend, in a cultural moment where “everyone has ADHD”.

However, a recent Guest Editorial piece published in the British Journal of Psychiatry by Samuele Cortese and colleagues suggests otherwise. By bringing together researchers, clinicians, individuals with lived experience and carers, the authors argue that there is no robust evidence to support the claim that ADHD is being over-diagnosed in the UK. Instead, they warn that such narratives risk being used to deny people with ADHD ‘the care they deserve’.

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ADHD, or attention-deficit/hyperactivity disorder, is a neurodevelopmental condition characterised by ongoing patterns of inattention (such as having difficulty paying attention), hyperactivity (such as often moving around or feeling restless) or impulsivity (such as interrupting or having trouble waiting one’s turn). These symptoms can affect multiple areas of life, from education and employment to relationships and emotional wellbeing.

Yet for many adults, particularly women, these difficulties are not always recognised for what they are. In my own case, the signs were there, but they did not align with the more visible, stereotypical presentations of ADHD that dominate the public understanding of the disorder. For example, although I was hyperactive, I could sit still in class; my hyperactivity was less a racing body than a racing mind.

Presentations like this do not fit common expectations of ADHD, which may explain why so many individuals go unrecognised by parents and teachers in school and seek diagnosis later in life.

So, is ADHD over-diagnosed?

Central to this debate is the concept of over-diagnosis itself. According to Cortese and colleagues, over-diagnosis occurs when the number of diagnosed cases exceeds the prevalence estimates of the condition in the population. This might happen if diagnostic criteria are applied too loosely or without sufficient clinical rigour. It is also linked to concerns about self-diagnosis, particularly in an era where mental health information is shared widely online. However, an increase in diagnoses does not in itself indicate over-diagnosis. It may instead reflect improved awareness, better access to services, or the diagnoses of individuals who were previously overlooked: something that may strongly resonate with the experience of many late-diagnosed adults.

This distinction becomes important when we look at the available data. Current prevalence estimates suggest that ADHD affects around 3.1% in children and young people in the UK and approximately 3.3% of adults globally. However, clinical diagnosis rates in England remain consistently below these figures: although diagnoses have risen over time, particularly among girls and women, the proportion of individuals diagnosed in 2018 was still lower than prevalence estimates. Cortese and colleagues therefore conclude that there is no evidence that ADHD is over-diagnosed at a population level.

So why are diagnoses increasing? One explanation offered by Cortese and colleagues is that a growing awareness of the disorder is helping to correct long-standing biases in how ADHD has been recognised. For many years, ADHD was primarily associated with hyperactivity in boys, meaning that people, like me, who do not fit this profile were more likely to be missed. For example, girls are more likely to present with inattentive behaviours and develop adaptive behaviours that mask their symptoms, perhaps leading them to be under- or mis-diagnosed with other disorders. Reflecting on my own experiences, it becomes easy to see how behaviours that appear functional on the surface, like overcompensating with excessive organisation, can obscure teachers and parents from recognising the underlying challenges.

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The consequences of mislabelling this trend as over-diagnosis are not trivial. One common criticism is that diagnoses can be used to avoid responsibilities or lower expectations. However, receiving a diagnosis is not about excusing behaviour, but understanding it. For many, receiving an ADHD diagnosis can be transformative: it can provide insight into long-standing behavioural or emotional difficulties, improve quality of life and self-esteem and allow effective support and strategies to be put in place to navigate daily life with more confidence. In my own experience, the diagnosis did not introduce new problems, but reframed old ones. It allowed me to be more compassionate towards myself; to recognise that my behaviours and challenges were not a personal failing, but part of a broader neurodevelopmental pattern. I am not broken; I am just different.

Of course, questions remain. Much of the data referenced in the paper predates the COVID-19 pandemic, and it is possible that patterns of diagnosis have shifted in recent years, particularly given the pandemic’s impact on mental health, disruption to daily routines, and changes in access to assessment and support. Ongoing research will be essential to understand the extent of these changes. However, based on the best available evidence, the claim that ADHD is over-diagnosed in the UK does not appear to hold true. 

Rather than signalling a problem of excess, rising diagnoses may reflect progress in recognising a condition in individuals who have been previously overlooked. For those who have spent years without an explanation, the shift is not a sign of overreach, or a passing trend, but of overdue recognition.

For me, a diagnosis did not change who I am—it changed how I understand myself. Dismissing ADHD as over-diagnosed risks silencing those like me before they are understood.

The question, then, is not whether too many people are being diagnosed, but whether we are finally beginning to listen to those who have been missed for far too long.