The Current - Why are more adults being diagnosed with ADHD?

Episode Date: March 5, 2025

There’s been an increase in the number of adults diagnosed with ADHD and prescribed medication to treat it. We talk to two adults about what getting a diagnosis meant to them, and ask a doctor if social media and private clinics might be leading to an overdiagnosis of ADHD.

In Scarborough, there's this fire behind our eyes. A passion in our bellies. It's in the hearts of our neighbors. The eyes of our nurses. And the hands of our doctors. It's what makes Scarborough, Scarborough. In our hospitals, we do more than anyone thought possible. We've less than anyone could imagine.

But it's time to imagine what we can do with more. Join Scarborough Health Network and together, we can turn grit into greatness. Donate at lovescarborough.ca. This is a CBC podcast. Hello, I'm Matt Galloway, and this is the current podcast. Top 10 signs of ADHD. Number 10 is they're easy to anger.

Don't set one of them off. I have ADHD. Here's my three emotional stages of an impulsive decision. When they diagnosed me with ADHD, they were like, okay, perfect. You have really bad ADHD. Don't know how you've actually gone this far in life without a diagnosis. Here's a test to see if you have ADHD. Start by focusing on the flashing blue and green dot in the middle of the screen. And as you stare at it, this is...

Does this sound familiar? If you have found yourself watching a TikTok video thinking, huh, maybe I have ADHD. Well, you are not alone. If you scroll through social media, you will see video after video listing the top signs that you have ADHD and that has led more Canadian adults to doctor's offices asking whether they have the disorder and to more of those adults being prescribed medication associated with treating ADHD. In a moment we will hear from a psychiatrist about what might be behind this,

but first I'm joined by two people. Kiri VanderWel was diagnosed with ADHD just over two years ago after giving birth to her second child. She's in Delta, British Columbia. And Keith Gellhorn was diagnosed at 34 years old, runs a life coaching business focusing on people with ADHD.

He's in our Halifax studio. Good morning to you both. Good morning. Good morning. Kiri, tell me about why you thought you might have ADHD. What was going through your mind? What were you thinking? I mean, at the exact moment, like in time,

that I was diagnosed, I was a mom of two littles, like very little people. And my experience was such that some elements of motherhood came quite easily, like my natural instincts and those types of things, but a lot of things associated with executive function that I didn't know that's what it was at the time was a lot harder.

My experience of motherhood in certain aspects relative to other friends of mine was a lot harder. What about before you were a mom? I mean, did this go back years before that when you were thinking, I wonder what's going on? Absolutely, absolutely. And it was less, I mean, I would love it if it was in your lovely voice in my head saying, I wonder what's going on.

But instead it sounded a lot more like, why can't I do this? What's wrong with me? I wish I a lot more like, why can't I do this? What's wrong with me? I wish I could just do X, Y or Z. What were X, Y or Z? I mean, what was happening there? I mean, for me, it's like, why can't I do this faster?

Why do I procrastinate until the absolute last minute? Why am I pulling an all nighter again? Why have I started this load of laundry and not finished it days later? Why can't I get my taxes in on time? Various different things that in isolation, a great many of us might experience one or two things where it's like, darn, I wish I got that done on time.

But in my world, it was a lot of those things in conjunction and it started to form a narrative that felt quite confronting. I so often was questioning myself and my own functioning, but didn't really realize that that's what was happening. So you become a mom and then how did that kind of urge you or push you in some ways to seek out an official diagnosis? As you said, these things are kind of swirling around

in the background, but that's obviously a clarifying moment in your life. Yes, absolutely. A girlfriend of mine in a sort of a similar circumstance, similar age children was having a similar struggle. She and I were both being seen at BC Women's for postpartum depression and anxiety. And while both of those things were in fact true, and I believe in those diagnoses, neither of us felt like it was

the crux of it. And so she and I were chatting and she said, yeah, I'm looking into an ADHD diagnosis. And I remember thinking, oh, wow, that's so nice for you. I didn't try it on. I didn't see those characteristics inside of myself. And then I looked into something specific that she had been looking at, like an article or might have been TikTok, as you say. And it all kind of hit me like a ton of bricks. Like, oh my goodness, me too. And, um, that was sort of the beginning of pursuing a diagnosis for myself. And honestly, Matt, my, my photo could be beside the definition of a, you know, a textbook ADHD case.

So. Keith, what was happening in your life? Uh, basically what happened with me is, uh, uh, I was working as a plumber and, uh, I got caught up in the economic downturn in 2008, working up in Kelowna and my company went from 77 of us to four in six months and I was the last to get cut. Following getting cut, I had like a massive mental

health breakdown and my wife to be saw me curled up, bawling my eyes out because there was nowhere to go at that point. And so I called up mental uh, mental health, end up getting a diagnosis of anxiety and depression. And in the situation, I'm like, well, obviously I'm anxious and depressed. And then I was describing a symptom, which is

the first thing that in your little clip there. So I had a flash anger. So I go from zero to 102 seconds, I yell, scream, road rage, and I'm a big dude. I'm six, seven, three, 50, right? So being like that was getting me in a lot of trouble and then this clinical social worker says, oh I think you have ADHD and I'm like, nah, that's kids that are bouncing off the walls, it's not me. And she gave me this book, it's called You Mean I'm Not Stupid, Lazy or Crazy,

it showed this flash anger which is now called intermittent explosive disorder. Um, and then I read the next paragraph, the next paragraph, and it's one book that I've actually read front to back, multiple times compared to the other hundred books on ADHD that I buy that haven't even been opened yet. So. What did it mean when you, when you read through that book and you saw yourself in those pages,

what did that mean to you? For me, uh, it kind of culminated when I was, when I was young, right? I was, I basically was struggling reading, writing and math. Um, I've spent every summer in summer school in grade 12. I skipped 133 classes and my principal told me that based on my performance at school, didn't matter what I did in life, it'd always be a failure. Um, went

off to college, failed out and, uh, finally had enough credits to go into social work is what I always wanted to do. When I went in there, they said, looked at my transcript, I like 70, right? And they said, well, there's no way you're ever going to see an academia. Like go get a trade, plumbers make good money

and defaulted into it, worked in the trades. I, you know, I did all this therapy and I was like, okay, I can tell you 50 ways why I think and act and feel the way I do. But, but I wanted somebody like me who could help me get through the day-to-day stuff and there's nobody to do it, so I'm like, screw it, I'll just start it myself. That's why I started advocacy and went from there. Pete Slauson Kiri, how did you, you talked about your friend getting that diagnosis and that you twigged that

maybe this would be something that you would follow up on. How difficult was it for you to get a formal diagnosis of ADHD? Fortunately, in my case, it wasn't too difficult. Over here, the clinic, although virtual, the clinic is called the Adult ADHD Center. And that's a private clinic? It is a private clinic. The doctor, however, does also do

the sort of public health route as well. The difference was that, you know, the wait to meet with a nurse practitioner virtually, which is sort of the first step before then meeting with the doctor for the formal diagnosis was a two week wait where the public health wait was over two years. And certainly there was a, you know, there's an economic difference in that. I believe it was a $300 fee to do it. And I was fortunately in the position to be able to do that.

So I don't want to suggest that everyone is, but that allowed me to get really confirmation of what at that point was more than an educated hunch. Like I knew it like that. What changed in your life when you got that confirmation? Gosh, everything. Everything. Validation for the thoughts that had been, that I sort of described before that had been pouring through my head for my whole life.

I wasn't alone. These things that I considered to be kind of curie quirks were actually defined quirks or defined characteristics of an entire subset of our population. I understood myself for, or started to understand myself for the first time in my life. Did it make a difference in life with your family too? Absolutely. What it did, obviously it allowed an opportunity for different strategies, different things like medication, et cetera, that helped to support some of the things that I was experiencing. And what it has done as well is it has allowed me to parent from a place inside of some of those characteristics

I now see in at least one of my children. And I can take that extra half beat to take a breath before I respond. Do you think about what you lived through before you got that diagnosis and how you managed up to that point? Yeah. Yeah. I mean, one of the things that I would be remiss not to speak about is, especially in adult diagnoses, a lot of those of us who have been diagnosed late talk about the grief of not knowing sooner of what life might have been like had I had the diagnosis sooner. I mean, that's a slippery slope and a long road to go down if you let it. So I

give myself a half beat, but then I kind of move on. I absolutely think that I would have benefited from knowing that sooner. I might have been able to support myself with strategies as a younger person. I might have been able to take care of some of that negative self-talk, that self-deprecation, that kind of bully in my brain, if you will. And so, absolutely, I think back on younger years and just wish I could tell her that it's okay. Like, it's going to be okay.

And you know, you're not lazy, you're not different insofar as there's nothing wrong with you. Keith, one of the things we know is that there has been an increase in the number of adults who are being prescribed ADHD medicine since the pandemic as well. I mentioned those videos that are on social media as well, and there are people who, and we're going to talk more about this in a moment, but there are people who are concerned that ADHD is perhaps being overdiagnosed and that people are being overmedicated as well. What would you say to people who raise based on, on what you know now?

Well, the thing with the, with the medication, so back in the day, and I'm sure the doctor will speak to this, but back in the day when it was, uh, people were getting prescribed like Adderall and, uh, Ritalin, um, that was an abusable medication. The current status of the medications like, um, Vyvanse, I think 80% of my clients I track whether they all take it, 80% are on Vyvanse. It's 80% of my clients I track whether they'll take

it. 80% are on Vyvanse. It's only in your system while it's in your system. So it's there from, you know, it's on a 10 to 12 hour bell curve and it's in your system and out of your system, right? And those of us who have it, what it does, it doesn't cure anything. That's the thing that bugged me with medication. When I got diagnosed is that I said, you know, from during work I was fine. I get home and I was turning is that I said, you know, from during work, I was fine. I get home and I was turning back into a bit of a demon, right? For those of us who do take it, what it does is basically quiet the hyperactivity of the noise in our brains, right? So. What do you think people need to understand? I mean, you now work with other adults with ADHD

as a life coach. The plumbing thing is long gone and this is your focus now. What do you think people need to understand about adults who are living with ADHD? That it's a lifetime challenge. We work with youth and adults 18 and up. School system takes care of the rest, well they say they do, but they don't. So we go 18 and up. So we work with like post-secondary students, people are struggling with careers and entrepreneurs and parents. And even if you come work with me and said, I'm not going to cure it.

There is no magic system that you can buy off me like a lot of other coaches will say that, you know, come work with me for $20,000 and we'll cure it. It's not a matter of curing it, it's figuring out a way of how to live with it. Like we're told like, what is it, 300,000 times by the time we're 18, don't do this, don't touch that, why are you doing things

this way, why do you do things that way? So we developed that inner dialogue, I call it my inner gremlin and that thing is going 24 seven telling me how crappy, crap I am. And also the clients are, and so what we do is like, how do you help silence that voice and figure out how us neurodivergent individuals, how do we fit into a world that wasn't built for us, right? We're like, you know, the world's designed for people that sit in their desk and

go to school and go to work and do the nine to five and control their lives that way and we're just not those people right? That's okay. That's important work that you're doing. It is really important. Yeah. Kiri, I'm going to let you both go, but you said something just a moment ago that one of the things that you wish you could have said back to the younger you was that it's going to be okay. Yeah. if you had heard that back then, what, what difference would that have made for you? Do you think? I think it might've made a world of difference in listening to that

inner dialogue and not, not giving it power, like really taking away the power from that inner dialogue. I definitely still hear a lot of those things. I simply just know where they're coming from now. And so I think for me, um, a lot of self-confidence comes from understanding. Understanding those differences, perhaps. I'm not different from those of us who also have ADHD, like Keith, who I also have a very busy brain. And I'm grateful to know that. And I would have been very busy brain and I'm grateful to know that. And I would have been very grateful to know that

as a younger person and that's why I speak up about it. I would love for more people to hear from other voices that might sound like theirs, that might sound like the voice in their head that it's going to be okay. That's an important message to hear. You're always welcome to come back on the program. It's good to talk to you.

Thank you very much, Kerry. Wonderful, thanks, Keith. Thanks, Matt. And Keith, belated happy birthday. Fifty is a big number. Yeah, I made it. So congratulations to you. And it's good to talk to you. Thank you very much. Really appreciate you having me on. Thank you. Kiri VanderWel and Keith Gellhorn were both diagnosed with ADHD as adults. In Scarborough, there's this fire behind our eyes.

A passion in our bellies. It's in the hearts of our neighbors. The eyes of our nurses. And the hands of our doctors. It's what makes Scarborough Scarborough. In our hospitals, we do more than anyone thought possible. We've less than anyone could imagine. But it's time to imagine what we can do with more.

Join Scarborough Health Network and together, we can turn grit into greatness. Donate at lovescarborough.ca. You're an entrepreneur. Growth is essential for your business. At BDC, we get that, and we're here to help you stay two steps ahead. With our flexible financing and advisory services, we help you adapt,

growing your business in the face of today's challenges and tomorrow's opportunities. Stepping up for entrepreneurs, we're on it. BDC, Financing, Advising, Know-How. Dr. Nick Gruich is a psychiatrist at Sunnybrook Health Sciences Centre. He's also an assistant professor at the University of Toronto's Faculty of Medicine he's been listening in. Dr. good morning to you. Good morning, Matt. Glad to be here. Good to have you here. What you heard from Keith and Kiri in terms of their stories, does that sound familiar when it comes to adults who are seeking an ADHD diagnosis? It does, Matt. Yeah, thank you. Both guests were quite eloquent

in describing the symptoms of ADHD and the importance of recognizing that the symptoms started in childhood and progressed into adulthood. What sort of increase have we actually seen in adult ADHD diagnoses? I said anecdotally, it seems like there are a lot more people who are talking about this.

What do we know about what the facts say? Well, I think the data would suggest that the numbers have been relatively consistent over time, but there's certainly been an explosion of interest in ADHD in a lot of people who've now self-identified as adults who struggle with ADHD. If you look at Google Trends, the searching of ADHD was relatively consistent over the last decade,

but over COVID period, during the pandemic, it spiked up significantly. And I think that there's been a real light shined on this concept of adult ADHD, which in medicine is still somewhat unclear how to understand it. Tell me more about that and what's going on. I've read that one in four people in the United States think they have undiagnosed ADHD. I mean, we talked about social media and the eruption of those sorts of videos on social media. What do you think is going on there?

Why would more adults be seeking an ADHD diagnosis? So I think it's important to recognize that ADHD is still seen as a neurodevelopmental syndrome, which means that in order to make a diagnosis of ADHD, the symptoms had to have been present before the age of 12. And so statistics from Canada suggest that about 9% of children meet the criteria for ADHD, and that it's good to break it into the rule of thirds. So about a third of children with ADHD will grow out of ADHD when they get into adulthood. A third will find a vocation where

ADHD is no longer problematic. So for example, if they become a hockey player, might not be an issue that requires treatment. And then a third of children will continue to struggle and require treatment into adulthood. And that corresponds with about 3% of adults having problematic ADHD that requires attention. And so we hear about ADHD disproportionately more than this 3% would suggest. And I think a lot of that has to do with media.

I think that media both propagates this notion that any inattention or any hyperactivity directly equates to ADHD. I also think that post-COVID, a lot of people are juggling a lot more tasks and multitasking, and I think technology has become also more taxing on the brain, and I think it's led us to feel like we're inattentive and not all inattention is ADHD.

One of the things is you could look at the symptoms and the symptoms might sound very familiar. Impulsiveness, disorganization, problems, multitasking, poor planning, a hot temper. People could read those and think I have all of those things and that could lead me to believe that I have ADHD. Do we know whether more people have ADHD now? So again, I wanna circle back to this idea that ADHD, as we understand it now in the DSM, which is our diagnostic manual, you have to have had the symptoms in childhood. So this idea that one develops ADHD in adulthood

is not consistent with the medical diagnosis. So what happens then with the diagnoses then? Are we, are we over diagnosing ADHD in adults? Well, I think it's complicated. There's probably some over diagnosis, some under diagnosis and some misdiagnosis. I think that when people look at social media, there's probably a lot of misdiagnosis happening.

There may be some under diagnosis happening because we know that practitioners, a lot of practitioners in primary care and in psychiatry are not quite comfortable or versed in doing the ADHD assessments. And then on the flip side, there are private ADHD clinics and I'm not familiar specifically, but one could understand where there may be the potential

for overdiagnosis. What does that mean? I mean, one of the things that we've heard is that because, and Kiri talked about this, the wait times for a public clinic could be a couple of years, there are private options that would spring up. When you suggest that perhaps that could lead

to a mis or over diagnosis, what are you talking about there? I mean, there's always the potential for bias in private clinics. And so there are potential benefits of having an ADHD diagnosis in terms of accommodation at work and school. And so those factors could contribute to overdiagnosis.

There's also been a rise in the adult prescriptions of medication that's associated with the treatment of ADHD in this country. What's going on there? What are the risks of overprescribing? So the ADHD medications can be abused. They are stimulant medications, and there is also the potential for diversion or Misusing the drugs so for children the stimulants are probably the most effective medications We have in treatment of ADHD in adults They are effective as well But not necessarily as effective as they are in children and so when working with adults with ADHD I think it's important to focus on behavioral strategies to help support them and improve their function. Should we be worried about over prescription?

I mean, I think in medicine, there's always the potential for over prescription, over pathologizing, over diagnosing. And so I think that, again, the concept of adult ADHD is relatively new. So ADHD became a popular diagnosis in children, but now all those children are growing up and becoming adults. And so we're not entirely sure what to do with this adult ADHD population. And so I think that to give everyone

a prescription of medications, probably not the right way to go. And these medications do have side effects. They can impact anxiety levels, they can cause difficulty with sleep, sometimes they can have taxing and negative effect on the cardiovascular system. So there is a physical cost to people taking these medications in terms of side effects. What are the alternatives to medication?

I think ADHD coaching or psychotherapy or even reading books around ADHD and learning individual strategies on how to manage the symptoms. In our current state of the world, technology has caused us to really demand multitasking of ourselves and that can challenge our ability to stay focused and attentive to complete tasks. I know that if I'm sitting crafting an email, my phone's right there buzzing on one hand and another screen may be buzzing on the other side. And so it's really challenging to stay focused. And so I think if we're mindful to incorporate strategies to help keep us focused and on track, that'll help us function. There is a report that came out recently,

a study in the UK that found that men with ADHD faced a reduced life expectancy of around seven years, women faced a reduction in life expectancy of around nine years time. That is obviously alarming to people who have or believe they have an ADHD diagnosis. What's going on there? So the belief is that it's not an inherent biological issue. It's not that people with ADHD are unhealthier, but it's more of the byproduct of ADHD behavior that can lead to worsening health outcomes. So imagine if someone has ADHD and they're struggling to remember to take their medications, they're struggling to remember to take their, to attend to their healthcare appointments, you could understand how they'd have a global reduction in their health. In addition, people with ADHD may struggle with impulsivity, may have higher issues with substance use, maybe make poor

health decisions. And then also there's higher rates of accidental death. For example, motor vehicle accidents, or even death by suicide is higher in this population. So when you look at all those things combined, you can understand that if ADHD is severe and it's untreated, there could be a risk of shorter life. Just finally, what do you want, given what we've been talking about here, what do you want adults to be thinking about if they feel like those symptoms are familiar and recognizable and they wonder perhaps what's happening and they might be choosing to pursue an ADHD diagnosis. What do you want them to be thinking about? I think the most important thing is to remember

that ADHD does not develop in adulthood. And so if someone is struggling with inattention or hyperactivity, there's dozens and dozens of different reasons why that could be the case. If they did have ADHD diagnosis or struggled with focus inattention or hyperactivity in childhood, then perhaps they could have the adult form of ADHD, which is continuous over time. If the person did not have inattention or hyperactivity or ADHD diagnosis in childhood, then what they're

experiencing is not, by definition, ADHD. That's not to say that it's not something that can be addressed either through a medical exam to see if there's any other causes for their symptoms, like a mental health disorder, like anxiety or depression, or some physical medical disorder. But I think that if they are struggling with inattention or ADHD-like symptoms, they should probably still read around behavioral strategies to improve focus and attention.

Dr. Nikruich, we'll leave it there. It's good to speak with you. Thank you very much. Thank you. Dr. Nikruich is a psychiatrist at Sunnybrook Health Sciences Center, also an assistant professor in the University of Toronto's Faculty of Medicine. Have you been diagnosed with ADHD as an adult? Has somebody that you know been diagnosed with that disorder as an adult? And what is that diagnosis meant for you or for them? We'd love to hear from you. You can email us, TheCurrent at cbc.ca.

For more CBC podcasts, go to cbc.ca slash podcasts.