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ADHD in the Age of RFK Jr.

Back in 1970, when I was seven and Ritalin was just getting comfy on pharmacy shelves, I got the ADHD label. No meds for me though. I wasn’t “sick.” I “compensated.” Which is a nice word for “white-knuckled my way through everything from school to adult life using sheer force of will, notes taped to every visible surface, and existential dread.” I also hurt a lot of people along the way. And while I eventually got decent at managing it (read: mostly passing for neurotypical on a good day), I’ve always known that some folks, friends, colleagues, patients, have ADHD symptoms that are just stronger, as in they regularly can’t find their keys, their train of thought, or a will to live before noon. For them, medication isn’t a luxury, it’s survival.¹

Which is why I get particularly angry when someone like our unfortunate chief potato of HHS, RFK Jr., shirtlessly does pushups in the national conversation with takes that belong in a time capsule labeled “Insanity.”

Here’s the issue: ADHD used to be conceptualized as a moral failing on the road to sociopathy.² Disruptive Behavior Disorders (DBDs) were seen as part of a tidy little pipeline: first you’re inattentive and hyper, then oppositional, then a juvenile delinquent, and finally, if all goes according to pathologizing plan, you wind up in prison with a label like “antisocial personality disorder” and a file thicker than your rap sheet. ADHD was seen as Step One on the path to moral collapse. This wasn’t just a theory; DSM-III (1980) listed it under "Disorders Usually First Evident in Infancy, Childhood or Adolescence," right next to Conduct Disorder.³ That legacy lingers.

For many of us diagnosed in those years, it wasn't just strangers or institutions who viewed us this way. It was people we loved, people we trusted. Parents, siblings, teachers, caregivers. Many of them truly believed we were headed for handcuffs and reform school. What they saw wasn’t a neurodevelopmental condition. It was a character defect. We weren’t struggling, we were “bad.” And when you internalize that message from the people who are supposed to protect you, it doesn’t just shape your childhood. It warps your whole understanding of who you are.⁴

This model was convenient for schools, courts, and anyone invested in control over compassion. And it dovetailed really nicely with racist narratives. In U.S. public schools, Black children are diagnosed with ADHD at half the rate of white children, yet they’re suspended or expelled nearly four times as often.⁵ Black boys are much more likely than their white counterparts to be started on antipsychotic medications. In fact, while only about 9.8 percent of white boys are suspended by high school, nearly 32 percent of Black boys with similar behavioral profiles are. So yeah, the early ADHD diagnosis model didn’t just have a medical bias. It had a racial one. And it’s not ancient history. Black children with ADHD are still 40 percent less likely to receive treatment than their white peers.⁶

But it’s not just the U.S. that has struggled to define and manage ADHD. If you zoom out and look globally over the last century, the picture gets even more complicated. While the United States leads in ADHD diagnoses and stimulant prescriptions, other countries have taken vastly different approaches—culturally, medically, and politically.⁷

In France, for example, ADHD is viewed primarily as a social and emotional disorder rather than a neurobiological one. French clinicians often turn first to psychotherapy and family counseling before considering medication. The result? Significantly lower diagnosis rates—some estimates suggest less than 0.5% of French children are diagnosed with ADHD, compared to over 10% in the U.S.⁸ That’s not necessarily because fewer French children have ADHD, but because the diagnostic criteria and cultural narratives around childhood behavior are so different.

Meanwhile, countries like the United Kingdom and Canada fall somewhere in the middle. In the U.K., ADHD has gained legitimacy in recent decades, and stimulant prescriptions have risen accordingly—though British guidelines still emphasize non-pharmacological interventions before medication. In Canada, particularly in provinces like Quebec, diagnosis and medication rates have historically mirrored those of the U.S., with increasing public debate over overdiagnosis and educational pressures contributing to rising numbers.⁹

In Scandinavian countries like Sweden and Norway, a more centralized healthcare system allows for earlier screening and interdisciplinary intervention, often with strong social support for families and children. That leads to more consistent care, though diagnosis rates remain lower than in the U.S.¹⁰ What’s interesting is that the same symptoms can yield wildly different outcomes depending on the system they’re filtered through—whether it’s a school counselor in Minneapolis, a GP in Oslo, or a psychoanalyst in Marseille.

Historically, ADHD as a diagnostic category didn’t even exist in most countries prior to the 1980s. The global uptake of the diagnosis has largely followed the dissemination of DSM guidelines and pharmaceutical marketing—meaning English-speaking countries adopted the framework earlier and more aggressively. As late as the 1990s, much of the non-Western world didn’t recognize ADHD as a formal diagnosis. But as awareness spread, so did the controversies: is ADHD a universal condition, or a Western construct? Does it manifest differently in collectivist cultures versus individualist ones? These questions still animate international research today.¹¹

So while the U.S. may lead the world in both recognizing and medicating ADHD, that leadership has come at the cost of intense medicalization, racial disparities, and public misunderstanding. Other nations, for better or worse, have told different stories about the same set of behaviors—and the result is a global patchwork of ADHD realities, ranging from under-recognition to over-pathologization, with no consensus in sight.

We’ve learned a thing or two since 1970. Or at least we’re supposed to have.

Today, more progressive understandings of ADHD view it as a form of neurodivergence. That is: not a disease, not a character defect, but a different way of processing information, organizing time, regulating emotion, and relating to the world. I see it as a different operating system that has absolutely nothing to do with a person’s intelligence. It’s not some fringe view either. Neuroscience backs it up. Twin studies show ADHD is about 74 to 80 percent heritable, which is higher than asthma, Type 2 diabetes, or major depression.¹² Structural MRI studies show consistent reductions in cortical volume, especially in the prefrontal cortex and basal ganglia. This isn’t about "bad parenting" or too much TikTok. It’s wiring.

Evolutionary psychiatrist Randolph Nesse, co-founder of the field of evolutionary medicine, once said: “The very traits that define ADHD today, impulsivity, hyperactivity, distractibility, may have been assets in our ancestral environments. The person always scanning the horizon may have spotted the lion first.” Right. ADHD might not be a flaw in the system. It might be a system adapted for a different kind of world, one where attention to novelty, rapid shifting, and risk-taking were survival traits, not “deficits.” When I was a resident at the University of Michigan, Dr. Nesse told a small group of us residents to think that “ADHD is the search for novelty.”

As Ricky Gervais, British comedian, writer, and gleeful provocateur, once observed, “Some people have no idea what they're doing, and a lot of them are really good at it.” Which honestly explains a lot about RFK Jr.'s entire psychiatric worldview: confident, loud, and catastrophically misinformed. Neurodivergent doesn’t mean broken. It means different. It means that the kid who can’t sit still for math class might hyperfocus for six hours designing a video game. It means the adult who double-books every meeting might also make connections no one else sees. It means that what looks like “laziness” is often executive dysfunction with a side of shame and burnout. It means we don’t punish ADHD out of people. We accommodate, support, and adapt.

This shift matters. Roughly 10.5 percent of U.S. children have been diagnosed with ADHD (CDC, 2023). Among adults, the number’s about 4.4 percent, but only 20 percent of them have ever been formally diagnosed. In other words, most adults with ADHD are flying under the radar, struggling silently, and wondering why they can never find their debit card or finish a book. Girls are diagnosed at a rate nearly 50 percent lower than boys, even though their symptoms (often internalized) are just as impairing. Girls were always the ones in class who were quietly confused, while the more externalizing boys with ADHD got the attention.¹³ Among women, diagnosis is often delayed until after age 30. That’s not overdiagnosis. That’s a decades-long blind spot.

And those medications? The ones RFK Jr. wants to ban? They help. In clinical trials, stimulants reduce core ADHD symptoms in about 70 to 80 percent of cases. That’s on par with insulin for diabetes. Kids who take them are less likely to drop out of school, get in car accidents, or engage in high-risk behavior. One longitudinal study even found that children with ADHD who received treatment were 35 percent less likely to be arrested in adolescence or young adulthood. So no, this isn’t just about “sitting still.” This is about function, safety, and actual life outcomes.

ADHD isn’t some scam to make Big Pharma rich. It's also not the result of too much screen time or not enough kale. It’s a real condition. And trying to “treat” it by sending people to a farm is not just insulting, it’s dangerous. You don’t solve brain chemistry with goat milking.

And speaking of meds, let’s talk about the Adderall shortage, because it didn’t just pop out of nowhere. Around 2021, right after we all spent a year and a half trying to homeschool our kids, Zoom into our jobs, and not melt into the couch, ADHD diagnoses started climbing, especially in adults. The increase was huge. From 2020 to 2022, Adderall prescriptions for adults jumped over 30 percent. But supply didn’t budge. The DEA caps how much amphetamine can legally be manufactured each year, and they didn’t raise the limit to match demand. So suddenly, thousands of people with legitimate prescriptions were calling pharmacies every week like they were hunting for black-market Jordan’s.

Was it the pandemic? Absolutely. People were stuck at home, trying to work while surrounded by distractions, no structure, and a constant, buzzing cloud of dread. For many adults, that was the first time they realized their brain never did what it was “supposed to,” and suddenly the word “ADHD” made sense. Plus, in 2013, the DSM-5 officially acknowledged that ADHD doesn’t magically disappear after puberty. Combine that with telehealth access expanding during COVID, and the floodgates opened.

Now, was there abuse? Sure. But that’s true of literally every controlled substance. You don’t cut off insulin just because some guy somewhere fakes diabetes. Yet that's exactly what happened with stimulants: instead of increasing manufacturing, or building a better tracking system, authorities just let the shortage roll on. As of 2025, the FDA still lists Adderall on its drug shortage database, and some generic versions are months behind.

So yeah, people finally got diagnosed, finally started treatment, finally began to feel like they had a handle on their lives, and then the meds just vanished. One of my patients told me a while ago that if he didn’t get treated for his ADHD, his wife threatened to leave him. And now you’ve got a presidential candidate casually suggesting those people were never really “sick” in the first place. That it was all made up. That instead of treatment, they need fresh air? Manual labor? A “get off my lawn” intervention?

Even astrophysicists, those high priests of reason and cosmic perspective, have weighed in on our very human tendency to pathologize anything outside the norm. Neil deGrasse Tyson, American astrophysicist and director of the Hayden Planetarium, once said: “There is no such thing as being too curious. That’s called being alive.” Lisa Randall, theoretical physicist at Harvard, has noted how breakthrough thinking often comes from people who “see around corners,” and Janna Levin, astrophysicist at Barnard and author of Black Hole Blues, has described her mind during deep creative work as “elastic, looping, not linear — thank God.” Brian Greene, a string theorist and co-founder of the World Science Festival, jokes that holding multiple competing ideas at once is basically physics foreplay. All of which sounds suspiciously like ADHD to me.

And if that’s not enough, Hunter S. Thompson, Gonzo journalist and architect of controlled chaos, said that “in a world of thieves, the only final sin is stupidity,” and frankly, refusing to understand the realities of ADHD in 2025 is about as stupid as it gets. Especially when Christopher Hitchens, the late journalist, polemicist, and international contrarian, reminds us that “the essence of tyranny is not iron law. It is capricious law.” Like, say, the DEA freezing production on essential medication for a condition it barely used to acknowledge? And if we pretend ADHD is just some personality quirk or pharma scam, Kurt Vonnegut, Jr., satirical novelist and veteran of both war and bureaucracy, reminded us that “we are here on Earth to fart around, and don’t let anybody tell you different.” Which might sound flip, but it’s actually a profound defense of being human in all our glorious neurodiverse unpredictability.

I get why people are angry. And scared. And confused. When someone who wants to run the country says people like you shouldn’t exist in public unless off their meds (because that’s really bad) and painting a fence, it kind of messes with your head. You are not crazy. You are not faking. And you’re not alone. This isn’t about some celebrity conspiracy theory. This is about your life. Your brain. Your truth.¹⁴

Despite all the fearmongering, studies show that when properly diagnosed and supported, people with ADHD are more likely to start businesses, show above-average creativity, and think in unconventional ways. Nearly 30 percent of entrepreneurs report having ADHD symptoms. In the right environment, that “distractibility” becomes curiosity, and “impulsivity” becomes initiative.

But none of that gets to flourish if we’re still operating from a framework built in the Nixon era.

RFK Jr. claims to be anti-elitist. But when it comes to ADHD, he’s recycling the most elitist, exclusionary version of psychiatry we’ve ever had. The kind that blames the patient, fears difference and confuses control with care.

I’m not here to say ADHD is easy to define, diagnose, or treat. It’s messy. And yes, we’ve gotten some things wrong. But that doesn’t mean the people living with it aren’t real. And it definitely doesn’t mean they should be herded onto farms like defective sheep.

What we need is more honesty, more nuance, and a lot less 1970s moral panic in a 2025 suit.

References

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² Smith, M. (2017). Hyperactive around the world? The history of ADHD in global perspective. Social History of Medicine.
³ Hinshaw, S. P., & Scheffler, R. M. (2014). The ADHD Explosion: Myths, Medication, Money, and Today's Push for Performance. Oxford University Press.
⁴ Willcutt, E. G., Nigg, J. T., & Pennington, B. F. (2012). Validity of DSM-IV ADHD symptom dimensions and subtypes. Psychological Bulletin, 138(4), 749–795.
⁵ Polanczyk, G., de Lima, M. S., Horta, B. L., et al. (2007). The worldwide prevalence of ADHD: A systematic review and meta-regression analysis. American Journal of Psychiatry, 164(6), 942–948.
⁶ Goldman, L. S., Genel, M., Bezman, R. J., & Slanetz, P. J. (1998). Diagnosis and treatment of ADHD in children and adolescents. JAMA, 279(14), 1100–1107.
⁷ Biederman, J., Fitzgerald, M., & Kirova, A. M. (2018). Further evidence of morbidity and dysfunction associated with subsyndromal ADHD in clinically referred children. Journal of Clinical Psychiatry.
⁸ Uchida, M., Spencer, T. J., & Faraone, S. V. (2018). Adult outcome of ADHD from MGH longitudinal family studies. Journal of Attention Disorders, 23(6), 594–603.
⁹ Chhabildas, N., Pennington, B. F., & Willcutt, E. G. (2001). A comparison of neuropsychological profiles of ADHD subtypes. Journal of Abnormal Child Psychology, 29(6), 529–540.
¹⁰ McGough, J. (2014). ADHD. Wiley-Blackwell.
¹¹ Spencer, T. J., Biederman, J., & Mick, E. (2007). A comprehensive review of the safety of ADHD medications. Clinical Therapeutics, 29(4), 926–943.
¹² Jensen, P. S., & Cooper, J. R. (2002). Children’s mental health and school performance. Journal of School Health, 72(4), 149–152.
¹³ Ramtekkar, U. P., Reiersen, A. M., Todorov, A. A., & Todd, R. D. (2010). Sex and age differences in ADHD symptoms and diagnoses. Journal of the American Academy of Child & Adolescent Psychiatry, 49(3), 217–228.
¹⁴ Barkley, R. A., Murphy, K. R., & Fischer, M. (2008). ADHD in Adults: What the Science Says. Guilford Press.