Is Our Modern Lifestyle Generating Acquired "ADHD-Like" traits?

The contemporary Western experience, characterized by constant digital connection and hyper-productivity, has generated a severe crisis of attention. As explored by Johann Hari in Stolen Focus, this phenomenon is increasingly being viewed through a diagnostic lens, raising a critical question for psychiatry and psychology: Is the modern environment inducing widespread, functionally impairing "ADHD-like" symptoms in the general population?

The clinical perspective suggests that the dramatic rise in reported attentional deficits may reflect an environmental mismatch, where powerful external forces disrupt the neurobiological systems that govern our focus, rather than a proportional increase in the genetically based disorder of ADHD itself.

External Pathogens: The Assault on Sustained Attention

Hari's analysis identifies systemic stressors that act as "attentional pathogens," creating the symptoms that mimic genuine inattention:

1. Surveillance Capitalism and Operant Conditioning: Social media and apps are engineered using principles of behavioural science to maximize user engagement. This architecture exploits our neural reward pathways, conditioning the brain to seek frequent, unpredictable bursts of stimulation (e.g. notifications and likes). Clinically, this fosters a state of fragmented attention and reinforces a habit of rapid task-switching, making it increasingly difficult to sustain effort on cognitively demanding, long-term goals.

2. Chronic Cognitive Load and Executive Dysfunction: The culture of "multitasking"—which is, in reality, rapid task-switching—imposes a significant "switching cost" on the brain. This continuous demand taxes the prefrontal cortex, leading to chronic cognitive exhaustion and impaired executive function (e.g. working memory, inhibition, planning). Our clients describe this as feeling perpetually "scattered," irritable, unfocused, disorganised, and unable to complete complex tasks. This presentation can be difficult to distinguish from genuine ADHD inattention.

3. The Neurobiology of Stress and Sleep Deprivation: The modern pressure for ceaseless productivity directly compromises the foundational requirements for healthy neural function: sleep and emotional regulation. Chronic stress triggers a state of hypervigilance, diverting cognitive resources from deep focus and thinking toward threat detection. Simultaneously, widespread sleep deprivation degrades the brain's ability to consolidate memory and regulate mood, further contributing to poor concentration.

The Critique of Diagnosis: Suzanne O'Sullivan's Perspective

Neurologist Dr. Suzanne O'Sullivan, in her book The Age of Diagnosis, provides a critical framework that supports and amplifies the concerns raised by Hari. O'Sullivan argues that our societal "obsession with diagnosis" can often be more harmful than helpful, leading to the medicalisation of normal human difference and suffering.

Her perspective on the rising tide of ADHD diagnoses is central to her critique of "diagnosis creep":

• Pathologizing Normal Variance: O'Sullivan suggests that the criteria for conditions like ADHD have broadened over time, effectively drawing ordinary human experiences—such as feeling "fidgety," struggling with procrastination, or being easily distracted—into the category of a psychological disorder. She notes that the increase in diagnoses may not reflect people getting sicker, but rather "attributing more to sickness."

• The Power of the Label (and the Nocebo Effect): For O'Sullivan, a diagnosis is not just an inert label; it can become a powerful narrative that we can overidentify with. While a diagnosis can provide access to valuable support, it also carries the risk of the "nocebo effect," where the individual begins to interpret every symptom or struggle through the lens of their disorder. O’Sullivan observes that a diagnostic label such as ADHD can become central to a person's identity, sometimes resulting in a "worrying gap between the perceived benefit of being diagnosed and any actual improvements in quality of life," particularly in milder cases.

• The Absence of a Definitive Biomarker: O'Sullivan also points out that despite decades of research, no definitive biological biomarker exists to distinguish the behaviours exhibited by many individuals with an ADHD diagnosis from other disorders or from the spectrum of normal human experience. This reliance on subjective behavioural checklists can lead to the ADHD diagnosis being given to individuals mostly affected by environmental and cultural influences.

The combined perspectives of Hari and O'Sullivan suggest that the dramatic rise in attention concerns might be a societal problem being managed with individual psychological diagnostic labels. To address this requires moving beyond simply diagnosing and labelling, and advocating for systemic changes that restore the environmental conditions necessary for each child and teenager to develop healthy levels of attention and focus.