SINGAPORE: Adults with ADHD are defending their “exhausting” condition as medical experts dismiss a spike in cases and medication rates as little more than lifestyle enhancements.

A new analysis of ADHD in adults- which now affects more than two per cent of the Australian population – attributes a sharp increase in cases to influencers and celebrities, university students seeking better grades and attention-depleted young adults hooked on social media.

The Australian neuroscience researchers and psychiatrists argue the increased ADHD medication rate of up to 450 per cent among women aged 25 to 44 raises “questions about its validity and implications”.

“If ADHD is truly a neurodevelopmental disorder, then why are we observing such a significant upsurge in adult diagnoses?” lead author Daniel Jesudason, a neuroscience researcher at the South Australian Health and Medical Research Institute, said.

The analysis in the latest Australian Psychiatry journal shows there has been a 206 per cent increase in males aged 25 to 44 taking subsidised prescriptions for ADHD compared to a 453 per cent increase in women the same age.

Mr Jesudason and his co-authors argue one explanation is “influencer-driven narratives surrounding ADHD, potentially shaping how individuals may perceive their own experiences”.

They also suggest parents whose children are tested for ADHD frequently could also be adding to the increase by self-recognising and seeking assessment.

Another explanation for the surge in adult-diagnosed ADHD cases is those “seeking cognitive enhancement through ‘cosmetic psychiatry’.”

This includes university students “seeking to optimise grades and prevent what may simply be neurotypical procrastination,” Mr Jesudason and his co-authors said.

They note that “prescribing stimulants purely for performance enhancement does not necessarily equate to a diagnosis”.

They also attribute a role to the “proliferation of fast-paced digital media, epitomised by social media platforms such as TikTok and Instagram, has contributed to a cognitive environment that rewards transient focus and fragments sustained attention”.

“In this context, stimulants become less a pathological necessity and more a socially sanctioned performance-enhancing tool,” Mr Jesudason said.

Despite this, they do not “deny the legitimacy of an adult-ADHD diagnosis, or the potential utility of prescribing stimulant medication for reducing ADHD core symptoms in the short term”.

The researchers suggest the high cost of ADHD assessments has led in part to the “clinical overdiagnosis” of ADHD in adults. “Patients may enter the encounter expecting to receive a diagnosis of ADHD, and clinicians may also inadvertently experience implicit pressure to provide one,” they say in the journal article.

Brianna Hardie, who was diagnosed with ADHD in her 20s, is part of a growing cohort of adults with the condition who are speaking openly about its impact.

Ms Hardie, who has spent thousands pursuing a diagnosis in her late 20s, said she understood why people might think ADHD in adults was “whoo-whoo and all in their heads”.

She said common ADHD traits are also typical mistakes, such as forgetting your phone or missing an appointment. But she said such things were happening everyday and she found it “emotionally exhausting” to cover up her lack of focus.

“At the age of 28 and 29 I realised how exhausted I was, something was not right,” she said.

“When I was younger in my early 20s, I was just go, go, go”, but later realised she could not keep the same pace forever, she said.

If she had sought a diagnosis earlier, she might have chosen a different career working in people-facing roles.

Ms Hardie said she has turned to the complicated and expensive medication route to ensure she is able to function at work.

This has cost thousands of dollars and has needed additional support from others on social media to navigate the system.

She spent more than $2000 on a psychologist assessment and then $800 for an initial psychiatrist appointment.

Ms Hardie said she was given little advice about the medication process and was told she needed to figure out what dosage was best.

When she was feeling side effects, she needed to pay $500 again for another appointment to get the prescription changed.

Ms Hardie said TikTok has helped her find other advice, like taking her medication in the morning along with eating protein and taking supplements.

But she said after paying the specialist so much for the prescription, she would have welcomed this information from an expert.

Ms Hardie encouraged people not to use the term ADHD for fun or as a joke, particularly when friends were describing each other’s idiosyncrasies.