“ADHD runs in families,” this WebMD article confidently states. “There are genetic characteristics that seem to be passed down.”

“Some research suggests genes are the largest factors in determining who develops ADHD. After all, genes are the building blocks for our bodies,” says this one from Healthline.

These are your first-page Google results for “ADHD genetic” — but these sites are also massive companies that get most of their funding from pharmaceutical industry dollars, and both have been criticized for shady editorial practices in the past.

What’s so bad about genetics? Isn’t it just a fact that genes determine who we are? The medical system would like for you to think so; the entire biomedical model of mental illness rests on genetic determinism, and while doctors love to present themselves as unbiased, there’s a political reason for this focus on genes.

The US government spends millions of dollars every year on genetics research. The National Human Genome Research Institute has requested $633 million dollars from Congress for 2022, an increase of $17 million from their 2021 budget.

The 2022 budget request cites the need “for genomics to inform the development of solutions for some of the greatest public health needs that the nation faces related to common diseases”, citing heart disease and autism as examples.

Autistic advocates loudly oppose genomic research. This September, the $4 million dollar Spectrum 10K project led by Simon Baron-Cohen was put on hold after fierce backlash from the autistic community, who are skeptical of its intentions and rightfully pissed that research like this continues without autistic input.

Beneath the emphasis on genetic research lies the ideology of biological essentialism, which has been used throughout history to support all kinds of racist, genocidal, and eugenic policies. The goal of finding “solutions for some of the greatest public health needs” implies that public health has nothing to do with social context and is entirely determined by biology.

But genes do not determine anything — they “define possibilities” as neurophysiologist Ruth Bleier said, and they are shaped by the environment where they develop. This makes studying genes difficult, because environments for all groups in an experiment have to be exactly the same — the slightest difference can trigger huge variations in the way a gene develops.

Robert Sapolsky uses the “warrior gene” to explain this in his book, Behave. It’s an MAO variant associated with aggression, a pop science favorite that was widely reported in mainstream media, and a defense in prior court cases. But what nobody mentions is the fact that it’s only associated with violent behavior when a person has a history of severe childhood abuse.

The DRD4 gene has been associated with ADHD (although not all studies have found such a link), but again, environmental effects are often overlooked. DRD4 has at least ten different variants, and the one most studied in regards to ADHD is 7R, which is said to affect novelty-seeking and impulsivity.

Sapolksy writes:

“..kids with the 7R variant are less generous than average. But only if they show insecure attachment to their parents. Secure-attachment 7Rs show more generosity than average. Thus 7R has something to do with generosity — but its effect is entirely context dependent…7Rs are worse at gratification-postponement, but only if they grew up poor.” [italics mine]

Despite WebMD’s claim that poverty does not cause ADHD, it actually has a huge effect on the development of genes and cognition. Sapolsky continues, “..genes are nearly irrelevant to cognitive development if you’re growing up in awful poverty — poverty’s adverse effects trump the genetics.”

The powerful do not want to talk about this aspect of genetics, though, because it would require admitting that inequality has far more adverse health effects than biology, and that true solutions for our biggest public health crises would involve treating socioeconomic injustice.

“The working class stress social conditions because they need them to change, and the capitalist class stress biology to justify their resistance to change,” Susan Rosenthal writes.

In an article titled “Is ADHD Genetic? Yes and No.” on my least favorite website, ADDitude Mag, Dr. Larry Silver does briefly mention what he calls the “controversial theory” that social context shapes human behavior, but in the end, he concludes that “while environmental and cultural factors can alter behavior and child development, research confirms that ADHD is primarily a biologically-based disorder.”

Every behavior is biologically-based, but that doesn’t mean it’s biologically-determined, or that biologically-targeted solutions are the best way to address them.

“Capitalism needs biological determinism. The claim that human maladies are genetic lets the system off the hook,” Rosenthal explains, “The claim that inequality, poverty, crime, and war are rooted in genetics makes them seem normal and natural. The claim that ‘attention deficit hyperactivity disorder’ is genetic shifts attention from overcrowded, underfunded, public schools.”

In 2013, a study found that “98% of all variation in educational attainment is accounted for by factors other than a person’s simple genetic makeup,” yet this was not mentioned in the title, abstract, or press release. Instead, they emphasized (and widely reported) that “three gene variants each contribute just 0.02% to variation in educational attainment.”

Their recommendation? More genetic research, which makes sense, because geneticists only receive funding to study genes, and the government is happy to fund them.

“Running” in the Family

Genetic determinists point to two different kinds of proof for ADHD genes: high heritability rates in families and twin studies.

The first is easy to debunk: just because something runs in the family does not necessarily mean it’s genetic, because families share environments. As psychologist Jay Joseph explains in ADHD and Genetics: A Consensus Reconsidered, family studies are unable to disentangle the two.

Adoption studies are then held up as further proof, but these are also flawed. Adopted kids in these studies had higher rates of ADHD and were compared to ADHD kids who live with their biological parents. The catch is that these studies did not have access to the biological parents of the adopted kids, so none could say whether their biological parents had ADHD or not.

Joseph explains how ADHD experts like Stephen Faraone and Russell Barkley take the results of these studies and write about them deceptively:

“…in a subsequent review article in which he discussed ADHD adoption research, Faraone wrote, ‘By examining both the adoptive and biological relatives of ill probands, one can disentangle genetic and environmental sources of familial transmission.’

…However, no ADHD adoption study has examined the ‘adoptive and biological relatives’ of the same ‘ill’ adoptees. Authoritative ADHD experts such as Barkley then write for a larger audience in technically accurate, yet potentially misleading ways: ‘Cantwell…and Morisson and Stewart…both reported higher rates of hyperactivity in the biological parents of hyperactive children than in the adoptive parents of such children.’”

But Barkley isn’t comparing the bio parents and adoptive parents of the same child, he’s talking about different study groups. What he also fails to mention is that, because adoptive parents are screened for mental illness before they are allowed to adopt, “they are — by definition — a group in which we would expect to find fewer psychiatric disorders than in the general population,” Joseph writes.

The second kind of genetic “proof” is the twin study. There are two kinds: monozygotic (MZ) or identical twins, who share 100% of genes, and dizygotic (DZ) or fraternal twins, who share 50% on average. Theoretically, if identical twins have ADHD at a higher rate than fraternal (which studies have found they do), then ADHD is genetic.

The problem with this is the fact that identical twins have also been shown to share more environmental aspects than fraternal.

They “spend more time together, more often have the same friends, are treated more similarly by parents and others, and so forth” and even experience something called “identity confusion” where they “view themselves as being two halves of the same whole”. We’re back to the issue of being unable to pull nature and nurture apart.

Joseph writes:

“..even if a gene is associated with ADHD, it still doesn’t mean that the gene contributes to its causation. For example, there is a strong correlation between having a Y chromosome and being the chief executive officer (CEO) of a Fortune 500 corporation. Yet, this does not mean that having a Y chromosome causes or predisposes someone to become a CEO.”

Psychologist Marino Pérez-Álvarez goes further:

“Of the four ways of inheritance, genetic, epigenetic, behavioral, and cultural, genetic is probably the least expectable in transmitting ADHD-type behavioral traits. It is not among the functions of genes to generate behavioral traits…The genome mediates adaptation and response to the environment; it does not cause response and adaptive action.”

He cites physicist Evelyn Fox Keller, who has argued that we need to shift our conception of genes from a static code to a reactive system shaped by interactions:

“What research in genomics has shown is that biology itself is constituted by those interactions, and is so constituted at every level, even at the level of genetics. Indeed, one might say that what makes a molecule — any molecule — biological is precisely its capacity to sense and react to its environment.”

Learning From History

When I see an emphasis on genetics in ADHD, my mind traces the roots of the biomedical model back through its horrible history, and it perplexes me that such ideas have become so commonplace in the age of neuroscience that most people don’t see any red flags.

“As a contemporary German psychiatric genetic researcher observed, ‘doctors and scientists involved in the crimes of the Nazi period…would undoubtedly have welcomed the technical possibilities of present-day genetics,’” Joseph writes.

Eugenics discussions inevitably point to Nazis, but the Nazis actually cited the 1927 US law Buck v Bell to defend their eugenics policy in 1933. American doctors had been forcibly sterilizing poor, disabled people for over two decades before that, as Anne Harrington recounts in her book Mind Fixers.

The American Journal of Psychiatry published arguments in favor of euthanizing disabled children in 1942 (yes, mid-Holocaust). Eugenics is not just a Nazi thing, it’s an American thing.

This isn’t even distant history, either. In 1992, the head of the National Institute of Mental Health announced the Violence Initiative, which planned to research a genetic cause for violence in inner city Black neighborhoods and find a pharmaceutical treatment that could “cure” it.

The program was shut down because of outrage from critical psychiatrists and activists, but it was not the end of this kind of racist research, and I see its echoes still.

In a recent article on what he’s calling “Deficient Emotional Self-Regulation”, Barkley brings up the comorbidity of Oppositional Defiant Disorder and ADHD:

“Given ADHD’s prevalence in ODD, we can assume that the emotional component of ODD arises biologically from ADHD. That is, ADHD likely creates one of the two dimensions involved in ODD…This framework helps us understand why emotion and ODD are managed so well by ADHD medication..”

What he doesn’t mention is that ODD is a heavily racialized diagnosis most likely to be placed on low-income Black and Latino youth.

There are no medications approved to treat ODD, so these comments make a lot of sense in the context of expanding pharmaceutical markets, and considering the racist aspects of ODD and the staggering number of years poor children under 6 labelled with behavioral disorders are prescribed multiple neuroleptic drugs, the innocent surface of this paragraph about “treatment” starts to give way to a disturbing underbelly.

Another ADDitude article that advises providers on equitable ADHD care does discuss the fact that children of color are less likely to receive an ADHD diagnosis, but systemic racism and socioeconomic inequality are treated like unfortunate and inevitable realities, and the solution provided is “early and adequate intervention” in childrens’ lives.

“Given what we know about the school-to-prison pipeline, could it be that ADHD, which can affect school behavior, increases the odds of incarceration for African American youth and adults?”

High rates of ADHD diagnoses in the prison population are listed in a passive way that informs but does not question, suggesting that the problem is not the racist practice of mass incarceration, but the fact that the incarcerated’s ADHD was not treated in time to keep them out of jail. These are bioessentialist messages that blame individuals for systemic violence.

David Edward Walker traces the history of behavioral genetics and racist psychology to the mass labelling of Native American children as “feebleminded” and the horrors of the boarding school era, remarking that this oppression has now “moved inside the bodies of this generation’s children as they line up to receive their stimulant medication from the school nurse.”

Challenging the biological tenets of the medical establishment will get you branded insane — the oldest tactic for squashing dissent in psychiatry’s book. Russell Barkley and friends put out an International Consensus Statement on ADHD that compared dissenters to flat-earthers or doubters of gravity, “social critics and fringe doctors whose political agenda would have you and the public believe there is no real disorder here.”

I do have a political agenda, as do doctors and researchers — Barkley is a libertarian who loves Ayn Rand, so bioessentialist arguments that blame individual dysfunction slot nicely into his own politics. It’s also worth mentioning that the Consensus Statement’s Financial Disclosures section is stuffed to the brim with pharmaceutical brand names.

To act like medical professionals are apolitical is dishonest, and to call critics of the medical system crazy is quite a convenient way to professionally avoid critique. (Barkley also called the journalist Alan Schwarz, who wrote ADHD Nation, a Scientologist, another common tactic for shutting down dissent, to which Schwarz replied, “I am as much a Scientologist as I am a grapefruit.”)

I’m not saying there’s no disability here — I experience what’s labelled ADHD, I was diagnosed with it as a teenager, and I know how distressing it can be. I also understand why the biomedical model comforts people who want an easy answer for their suffering, but bioessentialism, validating though it may seem at first, is ultimately an insidious trap.

Barkley & Co.’s International Consensus Statement did not go unopposed, but I have never seen anyone cite the rebuttal that thirty-four researchers wrote in response. I’m not sure most people even know that it exists, but its message is important:

“Not only is it completely counter to the spirit and practice of science to cease questioning the validity of ADHD as proposed by the consensus statement, there is an ethical and moral responsibility to do so. History teaches us again and again that one generation’s most cherished therapeutic ideas and practices, especially when applied on the powerless, are repudiated by the next, but not without leaving countless victims in their wake.”

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The FDA approved two new ADHD drugs this year, and they’re being marketed as shiny new medical advances. It sounds exciting, but are these drugs really new and different?

Azstaryz is a stimulant developed by KemPharm, whose CEO called it “the first truly differentiated ADHD medication in years”, and Qelbree is “the first novel non-stimulant approval in a decade,” developed by Supernus Pharmaceuticals.

Azstaryz, which the company’s press release calls “a first-of-its-kind treatment” and “a true advance in ADHD medicine” is made up of 30% d-methylphenidate, or d-MPH, currently on the market as Focalin by Novartis (itself a version of methylphenidate, the OG ADHD drug, Ritalin).

70% of Azstaryz’s compound is a d-MPH prodrug called serdexmethylphenidate, or SDX. A“prodrug” is one that only becomes active when converted through chemical reactions in the body slowly throughout the day (in this case, SDX converts into d-MPH).

This new version of an old version of Ritalin, Azstaryz is supposed to last longer than other similar ADHD drugs, addressing “unmet needs in the market” as KemPharm claims. The side effects, though, are all the same as any other stimulant: decreased appetite, nausea, anxiety, trouble sleeping, mood swings, weight loss, and rapid heart rate.

The biggest difference in Azstarys seems to be the chemical compound, which they note on their website would offer “the potential for long-lived composition of matter patent protection.” Big words that mean: we could patent this specific combination of molecules and profit off of it for a very long time.

Pharma companies have been falling all over themselves for decades trying to develop slightly different molecules of the same drugs so they can own the patents, but patents don’t last forever, and when they lapse, generic versions enter the market and undercut these companies’ profits. This battle over profits affects patient care.

In 2011, there was panic over a stimulant shortage, and some blamed “addicts” who faked ADHD to get drugs that other people needed to use as medicine. What really happened was that pharma companies manufactured scarcity to make more profits.

A similar shortage happened this year in Wisconsin when a change in policy aimed at saving the state money meant only Adderall would be covered under Medicaid. It seems that these companies — and the state that protects them — don’t care about your unmet needs, just the market’s.

KemPharm is also working on new drugs specifically to “target the large and growing population of adult ADHD patients” that make up “the largest segment of the ADHD market.” One tentatively titled KP484 is made of the same compound in Azstaryz; they’re also working on “a series of prodrugs of amphetamine”.

In a hilariously dark twist of irony, KemPharm is planning to use their stimulant prodrug SDX to treat Stimulant Use Disorder, “a potential first-ever therapeutic treatment for SUD” — developing stimulants and then using those same stimulants to treat stimulant abuse.

The newest non-stimulant, Qelbree (or viloxazine) has been approved for kids aged 6–17, and Supernus is trying to get approval for adults. It’s a norepinephrine reuptake inhibitor, but they think it may act on serotonin, too, and despite the claim that it’s new and exciting, it’s been used in Europe as an antidepressant for decades already.

David Rettew, M.D., the medical director of the Child and Adolescent and Families Division of the Vermont Department of Mental Health, was quoted by the American Psychiatric Association saying that Qelbree “has many of the same warnings [as antidepressants], such as the potential for increased suicidal thoughts and activation of mania. Some of the blood pressure and pulse increases have also been found with antidepressants that have norepinephrine reuptake properties such as venlafaxine,” aka Effexor.

Prescribing antidepressants to young children resulted in a massive increase in manic episodes and suicidality, as Robert Whitaker reported extensively in his book Anatomy of an Epidemic. Many children who received a diagnosis of “Childhood Bipolar Disorder” — child psychiatrist and pharma shill Dr. Joseph Biederman’s invention that resulted in “a 40-fold increase” in diagnoses — had previously been prescribed antidepressants or stimulants.

Qelbree might be a new name, but it carries the same risks, just like Azstaryz and all its familiar side effects. We’re going to see more new faces on old drugs in the coming years, as the ADHD market has been forecast to be worth $24.9 billion by 2025. That’s a lot of money on the table, and you can bet these companies are going to use whatever marketing tricks they can to grab it.

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Dopamine is the new serotonin, and people are blaming it for everything. Addicted? It’s the dopamine. Can’t concentrate? Not enough dopamine. No motivation? You need more dopamine! I’ve even seen people say that they can physically feel their lack of dopamine.

What they’re feeling, though, is not their actual neurotransmitter count, because that’s impossible. Researchers don’t have a test that can quantify the neurotransmitters in your brain. There are companies that claim to measure urinary neurotransmitter levels, but they’re sketchy — one was fined $6 million for manipulating results in order to sell supplements.

When someone says they’re feeling a lack of dopamine, they’re talking more about the cultural meaning of the word than the science; because we’ve been told that dopamine modulates pleasure and reward, it’s become a biochemical shorthand used to express certain experiences like disengagement or distraction.

ADHD is not a dopamine deficiency, though it is marketed as such to sell pharmaceuticals. Blaming dopamine for ADHD is just the newest iteration of the chemical imbalance myth that made everyone think depression is caused by low serotonin, despite research dating back to the 70’s demonstrating that it’s not.

Pay close attention to the phrasing that’s used when articles claim this — you’ll see vague verbs that make almost-claims, as in this copy on Adderall’s website that Jonathan Leo and Jeffrey Lacasse analyzed in their Study of Consumer Advertisements:

“Research suggests an imbalance in the levels of dopamine and norepinephrine, two neurotransmitters (substances that may transmit messages in the brain), may account for many of the signs and symptoms of ADHD” [emphasis mine]

The ADHD industry’s premier marketing publication ADDitude Magazine, however, eschews the vague verbs and makes outright claims:

“ADHD was the first disorder found to be the result of a deficiency of a specific neurotransmitter,” reads a March 2021 article that cites exactly zero sources. This is because ADDitude considers itself a source with a “Medical Review Panel” full of doctors who have ties to pharma companies and vested interests in furthering bioessentialist arguments about ADHD.

Why does the medical establishment want to push this story so badly? Because bioessentialism locates the problem inside individual brains, and does not require schools or workplaces to change at all.

It forces humans to standardize themselves into social structures, and completely glosses over the ways those structures cause dysfunction. This benefits the rich and the government alike, because it means they’re not the problem, you are, and all you need to do is take the drugs they’re selling to fix yourself.

Poking Holes in the Dopamine Deficiency Story

There’s nothing wrong with drugs — consenting and fully informed adults should take whatever drugs they want if they’re helpful — but presenting amphetamines as a treatment that fixes a deficiency in the brain is just an outright marketing scam. Short-term studies show good results, sure, but long-term studies? Not so much.

The largest study on the long-term effects of stimulants on children, the Multimodal Treatment of ADHD Study by the National Institute of Mental Health, published good initial results in 1999, but a 3-year follow up of their participants found that:

“…medication use was a significant marker not of beneficial outcome, but of deterioration. That is, participants using medication in the 24-to-26 month period actually showed increased symptomatology during that interval relative to those not taking medication.”

The latest follow-up in 2017 wasn’t any better, showing that “extended use of medication was associated with suppression of adult height but not with reduction of symptom severity.”

Stimulants work great at first, but over time, you have to up the dose more and more to get the same effects. This is well-documented in the literature— the American Academy of Child and Adolescent Psychiatry’s guidelines “state that ‘most’ children will ‘require dose adjustment upward as treatment progresses.’”

Any recreational user of stimulants could tell you this — it’s tolerance. Your body adjusts to the increase of dopamine levels by downregulating dopamine receptors.

This Critical Review of ADHD Neuroimaging Research compiles some supporting data; one study in 2001 found that methylphenidate (Ritalin) downregulated D2 receptors in people diagnosed with ADHD “similar to that observed in healthy adults” and a 2003 study found a downregulation of dopamine receptors and transporters after 3 months of methylphenidate use.

If your body is naturally adjusting to accommodate the influx of dopamine brought on by stimulants, are they really fixing a chemical imbalance in your brain, or are they actually causing a new one?

Long-term use of stimulants can cause a worse baseline of the symptoms they’re intended to treat — this is called “paradoxical decompensation” and this adverse effect has been shown to occur with anti-depressants and depression, and anti-psychotics and psychosis.

Here’s psychiatrist Jason Yanofski’s reasoning on the paradox of prescribing stimulants for dopamine deficiency:

“…the pre- and postsynaptic [dopamine] regulatory mechanisms associated with stimulants lead not only to tolerance of the stimulants, but to the brain’s endogenous [dopamine], as well. Since low dopamine is theorized to be the cause of ADHD, decreasing the brain’s sensitivity to [dopamine] is the opposite of what patients with ADHD need…”

Dopamine deficiency can happen, but truly lacking the dopamine you need would do a lot more to your body than just make you feel unmotivated, because dopamine has a ton of physiological functions far beyond pleasure and reward.

Parkinson’s disease is an example of low dopamine — it affects not just your mood, but your motor functions, too. Antipsychotic drugs that alter the dopaminergic system have been shown to induce parkinsonian symptoms over time, and also (because dopamine regulates milk production) cause people to lactate.

Many doctors recommend “drug holidays” from stimulants because of this well-known tolerance effect, which means taking weekends off or going on periodic breaks when possible. Letting the dopaminergic system reset can make the drugs more effective when you take them again.

Dopamine Deficiency As a Language of Suffering

Saying that your lack of motivation is not caused by a dopamine deficiency is not the same as saying that your lack of motivation isn’t real or disabling. I understand this feeling well because I have struggled with it my entire life (and racked up the psych diagnoses to describe it), but I think it has a lot more to do with the social context than brain chemistry.

Disengagement causes low motivation, distraction, and hyperactivity, too, and the factory-like way our schools and workplaces are structured contribute to widespread disengagement in students and workers. Kids check out in class or act up because they’re bored or distressed in some way, but we are made to believe it’s purely a neurological disorder that has nothing to do with the classroom around them.

Research has shown that boredom is “uniquely associated with feelings of meaninglessness,” according to psychologists James Danckert and John D. Eastwood in their book, Out of My Skull: The Psychology of Boredom. They point to the work of Lars Svenden, who describes boredom as “meaning withdrawal”.

Danckert and Eastwood explain that the endless repetition of our schools and workplaces has physiological effects:

“Monotonous tasks are boring because they demand our attention but at the same time fail to fully occupy our mental resources…As monotony drags on, our energy levels dip — a kind of habituation to the repetitive, unchanging nature of what we’re doing.”

Many people would argue that our modern world is full of stimulation, so still being disengaged and unmotivated despite this must be some kind of biological disorder, but daily information overload can be equally distressing:

“Simply being awake and engaged with the world can feel like drinking from a fire hose. It’s too much — too much mental stimulation, too little meaning, and after the rush of stimulation, ultimately boring.”

Most jobs, especially those done by the working class, are devoid of personal meaning — why would I feel engaged in finishing a spreadsheet or stocking shelves all day? How is that a “dopamine deficiency” and not an entirely reasonable response to a deep, everyday lack of purpose in my life?

Much of the biomedical ADHD discourse insists that we are “wired differently” from all other humans in that we need constant stimulation, a sense of passion in our work, and interest in the work we’re doing, but I think this is a dehumanizing idea.

All humans need a sense of purpose and interest to stay engaged and all humans experience burnout and exhaustion at some point — some of us are just more sensitive and have a lower tolerance for stimulation. The idea that ADHDers are unique in our need for the right level of stimulation and interest positions everyone else as emotionless automatons, happy to do repetitive, meaningless work their whole lives, and that’s just not true of humanity.

“Disengagement is a global phenomenon, with 85 percent of all employees feeling ‘not engaged’ or ‘actively disengaged’ from their work,” writes Susan Rosenthal in her book Rebel Minds. “Disengagement is so distressing that 90 percent of employees would be willing to trade up to 23 percent of their entire future earnings in order to have jobs that are always meaningful.”

There’s a reason “dopamine deficiency” resonates with so many people, and a reason so many people are seeking out ADHD diagnoses for inattention, hyperactivity, and a lack of motivation. We have medicalized this widespread disengagement and the only way we can understand it or see it as valid in our culture is to use diagnostic language.

Psychologist Svend Brinkmann calls this our “language of suffering” — but medical language is not the only way to understand distress, it’s just the only way we see distress as deserving of accommodation and support.

But there’s also existential language, which “sees various human problems as inescapable parts of our existence” and the capacity for despair as “precisely what makes us human” and political language, which deals with social injustice and refers to “the rights and interests of the citizenry as a whole”.

Brinkmann writes:

“In recent years, however, some analysts have argued that political language is gradually being transformed into a diagnostic language. Mary Boyle has argued that this is a process of ‘making the world go away’, which converts ‘distress and problem behaviours to ‘symptoms’ and ‘disorders’.”

I prefer to position my inattention, distraction, and distress within the citizenry as a whole, not to see myself as uniquely “disordered” and set apart from humanity. Even if research can one day quantify my dopamine levels and compare them to everyone else, there would still be the issue of cause-and-effect.

Our brains do not exist separate from the environment, but as part of a dynamic system, an interconnected relationship between our bodies, our health, and what happens to us. There’s no way to prove a “dopamine deficiency” came first, or that it has nothing to do with my social context, because my experiences literally shape my brain and my very sense of self.

It’s wildly inappropriate to treat such widespread distress and disengagement as a purely biological dysfunction to be fixed with pharmaceuticals without ever considering what kind of society is shaping that biology, but it’s not hard to see the political and economic motivations for pushing that narrative.

Rosenthal describes these symptoms of distress as our bodies protesting, but says instead of trying to understand why this protest is happening, “the protest itself is viewed as the problem, and the goal is to stop the protest.”

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I went to the doctor last week, a rare and difficult feat for me, and while the nurse was asking the standard medical history questions, he said, “Do you have any depression or anxiety?”

I didn’t want to give away too much about my deviant mental states lest my physical symptoms be overshadowed diagnostically, so I shrugged and joked, “Yeah, anxiety, but doesn’t everybody?” He shrugged back.

According to anti-capitalist group Plan C, my deflection actually held a deeper truth. They call it our public secret:

“Each phase of capitalism has a particular affect which holds it together. This is not a static situation. The prevalence of a particular dominant affect is sustainable only until strategies of resistance able to break down this particular affect and/or its social sources are formulated….every phase’s dominant affect is that it is a public secret, something that everyone knows, but nobody admits, or talks about.”

The first part of the last century was dominated by misery, then post-war Fordism shifted us into boredom, but now, “Today’s public secret is that everyone is anxious.” We only talk about anxiety in disorder terms though, as if it is an anomaly to be treated by medicine, a bug, but not a feature.

This collective anxiety is due to a couple things, first, “the multi-faceted omnipresent web of surveillance,” and second, our constant “performance in the field of the perpetual gaze of virtual others” on social media.

“In this increasingly securitised and visible field, we are commanded to communicate. The incommunicable is excluded.”

Exclusion is the punishment of our age, the thing we all fear most: “from ‘time-outs’ and Internet bans, to firings and benefit sanctions — culminating in the draconian forms of solitary confinement found in prisons.”

Another way the authors define the anxiety of our age is precarity: “a type of insecurity which treats people as disposable so as to impose control. Precarity differs from misery in that the necessities of life are not simply absent. They are available, but withheld conditionally.”

This isn’t the only way I’ve seen precarity defined, though. Anthropologist Anna Tsing says it is “the condition of being vulnerable to others.” What could leaning into that vulnerability look like? How could we transform it from an insecurity to a strength?

Plan C recommends forming affinity groups for consciousness-raising, which can also be “a life-support system” and “a space to step back from immersion in the present.”

If you consider anxiety to be strictly a medical disorder, this may sound like I’m shrugging you off with “We’re all a little bit anxious.” But as someone whom a psychologist once wrote has “anxiety high even for clinical levels,” I find the notion that my suffering is shared to be a comforting one.

Thinking about the forest makes me feel less like a lone tree, and thinking about the storms that shake us all makes me feel less despair.

Aside from surveillance and performance, there’s another weather pattern that contributes to our collective anxiety — the sheer pace and volume of modern life, and the fear of being left behind by it.

“In today’s liquid times, people’s problems are rarely about ‘breaking free’ from norms,” Svend Brinkmann writes in his book Diagnostic Cultures, “but rather about ‘catching up’ with developments that are experienced as constantly expanding.”

He continues:

“Our problems and disorders used to originate from a profusion of prohibitions, but nowadays they tend to grow from an oversupply of possibilities. In plain terms, this means that the statement: ‘I have done something wrong’ is replaced by ‘I cannot catch up’ as a fundamental explanation of human distress.

One might say that it is no longer allowed not to do the possible, not to live up to one’s ‘potentials’, not to realize one’s true self…Self-realization has become a duty…Marginalization no longer follows from a transgression of the norms only, but — to put the matter paradoxically — from a failure to transgress, develop and constantly be on the move.”

How much of our anxiety — and ultimately, our shame — stems from this feeling of not doing enough, not being enough, not accomplishing enough? How much marketing (which Brinkmann calls capitalism’s poetry) is targeted toward these anxieties? How much have we pathologized “a failure to transgress” by turning underperformance into medical disorder?

The antidote to these anxieties is not self-improvement work or pharmaceuticals, but slowness and connection; letting go of the rush we find ourselves caught in, the endless chasing of individual potential we can never truly reach, and reaching out to each other instead.

I don’t mean slowness in a strictly literal sense, but as self-described “recovering psychologist” Bayo Akomolafe says:

“Slowing down is not a function of speed. It’s not, ‘let’s take a break’, ‘let’s go on vacation’, ‘let’s leave it all behind.’ It’s none of that. Slowing down is a function of deepening awareness, noticing the others in the room.”

Capitalism relies on us ignoring the others in the room, and as a deeply social species, this makes societies ill — in their book The Inner Level, researchers Richard Wilkinson and Kate Pickett explain the dire health effects of economic inequality and status anxiety.

The health consequences of low status are obvious — poverty causes all manner of acute and chronic illnesses — but those at the top of the social status chain can also expect to see shortened life expectancies and worse quality of life due to the constant pressures of keeping up appearances, the fear of losing what they have, and the guilt of having it when others don’t. The more unequal a society is, the more public health crises it faces.

Status anxiety also makes societies more policed, as illustrated in research on guard labor by economists Samuel Bowles and Arjun Jayadev.

In his book Sedated, James Davies explains:

“After assessing employment statistics in many different societies, they found that the proportion of people employed as police, prison officers, security guards, bouncers, etc. — basically the people we use to protect ourselves from each other — actually increases with inequality. It is as if levels of fear and distrust grow proportionately with the social distances existing between us. In the era of extreme inequality, what matters is not whether you are safe but whether you feel safe.”

True safety doesn’t come from police or prisons, it comes from knowing your neighbors, having people you trust to lean on when you need help. This is what we need to foster in a capitalist system that would like to keep us solitary and precarious, that “turns human suffering into gold,” as Susan Rosenthal writes.

When the world is burning and anxiety is woven deep into the fabric of our everyday lives, community is really all we have.

The most popular psych story last week was about a woman named Sarah who found relief from a device implanted in her brain that sent an electrical pulse every time she had an irrational thought. It was supposed to be a breakthrough, but I couldn’t read about it without sci-fi dystopias playing in my head.

Granted, on an individual level, this implant — technically called Deep Brain Stimulation — could be helpful. All the articles I read said she had been suffering for years. While none explained anything about her life or her context whatsoever, they did quote her saying she was relieved.

Ars Technica’s take says:

“When it detects neural activity associated with irrational thoughts, which previously triggered depressive obsessions, its electrodes deliver a short, corrective electric pulse and ‘poof… the cycle stops,’ as Sarah put it.”

The researchers have hope that this could help alleviate an epidemic of depression, which is the leading cause of disability worldwide, currently afflicting one in five 15–24 year olds.

The brain implant is specifically for people with treatment-resistant depression, which usually means they don’t respond to anti-depressants. But this isn’t exactly rare, if you look at the data — in his book Sedated, James Davies writes that, in other areas of medicine, pharmaceutical advances resulted in better outcomes throughout the population over time, as you would expect if the medicines worked. But this hasn’t been the case for psychiatry.

Mental illnesses have actually gotten worse alongside the development and widespread prescribing of psychiatric drugs. Robert Whitaker wrote an entire book about this, finding that in any country where prescribing went up, the rate of people on disability for mental illnesses went up with it.

If the drugs treat depression, why haven’t rates of depression gone down? Why do studies actually show worse outcomes — more depressive episodes, for longer — when people stay on antidepressants long-term? And why are we still sinking money into changing individual brains instead of looking at ways to change the context out of which depression grows?

I think it has a lot to do with the fact that you can’t monetize structural changes like you can new drugs, electrical brain zappers, and video games that subconsciously train kids not to express their anger:

“The game, called Regulate and Gain Emotional Control (RAGE-Control)…trains kids to stay calm during stressful or frustrating situations. In the game, players try to shoot virtual asteroids while avoiding friendly craft, while a pulse oximeter on their wrist monitors their heart rate. If they remain calm and keep their heart rate down, they do better in the game. If their heart rate goes too high, they lose their ability to shoot.”

RAGE-Control doesn’t make kids less angry — when they surveyed the participants, they reported the same levels of anger — but their parents and clinicians rated the severity of their anger lower, which means, this game is just teaching kids how to mask their feelings. It’s another way to make them more manageable, like psych drugs do, without actually dealing with any of the root causes of their distress.

Games like RAGE-Control are attracting big funding — Mightier, which is a part of Boston Children’s Hospital, just snagged a $2 million grant from the National Institute of Mental Health to study the effects of biofeedback video games on kids diagnosed with ADHD, anxiety, Oppositional Defiant Disorder, and autism.

Partner company Magellan Health has received a total of $10 million to date for their own biofeedback game development, and a company called Akili Interactive just launched the first FDA-approved prescription game for treating ADHD.

Akili’s prescription game, EndeavorRX, costs $150 a month, which they say is “in line with what parents are used to paying” for stimulants. These are not cost-effective alternatives, but new, comparable revenue streams that can capture consumers who don’t want to or can’t take medication.

Magellan’s VP said in a statement:

“By teaching children how to navigate daily challenges through visual technology they learn how to cope and properly manage their stress in a meaningful and fun way.”

No mention of where their stress comes from, though. Just that it exists, mysteriously, and all we can do is throw millions of dollars into games that subconsciously alter their brains. It’s also not really teaching kids skills or coping strategies, or giving them any kind of meaningful release for their emotions, just teaching their bodies to contain them.

We know that bottling up anger has serious physical health consequences down the line, like raising your risk of heart attack, chronic migraines, muscle pain, ulcers…if the games are not reducing anger, but simply teaching kids how to hold it in, what kind of serious illnesses could this cause them as they grow up? Do we care about that, or is the goal just management, correction, and social control?

Davies writes that a targeted intervention like this, “by claiming to remedy so-called individual deficits, also subtly acquits new capitalist ideas, institutions, and policies of any causal responsibility.”

They are part of a “marketised vision of mental health” that “has stripped our suffering of its deeper meaning and purpose”:

“While each industry offers its own profitable elixir for emotional success, they all share and promote the same consumerist philosophy of suffering: your central problem is not that you’ve been mis-taught how to understand and engage with your difficulties (your ageing, your trauma, your sadness, your anxiety or grief), but the fact that you experience suffering at all — something that targeted consumption can address.”

The hero’s journey is perhaps our most ubiquitous cultural narrative: the protagonist, our hero, goes out into the wilds, suffers, learns, finds something, and brings it back home to share. Most of our modern day hero stories center around success, like a superhero who stops the bad guy and saves the world, but I would argue that is not the only way we could view the hero’s journey.

We could also think of it as the pursuit of wonder — that moment when you see something you’ve never seen before, or learn something new, and the moment when you share the wonder you have found with another person.

Watching the lights spark in someone’s eyes when they realize what you’ve realized, this is part of the experience of wonder, too. You don’t have to save the world. The goal doesn’t have to be success. It can be wonder instead.

We are trained from birth to consider success the ultimate goal, the alternative to success being failure. But there are other ways to think about failure, too.

“The queer art of failure turns on the impossible, the improbable, the unlikely, and the unremarkable. It quietly loses, and in losing it imagines other goals for life, for love, for art, and for being,” writes Jack Halberstam. He sees failure as a kind of resistance, a rebellion against capitalism’s requirement that we succeed.

By the standards of the Protestant, capitalist culture I grew up in, I am a failure. I have not lived up to the career expectations placed on me by the “academic giftedness” of my youth, I have not married a man, I do not own any assets, and I have not had any children. I am tolerated, but not celebrated.

But success, the kind that this culture recognizes, does not sound like anything I want. My ambivalence about money is perplexing — people can’t understand why I don’t try to make more of it, why I have “settled” for making just enough to survive. But I embrace my “failure” at capitalism because I value other things more, like art, and learning, and my own health. Trying to succeed on society’s terms drove me to illness, and it probably would have killed me early if I hadn’t stopped.

In the ADHD spaces I move through online, we are bombarded by life hacks. How to stay organized! How to plan your week! How to remember to do all the things you can’t ever remember!

At first, I was seduced by these hacks — they gave me hope that I could be like everyone else, if I just found the right bullet journal design or downloaded the best app. But life hacks only help until you forget about them, which isn’t very long when your working memory works like a sieve.

There is no way to “hack” your bodymind — it works how it works, and all you can do is learn its ways, accept them, and figure out how to ride the waves of your being to the things that you want.

Sometimes I use the word “workaround” for this instead. It’s not a hack — I’m not building a quick bridge across the raging waters of my mind so I can hop across, but rather, I’m surfing them in a kayak, and sometimes, all I can do is stand on the shore and wait for the water to go down.

Because here is the painful truth: you have limits. You can’t do anything if you just try hard enough. That is a capitalist fantasy, a clever kind of propaganda for an economy that relies on everyone continuing to work and consume. Self-hatred, anxiety, and shame are powerful motivators, but I refuse to keep operating on such toxic fuel.

I don’t have my shit together, and I don’t aspire to it, either. I aspire to wonder. Every day I want to learn something new, experience awe at the world and my consciousness of it, and keep myself from sobbing on the floor. If I manage to do all that at the end of the day, I try to consider myself accomplished. And if I do find myself crying into a carpet, I let it happen and try not to judge.

We cry because we need to — I consider it an emotional form of puking. I tie my hair back, get that shit out of my body, and then I put myself to bed. It is what it is, it will come out if it has to, and resisting only makes it worse.

Psychologists would call this approach Acceptance and Commitment Therapy, but it’s not hard to see its origins in Buddhist philosophy. I know, in a world of constant stimulation, mindfulness sucks — it’s boring and it’s hard, but I’ve tried all the hacks and the meds and I keep coming back to it.

The Buddhists realized centuries ago that the only answer to the existential suffering of desire is acceptance. You can only ever be where you are, and once you learn to do that, you can start to truly experience, and eventually — slowly — grow.

If success means ignoring my needs, performing as a person I am not, and driving myself into a hole of despair and ill health, I don’t want it. That’s not my success — it’s the success of whoever makes a profit off my labor. I’d rather fail, and wonder.

I am constantly being targeted by ads for telepsychiatry services on social media, and I’ve watched the niche quickly explode over the past year and a half — companies like ADHD Online, Done, Cerebral, and Ahead clutter my Instagram feed now.

The general model of these services goes something like this: you take an assessment online, meet with a psychologist virtually, and get a diagnosis and a prescription for a monthly fee. Most of them don’t take insurance, which can be a good thing for people who don’t have insurance anyway, or a bad thing if you do.

I appreciate improved accessibility in a country where healthcare is hard to get and insurance is a nightmare, and I’ve had good experiences with telemedicine personally. I’m glad it exists as an option and I think it can be helpful, especially for marginalized folks for whom access to healthcare services is even more limited. But despite the positives, I have questions about the message these companies are selling.

A quick look-up of ADHD Online on the Better Business Bureau came back with several eyebrow-raising reviews from discontent service users, many of which claimed they felt cheated or scammed, or that their own doctor did not accept the online diagnosis their $150 bought them.

“They are preying on people with poor impulse control during a time when they are having trouble seeing a doctor in person,” read one complaint written last December.

“The company is a complete scam,” read another on June 17.

The Michigan-based company was founded by business executive Zachariah Booker, who lists himself as “Visionary, Groundbreaker, Leader” on his LinkedIn page, and Dr. Randall Duthler, a physician in Grand Rapids.

ADHD Online seems to have invested heavily in Instagram ads. I am shown several per day, and I’ve also spotted the brand in TikToks by popular ADHD influencer Dani Donovan, who has half a million followers (though without ad disclosure — a big issue on TikTok — it’s unclear whether this was sponsored).

The healthcare industry has caught on to the cash cow that is influencer marketing. A company called WEGO Health, started by a former marketing executive at Yahoo, is capitalizing on this by connecting pharmaceutical companies to influencers they call “patient leaders”.

A post on their Industry blog, subtitled “Three Takeaways for Today’s Pharma Marketer”, explains why:

“Over 80% of respondents say that to navigate and find helpful health information available on social, they specifically watch what patient online community leaders share and discuss. 79% look to social media to answer specific questions about their own personal experiences.”

A different blog for pharma marketers elaborates:

“…small and micro-influencers can be a great choice. In fact, they provide an even greater ROI [Return on Investment]. Their audiences might be smaller but are very loyal and engaged.”

A loophole in advertising law allows pharma companies to pay influencers without disclosing sponsorship — and WEGO’s Terms of Service also include a confidentiality clause for their patient leaders. Instead of direct-to-consumer advertising, which is highly regulated, companies are now using a subtler tactic called disease awareness marketing.

They pay influencers to promote awareness about a condition like ADHD and prompt their followers to seek medical help. You’ve likely seen these posts — they usually follow the format of “Do you do x? You could have y! Talk to your doctor.”

Another TikTok by Connor De Wolfe, one of the most popular ADHD influencers with 2.8 million followers, seems to parody this format while actually just replicating it. In a skit between a kid who relates a bit too much to ADHD content and his mother, Connor explains co-morbidities and the pitfalls of self-diagnosing based on memes, but then suggests the viewer take a self-assessment linked in his bio.

When I clicked the self-assessment, I immediately noticed the massive Shire logo at the bottom. Shire is the company that manufactures Adderall, and it’s no secret that pharma companies have produced their own assessments to steer people toward an ADHD diagnosis for years — even winning awards for how clever this strategy is.

Again, there’s no ad disclosure, so it’s unclear whether this was sponsored or if Connor is just trying to be helpful (I would like to give these influencers the benefit of the doubt) but regardless, the video plays into a very effective marketing strategy for Shire.

Meanwhile, pharma reps market their drugs directly to doctors, often giving them gifts, which has been “associated with more prescriptions per patient, more costly prescriptions, and a higher proportion of branded prescriptions” according to a 2017 study.

So, you see a post from your favorite influencer that makes you think you might have ADHD, you ask your doctor about it, and they prescribe the medication that’s been marketed to them. An easy, effective strategy that skirts all those pesky ad regulations!

It’s Not All About Your Potential

This word, potential, is plastered all over the ADHD industry’s marketing materials.

“I have a unique opportunity to help people achieve their true potential by treating their ADHD,” reads ADHD Online Physician Devang Patel’s job description on LinkedIn.

“Empower everyone to reach their full potential” is the tagline on Done’s About Us page. The paragraph beneath it laments “low work performance” and “strained relationships with coworkers” and finishes with the line:

“There’s even the potential of getting fired from work without knowing they have a mental disorder.”

Job security is not just a personal problem in America, though — almost all states in the US operate under at-will employment, which means an employer can fire an employee at any time without just cause, and the US at large is extremely hostile to worker’s rights campaigns and labor unions that would protect people’s jobs.

Not to mention, no one anywhere in the US can currently pay rent working full-time at the minimum wage! Positioning these issues as solely caused by an undiagnosed mental disorder is grossly oversimplifying the complex social reasons many people struggle to survive in America, and it has a long history.

“Struggling with ADD/ADHD? WE ARE THE SOLUTION,” reads ADHD Online’s homepage.

Advertising is hinged upon locating a problem that someone has — especially a problem that causes someone anxiety and shame — and then presenting your product or service as the solution to that problem.

These companies are wrapping themselves in soft color palettes and progressive language about empowerment and accessibility, but at their core, they’re just businesses using the oldest marketing tactic in the book to sell you something.

In this case, it’s the idea that all your pain and suffering stems from an undiagnosed mental illness that you are just $150 and a 50-minute video chat away from fixing.

But as someone who was diagnosed with ADHD as a teenager, tried 4 different kinds of ADHD meds, and saw so many therapists and psychiatrists over the past decade I can’t even count them anymore, I can tell you that an online diagnosis and a prescription for pills is not the magic solution to all of life’s problems that these companies want you to think it is.

The reasons you’re not “living up to your true potential” are far more complicated than just wonky brain chemistry. You’re probably exhausted, forced to work most of your week making barely enough to pay all your bills, crushed by spending all your time doing something that likely bores you to tears with no energy left over for the things you actually love, in an environment where you have basically no control over your daily activities and no guarantee that you won’t be fired on the spot.

“You have to work hard, a lot is expected of you, and you have minimal control over the process,” Robert Sapolsky writes in his book on the physiology of stress, where he explains in detail how this combination of low control and high demand has been linked to all kinds of illnesses.

Unless you’re an entrepreneur or a CEO or you’re very lucky to work at a company that gives a shit about their employees’ health, this is probably your daily work experience.

I’ve begun to see these marketing tactics as a medicalized re-packaging of the American Dream — the belief that anyone can achieve success in the US if they just work hard enough, except in this case, it’s not your work ethic holding you back from your “true potential”, it’s your broken brain.

“I’m not lazy, I just have ADHD,” is one of the most common themes I see in ADHD diagnosis stories, and while I understand the relief found in this narrative, I don’t like the implications, because the subtext is: some people are lazy, and they do deserve their suffering, but not me, because I have ADHD.

We know by now that meritocracy is a lie and laziness is too, but these are the lies that keep us working, that keep us distracted from the fact that there are plenty of systemic barriers in place that you can’t bootstrap yourself past, and that poverty, like wealth, is inherited.

Inevitably, someone trots out a rags-to-riches story as proof that the American Dream is still alive and well, but these anecdotes are rare and based far more in luck than merit. They don’t represent the majority of experiences in the US at all, but they do give the masses hope that the system works, that nothing about it needs to change, that the only person you have to blame for your failure is yourself.

This can be psychologically devastating, and an ADHD diagnosis offers a welcome respite from this self-blame, much the same way mothers of autistic kids have leaned into medical model narratives to avoid the unfair blame of bad parenting. It’s understandable, but it also takes the focus away from society at large and locates problems solely within the bodies of individuals, a very convenient strategy for capitalism and the state alike.

Tropes that Sell

“I thought I was lazy, I thought I was a failure, I couldn’t keep up, I was overwhelmed — but then I got my ADHD diagnosis, and now it all makes sense.”

This is a recurring theme in diagnosis narratives — a person reaches rock bottom, they turn to doctors for help, and they are diagnosed with something, which becomes a key turning point in their story.

They take this diagnosis and look back at their life, re-narrativizing their past through this new lens. It’s a kind of sense-making, and research shows it can be empowering for some people, but make others feel worse.

Suffering and confusion in particular contribute to someone’s desire for sense-making, which is part of the reason these diagnosis success stories can be so seductive. The book that popularized ADHD in the 90’s, Driven to Distraction, made heavy use of these personal sense-making narratives.

Most of the book is just Drs. Hallowell and Ratey describing case studies of their patients’ struggles and explaining how being diagnosed with ADHD turned their lives around, which proved to be a very effective marketing tactic for ADHD itself, and in turn, doctors and pharmaceutical companies.

“The book ultimately sold more than a million copies and was translated into a dozen languages, making Hallowell and Ratey millionaires,” writes journalist Alan Schwarz in ADHD Nation, “Doctors began approaching Hallowell at psychiatry conferences and saying — in these exact words — “Thank you for filling my waiting room.’”

Hallowell calls ADHD a “good news diagnosis” and a “superpower” — he is constantly talking up the life-changing effects of diagnosis and treatment in a way that makes people feel like it could be an answer to all their problems.

This narrative is particularly effective in American culture, considering our obsession with superheroes, stories that often involve a hidden identity and a journey of self-discovery that allows the hero to become their true self — to reach their full potential.

“At their best, superhero origin stories inspire us and provide models of coping with adversity, finding meaning in loss and trauma, discovering our strengths and using them for good purpose,” writes psychologist Robin Rosenberg.

They’re centered around a main character (“you have to start romanticizing your life!”) finding their inner power through hardship, becoming a virtuous symbol of all that is good in a terrible world.

These stories promote individualism and American exceptionalism, so much that the US military has actually supported several Marvel productions. Three of the top five highest grossing films of all time in the US have been Marvel movies. If films are a mirror of the culture in which they’re created, this is a narrative Americans hold very dear, one that can be used to a marketer’s advantage.

Medicalizing Social Expectations

What I find particularly disordered are the expectations that are placed on us. The American exceptionalism that undergirds our superhero movies teaches kids that they’re special, gifted, destined for greatness, while the standards for academic achievement get higher every year at increasingly younger ages.

In an essay called Canaries in the Coal Mine, Thomas Armstrong proposes that rising rates of ADHD diagnoses should be seen as a form of “biocultural feedback” — early warning signs that how we’ve structured society is hurting us, and it’s affecting the most sensitive people first.

“Younger children these days are increasingly being asked by adults to do things they are not developmentally ready for,” he explains.

Children have homework in kindergarten now, something “unthinkable in the 1950s”, when kindergarten was still just a place for very young kids to play.

In the 1960’s, American education reform pushed the idea of accountability, which refocused classrooms on results in the form of grade point averages and testing.

“American educators besieged the Swiss developmental psychologist Jean Piaget and asked him how his cognitive stages of development could be speeded up, a problem he regarded as ‘the American question’,” Armstrong writes.

He explains how developmental researcher David Elkin coined the term “hurried child syndrome” to describe the effects of this developmental rushing on children, “which included physical symptoms (headaches, nausea, irritability), learning dysfunction, attentional difficulties, and behavioral problems.”

Because we teach them they can be anything they want to be if they work hard enough, that they can save the world like a superhero, kids aren’t prepared at all for the reality of life that awaits them after they graduate — most of which is average, mundane, and pretty fucking hard, even for the straight, middle-class white kids. Add marginalized race, gender, sexuality, and poverty layers to their identities and it only gets exponentially harder.

Many people who get diagnosed with ADHD in adulthood do so because the shift to college, their first job as an adult, or motherhood becomes overwhelming to the point that they seek medical help, another common trope in the narrative.

We are told this is underlying ADHD being triggered to emerge by stress, but hyperactivity, inattention, and fatigue are also pretty common human reactions to overwhelming circumstances (and especially to sleep deprivation, a chronic condition that 1 in 3 Americans have).

All of this distress is legitimate and deserves support, regardless what you label it. You shouldn’t need a doctor to sign off on your pain for it to be real, but unfortunately, that’s the system we live in. We are basically forced to medicalize our distress to get any help.

We are expected to juggle 40 hours of work, a social life, parenthood, hobbies, and self-care while being bombarded everyday with digital information overload, horror stories on the news, and all those broken promises of greatness we grew up believing we were destined to reach.

If we can’t keep up with these inhumane demands, then there must be something wrong with our brains. We’re not reaching our full potential, and that’s where companies like ADHD Online come in, presenting their service as the solution.

I’m not arguing that ADHD isn’t “real” (a silly argument, in my opinion, because “disorders exist insofar as they are recognized as legitimate in discursive practices within social, cultural, and institutional contexts.”), or that you shouldn’t be able to take stimulants if you want them or get a diagnosis online if you need one to access services and accommodations.

I’m arguing that we are being sold a bunch of individualistic bullshit to excuse the complete lack of societal change that would actually make a huge difference in people’s lives.

If you really want people to reach their full potential, you would push for a higher minimum wage, a shorter work week, and better labor laws. You would want to provide paid leave for new parents, tax billionaires (and especially, their inheritances) to invest in public services, or maybe even consider a universal basic income program that would cover the cost of survival so people can focus on thriving, creating, and caring for each other.

But the businessmen that run America don’t actually believe in your potential, not really, not beyond what they can use to generate profit for themselves.

Maybe it’s time we stop believing in the false dream they keep selling us, too.

There is a point in the healing process when you have to embrace all the things you learned to hate. You stop running and hiding from your own sins and you turn and look them in the face, stretch out a hand, let them take you. Wholeness means integrating the dark.

Carl Jung called it the shadow self. “How can I be substantial if I do not cast a shadow?” he asked. Of course, these ideas are older than Jung — the yin and yang of ancient Chinese Taoism had a great influence on his work.

In the Christianity of my childhood, we had good and evil, sin and grace, but there was no integration. “And God separated the light from the darkness,” the opening verses of Genesis told us.

We were taught to always be ashamed of our darkness, unable to escape it but by the grace of God that washes us clean. We were meant to chase a perfection that does not exist, even for the divine.

In the adult shadow lie all the things we were punished for as children — the shame we learn to feel. In mine you will find all the times that talking got me into trouble, the exasperating questions I asked, my inability to keep up, to be “normal”, all the ways that I was queer, and how I faked it to survive.

A little after midnight, every night, I take my dog out for a walk. I have always been a nocturnal type, found the stillness of night a comfort, the drama of stark contrast beautiful. There’s rarely anyone else out there when we walk, which makes it easier to notice the slugs.

They inch along the sidewalk toward the grass, slowly, slowly, some unfortunate ones crushed and smeared by an impatient passing foot. I mourn for these, and stop to wonder at the others, crouched down like a kid fascinated for the first time by ants.

Slugs are gross, their spotted bodies glistening in the street lamps, their little antennae wriggling out ahead, but I get excited when I see them, and for a while I can’t figure out why. Snails start to inch their way into my collages — my gut keeps reaching for images of them. The art makes itself, and sometimes it also makes me.

I start reading about snails. Christians thought they symbolized the deadly sin of sloth. Laziness, the greatest fear of Puritans and capitalists. In the middle ages, there were paintings of giant snails attacking knights — man confronted by his moral failings, perhaps, his sluggard shadow.

But there are older, deeper ideas about snails. The Navajo revered the snail for bringing water from the underworld to the earth, creating rivers with her slime. The indigenous peoples of Mesoamerica saw the snail’s spiral as “a symbol of birth and death.” The Sumerians thought snails were immortal.

The spiral that houses a snail’s body has long been a symbol for the cycles of the universe, a formula for beauty. It’s vast, expansive, unknowable, uncontrollable — these are things the white men of the Enlightenment did not like. They much preferred the rationality of a line, Point A to Point B, objective, distant, efficient — and the earth has suffered for this preference.

“Spiraling” is generally considered a bad thing, a loss of control, a fall into madness and despair. But how can something so natural that the earth and all her beings are stitched in its design be wrong?

Where I grew up in Southwest Florida, we usually had to board up our windows sometime between June and October every year, but hurricanes were such a regular part of life, we always waited until the last minute to do it. You can see them coming for days.

Category 2? Just a bad thunderstorm, not worth the trouble. But once it inched past 3 into 4 or the dreaded 5, it was time to fill the bathtub and get out the plywood. We comforted ourselves with the illusion of the weatherman’s predictions, but we knew the storm could “turn on a dime,” a favorite metaphor of the meteorologists.

When a hurricane hits you, there are three stages: the first band of wind and rain, the calm eye at the center, and the second band. Swirling around the peaceful center is the worst part, the eyewall, where the heaviest weather is raging. The eye is so still as it passes over that you can safely go outside in it, an eerie sort of intermission.

They say your first memory is usually connected to a strong emotion, like fear. Mine is standing in the street outside my aunt’s house in the outer winds of Hurricane Andrew, which passed far enough to the south of us that we were spared the worst.

I was 14 when Hurricane Charley hit the Gulf Coast coast head-on, the strongest storm in Florida since Andrew. It was an apt opportunity for the weathermen to use their line about dimes: Charley rapidly accelerated from Category 2 to 4 and shifted course toward us just two hours before landfall.

It should have been scary, but you know what they say about the devil you’ve known since birth. I spent most of that time cutting out stencils with an X-acto knife by flashlight, listening to branches smash against our boarded-up windows, waiting for it to pass so I could log onto AIM and talk to my friends.

After a hurricane is gone, you emerge from your house to survey the damage. Fallen trees, limbs askew, shingles gone — it’s a mess, but there is a sense of renewal, too. A world born again by chaos, and all the gratitude that comes with living to see it.

Destruction is creativity’s shadow, and a hurricane integrates the two: trees may be ripped from the ground, but this creates holes in the canopy where light can get to the earth and feed new kinds of plants, a cyclical process crucial to biodiversity called succession. Winds may destroy but they also sow seeds further; water floods and drowns, at the same time bringing nutrient-rich sands that can revitalize inland ecosystems.

After Charley, I went with my youth pastor to a nearby town that had been hit the worst, to pass out water and help where we could. I had never seen destruction up close before, how fragile a house looks after it’s been curled like paper. We were lucky that the worst damage to our house was two weeks without power. With nothing else to do, I ran around my neighborhood, spray-painting my stencil on all the fallen trees, trying to make something from their uprooting.

“The terrible writes poetry,” asserts the writer Yrsa Daley-Ward in her memoir.

“The terrible is here one month and gone for a while until the middle of the next, allowing you to catch your breath — and just when you almost think everything is okay and when you are not over- or under-breathing, it surprises you in the middle of the night again.”

The Terrible, the night; Sadness, and his friend, Fear. Naming the darkness is an attempt to know it— maybe that is why we look at a swirling, unfathomable monster made of weather and inanely call it “Charley”.

“People have a lot of words for it,” Daley-Ward explains of the terrible. Emily Dickinson wrote that she felt a funeral in her brain. Psychiatrists would write “mood episodes” or “dysregulation” or “panic attacks” in my records.

I called them storms, because that’s what they felt like. My brain had no meteorologist, so I was never ready, but I would board up the windows of my body as best I could and curl up on the bathroom floor til they passed.

“You may not run from the thing that you are,” writes Daley-Ward, but that did not stop me from trying. I was supposed to be a Christian girl who married a man and had a respectable career, but the more I tried, the more I unravelled.

Have you ever climbed a mountain? You cannot go straight up. Switchbacks carry you back and forth, side to side, weaving slowly upwards. Going up too quickly will make you sick; if you go too fast, it can kill you, because your body has no time to adjust when your oxygen levels drop. The only treatment for altitude sickness is slowing down and descending.

Therapy led to some insights; I tried the mood stabilizers and the antidepressants, but my storms would not be medicated. In the end I had to extend a hand to my demons; accept them, and in doing so, accept myself. Repression will destroy you from the inside. There are no drugs strong enough to change who you are, and one day you have to stop trying, or else try yourself to death.

It’s not just my moods that spiral — I don’t do anything in a straight line, and all those detours take more time. In this world, time is money I am not afforded. The psychiatrists called it “executive dysfunction”. They gave me amphetamines, which I hated, and the life coaches gave me daily planners, which I promptly lost.

But a community of people I saw myself in, who call themselves neurodivergent, gave me hope that there was a way to lean into this queer temporality, to work with my natural processes, not fruitlessly against them. “My Business is Circumference,” Dickinson wrote. I like to think she did not believe in straight lines, either.

Sometimes an idea comes to me all at once, so I sit down and write out the first thousand words of it. Then I spin away in raptured orbit, onto the next idea, perhaps spilling out more words, beginning a new document, and then another.

I forget these half-formed things exist for weeks at a time, reading whatever catches my interest, writing still more unfinished pieces, pulling in words from texts that I stumble upon, slotting them into documents I’ve begun like puzzles I am always solving for in the back of my mind. Then the forward momentum stops, often before I’ve finished any of them, and the words don’t come for a while.

My friend Marta Rose calls this “gathering stardust” — the necessary point in the ellipse of our process where we spin out and rest. This is when I always panicked. Am I dysfunctional? Have I failed? Everything unfinished hangs in the air around my head, taunting me.

I end up on the floor again, crushed by the weight of it. My dog tries to bait me into playing, misinterpreting my entry to ground level as an invitation, but all I can do is stare at threads in the carpet, frozen. A slug playing dead.

My partner, one of the few people I’ve allowed to see these storms, has come to know what it means when they walk into the room and find me in this position. There is nothing either of us can do but wait it out, so they point me toward the TV and put on a documentary about space.

In the dark, gravity pulls dust and gas into a swirl, birthing a galaxy. In her bands, smaller swirls become nebulas, become suns, become planets. This is called accretion, the creation of celestial bodies through spiral and collapse; and, over millions of years, the eventual creation of our bodies, too. Spirals echo from the cochlea to the human heart to the double helix of our very DNA.

“The health of the cell is the health of the species and the planet,” adrienne maree brown writes of fractals in her book, Emergent Strategy. She doesn’t believe in failure, but instead asserts: “It’s all data.”

Those unfinished things, that source of shame in a society obsessed with straight lines and accomplishments, are all part of the stardust that slowly accretes into planetesimals. I don’t panic anymore when I gather it, because I know I am swirling around something new, a form that I can’t yet understand. The art makes itself, and sometimes it also makes me.

The snail may be a symbol of sloth to the capitalist, who sees the world atomized and controllable, himself separate and above the beasts of the earth; but she is a teacher to those who understand our interdependence with the natural world.

In her book Braiding Sweetgrass, the botanist Robin Wall Kimmerer writes:

“In the Western tradition there is a recognized hierarchy of beings, with of course, the human being on top — the pinnacle of evolution, the darling of Creation — and the plants at the bottom. But in Native ways of knowing, human people are often referred to as ‘the younger brothers of Creation.’ We say that humans have the least experience with how to live and thus the most to learn — we must look to our teachers among the other species for guidance. Their wisdom is apparent in the way that they live. They teach us by example. They’ve been on the earth far longer than we have been, and have had time to figure things out.”

I think of this at 1 AM, when I’m stopped in my tracks at the door to my apartment building once again. There’s a leopard slug on the wall above my head, more than 300 million years of evolution’s wisdom inching vertically down the concrete on a trail of her own slime, her spotted body lit in streetlight chiaroscuro.

“Snails seldom take the most direct route, instead choosing a meandering path with numerous switchbacks and self-correcting U-turns,” David George Gordon writes in his book on gastropods. Snails know how to climb a mountain.

Psalm 58 tells us what we should do with the wicked: Let them be as a snail which melteth and passeth away. But the Bible was wrong about snails. Their slime is not their bodies melting, as was commonly believed, but an act of generation, creating the conditions they need to move and survive.

Their muscles contract and expand in waves, Gordon explains, the goo getting stickier in places where they need it and releasing where they don’t. Something we were taught to see as gross, deviant, and wrong, that we crush underfoot without thought, is actually a wonder of nature’s engineering.

I used to sit in the pew on Sunday morning and listen to the pastor remind us that we are not of this world, that it’s a sin to love anything that is. God gave us all the creatures of the earth to rule and use as we see fit, he said. But how arrogant this worldview seems to me now! How ridiculous! Like trying to name a hurricane, or diagnose the terrible.

This world stitched my body together across millennia, and her shape is not a line, but a spiral. How can I be dysfunctional when I spiral, too? How can I be substantial if I do not cast a shadow?

Books were my closest friends in Brunswick. I had moved to the neighborhood in Melbourne on little more than a whim, one foot still in the closet. I was chasing a place I’d imagined would be full of other queer people, which would obviously solve all my problems immediately.

I thought if I just kept moving, like a shark, I couldn’t possibly be so sad, because surely I would find something that would fix it. But what I found was a 9-to-5 in a soulless office where I spent 8 hours a day alone in a dark room, methodically photographing decrepit old books from the National Library of Australia, submitting them as files to a cold warehouse full of blinking servers where they could live on digitally forever.

When I got off work I wandered Brunswick alone and usually ended up at the local library. It was a historic building with the sign “Brunswick Town Hall” left across the top, gutted by modern sliding glass doors that whooshed open automatically and long skinny fluorescent lights that hung from high ceilings.

At the back wall was a massive mural, a scene of antiquity — an angel playing a harp, a cherub, some guy who looked like Shakespeare — painted over with characters from another language, bright yellow dots, and modern geometric shapes.

Usually I would find a chair in a corner somewhere and read poetry books. Once I was reading The First Bad Man by Miranda July and laughed out loud so unexpectedly, I got up and left, a self-punishment for disturbing the sacred silence of the stacks. Most of the time I stuffed my backpack full of my paper treasures and went home to curl up in bed with them.

Inside books, I didn’t have to think about my loneliness so much. I was too depressed to do anything but fill my head with other people’s words, too exhausted to leave the house.

It was the first time since childhood that I had read so much. There was a library near the house where I grew up, next to the public swimming pool where I begrudgingly participated on the local swim team. The water was cold, and I was weird, and competition stressed me out. But I could always walk across the parking lot to the library, through those whooshing doors, and find the row where my favorite series of horse books lived.

I would sit on the floor cross-legged and run my eyes across every spine, needing to read every title to be sure I didn’t miss anything good, feeling a rush of pleasure at this breathless task, a surge of ecstasy when I found something interesting and plucked it from the shelf in triumph, adding it to my stack of books to take home.

An anxious child that someone definitely should have put in therapy, every night before I got into bed I planned what I would read. This was how I kept the intrusive thoughts away, those things I didn’t have a name for then. I just knew instinctively that if I didn’t give my mind something to chew on, it would take me to frightening places in the dark. I would fall asleep whenever the words started to blur together and my hand could no longer hold the heavy pages open.

When we got a computer in 1997, I sat in front of it for hours at a time, typing up my own stories. I made up friends and characters to replace the ones I didn’t have, but as I grew up and studied people, I started to understand the strategies of socializing. I wanted to collect friends like I had collected books, and figure out all the ways I could make people like me. One of those ways not telling people I’d competed in the state spelling bee twice — another was spending less time alone, reading.

In high school I found that drugs could be a practical replacement for books, another category of things I could study and collect, another easy remedy for my harried mind. In a way, they were a social badge of honor — I knew things other teenagers didn’t, I tried things they never had, and I was too high to give a fuck.

Drugs led to parties and relationships and a variety of strange lives abroad that maybe I will tell you more about one day. I barely read any books for most of my 20’s, until drugs stopped working, and the sadness crept back in, and I moved to Melbourne, hoping to run faster than it could get me.

One day in my dark room with my ancient texts, taking a break from the brain-liquefying monotony of archiving by curling up on the floor (as you do), I was texting about books with a friend who lived in Thailand. “Do you know about libgen?” he asked, and sent me a link.

It’s referred to as a “shadow library”, a controversial aspect of the open access movement that seeks to make knowledge freely accessible to anyone, anywhere in the world, but especially in the Global South, and especially for people outside academia.

Academic publishing giants like Elsevier, whose profit margin is even higher than Apple, have been trying to shut these shadow libraries down for a while, but in the last few years, even major universities have begun to cancel their subscriptions in protest. A band-aid for the larger issue of knowledge privatization, shadow libraries untether researchers from institutions.

But back to me and my problems. Distressed in the city, I made a very normal and not at all drastic choice and took a job at a luxury truckstop (they had a pool, it’s a thing). This combination motel, restaurant, and only liquor store for 100 miles was located off the lone highway that runs through Australia’s Northern Territory — 520,000 square miles of desert that just a little more than the population of Boise, Idaho call home.

Unfortunately, the tight-knit group of snobs who worked there did not like my jokes, so I only lasted a week. They dropped me and my backpack off unceremoniously in the nearest town, but were nice enough to introduce me to the owner of another, less luxurious motel/bar/liquor store who had just happened to lose one of their bartender/waiter/housekeepers (also, a thing).

I was bewildered, alone, and a 16-hour bus ride from the nearest international airport. The first thing I did was find the local library. It was one small room with a couch and a table and a dedicated UFO section, with giant windows that opened onto the beautiful red dirt and the blue, blue sky of the outback. I poured beer and made beds from 7-to-9 and was generally too busy to feel how sad I still was, but in my rare time off, I would go sit on the floor next to the racks in that tiny library and hunt for books.

When my visa ran out, I left Australia to do a very long mountain trek with a very good friend, one who is never in the same place for long but reads even more voraciously than I do. Everybody said nature and exercise were the cures for sadness, so I thought maybe this would do the trick.

My friend and I spent many hours on that trip laying next to each other in silence, reading sci-fi/fantasy ebooks on our phones, until one of us inevitably turned to the other and asked, “Are you hungry?” (It goes without saying, but I will say it: this is the perfect friendship.)

Mountain-trekking was a beautiful and formative experience, the hardest thing I’ve ever done and probably the most rewarding, but unfortunately, none of it made me less sad. At best, it just distracted me while the situation inside my head got worse. A psychiatrist told me I had a disorder, so I moved back to Florida and told my mom I was gay.

I always hated the place where I grew up, a sprawling land of golf courses and open-air malls which I call (unaffectionately) swampburbia. But in a sadistic twist of fate, it turned out I didn’t need to go to the other side of the world to figure myself out — I needed to go back home.

On my 28th birthday, I went to a gay bar called Cruisers and perched on a stool alone. By the end of the night, I knew everyone’s name (people love to take me under their wings, for some reason) and I knew that I needed to embrace the queer kid inside me that I’d been trying to flee.

I went on Tinder, which I generally don’t recommend, but when I opened my heart to chaos, I was rewarded with a great love. They were from upstate New York, but had grown up visiting their grandparents a few blocks away from the house that I grew up in, and that library by the pool. We imagined our childhood selves crossing paths unbeknownst at the local 7/11, or making sand castles on the same beach.

The sadness had been, until this point, something I dealt with entirely alone, but they were the first person who read books to me in bed when I could not stop crying. Years later (because they are a Scorpio, and thus have many secrets), I found out they’re dyslexic and actually hate reading — acts of service, truly.

We took our relationship to the next level (read: got a dog) and moved to DC, where I got to add a card at the Library of Congress to my prized collection. But then the pandemic happened, and all the libraries closed, and I stopped going outside.

Curled up on a chaise lounge in our basement apartment, I started collecting ePub files and PDFs on my tablet, highlighting and making notes like a mad scientist formulating a grand theory. Yes, I love the smell of a printed page as much as the next bookworm, but I am not a dinosaur; I adapt or I die. With nowhere to go and almost every book I could ever read available in my hand, I’ve spent the last year inhaling words at an unnatural rate.

But the best part, my favorite part, is dumping all the words I collect on other people. They burst out the seams of me, spilling over onto anyone near enough to hear them, pouring into content on the internet. They fill the shelves of my mind but they do not want to collect dust. A library no one visits is a tragedy; a stack aches to be consulted.

Quarantine was a break from the horrible world of work/life balance, the likes of which I hadn’t known since I was a kid on summer vacation, eating lemon italian ices during an afternoon thunderstorm. Many people withered without workplaces or daily social interactions, but in solitude, with my books, I bloomed like a plant that had finally been fed. The sadness became a shell of its former self — no longer a constant tinnitus of the soul, but an infrequent clang that still hurt my ears sometimes, yet faded quickly.

“Have you thought more about dating other people?” my partner asked recently on a rare date, in the awkward post-vaccination lull between mask mandates that made us temporarily feel okay going to a restaurant. We were sitting at a bar with two different burgers between us, cut in half and swapped. We liked to try new things, and sharing was the best way to do it.

It was a question that had hung above our relationship since the first date, a place we’d always met philosophically but hadn’t yet visited together, practically. But the world was opening up, slowly, and the question was resurfacing more and more.

I thought back to all the years I’d sacrificed reading for a social life, all the time I spent trying to be what other people wanted so they would like me, all the parties and the drugs — I have sown my wild oats, as they say, and it just doesn’t sound that interesting anymore. I’d been running for so long, but returning to books felt like finally coming home to myself. I’m ready to let the words take me.

“I don’t know if I have time,” I replied, “I just have so many books to read.”

It’s not a euphemism for disorder.

The term “neurodiversity” is everywhere lately, and it’s being used in ways that appear to be progressive, but underneath, are really just the same old pathology paradigm re-packaged.

Criticisms of its improper usage mostly focus on grammar — a person cannot be neurodiverse, that is a word that describes a group. An individual should be called neurodivergent. But these are superficial and far less concerning to me than the distortion of the term conceptually.

Discussing autism, ADHD, and dyslexia, this Forbes article claims the term neurodiversity was created to “shift the focus from the negative connotation of these conditions toward the positive,” a statement that waters the entire concept down into a floppy milquetoast version of its former self.

It’s not a nice euphemism for autism, and it’s about far more than just fighting negative connotations.

Neurodiversity is a paradigm, a lens through which we look at human neurology, and it stands in opposition to the pathology paradigm.

The pathology paradigm says: there is a normal, healthy brain and an abnormal, unhealthy brain. People with abnormal brains have something wrong with them and need diagnosis and treatment to become more normal.

The neurodiversity paradigm says: there is no such thing as a normal brain. Variation in neurology is natural, and none is more right or wrong than another.

Autistic author Nick Walker elaborates:

“The social dynamics that manifest in regard to neurodiversity are similar to the social dynamics that manifest in regard to other forms of human diversity (e.g., diversity of race, culture, gender, or sexual orientation). These dynamics include the dynamics of social power relations — the dynamics of social inequality, privilege, and oppression — as well as the dynamics by which diversity, when embraced, acts as a source of creative potential within a group or society.”

The term neurotypical exists as an alternative to the word normal, but it does not describe a type of brain in any biological sense. It describes a way of being, or a disposition, as scholar Damian Milton says, that is culturally valued and socially advantaged over other dispositions, which we call neurodivergent.

Milton writes:

“…there is no neuro-typical to deviate from other than an idealised fantastical construction of Galtonian inspired psychological measurement.” (Galtonian referring to Francis Galton, who invented eugenics.)

These terms are sociopolitical, not biological, but everyday I see people making statements like “The neurotypical brain does x” or “The neurodivergent brain is y”, despite the fact that adhering to the neurodiversity paradigm means acknowledging that there is no biologically neurotypical brain, and a vast generalization about “the neurodivergent brain” is nonsensical considering that it’s an umbrella term encompassing many different dispositions.

Usually at this point in the discourse, someone pops in and says, but Judy Singer, who coined the term neurodiversity,** was just referring to biodiversity! It’s separate from the neurodiversity paradigm Walker was writing about!

To which I would counter that Singer has written on her blog as recently as February of this year to re-assert that yes, “neurodiversity” is a political term:

“..my intent was political, unifying and liberatory, not divisively intent on putting individuals ‘under a microscope’.”

In summary, she writes:

“ND is not a classificatory term dividing us from them. We are all Neurodiverse. We live on a Neurodiverse planet in which amoral nature generates endless genetic diversity, while we humans have evolved the capacity to make judgments about nature’s bounty. What Neurodiversity brings us is a challenge to find a place for everyone and to distribute the bounty fairly.”

I see a lot of confused usage of these terms lately in ADHD spaces. Often people use the language of disorder and deficit, but then slap the word “neurodivergent” in there a few times and call it radical.

This is not radical — it’s just putting a fresh coat of progressive paint on an old fucked-up house. Here’s an example to illustrate the difference.

A neurodivergent take on ADHD:

Hyperactivity, impulsivity and distraction are natural traits in human beings that exist on a spectrum and can serve many purposes depending on the context. Our current social context, which favors self-control, efficiency, and productivity, is set up to disadvantage, punish, and/or ostracize people who exhibit more of these behaviors.

People with these traits experience significant distress in this social context, which results in shame, anxiety, depression, and suffering. We are not so much treating a disorder as we are pharmacologically, behaviorally, and socially forcing people with these traits into assimilation, often to the extreme detriment of their mental well-being.

Instead, we should be more accepting of people who have higher energy levels, require more stimulation, or operate in spiral, non-linear ways by accommodating their natural processes. 

We should be allowed to set our own schedules and expectations for our lives, and if spending time in modern schools and workplaces causes this much distress to this many human beings, we need to reassess how we’ve designed them. People should be able to take stimulants if they want to, but no one should be coerced to medicate.

A pathology take on ADHD:

Hyperactivity, impulsivity and distraction are the result of structural abnormalities in the brain, which we should respect as neurological differences. People need to be diagnosed and treated for these abnormalities with behavioral therapy or stimulant drugs, which is just like taking insulin for diabetes or wearing eyeglasses. With proper treatment, anyone with ADHD can succeed in life.

Just because it sounds nice and accepting (“Anyone can succeed in life! Respect differences!”) does not mean it’s neurodivergent. This stance is still firmly rooted in the idea that ADHD is abnormal pathology, and treatment would mean making a person more normal.

A neurodivergent take rejects the normal/abnormal binary altogether.

You can’t be “diagnosed with neurodiversity”, and it is also not a club that admits people based on a list of accepted diagnoses.

There is much clamoring over who “counts” as neurodivergent, but we don’t need to define which DSM diagnoses count because the entire point of the neurodiversity paradigm is opposing the pathology inherent in DSM diagnoses.

These things are in direct contradiction to each other conceptually.

Being neurodivergent is experiential and political, “a category of power relations and social hierarchisation” as scholar Dieuwertje Dyi Huijg writes in the book, Neurodiversity Studies.

Arguing over who “counts” as neurodivergent is sort of like arguing over who counts as queer.

You count if your experience of the world is neurodivergent, meaning, you have been disadvantaged, punished, or ostracized due to your disposition, if you align with the sociopolitical aims of the paradigm, and if you identify as such.

pinned tweet = critiques of psychiatry&psychology on Twitter: "if you're wondering how the gay liberation movement became the white-centric LGBTQ assimilationist movement whose ultimate goal were same-sex marriage & homonormativity, pay close attention to how the neurodiversity movement became popular at the cost of its liberation politics / Twitter"

if you're wondering how the gay liberation movement became the white-centric LGBTQ assimilationist movement whose ultimate goal were same-sex marriage & homonormativity, pay close attention to how the neurodiversity movement became popular at the cost of its liberation politics

In order to shift paradigms on a large scale, you need more people, not less. Gatekeeping does not help us — gatekeeping is for children who need to put up firm walls to feel secure in their identities. It’s politically necessary to grow out of this phase, because solidarity is where the strength of any movement lies.

“Neurodiversity” also carries with it a certain amount of flux and contradiction. It can’t be easily defined and it’s not totally agreed upon, and that’s probably a good thing.

In the essay Defining Neurodiversity, Robert Chapman describes the concept as a “moving target” that will continue to shift and change in meaning:

“I do not think it is the kind of thing we can or should hope for a final definition of.”

According to Chapman, neurodiversity is an “epistemically useful concept” that helps us “access and generate new forms of knowledge” and “imagine the world differently to how it currently is.”

But if your use of the term is just re-branding the pathology paradigm we already live in, you’re not doing that.

**Correction 7/27/2023: Following transphobic comments from Singer on social media, Martijn Dekker has published a correction regarding the claim that Singer coined the term neurodiversity. In actuality, the concept was already in use on his autistic-run listserv years before she used it in her work. See more details here.