ADHD & Neurodivergent Stigma

Changing Perspectives

Throughout the course of human history, our beliefs and perspectives about the world and ourselves are constantly evolving. For thousands of years, the greatest minds of their time were convinced that the Earth was flat. Then, for centuries, humans believed that the Earth lay at the centre of our solar system. History is full of examples, like these, of how society’s view on various issues has shifted over time, often for the better. Consider the case of left-handedness. In the mid-20th century, a prominent psychiatrist, Abram Blau, promoted the idea that left-handed children were at risk of severe social and cognitive deficits unless they were retrained. This view may seem shocking when we contemplate that today, 10-15% of the population is left-handed [1]. This perspective shift highlights the power of changing societal beliefs and underscores the need to alter perceptions regarding conditions like ADHD and neurodiversity.

ADHD & Neurodivergent Stigma

Stigmatisation is a term that has deep roots in human history, its origins tracing back to the practice of marking individuals with a hot iron—a physical and metaphorical scar of disgrace [1]. While this is no longer the accepted definition of the term (another example of evolving human perspectives), it does still underscore the scarring effect that modern stigmatisation can have. In the context of mental health and neurodivergent stigma, the American Psychiatric Association identifies three distinct dimensions. Stigma manifests as prejudice, self-stigma, and institutional discrimination [2].

Prejudice, or public stigma, is the negative attitudes society holds toward people with mental illness or neurodivergent conditions. It creates an environment in which individuals with ADHD, autism, or other neurodivergent traits may feel marginalised, judged, or excluded [4]. A recent study also found that people living with ADHD often put off seeking treatment or support due to their fear of public stigmatisation [6].

Self-stigma, when individuals internalise these negative attitudes, perpetuates the cycle of discrimination from within [5]. For example, researchers found that when a publicly held stigma about people with ADHD is internalised, such as the belief that they are just lazy or “bad learners”, the ADHD sufferer is more likely to experience feelings of hopelessness and demotivation [5].

Institutional stigma or discrimination is often embedded in laws and policies, further exacerbating the struggle of neurodivergent individuals, and resulting in disparities in services and opportunities [2,4,5]. One example of institutional stigma is the disparity in ADHD services compared to those for other conditions [7]. Not only can this inequity prevent the full participation of individuals with ADHD in society, but it can also stifle their acceptance of who they are, with all their unique strengths and challenges.

A Modern Perspective

To enact change, we must adopt a more modern perspective on neurodiversity, much like the evolving view of ADHD articulated in the “Modernised concept of ADHD” (MocA) [3]. This approach, developed by Professor Barbara Franke, moves away from a limited, symptom-and-impairment-driven template towards a dynamic model that acknowledges neurodiversity’s broad spectrum. This model moves away from a focus on the “average” person with ADHD and embraces everyone’s path in functioning and self-management, recognising that neurodivergent individuals have a vast array of strengths and weaknesses that should be celebrated rather than stigmatised.

 

8 Ways to Reduce Stigma and Promote Neurodiversity

In the context of changing perceptions about ADHD, it is important to not only identify the different forms of prejudice but also highlight ways in which we can help to reduce stigma and promote neurodiversity.

Recognise the Spectrum and Variability: Every neurodivergent individual is unique. Acknowledge the spectrum of neurodiversity and the variability between individuals. Celebrate the diverse strengths and talents neurodivergent individuals bring to our communities.

Lifelong Change: Understand that individuals change across their lifespan, including how they manage and express their neurodivergent traits. Avoid rigid labels and assumptions.

Education and Awareness: Increase knowledge and awareness of neurodivergent conditions among healthcare professionals, educators, and employers. This will boost confidence in supporting neurodivergent individuals effectively.

Empowerment through Self-Management: Encourage self-management and reduce ignorance. Empowering people with ADHD and other neurodivergent traits can help them overcome self-stigma and mitigate prejudice, contributing to primary and secondary prevention.

Media and Representation: Media plays a pivotal role in shaping public perceptions. Mass-media interventions that provide accurate information about neurodiversity can help to reduce prejudice. Diverse and authentic portrayals of neurodivergent individuals in various forms of media can make a significant impact.

Evidencing Inequity: Collect and present data on the economic and societal impact of neurodiversity. Highlighting disparities in services and opportunities can underscore the urgency of addressing these issues.

Promote the Benefits of Neurodiversity: Emphasise the advantages of having a neurodiverse world. Neurodivergent individuals often possess unique perspectives and problem-solving abilities that can benefit society.

Be an Ally and Correct Misinformation: Stand up against misinformation and misconceptions about neurodiversity. Allies play a crucial role in advocating for equal rights and opportunities for neurodivergent individuals.

 

Conclusion

In conclusion, the transformation of societal perspectives is not only possible but imperative when it comes to neurodiversity and conditions like ADHD. Just as we have come a long way from the erroneous beliefs about left-handedness in the past, we have the potential to change the narrative surrounding neurodivergent individuals. It begins with recognising the richness of diversity within our society, spreading awareness, and dismantling the barriers that perpetuate stigma. By doing so, we can pave the way for a more inclusive, accepting, and empathetic world for all.

Here at Smart TMS, typically, a series of TMS sessions for Attention Deficit Hyperactivity Disorder (ADHD) comprises of 30 treatment sessions spread across three to six weeks. Each session, lasting 30 minutes, allows some patients the option of undergoing more than one session in a day.

Find out more on our website

Adam, St Albans Practitioner

References
  1. www.linkedin.com. (n.d.). Neurodiversity 101: why it is time to modernise our views of ADHD and other ND traits. [online] Available at: https://www.linkedin.com/pulse/neurodiversity-101-why-time-modernise-our-views-adhd-other-kirby/?trackingId=j02t7NFSR8ikXbYLk%2ByN8A%3D%3D [Accessed 8 Jan. 2024].
  2. Borenstein, J. (2020). Stigma, prejudice and discrimination against people with mental illness. [online] American Psychiatric Association. Available at: https://www.psychiatry.org/patients-families/stigma-and-discrimination.
  3. Franke, B. (2023). Editorial: It is time to modernize the concept of ADHD ! 64(6), pp.845–847. doi:https://doi.org/10.1111/jcpp.13812.
  4. Masuch, T.V., Bea, M., Alm, B., Deibler, P. and Sobanski, E. (2018). Internalized stigma, anticipated discrimination and perceived public stigma in adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11. doi:https://doi.org/10.1007/s12402-018-0274-9.
  5. ‌Corrigan, P.W. and Rao, D. (2012). On the Self-Stigma of Mental Illness: Stages, Disclosure, and Strategies for Change. The Canadian Journal of Psychiatry, [online] 57(8), pp.464–469. doi:https://doi.org/10.1177/070674371205700804.
  6. Godfrey, E., Fuermaier, A.B.M., Tucha, L., Butzbach, M., Weisbrod, M., Aschenbrenner, S. and Tucha, O. (2020). Public perceptions of adult ADHD: Indications of stigma? Journal of Neural Transmission, [online] 128(7). doi:https://doi.org/10.1007/s00702-020-02279-8.
  7. National Guideline Centre (UK) (2018). Evidence reviews for Information and support for people with ADHD: Attention deficit hyperactivity disorder: diagnosis and management: Evidence review B. [online] PubMed. London: National Institute for Health and Care Excellence (NICE). Available at: https://www.ncbi.nlm.nih.gov/books/NBK578095/.