Despite its prevalence, attention deficit hyperactivity disorder (ADHD) remains poorly understood and underdiagnosed in Europe, especially among adults.
Despite its prevalence, attention deficit hyperactivity disorder (ADHD) remains one of the diseases most misunderstood and forgotten of Europe.
Characterized by the lack of attentionthe hyperactivity and the impulsivenessIt is neurodivergent disorder It has become not only a challenge for the children it most commonly affects, but also for adults who continue to struggle with its symptoms later in life.
He underdiagnosis and undertreatment of this condition have created significant barriers, preventing effective support for those affected.
Dr Tony Lloyd, Director General of the ADHD Foundationattributes one of the main reasons for this problem to historical stigma and misconceptions.
“Due to the historical stigma and ignorance that surrounds ADHD “Because it is a behavioral disorder and is commonly associated with children who are considered rude at school, there is great shame and stigma around this disease, as well as great misunderstanding,” Lloyd told Euronews Health.
However, in recent years there has been a significant change, with increased recognition and the diagnosis of ADHD, especially intensified by the COVID-19 pandemic.
According to Lloyd, this trend is due to altered coping mechanisms during lockdowns, which affected many individuals.
“When the pandemic hit, people were locked down, they couldn’t go out, exercise, interact with other people, have close personal support from co-workers. Many of the support structures that allowed them to successfully manage ADHD disappeared“he explained.
Understanding ADHD in Europe and its challenges
Although the pandemic has increased recognition and support for ADHD, it remains underdiagnosed in Europe, according to experts. For example, in the United Kingdom, the rate of ADHD diagnoses is significantly low.
“In the UK, only 13% of children with ADHD receive medication, and only 11% of adults. So it’s very underdiagnosed and very undertreated,” Lloyd said.
This coincides with a consensus statement published by members of the British medical community, stating that “despite evidence-based national guidelines for ADHD in the UK, the disorder is underdiagnosed, undervalued and undertreated.”
The statement also notes that people seeking help in the country face many problemssuch as prejudice, long waiting times and inconsistent availability of services.
On the other hand, the situation seems to be better for those who live in the Nordic countries.
Nina Hovén, president of ADHD Europepointed out that these countries are at the forefront in terms of support and diagnosis.
“If I compare what happens in the Nordic countries and the rest of Europe, we can see a big difference because our organization has a very good structure and we also receive money from the Government or other organizations,” Hovén told ‘Euronews Health’.
Additionally, countries like Finland have even updated their guidelines to include adults, which has led to a increased self-awareness and diagnosis among older people.
However, Hovén added that Southern and Eastern European countries, such as Italy, Albania, Macedonia and Serbia, continue to lack adequate resources and access to ADHD medication.
Dr. Mia Vieyra, a clinical psychologist living in France, explained the situation in the country, where adults have special difficulties in obtaining a diagnosis of ADHD and finding appropriate treatment due to the generalized lack of knowledge of the disease among health professionals.
ADVERTISING“France is still very slow in developing a more modern view, diagnosis and treatment of ADHD. It is improving, but it is still not great,” he told Euronews Health.
“In France, [el TDAH] It is not a diagnosis – especially for adults – recognized by many psychologists or psychiatrists, which is why they often have a hard time getting into the concept of ADHD,” he added.
Furthermore, Vieyra stressed that the availability of treatments in France is limited, with a smaller range of medications and significant difficulties in accessing effective non-pharmacological treatments.
“There is the problem of access, because There are not many psychologists trained to work with people with ADHDso it’s hard to find someone,” Vieyra said.
“And then it is expensive because it is usually not really reimbursed, or is little reimbursed by Social Security,” he added.
ADVERTISINGADHD has a very negative public image
Although ADHD is one of the most discussed neurological conditions today, it remains very susceptible to misconceptions which can lead to wrong diagnoses.
According to Lloyd, neurodiverse people were long considered less intelligent or morally weak, which contributed to create a stigma around ADHD.
Dr. Jan Buitelaar, Professor of Medical Sciences at Radboud University in the Netherlands, further argues that ADHD tends to be perceived negatively, which impacts how people who suffer from it are perceived and treated socially.
“In general, ADHD has a very negative public image. “If you look at the media, social media, people with ADHD are portrayed as lazy, loud, not very nice people,” she said.
Additionally, doctors’ and educators’ lack of understanding and training to identify ADHD is a leading cause of misdiagnosis.
ADVERTISING“In general, ADHD is not well understood throughout Europe. “Doctors are not properly trained to identify it,” Lloyd said.
Hovén also added: “I have met people who have had eight diagnoses of depression and then they meet a doctor who tells them no, it’s not depression, it’s ADHD. The key to our work is awareness.”
Additionally, according to Lloyd, although ADHD often coexists with other conditions such as dyslexia and autism, many people with multiple neurodevelopmental disorders only receive one diagnosis.
From there the need to improve health information, training and social understanding to better diagnose ADHD.
“It is a big public health problem for Europe, and we have to better train teachers so that they understand that the fact that a child does not perform in school does not mean that they have low abilities,” Lloyd emphasizes.
ADVERTISINGHow is ADHD diagnosed?
The diagnosis of ADHD usually involves behavioral assessments and interviews with input from a variety of sources, including parents, teachers, and self-reports from older adolescents and adults.
Additionally, for a diagnosis to be made, symptoms must have been present for at least six months and started before age 12, Buitelaar explained.
The diagnostic process specifically looks for patterns of inattentive, hyperactive-impulsive, or combined behaviors in different environments.
Although ADHD symptoms usually appear during childhood and are not conditions that develop suddenly in adulthood, many adults who were not diagnosed in childhood tend to seek a diagnosis later. For those adults, ADHD symptoms They may differ, requiring adjustments in the support provided.
“We have to remember that ADHD in children is not like that of adults. Children can be hyperactive, they can’t concentrate, but when you become adults, things change,” Hovén said. Even so, an early diagnosis in childhood is usually preferable.
ADVERTISING“If identified early in childhood and supported by children and their parents from the beginning, their trajectories of life opportunities are profoundly better.“Lloyd said.
Gender disparity in the diagnosis of ADHD
The mischaracterization of ADHD as a behavioral disorder often results in diagnostic criteria that girls and women tend to be overlooked.
This is because ADHD presents differently in women, who show less visible hyperactivity and its symptoms tend to be less disturbing.
“We have the girls who we don’t usually see what happens to them because they are nice, calm, but we don’t know that they are in their own mind,” Hovén said. “They sit still in the classroom, but they are not there,” he added.
According to Lloyd, this has led to a historic gender disparity in diagnosisas women are often misdiagnosed with some other mental disorders.
ADVERTISING“Women with ADHD were more likely to be misdiagnosed with anxiety, depression, eating disorders, and even bipolar disorder,” Lloyd notes.
Managing ADHD beyond medication
According to Buitelaar, ADHD treatment should include multiple components: psychoeducation, medication, and behavioral interventions.
The treatment of the disorder is not limited to the prescription of drugsbut also requires lifestyle adjustments.
“Successfully managing ADHD is not just about taking medication, which lasts eight hours. It’s about understanding how ADHD affects you and what lifestyle choices you have to makeand what your cognitive strengths are,” says Lloyd.
Hovén also explains that people with ADHD need support from their environment to better manage their ADHD.
ADVERTISING“I think it’s very important to take into account the whole family, if you receive support for the children in daycare, it doesn’t help if you have chaos at home,” Hovén said.
In the case of adults with ADHD, Lloyd explains that society You have to start opening up to your various cognitive abilities and change how this condition is perceived in the workplace.
“We have to recognize that the diversity of human neurocognitive capacity is much greater than we think. That 20% of people think differently It doesn’t mean they are less intelligent or less employable,” he said.
According to Lloyd, neurodiverse people, including those with ADHD, offer unique cognitive strengths associated with their conditions that can be advantageous in the workplace and even help boost the economy.
In general, Lloyd insists on the need to recognize the potential of neurodiverse people instead of pathologizing them.
ADVERTISING“It’s about recognizing that diversity in human neurocognitive capacity. It’s much bigger than we think. And the fact that there are 20% of people who think differently than the majority does not mean that they are less intelligent, less employable or that they suffer from some disorder,” he says.
