Superpower, disability or disorder?

This blog post by Dr Shevonne Matheiken is part of the 2025 Thrive in Psychiatry campaign.

One could easily argue that the current state of ADHD care in the NHS has long gone past the threshold of becoming a public health issue, with half a million people on a waiting list for assessment, one-third of these being children.

The average waiting lists were estimated at being between 5-10 years across regions (Smith et al 2024). Different sources report that around 40-50% of the prison population in the UK could have unsupported or undiagnosed ADHD.

Lack of reasonable adjustments (as per the Equality Act 2010) contribute to poor wellbeing and retention amongst the neurodivergent workforce, and the number of employment tribunals relating to this has gone up by 30% in the last year.

Parents are having to fight incessant battles to get timely diagnosis and/or EHCP funding for their neurodivergent children to support them to stay in school.

A recent Freedom of Information request from one local authority in England reported that over 90% of EHCP requests were rejected in the first round of applying.

With this as background, it is no surprise that the experience of neurodivergent/disabled doctors and medical students in the NHS is also far below par. A BMA survey (2025) with 801 respondents revealed the following:

• 53% said that, in the past two years, they had left a job or considered leaving the profession due to lack of support
• 34% said they had experienced bullying or harassment related to their being disabled/neurodivergent/having a long-term health condition
• 78% said they had worried about being treated or viewed unfavourably for disclosing their disability/neurodivergence/long-term health condition
• 73% hadn’t gotten all of the reasonable adjustments they need.
  

Whilst it is positive that there is a slow trickle of neurodivergent doctors coming forward with openness about their lived experience, that might only be a drop in the ocean towards fostering inclusive workplaces that tackle intersectional discrimination with accountability and allyship.

Those who feel that ADHD is their superpower tend to (rightly so) highlight the many strengths of their neurodivergent brain, such as curiosity, innovative thinking, pattern recognition, heightened empathy, justice sensitivity and entrepreneurial skills to name a few.

Those that come forward referring to it as a disability may be far less than those whose views align with the superpower narrative. As for myself, you only need to spend 24 hours inside my head or home, or see how exhausted I am after a clinical work day, or speak to my spouse, to understand that it is most definitely a hidden disability for me at present.

With the current political climate that is buying into the myth of ‘overdiagnosis’ despite no scientific evidence to support this, there is a real risk of disadvantaging and gaslighting the lived experience of disabled people, especially those needing benefits to function and stay in work.

With this in mind, I believe that the superpower narrative by those from privileged backgrounds (which they may not realise they have) is dangerous – for instance, when you have the means to compensate for executive dysfunction by delegating tasks that you struggle with, or if you have no young children to care for after a long day of masking at work, that may blur your views on how the condition affects you.

The understanding of ADHD is changing rapidly, influenced by various schools of thought, such as one view that it is primarily an issue of attention ‘regulation’ rather than attention deficit.

There is also increasing awareness of emotional dysregulation which got dropped from diagnostic criteria years ago, but this has possibly contributed to misdiagnosis and underdiagnosis, particularly in women.

With regard to debates about dropping the other 'D' (i.e. 'disorder'), this is much easier to discuss in the case of autism as compared to ADHD.

Many neurodiversity-informed clinicians are moving away from using ASD (as we have traditionally been taught) and using ‘autism’ or ‘autism spectrum condition (ASC)’ because it is increasingly getting accepted that autism is not something one needs to ‘cure’ or ‘treat’.

This is trickier with ADHD because we do absolutely need the medical model and the safeguards of diagnostic criteria in order to warrant prescribing controlled drugs, and rightly so.

However, we must keep in mind that current diagnostic criteria were designed without a deep understanding/consideration of how ADHD presents across the lifespan, across genders, and across ethnicities.

They were also not designed to pick up clinical features in those who have ADHD and are also autistic. Coming back to those who have a formal diagnosis, it would be morally and ethically wrong to deny life changing medication to them, many of whom would agree without a doubt that it is a disorder for them, which requires medication (along with other non-pharmacological interventions) to manage.

Yet, many regions have a second waiting list for medication, once the assessment waiting list has been tackled. In the paper ‘Adult ADHD: time for a rethink?’ we discuss the need to use both the medical model as well as the social model of disability to understand lived experience better.

In conclusion, ADHD may manifest as a superpower for some, a disability for others and a disorder for many, but it should not be those with the most privilege (and/or no lived experience) who decide how the condition affects someone else’s functioning or existence.

These debates are a waste of time and resources, and we should rather endeavour to make meaningful change towards equity and inclusion. That is just my opinion, but the ones whose voices really need to be heard are probably struggling through life sat on a waiting list, without the energy or opportunity to advocate for themselves.

Further reading

1. Survey finds medical profession more ableist than wider society, with hundreds of disabled and neurodivergent doctors leaving the workforce – BMA media centre – BMA
2. Different, not deficient blog : ptc---registrar---summer-2024.pdf Page 6,7
3. Providing Reasonable Adjustments – for mental health employers
4. Adult attention-deficit hyperactivity disorder: time for a rethink? | BJPsych Advances | Cambridge Core