Scatterbrain

In 2014, researchers in Florida pitted a group of mice with ADHD against their neurotypical peers. The rodents were trained to make their way through a maze—from a noisy, distressing environment to a cozy escape pod, with a bunch of alternative paths jutting out along the way. Two weeks in, the “normal” mice had memorized the most direct route from A to B. Meanwhile, the ones with ADHD continued to get there via a series of unnecessary diversions—like middle-aged women bouncing between the jam and souvenir shops on their way out of wine country. This was to be expected: ADHD is, in the simplest possible terms, an inability to tune out distractions and stay on task. What was remarkable was that the mice with ADHD completed the course in the same amount of time as their competitors. Only they wasted more energy, made more mistakes, and arrived at the final destination feeling so wrecked and frazzled that they just wanted to get drunk or go to bed. Not that I’m projecting.

People with ADHD will cite this research as evidence of our ability to achieve the same things as other people. While that may be true, I like the mouse experiment because it articulates another important aspect of having ADHD: it’s exhausting—the time and energy that go into the most basic tasks, the cycle of guilt and self-flagellation that accompanies an inevitable series of fuck-ups, the relentless internal dialogue between the me that must exercise total vigilance to keep life from flying off the rails and the other me that is programmed for derailment.

Neuroscientists believe that brains with ADHD are deficient in dopamine and norepinephrine, two key neurotransmitters that stimulate executive function. Think of them as the office assistant who sits in your frontal cortex, organizing and prioritizing, making sure that only important memos get to the boss—the conscious brain. With ADHD, that assistant is asleep on the job, so everything gets through and whirls around like mental confetti. I call it short-circuiting: that feeling when the maelstrom of relevant thoughts and random ideas, action items and existential curiosities, collects in a bottleneck, and rather than forming an orderly queue, they all fight for attention, causing what amounts to a total system malfunction.

Executive function is also involved in emotional regulation and impulse control, meaning people with ADHD tend toward big feelings and bad decisions. What smug neurotypicals often think of as willpower or discipline is actually a chemically triggered reaction to a tiny hit of dopamine. Without this internal reward system, people with ADHD are both less able to focus on the task at hand and more likely to go in search of external dopamine sources to compensate. We’re significantly over­represented in the skydiving community. And in prison.

I was closing in on 40 by the time I saw my doctor to discuss the possibility that I wasn’t a normal mouse. There’s no brain scan or blood test to provide a definitive yes or no. Instead, an ADHD diagnosis is based on the presentation of key symptoms: difficulty paying attention, impulsiveness and restlessness. And because these traits are common to most people, the second part of an assessment investigates what’s known as functional impairment. Basically, how bad is it? How persistent? With what level of frequency do you feel the world caving in on you? Finally, since ADHD is a developmental disorder, symptoms must trace back to childhood or early adolescence. “Do you remember struggling with these things as a kid?” my doctor asked me.

If this were a movie, we would now hear the gentle strums of Wilson Phillips as we cut to the early ’90s, my homeroom at Branksome Hall, a Toronto private school where I was forever showing up without the regulation bloomers under my kilt. I don’t remember exactly what I’d done that day—probably forgotten my spelling book or failed to produce a protractor. But I’ll never forget the moments that followed as my teacher made her way to the board, reached for a piece of chalk and scrawled COURTNEY IS DISORGANIZED in block letters. My friends laughed. I think I laughed too. I was a happy, confident kid who simply struggled to meet the demands of her job at the time: being 12.

I was always pretty good at tests but dreaded the day when the teacher would ask us to hand in our binders. Other students seemed to think nothing of it, passing their bubble letter–covered monuments to neurotypicality to the front while I pulled crumpled pieces of looseleaf from the depths of my backpack. Still, nobody ever suggested that I had ADHD. That was Trevor, the mischievous redhead in kindergarten who ran around poking his classmates with a freshly sharpened pencil.

In high school, I skipped class with the reckless abandon of someone whose brain is hardwired against impulse control. Every report card said something to the effect of “Courtney is failing to live up to her potential.” I moved from Toronto to Montreal for university, where I underperformed in school and overperformed in staying out late and accumulating debt. As friends started their careers, I stalled. Still, ADHD? That was for kids.

At 28, I landed an internship at this magazine—the first step toward a career that is, in some ways, a good fit. Brains with ADHD are stimulated by novelty, interest and competition, all of which journalism delivers on the regular. I had always loved writing and that feeling when the swirling confetti parts to reveal a thought worth sharing. I still love that, and as far as external dopamine sources go, it’s safer than skydiving. I am not great with deadlines, but I’m truly terrible without them, so I spent my 30s building a career from a combination of pressure and purpose, a near pornographic obsession with productivity hacks, and the occasional self-prescribed “banker bomb”—a quadruple-shot Starbucks latte plus two daytime Tylenols, which my Bay Street friend once told me was how he managed to stay vertical on Friday mornings.

And I managed—not perfectly and not without setbacks. I’ve let people down, and I remember every instance. A couple of years ago, an editor I really liked fired me for being too stressful to work with, and it was like Grade 7 homeroom all over again. Overall, though, I’ve been very happy and reasonably functional, blessed with a supportive family and a socioeconomic head start that has afforded me soft landings and second chances, not to mention a partner who knows to just hang back when I begin obsessively reorganizing the furnace room as a form of procrastination. It makes a big difference that my symptoms are mild, which may also explain why it took me almost four decades to seek out an assessment. But there is another reason why an adult ADHD diagnosis eluded me for so many years: until recently, nobody was talking about it.

Maybe it sounds glib to suggest that a complex neurodevelopmental disorder is having a moment, but if you haven’t noticed that ADHD is everywhere these days, you haven’t been, well, paying attention. Before the pandemic, minimal buzz; now, a list of mainstream bona fides any publicist would kill for: a multi-episode arc on Grey’s Anatomy, mentions in Paris Hilton’s recent memoir, an Amazon collab where Alexa will help you ADHD-proof your mornings, a dating app to connect neurodivergent love seekers with partners more likely to understand their struggles and misplace their keys. Canadian pop star Nelly Furtado recently returned to the spotlight with new music and a new diagnosis. “ADHD feels like a superpower,” she told Euphoria magazine, describing how her frenetic brain was a good fit for the modern music business. Prince Harry received a “diagnosis” in 2023 during a live-streamed promotional event for his bestselling memoir, Spare—not the best example of a scientifically scrutable assessment but a nearly perfect articulation of the current cultural frenzy.

Conversations about ADHD are unavoidable—on podcasts, in group chats and even in the House of Commons, where the proposed Bill C-329 is pushing for equitable access to ADHD care. Recently, a cashier apologized for putting my groceries in the wrong bags, joking that she “forgot to take her ADHD meds.” (Or not joking—I have no idea.) A couple of months back, I set up an ADHD Google Alert to direct me to new headlines, but I had to turn it off because of the near-constant distraction: ding (new research suggesting that LSD may reduce ADHD symptoms), ding (a new bestseller called ADHD Is Awesome by a guy who used to be on The Amazing Race), ding (a HuffPost article explaining why a “floordrobe”—the habit of keeping one’s clothes on the floor rather than putting them away—is the latest sign that you may have…well, you get it). In 2022, “focus with ADHD” was one of the top health-related Google searches in Canada. On TikTok between 2021 and 2023, #ADHD Goodyear Blimp–ed its way from a respectable two billion views to a gobsmacking 20 billion. The word “subculture” now feels insufficient to describe the interconnected ecosystem of influencers and memes, quizzes and services, branded content and straight-up advertising, all positioning ADHD as an infinitely relatable condition at a time when it is easier than ever to relate.

“Aren’t we all a little ADHD these days?” is a comment I heard again and again while working on this story, often said with an eye roll (Is this thing even real?), but at other times it came with a palpable sense of desperation—a desire to pledge mental health’s suddenly trendy sorority. And I get it. The past few years have been a never-ending dumpster fire. Now here we are, still absorbing the aftershocks of the pandemic, swallowing a cocktail of economic and existential insecurity, measuring our productivity on smartwatches, comparing ourselves to the Perfect Perfectsons on social media. Half the people I know are hanging on by a thread. Enter ADHD as a convenient cultural shorthand, a vibe shift, a virtual campfire around which to commiserate and maybe even the answer to a nagging question: Could this be what’s wrong with me?

If you haven’t noticed that ADHD is everywhere these days, you haven’t been, well, paying attention

  A friend recently told me about sitting around with her girlfriends—a group of professional adult women—catching up, drinking wine and completing “Do you have ADHD?” online tests the way my friends and I used to do quizzes in Seventeen: Are you a summer or a winter? A Jen or an Angelina? Do you have ADHD, or are you just the regular kind of overwhelmed and underproductive?

It’s an important distinction and one that’s getting harder to parse, says Josh Levin, a family doctor in Victoria who has had dozens of patients come to him with similar concerns. “They’re feeling like they’re not functioning well, and they hear about this condition that might put everything into context—that’s very alluring,” he says. Levin describes a particular woman in her late 20s, finishing a master’s program, renting an apartment in Victoria (where the cost of living has soared), working as a server and dealing with family drama. “She talked about how she was struggling to keep up, and it’s like, ‘Maybe you’re not the problem here.’”

Levin is a member of the University of British Columbia’s Therapeutics Initiative, a watchdog group focused on responsible prescribing practices. Last fall, the organization identified a sizable uptick in the province’s use of ADHD medications, which had been stable through the 2000s at roughly two prescriptions for every 1,000 adults, climbed gradually in the 2010s and then spiked dramatically during the pandemic to 16.6 per 1,000. The national picture is similar, with an eightfold increase in ADHD drug claimants over the age of 18 since 2008. “I challenge anyone to find a medication other than Ozempic that has increased in popularity like Vyvanse has,” says Levin, referring to one of the leading ADHD drugs.

Levin believes that researchers and doctors need to consider the uncomfortable question of whether adult ADHD is being over­diagnosed in certain populations. It’s an issue that’s making headlines in the US, where a similar spike is at least partly to blame for shortages of ADHD drugs including Vyvanse and Adderall. People who desperately need medication are now flocking to the black market, as are people who don’t (night-shift workers, students cramming for exams, ravers chasing a high). The big winner is the ADHD industrial ­complex—the decades-old cabal of Big Pharma companies, newly fortified by influencer culture and algorithmic advertising. This spring, a senior official with the US Drug Enforcement Agency compared what’s happening with ADHD meds to the early days of the opioid epidemic, a comparison that is both extremely concerning and extremely loaded.

But it’s not one that adds up, according to the Centre for ADHD Awareness Canada and others in the medical and advocacy communities, who say that the panic around overdiagnosis is overblown. Globally recognized sources like the US National Institute of Mental Health put the prevalence of adult ADHD between four and five per cent of the population. Since 16.6 prescriptions per 1,000 people is less than half of that, the latest uptick reflects an appropriate expansion of care prompted by greater public awareness and a medical establishment that has gotten better at recognizing ADHD in its subtler forms. For so long, we have been pushing back against this idea that ADHD is the little boy bouncing off the walls—it is that, “but it is much more,” says Heidi Bernhardt, a psychiatric nurse and the founder of the Centre for ADHD Awareness. “People who have been struggling are finally getting the help that they need.”

This question of who “needs” a diagnosis is at the centre of everything and becomes all the more contentious as ADHD pervades the popular consciousness like the latest “it” bag: set the bar too high and you risk separating the right candidates from potentially life-saving care; set it too low and a medical diagnosis becomes vulnerable to commercial agendas, drug abuse and confusion with another often punishing condition known as being human in 2024.

ADHD diagnoses are up across the board, but the most notable increase over the past few years has been among adult women who, like me, slipped through the cracks as kids. Though ADHD presents equally between genders, boys have historically received diagnoses at more than three times the rate of girls based on their tendency to exhibit more hyperactive symptoms, whereas girls (generally speaking) are more inattentive, their symptoms easier to miss. Or mask.

Rimshah Ahmed is a 40-year-old program analyst, mother and wife in Toronto who spent most of her life desperately trying to fit in. On the outside she was reserved, always smiling, invariably calm. As she puts it, “I wore my mask for almost 40 years.”

In 2013, Ahmed visited her doctor because her difficulty managing parenthood felt excessive. She was told that it was just baby blues and it would pass. Instead, it got worse, and when the pandemic hit, life became unbearable. In 2022, her son, then seven years old, received a diagnosis of ADHD. Wanting to understand what her kid was going through, she did an internet deep dive. The more she read about ADHD, the more she realized she was reading about herself. She got her own diagnosis last year and has since been working to bring more awareness of ADHD to South Asian communities. (Like women, racialized people have been historically underdiagnosed.) “For so long,” she told me, “I had held it together, focused on what I needed to be for all of the other people in my life, and then it was like, I just couldn’t do it.”

What she’s describing is often how adult ADHD emerges. You don’t “get” ADHD as an adult, but it can lurk beneath the surface, awaiting that tipping point when your inability to pay attention starts to outweigh your natural ability to process information. Often this occurs at a time of transition: leaving home, starting a new job, becoming a parent and, yes—obviously—enduring a global pandemic. In the spring of 2020, millions of Canadians saw their routines and coping mechanisms collapse as living rooms became workspaces, children became co-workers, even our groceries needed a bath time, and lives that may have previously felt manageable suddenly felt a lot less so. Under lockdown, online and absent the traditional medical gatekeepers, women in particular were finding one another on social media, where ADHD was trending alongside dance crazes and one-pan feta pasta bakes.

Olivia Lutfallah wasn’t part of this recent diagnostic tidal wave, but she is certainly riding it. The 22-year-old biology student at Western received a diagnosis when she was seven and has been managing ADHD for as long as she can remember, but during the pandemic she found herself fielding a lot more questions about it from friends and friends of friends. She figured there might be a broader audience for the kind of experience-based real talk she was dispensing. In March of 2022, she uploaded her first TikTok, promising tips on how to do better in school and keep your house clean. A week later, she posted an eight-second clip in which she hangs from a sensory swing (a fabric cocoon that helps with emotional regulation and sensory processing). Eighteen million views later, she was on her way to internet famous. Today she has huge followings on TikTok (382,000), Instagram (232,000), YouTube (492,000) and Snapchat (89,000).

In a typical skit, she will act out conversations where she plays both herself and her ADHD brain. Or she’ll re-enact common ADHD tendencies (when you walk into a room and forget why you went there). She does quick explainers on trending terms and offers tips on how to manage frequent ADHD foes: the difficult teacher or boss or doctor or tampon. Pushing back against ignorance is central to Lutfallah’s mission. In one charmingly unhinged PSA, she explains why telling people with ADHD to “just concentrate” is like telling someone else to put their open palm down on a scalding hot stove. One video at a time, she’s reframing the way we think about neurodivergence: “Welcome to the cool kids’ club,” reads her Instagram bio, upending decades of stigma with a single sunglasses emoji.

Lutfallah is also “cool” by more traditional metrics: Hailey Bieber before the airbrushing, your ideal internet bestie who lands at that improbable inter­section of aspirational and authentic. She has done ads for Savoiz (a Toronto-based company that makes sensory swings), a line of fidget spinners (good for keeping restless hands occupied), earplugs (excellent for tuning out distraction), HelloFresh meal kits (an ADHD-friendly solution to the monumental challenges of meal-planning) and Bloom (TikTok’s favourite elixir). At one point, she was promoting Done (an American ADHD telehealth start-up that is currently under investigation by the DEA), but she opted to end that partnership.

Lutfallah isn’t a medical expert, and she doesn’t claim to be. If you ask a medical expert (I asked many), they will point out that her content can, at times, strain scientific credibility. A tutorial on “ADHD paralysis” got five million views, but the same term was cited in a 2022 study about ADHD misinformation on TikTok. The study found that more than half of the platform’s most popular ADHD videos were inaccurate or misleading, which is a problem, but it may also be missing the point. Of course science matters, but isn’t “ADHD paralysis” just another way of saying total system malfunction? Personal anecdotes aren’t peer-reviewed research, but I don’t need a double-blind study to tell me what it feels like in my head. And I don’t want to throw too much shade on a young woman who, I believe, is doing a huge amount of good for people with ADHD. “We have been working for decades to attract the kind of awareness that ADHD has gotten on TikTok,” says Heidi Bernhardt. So I guess the question is whether the good outweighs the bad.

It’s a question that extends across the #ADHD universe, where pretty much everything awesome is also terrible. The same influencers busting stigmas are also chasing clicks. The same social media platforms empowering individuals are a new frontier for Big Pharma—profit-driven businesses paying big money to stay in the algorithm’s good books. Good god—the algorithm. I watched only a handful of influencer videos and, yes, fine, couldn’t resist one of those stupid Rorschach tests that asked whether the image is a forest or a duck (both responses, I’m guessing, clear signs of ADHD). Now my social media is an endless parade of interchangeable women telling me how I can cook or parent or dress or do yoga with ADHD.

At first, I loved the memes: “Tell me you have ADHD without telling me you have ADHD” over a photo of a kitchen with every last cabinet wide open for no apparent reason. I sent it to my partner, who is forever calling me out for this annoying tendency. I can’t confirm a scientific connection—only the intoxicating flash of self-recognition. It feels good to be seen, as the generational mantra goes. And this may be particularly true of the parts of ourselves that we feel compelled to conceal. Step outside social media, and mental health stigma is very much an issue. In a 2013 study, more than half of Canadians surveyed believed that people with ADHD are not capable of holding down a job. A recent piece in the Globe and Mail wondered whether it was wise to share an ADHD diagnosis with your employer, which makes me question my decision to share my diagnosis with every prospective employer on the planet. Still, the charm of seeing my mental health meme-ified wore thin. I saw ADHD connected to everything from singing in the shower to a preference for pineapple on my pizza, and I had to wonder whether these depictions were doing more harm than good.

Morgan O’Grady, a 28-year-old Toronto voice teacher, laughed when her therapist asked whether she’d ever considered the possibility that she had ADHD. She had started therapy because of overwhelming mental chaos, but ADHD? Pfft. “I had this idea of the ADHD girlies on the internet and how it was this cool thing that everyone wanted to have,” she says, circling around a new stereotype: the self-involved snowflake who can’t get her life together and wants in on the latest fad diagnosis, the hypebeast who’s in it for the bragging rights. With even Taylor Swift singing about dopamine these days, I’m not going to rule out some level of social contagion. But maybe young women on the internet wouldn’t feel so compelled to share “their truth” if the world weren’t constantly denying it.

A close friend of mine has a daughter who recently received a diagnosis—grade-school age, unable to pay attention in class. My friend was, understandably, worried, particularly about the medication. I’m also not a medical expert, but I told her about what it felt like to spend 35 years undiagnosed (in a nutshell: not good) and how lucky I feel to have emerged with my self-esteem intact, since that isn’t normally the path that ADHD puts you on.

At her Brampton grade school, Daphne King would read a novel under her desk during class. Her report cards always mentioned her tendency toward dreamy distraction, but she wasn’t running around the classroom poking other kids with freshly sharpened pencils, so nobody intervened. At 18, she moved to Waterloo for university. A few months in, she was failing courses and starting to suspect that she was just bad at life. How else to explain the way her friends welcomed their ­independence—balancing school with frosh parties and new relationships—while she struggled to get out of bed, thoughts racing but unable to act. “It’s not just one train of thought,” she told me. “It’s a whole junction: 10 or 20 trains, and many of them are flying off the track. They’re hitting pedestrians, crashing into trees. New trains are emerging out of mid-air. I’d always think, How are people managing this?” She never considered that maybe they weren’t.

After many false starts, she began her career in marketing, where her creativity and crisis-management skills are both assets. In 2018, she received a diagnosis of anxiety disorder. Her medication helped her calm down, but her ADHD issues—task management and physical restlessness—got worse. During lockdown, she was living with her boyfriend. Observing his non-frantic approach to the workday was a wake-up call that arrived around the same time she discovered ADHD on TikTok. One minute, she was watching tutorials on organizing your apartment; the next, she was on the path to self-diagnosis, ­seeing her struggles outlined as symptoms of ADHD. The TikTok influencer community gave her a new vocabulary—the tools to articulate something she had previously found impossible to wrap words around. It also gave her the confidence to speak up.

King’s first stop was her family doctor, who agreed that her symptoms sounded like ADHD and referred her to a psychiatrist. (Family doctors are permitted to diagnose ADHD, but many don’t feel comfortable prescribing drugs for a condition that gets about 20 minutes of coverage in medical school.) At her appointment six months later, she reiterated her case, but the psychiatrist wasn’t convinced. After a 20-minute virtual visit, she gave King a diagnosis of borderline personality disorder.

A recent survey by the Centre for ADHD Awareness found that 46 per cent of Canadian women with ADHD diagnoses had previously been misdiagnosed: anxiety disorder and depression are the most common. For Rimshah Ahmed, it was baby blues. This reflects the similarity of symptoms and comorbidities among a number of mental illnesses but also the level of ignorance that still exists around ADHD. King’s psychiatrist told her that she couldn’t possibly have ADHD because she had managed to graduate from university and decorate her apartment (King wanted to tell her to have a look in the closet).

When she went back to her family doctor to request a different psychiatrist, she was told that wait times were now up to two years. This was late 2021 (Omicron!), and the public health care system was buried under an avalanche of demand. What were once cracks (the deficiency in mental health services before the pandemic) were now craters, and that’s still the case nearly three years later.

Private ADHD treatment has been an option for a while now—for people who can afford it. The first clinics opened in Canada in the late aughts to meet the demand for psycho­educational assessments for kids, and many have expanded along with the adult ADHD boom. The services on offer are the whole shebang, including options for seeing a social worker and cognitive behavioural therapy. Some of it is covered by OHIP, but much of it isn’t, and the price tags range between $2,500 and $5,000—not an option for King. One night, in desperation, she took her search to Reddit, where she discovered a clinic called Frida. The Canadian telehealth start-up charged $600 for an assessment, and she could begin immediately.

That night, King filled out Frida’s intake form: six questions intended to identify the presence of potential ADHD symptoms. It took about 10 minutes for her to complete it and another 10 seconds for the results to be processed: yes, she would be a good candidate for an ADHD assessment. The second online form was a more detailed look into her medical history. A week later, she was sitting virtually across from one of Frida’s nurse practitioners, and by that time she really wasn’t doing well. It was her ADHD but also the horrible experience of trying to get help. She felt indignant about the runaround, but beneath the bluster there was shame and the fear that maybe nobody would ever believe her. Maybe she shouldn’t even believe herself. Maybe it wasn’t that bad, right? Surely other people had it worse. She remembers the first few minutes of her Frida consultation, answering questions about her symptoms, punctuating whatever challenge she described with a reflexive “but I’m fine.” “I didn’t even realize I was doing it,” King tells me. Then the nurse interrupted her: “You know, if you’re not fine—that’s okay too.”

Frida’s parent company is a health-tech start-up called PurposeMed, launched in 2020 by three friends who saw how the pandemic-era shift toward virtual diagnoses and prescriptions could help bring accessible treatment to underserved communities. (PurposeMed is also behind Freddie, Canada’s leading purveyor of preventative HIV drugs, and Foria, which provides hormone therapy for gender-affirming care.) The company is based in Calgary, but more than half of its staff, including co-founder Amaan Banwait, are located in Toronto—and really, the whole enterprise lives online. Assessments performed by nurse practitioners who are not covered by OHIP are how services like Frida circumvent public health care and charge for their services. Automating the initial assessment stages is how they keep costs low and wait times short: “Get an ADHD diagnosis in days, not months,” reads the copy on Frida’s homepage, beside a chic 30-ish woman who appears to be emerging out of a gerbera.

Frida isn’t gender exclusive, but you’d be forgiven for making this assumption. In the early days of development, the team ran ads on Instagram, Facebook and Google to identify a target demographic. Eighty per cent of the clicks came from women, which has informed every aspect of the company’s branding. The name is inspired by Frida Kahlo, the Mexican artist who struggled with mental illness and wrote the book on flower crowns. On Frida’s social media, everything is candy-coloured, ethereal, emphatically nonclinical and not unlike the golden era of the Body Shop. But if Banwait sees any problem with marketing an ADHD diagnosis the way you would a lip balm, he’s not copping. Frida’s look and feel are important aspects of the company’s commitment to “affirmative health care,” he explains, touting a philosophy focused on validating experience and meeting patients where they are. For a lot of women with undiagnosed ADHD, that location is the southernmost tip of their wit’s end. For them, Frida is a balm.

It’s also an effective business model that has leveraged targeted advertising on social media to generate huge revenues. PurposeMed ranked second on Deloitte’s 2023 “tech companies to watch” list and was named as a start-up on the path to $1 billion in revenue by Kitchener-Waterloo tech innovation news site Communitech. It’s also in the process of expanding into the US. In other words, there is at least some theoretical tension between the best medical practices and the bottom line.

ADHD telehealth start-ups have already caused an uproar in the US. In 2022, the DEA launched investigations into two of the biggest players—Done and Cerebral—after nurse practitioners at both companies reported feeling pressured to diagnose. The scrutiny has been enough that a number of US pharmacies, including Walmart and Rite-Aid, have stopped accepting prescriptions from telehealth companies, and Cerebral stopped prescribing ADHD medication altogether.

Banwait told me about the guardrails his company has put in place to avoid a similar fate. One former Cerebral employee complained about being forced to conduct up to 30 assessments a day; Frida’s nurse practitioners are capped at three. Of the 233,000 people who have completed Frida’s initial screening quiz, only 25 per cent were approved for an assessment. The system is not un-dupable: there are crib sheets on Reddit that explain what to say to ensure a diagnosis from Frida and similar telehealth operations. Banwait concedes that even their best efforts can’t prevent isolated instances of abuse. But this is true in every health care setting, perhaps even more so in the public system, where overstretched doctors are struggling to manage mental health care deficits amid the broader implosion of primary care.

The first time I tried Vyvanse, I felt like Animal from the Muppets. I told my doctor, who scaled back the dosage, and now it works like it’s supposed to, muting the maelstrom so I can just do the thing I desperately want to be doing. I take it only on “big project” days, which is not as recommended. You wouldn’t tell someone who wears glasses to leave them off on the weekends, goes one school of thought. Glasses are not a potentially addictive controlled substance, goes another. I honestly don’t know if my approach reflects common sense or an internalized prejudice that makes me feel better about needing drugs less, but I’m also self-employed, and I pay for my medication out of pocket, so I have chosen a course of treatment that makes sense for me.

Stimulant medication doesn’t work for everyone and comes with risks, including the potential for abuse and some negative side effects like an increased risk of cardiovascular disease. But it’s also the best defence against negative ADHD outcomes: financial insecurity, unemployment, divorce, car accidents, addiction, domestic partner violence, eating disorders, depression and suicide. Whereas pharmaceutical interventions to treat anxiety or depression tend to be endlessly trial-and-error and often don’t have a huge impact, the rewards of medicating ADHD tend to be significant and immediate. “It’s like putting someone on level ground after they have spent a lifetime walking uphill,” is how one doctor described it.

Morgan O’Grady felt a profound unburdening after her diagnosis: “Like maybe I’m not just a lazy bitch”

  Morgan O’Grady was hesitant to go the drug route, worried that the same medication that helped with focus could also interfere with the parts of herself she liked best, like her capacity for inspiration. (“My ability to experience awe” is how she phrased it.) But, following her diagnosis, she figured it was worth a try. She took a pill and went for a walk in High Park to gauge the effects in a stress-free setting, and what she felt was a profound unburdening. “It was maybe the first time in my adult life I had experienced inner peace,” she says. It was the medication, but it was also more than that. Having spent so many years coming down on herself, her diagnosis was a revelation: “Like maybe I’m not just a lazy bitch.”

Daphne King no longer struggles to get out of bed in the morning. “I don’t even have to set an alarm!” she tells me. She got a promotion—turns out she’s even better in a work crisis when her own life isn’t devolving into one. And she’s in the process of going off her anxiety medication because managing untreated ADHD was what was making her so anxious. ­Rimshah Ahmed says she felt her diagnosis as a weight slowly lifting from her neck, her shoulders, her toes. ADHD was a load she didn’t even know she was carrying, and I know exactly what she means.

A few years ago, I made an appointment to see a therapist specializing in ADHD treatment. What I’d envisioned as a strategy session (how to improve productivity) quickly turned into a sob-fest—I’m talking Grey’s Anatomy season finale level waterworks, both grief for the past and gratitude for the chance to reframe it via an explanation that didn’t come down to personal failings and wasted potential. Maybe this, and not the desire to build identity around a hashtag, is what makes a mental health diagnosis so universally appealing: the chance to name your Voldemort and get on with it.

But my ADHD is not my enemy—at least not entirely. A mental illness is not a broken limb. How my brain works is inextricable from who I am, and while the question of where to set the diagnostic bar matters on a broader level, it’s less important to each atypical mouse just trying to make her way in the world. I try to appreciate the upsides: low impulse control and high risk tolerance mean there are few adventures I’m not up for. I don’t sweat the small stuff—I’m pretty sure I couldn’t if I wanted to. And while everything-everywhere-all-at-once can be tricky in terms of standard life maintenance, it’s a pretty spectacular vantage point from which to appreciate the bigger picture. O’Grady calls it “lantern brain”—the wide-angle way that ADHD brains perceive their surroundings. “Regular people drop acid to experience what we do every day,” she says, which is almost certainly not true, but I’ll take a second to sit back, enjoy the sentiment and experience a little awe of my own before I fact-check.

This story originally appeared in the July 2024 issue of Toronto Life magazine. To subscribe for just $39.99 a year, click here. To purchase single issues, click here.