Are We in an ADHD Epidemic or an Epidemic of Distractibility?
Are We in an ADHD Epidemic or an Epidemic of Distractibility?
Everywhere you look these days, people are talking about late diagnosis or having been recently assessed for ADHD. And it's easy to look at this and think we are living in an epidemic of ADHD. In my work as a counsellor in Vancouver, this comes up constantly, and I want to offer a more nuanced take. Because while I do think we are more aware of the signs and symptoms of ADHD than we've ever been, I'm hesitant to buy into the idea that we're seeing a dramatic surge in the condition itself. What I think we're also seeing is a world that promotes constant distractibility and a real discomfort with being bored or unstimulated. And those are not the same thing, even when they look similar from the outside.
Are the signs and symptoms of ADHD always ADHD?
Distractibility, difficulty focusing, procrastination, time blindness, executive dysfunction. These are consistent signs of ADHD, but they're also consistent with other things.
One pattern I'm seeing a lot right now is women in midlife presenting with symptoms that look a lot like ADHD, but that are actually connected to the onset of perimenopause. Hormonal fluctuations that are common in midlife do impact executive function in ways that can look very similar to ADHD. That doesn't mean those women have ADHD. It means the root cause is different, and understanding that distinction matters for how we support them.
When it comes to the origins of ADHD itself, I tend to think of it as the result of an interaction between genes that might be responsible for a more sensitive temperament, and early environmental experiences of attention and attunement. What we often see with women who are presenting with these symptoms in midlife is that they didn't struggle in these ways from a young age. The symptoms came on later. And that history matters.
What does ADHD and screen use actually have to do with each other?
We all carry pocket computers with us everywhere we go. And those devices offer an endless amount of stimulation, hit after hit of dopamine-producing content, whether that's reels, articles, news, social media, or anything else. Most of us reach for our phones impulsively, without even deciding to, just looking for something to create that little dopamine surge.
What prolonged and excessive screen use does over time is deplete dopamine, because we've been chasing hit after hit without allowing our brains to regulate. What we're left with is a very low tolerance for being unstimulated or bored. And that low tolerance can look a lot like ADHD from the outside, even when it isn't.
The difference matters. For someone whose attention has been conditioned by screens, removing those screens will produce an initial period of discomfort, something not unlike a detox. But over time, their brain will come back down to baseline. They'll find they can engage in other activities, read a book, go for a walk, sit with a friend, without needing to layer stimulation on top of it. That's not necessarily what happens with an ADHD brain. An ADHD brain doesn't just come back to baseline in the same way.
How do we tell the difference?
The answer, in my experience, lies in a historical picture. When did these signs and symptoms first show up?
If the attention difficulties only started appearing as screen use increased, that's important information. But if there's a longer history, difficulty focusing in school, being flagged for behavioural issues, excelling in some areas while struggling to complete anything in others, a longstanding pattern of procrastination, that paints a different picture.
This is also why we're cautious about exploring ADHD with people who are in early recovery from drugs or alcohol. That post-acute withdrawal period can produce a lot of signs and symptoms that look consistent with ADHD. We need to give the brain time to come back to baseline before we can get a clear sense of how someone functions day to day. It's only once there's a period of sustained sobriety that the picture becomes clearer.
For a deeper look at how ADHD and addiction overlap, our post on ADHD, Dopamine, and Recovery explores that connection further.
Why getting this wrong has real consequences
For people who are living with ADHD, access to the right support can be genuinely life-changing. I've heard from clients that when they found the right treatment for the first time, they could suddenly hear the birds outside because their brain was no longer so busy and so chaotic. That kind of shift matters.
If attention difficulties are being dismissed as a screen problem when something more is going on, people can spend years without the support that could make a real difference. On the other side, if screen-driven distractibility is being treated as ADHD when it isn't, people may not get the opportunity to address what's actually driving the pattern.
Neither outcome serves the person well. Which is why a thorough history, and support from someone who understands both, matters. Our ADHD support work is a good place to start if you're trying to make sense of what you're experiencing.
What has screen use done to our relationship with boredom?
We have become so conditioned to having something to distract us from our own internal experience that many of us can no longer tolerate being bored or unstimulated. We've lost sight of the fact that boredom actually serves a purpose. When we're bored and unstimulated, our brains have an opportunity to be creative, to seek other strategies for engagement and reward. That capacity gets eroded when we're always reaching for a screen.
For people with ADHD, there's a kind of hyperactivity in the brain that makes boredom genuinely hard to sit with. For people whose attention has been conditioned by screens, boredom is also hard, but for different reasons. Learning to sit in the discomfort of being unstimulated is a significant part of the work in both cases, even if the underlying cause is different.
What to do if you're not sure what's going on
If you've been told that your attention difficulties are just about your phone use but you suspect something more might be going on, run an experiment. Set some limits around when and how you use your screens. Invest time in other activities. Can you read a book? Do a puzzle? Go for a walk without your phone? Exercise without music or a podcast layered on top? Notice what happens. Notice how your attention functions in the absence of screens, and be curious about what that tells you.
That's not to say it will be straightforward. But it's a useful starting point. And if the pattern persists regardless of your screen use, that's worth exploring further with someone who understands the difference.
If you'd like to explore what's going on for you, you're welcome to take our Match with a Therapist quiz or email us at hello@opcounselling.com to book your first session.
Orli Paling, RCC is a Registered Clinical Counsellor with the BC Association of Clinical Counsellors, with an MA in Counselling Psychology and over 13 years of experience working with adults navigating ADHD, trauma, and emotional regulation. She practices at OP Counselling in Vancouver, BC.
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