The Evolution of ADHD:

A Journey Through Time

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterised by persistent patterns of inattention, hyperactivity, and impulsivity. Its recognition and understanding have evolved significantly over centuries, reflecting shifts in medical knowledge, societal perceptions, and cultural narratives.​

Early Observations and Descriptions

Hyperkinetic Reaction of Childhood (1968): The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-II) introduced this term to describe children with excessive movement and attention difficulties. ​

Yellow cover of a manual titled "Diagnostic and Statistical Manual of Mental Disorders," second edition (DSM-II), published by the American Psychiatric Association.

Melchior Adam Weikard (1775): German physician Melchior Adam Weikard provided one of the earliest known descriptions of attention-related difficulties. In his comprehensive work "Der Philosophische Arzt" ("The Philosophical Doctor"), Weikard discussed "Mangel der Aufmerksamkeit" ("lack of attention"), detailing behaviours that align with modern understandings of inattention and distractibility. ​

Image: A portrait of Melchior Adam Weikard.​

Sir Alexander Crichton (1798): In his seminal publication "An Inquiry into the Nature and Origin of Mental Derangement," Scottish physician Sir Alexander Crichton introduced the concept of "mental restlessness." He described individuals, particularly children, who struggled to sustain attention and were easily distracted, noting that these traits could be innate or arise from external factors. ​

Image: An illustration of Sir Alexander Crichton.​

19th Century Cultural Depictions

Heinrich Hoffmann (1845): German psychiatrist Heinrich Hoffmann authored "Der Struwwelpeter," a collection of illustrated children's stories. Among them, "Die Geschichte vom Zappel-Philipp" ("The Story of Fidgety Philip") portrays a boy unable to sit still at dinner, leading to a chaotic outcome. This narrative mirrors behaviours associated with ADHD and reflects societal awareness of such traits during that era. ​

Image: An illustration from "Die Geschichte vom Zappel-Philipp" depicting Fidgety Philip at the dinner table.​

Sir George Frederic Still (1902): Often regarded as a foundational figure in ADHD's medical history, British paediatrician Sir George Frederic Still presented a series of lectures to the Royal College of Physicians in London. He described children exhibiting "an abnormal defect of moral control," who, despite normal intelligence, displayed significant impulsivity and behavioural issues. Still proposed that these behaviours were not solely due to environmental factors but could have a biological basis. ​

Image: A photograph of Sir George Frederic Still

Attention Deficit Disorder (1980): The DSM-III replaced the previous term with "Attention Deficit Disorder (ADD)," recognising that attention deficits could occur with or without hyperactivity. ​

Cover of the diagnostic and statistical manual of mental disorders, third edition (DSM-III), published by the American Psychiatric Association, green cover with yellow and white text.

Advancements in Treatment Approaches

1937: Dr. Charles Bradley discovered that the stimulant Benzedrine improved behaviour and academic performance in children with behavioral disorders, marking the beginning of stimulant use in treating attention-related conditions. ​

Image: A historical image of Dr. Charles Bradley.​

1955: The U.S. Food and Drug Administration approved methylphenidate (Ritalin), which became widely used for treating ADHD symptoms, and other things apparently. ​

Images: An early advertisements for Ritalin

Black and white advertisement featuring a smiling man in a suit and tie, with hands on his hips, promoting Benzedrine Sulfate Tablets as a theraputic treatment for depression, dating from the 1950s.
Vintage black-and-white advertisement featuring a woman laughing, promoting Ritalin to improve mood and performance, with text about overcoming depression, fatigue, lethargy, and indications for use.

Contemporary Perspectives and Ongoing Debates

Recent Trends: In recent years, there has been a notable increase in ADHD diagnoses, particularly among adults. This trend has sparked discussions about potential over diagnosis and the medicalisation of behaviours that might fall within the spectrum of normal human experience. ​

Image: A graph illustrating the increase in ADHD diagnoses over recent years.​

Social Media Influence: The role of social media platforms, such as TikTok, has also been highlighted in raising awareness about ADHD. While these platforms have contributed to greater recognition of the disorder, they have also been sources of misinformation, underscoring the need for accurate public education.​

Image: A screenshot from a TikTok video discussing ADHD awareness.​

A man sitting at a desk reading a book in a dimly lit room, depicted in a pencil sketch style.
Portrait of a man with light-colored hair, wearing a black coat and bow tie, sitting on a red chair against a dark background.
Illustration of three people sitting around a dinner table with a poem below, featuring decorative floral elements.
Black and white portrait of a man with a mustache, dressed in academic robes, sitting with his right arm resting on a surface.

Terminological Evolution and Diagnostic Criteria

Minimal Brain Dysfunction (1930s–1950s): During this period, children exhibiting hyperactive and inattentive behaviours were often diagnosed with "minimal brain dysfunction," reflecting a belief in an underlying neurological cause. ​

Images: Medical texts from this era discussing "Minimal Brain Dysfunction."​

Book cover titled 'Minimal Brain Dysfunction: A Clinical Study of Incidence, Diagnosis and Treatment in Over 1,000 Children' with authors Mortimer B. Gross, M.D., and William C. Wilson, M.D. The cover features a black and white photograph of a child's face with cartoon-like glasses, overlayed on electroencephalogram lines.

Attention-Deficit/Hyperactivity Disorder (1987): The DSM-III-R refined the diagnosis to "Attention-Deficit/Hyperactivity Disorder (ADHD)," integrating both attention deficits and hyperactive behaviours into a single disorder. ​

Cover of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised (DSM-III-R), published by the American Psychiatric Association.
Black and white portrait of a man with short dark hair, a full mustache, wearing a dark coat and a white shirt, looking straight at the camera.

Attention-Deficit/Hyperactivity Disorder (1994): The DSM-IV. No major changes.

Vintage illustration of a happy family celebrating, with the text 'RITALIN! So Much Easier Than Parenting'.
A black and white photo of a person sitting on the floor with their back to the camera, leaning against a wall near a radiator, wearing a jacket, appearing to be in distress. Text at the bottom advertises a medication called Ritalin for stimulating treatment in patients with severe psychiatric conditions.
Black and white photo of a smiling older woman holding a young child, with the text 'Brighten the day' at the top. The ad promotes Ritalin, describing its uses for various medical conditions.
Book cover titled 'Minimal Brain Dysfunction: Fact or Fiction' from the 'Advances in Biological Psychiatry' series, edited by A.F. Kalverboer, H.M. van Praag, and J. Mendlewicz. The background of the cover is yellow with black and white text.
Cover of a book titled 'Quick Reference to the Diagnostic Criteria from DSM-IV' published by the American Psychiatric Association, with a red background and gold text and borders.
A vintage tin container labeled 'Benzedrine Tablets,' a medicinal product, with a black lid and a green and white label.
Black and white image of a distressed woman sitting on the floor with her head down and clasping her knees, in a therapy or hospital room. Text around the image describes Ritalin as a treatment for depression and related psychiatric conditions.
A young boy sitting at a school desk reading a book in a classroom, with other children in the background, and overlay text promoting Ritalin for studied attention issues.
Line graph titled 'ADHD Diagnosis Rates Over the Last 40 Years' showing diagnosis rates for children and adults from 1985 to 2025. Child diagnosis rates increase from 3% in 1985 to 14.2% in 2025. Adult diagnosis rates rise from about 0.5% in 1985 to 12% in 2025. The two lines are color-coded, with children in yellow and adults in orange.
A woman with dark hair and a pink shirt looks frustrated, next to an image of a smiling woman in a brown hat and black shirt, with text above that reads "That's not a symptom of ADHD" and "PLS STOP".
Book cover titled "Minimal Brain Dysfunction in Children" by Paul H. Wender, M.D., with a green and pink circular brain illustration.

Attention-Deficit/Hyperactivity Disorder (2013): The DSM-V brought major updates to diagnostic criteria e.g. the onset age changed from before 7 to before 12 years.

Cover of a book titled "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5", published by the American Psychiatric Association, with a purple background and white text.