Why Is Everyone Being Diagnosed with ADHD and Autism? An Educational Psychologist's Perspective

There is a question I hear more often now than ever before — in consultation rooms, at dinner tables, in Instagram comments: "Why does everyone seem to have ADHD or autism all of a sudden?"

It is a fair question, and it deserves a thoughtful, honest answer. One that holds space for the complexity of what is happening, without dismissing the very real experiences of those who have spent a lifetime wondering why the world never quite fit them.

I ask it with a particular kind of gratitude, because I have the absolute privilege of walking alongside individuals as they discover that their patterns of behaviour do not reflect weakness, rudeness, or being "broken." Rather, they reflect a brain with biological differences in how it experiences the world and responds to the beautiful chaos that is human nature. Watching someone arrive at that understanding is, without question, one of the most meaningful things I witness in my work.

The Numbers Are Real — But the Story Behind Them Is Complicated

Let us start with what the data actually shows.

Globally, the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) is approximately 5% in children and 2–3% in adults. In South Africa, some studies have reported prevalence rates as high as 19.7% in children, reflecting significant variation depending on the tools and criteria used. For Autism Spectrum Disorder (ASD), diagnosis rates have risen dramatically: the CDC reports that approximately 1 in 36 children were identified with ASD in 2020, compared with 1 in 150 in the early 2000s.

Here is the nuance, though: most experts agree that this is not an epidemic of new cases. The underlying neurobiology has not changed. What has changed is our ability, and our willingness, to see it.

Rising diagnostic rates primarily reflect changes in diagnostic conventions rather than an increase in the underlying condition itself. Since the 1990s, criteria have broadened to include a far wider range of presentations, including people without intellectual disability, those with fluent language, and those whose difficulties only become apparent later in development. The DSM-5, introduced in 2013, collapsed eight previously separate diagnoses (including Asperger syndrome and childhood autism) into one spectrum, and critically, removed the exclusion that previously prevented co-diagnosis of ASD and ADHD. This single change opened the door for many people to finally be seen.

Who Is Being Diagnosed Now?

For decades, our clinical picture of ADHD was a hyperactive, disruptive boy in a classroom. Our image of autism was a non-speaking child with severe support needs. These archetypes were never the whole story, but they dominated research, diagnostic tools, and clinical training.

What we are witnessing now is the recognition of those who were always there but never seen.

Women and girls. Women are significantly more likely to present with inattentive symptoms rather than hyperactive ones: subtler, more internal, easier to attribute to anxiety, depression, or simply "being highly sensitive." They are also more likely to develop sophisticated coping strategies that mask their symptoms, delaying diagnosis sometimes by decades. The most common age for women to receive an ADHD diagnosis is their late 30s to early 40s, compared to age 7 for boys. A recent study estimated that approximately 14% of adults are undiagnosed with ADHD, with women disproportionately represented in that group.

Following the COVID-19 pandemic, ADHD diagnoses in females surged. UK data showed that ADHD diagnoses in women aged 20–24 years increased by 24.7% above expected rates in the two years after March 2020, with social media awareness cited as a likely contributor alongside pandemic-exacerbated symptoms.

Adults who grew up before awareness existed. Prior to 2013, DSM criteria for ADHD were not validated in adults and did not include developmentally appropriate thresholds for adult presentations. This meant that clinicians could not readily identify many affected adults, even when they tried. Many people now being diagnosed in their 30s, 40s, and 50s spent their formative years being told they were lazy, dramatic, "too much," or simply not trying hard enough.

People from marginalised communities. Systemic barriers, including limited healthcare access, culturally biased diagnostic tools, and persistent stigma, have historically meant that neurodivergent people from Black, Brown, and lower socioeconomic backgrounds were less likely to be referred, assessed, or believed.

What Is Actually Driving the Increase in Diagnoses?

Several converging factors are at play, and it is worth naming them honestly.

Better Diagnostic Criteria

Broadened diagnostic criteria now capture presentations that were previously invisible, particularly in females, adults, and people with average-to-high intelligence whose compensatory strategies masked their difficulties.

Increased Awareness

Clinician and public awareness has grown substantially. People are more likely to recognise their own experiences, seek assessment, and find professionals willing to listen. This has been particularly significant for women and historically underdiagnosed groups.

Reduced Stigma

Destigmatisation, while still incomplete, has made it safer for people to seek help. The neurodiversity movement has contributed meaningfully to this shift, reframing brain difference not as disorder, but as natural variation.

Social Media Visibility

Platforms like TikTok and Instagram have made neurodivergent experiences visible in ways that were simply not possible a generation ago. For many people, seeing their own experience reflected back for the first time — the executive dysfunction, the sensory sensitivities, the masking, the exhaustion — has been a genuine lightbulb moment that prompted them to seek formal evaluation.

Environmental and Social Complexity

Contemporary life makes significant demands on social communication, emotional regulation, cognitive flexibility, and self-management. Rising diagnostic rates also reflect a growing mismatch between neurodivergent characteristics and the expectations of modern environments. The brain has not changed; the world it is being asked to navigate has become increasingly unforgiving of difference.

The Masking Problem: Why So Many People Were Missed

Central to understanding late diagnosis is the phenomenon of masking (also called camouflaging): the conscious or unconscious suppression and compensation of neurodivergent traits in order to appear neurotypical.

Masking involves strategies like memorising social scripts, forcing eye contact, suppressing stimming behaviours, over-preparing for tasks, and performing "organised" while internally overwhelmed. It is mentally and emotionally costly. Research consistently shows that sustained masking is associated with depression, anxiety, burnout, and significantly increased suicidality.

Girls and women are disproportionately affected, partly because social expectations for female behaviour have historically allowed for greater tolerance of social conformity, and partly because masking is socially reinforced from a very young age. Many autistic women are only identified after a significant mental health crisis, after their child receives a diagnosis, or after reaching their 30s or 40s and finally having the language to describe their experience.

The cost of not knowing? A lifetime of misdiagnosis (anxiety, depression, borderline personality disorder), inadequate treatment, educational underachievement, occupational instability, fractured relationships, and profound damage to self-worth. All of this arising not from the neurodivergence itself, but from navigating a world that was never designed with that brain in mind.

Knowledge and Visibility Are Powerful — But Self-Diagnosis Has Real Risks

I want to be clear: the increased visibility of neurodivergent experiences is a genuine good. It has reached people who would otherwise have spent another decade, or their entire lives, searching for an explanation for their struggles.

But I also want to be honest about the risks of self-diagnosis, because they are real and they matter.

Social media content is not diagnostic. Viral posts about ADHD or autism typically capture a narrow slice of experience, often the most relatable, universal, or visually compelling features. A TikTok video describing difficulty with task initiation or sensory sensitivity may resonate deeply, but resonance is not a diagnosis. Many experiences described in neurodivergent content are genuinely common human experiences — the spectrum of attention, social discomfort, sensory preferences — that, in isolation, do not constitute a clinical condition.

A formal diagnosis requires that symptoms are pervasive (present across multiple settings), persistent (present since early development), and functionally impairing, and not explained by another condition, life circumstance, or developmental stage.

The creator problem. Research has noted that online neurodivergent content disproportionately reflects the experiences of white, middle-class, articulate creators, producing narrow templates of what ADHD or autism "looks like." This means some people may misidentify with content that does not reflect their experience, while others, whose presentation differs significantly from the template, may miss their own diagnosis entirely.

Misdiagnosis has consequences. Self-diagnosis without professional evaluation risks missing conditions that closely mimic ADHD or autism, including anxiety disorders, mood disorders, trauma responses, and sleep disorders, all of which require different interventions. Seeking treatment for the wrong condition is not neutral. It can delay appropriate care, create false certainty, and in some cases cause harm.

This does not mean dismissing self-identification. Rather, it means that the journey beginning with "I see myself in this" should lead toward, not away from, professional evaluation. Self-awareness is a beginning. A thorough assessment provides the clarity, depth, and specificity that a social media feed simply cannot.

"Everyone Is a Little Neurodiverse" — Why This Is Harmful

I need to name something directly, because I hear it often and it troubles me.

The phrase "everyone is a little neurodiverse", however well-intentioned, is minimising. It flattens real difference into a general human experience and, in doing so, invalidates the genuine challenges, societal barriers, and daily labour of living in a world that was not designed for your brain.

Yes, all brains differ. That is the literal biological meaning of the word "neurodiversity." But there is a meaningful, clinically significant difference between someone who occasionally loses their keys and someone who has never been able to hold a job because of executive dysfunction; between someone who prefers alone time and someone for whom every social interaction requires active cognitive rehearsal, followed by days of exhaustion and self-reproach.

Neurodivergent people face measurably worse outcomes across education, employment, mental health, relationships, and life expectancy — not because their brains are broken, but because the systems and structures around them were built by and for neurotypical people. To say "everyone is a little like this" erases those structural barriers. It suggests that the solution is a mindset shift, when what is actually needed is genuine accommodation, access, and systemic change.

A diagnosis is also not an easy fix or a convenient label. For most people, it is the beginning — not the end — of a long process of self-understanding, grief, recalibration, and healing.

The Power of a Diagnosis: What We Know From Research

When done well, diagnosis changes lives, and the evidence supports this clearly.

Adults diagnosed with autism in later life describe the experience as transformational: "everything began to make sense." In one qualitative study, all late-diagnosed autistic adults (diagnosed after age 40, some as late as 64) described the diagnosis as pivotal to their self-understanding and quality of life. Adults diagnosed with ADHD report significantly higher quality of life, work productivity, and self-esteem compared with those who have equivalent symptoms but no diagnosis.

Formal diagnosis provides access to support, accommodations, treatment, and, critically, the internal permission to stop blaming yourself for struggling in ways that were never about effort or character.

In my own practice, I witness this regularly. When someone begins to understand that their brain has genuine, measurable differences in how it processes the world, something shifts. The narrative changes from "I am broken" to "I have been operating in a system that was never built for me." With a growing awareness of how their differences are not deficits — and that their difficulties often stem from operating in a world that expects conformity — these individuals begin a journey of self-awareness and self-acceptance.

From that point, we move forward together. The goal is not to eliminate difference, but to understand it: to recognise that, while we still operate in a world that is not always accepting or accommodating, it is entirely possible to carve out a place within it where the genuine strengths and gifts of a differently wired brain can be embraced and celebrated.

Holding Both Truths

What I hope to leave you with is this: it is possible to hold two things as true at once.

It is true that increased visibility, awareness, and reduced stigma are bringing long-overdue recognition to people who have struggled unseen for years. That is worth celebrating.

It is also true that social media is not a diagnostic tool, that self-identification requires professional validation, and that casual use of neurodivergent identity as a personality descriptor risks minimising the lived experience of those for whom these differences represent daily, significant, and sometimes life-threatening challenges.

The goal is not to gatekeep. The goal is to ensure that every person who might be neurodivergent has access to rigorous, affirming, and thorough professional assessment — the kind that sees all of them, not just the parts that fit the TikTok template.

Because understanding your brain is not a trend. It is a profoundly human act of self-compassion, and it deserves to be taken seriously.

Aliece van der Merwe is an educational psychologist based in Cape Town who prioritises providing neuro-affirming support to children, adolescents, and young adults.