#61. Challenging the 'ADHD Was Always There' Narrative

#61. Challenging the 'ADHD Was Always There' Narrative

From Psychobabble by Hannah Spier, MD

March 25, 2026 · 26 min

About this episode

This episode explores the historical evolution of ADHD and challenges the narrative that it has always existed.

ADHD did not expand by accident.In some U.S. states, nearly 1 in 5 boys have been diagnosed. Adult diagnoses continue to rise. The standard explanation is simple: "It was always there — we're just recognizing it now."But genuine medical conditions do not behave this way.In this episode, I trace the historical evolution of ADHD from a rare and severe childhood condition to a lifelong, broadly defined neurodevelopmental diagnosis. We look at the DSM revisions that expanded criteria, the shift from hyperactivity to inattention, and the moment adult self-report became sufficient for diagnosis.More importantly, we examine the forces that benefited from this expansion Become a Psychobabble Insider and join us Saturday the 28th of March at 3 PM Eastern for a Live Clinical Session on helping men grieve with Tom Golden! 0:00 The Epidemic of ADHD Diagnoses and Medication0:20 Challenging the 'ADHD Was Always There' Narrative1:02 Why Prevalence Data Disproves the 'Always There' Argument1:40 DSM Revisions and Shifting Diagnostic Criteria2:24 ADHD as a Reflection of Institutional Demands2:52 The Intellectual Roots of Psychiatric Diagnosis: Wundt's Lab3:39 Sir George Still's Early Description…

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