A Short History of ADHD: From “Fidgety Phil” to Today
It's 2am and you've typed "is ADHD real" into your phone for the third time this month.
Not because you're a sceptic. Because part of you is wondering whether you're allowed to think this about yourself.
One of the most common things I hear from adults exploring ADHD is some version of "but isn't it a bit of a trend?" It's said almost apologetically. Underneath it is a harder question. If this is real, why did nobody notice for forty years?
So here's the history. It turns out people have been describing this brain for more than two hundred years. The name kept changing. The brain didn't.
The first descriptions (1798 and the 1840s)
In 1798 a Scottish doctor, Sir Alexander Crichton, wrote about people who could not hold their attention on one thing for long and were pulled off course by every passing distraction. He noticed it began in childhood, and that for some people it carried on into adult life.
That last part is worth sitting with. The first medical description of this pattern, written before Australia had a single city, already said it didn't always go away.
In the 1840s a German doctor, Heinrich Hoffmann, wrote a children's book with a character called Fidgety Phil, a boy who could not sit still at the dinner table no matter how many times he was told. It wasn't research. It was a picture book. But it shows that restless, impulsive kids were being noticed, and judged, long before anyone had a name for what was going on.
Early medical research (1902 to the 1920s)
In 1902 a British doctor, Sir George Still, gave a series of lectures describing children who were bright, often kind, and still couldn't control their attention or their impulses the way other children could.
His conclusion mattered. He thought this came from the brain, not from bad parenting. In 1902, that was a radical thing to say.
Between 1917 and the late 1920s, a wave of brain inflammation called encephalitis lethargica left some children with the same restlessness and inattention afterwards. It was another clue that this was about how the brain works, not about character.
The name kept changing (1968 to 1994)
By 1968 the official diagnostic manual called it "hyperkinetic reaction of childhood". The focus was almost entirely on hyperactivity. If you weren't bouncing off the walls, you weren't in the picture.
In 1980 the name changed to attention deficit disorder, or ADD, and for the first time there was a version without hyperactivity. This is the first moment the quiet, daydreaming child officially existed.
In 1987 it became attention-deficit/hyperactivity disorder, ADHD, which is the name we still use.
In 1994 it was split into the three presentations you'll recognise today. Inattentive, where the struggle is focus, organisation and follow-through. Hyperactive-impulsive, where it's restlessness and acting before thinking. And combined, which is both.
Where we are now (2013 onwards)
The 2013 manual, DSM-5, made two changes that matter a great deal if you were diagnosed late.
Symptoms now need to have started before age 12, rather than before age 7. And adults need fewer symptoms than children to meet the criteria, because the condition looks different at 45 than it does at 9. Both changes were an admission that the old picture had been too narrow.
ADHD is now understood as a neurodevelopmental condition. It begins in childhood, it involves differences in the brain networks that handle attention, impulse control and planning, and it is shaped by a mix of genetics and environment.
As for how common it is, the two best worldwide reviews put it at about 5 per cent of children, and somewhere between 2.6 and 6.8 per cent of adults, depending on whether you count only people who were diagnosed as children or everyone who meets the criteria now. The gap between those two adult numbers is, in a way, this whole post. A lot of people meet the criteria and were never counted.
And if you've heard that ADHD is being diagnosed more because it's suddenly everywhere, a review covering three decades of studies found no evidence that more children actually have it. What's changed is awareness, and access to someone who knows what to look for. I've written more on that in ADHD Isn't Suddenly Everywhere: Why More Adults Are Being Diagnosed.
Who the history left out
Read that timeline again and notice who's in it. Phil. A boy at a dinner table. Children who couldn't sit still.
For most of two hundred years, the picture was a disruptive boy. The girl reading under the desk didn't fit it. Neither did the capable woman holding a household and a career together through sheer effort, or the adult who was told it was anxiety, or stress, or just the way they were.
It's not that those people didn't have ADHD. It's that nobody thought to look. If that's you, you weren't missed because you were imagining it. You were missed because the description was written for someone else. I've written about this in Why ADHD Often Goes Unnoticed in Women.
If you're worried you're jumping on a bandwagon
You're not. A bandwagon is new. This is 1798.
Wondering about yourself after decades of effort, after your child's diagnosis made the paperwork sound uncomfortably familiar, after the systems that held for years stopped holding, isn't a trend. It's a question you're allowed to ask, and you're allowed to take your time with it.
ADHD isn't new. We've been noticing it, describing it and arguing about it for centuries. What's still growing is our understanding, and who we think to include.
If you'd like to talk through whether what you're noticing might be ADHD, I work with adults across Australia by telehealth. You can see the full assessment process and the fees before you decide anything, and you don't need a GP referral to start. You can book a session here.
Does this resonate? I'd love to know. You can follow me on LinkedIn and Facebook, where I share a new post most weeks.
Interested in reading more? These ADHD Myths Have Been Wrong for Decades
This post is general information, written to help you understand your own experience. It isn't therapy, and it isn't a substitute for advice from a health professional who knows you.
