The key points in 30 seconds:
→ ADHD is a disorder (Faraone et al., 2024; Shah et al., 2022).
→ ADHD is at the same time a natural human variation (Sonuga-Barke et al., 2023).
→ Both are true. In public debate this gets lost — as if it were complicated or a turf war.
→ At work, it's not the label that counts, but the fit.
The question that got brushed aside
A few weeks ago, at the end of an online talk on neurodiversity, I got to ask a professor a question: "Is ADHD a disorder or a natural variation?" He just answered: "Variation." — and moved on. First I was stunned, then angry. Why?
Because the answer is too short. ADHD is a disorder. ADHD is at the same time a natural variation of humanity, a particular way of being. Both are true. In public debate this gets lost, because it seems complicated — and because it's partly about turf wars. That makes no sense, neither from a research nor a personal-experience point of view. I write as someone with ADHD and as a reasonably seasoned psychologist.
ADHD is a disorder — the medical-psychological view
A neurobiological disorder with a clear clinical diagnosis. It's assigned in cases of clinically significant distress or impairment (DSM-5-TR; ICD-11). The goal: reduce symptoms, live well with it. Research looks at origin, course, and support. The executive functions — planning, organization, prioritization — develop differently (Faraone et al., 2021).
ADHD in the neurodiversity approach
Neurological differences are natural and value-neutral. ADHD — and autism too — is not a disorder, not a deficit. If there are problems, they're with the "neuronormative" environment in which the majority gets by. This is more a political and social movement than a medical statement.
What bothers me as someone with ADHD
By the pure neurodiversity approach, I'm perfectly normal. ADHD a social construct, an annoying fad. That my prefrontal cortex lights up in a scan like a disco and my neurotransmitter balance differs from 95 percent of people: supposedly completely normal. Basic research on genetics and physiology? People don't want to hear it. The environment wasn't for me — so just work on it. Medication out of place. "Take it easy, Tobias."
The medical-psychological research is clear here: a neurodevelopmental disorder (Faraone et al., 2021). Deficit-oriented — but it helps those affected. That it long neglected social and environmental factors is true; that's being addressed (Sonuga-Barke et al., 2023). And often people talk over the heads of those who live with it — and get stigmatized as stupid.
The synthesis
Everyone with ADHD is "neurodivergent." But not everyone who is neurodivergent has a clinical disorder. The environment — the majority — cushions the distress or amplifies it. What disables, above all, is the mismatch with the environment (van der Oord, Vanaken & French, 2026). Once you know that's how it is, you can acknowledge it and treat each other "normally."
At work this means: fit, not repair
Don't repair the person — look at the fit. That's where performance begins. The same is true for children and adolescents in school.
It's about acceptance. And for that, you have to understand.
Sources
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Faraone, S. V., et al. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022
Faraone, S. V., et al. (2024). Attention-deficit/hyperactivity disorder. Nature Reviews Disease Primers, 10(1), 11. https://doi.org/10.1038/s41572-024-00495-0
Shah, P. J., Boilson, M., Rutherford, M., Prior, S., Johnston, L., Maciver, D., & Forsyth, K. (2022). Neurodevelopmental disorders and neurodiversity: Definition of terms from Scotland's National Autism Implementation Team. The British Journal of Psychiatry, 221(3), 577–579. https://doi.org/10.1192/bjp.2022.43
Sonuga-Barke, E. J. S., et al. (2023). Annual Research Review: Perspectives on progress in ADHD science — from characterization to cause. Journal of Child Psychology and Psychiatry, 64(4), 506–532. https://doi.org/10.1111/jcpp.13696
van der Oord, S., Vanaken, G.-J., & French, B. (2026). Can the neurodiversity approach apply to ADHD? Exploring the lived experience of ADHD as neurodivergence. Journal of Attention Disorders. Advance online publication. https://doi.org/10.1177/10870547261459222
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