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“For Me, ‘Normality’ is Not Normal”: Rethinking Medical and Cultural Ideals of Midlife ADHD Diagnosis

Culture, Medicine, and Psychiatry (2023)Cite this article

Abstract

According to psychiatry, Attention-Deficit/Hyperactivity Disorder (ADHD) is a chronic condition beginning in early life. Psychiatry advocates for early diagnosis to prevent comorbidities that may emerge in untreated cases. “Late”-diagnosis is associated with various hazards that might harm patients’ lives and society. Drawing on fieldwork in Israel, we found that ‘midlife-ADHDers,’ as our informants refer to themselves, express diverse experiences including some advantages of being diagnosed as adults rather than as children. They share what it means to experience “otherness” without an ADHD diagnosis and articulate how being diagnosed “late” detached them from medical and social expectations and allowed some to nurture a unique ill-subjectivity, develop personal knowledge, and invent therapeutic interventions. The timeframe that psychiatry conceives as harmful has been, for some, a springboard to find their own way. This case allows us to rethink ‘experiential time’—the meanings of timing and time when psychiatric discourse and subjective narratives intertwine.

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Authors and Affiliations

  1. Bar-Ilan University, Ramat Gan, Israel

    Lior Tal

  2. Hebrew University of Jerusalem, Jerusalem, Israel

    Yehuda C. Goodman

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  1. Lior Tal
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Correspondence to Lior Tal.

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Appendix A: Experts’ Questionnaire

Appendix A: Experts’ Questionnaire

Diagnosis

  • Who can diagnose ADHD according to Israeli law today?

  • What types of diagnoses are made today for ADHD in Israel?

  • What is the diagnosis protocol in your field?

  • Are there any differences between the protocol and the diagnoses you have made or heard from other colleagues?

  • Does the diagnosis you perform entitle patients with a formal ADHD diagnosis? (Or do they need to go forward / back to another professional to be formally diagnosed?).

  • Based on your experience, who usually comes for an ADHD diagnosis, and for what common reasons?

  • What are the focal points when performing an ADHD diagnosis?

  • Do you examine the patient’s body during the diagnosis? And if so, in what ways?

  • Have you encountered any incidents of forgery in a diagnosis?

Midlife Diagnosis

  • When did you start diagnosing/treating adults?

  • What are the differences between diagnoses of children and diagnoses of adults?

  • Did the diagnosis/treatment for adults change over the years?

  • Given the recommendation to diagnose as early as possible, do you see any advantages to diagnosing during adulthood?

  • Why do adults request or inquire about an ADHD diagnosis?

  • Are any traits (physical, behavioral, cognitive, or other) unique to adults (as opposed to children)?

  • How would you describe patients diagnosed with ADHD during their adult lives?

Treatment

  • Are you eligible for prescribing medication for ADHD?

  • Do you recommend pharmaceutical treatment?

  • Are there patients you would recommend not to take medication? Why? Which patients?

  • Which treatment do you consider most effective for adults? Why?

  • Would you recommend non-pharmaceutical treatments to adults? Which treatments? Why?

  • Given the increased interest in “mindfulness” nowadays, is there a method you consider adequate specifically for adults? Why?

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Tal, L., Goodman, Y.C. “For Me, ‘Normality’ is Not Normal”: Rethinking Medical and Cultural Ideals of Midlife ADHD Diagnosis. Cult Med Psychiatry (2023). https://doi.org/10.1007/s11013-023-09825-5

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