They sat on the media panel at the Maudsley Hospital — a journalist and historian, a BBC producer and a distinguished psychiatrist — thrashing out ways to make newspapers and television in Britain take adult ADHD seriously. It was the first conference the London psychiatric hospital had hosted on adults with attention deficit hyperactivity disorder — the downsides of which include inattention, disorganisation, and impulsiveness. Plans were hatched to letter-bomb journalists who suggest (as they do all too often) that it does not exist, or that it is an condition invented to justify drugging up naughty schoolchildren.
Philip Asherson, professor in molecular psychiatry at King’s College London, argued that what was really needed to remove the stigma about treating adults with drugs such as Ritalin, Concerta and Adderall was for one of the famous people who have outed themselves as sufferers — people like Olympic gymnast Louis Smith, judo gold medallist Ashley McKenzie or Will.i.am, the -singer and coach on the BBC talent show The Voice, to talk about how medication had helped them. The problem (although the professor didn’t say it outright) is that none of them seem to take any.
Professor Asherson, who has worked as a consultant for the company that makes Concerta, the first-line treatment for UK adults with ADHD, knows this better than anyone. In 2013 he scanned Smith’s brain for a Channel 5 documentary. Louis Smith: Living with ADHD was a breakthrough in his decade-long push to hammer through to the public that a condition still wrongly believed by many to affect only children more often than not continues into adulthood. But when Smith was asked about Ritalin (like Concerta, a preparation of the stimulant drug methylphenidate) he said he had hated it and refused to take it from the age of 13.
‘It wasn’t a nice tablet,’ he wrote in his auto-biography. ‘It made me feel a bit like a zombie… anything that makes you feel “zombified” surely can’t be good for you.’
It is striking that, while methylphenidate has been recommended by Nice guidelines as the first-line treatment for adult ADHD since 2008, just about every high-profile person who has gone public with a diagnosis seems hostile to it. ‘It reduced my energy and made me tired all the time,’ judo medallist Ashley McKenzie told the Daily Mirror. ‘It wasn’t a long-term solution.’ Will.i.am told the same paper: ‘Music is my therapy,’ ‘Music keeps me sane and keeps my mind on something.’ David Neeleman, a US airline founder who credits his own ADHD for his success, told specialist website Additude: ‘I’m afraid of taking drugs once, blowing a circuit, and then being like the rest of you.’
Even the pop star Justin Bieber, who told GQ in February that he had been on Adderall ‘for about a year’, didn’t seem happy about it. ‘I think I’m about to get off of it because I feel like it’s giving me anxiety,’ he said.
There is little doubt that the very real stigma attached to ADHD holds famous people back from revealing their diagnoses. Comedian Rory Bremner —who has tirelessly campaigned to raise awareness since realising that he has it — described at the Maudsley conference how he had raised the link between ADHD and celebrity with his agent, who also represents comics such as Eddie Izzard, Rowan Atkinson, Noel Fielding and Mark Gatiss.
‘I said, “How many of your clients do you think have ADHD?” She said, “Do you know what? I think… all of them.” ’ This doesn’t mean any of them actually have been or would be diagnosed with ADHD, but it may suggest that comedy is one of those fields where people with the condition can thrive.
The brains of people with ADHD appear, among other things, to have lower levels of the neurotransmitters dopamine and norepinephrine, so an experience needs to be more stimulating for it to draw and hold their attention. This makes for tough school years — one UK businessman remembers a teacher sellotaping him to his chair — and more chance of ending up in prison or being addicted to drugs. But if someone with ADHD has talent and gets the right breaks, their impulsiveness, out-of-the-box thinking and compulsion to seek out the surprising, dramatic and unconventional can power them to success. For Dr Ellen Littman, a US clinical psychologist who is soon to publish a book on gifted people with ADHD, it is not surprising that those who do make it largely forgo drugs. ‘Medication inhibits impulses, so it can make one less spontaneous,’ she explains. ‘I’ve had artists and athletes tell me that it’s not a worthwhile trade-off.’
The same, largely, goes for entrepreneurs: people with ADHD are six times more -likely to start their own business. Littman interviewed Ted Turner, the founder of CNN, who, she says, has ‘terrible ADD’ (as it used to be known). He told her that instead of using medication, he hires people. ‘He has a fleet of people who follow him around, and no matter how he treats them, they write down things that he says, they pick up things that he drops, they dress him while he’s walking, they turn his body if he’s supposed to go in a different direction.’
Turner is not at all unusual in this. Cameron Herold, a Canadian business coach who has ADHD, says none of his ‘entrepreneurial type’ business clients uses medication. ‘Of the 16 entrepreneurs that I coach, I can pretty safely say that 15 of 16 are ADD and zero use meds,’ he says. ‘I’m not a fan of medication. The entrepreneur is not supposed to be focused. Is medication trying to make us better or is it trying to make us just like everybody else? We don’t need more people like everybody else.’ Incidentally, not one of three high-profile psychiatrists in the US who say they have ADHD (Ned Hallowell, John Ratey, and Dale Archer) take medication, although the first two recommend it for their patients.
While many successful people have ADHD, the reverse is not at all true. Many with the trait struggle to hold down any job or get any qualifications. They don’t have the luxury of a personal assistant or a stimulating profession. For them, Herold concedes, medication may help. And Dr Tony Lloyd, acting CEO of the ADHD Foundation, the UK’s leading advocacy group, points out while entrepreneurs may choose not to take the medication, the same doesn’t go for barristers, a surprisingly large number of whom appear to have ADHD. ‘I know a few, incredibly successful people in their fields, who couldn’t get by without medication,’ he says. Unlike comedians, pop stars, or maverick entrepreneurs, lawyers need to appear professional.
This also applies to the only two well-known British people brave enough to admit taking the meds — Louise Mensch, the novelist, journalist and former Tory MP, and Trudie Styler, the actress, film producer and wife of rock star Sting. Both have demanding executive roles. Mensch has said on Twitter that her medication makes ADHD ‘eminently manageable’, while Styler says she uses the stimulant Adderall (but only when she has mounds of scripts to read). Dr Lloyd suspects that many more celebrities use ADHD medication than admit to it, and is working with Rory Bremner, now the ADHD Foundation’s patron, to coax more of them into coming forward.
Many of those cited as having the condition on internet lists — including businessmen, celebrity chefs, comedians and even the US presidential hopeful Donald Trump — have never come forward themselves.
Lloyd and Bremner are also working on a documentary for the BBC in which the comedian will take ADHD medication for the first time. Indeed, part of the reason he has not taken anything until now is because he wants to record the experience on film. Could Bremner himself end up being the poster-boy for medication Professor Asherson is looking for?