ADHD Is Not a Superpower. I Have It, and So Does My Son.

Magnus is nine, and he cannot stay in his chair long enough to finish a math worksheet.

After only two minutes, he asks for water. Then he needs to use the bathroom. He checks the clock. Soon his nose is running, but the tissues are in another room. It takes us thirty minutes to finish half the worksheet. He really wants to do well. He asks if he is getting the answers right, and he means it. But his body just will not let him stay still.

I know exactly what I am watching. I was him.

I grew up in the Bavarian countryside in the 1980s. I was the lively one, the class clown, the boy who read everything but never finished, and I could never follow a lesson to the end. Where I lived, no one used the word ADHD. You were just called spirited. If you remembered things easily, like I did, you still passed your exams, and no one looked any further.

Nobody looked any closer. For forty years.

Now I sit across the kitchen table from my son and see the same patterns in a smaller body. This time, it has a name.

At home, we have another name for it, one that came before the diagnosis: the monkey. It is the part in his head that jumps from thought to thought and never sits still. When I ask Magnus if the monkey is loud today, he knows exactly what I mean. Most days, it is.

Now I see this from three sides. I have it myself. I am raising a boy who has it. And for years, I have worked with people who have it, even if they did not know it.

So here is my view as a doctor on ADHD: what it really is when you take away the panic and the hype, how to spot it, what truly helps, what is just for show, and the one thing that decides if this trait helps or hurts you. This advice is the same whether the person in the chair is your child, your coworker, or yourself.

It Is Real, and It Runs in Families

Let’s start with what answers the blame question. If your child has ADHD, it is not because of anything you did as a parent. ADHD is one of the most inherited conditions in medicine: across 37 twin studies, the average heritability is 74% [1]. That is closer to height than to anything you can control as a parent. You probably passed it down, which is a strange kind of comfort.

The brain develops more slowly in ADHD. If you track brain growth in hundreds of children, those with ADHD follow the same pattern as others, just later. Peak thickness comes about three years later overall, and about five years later in the prefrontal cortex, which controls planning and self-control [2].

ADHD is common, and it does not stop at age eighteen. In the United States, 11.4% of children have been diagnosed, and nearly 78% of them also have another condition, usually anxiety or a learning difficulty [3]. It continues into adulthood. About 2.6% of adults have the full diagnosis [4], and by age 25, only about 15% still meet the strict criteria, while around 65% still have some impairment [5]. Most people do not outgrow it. They either learn to work around it, or they do not.

How to Spot It, in a Child and in Yourself

Having lots of energy is not enough for a diagnosis. The clinical standard is stricter. Symptoms must appear in more than one setting, cause real problems, and start before age twelve [6]. They need to show up at home and at school, not just at home.

The diagnosis can be wrong in both directions. Sometimes, it is given out too easily. The youngest child in a class gets diagnosed much more often than the oldest, just for being a few months less mature. Across nearly a million children, the youngest boys were 30% more likely to be diagnosed than the oldest, and the youngest girls 70% more [7]. Some of what we call ADHD is just being five in a room made for six-year-olds.

In the other direction, real cases get missed. In childhood, the diagnosis is about three boys for every girl. By adulthood, it is nearly even, because the quiet, inattentive girl who does not disrupt anyone gets overlooked and is treated for anxiety first [8]. The clever get missed most of all. In adults who had never been medicated, a high IQ hid the problem so well they failed only one test, while others failed many [9]. That was me. I remembered enough to pass, so no one looked, and no one saw the cost underneath: the meetings I sat through without catching a word, the restlessness that never showed on my face.

One sign the checklist leaves out is emotion. Trouble managing feelings is one of the biggest causes of impairment, and this is true even after you consider every other diagnosis [10]. Having a short fuse is part of the condition itself.

Superpower or Limitation

Here, I disagree with most of what you may have read online. The internet often says ADHD is a superpower. But the evidence does not support that.

The costs come first, and they are serious. A Danish study of 1.9 million people found those with ADHD died at about twice the rate of everyone else, mostly from accidents [11]. A 2025 UK analysis estimated that diagnosed adults lose about 7 years of life expectancy if they are men, and 9 years if they are women [12]. Both numbers need caution: the mortality figure is relative, not a high absolute risk, and the life-expectancy estimate is for diagnosed adults, who tend to be more severe cases. But the direction is clear. Untreated, this shortens lives.

Now for the superpower side, judged by the same standard. The link to entrepreneurship is real but limited: the sensation-seeking part of ADHD draws people to start things, while the inattentive part makes it hard to finish them [13]. Studies that highlight strengths often recruit people who have already succeeded. The most-cited study interviewed six successful men and asked what was good about having ADHD [14]. A 2026 review of 125 studies found that 70% looked for strengths on purpose, and concluded the benefits show up “in contexts where they are most likely to flourish” [15]. The loudest source fails completely: of the 100 most-viewed ADHD videos on TikTok, 52% were misleading, and most were posted by people with no medical training [16].

The honest answer is less exciting than the headlines. ADHD is a real impairment, and whether it helps or hurts depends almost entirely on where you direct it. Here is what the superpower posts leave out, both from my own experience and from watching my son: this is a lot of work. It is hard for the person who has it and hard for the parent raising them, and it shows you your own limits. It is not fun, and it is not something I would wish on my son or anyone else.

What Decides It Is the Environment

If the trait is fixed but the outcome is not, something in between makes the difference. That something is the environment you put the wiring into.

Consider one strange study. A dopamine-receptor variant tied to ADHD was carried by men in two branches of the same Kenyan people, one still nomadic, one recently settled into farming. Among the nomads, carriers were better nourished than non-carriers. Among the settled, the same variant left them worse off [17]. Same gene. Opposite lives. The environment cast the deciding vote.

I know that difference from my own life. For more than five years, early in my medical career, I worked in a hospital emergency and trauma room, where the ambulance doors would swing open and you never knew if it was a sprained wrist or a major accident. Chaos was normal, and I was always the calmest person in the room. The worse things got, the more settled I became. For years I thought that was discipline. It was not. It was a brain built for emergencies finally given a job that was all emergencies.

The opposite is also true. The worst four months of my career were during a corporate reorganization: the same org chart on the same slide, the same boxes moved in the same order, week after week, with nothing ever really decided. The brain that thrived in the trauma room could not handle that setting. It is not built for it. It shows up in smaller ways too. Over the years I have ignored a steady stream of invoices, traffic fines, and forms, and my brain declared victory every time. The fines disagreed.

Most of the time, the environment does not organize itself, so I do it. My phone has no notifications. None, from anything. Every screen I own has a plain black background, because a photo of my kids would distract me. When I need to get something done, I use a Time Timer, a clock for children that shows the minutes disappearing, because otherwise thirty minutes and four hours feel the same to me until the deadline hits. And when a subject grabs me, the systems do not matter: I disappear into it for hours, unreachable, as my wife can easily confirm.

You could call it a treatment plan, the way I manage myself: remove distractions, make time visible, and focus attention on work the brain can actually handle.

That is what a parent has to do, too, even though it goes against every instinct. The instinct is to push harder: correct, repeat, sit the child down, and demand focus. But pushing harder backfires. Children whose parents stayed very critical over the years were more likely to stay stuck in the severe form [18]. Cause goes both ways, and none of it is about blame. But the practical answer is clear: you cannot argue a child out of this, and shame only makes it worse. What helps is quieter and less satisfying. Fewer open tabs on his desk. A timer he can see. A task that matches his attention span. A parent who has stopped keeping score.

This is part of the Capacity pillar in my Upward ARC framework, which is about raising the ceiling on what a person can handle over a lifetime. For ADHD, you raise that ceiling by fitting the environment to the person, and this is true from all three perspectives. For me, it means a working life full of variety and deadlines. For Magnus, it means a childhood built around how he actually learns. And on a team, the colleague who cannot stand paperwork is often the one you want beside you when the ambulance doors swing open.

Try This Today

Get assessed, and do not stop at therapy alone. Get a real evaluation, not just an online checklist. The diagnosis usually comes from a psychologist or psychiatrist. Once medication is considered, that part is a psychiatrist’s or physician’s job. We spent more than two years on occupational therapy with Magnus because it seemed like a gentler start. It helped a little, but it was not enough. For young children, the guidelines rightly put behavioral parent training first [6], but do not let “we tried therapy” be the reason you wait for years.

See medication as the most effective tool, and do not be afraid of it. Stimulants are among the most effective treatments in psychiatry, with strong effects on symptoms in both children and adults [19]. And it is not just about grades: across 2.3 million patients, the months people took their medication saw 38% fewer car crashes for men and 42% fewer for women [20]. At the right dose, this is a safety measure.

Fix sleep at the same time. ADHD and poor sleep make each other worse. In a trial of children with both, a short behavioral sleep program clearly lowered their ADHD symptoms months later [21]. Protect the wind-down, keep a steady bedtime, and treat sleep as part of the treatment.

Shape the environment, and skip the showy solutions. Build the day around the way the brain works: single-task blocks, outside deadlines, and let someone or something else handle the boring follow-through. Skip the brain-training apps that claim to fix attention. In blinded tests, their benefit for real-world symptoms is limited at best [22].

If you lead someone like this, focus on the fit. When they keep struggling, it is usually the wiring, not a lack of effort. Give them work that sparks their brain: novelty, variety, or the crisis no one else wants. Take the ongoing admin tasks off their plate, or pair them with someone who can handle it. Provide structure from outside, and never use shame as a tool. You get their best work the same way a parent does: by shaping the environment.

The Chair He Can Stay In

For the first time in my life, I sat at the same desk, working on the same task, for two hours last week. I did not get up. I did not reach for my phone. I did not get distracted by something I never meant to open.

I am forty-seven, a few weeks into treatment, and the quiet in my head is so unfamiliar it is almost loud.

I did not do this for myself. I did it because of a nine-year-old who cannot sit through eight math problems, and whom I recognized right away, because he is me. We got his diagnosis. Then, in solidarity, I got mine. The psychologist said it was about as clear a case as she had seen.

Two months ago, we added medication to the years of therapy. One evening, a few weeks later, Magnus looked up from his worksheet and said, “The monkey in my head isn’t jumping around all the time anymore. I can focus now.” He was nine years old, and he found the words before I ever did.

The worksheet still takes time. He still gets up. But now he finishes it, and he knows why he is in the chair.

That is why naming it early matters. Not to label a child, but to give him what I spent forty years without: a chair he can stay in when it matters, and the choice of when to leave it.

We are doing this together. That was never the plan, but it turned out to be the point.

Stay healthy.

Andre

PS: If you read this and thought of someone, your child, your colleague, or the version of yourself who could never sit still, please forward it to them. Not everyone gets to find the name for this at nine. Those who find it at forty-seven still feel lucky. That is how this newsletter grows, and it is the only way I want it to.

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References

[1] Faraone, S. V., & Larsson, H. (2019). Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry, 24(4), 562-575. https://doi.org/10.1038/s41380-018-0070-0

[2] Shaw, P., Eckstrand, K., Sharp, W., Blumenthal, J., Lerch, J. P., Greenstein, D., Clasen, L., Evans, A., Giedd, J., & Rapoport, J. L. (2007). Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proceedings of the National Academy of Sciences, 104(49), 19649-19654. https://doi.org/10.1073/pnas.0707741104

[3] Danielson, M. L., Claussen, A. H., Bitsko, R. H., Katz, S. M., Newsome, K., Blumberg, S. J., Kogan, M. D., & Ghandour, R. (2024). ADHD prevalence among U.S. children and adolescents in 2022: Diagnosis, severity, co-occurring disorders, and treatment. Journal of Clinical Child & Adolescent Psychology, 53(3), 343-360. https://doi.org/10.1080/15374416.2024.2335625

[4] Song, P., Zha, M., Yang, Q., Zhang, Y., Li, X., & Rudan, I. (2021). The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis. Journal of Global Health, 11, 04009. https://doi.org/10.7189/jogh.11.04009

[5] Faraone, S. V., Biederman, J., & Mick, E. (2006). The age-dependent decline of attention-deficit hyperactivity disorder: A meta-analysis of follow-up studies. Psychological Medicine, 36(2), 159-165. https://doi.org/10.1017/S003329170500471X

[6] Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., & Zurhellen, W. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528. https://doi.org/10.1542/peds.2019-2528

[7] Morrow, R. L., Garland, E. J., Wright, J. M., Maclure, M., Taylor, S., & Dormuth, C. R. (2012). Influence of relative age on diagnosis and treatment of attention-deficit/hyperactivity disorder in children. CMAJ, 184(7), 755-762. https://doi.org/10.1503/cmaj.111619

[8] Attoe, D. E., & Climie, E. A. (2023). Miss. Diagnosis: A systematic review of ADHD in adult women. Journal of Attention Disorders, 27(7), 645-657. https://doi.org/10.1177/10870547231161533

[9] Milioni, A. L. V., Chaim, T. M., Cavallet, M., de Oliveira, N. M., Annes, M., dos Santos, B., Louzã, M., da Silva, M. A., Miguel, C. S., Serpa, M. H., Zanetti, M. V., Busatto, G., & Cunha, P. J. (2017). High IQ may “mask” the diagnosis of ADHD by compensating for deficits in executive functions in treatment-naïve adults with ADHD. Journal of Attention Disorders, 21(6), 455-464. https://doi.org/10.1177/1087054714554933

[10] Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in attention deficit hyperactivity disorder. American Journal of Psychiatry, 171(3), 276-293. https://doi.org/10.1176/appi.ajp.2013.13070966

[11] Dalsgaard, S., Østergaard, S. D., Leckman, J. F., Mortensen, P. B., & Pedersen, M. G. (2015). Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: A nationwide cohort study. The Lancet, 385(9983), 2190-2196. https://doi.org/10.1016/S0140-6736(14)61684-6

[12] O’Nions, E., El Baou, C., John, A., Lewer, D., Mandy, W., McKechnie, D. G. J., Petersen, I., & Stott, J. (2025). Life expectancy and years of life lost for adults with diagnosed ADHD in the UK: Matched cohort study. The British Journal of Psychiatry, 226(5), 261-268. https://doi.org/10.1192/bjp.2024.199

[13] Wiklund, J., Yu, W., Tucker, R., & Marino, L. D. (2017). ADHD, impulsivity and entrepreneurship. Journal of Business Venturing, 32(6), 627-656. https://doi.org/10.1016/j.jbusvent.2017.07.002

[14] Sedgwick, J. A., Merwood, A., & Asherson, P. (2019). The positive aspects of attention deficit hyperactivity disorder: A qualitative investigation of successful adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11(3), 241-253. https://doi.org/10.1007/s12402-018-0277-6

[15] Rafael, R. B., Jia, H., Rouel, M., Wootton, B. M., & Mitchison, D. (2026). Attention deficit/hyperactivity disorder (ADHD)-related strengths in adults: A scoping review. Journal of Attention Disorders. Advance online publication. https://doi.org/10.1177/10870547261425737

[16] Yeung, A., Ng, E., & Abi-Jaoude, E. (2022). TikTok and attention-deficit/hyperactivity disorder: A cross-sectional study of social media content quality. The Canadian Journal of Psychiatry, 67(12), 899-906. https://doi.org/10.1177/07067437221082854

[17] Eisenberg, D. T. A., Campbell, B., Gray, P. B., & Sorenson, M. D. (2008). Dopamine receptor genetic polymorphisms and body composition in undernourished pastoralists: An exploration of nutrition indices among nomadic and recently settled Ariaal men of northern Kenya. BMC Evolutionary Biology, 8, 173. https://doi.org/10.1186/1471-2148-8-173

[18] Musser, E. D., Karalunas, S. L., Dieckmann, N., Peris, T. S., & Nigg, J. T. (2016). Attention-deficit/hyperactivity disorder developmental trajectories related to parental expressed emotion. Journal of Abnormal Psychology, 125(2), 182-195. https://doi.org/10.1037/abn0000097

[19] Cortese, S., Adamo, N., Del Giovane, C., Mohr-Jensen, C., Hayes, A. J., Carucci, S., Atkinson, L. Z., Tessari, L., Banaschewski, T., Coghill, D., Hollis, C., Simonoff, E., Zuddas, A., Barbui, C., Purgato, M., Steinhausen, H.-C., Shokraneh, F., Xia, J., & Cipriani, A. (2018). Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: A systematic review and network meta-analysis. The Lancet Psychiatry, 5(9), 727-738. https://doi.org/10.1016/S2215-0366(18)30269-4

[20] Chang, Z., Quinn, P. D., Hur, K., Gibbons, R. D., Sjölander, A., Larsson, H., & D’Onofrio, B. M. (2017). Association between medication use for attention-deficit/hyperactivity disorder and risk of motor vehicle crashes. JAMA Psychiatry, 74(6), 597-603. https://doi.org/10.1001/jamapsychiatry.2017.0659

[21] Hiscock, H., Sciberras, E., Mensah, F., Gerner, B., Efron, D., Khano, S., & Oberklaid, F. (2015). Impact of a behavioural sleep intervention on symptoms and sleep in children with attention deficit hyperactivity disorder, and parental mental health: Randomised controlled trial. BMJ, 350, h68. https://doi.org/10.1136/bmj.h68

[22] Cortese, S., Ferrin, M., Brandeis, D., Buitelaar, J., Daley, D., Dittmann, R. W., Holtmann, M., Santosh, P., Stevenson, J., Stringaris, A., Zuddas, A., & Sonuga-Barke, E. J. S. (2015). Cognitive training for attention-deficit/hyperactivity disorder: Meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials. Journal of the American Academy of Child & Adolescent Psychiatry, 54(3), 164-174. https://doi.org/10.1016/j.jaac.2014.12.010