A growing body of research and clinical observation suggests that adult ADHD diagnosis is becoming increasingly inclusive – and contrary to common fears, it is not being overdiagnosed. As reported in a recent essay by a US clinical psychologist published on Aeon (aeon.co), the COVID-19 pandemic, rising mental health awareness, and shifts in diagnostic frameworks have all contributed to sharp increases in adult ADHD diagnoses worldwide, with profound implications for healthcare systems, patients, and policymakers, including those in Thailand.
This surge in adult ADHD diagnoses first attracted widespread attention in 2023 when new Centers for Disease Control and Prevention (CDC) data revealed a record 7.8% of American adults reported an ADHD diagnosis. Stimulant prescriptions climbed steeply in tandem, while internet searches and social media conversations about ADHD exploded—over 20 billion TikTok views were tagged with #ADHD. Similar awareness and self-identification trends are emerging in many countries, including among Thai adults navigating growing pressures at school, work, and home.
Understanding why ADHD is now so widely identified in adults is of vital importance. Global mental health experts note that, while neurodevelopmental disorders like ADHD have long been seen as childhood conditions, many adults struggle with undiagnosed symptoms that can significantly impair daily life. The Diagnostic and Statistical Manual of Mental Disorders (DSM), widely used in Thailand and internationally, classifies ADHD as a chronic, lifelong disorder rooted in genetics and neurodevelopmental variation. However, traditional criteria required that some symptoms be present by age 12—a rule updated in the DSM-5 (2013), which raised the cutoff to 12, reduced the adult symptom threshold, and loosened impairment requirements. These changes, while intended to reflect the lived experience of ADHD as a spectrum with a range of severity and manifestations, planted the seeds for today’s more inclusive approach.
A key insight from the Aeon report and recent scientific studies is that the increase in adult ADHD diagnoses is not simply the product of “diagnostic fads.” Rather, it reflects deeper shifts in how both society and medicine conceptualize attention, self-regulation, and mental health—themes familiar to many Thais confronting digital distractions, changing work patterns, and new expectations for success. The notion that ADHD falls along a spectrum, from very mild “trait ADHD” to clinically disabling forms, is now supported by genetic, psychological, and epidemiological research. Global bell-curve distributions of ADHD symptoms mean everyone exhibits traits to some degree, and clinicians must distinguish between everyday forgetfulness and dysfunction that seriously impairs education, employment, relationships, or wellbeing.
Evidence for this new inclusivity is compelling. More adults with “light” or “subclinical” ADHD—individuals on the edge of formal diagnostic thresholds—are seeking evaluations, in part inspired by viral social media content and targeted online advertising, especially during the isolation and upheaval of the pandemic. Many recount how social and professional functioning was chronically undermined by symptoms, even if childhood markers were subtle or overlooked. For instance, a composite case study from the Aeon essay describes an individual whose lifelong indecisiveness, social difficulties, and job instability were recognized only after engaging with online ADHD content. This echoes trends reported by Thai clinicians, where decades of underreporting among adults, especially women, have led to a backlog of unaddressed need.
Women, in particular, are fueling a “great awakening” around adult ADHD identification, as both US and international data show that most new adult diagnoses are now sought by women in their 20s to 40s. For decades, ADHD research and diagnostic frameworks were calibrated to the more externalized behaviors typical in boys, leaving many girls (and later women) undiagnosed and unsupported. Social media has allowed women worldwide, including in Thailand, to share lived experiences and advocate for more nuanced criteria that capture the diversity of ADHD presentations, such as emotional dysregulation and internal restlessness—symptoms historically regarded as “not serious enough.” (aeon.co)
Yet, this inclusivity brings clinical dilemmas. How should clinicians respond when individuals present ambiguous or fluctuating symptoms, some of which fall outside traditional checklists? Research finds that ADHD is not a static condition—it can wax and wane throughout life as circumstances, emotions, and environmental demands change. A large review of studies during the pandemic confirmed global increases in ADHD-type complaints, driven by heightened stress, disrupted routines, and more dynamic work environments. “ADHD mimics,” including depression, anxiety, sleep disorders, and hormonal fluctuations (all common in Thai society as elsewhere), further obscure the diagnostic picture and require careful, time-consuming evaluation.
Critically, the rise of telemedicine and online healthcare platforms has lowered barriers to ADHD screening and care, as also observed in Thailand during COVID-19. CDC data from the US indicate that up to 20% of adults with ADHD received their diagnosis virtually. In response, similar digital pathways for assessment and medication are now emerging in Southeast Asia. Convenience and privacy are balanced against risks of misdiagnosis, especially with “instant-diagnosis” startups—some of which have faced regulatory crackdowns for unregulated stimulant prescribing.
Despite such concerns, experts caution against conflating rising numbers with overdiagnosis. On the contrary, research shows subclinical cases left untreated often develop additional complications, such as substance use or anxiety disorders, which burden healthcare systems and families. Evidence from Europe, the US, and Japan—contexts with relevance to Thai mental health—demonstrates that individuals with mild or fluctuating ADHD benefit from early interventions like cognitive behavioural therapy (CBT) and targeted lifestyle support, even if medication is not always indicated. (PubMed: Early interventions for ADHD)
Other specialists emphasize the importance of distinguishing ADHD from its “mimics.” For instance, a Thai psychiatrist affiliated with a leading Bangkok hospital recently underlined in a public webinar that “while many adults feel overwhelmed and distracted, a true ADHD diagnosis depends on longstanding, function-impairing symptoms—not just transient stress or digital fatigue.” This view is mirrored by international consensus statements, which stress thorough, multi-source clinical assessments rather than self-report quizzes or single consultations. (WHO guidelines for ADHD)
In Thailand’s context, the inclusivity of ADHD diagnosis carries additional cultural implications. Traditional Thai family life, with its multigenerational households and strong communal ties, can sometimes mask or compensate for mild ADHD traits—a young adult may rely on parental support, for instance, to manage daily routines or workplace responsibilities, just as case studies in the Aeon essay describe. However, as Thai society modernizes and individuals are expected to function autonomously at university or on the job, previously “hidden” symptoms become more visible and distressing.
Furthermore, stigma about mental health may still deter some Thais from seeking a formal diagnosis, particularly men, who may fear the label’s impact on social perceptions or career prospects. The emerging neurodiversity movement, however, offers a more affirming, less stigmatized framework—encouraging people to see ADHD traits as part of natural cognitive diversity rather than a personal failing. This view finds growing resonance in Thai urban youth culture, fostered by proactive mental health advocacy, online support groups, and campus forums.
Looking ahead, the evolution of ADHD diagnosis seems set to continue. Some clinicians and researchers advocate for further subdivision of ADHD into multiple related disorders—analogous to how depression is now understood as a family of conditions—so as to reflect differences in severity, stability, gender expression, and comorbidities like emotional regulation. This approach is gradually influencing international guidelines and may lead to more individualized treatment and policy in Thailand as well.
In the meantime, experts urge Thai adults concerned about ADHD symptoms to seek comprehensive evaluations from licensed psychiatrists, psychologists, or mental health providers—ideally those with experience in adult ADHD. Self-screening tools and online information can be helpful starting points, but should not substitute for proper assessment. When ADHD is diagnosed, proven interventions include CBT, structured skills training, and, where appropriate, prescription medications. Social support and practical accommodations at work or university are also vital in helping those affected reach their full potential.
For Thai policymakers and healthcare planners, the message is clear: psychiatric services must expand training in adult ADHD assessment, ensure equitable access to both traditional and telehealth pathways, and reduce stigma through education. Tailored outreach to women, and culturally sensitive approaches for diverse Thai communities, will help ensure that individuals across the spectrum of attention and self-regulation challenges receive appropriate recognition and support.
As ADHD awareness grows and diagnostic practices evolve, experts worldwide agree that increased inclusivity represents progress toward meeting the real needs of patients—not an epidemic of overdiagnosis. For every Thai adult living with undiagnosed symptoms, this shift offers renewed hope for understanding, treatment, and a more supportive future.
Sources: Aeon: Adult ADHD is becoming more inclusive, but not overdiagnosed, CDC data on ADHD, PubMed: Early interventions for ADHD, WHO guidelines for ADHD.