#87. ADHD Is a Personality Trait, not a Disorder

ADHD, like other traits, is a problem in some contexts and not in others.

Printerval

Dear friends,

Years have passed since I previously examined and wrote about research on ADHD. Recently, an article, by Paul Tough, in the April 13, 2025, issue of New York Times Magazine, entitled Have we been thinking about ADHD all wrong, prompted me to delve, again, into the ADHD research literature. What I found is that new research has tended to confirm the ideas about ADHD that I presented 15 years ago. Fifteen years ago my thoughts about ADHD seemed unconventional to many, but that is less true today, at least among researchers and those who follow the research. Here I will begin with summaries of my previous essays on the topic and then move on to some of the new findings.

My Previous Claims About ADHD

My Informal Study of Kids Who Left School for Homeschooling after ADHD Diagnosis.

Fifteen years ago, I conducted a small, informal study to see what happens to kids diagnosed with ADHD who are subsequently taken out of school for homeschooling. I put out a call for such cases through my Psychology Today blog, and in that way I found 21 such cases and received stories from the parents describing what happened in each case. The results led to three general conclusions:

1. Most children who had been medicated for ADHD while in conventional schooling were taken off drugs and were coping well without drugs after being removed from conventional schooling.

2. The children’s behavior, moods, and learning improved when they were removed from conventional schooling, not because their ADHD characteristics vanished but because they were now in a situation where they could manage those characteristics.

3. Many of these children seemed to have a very high need for self-direction in education. Far from being unfocused, many were “hyper-focused” on tasks that interested them.

The study was a little more complicated than I have described here. You can read about it and read some of what the parents wrote about their children’s adaptations, in my Psychology Today article posted here. I would love to see a study like this conducted on a larger scale, more formally.

The results of this little study fit well with ideas about ADHD that I had put forth in two previous Psychology Today articles. In the first of these previous articles I argued that, for most children diagnosed with ADHD, the condition is fundamentally a school adjustment problem. I pointed out that most diagnoses originate in school, when a teacher or counselor suggests to parents that the child should be assessed for ADHD, or when parents seek such assessment because of their child’s poor performance in school. I also pointed out that the defining symptoms for ADHD listed in the official diagnostic manual of the American Psychiatric Association (APA) are heavily weighted toward issues that would especially be problems in school, such as not remaining in your seat, speaking out of turn, and not paying attention to details.

My Claim that ADHD is a Personality Trait, not a Disorder

In the second of these Psychology Today articles, I argued that what we call “ADHD” is not a “disease” or “disorder” that people either “have” or “don’t have,” but is a personality trait that can exist in people to a matter of degree. The primary personality characteristic that leads to a diagnosis of ADHD is best described as impulsiveness. Some people are, by nature, more impulsive than others. On average, boys are more impulsive than girls, which explains why boys get diagnosed with ADHD at much higher rates than girls.

As I pointed out in that article, impulsiveness seems to underlie most, maybe all, of the APA’s defining characteristics of ADHD. Impulsiveness leads one to be easily distractible, which is why they are seen as inattentive. It also leads one to be impatient and restless, unable to tolerate tedium or to sit still unless something truly grabs and retains their interest, which is why they may seem to be hyperactive. And it leads one to be highly emotionally reactive, tending to respond immediately, emotionally, overtly, to arousing situations.

I also pointed out that, like other personality dimensions, impulsiveness can be a detriment in some situations and a benefit in other situations. From an evolutionary perspective, the reason human beings come into the world differing from one another in personality traits is because, throughout our biological history we lived and worked in groups, and groups benefit when the individuals within them are not just like one another. To illustrate, I described as follows the advantage to any group in having some members high in ADHD-like characteristics:

“Distractibility may result in efficient monitoring of changes in the environment, so sudden dangers or new opportunities, which others would have missed, are detected. Impatience may be a valuable counterweight to the tendency to dwell too long on a way of thinking or behaving that isn't going anywhere. Impulsive action may underlie bravery in the face of dangers that would keep others immobile. Difficulty following instructions may imply independence of mind, which can lead to novel ways of seeing and doing things. Emotional reactivity may be a good counterweight to the tendency of overly controlled people to hold in their emotions and ruminate. One thing I have observed (informally) in people diagnosed with ADHD is that they rarely hold grudges; they let their emotions out and then get over it.”

In yet another Psychology Today article, in 2016, I summarized the findings of a study that illustrates well the idea that groups benefit when at least one member of that group is high in ADHD-like characteristics. This was an experiment in which middle-school children were divided into groups of three and each group was asked to work together in solving two difficult problems involving insight and logic. Some of the groups included one student with clear ADHD symptoms and other groups included no such student. The remarkable result was that although groups with an ADHD-like student looked more chaotic and random in their work together than the other groups, they were far more likely to solve the problems than were the other groups. My way of explaining this was to suggest that the impulsive kids were able to come up with novel, outside-the-box ideas about how to solve the problems, which the more focused kids could use to derive a solution. In contrast, the other groups persisted in trying to solve the problems along a conventional line of thought that did not work. By failing to persist, the ADHD kids came up with new solution paths.

New Research Confirming and Extending Ideas About ADHD as Personality, not Disorder

As I mentioned at the beginning, I was alerted to new research relevant to ADHD through a NYT Magazine article, by Paul Tough, entitled Have we been thinking about ADHD all wrong? The article was based largely on Tough’s interviews with researchers who have long been studying ADHD. He found that some of the pioneering researchers, who were among the first to describe ADHD as a “disorder” now have regrets about how they characterized it years ago. Some of the early claims—such as the claim of a reliable brain difference between those with ADHD and those without—turned out not to be replicable. Moreover, longitudinal studies have revealed that ADHD as a problem is very much context dependent. It can come and go over time in a person’s life (Sibley et al., 2014), which runs counter to the claim promoted by drug companies (and by physicians and parent advocacy groups paid by drug companies) that ADHD is a disorder, like diabetes, which you either have or don’t have, which must be treated with daily medication.

I tracked down and read the research articles referred to by Tough, as well as several others. Here I summarize some of the findings that help to characterize ADHD as a personality trait—findings that seem to validate what I wrote in those Psychology Today posts 15 years ago.

The Context Dependence of ADHD Symptoms.

A long-term study that followed a group of people for a 16-year period, from when they were diagnosed with ADHD as children until they were young adults, revealed that only 11% of them experienced symptoms of ADHD consistently from year to year (Sibley et al, 2024). For most, the symptoms that would lead to a diagnosis of ADHD disappeared for periods of time and reappeared at other times.

In another study (Lasky et al., 2016), 125 young adults who had been diagnosed with ADHD as children were interviewed about their experiences over time. A common theme that emerged from the interviews was that ADHD was a big problem when they were students in conventional schools, where they had little choice about what they had to do, but as adults, with more choice, it was either no problem or much less of a problem. As one young man studying film put it, “I used to not be able to focus, like, on schoolwork and stuff, but now at this point in my life everywhere I’m at is where I want to be. Public education you’re forced into it.”

A qualitative analysis of the interviews revealed some consistent themes in their reports about the settings in which they thrived, including the following:

• Stress and challenge. Contrary to what one might guess, many of these young adults reported that they thrived in careers and tasks that were highly stressful and challenging. Intense situations occupied their attention fully, so they were not distracted, and they enjoyed rising to the challenge. As one young fire fighter put it, “If we go out on a call I’m focused on that one thing. Like nothing else is going on. This is what I’m here to do. And then it’s almost like nothing else matters.”

• Novelty and multitasking; busy and fast-paced. Many described thriving in careers and settings that require nearly continuous mental and/or physical activity, where there are regularly new problems that must be solved, and where one must solve the problems quickly. One young chef explained that these characteristics of his career were what appealed to him. He said, “I love being busy; I find when I’m not busy, I’m just—I don’t know what to do with myself.” [Personal note: My wife, who claims to have an ADHD personality (and I believe her), thrived as an obstetrician because the fast-pace, challenge, and sometimes stress of the delivery room motivated her; and my wife’s son (my stepson), who was diagnosed with ADHD and got low marks in high school, excelled in culinary school and became a successful chef able to run a very busy kitchen.]

• Hands-on work and active learning. People with the ADHD personality are not by nature theoreticians; they are doers. They learn by doing things. Several of the interviewees described themselves as “mechanically inclined,” able to focus intently when fixing or building something. [I noticed early on that my ADHD-diagnosed stepson could put complicated things together without looking at the instructions, completing the task in a fraction of the time that I would have taken. And my wife’s favorite saying, when discussions of theory bog down and delay action, is “OK, it’s time to get the baby out.”]

• Intrinsic interest. A theme expressed by many of the interviewees was that they had no problem focusing attention on things that interested them but had great difficulty focusing on things that were boring to them. Focusing in conventional schooling, when they had no choice about what to study, was difficult because so much of it was boring. But now, as adults, they could choose their activities and spend more time on things that interested them. Some noted that even academic work became interesting when they could choose what they studied. One of the interviewees, a college student majoring in anthropology, said that her deep interest in anthropology made it easy for her to focus on that subject. She added, “When studying anthropology I have a photographic memory.”

Intrinsic interest, I think, helps explain why the kids in the study I described at the beginning of this letter could focus much better on their studies in homeschooling, where they had more choice, than they could in the conventional school. Of course, we all focus and learn better when we are allowed to follow our interests than when we are forced to study material we didn’t choose; but this is apparently even more true of those with an ADHD personality than it is of the rest of us.

ADHD Personality and Creativity

Many research studies indicate that people diagnosed with ADHD, or who have ADHD-like characteristics without diagnosis, are, on average (though by no means always), worse than the rest of us at convergent thinking but better at divergent thinking (e.g., Hoogman et al., 2020; White, 2018). Convergent thinking involves the bringing together of available information to find a single best solution to a problem. Most of the thinking demanded in schools is convergent, the kind of thinking that can lead to the single “correct” response to items on a multiple-choice test. Divergent thinking, in contrast, involves coming up with alternative, diverse, often unusual ways of viewing the problem and solving it. Divergent thinking is involved in what we usually call creativity.

This difference between the ADHD way of thinking and the non-ADHD way is why, I think, teams that include at least one person with ADHD characteristics along with others low on those characteristics are good at solving problems that require both ways of thinking, which is true of most real-world problems.

Concluding Thoughts

The diagnosis of ADHD is clearly subjective. The professionals making the diagnoses rely on reports by the child’s parents or others concerning the child’s behavior and then use their judgment as to whether those reports, accurate or inaccurate, represent sufficient disruption of the child’s life to warrant a diagnosis. It is very common for different professionals, using the same data, to come to different conclusions (Wolf, 2023; Wong, 2021).

Increased rates of diagnosis of ADHD among children clearly track increased rigidity in the school system. As so-called “academic training” took ever greater hold in kindergartens and preschools (here), rates of diagnosis of little children greatly increased. As No Child Left Behind and then Common Core narrowed the focus and increased the pressure of schooling at all grade levels, rates of diagnosis of ADHD increased at all grade levels. According to the most recent report by the CDC, a staggering 23 percent of 17-year-old boys in the United States had been diagnosed with ADHD at some point in their school career (Tough, 2025). If you call ADHD a “disorder,” that makes nearly a quarter of American boys disordered.

In other countries, too, rates of diagnosed ADHD commonly track changes in schooling. Between 2006 and 2017, which encompasses the period when Sweden adopted education changes similar to our Common Core ( here), rates of diagnosed ADHD increased five-fold (Wong, 2021). Kids’ brains didn’t change during that period; the school system changed. Another study in Sweden revealed that children born in December were 30% more likely to have been diagnosed with ADHD than children born in January. That difference clearly is not because of a brain difference. That difference is the result of the Jan 1 cutoff date for starting school. Those born in December are naturally more immature, being nearly a year younger, than those in the same grade born in January. They no doubt struggled more in school and were more impulsive because they were younger. I recall long ago reading a comic satire of a scientific article entitled “The diagnosis and treatment of childhood.” For some cases of early diagnosis of so-called ADHD, that’s pretty much what it’s about.

I haven’t touched here on the drug treatment of ADHD. I’m saving that for my next letter.

Before closing, I should note that, like any personality characteristic, in some few people the characteristic (in this case impulsiveness) can be so extreme as to be a problem in essentially any environment. For them, continuous drug treatment can provide an enormous benefit. I don’t want to minimize the problem for those who truly suffer. But they represent a small minority of the cases currently being diagnosed.

And now, what do you think? If you have had experiences with ADHD, feel free to share them in the comments section below. This Substack is, in part, a forum for discussion. Your thoughts and questions are valued and treated respectfully by me and other readers, regardless of the degree to which we agree or disagree. Readers’ thoughtful comments and questions add to the value of these letters for everyone.

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With respect and best wishes,

Peter