I watched The Great ADHD Myth last night.

Channel 4's latest provocation asked good questions and then answered them badly.

The Great ADHD Myth? contained two documentaries.

One was a valuable, if provocative, examination of whether ADHD is being overdiagnosed, whether the very broad and subjective criteria can turn normal variations into a condition, and whether medication is sometimes used to make children fit an educational system that is itself failing them. It asked necessary questions about environment, creativity, movement, screens, diet, diagnosis, and the difference between improving health and optimising performance.

The other was an ill-conceived piece of sensationalist television in which one child was taken off medication while almost every other aspect of his life was also changed. That experiment could tell us something about that child's needs, and perhaps about his previous treatment. It could not tell us whether ADHD is a myth.

I thought that the premise itself had real substance behind it. ADHD referrals in England rose by roughly 200% between 2020 and 2025, and the presenter, Dr Max Pemberton, is a working NHS psychiatrist who had already argued in print that the condition was "wildly over-diagnosed" before this film existed. That is exactly the kind of person I want asking the question, because a referral system that has tripled in five years deserves scrutiny, not defensiveness.

Diagnosis leans heavily on self-report. A child or adult who wants the diagnosis, and who has read enough about it to know what to say, will often be able to get it. Some private providers who are paid per assessment have a structural incentive that has nothing to do with clinical rigour. None of that makes the underlying condition fictional. But all of it is worth saying out loud.

The experiment that couldn't answer them

Then the film abandoned that seriousness for a stunt.

Producers took one ten-year-old boy, Mason, off his medication for six weeks at his mother's request, while changing his school routine, his diet, and his daily structure at the same time. His mother said he'd lost his "sparkle" on medication, then conceded his school report had actually improved while he was on it.

That is a single child, multiple variables changing at once, no control, and a result that contradicted the point it was supposedly illustrating. You cannot isolate the effect of medication by changing everything else around it in the same six weeks. A child psychologist in the film went further still, comparing stimulant medication to corporal punishment. A line clearly built to feed the outrage addiction trend.

This one experiment was an interesting (if infuriating) case study but nothing more, and it did real damage to a serious argument by chaining it to a flimsy one.

The binary ask at the centre

The programme's fundamental mistake was its black and white structure. Brain or environment. Real condition or social construct. Medication or natural coping. Focused or fully oneself. These are precisely the false choices that prevent a serious conversation.

The backlash proved it. ADHD UK had warned Channel 4 before broadcast that the title's question mark was "not a get-out-of-jail-free card" for how the content would land, and afterwards said plainly: "ADHD is not a myth". Channel 4 responded that it has "a remit to stimulate public debate and challenge the status quo".

Both things can be true. A broadcaster can be right to provoke debate and still have made a film whose structure guaranteed that debate would be fought at the extremes, rather than in the middle, which is where the actual answers live.

What I actually believe

I accept that ADHD has become a "diagnosis du jour." I have witnessed what I believe to be overdiagnosis and over-attribution, in the way I've described above: a self-report system, private incentives, and people who arrive at assessment already expecting, even needing, a particular answer. People may well answer sincerely, but with the diagnosis already in mind, which shapes what they notice about themselves without anyone acting in bad faith.

I also believe that ADHD describes recognisable, persistent, and sometimes profoundly disabling patterns. Its lack of an individual biological test does not make those patterns imaginary, nor does diagnostic overreach mean that every diagnosis is a dud.

In my own work, I see the opposite failure just as often: adults, especially women, who were missed for decades because their presentation didn't match the hyperactive boy stereotype the whole system was built around, and who arrive at forty having been told for most of their life that they were simply lazy, chaotic, or too much.

What a better conversation looks like

We should be able to question ADHD diagnosis without humiliating people who have ADHD.

We should be able to scrutinise medication without describing all treatment as drugging children into obedience. We should be able to recognise symptoms as part of, and outside of, an ADHD diagnosis. We should be able to recognise the unsuitability of aspects of the educational system and its expectations for young people, without denying neurodevelopmental vulnerability.

We should be able to recognised the massive difference in the world now to the world 100 years ago. And we should be able to recognise overdiagnosis in some people alongside catastrophic under-recognition in others.

The documentary asked some very good questions. Unfortunately, it repeatedly demanded black-and-white answers to questions whose truth lies in the interaction between the individual, the environment, the diagnosis, and the available support.

That interaction is harder to film than a boy going off his medication for six weeks. It's also the only place the real answer has ever lived.

Did you watch it? I'd genuinely like to know where you landed. Reply and tell me.