A brief history of ADHD

In 1775, German physician Melchior Adam Weikard, book Der Philosophische Arzt described people with:

• an inability to sustain attention,

• becoming distracted by every sound or event,

• making careless mistakes,

• and struggling to complete tasks.

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Scottish physician Sir Alexander Crichton wrote in 1798 about an “incapacity of attending” that began early in life. These descriptions resemble what we now call ADHD, although the diagnosis did not yet exist. 

British paediatrician George Frederic Still presented lectures about children who struggled with attention, impulsivity and behavioural regulation despite having typical intelligence. Unfortunately, he described this using the moral language of the period, referring to a “defect of moral control”.

 

This is often presented as the first formal clinical description of ADHD, but earlier accounts show that similar traits had already been documented. 

After the encephalitis epidemic and growing interest in brain injury, children displaying hyperactivity and impulsivity were sometimes labelled as having minimal brain damage or later minimal brain dysfunction.

 

These labels were based largely on assumption. Most children had no identifiable brain injury, and the terminology was eventually abandoned. 

American physician Charles Bradley discovered that benzedrine, an amphetamine, improved school performance and behaviour in some children receiving residential treatment.

 

This was an important early indication that stimulant medication could sometimes improve attention and self-regulation rather than simply making children more active. 

ADHD-like difficulties first appeared in the American diagnostic manual, the DSM-II, under the name:

 

Hyperkinetic Reaction of Childhood

 

The emphasis was primarily on visible hyperactivity, meaning quieter, inattentive children—particularly girls—were much less likely to be recognised. 

The DSM-III introduced the term:

 

Attention Deficit Disorder, with or without hyperactivity

 

This was an important shift because it recognised that difficulties with attention could occur without obvious hyperactivity.  

The revised DSM-III replaced ADD with:

 

Attention-Deficit Hyperactivity Disorder — ADHD

 

Although people still commonly use “ADD”, it has not been the formal diagnostic name since 1987. Someone previously described as having ADD would now generally be considered to have ADHD, predominantly inattentive presentation.  

The DSM-IV recognised three forms:

 

• Predominantly inattentive

• Predominantly hyperactive-impulsive

• Combined

 

Research and clinical practice were also beginning to recognise more clearly that ADHD could persist into adulthood.

DSM-5 formally placed ADHD within the category of neurodevelopmental disorders. It also:

• Changed “subtypes” to presentations

• Raised the age by which symptoms must have appeared from 7 to 12

• Reduced the symptom threshold for adults

• Made it clearer that ADHD can continue throughout adult life 

ADHD is understood as a lifelong neurodevelopmental condition involving development and regulation of attention, activity, impulses and executive functioning. It is not simply poor behaviour, inadequate parenting, laziness or excessive screen use.

 

Modern understanding is also expanding beyond the stereotypical “hyperactive young boy”. Greater attention is now being given to:

 

• Women and girls

• Adults and older people

• Emotional dysregulation

• Internal restlessness

• Masking and compensation

• Co-occurring autism, anxiety and learning differences

 

The history of ADHD is therefore not the story of a condition suddenly being invented. It is the history of society gradually becoming better at recognising and describing a longstanding pattern of human neurodevelopment.