Industry must do more to understand ‘ADHD tax’

Wealthier adults in England are driving a sharp rise in demand for drugs used to treat a neuro-developmental condition previously associated with children, at a time when the medicines are in short supply globally.

The number of prescriptions for attention deficit hyperactivity disorder (ADHD) medications grew at twice the rate for the least deprived 20% of the population as for the most deprived 20%, between May 2020 and September 2023.

While awareness around ADHD and other executive functioning conditions is growing, there’s a silent cost no one is talking about. Research shows living with ADHD can cost an extra £1,600 per year – and that’s just the financial cost.

As a recent diagnose, I can testify that, untreated, ADHD can cause very real financial difficulties due to the nature of how the condition affects our executive function. From impulsive spending to forgetfulness, and even emotional dysregulation, all these symptoms can translate to serious financial consequences.

Better neurotypical understanding of neurodiverse behaviours is key to better outcomes.

People with ADHD find it difficult to think before they act and are susceptible to their own energy levels and cognitive overactivity. This creates several issues when managing money.

The lack of attention to detail poses a challenge because it’s hard to sort out all the financial information floating around. They may only hear one detail of a financial product, which makes it challenging to make an informed, appropriate decision.

Impulsivity can create problems with prioritising financial outlays, leading to risks of inadequate protection and long-term savings provisions, in particular.

So, when we refer to the marmite term ‘ADHD tax’, we’re highlighting the very real cost of things like:

• Absent or insufficient protection cover and pensions provision
• Missed deadlines on loan repayments
• Late or missed tax payments

But the ADHD tax isn’t collected in money alone. Other costs associated with ADHD – like constant guilt and shame, compromised relationships and poor self-esteem – often weigh more and do more damage than any monetary penalty ever could.

The ADHD tax takes its toll, but we are certainly not helpless. We can take steps toward managing the symptoms that cost us the most – financially and emotionally. But better support and understanding of neurodiversity across the industry is paramount.

The ADHD brain and its owner are at odds with one another. It’s difficult to compel a disengaged brain to engage by force of will. “Intention deficit disorder” might be a better name for ADHD, as it captures our never-ending struggle to act on decisions (i.e. failing to do what we know we should do.)

We intend to get the car’s oil changed but we don’t, for whatever reason. Down the line, that neglected oil change becomes a wrecked engine that breaks the bank and/or leaves us carless.

Acting on a decision is a big problem, but so is decision-making. It’s a problem that’s often looped in with perfectionism, procrastination and difficulty prioritising. Many adults with ADHD, overwhelmed by the decision in front of them, simply shut down and further delay action. Cue mountains of paperwork and unopened bills.

‘Now’ versus ‘not now’ thinking also plays an enormous part. Because of time blindness (and related to the intention-action gap), we seriously downgrade the impact our current choices have on our future in favour of instant gratification.

Sure, the ADHD tax shows up in day-to-day inconveniences such as forgotten groceries, cash flow faux pas and late payments. But we mustn’t discount its long-term costs and other hidden, far-reaching consequences.

The exact cause of ADHD is not known, but it is associated with changes in neurotransmitter activity in certain areas of the brain. Neurotransmitters are chemicals that nerve cells release to coordinate the action of the nervous system.

Dopamine is one neurotransmitter that plays a role in ADHD symptoms. Dopamine is essential for learning and motivation, but it’s best known for giving you a feeling of pleasure or satisfaction. It’s your brain’s reward for exercising, saving, turning up for that life-insurance medical.

Research studies examining the metabolic activity of the brain have found the action of multiple neurotransmitters is disrupted in people who have ADHD. The neurotransmitter change that is most significant in ADHD is a decrease in dopamine activity. This means attending to things that yield long-term gratification involves learning to psych out the brain, so it will attend to necessary, low-stimulation tasks.

This doesn’t mean ADHD-ers are exempt from taking personal responsibility, but there are very real neurobiological forces at play that pit the ADHD brain and its owner against each other in a daily tug-of-war that the industry would benefit from better understanding.

Not least because ADHD-ers typically also have unique traits and abilities that make them more creative, spontaneous, caring and energetic. People with ADHD can push past setbacks, adapt to new strategies and troubleshoot solutions to complex problems.

Individuals with ADHD are bright, creative and funny — often using self-deprecating humour to remind the world perfection is wholly uninteresting. We’ve faced challenges and learned novel ways to manage our symptoms, but we also need a little extra help and understanding sometimes.

Phillip Wickenden is chief executive of Ad Lucem