DR MAX PEMBERTON: Brain fog, tired, anxious and unable to focus? These are all signs of this one common condition – and NO it’s not ADHD

ADHD medication use has more than tripled in the UK since 2010, a study revealed last week. The most striking finding?

The sharpest rise has been in women, particularly those aged over 25.

In this age group, prescriptions have increased twentyfold compared with fifteenfold in men. What on earth is going on? 

I’m afraid I’m sceptical that we are witnessing a genuine epidemic of a neurological condition that was, until recently, considered relatively rare.

And this latest finding particularly troubles me when it comes to women, because I suspect something else entirely is being missed. Among my female patients, I have noticed a pattern. 

Many of the women seeking ADHD assessments are in their 40s and 50s. They describe struggling to concentrate, feeling scatty, forgetting things, being unable to focus on tasks they once managed easily.

They have read about ADHD online, taken a quiz, watched videos on TikTok or Instagram, and become convinced they have the answer. An ADHD diagnosis explains everything.

This is what worries me. Every single one of those symptoms is also a hallmark of perimenopause and menopause. From brain fog, difficulty concentrating and forgetfulness, to poor sleep, anxiety and low mood – these are textbook menopausal symptoms, experienced by millions of women as their oestrogen levels fluctuate and decline.

Oestrogen plays a crucial role in brain function, affecting neurotransmitters including dopamine, the very chemical implicated in ADHD.

When oestrogen drops, cognitive function can suffer. This is not a permanent neurological condition. It is a hormonal shift that can often be addressed with hormone replacement therapy. 

Yet instead of exploring this, many women are being handed an ADHD diagnosis and a prescription for stimulant medication. Ritalin instead of HRT. A psychiatric label instead of recognition that their body is going through a profound biological change.

I find this deeply worrying for several reasons. First, there is the issue of labelling. Once someone is told they have ADHD, it changes how they see themselves. 

Research into labelling theory shows that diagnoses can seriously affect how people view their own capabilities – and the effort they make to change their behaviour.

A diagnosis can feel like an explanation, even a relief. But it can also become a cage, telling someone there is nothing they can do except take medication indefinitely.

Secondly, stimulant medications are not without risks. They can affect sleep, appetite, blood pressure and heart rate.

For a woman who might simply need her hormones addressed, taking amphetamine derivatives for the rest of her life seems a peculiar solution.

Thirdly, and perhaps most importantly, this rush to diagnose ADHD in midlife women means we are failing to have proper conversations about menopause. Despite affecting half the population, menopause remains poorly understood, under-researched and often dismissed.

How much easier, it seems, to give women a psychiatric diagnosis than to take their hormonal health seriously. 

I am not suggesting that no woman over 40 has genuine ADHD. Of course many do. But the sheer scale of this increase should give us pause. A twentyfold rise in just over a decade cannot simply reflect better awareness. Something else is happening.

Part of the problem lies with social media. TikTok and Instagram are awash with content about ADHD, much of it created by people who are not medical professionals. 

Algorithms serve up endless videos about symptoms that are, in truth, common human experiences: losing your keys, struggling to finish tasks, feeling overwhelmed by your To Do list.

The message is seductive: you are not lazy or disorganised, you have a condition, and there is medication that will fix it. 

Private clinics have sprung up to meet this demand, charging hundreds of pounds for assessments and ready to provide the diagnosis. The financial incentives are obvious. 

The NHS, meanwhile, has years-long waiting lists, which only drive more people towards private providers.

Senior figures including Sir Professor Simon Wessely, former president of the Royal College of Psychiatrists, have spoken about the responsibility doctors have to resist over-diagnosis.

Yet, raising these concerns publicly invites accusations of being dismissive or uncaring. The opposite is true. Giving someone the wrong diagnosis is not helpful. It is a failure of care.

For any woman in midlife struggling with concentration and memory, I would urge you to consider whether your symptoms might be hormonal before assuming they are neurological.

Speak to your GP about menopause. Ask about HRT. These symptoms can often be addressed without a lifelong psychiatric diagnosis.

The brain is remarkably adaptable. Given the right support, whether that is hormonal treatment, lifestyle changes, or simply understanding what is happening to your body, most people can manage these difficulties. That seems a more hopeful message than telling millions of women they have a permanent neurological disorder.

Beckham family’s tragic split 

Brooklyn Beckham’s six-page Instagram post detailing his grievances against his parents made for uncomfortable reading. 

Whatever the truth, my heart sinks when I see family conflict played out so publicly. Because in my experience, this kind of public airing almost never helps. 

Family estrangement is agonising for everyone involved. The pain is real on all sides. When grievances are broadcast to the world, people become entrenched.

 Positions harden. The hurt partly feels vindicated by public sympathy. The accused feels attacked and defensive. 

That is a tragedy for everyone. Family estrangements do heal, but it takes time, patience and private work. 

The public glare makes everything more difficult. For the sake of the whole family, I hope they can find their way back to each other, away from Instagram and out of the spotlight.

For anyone who has watched a loved one struggle with arthritic knees, shuffling painfully, dreading stairs, losing their independence, this week’s news from Stanford University offers real hope. 

Scientists have developed a drug to regenerate cartilage. 

Let me repeat that, because it bears emphasis: regenerate cartilage.

 Until now, this was considered impossible. Of course, there is a long way to go, but a drug that could be injected into the knee to regrow damaged tissue would be transformative. 

An Oxford study has found people with severe vitamin D deficiency are 33 per cent more likely to be hospitalised with flu or similar illnesses. 

At around 10p a day for a decent vitamin D supplement, it is cheap insurance against winter bugs. Why not start today? 

Dr Max prescribes…The Happiness Lab podcast

If you fancy something to listen to while out on a January walk or doing the housework, try Yale professor Dr Laurie Santos’s podcast. 

Each episode explores the science behind what makes us feel good, often debunking our assumptions along the way. 

You will come away with practical ideas for improving your own wellbeing. The perfect antidote to the January blues.