Content warning: This article contains historical terminology, classifications, and treatment of people that, in today’s terms, is ableist and discriminatory. We’re sharing this information because it’s at the core of some of the stereotypes and misconceptions of ADHD we still see today.

Introduction

While ADHD is more visible and accepted in Western society in 2025 compared to the past, many negative stereotypes and stigmas still persist. For example, the ideas that ADHD means someone is “bouncing off the walls,” or “can’t sit still,” or is a “troublemaker in class,” are all common ideas that often emerge in educational settings. 

So, where do these ideas come from? To understand the answer to this question, we need to look at the origins of ADHD in Western history.

ADHD in Western History

The absolute earliest mention of ADHD-like characteristics exists within a few lines in the writing of ancient Greek scholar Hippocrates, who lived from about 460-375 B.C.E. According to records, Hippocrates described some individuals who “could not keep their focus on any one thing” and had “exceptionally quick reactions to things around them.” At the time, an excess of “fire over water” caused these attributes in people.

More formally in medical literature, the German physician Melchior Adam Weikard, described a condition he termed “attentio volubilis” (loosely translated as “unstable attention”) in 1775. Many researchers today consider this to be the first clear medical description resembling what is now referred to as ADHD (particularly related to the inattentive type).  

Shortly thereafter in 1798, a Scottish doctor named Sir Alexander Crichton described a “disease of attention” in his work, An Inquiry into the Nature and Origin of Mental Derangement. Crichton described a mental “restlessness”, or an inability to maintain attention to a single object, and the tendency for the mind to shift rapidly from one thing to another.

In the 1930s, doctors believed that inflammation in the brain caused“hyperkinetic disorder” (ADHD symptomology). Modern doctors now know is not true. Children with symptoms received prescriptions for stimulatn medication.

Throughout history, physicians, clinicians and observers continued to describe characteristics in children and adults that reflected difficulties or differences with hyperactivity, inattentiveness or “nervous” behaviors that align with modern symptoms associated with ADHD. 

Emergence of a “Deficit”: ADHD & the DSM

In 1968, in the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-II, ADHD-like symptoms were classified as “hyperkinetic reaction of childhood.” The language of the diagnosis reflected the thinking of its time: difficulties with hyperactivity were thought to be a result of environmental or developmental stress, rather than an inherent neurodevelopmental disorder. The emphasis was also on hyperactivity, restlessness and impulsivity (not attention). 

In the revised DSM-III (published in 1980), “attention deficit disorder” (ADD) was first introduced, and split into two subtypes: 1) with hyperactivity and 2) without hyperactivity. This change resulted from several changes in the field and emerging research results. Namely, attentional deficits were now understood as central, rather than difficulties with hyperactivity, and related to developmental deficits in self-regulation and attention, rather than environmental factors of behavioral issues. 

Then, in 1987, the revised DSM-III-R replaced ADD with ADHD (attention deficit hyperactive disorder), and the previous two subtypes were collapsed into a single diagnosis. Although controversial, hyperactivity and attentional problems were now considered inseparable from parts of the same underlying condition. 

The DSM-IV, published in 1994, retained the modern framework of ADHD, but reintroduced the differentiation of three subtypes: Inattentive, Hyperactive-Impulsive, and Combined. The DSM-IV used more structured and empirical criteria to define symptom thresholds, duration requirements and age of onset (before age 7, but later changed to 12 in DSM-5). The people who made the DSM-IV emphasized impairments across multiple settings and clearer symptom clusters in groups together.

Now, in modern day, the DSM-5 lists ADHD as having three different focal points: inattentive type, hyperactive/impulsive type, and combined type, recognizing that these are presentations–rather than separate types–and how it presents in people can change over their lifetime.

It’s worth mentioning that in 2013, the DSM-5 introduced a new category of disorders called “neurodevelopmental disorder” that was meant to acknowledge how ADHD may be present in early development, including at times alongside Autism Spectrum Disorder (ASD). This version of the DSM-V adjusted assessment criteria to provide earlier diagnosis and treatment.

How does the history of ADHD impact us today? 

Reflected throughout its history, difficulties with attention and hyperactivity were characterized and defined by members of the medical profession: ADHD and its related symptoms were classified as outside of “normal” behavior or functioning. Rather than adjusting social expectations or environments to fit the needs of individuals with varied cognitive profiles, medical and academic settings focused on diagnosis and treatment to make folks appear and behave in more “neurotypically” conforming ways. As a result, these standards have shaped ways in which neurodivergent individuals see themselves, as well as how others see them. 

Modern educational systems or medical systems still sometimes treat ADHD negatively–as a problem to solve, manage or eliminate.

As a result, many people who receive an ADHD diagnosis often feel their only options are medication. While this can be a supportive option for some people, there are many other resources and helpful tools out there. 

Thankfully, strides are being made to understand that neurodiversity is not something to be controlled or “solved,” but rather, that people with ADHD need different tools, supports, structures, and, sometimes, medication support, to feel like they are thriving. All people deserve to function in a way that aligns with their strengths, rather than feeling the need to conform to the expectations or standards of others.