Four Things You Should Know About ADHD
In the three decades that I have been a part of the biblical counseling movement, one role I have occupied has been an umpire of the value of new medical research. In the steady stream of published research, there will be articles that should interest those of us in biblical counseling. Reading and reviewing them is important to counselors and counselees.
Recently, my morning trip through the Wall Street Journal and a cup of coffee yielded an interesting article about ADHD (attention-deficit/hyperactivity disorder) medication. We are going to examine that article and a couple more that impact the subject. It is always fun as a biblical counselor and physician when secular sources start saying things in public that I have been saying for decades.
The article in the November 19, 2025, issue of the Wall Street Journal, “Millions of Kids Are on ADHD Pills. For Many it is the Start of a Drug Cascade,” discusses the outcomes of children who are started on amphetamine/stimulant medications as early as age three.[1] While the article states that some children benefit from the medication, the most common outcome will be added prescriptions.
The article explains that according to the American Academy of Pediatrics, the standard of care for children with ADHD is first Parent-Child Interaction Therapy, or PCIT. But finding clinicians who provide this care is difficult. The result for parents who are desperate for help to keep their child from being expelled from daycare or falling behind in school is that half of the children diagnosed with ADHD will be treated with stimulant medication. The article goes on to document that 25% of those children will be on multiple medicines eventually, including antipsychotic medication, antidepressants, and sedatives, without great benefit.
While the article was discouraging in many ways, it does point us to an opportunity. If the diagnosis of ADHD is not certain, and the medical treatment is hazardous, we should be able to offer parents and educators a better alternative. For those parents and children who struggle with hyperactivity, inattention, and impulsiveness, there are principles of Scripture that apply.
What no one could foresee when I started in medicine 50 years ago was that the definition of ADHD would change. In 1970, it was considered a childhood problem that would resolve as the child grew into adulthood. In 1980, the diagnosis was added to the third revision of the Diagnostic Statistical Manual of Mental Disorders, or the DSM 3, as a childhood disorder. By 2013, the DSM criteria were changed to extend the diagnosis to adults. Since that time, the number of adults labeled with ADHD and treated with medication has exploded.
In the 2023 article “The Making of Adult ADHD: The Rapid Rise of a Novel Psychiatric Diagnosis,” the authors contend that Adult ADHD is not a valid diagnosis.[2] They make a point of saying that they do not mean that struggles with attention, hyperactivity, and impulsivity do not exist. They certainly do, but they do not constitute a new disease or the persistence of childhood ADHD into adulthood.
They also noted that a “common claim is that since psychostimulants improve the cognition of individuals diagnosed with adult ADHD, then they must be treating an underlying disease. But this is faulty logic. Psychostimulants improve cognition for everyone, including normal patients…” Considering that the medications used to treat adults offer the same side effects as they do to children, it would appear that there are significant risks involved. There should be a better way to deal with the problem.
The third article of interest calls into question the theoretical understanding of how ADHD works in the human brain. At the heart of ADHD is the concept that the medicines used affect the area in our brains that enables us to pay attention. For affected adults and children, medicines such as amphetamines are prescribed and assumed to improve attention.
Research published in the journal Cell on December 24, 2025, has given us a Christmas Eve gift. The title of the research gives away the punch line: “Stimulant Medications Affect Arousal and Reward, Not Attention Networks.”[3] Using fMRI brain scanning, this research examined the effect that medication has on the areas associated with the ability to pay attention.
For 50 years, the medical community has operated on the assumption that stimulant medicines improve attention in children and now adults. This study demonstrates that it does not. Instead, the researchers found that the medicine affected areas that were associated with reward and arousal.
Instead of stimulating the areas associated with attention, the main benefit may come from being able to stay awake. It is hard to pay attention when you cannot stay awake. This research indicates that the current theory that ADHD is a disorder of the ability to pay attention is now in doubt.
Four Things to Know About ADHD
ADHD is not a disease. The theory that has supported it is in question. Instead, it is a difference in the way we learn and how we organize our lives.[4] So, the question becomes: how can we help the individual who is distractible, sometimes impulsive, and struggles to stay still in one place? I think we can help the adult believer by encouraging them to live intentionally.
When I think of Scripture that applies to intentional living, Psalm 90 comes to mind. It is the one Psalm attributed to Moses, and in it is a biblical principle that may be helpful to the distractible.
Moses reminds us in verse 10 that our time here is limited. “As for the days of our life, they contain seventy years, or if by strength, eighty years.” If we wish to accomplish anything in the time we have, we must be intentional. In verse 12, Moses admonishes us. “So teach us to number our days, so that we may present to you a heart of wisdom.”
Planning is Helpful
If those of us who are distractible are going to succeed with anything in life, it will be because we plan to do it. I believe that it is God’s intent for us to plan our days in such a way that we honor Him. God will enable us to do His will. (Phil. 2:12-13) Planning can take many forms. For me, for the past 30 years, it has been a Franklin Planner. It can be any organized method of numbering our days. It may require breaking those days down into fifteen-minute increments. My work does it for me, as office visits come in twenty and forty-minute sizes.
Take a Break from the Screen
Many have written about the adverse effects of social media and the difficulties associated with smartphones grabbing our attention.[5] Regaining control of our attention may require taking a break from internet connectivity. Returning to the old flip phone without internet access may be helpful.
Finding Our Place in Life
Distractibility has not always been a problem for children and adults. It became a greater problem as education focused on classroom learning that required students to sit for long periods. It also became a problem as work for adults shifted to occupations that do not offer variety or the ability to move about in the process. Educational and career choices need to be made with these differences in mind.
Reading Research Is Helpful
Finally, it is important to review current research. There is much in medicine that is based on theory but is sometimes presented as fact. It is good to know when theories are called into question or bite the dust.
Reviewing the medical literature is certainly not required to counsel distractible individuals from the Scriptures. It can be a help when dealing with counselees who come with the ADHD label. It is useful to know that current research indicates we are dealing with a difference in learning, not a disease.
Questions for Reflection
- How do you approach counselees who come with labels?
- What resources do you use to understand what their label means?
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[1] Shallini Ramachandran, Betsy McKay, and Tom McGinty, “Millions of Kids Are on ADHD Pills. For Many, It’s the Start of a Drug Cascade,” The Wall Street Journal, November 19, 2025, retrieved electronically.
[2] Mark Ruffalo and S. Nasir Ghaemi, “The Making of Adult ADHD: The Rapid Rise of a Novel Psychiatric Diagnosis,” The Psychiatric Times, September 11, 2023, Vol 40, Issue 9, retrieved electronically.
[3] B.P. Kay, M.D. Wheelock, J.S. Siegel, et al. “Stimulant Medications Affect Arousal and Reward, Not Attention Networks,” Cell, Dec 24, 2025,188(26): 7529-7546. e20. DOI: 10.1016/j.cell.2025.11.039. PMID: 41448140.
[4] T. A. Hartanto, C. E. Krafft, A. M. Iosif, J. B. Schweitzer, “A trial-by-trial analysis reveals more intense physical activity is associated with better cognitive control performance in attention-deficit/hyperactivity disorder,” Child Neuropsychology, 2015; 1 DOI: 10.1080/09297049.2015.1044511.
[5] See R U Hooked, Jonathan Smith, Tristan Press, and The Anxious Generation, Jonathan Haidt, Penguin Publishing.