Adult ADHD Cases Jumped 5x in 5 Years—Blame the Environment

Opening

Reader, can you actually make it to the end of this newsletter?

It’s a provocative question, but I’m asking it seriously. According to a 20-year study by UC Irvine professor Gloria Mark, the average time people spend on a single screen dropped from 2 minutes 30 seconds in 2004 to just 47 seconds in 2024. What makes this even more striking is that the median is 40 seconds — meaning in half of all cases, people can’t even hold on for 40 seconds.

But what if this isn’t a matter of willpower — what if it’s the result of something deliberately engineered? In Korea, the number of adults treated for ADHD has surged nearly fivefold in just five years. Has the number of people with genuine brain-based conditions really grown that much, or has the world itself started making everyone look like they have ADHD?Today, I want to trace the answer to this question through data.

What the Numbers Are Really Telling Us

Let’s start with the facts. According to the National Health Insurance Service’s “ADHD Treatment Status Over the Past 5 Years,” the number of adults (age 20+) treated for ADHD in 2024 reached 122,614 — up 4.85 times from 25,297 in 2020. 2024 was the first year the adult figure crossed 100,000. Treatment costs over the same period jumped 5.74 times, from ₩18.8 billion (~$13.5 million) to ₩108 billion (~$78 million).

Women in their 30s stand out in particular. Their numbers rose 8.87 times, from 2,325 in 2020 to 20,624 in 2024, while related treatment costs grew 10.92 times. The U.S. shows a similar pattern. CDC data shows adult ADHD prevalence climbing from 4.4% to 6.0% (about 15.5 million people), and a 2024 meta-analysis estimated global adult ADHD prevalence at 6.76%, or roughly 366.3 million people.

Here’s where anyone reading the data carefully needs to pause. These numbers represent “people who received treatment,” not “prevalence.” Treatment count measures “how many people went to a hospital,” while prevalence measures “what share of the population actually has the condition.” These are entirely different metrics, yet most reporting conflates them into a single claim: “ADHD has exploded.”

There are at least three structural reasons behind the surge in treatment numbers.

First, an expansion of diagnostic criteria. In 2013, the DSM-5¹ relaxed the symptom criteria for adult ADHD, and in 2016 Korea expanded national health insurance coverage from ages 6–18 to ages 6–65. Open the faucet wider, and naturally more water comes out.

Second, a shift in awareness. The top 100 videos under the #ADHD hashtag on TikTok have amassed roughly 500 million combined views. The thought “wait, could this be me?” has been driving people straight into doctors’ offices.

Third, improved accessibility. Since the COVID-19 pandemic, the spread of telehealth has physically lowered the barrier to visiting a psychiatrist.

The problem is that none of these three factors actually means “more people genuinely have ADHD.” Rather, the numbers grew because the measuring instrument and the measuring environment changed. It’s structurally similar to recalibrating a bathroom scale and then declaring, “everyone suddenly gained weight.”

Stolen Focus — The Architecture of the Attention Economy

So why have so many people started suspecting they have ADHD? The broadening of diagnostic criteria alone doesn’t explain it — people are genuinely feeling like they “can’t concentrate.”

In 1971, Nobel laureate economist Herbert A. Simon offered a prophetic insight: “A wealth of information creates a poverty of attention.” When information becomes abundant, the human attention needed to process it becomes the scarce resource. Fifty years later, this insight has become the literal business model of Silicon Valley. What tech companies sell isn’t software — it’s your gaze.

Infinite scroll, autoplay, notification badges — none of these are accidents. They’re engineered on the same principle as slot machines: “intermittent variable reward.”² Because you can never predict what comes next, your brain’s dopamine circuitry gets stimulated endlessly. Within this structure, everyone’s attention gets fragmented — regardless of willpower.

Let’s revisit Professor Gloria Mark’s research data. Screen dwell time fell from 2 minutes 30 seconds in 2004, to 75 seconds in 2012, to just 47 seconds from 2016 onward. The average time it takes to return to an original task after being interrupted is 25 minutes. If you’re interrupted every 47 seconds and it takes 25 minutes to recover each time, deep thinking becomes structurally impossible.

In his book Stolen Focus, Johann Hari lays it out plainly: the collapse of our attention isn’t a personal failure — it’s the result of a systematic theft carried out by enormous forces. Some estimates suggest daily information exposure grew from the equivalent of 40 newspapers in 1986 to 174 newspapers by 2007.

Here’s the core point. In this environment, applying the old ADHD diagnostic criteria can make an ordinary person look like a patient. The DSM-5’s diagnostic markers for ADHD — “fails to give close attention to details,” “has trouble organizing tasks and activities,” “is easily distracted by extraneous stimuli” — could apply to nearly everyone living in 2025.

Manufactured Patients — Overdiagnosis and the Shadow of Smart Drugs

This creates one serious side effect: when boundaries blur, real patients get hurt too.

JAMA Network Open (2023) reported that up to 25% of U.S. middle and high schoolers have used ADHD-prescription stimulants (Adderall, Ritalin, etc.) non-medically. About 20% of college students take prescription stimulants illegally during exam periods — the so-called “smart drug”³ phenomenon. FDA data shows U.S. stimulant prescriptions rose 45.5% between 2012 and 2021.

Ironically, numerous studies show that stimulants provide little to no academic performance benefit for people without ADHD. Instead, they bring side effects like insomnia, appetite loss, cardiovascular risk, and dependency. Yet prescriptions keep climbing. In Korea too, prescriptions of methylphenidate⁴ — the drug most commonly used to treat ADHD — rose roughly 2.4-fold from 2020 to 2024.

Social media has undeniably raised ADHD awareness in a positive way — plenty of people who suffered from delayed diagnosis finally found a path to treatment. But there’s a real gap between clinical diagnosis and social-media-based self-diagnosis.Psychiatrists themselves are increasingly noting that “most patients say they first learned about ADHD from social media.”

Genuine ADHD is a real, well-established neurodevelopmental disorder — I’m not disputing that. The problem is that when environmentally-induced attention decline gets tangled up with ADHD as a neurodevelopmental disorder, real patients’ proper treatment gets disrupted, while healthy people can end up being pulled into unnecessary medication.

Oz’s Lens

When I look at this phenomenon, what catches my attention is the trap hidden in the data.

The headline “Adult ADHD up fivefold in five years” is factually true. But to properly read what this number means, you have to understand the nature of the metric “number of people treated.” Treatment counts are heavily driven by supply-side variables — expanded diagnostic criteria, insurance coverage, healthcare accessibility. Even if demand (actual prevalence) hasn’t changed, the number can spike the moment supply conditions shift.

Korea’s 2016 expansion of insurance coverage to age 65 effectively opened up an entirely new market. A latent patient pool entered the treatment system all at once, so the subsequent surge in treatment numbers was, to some degree, predictable. Layer on top of that the spread of telehealth post-COVID and the amplification of awareness through social media.

Of course, this doesn’t mean “the rise in ADHD is just an illusion.” It’s an undeniable fact that the attention economy has lowered everyone’s baseline attention span. What I want to emphasize is simply this: the same number can mean something entirely different depending on the measurement conditions behind it.

The question we should really be asking isn’t “why has ADHD increased?” It’s “given that diagnostic criteria, awareness, and accessibility have all shifted simultaneously, how should we accurately interpret this number?” And more fundamentally: “Is it right to treat only the individual brain while leaving intact an environment that limits attention to 47 seconds?”

The core of the problem isn’t the individual brain — it’s the system. Before we treat the patient, we may need to ask whether we should be diagnosing the environment first.

Closing

Let me sum up today’s newsletter in three points.

One, a substantial portion of the surge in ADHD diagnoses reflects expanded diagnostic criteria, greater awareness, and improved accessibility — not a pure increase in prevalence. When reading any statistic, it’s crucial to first ask “what exactly was measured?”

Two, the attention economy has structurally weakened everyone’s attention span, creating an environment where, by past standards, almost anyone could show ADHD-like symptoms.

Three, this confusion can disrupt proper treatment for genuine ADHD patients while pushing healthy people toward unnecessary medication.

In the next newsletter, I’ll turn to the architects of this system. Does Silicon Valley — the very industry that built the attention economy — know about this problem? And how are governments around the world responding? I’ll cover this in Part 2 of the ADHD series.

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📎 References & Further Reading

• National Health Insurance Service, “ADHD Treatment Status Over the Past 5 Years,” 2024 (submitted to the office of Rep. Nam In-soon). : The original source of the Korean ADHD treatment data cited in today’s newsletter.
• Gloria Mark, Attention Span: A Groundbreaking Way to Restore Balance, Happiness and Productivity, Hanover Square Press, 2023. : The original source of the “47-second attention span” data, and the most comprehensive synthesis of attention science available.
• [CDC, “Data and Statistics About ADHD,” 2024.](https://www.cdc.gov/ncbddd/adhd/data.html\) : Official U.S. statistics on childhood and adult ADHD.
• JAMA Network Open, McCabe et al., “School-level Stimulant Prescription Rates and Student Nonmedical Use,” 2023. : A key study analyzing the correlation between school-level stimulant prescription rates and student misuse.
• Johann Hari, Stolen Focus: Why You Can’t Pay Attention, Crown, 2022. : A reported investigation into 12 causes behind the attention economy’s destruction of focus. Recommended for grasping the full picture of this topic.
• Herbert A. Simon, “Designing Organizations for an Information-Rich World,” in M. Greenberger (ed.), Computers, Communications, and the Public Interest, Johns Hopkins Press, 1971, pp. 37-52. : The original source of the concept “a wealth of information creates a poverty of attention.”
• PMC, “ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis?,” 2022. : An academic review summarizing the overdiagnosis vs. increased-awareness debate.

The author, Kwangseob Ahn, is a professor in the Department of Business Administration at Sejong University and lead consultant at OBF (Oswarld Boutique Consulting Firm). He teaches statistics and data analysis — including business data management and business analytics — at the university level, while leading GTM strategy and AI strategy consulting in the field, working at the intersection of technology and business. He has published an academic paper on HEMA (Hierarchical Episodic Memory Architecture) for AI conversational systems, and runs Daily Arxiv, a project curating global AI research papers every day. He completed his master’s coursework at Korea University’s Graduate School of Technology Management and holds a KMBA from Korea University. He is the author of People Who Outsource Their Thinking: Homo Brainless.

Footnotes

1. DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition): A diagnostic manual for mental disorders published by the American Psychiatric Association. It serves as the de facto global standard for mental health diagnosis, defining the diagnostic criteria for hundreds of conditions, including ADHD. ↩

2. Intermittent Variable Reward: A system, like a slot machine, in which unpredictable rewards are delivered irregularly. Social media’s likes, comments, and new content all operate on this principle. The brain releases more dopamine specifically in situations where it can’t predict “what comes next.” ↩

3. Smart Drugs / Study Drugs: The practice of taking ADHD medications like Adderall or Ritalin without an ADHD diagnosis, purely to enhance focus for academic or work purposes. Medically, no benefit has been demonstrated for people without ADHD. ↩

4. Methylphenidate: The central nervous system stimulant most widely used to treat ADHD, prescribed under brand names like Ritalin and Concerta. It works by raising dopamine and norepinephrine levels in the brain, improving concentration. ↩