Understanding ADHD and Its Association with Creativity

Abstract

Though the term was not coined until recent decades, scholars have written about individuals who fit the description of what we now call attention deficit hyperactivity disorder (ADHD) for centuries. The current paper reviews the history of ADHD, its diagnostic criteria, and reasons behind rising diagnosis rates. It then applies the evolutionary mismatch hypothesis to argue that ADHD traits, though challenging in modern settings, may have been adaptive in ancestral environments. Finally, it examines research linking ADHD to creativity, focusing on divergent thinking, real-world creative achievement, and mind wandering.

History of ADHD

Attention-Deficit/Hyperactivity Disorder, or ADHD, is one of the most common disorders that affects attention and behavior. Even though ADHD is widely known today, modern researchers have noted that earlier scholars have reported deficits in some children’ s abilities to pay attention, control their actions, and stay focused on tasks for hundreds of years (e.g., Lange et al., 2010; Martinez-Badia & Martinez-Raga, 2015). According to Lange and colleagues (2010), one of the earliest descriptions came from a Scottish doctor named Alexander Crichton in the late 1700s who wrote about people who seemed unable to keep their attention on one thing for very long. He observed that some individuals were easily distracted by things happening around them and found it difficult to maintain attention on tasks, which often interferes with learning and education (Lange et al., 2010). Additionally, Martinez-Badía & Martinez-Raga (2015) recount that in 1902 British doctor George Frederick Still described children who had difficulty controlling their behavior even though they were intelligent. It noted that these children were often aggressive, defiant, resistant to discipline, and also had difficulty in concentrating or learning from the consequences of their actions despite having normal intelligence (Martinez-Badía & Martinez-Raga, 2015). Today, many researchers believe that the children he described likely had ADHD (e.g., Lange et al., 2010; Martinez-Badía & Martinez-Raga, 2015; Taylor, 2011).

As doctors learned more about the brain, they started to look for medical explanations for behaviors that had previously been seen as problems with discipline or poor self-control. During the middle of the twentieth century, ADHD was often linked to problems in brain development that could affect behavior (Martinez-Badía & Martinez-Raga, 2015). Different names were used over time, including “Minimal Brain Dysfunction” and “Hyperkinetic Reaction of Childhood,” reflecting changing ideas about the condition. These terms focused mainly on hyperactivity, but they also helped shift attention away from blaming children for their behavior and toward medical explanations. As these ideas became more widely accepted, ADHD came to be recognized as a medical condition rather than simply bad behavior or poor discipline. Over time, the diagnosis and treatment of ADHD expanded beyond North America and became more common in many parts of the world. In 1980, the American Psychiatric Association introduced the term “Attention Deficit Disorder” (ADD) in the DSM-III, recognizing that difficulties with attention were a major part of the condition. Later editions changed the name to Attention-Deficit/Hyperactivity Disorder (ADHD), which is still used today. This process of treating ADHD as a medical condition contributed to the global acceptance of ADHD, and today it is considered one of the most common neurodevelopmental disorders, with studies estimating that about 5% of children and adolescents worldwide are affected by the condition (Conrad & Bergey, 2014). Although scientists did not fully understand ADHD during its early development, these changes helped shape the modern understanding of the disorder (Martinez-Badía & Martinez-Raga, 2015).

Common Characteristics and Diagnostic Criteria

Doctors use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), to diagnose ADHD. According to the DSM-5, symptoms must begin before the age of twelve. ADHD affects people in different ways, but most symptoms fall into two main groups: inattention and hyperactivity-impulsivity (American Psychiatric Association, 2022). Some people mainly struggle with attention, while others mainly struggle with hyperactivity and impulsive behavior. Many people experience a combination of both. Lange and colleagues (2010) reported that researchers as early as Crichton observed individual differences in these characteristics throughout the population. Modern researchers report that these two symptom types have differing impacts on the daily lives of individuals with ADHD (Knouse et al. 2008). People with inattentive symptoms often have difficulty focusing on tasks for a long time. They may forget assignments, lose important items, become easily distracted, or have trouble following directions. In school, these students may understand the material but still struggle because they miss details or lose focus during class. Hyperactive and impulsive symptoms are different. A person with these symptoms may have trouble sitting still, feel restless, talk a lot, interrupt others, or act before thinking. Young children with ADHD may run around or move constantly. Older teenagers and adults may not be physically hyperactive, but they may still feel restless inside.

The absence or presence of each of the two types of symptoms results in three types of presentations: predominantly inattentive, predominantly hyperactive-impulsive, and combined. Individuals with the predominantly inattentive presentation often struggle with sustaining attention, organization, and completing tasks, while those with the predominantly hyperactive-impulsive presentation are more likely to exhibit excessive movement, impulsive behavior, and difficulty remaining still. The combined presentation includes significant symptoms from both categories and is generally associated with greater overall impairment than either presentation alone (Ghaderi et al., 2017; Willcutt et al., 2012). The symptoms must also appear in more than one setting, such as at school and at home. In addition, the symptoms must cause real difficulties in daily life. However, ADHD symptoms may not appear the same in every environment. Adolescents with ADHD have been found to report higher levels of symptoms on school days than on non-school days. Symptoms also tend to worsen throughout the day and often reach their highest levels during the afternoon. These findings suggest that the demands of different settings, such as school and home, can influence how ADHD symptoms are expressed (Pedersen et al., 2020).

ADHD can affect school performance, friendships, and everyday responsibilities. However, not every person with ADHD experiences the same challenges. Some people have mild symptoms, while others have more serious difficulties. Because ADHD affects people differently, proper evaluation and diagnosis are important.

Historical Trends and Modern Rates

ADHD diagnoses have become more common over the last several decades. Today, experts estimate that about 5.29% of children worldwide have ADHD (Polanczyk et al. 2007). In some countries, especially the United States, diagnosis rates are even higher (Centers for Disease Control and Prevention [CDC], 2024). This increase has led many people to ask whether ADHD is becoming more common or whether doctors are simply getting better at identifying it. Many researchers believe that better diagnosis is a major reason for the increase (e.g., Martin et al. 2025; Sayal et al. 2017), while others suggest that increases in ADHD rates may also reflect increased misdiagnosis (e.g., Abdelnour et al., 2022). Teachers, parents, and doctors now know much more about ADHD than they did in the past. As a result, children who may have been misunderstood years ago are more likely to receive help today.

Changes in diagnostic rules have also affected the number of diagnoses. As doctors learned more about ADHD, the definition of the disorder became clearer. This allowed more people with symptoms to be recognized and diagnosed. Some researchers believe that modern society may also play a role (e.g., Kazda et al., 2021; Sayal et al., 2018;). Modern schools often require students to sit still for long periods, pay attention during lectures, and complete structured assignments. These expectations can make ADHD symptoms easier to notice. Technology may also affect attention in some ways, although scientists continue to study this issue (e.g., Domingues-Montanari, 2017; Nikkelen et al., 2014; Ra et al., 2018).

While experts continue to debate the exact reasons for increasing diagnosis rates, most agree that greater awareness and better evaluation methods are important factors (e.g., Kazda et al., 2021;Sayal et al., 2018). Thus, it appears that more people are being identified because ADHD is now better understood than it was in the past.

ADHD and Creativity

ADHD is also becoming increasingly understood as a cluster of characteristics that are not objectively “disordered” but that are moreso poorly matched with our modern human environment. The evolutionary mismatch hypothesis posits that many human traits evolved to help our ancestors survive in past environments but may not function as well in today’s rapidly changing world (Lloyd et al., 2011). As a result, characteristics that were once adaptive can appear maladaptive when they no longer match the demands of modern environments. Perhaps the most well-known example of evolutionary mismatch wherein our innate psychology produces poor outcomes in modern settings has to do with eating behavior and obesity. Humans evolved in environments where food was often scarce, so storing energy efficiently and consuming calorie-rich foods increased the chances of survival. In modern societies, however, the widespread availability of inexpensive, high-calorie foods combined with sedentary lifestyles creates an evolutionary mismatch that contributes to high rates of obesity (Sellayah et al., 2014).  Norman and colleagues (2018) further highlight that the evolutionary mismatch hypothesis applies to ADHD among other issues and make note of the implications of evolutionary mismatches for psychological science and public policy. Those implications include designing environments and interventions that better match evolved human psychology instead of working against it. The authors argue that understanding evolutionary mismatches can help researchers develop more effective policies to improve physical and mental health and address problems in modern society.

With this understanding that ADHD characteristics are not inherently flawed but rather mismatched with many aspects of modern environments, we can begin to explore the ways in which ADHD characteristics are related to traits and outcomes that are perceived. One such positive characteristic is creativity. Researchers have long noticed a link between ADHD traits and creative thinking, especially divergent thinking (e.g., White & Shah, 2006). Divergent thinking is the ability to come up with many different ideas or solutions to one open problem. This skill is different from convergent thinking, which means finding one correct answer through logical steps (Runco & Jaeger, 2012).

Several studies show that people with higher ADHD symptoms often score well on divergent thinking tasks. White and Shah (2006; 2011; 2016) found that adults with ADHD produced more ideas, more different types of ideas, and more original ideas than adults without ADHD. White and Shah (2006) used the Unusual Uses Task to test this, and also found ADHD adults scored worse on a task requiring one single correct answer. In their 2011 paper, the same authors found that ADHA adults also reported more real-world creative achievement, such as engaging in artistic pursuits or creative writing (White & Shah, 2011). In yet another followup, White and Shah (2016) further unpacked the relationship between ADHD and creativity by showing ADHD minds activate a wider, more flexible network of word associations, giving them more raw material for original ideas. This pattern suggests that while ADHD traits like distractibility and impulsivity cause problems in school or work settings, other ADHD traits might actually help people think in more flexible and open ways

However, the connection between ADHD and creativity is not simple and not all studies support a clear connection. Healey and Rucklidge (2006) tested children with and without ADHD using creativity tests and found no clear difference between the two groups. A more recent review of 31 studies by Hoogman and colleagues (2020)  also found mixed results. It reported that divergent thinking was linked to higher ADHD symptoms mainly in people who showed ADHD traits but did not have a clinical diagnosis. Among people who had an actual clinical diagnosis, the results were less consistent (Hoogman et al., 2020). This means that having a few ADHD-like traits might support creative thinking, but having a full, severe form of ADHD does not always lead to the same benefit.

Even with these mixed results, one finding appears fairly steady across studies: people with ADHD often show strong creative achievement in daily life. Creative achievement means real-world creative output, such as writing, art, music, invention, or new business ideas, rather than just scores on a lab test. Hoogman et al. (2020) noted that both people with a clinical ADHD diagnosis and people with subclinical ADHD traits reported higher levels of everyday creative achievement compared to people without these traits. This suggests that the ADHD mind may not always shine in a structured testing room, but it often shines in open, flexible, real-life situations where new ideas are needed.

Why would this happen? One possible answer connects back to the evolutionary mismatch idea. In ancestral environments, quick shifts in attention could have helped early humans notice new threats, spot unexpected food sources, or explore new territory (Hoogland & Ploeger, 2022). A mind that jumps between ideas, notices small details others miss, and feels drawn to new and different stimuli may have supported exploration and problem-solving in a world that was less structured and less repetitive than modern schools or offices. Today, this same style of thinking can look like a lack of focus in a classroom. But in an open, creative task, the same style of thinking can produce many new and useful ideas.

Mind wandering is another trait connected to this pattern. Mind wandering happens when a person’s thoughts drift away from the main task and move to unrelated ideas (Smallwood & Schooler, 2006). Mind wandering is common in ADHD (Seli et al., 2015). It is often seen as a weakness because it can reduce performance on repetitive or boring tasks (Mooneyham & Schooler, 2013). Yet some studies link mind wandering to stronger divergent thinking, since a wandering mind naturally makes new and unusual connections between ideas (Yamaoka et al., 2020). In other words, a trait that looks like poor focus in a mismatched environment can become an advantage in a creative environment that welcomes free thinking.

Together, these findings support the evolutionary mismatch view of ADHD. The same traits that cause trouble in a traditional classroom or a strict nine-to-five job, such as restlessness, quick shifts in attention, and a pull toward novelty, may also support flexible, original thinking. Instead of framing ADHD only as a set of deficits, researchers increasingly argue for a more balanced view. This view sees ADHD traits as tools that were shaped by an older environment and that still hold value today, especially in fields that reward new ideas rather than repetitive routine. This shift in framing does not deny real challenges that come with ADHD. It simply asks us to look at the full picture, including the strengths, rather than only the difficulties that appear in mismatched modern settings.

References

Abdelnour, E., Jansen, M. O., & Gold, J. A. (2022). ADHD diagnostic trends: Increased recognition or overdiagnosis?
 https://pubmed.ncbi.nlm.nih.gov/36337990/

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
 https://doi.org/10.1176/appi.books.9780890425787

Centers for Disease Control and Prevention. (2024). Data and statistics on ADHD.
 https://www.cdc.gov/adhd/data/index.html

Conrad, P., & Bergey, M. R. (2014). The impending globalization of ADHD.
 https://pubmed.ncbi.nlm.nih.gov/25441315/

Domingues-Montanari, S. (2017). Clinical and psychological effects of excessive screen time on children.
 https://onlinelibrary.wiley.com/doi/abs/10.1111/jpc.13462

Genné-Bacon, E. A. (2014). Thinking evolutionarily about obesity.
 https://pmc.ncbi.nlm.nih.gov/articles/PMC4031802

Healey, D., & Rucklidge, J. J. (2006). An exploration into the creative abilities of children with ADHD.
 https://doi.org/10.1207/s15326934crj1804_5

Hoogland, C., & Ploeger, A. (2022). ADHD and evolutionary mismatch: A critical appraisal.
 https://www.worldculturalpsychiatry.org/wp-content/uploads/2024/05/ADHD-and-evolutionary-mismatch.pdf

Hoogman, M., Stolte, M., Baas, M., & Kroesbergen, E. H. (2020). Creativity and ADHD: A review of behavioral studies, the effect of psychostimulants and neural underpinnings.
 https://pubmed.ncbi.nlm.nih.gov/33035524/

Kazda, L., Bell, K., Thomas, R., McGeechan, K., Sims, R., & Barratt, A. (2021). Overdiagnosis of attention-deficit/hyperactivity disorder in children and adolescents.
 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778451

Knouse, L. E., Mitchell, J. T., Brown, L. H., Silvia, P. J., Kane, M. J., Myin-Germeys, I., & Kwapil, T. R. (2008). The expression of adult ADHD symptoms in daily life.
 https://journals.sagepub.com/doi/10.1177/1087054707299411

Lange, K. W., Reichl, S., Lange, K. M., Tucha, L., & Tucha, O. (2010). The history of attention deficit hyperactivity disorder.
 https://link.springer.com/article/10.1007/s12402-010-0045-8

Li, N. P., van Vugt, M., & Colarelli, S. M. (2018). The evolutionary mismatch hypothesis: Implications for psychological science.
 https://journals.sagepub.com/doi/10.1177/0963721417731378

Lloyd, E. A., Wilson, D. S., & Sober, E. (2011). Evolutionary mismatch and what to do about it: A basic tutorial.
 https://www.evolution-institute.org/wp-content/uploads/2015/08/Mismatch-Sept-24-2011.pdf

Martin, A. F., Rubin, G. J., Rogers, M. B., Wessely, S., Greenberg, N., Hall, C. E., Pitt, A., Ellis Logan, P., Lucas, R., & Brooks, S. K. (2025). The changing prevalence of ADHD? A systematic review.
 https://www.sciencedirect.com/science/article/pii/S0165032725008638

Martinez-Badía, J., & Martinez-Raga, J. (2015). Who says this is a modern disorder? The early history of attention deficit hyperactivity disorder.
 https://pmc.ncbi.nlm.nih.gov/articles/PMC4694551/

Mooneyham, B. W., & Schooler, J. W. (2013). The costs and benefits of mind-wandering: A review.
 https://pubmed.ncbi.nlm.nih.gov/23458547/

Nikkelen, S. W. C., Valkenburg, P. M., Huizinga, M., & Bushman, B. J. (2014). Media use and ADHD-related behaviors in children and adolescents.
 https://pubmed.ncbi.nlm.nih.gov/24999762/

Pedersen, S. L., Kennedy, T. M., Joseph, H. M., Riston, S. J., Kipp, H. L., & Molina, B. S. G. (2020). Real-world changes in adolescents’ ADHD symptoms within the day and across school and non-school days.
 https://link.springer.com/article/10.1007/s10802-020-00695-8

Polanczyk, G., de Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007). The worldwide prevalence of ADHD: A systematic review and metaregression analysis.
 https://pubmed.ncbi.nlm.nih.gov/17541055/

Ra, C. K., Cho, J., Stone, M. D., De La Cerda, J., Goldenson, N. I., Moroney, E., Tung, I., Lee, S. S., & Leventhal, A. M. (2018). Association of digital media use with subsequent symptoms of attention-deficit/hyperactivity disorder among adolescents.
 https://pubmed.ncbi.nlm.nih.gov/30027248/

Runco, M. A., & Jaeger, G. J. (2012). The standard definition of creativity.
 https://doi.org/10.1080/10400419.2012.650092

Sayal, K., Prasad, V., Daley, D., Ford, T., & Coghill, D. (2018). ADHD in children and young people: Prevalence, care pathways, and service provision.
 https://pubmed.ncbi.nlm.nih.gov/29033005/

Seli, P., Smallwood, J., Cheyne, J. A., & Smilek, D. (2015). On the relation of mind wandering and ADHD symptomatology.
 https://doi.org/10.3758/s13423-014-0793-0

Smallwood, J., & Schooler, J. W. (2006). The restless mind.
 https://pubmed.ncbi.nlm.nih.gov/17073528/

Taylor, E. (2011). Antecedents of ADHD: A historical account of diagnostic concepts.
 https://pubmed.ncbi.nlm.nih.gov/21431827/

White, H. A., & Shah, P. (2006). Uninhibited imaginations: Creativity in adults with attention-deficit/hyperactivity disorder.
 https://www.sciencedirect.com/science/article/abs/pii/S0191886905003764

White, H. A., & Shah, P. (2011). Creative style and achievement in adults with attention-deficit/hyperactivity disorder.
 https://www.sciencedirect.com/science/article/abs/pii/S019188691000601X

White, H. A., & Shah, P. (2016). Scope of semantic activation and innovative thinking in college students with ADHD.
 https://www.tandfonline.com/doi/full/10.1080/10400419.2016.1195655

Willcutt, E. G., Nigg, J. T., Pennington, B. F., Solanto, M. V., Rohde, L. A., Tannock, R., Loo, S. K., Carlson, C. L., McBurnett, K., & Lahey, B. B. (2012). Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes.
 https://pubmed.ncbi.nlm.nih.gov/22612200/

Yamaoka, A., & Yukawa, S. (2020). Mind wandering in creative problem-solving: Relationships with divergent thinking and mental health.
https://doi.org/10.1371/journal.pone.0231946

---