Soldiers wait to board a chartered plane in Savannah, Ga., March 11, 2022.
Photo:
Stephen B. Morton/Associated Press
The military is making it easier for people with attention deficit hyperactivity disorder to join. This is a good development, though the rationale and the rules should be changed to reflect better the science of ADHD and to be more welcoming.
Pentagon officials explain that we can understand ADHD as a developmental condition that goes away in adulthood. But ADHD typically persists into adulthood. Officials also portray the loosening of rules about ADHD as necessary because of shortfalls in military recruiting, making the change seem like a watering down of standards to accommodate a disability. Yet while ADHD is a disability in some roles, in others it is a super-ability that can be advantageous in the military.
ADHD is best understood as a condition with sensory overstimulation and easy distractibility. People with ADHD describe it as similar to being in a store with 10 televisions tuned to different channels and being unable to turn down the sound on nine of them to pay attention to the one they want to hear. At a party, they have difficulty focusing on one conversation and ignoring others. The reason it seems to go away in adulthood is that many people with ADHD discover they can manage their symptoms with caffeine and exercise.
People with ADHD also find jobs in which their broad attention isn’t a problem, or is even an advantage. ADHD is perfect for hunters, allowing them to notice the slightest sound or movement in a forest and find the prey or avoid a predator. In modern society ADHD is common in jobs requiring abstract awareness of opportunity and danger, such as in venture capital and financial trading. ADHD is also frequent among people in high tech, not only audacious leaders but also software engineers.
But ADHD isn’t always advantageous. As society made the transition from hunting to other activities, some of the disadvantages became more important. Untreated ADHD can be a disability in agriculture, for which organizational skills and focus are central, and for driving, which requires filtering out many distractions.
A society in which 100% of people had ADHD would be chaotic, though it might be fine for a tribe engaged in hunting. But zero ADHD would also be bad: For a hunting tribe, it would result in starvation, and for an advanced society, it would mean a dearth of innovation and vigilance. We have what may be a happy medium. Some 10% of American children had been diagnosed with ADHD as of 2016-19, according to the Centers for Disease Control and Prevention.
The military should welcome recruits with ADHD because of a manpower shortage and because they have some of the skills most important to winning wars. As we’ve seen in Ukraine, using advanced technology in flexible ways is crucial to success, and many of those most fascinated with technology and adept at its use have ADHD. Many other roles in the military need other super-abilities found in people with ADHD, such as hunting skills.
The service branches already make stimulant drugs available to those with ADHD who have managed to join, allowing them to dial down their sensory overstimulation when needed for activities requiring more focus. The same practical attitude should be extended to those seeking to join the military.
The military’s decision to make it easier for people with ADHD to join is therefore important progress. Until now, recruits who had been diagnosed with ADHD typically needed a waiver, which added time and uncertainty to recruitment. Now no waiver is needed if no medication has been prescribed for 24 months. That helps, but only for those who have abstained from medication or concealed it despite the military’s new capacity for checking electronic records.
The current recruitment approach is still based on the assumptions that ADHD is always a disability and that it goes away in adulthood. Instead, the military should recognize that it needs some people with ADHD and that taking medication for it shouldn’t be a barrier to recruitment any more than it is a barrier to continued service. Recruitment should be based on the ability to function well in the military.
In the short run, the Pentagon can move in that direction by making waivers for recent or current use of ADHD medication easier to obtain. In the long run, it should eliminate restrictions on medication use and allow people with ADHD to be assessed by standards of performance in both recruitment and service.
The medical profession has contributed to the misunderstanding of ADHD by naming it a “disorder.” It would be better to call it a “condition” and recognize that it entails both disability and heightened ability. The Pentagon should welcome people with ADHD and direct them toward roles in which they enhance military effectiveness.
Dr. Segal is a neurologist and neuroscientist who works on ADHD.
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