It seems like every couple months, the ADHD community on twitter has another phase debating capitalism and ADHD. How many of our problems are caused by capitalism, and how many are just a medical condition that will never go away? This tends to end badly, with polarisation and over-simplification on all sides. But if we step away from that for a second, there are some things worth talking about. A lot of the things ADHDers experience aren't inherent to our condition, and our society could do a lot to make ADHD more livable. How can we make that happen, and what does it have to do with capitalism or disability activism?
Before we start, it should go without saying that ADHD is never going to just disappear as if by magic. And even if it could, capitalism isn't ending tomorrow. In the meantime a lot of us depend on medication and diagnosis to be able to pay bills and not end up homeless. Utopian thinking - acting like an "ideal world" is just around the corner - misses the point and means we forget to do anything about real problems here and now (*). The reason we talk about this stuff is that in order to get anything done, we need to understand the system we live under - and that system is capitalism.
What I want to ask is: what is the best way to improve our lives? How can we get better access to medication, support, and accommodations? Who do we work with to achieve that - just ADHDers, other disabled people, or something broader?
The starting point has to be figuring out why. Why is living with ADHD so difficult? Why do so many people struggle to get diagnosed and access medication? Why are people hurtful toward us? Why do so many of us struggle to hold down jobs and relationships? If it's just a result of mass ignorance and prejudice, then the answer is simple - we raise awareness and we educate and in the end the problem will fix itself. On the other hand, if we are kept in this position for the sake of a system of class exploitation (capitalism), then change is going to take a lot more than that. All the awareness-raising in the world will not convince the wealthy to give up their wealth. So we would need a different method to advocate for ourselves
While our issues are not all precisely the same, disabled people share a lot in common. We have to struggle to get accommodations at work, or to get understanding at home. Our access to support is threatened every time governments have another round of "austerity" (one reason waiting lists are so long!). Since we are stronger together, it makes sense for people with all kinds of disabilities to campaign as one group on these problems. For example, I'd encourage all ADHDers in the UK to join DPAC, if you want to get something done about wait times for a diagnosis.
The next question to ask is: what precisely is disability discrimination about in the first place? No human being can survive alone, we are social creatures and every one of us depends on mutual accommodations and support from our community. We've created a world full of adaptions to make life more bearable - pavements, roads, lighting, and so on. But in the world we live in, not all adaptations are created equal - some needs matter more than others. There are adaptations we expect to be provided. Some of them collectively (roads), some of them privately (stairs into your flat)
The difference between having the adaptations you need automatically, or not, is what it means to be marked as disabled. When the society we live in treats you as an exception, your needs become "disabilities". (This is called the Social Model of disability) No landlord would rent a flat with no stairs, and then say "if the tenant can't climb up the walls then that's their problem, not mine". But as soon as you need a wheelchair ramp, that is exactly their attitude!
If it wasn't for the activists before us, this would be much worse. Thanks to them we can get some accommodations by law. But that only works if you can get a diagnosis and know your rights in the first place.
Now, how does society decide what are "normal" needs, and what are disabilities? The particular society we live in here and now, is one where a few capitalists own and control almost everything. Pretty much every institution is set up to keep them wealthy - by exploiting the rest of us (working class people) for their profit. That's capitalism, and that's the system whose interests determine who counts as disabled.
It is a system that depends on dividing us up into neat, manageable units who are all as similar as possible. And it's on us to ensure we conform. So right there, you have the issue of numbers. If your needs are in a minority and too expensive to accommodate easily, you are now disabled under capitalism. With ADHD in particular, it's also about productivity. If we are late for work or go at a different pace, that means less profit for the rich. As a minority, it's often cheaper to just fire us than to make any kind of accommodation. Even better for them is masking: when we exhaust ourselves trying to fit into their standards.
Individual accommodations scare them, because they are perceived as disrupting the order and conformity that they have built up - order that is part of workforce discipline, and therefore profits. That may be why there are so many barriers to getting a diagnosis. Unless we have that hard-won slip of paper from a doctor, they can say any issues are OUR problem to adapt to, not theirs to accommodate.
This spills over into the world outside of work. Into the personal discrimination of microagressions and meanness. Because capitalism is the system we live under, we have internalised its values and made them our own. Just as they expect order at work, we judge people for having a disorganised and untidy home. Just as they expect us to be on time for work, we feel guilty about being late to meet our friends as well. Some psychiatrists estimate that by age 12 ADHDers get 20,000 more negative messages than other kids their age, leaving behind a lifetime of broken self-esteem This is the result of growing up under a system that only values our class for how the wealthy can exploit us.
Why is this important? Because if disability discrimination is an integral part of a system for making a few people very wealthy, then there is only so far we can go by "raising awareness" or asking nicely. Challenging individual attitudes is a loosing battle unless we address the root causes. Nor will it help, in the long run, to cosy up to our exploiters. That is just what the "ADHD is a superpower" and "ADHD is not a disability" discourse ends up doing. It tries to gain acceptance by telling the rich that we can be productive and we can conform, while throwing those who cannot mask well enough to do that under the bus. Giving businesses tips on how to use hyperfocus to exploit us more fiercely is not going to fix the problem. No, what is needed is activists prepared to be a bigger threat to their profit-margins than the accommodations we are asking for.
That's why the laws we have today came from direct action - in the UK we had campaigners chaining themselves to busses and blocking roads. That's how we got the Disability Discrimination Act. If we want to cut waiting times and get access to diagnosis, then we need to organise into groups that can take action and protest decision-makers into doing something about it.
Once we are organised, we need to make sure that our activism goes further than just winning surface-level changes. Access to medication is a great start, but many prescriptions are only enough to cover the working day - about 8 to 10 hours. Outside of our productivity, home and family life won't matter unless we demand it. Treatment should include good quality counselling and psychoeducation as well as meds. Diagnosis needs to be part of a free public service, not run by unaccountable corporations who put wealthier patients first. This needs to be accessible to everyone, including the most under-diagnosed, not just middle class white men who always come first under the present system. And that doesn't begin to address issues like incarceration.
A disproportionate number of ADHDers end up in prison. The explanation, if it is discussed at all, is "they are impulsive so they commit more crimes". But how many plead guilty to crimes they didn't commit, because of that impulsivity? How many had no choice but to shoplift, for lack of income? How many turned up late for court, and had the judge turn against them for that? The prison system is set up to maintain capitalist order and it seems to be punishing many ADHDers for not conforming to that order, rather than for doing any harm. This is the kind of thing we need to look into.
That sounds like hard work, but there is some very good news in all this - we are not alone. As disability discrimination is part of the system that exploits all working class people, other people have a reason to help us. We don't have to go cap in hand asking for charity - this is about solidarity, about doing what is in the best interests of all of us.
That's why, when we campaigned for better ADHD and Autism services where I live, the health workers' union Unison gave us their support. That's why lots of unions in the UK have groups for disabled members, and why some have committed to educate their members about disability. Asking people to join our campaigns is one way to challenge the stigma we face from abled people. It changes the narrative: we are no longer failures or weak people looking for a handout, but people who want to stand together with them in solidarity. Campaigns that create relationships based on solidarity challenge the idea that we exist just to be productive, that we are only valuable because we are exploitable. The communities we have online are a good beginning. By helping each other (mutual aid) we are already creating that kind of relationship. Now we need to take it further, into organising and action.
Our ADHD isn't going to disappear no matter what system we live under. But we can make things a lot better for ourselves, so long as we are willing to fight for it. If we go beyond raising awareness and put our work into systemic change, alongside other disabled people and working class activists in general - then we have a real hope of reducing the suffering and discrimination we face every day.
(*) - footnote: for the anticapitalists reading this, that does NOT mean we reject revolution in favour of reformism. It may not be clear from this article, which is a general call to action, but in brief: the difference between revolution and reform is not about utopia versus making small improvements, but the *means* we use to do so. Direct action and grassroots organising are revolutionary because they tend towards creating a total change in society, whereas reformism tends to reinforce the structures that already exist. The difference is the kind of social relationships that each creates. Does the action reinforce passivity and hierarchy? Or does it nurture empowerment and initiative? The latter is what defines revolutionary action (so even with a utopian goal, an action can still be reformist!) The important point is that revolutionary forms of action make the next action easier to do. They leave behind organisations of empowered people, whereas reformist action tends to be a dead end. Even if reformism succeeds, the next organising effort has to begin again from scratch. That's what we mean by reform and revolution. Suggested reading - Fighting for Ourselves (text, audio)
Image credit: from amenclinicsphotos ac, licensed under the Creative Commons Attribution-Share Alike 2.0 Generic license