The ADHD Advantage

The ADHD Advantage: What You Thought Was a Diagnosis May Be Your Greatest Strength came out in the summer of 2015 in Penguin's Hudson Street Press edition. Publisher records give August 2015, and the e-book record is dated July 28, 2015. The hardcover edition runs to 288 pages, and the paperback edition published by Avery in 2016 to 304 pages. Some library catalog records say 280 pages, because the page count changes from edition to edition.

I could not find a verified Turkish edition; I am writing it under its original title.

In writing this review I relied on the book's table of contents, the publisher's description, the Publishers Weekly review and summaries that relay the book's arguments. Since I have not seen every page of the book, I will describe not the inside of the chapters but what the chapters promise, and as much as I could verify. I say this at the start so that it is clear everywhere where each sentence comes from.

Who the author is

Dale Archer is a psychiatrist working in Lake Charles, Louisiana. He studied philosophy at Tulane University and also earned his medical degree there. He serves as medical director of psychiatric services at Lake Charles Memorial Hospital and is counted among the distinguished fellows of the American Psychiatric Association. According to the publisher's description, he has appeared on more than eight hundred television programs. In other words, this is the book of a clinician known through the media rather than of a researcher in the field.

His previous book, Better Than Normal, published in 2013, made the bestseller list and, as its subtitle says, works through the thesis of "how what makes you different can make you exceptional." The ADHD Advantage is that thesis applied to ADHD. According to one review, he noticed his own ADHD while researching Better Than Normal. He also says himself in the promotional text that he has never taken medication to this day. I keep this in mind, because when I read the book's medication advice, this fact stands behind the author's voice.

The starting idea

The book's thesis is in the subtitle: what you thought was a diagnosis may be your greatest strength. The publisher explains this as the claim that some of the most successful entrepreneurs, leaders and artists reached the top not despite ADHD but because of it. Traits such as curiosity, adventurousness, calculated risk-taking and resilience are said to be part of ADHD, and it is said that they can be put to use without medication, too.

Allen Frances, who wrote the book's foreword, was the chair of the DSM-IV task force. In the foreword he warns that in trying to suppress ADHD with medication, the talents that come with it may be suppressed as well. Frances's concerns about overdiagnosis are well known. Having his name on the cover turns the book from a single personal opinion into one side of a debate.

This framing is not new, but in 2015 it was presented as a fresh move: describing ADHD as a temperament to be managed rather than a problem to be treated. I took up the same subject from my own angle on the site in the piece on the question of strengths. Where I arrived there is different from where this book arrives.

Part one: exploding the myth

In Open Library's table of contents record, the book is divided into three parts and the introduction is titled "Why ADHD can be your greatest strength." Part one carries the title "Exploding the myth" and has seven chapters.

The first chapter is "Born This Way." The title says that ADHD is an inborn trait, and this is in line with mainstream science. The second is "A Diagnosis of Boredom": the claim that boredom turns into a diagnosis. I read this as the entry point to the book's critique of overdiagnosis. According to what summary sites relay, Archer says that some diagnoses may be wrong, and he stresses that the diagnostic criteria rest on a measured list and that adults interpret children's behavior.

Then come two medication chapters: "Medications for ADHD" and "Pop-a-pill culture." Publishers Weekly writes that the book's most controversial material is in part one, and that Archer's "skills, not pills" approach, which advises people with ADHD and those who care for them to avoid medication, sits there. I will come back to this advice separately below.

"You Are Not (Necessarily) What You Eat" must be looking at the relationship between nutrition and ADHD. I could not see the content of the chapter "The Explorer Gene." In popular writing, the nickname "explorer gene" is usually pinned on the 7R variant of the DRD4 gene. The study by Eisenberg and colleagues in 2008 among the Ariaal community in Kenya is one of the best-known pillars of this debate. But that study measures body composition, not ADHD. I could not verify whether the book's chapter rests on this study, so I do not say that it does. The scientific basis of such "explorer" narratives is disputed.

The part closes with "Learning with ADHD." Since its subject is the school experience, parents and students will look here most.

Part two: an inventory of strengths

This part, titled "Discovering your strengths," is the heart of the book. The chapters: "Resilience," "Bingo Brain," "Juggling Act," "Cool in a Crisis" and "Your Antidote to Boredom." In plain terms: resilience, the bingo brain, juggling, keeping cool in a crisis and the antidote to boredom.

As far as I can tell from the titles, each chapter turns a trait into a positive name: jumping attention, taking on many tasks at once, working well under pressure. These have a counterpart in everyday life; the state of working well in a crisis appears in the glossary as crisis performance. According to summary sites, Archer invites the reader to list their symptoms and think about the situations in which each of them could be useful. I do not find this a bad exercise. It resembles what I did when making my own list, but my list had a third column: the place where the same trait cost me dearly.

Part three: success

The "Finding success" part consists of chapters on the entrepreneur, the athlete, relationships and job fit: "The Entrepreneur's Superpower," "In the Zone: The ADHD Athlete," "Relationships: Life of the Party," "Find Your Fit" and, at the close, "In Their Own Words." The last chapter, as far as its name suggests, gives room to people with ADHD telling their own stories.

There is a real literature behind the entrepreneurship chapter. One of the blurbs on the book's back cover was written by the entrepreneurship professor Johan Wiklund. The 2016 qualitative study by Wiklund and colleagues is based on interviews with fourteen entrepreneurs with ADHD, and its findings are limited. A more recent meta-analysis combined 47 studies and found that hyperactivity and impulsivity are positively associated with entrepreneurial behavior, while inattention is negatively associated with outcomes after the business is founded. I described this detail in the piece being an entrepreneur with ADHD. To me this finding shows the book's strongest point of defense and its weakest point at the same time: starting a business and running a business are not the same thing, and the word "superpower" covers up the second part.

The title of the "Find Your Fit" chapter was the one that gave me the most confidence. Because when it is set up correctly, it ties the whole debate to the environment. The question of which job suits whom is, to me, the most fruitful place in the debate.

Its strongest sides

The book puts something up against shame. For someone who has been diagnosed and called "lazy" for years, giving their own traits a positive name for the first time can be a great relief. The qualitative study by Sedgwick and colleagues with successful adults shows that these people often report traits such as curiosity, crisis performance and perseverance. What Archer is looking for has real ground.

Its second good side is that it gives the reader a job to do: list your traits and choose your environment accordingly. The third is the tone. Instead of saying "you can't," the author asks "what can you do," and this is a warmth missing from most ADHD books.

Its weak sides and the problem of evidence

First, the frame itself. The word "advantage" overshadows the fact that the diagnosis rests on loss of function. For a diagnosis to be made, the symptoms have to disrupt life. Conclusions drawn from interviews with successful people and from famous examples cannot separate how much of those people's success came because of ADHD and how much came despite it. Looking at the survivors and deriving a general rule is a classic selection bias. On a summary site, Richard Branson comes up as an example. Branson's success is an anecdote, not evidence.

The second problem is the medication advice. This is where Publishers Weekly's main objection lies. According to summary sites, Archer says that as many as one in six diagnoses may be wrong, that is, 1.1 million of 6.4 million diagnoses. I could not see the basis of this estimate. That medications can be addictive and can affect growth in children is also relayed among the book's objections. I examined these two subjects separately on the site. The answer to the addiction question is in the piece are ADHD medications addictive. With use under a physician's supervision, the picture is much calmer than the line relayed from the book.

The World Federation of ADHD consensus statement (Faraone et al., 2021) says that untreated ADHD is associated with measurable negative outcomes in education, work and health. The same statement counts medications among the treatments with the most solid evidence. The "skills, not pills" pairing is also a false dichotomy: as I described in the piece medication or therapy, these two methods aim at different problems. Archer's own experience without medication is one person's experience. That experience cannot be a rule for others.

Who it is for, and who it is not for

For someone in the period of shame and "what is wrong with me" after a diagnosis, this book can offer a point of view. If I were reading it, I would not let go of two questions: in what environment does this trait work, and who pays the price for it.

For someone trying to make a decision about medication, who is afraid of medication or confused, this book should not be the only source. The book's anti-medication line, if read without talking to a physician, can push the decision in the wrong direction. The medication decision is made with a physician.

Adults who are thinking of starting their own business, or who feel lacking because they keep changing jobs, may also find something in the book. To me the most fruitful way to use it is to ask a single question of every chapter while reading: under what condition does this trait work for me, and under which does it not. Looking for the answer in your own journal rather than in the book gives a more honest result.

A person who expects a treatment plan from the book will be disappointed. The table of contents proposes a change of perspective more than it offers a plan.

A careful word for parents, too: if your child has a real loss of function, the "find the advantage" approach can delay support.

Its place on the shelf

It helps to think of this book together with three others on the same shelf. ADHD 2.0 comes from the same warm vein that brings out the opportunities. It was written in 2021, and there too the level of evidence behind the "new science" label had to be weighed separately. ADHD Nation and The ADHD Explosion, on the other hand, take up Archer's concern about overdiagnosis at the level of journalism and research, with a different anger or a different balance. Putting the three side by side, what Archer's book does becomes clearer: it stands at one end of the debate.

One of the five patterns I described in the site's piece on choosing books is the superpower narrative, and this book is the example that fits it most directly. I am not saying it is a bad book, but to me it should be read with that pattern in mind.

Final word

There is one question Archer asks well: in what environment does a person with ADHD work well. What he gets wrong is tying that question to the medication debate and making the diagnosis lighter, like a label. I would open the book for its chapters on choosing an environment, and I would leave its medication chapters on a physician's desk.