„ADHD and Autism Are More Prevalent in High-Migration Societies“ - Psychotherapist Olga Movchan on the Diagnoses of Our Time

Why are we seeing a steady rise in psychiatric diagnoses, and how did conditions like ADHD and autism become part of the cultural conversation? What roles do social media, migration, economic uncertainty, and parental overprotection play in shaping the mental health landscape today? And are people in less affluent societies really more resilient to anxiety than those in wealthy ones?

In an interview with Accent UK, psychotherapist, physician, lecturer and supervisor Olga Movchan - co-founder of the ‘Metamorphoses’ collective and a member of international professional associations EAGT, GPTI and UKCP - explores the real and perceived epidemic of mental disorders, the psychological vulnerability of migrants, the influence of social media, and how our understanding of mental health and pathology is being reshaped by global upheavals, information overload and cultural shifts. Movchan has lived and practised in London since 2020.

Over the past decade, there’s been a sharp increase in psychiatric diagnoses. Are we facing a real epidemic, or has diagnostic practice simply improved?

We’re seeing several things at once. On the one hand, there is a genuine rise in mental health conditions. Social pressure, the relentless pace of life — especially digital overload — as well as economic and political instability, all contribute to higher levels of anxiety, burnout and other emotional challenges. At the same time, diagnostic tools have improved, partly due to the sheer availability of information. People have become more self-aware and more willing to seek help, which means we’re now identifying conditions that might once have gone unnoticed. But there are two other important dynamics at play. First, destigmatisation: mental illness is no longer the taboo it was even twenty years ago. Today, recognising a mental health issue and asking for support is far more socially acceptable. Second, there’s a tendency to pathologise difficult - but normal - human experiences. For instance, grief after losing a loved one or the stress that comes with life changes are deeply painful, yet entirely natural. Increasingly, though, these are being mistaken for pathology. That doesn’t mean people shouldn’t seek support - of course they should, but it’s vital to remember that suffering, in itself, is not a disease.

In the UK, nearly 40% of people from vulnerable social groups — including drug users, the homeless, and victims of gender-based violence - are diagnosed with mental health disorders. How do commonly diagnosed conditions like depression, anxiety or ADHD relate to today’s socio-economic conditions?

It’s a two-way process: social groups tend to form around people who share common traits. For example, among the homeless or those struggling with addiction, the proportion of individuals with psycho-emotional disorders is initially higher than in the general population. But their vulnerability is significantly worsened by exposure to crisis conditions or the development of addiction. Many who become homeless, experience violence, or fall into addiction may develop or reveal psycho-emotional changes that might never have appeared had they lived in more stable circumstances. It’s important to note that although these groups are often lumped together as ‘disadvantaged,’ their problems differ, and so do the ways these problems manifest. Among victims of violence, for instance, you’re more likely to see symptoms related to trauma - fears, memory disturbances, outbursts of rage, and so forth. In contrast, among people with addiction, you’ll often find underlying issues that led to the addiction in the first place, as well as the additional complications that the addiction itself conceals. I would add one more risk group to your list: migrants, in the broadest sense. In societies with high levels of migration, such as the UK, ADHD and autism spectrum disorders are more frequently observed. Migrants tend to display stronger neurodivergent traits - possibly as part of an adaptive process, a way of coping with the overload of new information and the loss of their familiar status. In a new society, migrants who lack sufficient language skills and are unfamiliar with local customs, mentalities, and cultural codes may, even if mentally healthy, socially feel much like people on the autism spectrum. There may also be feedback loops at play, where a natural predisposition to neurodiversity becomes more pronounced. Finally, socio-economic instability undoubtedly affects mental health, especially for people in developed countries, particularly among recent generations. When familiar supports- stable jobs, a sense of security - crumble, people lose fixed points of reference. Those accustomed to care and paternalism often don’t cope. In such conditions, it’s more effective not to search for islands of stability, but to learn to balance like on a surfboard or skateboard. For many, especially children and young people, this is difficult. Many have grown up - I’m speaking mainly about Europe and the US - in environments characterised by what could be called ‘social cuddling’: children were protected, and continue to be shielded from harsh shocks (fights, bullying, physical punishment). On the one hand, this is clearly positive. On the other, it has produced generations far less resilient to stress. When global crises hit - wars, political and economic instability - these individuals find themselves particularly vulnerable.

Why do wealthier countries report more psychological diagnoses than poorer ones? Are people in poorer countries less triggered by uncertainty?

Yes, they tend to be less triggered by it. In poorer countries, there are fewer societal demands and more early socialisation to accept uncertainty, risks, effort, and the inevitability of failure. These societies place less emphasis on achievement and competition, which creates less pressure. On an individual level, this doesn’t always hold true - some people want to escape, emigrate, take their children away - and then stress levels rise. But overall, looking at society as a whole, that’s generally the case. It doesn’t mean they have fewer disorders for other reasons, but this kind of discomfort isn’t a trigger for them. Furthermore, diagnosis is poorer in disadvantaged countries because they have far fewer psychiatrists - about a hundred times fewer per capita. People seek help less often and tend to pay less attention to psychological distress, including that caused by mental disorders. Another key factor is the stigma around weakness, difference, and mental illness. In more traditional societies, people often hide their condition out of shame to avoid ostracism and bullying.

Nowadays neuroscientists are studying whether the rise in psychiatric diagnoses is linked to obsessive use of social media, fragmented attention, and multitasking online. How much do technology and social networks impact mental health and the emergence of new diagnoses?

On one hand, it’s a trap our brains fall into when the focus shifts towards seeking quick, short bursts of stimulation and immediate gratification. Social media and gadgets can become addictive; endless scrolling turns into a habit that distracts people from their feelings, locking them into a dopamine loop. Neuroscientists are studying this exact mechanism: once caught in this cycle, a person never reaches true satisfaction and constantly craves new stimuli. That’s the core of the scrolling phenomenon - people get stuck and struggle to break free. There has long been discussion around gadget addiction (which follows the same rules as other addictions) and gaming addiction. These dependencies often substitute real needs - people don’t have time to recognise their true desires and instead use games or constant internet use as an escape from feelings or unresolved problems.

New problems linked to gadgets have also been identified. For example, nomophobia - the fear of being without a mobile phone or away from it - is increasingly seen as a distinct disorder. Many people experience discomfort without their phones, checking them constantly and rarely turning them off, even at night. Estimates suggest that symptoms of nomophobia affect around 60% of the population. Although it’s not yet officially classified as a disease, it’s a serious issue. Other negative consequences include:

Digital dementia (especially caused by uncontrolled scrolling) — a decline in cognitive abilities;

Sleep disruption due to phone use before bed — blue light from screens suppresses melatonin production;

Computer vision syndrome — physical strain and problems with the eyes.

Alongside physical effects, there are psychological ones. Social media users create idealised versions of themselves online, which drives a desire to live up to unrealistic standards. Seeing others’ curated lives provokes envy and lowers self-esteem, especially among teenagers who often mistake these idealised portrayals for reality. Constant exposure to such distorted realities triggers anxiety and depression.

How does the perception of what is considered normal and pathological change over time? For example, homosexuality and hysteria were once classified as illnesses, but now they are not.

Homosexuality is indeed no longer regarded as a disease, whereas hysteria was, and still is, considered a psychopathological condition. In the International Classification of Diseases, hysteria is classified as a dissociative or conversion disorder. Gestalt therapists view psychological suffering as a form of adaptation to society - a voice through which a person tries to express their relationship with their environment. Psychotherapist Giovanni Salonia wrote that in the 19th century hysteria was the voice of those who had no voice in social reality. Women could not openly declare that their lives were unbearable or change their situation in a conventional way, so they expressed protest or tried to escape their hardships through illness. This was a creative form of adaptation, like any psychopathology. If someone claims there are no patients with hysteria nowadays, that is not true. There are still quite a few cases of hysterical disorders, with symptoms appearing equally in men and women, but their social meaning has changed. At its core, hysteria reflects a need to attract attention, to be noticed, while avoiding real relationships. Incidentally, social networks are perfect for this scenario: you can present yourself however you want, receive likes, and hardly engage in real interaction.

Returning to the question… Attitudes toward normality and pathology have indeed changed radically. Today, we regard pathology as something that either harms the individual or society. Traditionally, until the mid-20th century, any deviation from the norm was seen as harmful to society by default and easily labelled a disease. A striking example is homosexuality. Attitudes toward psychopathological phenomena have also evolved. Modern psychotherapists often avoid the word “diagnosis,” treating diagnosis as a merely auxiliary tool. Gestalt therapists, for instance, use the term “experience” (such as “a person with narcissistic, borderline, or hysterical experience”), highlighting the temporary nature of the state. Indeed, we see that this experience or mode of behaviour changes depending on who is on the other end of the line, whom the person interacts with. If the person does not feel discomfort, we do not try to treat them. Today, compulsory treatment is possible only through court decisions and in exceptional cases. Otherwise, help is offered only if the person seeks it or at least consents to it. Furthermore, many phenomena once considered abnormal or rare have become part of the modern norm. Take neurosis, for example - when a person finds it difficult to make a choice and sacrifices personal fulfillment to belong to a group or maintain relationships. This was once seen as pathological but has become so widespread it has turned into a kind of conditional norm. Finally, social policy in recent times has become much more rational - the question is increasingly framed not as “Right or wrong?” but as “Can it be fixed or not?” For example, with homosexuality: large-scale studies have found no connection with psychopathology and have shown that the proportion of heterosexuals and homosexuals in the population remains fairly stable across different eras and societies, regardless of social attitudes toward homosexuality. It is not a matter of upbringing - though the social context can play a role.

Why do some diagnoses become fashionable? For instance, in the 1990s it was vegetative-vascular dystonia; now it’s ADHD (although many reject it and consider it a variation of the norm) and autism spectrum disorders.

As for vegetative-vascular dystonia (or neurocirculatory dystonia), this is a product of the Soviet era - a diagnosis that never existed in the international classification of diseases - and a byproduct of punitive psychiatry. This term was used to encompass some hard-to-diagnose conditions: endocrine disorders, somatic illnesses, genetic pathologies, infections, as well as psycho-emotional disorders of varying severity, from neuroses to somatised depressions and schizophrenia. On one hand, it was a way to label difficult-to-diagnose illnesses. On the other, by the late 1980s, this diagnosis allowed people to avoid stigma, job loss, and other social consequences linked to more serious psychiatric diagnoses. Back then, such labels could severely damage a person’s life. Regarding ADHD and autism spectrum disorders (ASD), their prevalence is partly linked to attempts to adapt to overwhelming information overload. Of course, that’s not the whole story, but the constant stream of stimuli exacerbates symptoms in predisposed individuals, as they require more mental resources to cope. Another important factor is that such diagnoses were rarely given to adults in the past but are now routinely made, creating the impression that cases have increased. Migration also plays a role. As I mentioned before, immigrants often exhibit pseudo-atypicality - a condition mistakenly diagnosed as ADHD or ASD. I have several immigrant clients who unexpectedly received an ADHD diagnosis in their forties. Immigration brings immense strain: even with language proficiency, social interaction within groups is difficult, leading to isolation. The response to this pressure can mimic autism spectrum symptoms. Another factor is changing cultural trends. Whereas the ideal once was the flawless James Bond, today’s heroes include Inspector Morse (a talented professional with Asperger’s syndrome) and the new Sherlock Holmes, who has evolved from a pipe-smoking genius dabbling in opium (in Conan Doyle’s version) into a drug-dependent, struggling, hopelessly in love figure. Openly discussing vulnerabilities has become the norm; society no longer demands heroes to emulate, but heroes to identify with. Overall, the ability to acknowledge and present vulnerability is a positive trend, but it’s important to recognize the feedback loop. People still look up to role models, and society, in creating heroes, strives to resemble them.

Is it possible that the sharp rise in diagnoses of depression, anxiety, and ADHD is linked to the profit motives of private psychiatry and pharmaceutical companies?

There’s no doubt that medications are now more actively advertised and prescribed, but that isn’t the sole reason for the increase. The detection of these disorders has genuinely improved, so part of the rise is real. While commercial interests cannot be discounted, the medical industry has easier ways to make money - through tests like blood work, CT and MRI scans, or selling vitamins than pushing antidepressants.

Does the fact that celebrities become ambassadors for these conditions influence diagnosis? For example, Hollywood actors like Catherine Zeta-Jones and Johnny Depp have spoken openly about their ADHD diagnoses, Elon Musk has shared his autism spectrum diagnosis, and Greta Thunberg has talked about having Asperger’s syndrome.

This is largely a matter of destigmatisation: it has become normal to have such diagnoses, including depression. Overall, this is a positive process that offers hope. Having autism spectrum disorder doesn’t mean I can’t be successful. However, there are downsides. In particular, this can lead to the pathologisation of normal, though difficult, emotional experiences - grief is not depression, and going through a crisis is not a pathology. The ability to endure hardship and to distinguish truly painful symptoms from normal reactions to life’s challenges loses its value. There’s a temptation to claim illness - after all, even celebrities get sick, which almost becomes a kind of status symbol (somewhat reminiscent of the late antique fad for epilepsy, when it was considered a special mark from the gods).

How dangerous is the so-called diagnostic overshadowing, where physical illnesses in people with mental health disorders are overlooked?

This is an extremely serious problem. For example, seizures in a child with autism can be mistaken for zoning out or inattentiveness, especially if they are absences (brief epileptic episodes). Or if the child has stomach pain but cannot clearly explain what’s wrong, it may be interpreted as a behavioural issue. In people with depression, weakness might be attributed to their psychological state, when in fact the cause could be physical - anemia, the onset of a serious illness, or even cancer. Such symptoms are often masked in individuals with mental or psycho-emotional disorders and go undiagnosed. I have seen such patients - it really is a major problem. They have the right to treatment for any physical illness, but often they simply go unnoticed.

How do global crises - pandemics, wars, environmental disasters affect patterns of illness? „They inevitably change the picture, increasing vulnerability to anxiety, depression, and identity crises. Migration, digitalisation, the blurring of social boundaries - all these generate a background anxiety that gradually becomes part of life. During acute crises (wars, pandemics), trauma cannot yet be fully processed because we are still living through the events, so neurotic reactions tend to predominate. But there is another side: some people, confronted with cruelty - whether victims, perpetrators, or witnesses - exhibit reduced empathy and signs of psychopathy as a defence mechanism. This is a worrying trend, as society risks becoming more indifferent and cruel.

A recent UK study confirmed that children exposed to verbal abuse are more likely to have mental health problems. How widespread is this issue? Should national programmes introduce measures to hold parents accountable for shouting at children?

There are many serious negative consequences of verbal abuse, without doubt. However, tackling this issue is very complex and ambiguous. Physical violence is clear-cut: it is easy to recognise and forbidden. Verbal abuse is much harder to detect. You cannot simply ban it - not least because it leaves no physical marks; it often manifests not in shouting or swearing but in subtle speech patterns. Simply outlawing verbal abuse or including such a ban in national programmes could have many unintended consequences, from manipulation to exploitation. Attempts at formal bans risk undermining safe communication between parents and children. Abuse might transform into other, even harsher forms. For example, some families already go months without speaking at all. Or interactions might become purely formal: parents could fear that any word will be deemed abusive. It’s a very complex issue. It would be better to try to understand, on a social level, what is happening to these adults and why they struggle.

Around 4.5 million members of Generation Z want to quit their jobs due to worsening mental health. Why are anxiety levels and mental health issues reportedly 40% higher among young people compared to older generations?

I haven’t seen research that clearly confirms anxiety is 40% higher among young people than older generations. It’s possible that in the past people were less likely to seek psychological or psychiatric help because it wasn’t socially accepted or seen as normal. There are many factors at play. For instance, professional identity - it used to be an achievement to stay in one job from your twenties until retirement at fifty-five. Today, long-term employment has lost much of its value. Young people change jobs easily; half of the professions are now connected to the online world, skills are widely transferable, and moving to another company or even another country is almost seamless. If someone stays in one job for five years, employers might even start asking questions. You mentioned the age group of eighteen to twenty-four - this could include students or those without higher education. Students often change jobs since work isn’t their primary focus. Those without university education might be less resilient to hardships than those attending university, since universities tend to select young people who can demonstrate the capacity for sustained effort. Nowadays, many young people can afford not to work - thanks to benefits or parental support. Whereas at eighteen, many in previous generations were already starting families, today parents may support their children into their thirties or even forties while they ‘find themselves’. Modern youth are less inclined to endure discomfort, physical or psychological, partly because parenting styles now often protect children from hardship during their upbringing. They simply say, ‘No, this isn’t for me,’ and walk away - and society doesn’t judge them for it. Moreover, young people see the efforts of older generations being devalued. They watch parents lose what they spent years building and conclude: ‘Why bother?’ This also impacts their motivation.