ADHD from the past to the future

ADHD from Past to Future

Attention Deficit Hyperactivity Disorder (ADHD) has become an increasingly recognized and widely discussed topic over the years. In this interview, we explored the individual and societal impacts of ADHD, changes in diagnostic and treatment processes, and awareness efforts through the experiences and research of Dr. Yankı Yazgan. We discussed the challenges faced by individuals with ADHD, how we can support their strengths, and the contributions of scientific developments to the field. We also evaluated the transformation in society’s perspective on ADHD.

This interview was featured in the podcast Kendime Rağmen, hosted by Clinical Psychologist Bedia Kalemzer Karaca. Dr. Yankı Yazgan and Assoc. Prof. Dr. Eylem Özten Özsoy participated as guests. The text is based on the fourth episode of the podcast’s second season.

Bedia Kalemzer KARACA: I'd like to begin with my first question. You have worked with children with ADHD for many years and have become one of the pioneering figures in this field in Turkey. The children you worked with back then are now adults. From the early years of your professional career to the present day, what changes have you observed in the awareness processes regarding Attention Deficit Hyperactivity Disorder in Turkey?

Yankı YAZGAN: I can say that I have observed major changes. We are talking about a period of over 30 years. When I reflect on my work in the field of child and adolescent psychiatry, many things have changed regarding ADHD over this time. One of the most significant transformations—and the one that has triggered many others—has been the improved understanding and wider recognition of the concept of ADHD. Over time, as more of our colleagues began to implement practices related to this condition, the concept became clearer and more comprehensive.

One of the most important outcomes is that, compared to individuals in the past who were unable to receive a diagnosis or access treatment, people with ADHD today have far better opportunities. Treatment options—whether medication, therapeutic approaches, or school and life accommodations—have become much more widespread and accessible than in previous years.

In the past, ADHD was seen more as an issue that needed to be addressed on an individual level. It was often associated with children who were inattentive, performed poorly in school, or were considered naughty. Today, however, it has evolved into a public mental health issue. ADHD is now understood to be a significant topic not only in terms of academic performance, but also in relation to quality of life, individual well-being, and social integration.

Of course, there are still challenges and gaps that we face; but when we look at the overall picture, the past 30 years have been a much better period for individuals with ADHD.

Bedia Kalemzer Karaca: What are your thoughts, Professor Eylem?

Eylem Özten Özsoy: Professor Yankı is far more experienced than I am in this field—he is a teacher to all of us. His observations are therefore extremely valuable. Today, we are seeing individuals in their thirties, forties, even fifties receiving an ADHD diagnosis for the first time. This shows how much awareness in the field has grown. When I first entered the field of psychiatry in 2006, adult ADHD was not a widely recognized condition. Even during my residency and early specialist years, there was only limited interest in this topic. So, there has truly been a major development.

Bedia Kalemzer Karaca: The role of schools and community mental health in this matter is also significant. Professor Yankı, as someone who frequently collaborates with teachers and institutions in the field of community mental health, what would you like to say on this topic?

Yankı Yazgan: Teachers play a key role in this process. We need them to directly observe what children are going through and to be sensitive to these issues. The school environment is one of the main settings where problems become visible. It can be seen as a stage or field where the “game” unfolds.

Parents may also be aware of many issues, but sometimes difficulties can be managed or compensated for at home, or they may simply go unnoticed. In such cases, the observational skills of teachers and school counselors make a significant difference. Strengthening training programs for professionals in this field and producing concrete information have led to better identification not only of ADHD but also of general mental health and neurodevelopmental issues in childhood and adolescence.

For instance, in a field study we conducted between 2004 and 2006 with my colleagues at Marmara University Faculty of Medicine—where we collected data from teachers and parents for nearly 4,000 children—we observed the following: parents and teachers often did not agree on whether a child had a problem. Sometimes, while parents believed there was an issue, teachers did not see it, or vice versa. Teachers might notice a difficulty that parents completely reject. In this study conducted in Kadıköy, we found that parents generally did not seek clinical help for children showing ADHD symptoms unless another mental health problem or behavioral disorder was also present. Particularly in larger classrooms and socially or economically disadvantaged areas, it was most often the teachers who noticed the problem.

However, this is data from 20 years ago. Even if there was awareness at the time, the resources to turn to were very limited. Over time, major changes occurred. The increase in the number of child psychiatrists, the growing interest of psychologists and school counselors in the topic, teachers witnessing the positive impact of treatment on children’s lives, and the rise in awareness of ADHD in adult psychiatry all significantly transformed the process.

In the 1990s, many people denied the existence of ADHD. Over time, with the emergence of scientific evidence in the field of neurodevelopmental disorders, they came to a different understanding. Some who initially rejected the condition later became pioneers in the field. But, as with any process of change, there were also some excesses. Criticisms emerged, such as “overdiagnosis” or “unnecessary medication treatments.”

However, epidemiological studies showed that a significant portion of individuals who should have received a diagnosis remained undiagnosed and untreated.

So, how does the perception of overdiagnosis and overtreatment arise? In wealthier districts of Istanbul, there may have been a tendency among some families to seek treatment prematurely for their children in borderline cases, in hopes of boosting academic performance. But looking at the bigger picture, many children who meet the criteria for an ADHD diagnosis do not receive counseling or treatment and cannot meet their basic learning and socialization needs.

In the past, due to low awareness among teachers and, to some extent, physicians, many children and adolescents missed out on treatment opportunities they could have benefited from. Families’ concerns about medication also played a role in this. Due to negative portrayals in the media, some parents rejected the treatment recommended by doctors. These same children returned years later as individuals who struggled in academic and social life and faced difficulties in identity development because they had not received treatment.

If we evaluate the last 30 years from the perspective of clinicians and individuals living with ADHD, the first 15 years focused on understanding ADHD, clarifying treatment options, and disseminating scientific data. The next 15 years have been about applying that knowledge and skill in practice. Across Turkey, services related to ADHD have expanded in public hospitals, and teacher awareness has increased. There has also been significant progress in the recognition of adult ADHD.

Bedia Kalemzer Karaca: What are your observations at this point, Professor Eylem?

Eylem Özten Özsoy: Professor Yankı has summarized it very well. When we look at clinical referrals, we often find that the diagnosis has never been recognized in individuals aged 35-40 and older. However, in cases in their 30s, we frequently see that they were evaluated during childhood but the treatment was rejected by the family. If the treatment recommended in childhood had been implemented, these individuals would likely have faced fewer difficulties in many areas, especially in terms of self-esteem, and they might have been able to navigate certain processes more easily without reaching the point they are at today. Therefore, we often encounter similar examples in the stories of individuals who are diagnosed with adult ADHD.

Yankı Yazgan: An important question arises here: Do individuals who receive ADHD treatment at a young age completely overcome this condition when they become adults?

No. ADHD is a lifelong condition. However, this does not mean that individuals will experience clinical problems at all times. It is not a disorder that continuously causes problems; rather, it is a process that manifests symptomatically depending on specific periods and conditions. It is important to make this distinction clearly.

One of the most comprehensive studies on individuals diagnosed with ADHD in childhood is the MTA (Multimodal Treatment Study of ADHD). This large study, which started in the 1990s and continued into the 2020s, follows children with ADHD, examines the effectiveness of treatments applied, and analyzes many variables that impact the condition. Similar to long-term follow-up studies conducted in fields like cardiology or oncology, this study serves as a cornerstone in establishing diagnosis and treatment standards in the field of ADHD.

Looking at the latest data from the MTA study, we see that about 10% of the children followed did not respond to treatment at all and continued to struggle. In contrast, another 10% had received good early treatment and experienced full remission, while 15% had partial remission, with only a few remaining symptoms causing some disruption. These individuals no longer had a relationship with ADHD. However, the largest group, about 60-65%, follows a pattern called "fluctuating course." These individuals experience ADHD symptoms periodically, depending on life events, environmental factors, and the presence or absence of other mental disorders, and require treatment during these periods. In between these phases, they are symptom-free, without ADHD.

So, does receiving treatment in childhood solve everything completely? No, it does not solve everything. However, it provides a gain that positively affects the future, which is somewhat related to whether the symptoms disappear or not, but also has an independent impact. Keeping ADHD symptoms under control during childhood and adolescence is crucial for preventing mental health complications that may arise in later years. 

Treatment supports the completion of education, helps the individual establish healthier relationships with themselves and others, and promotes more positive participation in social life, even if symptoms return in adulthood. Having healthier relationships with family ensures that the child receives the necessary support during their development and progresses through the later stages of life with meaningful connections.

In conclusion, early interventions do not completely eliminate ADHD symptoms throughout life, but they enable the individual to meet the developmental requirements specific to their age, improve their current and future quality of life with the gains they have made, and lead a more balanced life. Moreover, treatment is not solely about medication; addressing the child’s developmental needs, providing psychosocial support, positive contributions from parents and other adults, and adopting appropriate educational approaches are crucial parts of the process. Thus, individuals with ADHD can lead happy, comfortable, and successful lives, even if they are diagnosed.

Bedia Kalemzer Karaca: I would like to address a point here, Professor. You have already touched on the topic I wanted to ask you about. You mentioned the impact of early diagnosis on the lives of individuals in adulthood. We know that medication is the primary treatment method for ADHD, but there are many supporting factors as well: family, school, teachers, and perhaps psychotherapy support... What are your thoughts on this?

Yankı Yazgan: Let’s think about it this way… Childhood is a period that shapes many aspects of our lives. An important question here could be: How will today’s experiences be remembered in the future? School, classroom environment, experiences, relationships... Because we know that events and things said can be forgotten, but the emotions created by those situations will always remain.If ADHD is not properly addressed, it can disrupt development in many areas. However, this is not a situation that can be solved solely by medication; in many cases, it cannot be solved even without medication. There are several critical factors that have positively changed the lives of many people, both those who use medication and those who do not.

It is very important for a teacher or parent to truly understand the ADHD in their child and the child themselves. Beyond general theories or popular information, they need to find a clear answer to the question: "What kind of effect does ADHD have on my child’s life?" This awareness determines how the relationship with the child will be established, which emotional developmental needs need to be met, and which skills need to be prioritized.

Many children will remember adults who set clear boundaries, were honest, loving, and understanding years later. This could be a primary school teacher or a relative. But the ones who make the biggest difference are the parents who, instead of ignoring the child’s problems, courageously address them, provide support, and organize the support system.

The basic goal of all interventions related to ADHD—whether educational, psychological, or medical—is the same: To support the child’s development without shaking their belief in themselves and their trust in the world as they move forward. The method used to achieve this depends on the child's needs. Sometimes medication, sometimes psychotherapy, and sometimes family counseling may be more effective in improving the situation. 

Let’s note that these methods don’t fix the same things; for example, medication is the most effective tool for improving symptoms. In addition to this evidence-based approach, the improvement from medication can be transformed into therapeutic healing through a therapeutic relationship that heals psychological wounds. The role of families, schools, and individual support is crucial here.

Sometimes, just taking a private lesson can make a big difference in a child's process. This private lesson can be given by an older sibling who offers loving support or by a very skilled teacher in the field... The important thing is to establish a meaningful relationship in the child's life. Carrying the feeling of this relationship into the future creates a positive impact.In conclusion, meaningful relationships and proper support increase the quality of life for individuals diagnosed with ADHD, reduce the risks carried into the future, and help them undergo a healthier developmental process.

Bedia Kalemzer Karaca: What do you think, Eylem Hocam?

Eylem Özten Özsoy: What Yankı Hocam referred to as "the effects carried into the future" is so important... Because it is exactly at this point that we encounter the impacts carried into the future. Whether a diagnosis is made in childhood or whether treatment is received is certainly important, but the point I want to emphasize the most is a person’s belief in themselves. Self-esteem, confidence, whatever it’s called, the belief in oneself is one of the key factors that determine a person’s capacity to deal with challenges. However, we see significant damage at this point. In individuals who have never received a diagnosis, have not received support, or whose ADHD has been overlooked and left untreated, over time, this belief gets damaged. And when they approach us in adulthood, we often find that this is the area we need to work on the most. We encounter individuals who have lost their belief in their competence and their ability to succeed, and who have no energy left to fight. Moreover, this is not just a situation limited to ADHD; it can vary depending on whether other mental health conditions have developed over time. That’s why this issue is really important.

Yankı Yazgan: You’re describing a sense of fatigue here, aren’t you? I think the phrase “having no energy left” is a very insightful observation. ADHD, in essence, is a state of burnout... Because we know that not receiving treatment, not getting the necessary support, and even not naming the problem, having to hide it, leads to the individual wearing down and getting increasingly exhausted. There is an emotional cost to this. That’s why we often see more emotion-based behaviors like irritability, anger, intolerance, and impatience in individuals with ADHD. It directly affects their connections with the world, especially the closest relationships. Fatigue is a critical concept; individuals who have had to fight this battle alone for years experience not only physical but emotional burnout as well.

Eylem Özten Özsoy: Absolutely, Hocam, we see this very often. And over time, this situation can turn into helplessness and pessimism. The individual may fall into the belief that “no matter what I do, nothing will change.” In fact, this can evolve into what we call "learned helplessness." Whether depression is present or not, we encounter these kinds of thoughts frequently. That’s why, when you mentioned a child’s belief in themselves and the world earlier… We are trying to rebuild exactly that in adults. Because these individuals may have been labeled as "lazy" or "careless" for years for not fulfilling their responsibilities. 

Over time, this stigmatization leads the person to see themselves in the same way. Therefore, when an ADHD diagnosis is made, it’s important to provide information not only to the individual but also to their immediate environment, family, and spouse. Along with general psychoeducation, raising awareness about the effects on their life is crucial.

Yankı Yazgan: Absolutely. Here’s an important point: ADHD is not just an issue the individual experiences internally, it’s also a change that directly affects their interaction with their environment. Psychiatry, unlike other medical fields, cannot think of an individual independently of their social context. When evaluating ADHD symptoms, it’s necessary to also consider the psychological and social context in which the individual exists. This context, such as childhood experiences in school, adulthood in the workplace, and relationships with society in general, influences how symptoms manifest, and in turn, the symptoms also affect the context. For example, behaviors exhibited in traffic are one of the key areas of ADHD. 

Impatience, reacting suddenly, struggling to follow rules—these symptoms directly and immediately impact the individual's 'social' life in traffic. On a more micro level, one of the areas of interaction I find most important is close relationships. ADHD’s early signs often show up in difficulties in forming close relationships in childhood. Especially in the preschool period, the attachment processes between the ages of 0-6 shape our future social skills. 

The fundamental neurobiological factors that lead to ADHD also influence how the individual forms these relationships, which is why it’s a common mistake to view ADHD only as a behavioral issue related to academic or social adjustment. However, ADHD is not just a school issue; it directly affects child-parent relationships, sibling relationships, and even social interactions during preschool years. It shapes all relationships in the long term, creating a kind of social myopia. While these effects may be more pronounced in some individuals, in others, they can develop in a more insidious manner. 

Particularly in individuals with higher cognitive capacity, who receive family support, and who are socioeconomically advantaged, symptoms may generally be less severe. However, this doesn’t mean there is no problem. It simply means that the damage is not immediately noticeable, and it can take years to be identified. So how do we identify this early on? This is where schools come into play. Preschools, elementary school teachers, educators, and even professionals who may not be in the education field but are sensitive to human development—when they are aware of this issue, the early diagnosis process can proceed much more effectively. But this shouldn’t be interpreted as, “If childhood is over, it’s too late for everything!” No, that’s absolutely not true. We know this very well, right Eylem Hanım? I would love to hear your experiences on this topic.

Eylem Özten Özsoy: Absolutely, absolutely! Here, we can't talk about helplessness. Yes, early diagnosis and intervention would certainly be better, but that doesn’t mean there’s no solution if things are delayed. Professor, your definition of the "insidious course" is really spot on. We see this a lot in our clinical practice, and I encounter this concept frequently with patients who experience it firsthand. In individuals with high cognitive capacity, strong family support, a social circle that supports them, or those who have developed a sense of responsibility, ADHD can sometimes progress unnoticed for years. This is particularly true in individuals with obsessive personality traits. These individuals, even when the attention deficit is dominant, can continue their daily lives by putting in extra effort. However, this requires a tremendous amount of energy, and the person tolerates the situation by exerting extra effort for years. Therefore, this process, which we call "insidious course," actually manifests itself in other ways over time. They sometimes come to us with complaints of depression, sometimes with relationship problems, and sometimes due to difficulties in their work life. But the underlying issue can be ADHD. You mentioned earlier, "This is not a school problem." We also see very clearly in the clinic: This is not just an issue related to academics or work life. It’s a condition that affects all areas of life. Especially when it follows an insidious course, it can present itself through entirely different problems. That’s why early diagnosis and awareness are crucial.

Yankı Yazgan: Close relationships, especially... Because for many people, happiness is defined not by work or academic success, but by meaningful and strong relationships with close ones. These close ones could be romantic or sexual partners, but also friends and other groups we belong to. Being part of these groups, the presence or absence of situations where we feel valued, important, and worthy of love, directly affects the individual’s psychological well-being. ADHD comes into play here, making it more difficult for these relationships to develop or causing them to form outside of the individual's control. 

The issue of control is important here. For instance, you might be part of a group, but it may not be a group you truly want to be in. You could be a member of a gang, or be seen as an important figure in a community, but there could be a problem with whether this is truly what you want. This issue is more commonly encountered by individuals with ADHD. Because ADHD is a problem that causes a loss of control over life and makes it difficult to make choices "for ourselves." It starts with the insufficient development of self-control mechanisms, but over time, it leads to the individual losing control over life in general. It affects choices and, at some point, makes the individual feel powerless. 

Individuals with ADHD may find themselves in many areas of their life not as the person making the choices, but as someone caught up in the flow of life. Although it may seem like they are making decisions, they actually feel as though they are being dragged along. And we know that for psychological well-being, having autonomy over one’s life, a sense of control over it, is one of the fundamental pillars. You as therapists are more knowledgeable about these topics, but this loss of autonomy can eventually lead to the individual being dragged into a passive role. Of course, following someone or being part of a group is not inherently negative. But what’s important is whether this happens with our own will, as a conscious choice, or whether it happens involuntarily. 

For individuals with ADHD, the line between these two situations can become blurred over time. As individuals age, the effects of ADHD seem to lessen in terms of behavioral extremes, but in certain contexts, especially in the internal world, at the level of psychological well-being, it continues to manifest. It’s not always easy to make decisions by looking at behaviors in school or daily life. This is where the concept of "developmental sensitivity" comes into play. Developmental sensitivity is a factor that must be considered when evaluating an individual's symptoms according to their age and developmental stage. Age is a determining factor in understanding how ADHD symptoms manifest. For instance, a common mistake in childhood is commenting, "This child is sitting still, calm, doesn’t get distracted in front of the TV or computer for hours." However, the most important feature of ADHD is its contextual nature.

A behavior cannot always be observed in the same way everywhere. In fact, many medical conditions present symptoms contextually. For example, if you have a heart problem, you may not feel anything while walking on a flat road. But when you climb three flights of stairs, you may feel shortness of breath or chest pain. ADHD is similar. If your life is progressing along a straight path, you might not feel or experience any problem. However, we all know that life will eventually confront us with slopes. Some people have to walk a rough path from the beginning, while others experience these difficulties at certain points in their lives. And the societal conditions we are born into also become a determining factor.

Bedia Kalemzer Karaca: This reminds me, professor... Sometimes children don’t realize that the roads are uphill because their parents carry them on their backs.

Yankı Yazgan: You are absolutely right, very true.

Bedia Kalemzer Karaca: When individuals step into adult life and face romantic relationships and work life, they realize something: No one is here to carry me. I’m an adult now, and ADHD exists. Sometimes, when parents notice their children are struggling at school, they connect it with their own past by saying, "This is very similar to my childhood," and through this connection, they come to the diagnosis. This shows that ADHD is not just an individual issue; it's intertwined with family, society, and the environment. It affects many aspects of daily life.So, what role does the environment play in adulthood? Now, it's not just parents but also romantic relationships, friendships, and work life that become the determining factors in our lives. How can the environment communicate more healthily with someone with ADHD? Especially in work life, how can a team leader or manager work effectively with these individuals? What are your thoughts on this?

Yankı Yazgan: This topic contains important issues that could be discussed at length, and you’ve addressed many of them in your book. We can perhaps separate participation in workplaces and societal involvement into two categories:

On one side, there are informal relationships, driven more by personal bonds—close friendships, romantic relationships, family dynamics... These are not bound by any explicit contracts, nor are they directly regulated by laws and rules. On the other side, there is participation in workplaces, schools, and society in general, which is subject to specific protocols.

How can we ensure participation in workplaces and schools? If ADHD leads to skill loss as a neurodevelopmental disorder, it can sometimes be considered a disability. This, in turn, grants the individual certain legal rights. Let me give you a simple example: I’ve known someone since childhood who is currently completing their doctorate in law. They will take an exam in another country. A letter from the university’s psychological counseling and disability services department is sent to the jury. The letter says: “The 36-year-old X person, who will enter the jury, has been diagnosed with ADHD. They may become distracted or deviate from the topic while answering questions. Please remind them to return to the main topic when necessary.”What does this mean? If the individual’s ADHD diagnosis is documented, the jury cannot use deviations from the topic as a disadvantage. On the contrary, by considering their characteristics, they should guide the exam in a way that ensures it is conducted fairly, allowing the individual’s skills and knowledge to be evaluated justly. The same responsibility exists in workplaces. Of course, there can be discussions about potential abuse in the adjustments made for different disability groups. However, this does not prevent the recognition of rights. The real issue is how these rights are properly used and ensured. Individuals with ADHD can make significant contributions to their environment when proper accommodations are made. Their direct, clear, unfiltered, and sometimes what could be called "blunt" behavior can even help increase sincerity in group dynamics and contribute to creative solutions.

But there is a critical point here: Accommodations should not be made to offer individuals a privilege but to enable them to showcase their potential in the best possible way. The goal is not to create privilege, but to establish conditions where the individual can fully contribute to the team.

Bedia Kalemzer Karaca: You’re exactly talking about inclusivity.We’re discussing how inclusivity is ensured in the school environment during childhood—teachers, students, classmates, parents, even school staff... It’s a system that involves everyone. In the workplace, the situation is quite similar. Everyone there needs to be a part of the inclusivity process.

Yankı Yazgan: You’ve pointed out a very important issue. If we’re talking about a truly inclusive society, we must think about how we can help individuals with ADHD unlock their full potential while being with us. The way a team manager or leader—whatever their title is—approaches this will shape the process.

This is true not only for ADHD but for all disability groups. However, the fact that ADHD is an invisible disability, along with the individual’s reluctance to accept it as a disability or the concern about stigma, makes the situation even more complex. Unfortunately, the stigma anxiety surrounding neurodevelopmental and psychiatric conditions makes it difficult for individuals to be open about it.

Bedia Kalemzer Karaca: What is your perspective on this issue, Professor Eylem?

Eylem Özten Özsoy: What comes to mind, Bedia, is this…When we worked on the book together, we talked about the challenges that ADHD brings, but at one point, we also said: "If managed well, ADHD has many beautiful and strong aspects."People who are sincere, genuine, non-negotiable, open-spoken, and capable of developing creative perspectives… And we can extend the list even further. That’s why it’s important to not forget the strengths. But the key point here is: “If managed well.” This is something that needs to be emphasized.

Yankı Yazgan: Yes, yes. Because there’s a situation like this… ADHD, while bringing certain disadvantages, also “teaches” some negative habits.How does this happen? For instance, the inability to develop strategic thinking skills, like accounting, is not easy for people with ADHD. While this may seem like an advantage, in practice, it can create problems. They may end up in situations where someone says, "Doesn’t your ear hear what your mouth is saying?" 

Excessive honesty, speaking without thinking, and struggling to keep secrets are commonly observed situations. It brings a certain childlike charm, cuteness, and sincerity, but it can also make life difficult for both the individual and those around them. However, it’s important to make a clear distinction here. I don’t want to romanticize ADHD. Because the challenges faced aren’t just about those positive traits. We’re talking about the strengths that some individuals with ADHD possess, but this isn’t true for everyone. 

Many people face exclusion, rejection, humiliation, and even insults because of these traits. Additionally, it’s important not to ignore other complications caused by ADHD. For example, substance use and addiction problems are more common among individuals with ADHD. When combined with behavioral disorders, the risk of getting involved in minor or major crimes increases. For example, impulsivity may lead someone to act as a guarantor for another person, only to end up in debt. They may think they’re doing a good deed, but they act without considering, "Who is this for, is there a need, and what will the consequences be?" This could be called “emotional impulsivity.” They make hasty decisions with good intentions and strong emotions in the moment, moving forward without thinking enough. This is why accidents are so frequent in childhood. Just like someone who doesn’t realize how far they’ve drifted from the shore when swimming, people with ADHD sometimes make decisions in life that are hard to reverse.

That’s why, for individuals with ADHD, in addition to good treatment and proper therapies, it’s critical to have trustworthy people in their lives who can act as a "reality check" for them. This support system is sometimes provided by friends, sometimes by spouses. Individuals with ADHD can protect themselves from difficult situations by holding on to people in this role during different stages of their lives.

At this point, the role of schools is also very important. As you emphasized in the four-year project we carried out with Sabancı Foundation’s support at Sakıp Sabancı Anadolu Lisesi, schools create an environment that supports children and young people in building strong connections they can carry into the future. This is a great gain for everyone, not just for those with ADHD.

Especially for individuals with ADHD, being able to establish a strong network of relationships that they can rely on and see as a counseling board when necessary makes a huge difference. However, as we grow older, building such connections becomes more difficult. Because as people grow, establishing new, trust-based relationships becomes increasingly complex, doesn’t it?

Bedia Kalemzer Karaca: And in the end, the individual has to manage the entire process on their own. Without a framework, as we discussed earlier, moving forward without the support of a classroom environment or a structure to belong to becomes completely dependent on the person’s own traits and internal dynamics. Sometimes, missing emotional details can create a significant challenge for individuals. Professor Yankı, you have been conducting psychoeducational studies on ADHD for years, and I believe these efforts have greatly contributed to the wider reach of mental health in Turkey. Especially when it comes to ADHD, you and your colleagues have ensured that the concept is heard and that awareness has been raised.

As a final thought, what would you like to say about this? Perhaps to an adult with ADHD, or to a child or families… What would be the last message you’d like to share?

Yankı Yazgan: I've learned a lot from ADHD throughout my career. This shouldn't just be considered in the context of Turkey; the concept of ADHD has been studied worldwide for many years. Even though it wasn't formally named ADHD until recently, as early as the late 19th century, there was a great deal of thinking about the consequences of developmental delays in controlling behavioral and cognitive processes. Especially after the world wars, psychiatry became more widespread and established as a medical field, which also changed our perspective on ADHD. One of the most important advancements was the development of neurobiology, which helped us understand this condition better.

At this point, it’s important to emphasize: As scientific data on a condition increases, our understanding deepens. This signifies not only an academic shift but also a direct change that affects human life and society. ADHD is one of the most positive examples of this growth in knowledge. Looking at the changes in Turkey, if someone had told me 30 years ago that we’d be recording a podcast about ADHD, I would have considered it a very optimistic prediction. At the point we’ve reached today, seeing this optimism turn into reality brings me great joy professionally. Even more importantly, the fact that many people in our country are now asking themselves, "Do I have characteristics of ADHD?" and that adults, children, and young people are becoming more aware of it, is making a significant difference. I think this is encouraging for individuals who experience these challenges. 

The concept of ADHD should be evaluated not only for its difficulties but also for the strengths it brings to individuals’ lives. Moreover, the number of colleagues working in this field in Turkey has significantly increased. It is no longer a field of study led only by a few pioneers or opinion leaders; it has become a manageable process that almost everyone working in mental health is familiar with and can offer support for. Therefore, I would suggest keeping in mind that ADHD is often a situation in which positive scenarios are possible.

Bedia Kalemzer Karaca: Thank you, Professor. Eylem, is there anything you would like to add?

Eylem Özten Özsoy: ADHD, especially in adults, is an area where awareness has only recently increased, but it is rapidly developing. The work done since childhood and the awareness campaigns over the years have created a strong foundation for this issue. Professor Yankı, we thank you both for joining today’s program and for the contributions you've made to the field in general.

Bedia Kalemzer Karaca: Thank you, Professor Yankı, we really appreciate it.It was truly an enjoyable conversation. Hearing from one of the most knowledgeable experts about how ADHD has evolved from the past to the present was invaluable for us.We thank you again for your contributions and insights.