Comment by JohnBooty

    but the fact that someone can focus just fine 
    when their environment is minimally structured 
    to keep distractions at a reasonable level would 
    suggest that person doesn’t have classic ADHD

    [...] 

    Patients with ADHD struggled everywhere, even in 
    distraction-free environments like a quiet library 
    or quiet test taking environment.

Imperfect analogy, but this is a bit like saying that somebody who is able to walk with reasonable assistive devices doesn't have a physical disability.

Like many or perhaps most things we classify as disorders, ADHD isn't a binary "you have it or you don't" condition.

Also, what constitutes "distractions at a reasonable level?" Very few jobs would meet my personal definition of that.

    declaring ADHD even when someone is operating 
    under a constant barrage of environmental distractions

The definition of "disorder" in an individual is always going to be somewhat relative to the society in which that person lives and that person's life.

A person who lightly dabbles in illicit substances once in a blue moon would not generally be considered to have a drug problem. However, this is also going to be relative to that person's circumstances. Are you a 23 year old with no responsibilities? Are you a breastfeeding mother? Are you in a profession with frequent random drug tests? Are you a shaman in a culture where psychedelics have been a sacred part of your culture for thousands of years? The definition of problematic drug use is going to be very different for some than others.

As our society changes, and the number of assaults on our focus multiply, I think it is reasonable to expect more ADHD diagnoses.

Another way to think about it is that modern (and future) society will expose ADHD more aggressively. A farmer in 1923 lived a hard and demanding life, but he faced a very different set of cognitive challenges than a software engineer in 2023.

Think about how changing society exposed some humans' susceptibility to motion sickness. Motion sickness was not a thing until we learned to ride animals and build vehicles. Perhaps someday the DSM may contain some disorders specific to humans living in colonies on other planets.

    I don’t know where we go from here, but I can say it’s 
    been an uphill battle to get recent mentoring cohorts 
    to accept that attention is something they can improve 
    with practice

A thousand times yes.

I love that we've made great strides toward destigmatizing mental health issues. But holy shit, it feels like younger people wear this shit as a badge of pride and it often feels like an excuse to avoid actual solutioning.

A loved one was recently diagnosed with ADHD. I told them I'll be their best friend and their toughest critic when it comes to ADHD. I told will love you and empathize with your struggles all day long because I have been fighting this shit for almost 50 years and it is soul-draining.

I also told them, watch the fuck out. I accept zero excuses. We can struggle together, we can cry together, but you better be looking at every single facet of your ADHD through the lens of figuring out a working solution.

"I have ADHD!" is not an acceptable excuse or thought-terminator. What I want to hear is, "I have ADHD so what works for me is doing it this way: ______" or perhaps even better yet just leave off the ADHD part and tell me your solution. Or that you are working on the solution. I will be by your side for that too. But overall that has got to be your mindset.