Rethinking A.D.H.D.: What We Might Be Missing
Learn how researchers have begun to challenge previous understandings of and treatments for the neurodevelopmental condition
For decades, we’ve understood A.D.H.D. as a clear-cut brain disorder — a “diabetes of the brain,” as one researcher famously put it — that requires medication to manage. But as Tough’s piece explores, some of the very scientists who helped establish that view are beginning to wonder whether it’s too narrow.
A Multifaceted Condition
Recent research suggests that there may not be a single biological marker or “switch” for A.D.H.D. Instead, symptoms appear along a continuum of behavior, biology, and environment. Factors like early stress, trauma, learning differences, or classroom expectations can all play a role in how attention and self-regulation develop.
A New Perspective on Treatment
The article doesn’t dismiss A.D.H.D. or deny the real challenges that those who have A.D.H.D.—or their families—face. Rather, it asks us to consider whether our treatment model has become too one-dimensional: whether medication, while often transformative, has been asked to carry too much of the weight.
Points of Conflict
As a therapist, I see this tension often: families wanting clarity, a label, a plan; clinicians wanting to help quickly; and a system that rewards efficiency over depth. But human minds are rarely that simple. Medication can absolutely help — sometimes profoundly — but it can’t replace relationship, structure, and understanding.
Final Thought
If we think of A.D.H.D. less as a fixed diagnosis and more as a reflection of how a child or adult’s nervous system interacts with their world, we open the door to richer questions:
What environments bring out this person’s strengths?
How can we reduce overstimulation or stress that amplifies symptoms?
How do identity, pressure, and expectations shape our attention?
Tough’s article doesn’t offer easy answers — and that’s exactly what makes it valuable. It challenges us to stay curious, to question certainty, and to remember that behavior is communication.