A reader wraps up the popular thread:
It’s remarkable how to me how much of the ADHD discussion has focused on people who seem to have been, even before diagnosis and medication, abnormally high achievers: elite college graduates, law school graduates, medical students. Recall that only about a third of this country attains the level of a bachelor’s degree. I think a large part of people’s knee-jerk skepticism about ADHD stems from the fact that, at least anecdotally, this condition seems to disproportionately afflict people at or near the top of the income/education distribution. I don’t doubt the sincerity of your readers who describe what a life-changing experience it was to start taking amphetamines, and I’m sure their diagnoses have allowed them to thrive in the rarefied ranks of fast-paced, high-pressure fields like law and medicine. But it’s the preponderance of ADHD cases among exactly those kinds of people that causes the suspicious looks from the pharmacists and the eye rolls from people like me.
Is it not worth considering the possibility that the pressures and expectations of modern-day elite occupations are, for lack of a better word, insane? That the person who can simultaneously excel and be happy under the typical demands of, say, a medical resident or first-year law associate is a very rare psychological outlier? My sense is that the strong feelings some people have about the (over)diagnosis of ADHD has to do with the fear that we’re trying to medicate our way out of an existential crisis: most people were simply not designed to thrive under the conditions that society holds up as the very height of achievement.