ADHD is a Neurological Reality: Not a Trend, Not a Choice

(And why one NYT article cracked things open - but didn’t tell the whole story)

So here's what happened:

I read this New York Times piece by Paul Tough about ADHD - and I shouted.

Out loud.

From my kitchen table.

Then I sat down.

Then I stood up again.

Because I needed to do something with the feeling that was making me want to crawl out of my skin.

It touched something real - something those of us in this space have been saying for years:

ADHD isn’t a character flaw. It’s not laziness. It’s not a choice.

It’s a brain trying to function in a world that was never built to hold it.

And when mainstream media finally says that out loud? That matters.

It means we’re one step closer to supporting those who support us - with a new understanding.

That matters.

But (you knew there was a “but”) - it didn’t tell the whole story.

And that’s why we need to talk.

Why This Article Got Everyone Talking

This is what everyone’s been talking about (and what my brain won’t stop ruminating on):

The piece pulled from decades of ADHD research - including the massive MTA study - and made a few big claims:

Yes, stimulant meds help with short-term behaviour. It is validating - but also incomplete. And for many in the clinical and lived-experience world, that incompleteness can feel dangerous.
No, meds don’t magically fix learning or lead to better long-term outcomes.
And the kids who seemed to “grow out of it”?

Their brains didn't change.

Their context did.

They found teachers who got it.

Work that clicked.

A life that finally made sense.

And their traits - the ones Tough kept calling ‘symptoms’ didn't disappear.

They just stopped needing to scream for help.

Because while the piece pointed to environment, it skipped over biology - and you can’t leave that out without leaving people behind.

For those of you newer to this space - you might notice I use the word traits instead of symptoms. That’s intentional.

In neurodivergent-affirming care, we don’t pathologize difference. We recognize that ADHD is a brain-based variation - not a disease to cure.

We use language that reflects that truth.

We work with brains, not against them.

I Felt Seen… and Also a little Sidelined

Because - yes - the article helped crack open a truth in mainstream media many of us in the ADHD community have been saying for years:

ADHD isn’t a lack of effort.

Paul Tough says - "It’s a mismatch. It’s about fit."

And I’m genuinely grateful that Tough brought that into a space as visible as The New York Times.

Visibility matters. But visibility without accuracy?

That’s where we run into trouble.

Some of the messaging felt...well...slippery.

It was as if by saying traits can shift with the right environment, it meant they weren’t neurological to begin with.

And honestly? I get it. Because there’s a difference between making space for environmental context and undermining ADHD’s neurological reality.

Experts like Dr. Russell Barkley and clinicians from ADDitude Magazine weren’t upset just because of language - they were calling out factual omissions, the use of old data and oversimplified conclusions that risk confusing the public and minimizing the seriousness of the condition.

That's a big deal for those of us live, breathe and just try to survive in this sphere.

And as someone who works in ADHD specialized functional nutrition and ADHD life coaching - I need to say this loud and clear:

ADHD is real.

It’s structural.

It’s chemical.

It's functional.

It’s lived.

And while environment absolutely shapes how ADHD traits present - that doesn’t mean the neurobiology disappears. It means we’re finally seeing what happens when a nervous system is supported instead of overloaded.

Yes, this environmental support helps - but it doesn’t erase the ongoing physiological needs of an ADHD nervous system.

So no, it’s not all about context.

And it’s definitely not just about behaviour.

We’re talking about dopamine signalling. Cortisol rhythms. Blood glucose sensitivity. Mitochondrial load. Nutrient absorption. Emotional regulation.

That’s not “trying harder.”

That's not character.

That's not moral integrity.

That's chemistry. That's physiology.

Period.

And when we oversimplify that - when we reduce ADHD to “just a mismatch” and ignore the body’s deeper needs - we risk pulling people away from the very support that helps them function.

Because I don’t just understand this work - I’ve walked it.

Every messy, misdiagnosed, misunderstood step of it.

Biology matters.

Acknowledging environment is crucial - but omitting biology isn’t nuance, it’s negligence.

Why I’m Not Sitting This One Out

Because watching the world debate our brains - without our voices - doesn’t sit right with me.

I wasn’t diagnosed until my mid-40s.

By then, I had spent over 25 years trying to "fix" myself.

Fix the energy crashes. The focus blackouts. The depression. The constant anxiety. The major postpartum depression after the birth of both of my lovely boys.

I tried to eat better. Sleep more. Get organized. I was doing everything “right” - and still couldn’t hold it together.

Before my ADHD diagnosis, I’d already collected a stack of other labels: Generalized Anxiety Disorder. Major Depressive Disorder. Borderline Personality Disorder (don’t even get me started on this last one - that label alone has done more harm than any sort of good).

I was told I was “medication-resistant.”

But really? I wasn’t resistant. The medications didn’t help because they weren’t treating the right thing.

They missed the ADHD. My whole life.

And when ADHD is misread, masked, or missed entirely - especially in women and girls - the fallout can be devastating.

The interventions I was pushed toward weren’t just ineffective.

They were traumatic.

And that story? I will tell it. Just not here.

Because what I went through in the name of “care”?

Should never happen to anyone.

Misdiagnosis isn’t just a clerical error.

It shapes the path you’re offered, the treatments you’re given and the trauma you carry when the system gets it wrong. On top of the trauma of living with undiagnosed ADHD to begin with.

But for now, just know:

If someone stamps “medication-resistant” on your chart without asking the bigger questions?

Run.

When I finally got my ADHD diagnosis (which was a whole battle of its own), I just sat there like…

Oh. OH. Yes. And thank you for finally hearing me. (That was a serious understatement if there ever was one).

It was like exhaling for the first time in decades.

I gave myself permission to stop fighting who I was - and start getting curious about who I actually am.

Suddenly, I wasn’t broken. I was just unrecognized. Unsupported.

Just running the so-called "wrong" operating system for the world I was trying to function in.

ADHD meds helped. A lot.

They didn’t change who I was - they helped me access who I already was, underneath the fog.

They made regulation possible.

They gave me the space to parent, to partner, to be - without constantly bracing.

They didn’t and still don't make me perfect.

But they help me feel more like me. The me I'm finally able to get to know.

And I’m not alone.

We now have clear data showing that stimulant medication reduces risks of overdose, car accidents, incarceration and even premature death.

That’s not a small deal. That’s life-changing. For some, it’s life-saving.

But meds aren't the whole story. Not even close.

Meds don’t build skills.
They don’t help you plan a week.
They don’t explain why you’re losing your keys or why mornings feel like chaos.
And, they definitely don’t help your nervous system feel safe enough to stay regulated through a full school day or workday.

Medication can open the door - but it’s everything else that builds the house.

Movement

Nutrition.

Hydration.

Sleep.

Nervous system safety.

Structure & routine that meets your brain where it’s at.

That’s what turns coping into capacity.

This is the Truth We Need Loudest Right Now

ADHD isn’t a tragedy - but it also isn’t a trend.

It’s not a life sentence - but it does require support.

It doesn’t mean you’re broken - but it also doesn’t mean you can go it alone.

And honestly? The people I know with ADHD - we’re not just surviving.

We’re thriving in spite of everything.

In spite of school systems that shamed us.
In spite of doctors who missed us - or misunderstood us.
In spite of a world that kept asking, “Isn’t everyone a little ADHD?”

(Seriously - stop saying that. I’ve got a 45-minute monologue locked and loaded - full of feelings, science and fury - just ask my lovely husband.)

We’ve done brilliantly with brains that were misunderstood from the start.

That’s not dysfunction.

That’s resilience.

That’s misread brilliance.

And here’s what else is true:

We haven’t done it alone.

There is no community more generous, more fiercely supportive or more deeply resourced than this ADHD community.

We lean on each other.

We share what’s worked, what hasn’t and what we’ve learned the hard way.

We’ve learned to honour how we’re built - and help others do the same.

We’ve built something powerful here. And it deserves to shape the narrative.

This isn’t just about getting louder voices into the conversation.

It’s about getting accurate ones.

We need to uplift the science, lived experience and holistic care - not cherry-picked headlines that oversimplify a lifelong neurodevelopmental difference.

So What Now?

We don’t throw out the science.

We don’t reject the nuance.

We build systems - homes, schools, workspaces - that finally fit.

We support ADHD brains like they were worth supporting all along.

Because they are.

And if you’ve felt broken this whole time?

Let me say it again - you’re not.

Because science and lived experience aren’t at odds - they’re teammates.

And when we put them together, we finally give ADHD the care it deserves.

Maybe you just haven’t found your team yet.

Let’s change that.

Curious about nutrition for your family?

If you’re looking for support with your family’s health goals regarding mental health, ADHD or fostering a healthy relationship with food, feel free to book in a FREE assessment call so we can chat to see if Holistic Nutrition is a good fit for your family!

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Amy Jones

BA Hons, BEd, OCT, RHN, CNE

Care-Informed & Health At Every Size® Registered Holistic Nutritionist

Ontario Certified Teacher

Certified ADHD Coach Candidate (iACT)

Canadian School Of Natural Nutrition Instructor

Metabolic Balance® Coach