You can’t finish the report. You lose your train of thought every few minutes. Your mind feels scattered all day. That struggle is real, and I’m not questioning it. What I’m questioning is the explanation you’ve been given.

In part 2 of our ADHD series, my daughter Dominique and I dig into a major new UK review and what the research actually says about the label.

No blood test, no scan, no marker

In October, England published a 600-page independent review into ADHD, autism and mental health, led by psychologist Peter Fonagy. Open ADHD referrals in England passed 560,000 by the end of 2025, more than 17 times the number in 2019. The review states there’s no biological test for ADHD, yet it also describes ADHD as strongly genetic. Those two claims don’t sit together easily.

When the name becomes the cause

Psychiatrist Joanna Moncrieff explains it with a cough. If your doctor finds lung cancer, the cancer explains the cough. If your doctor says you have “coughing disorder,” that’s just the cough with a new name. Why can’t she finish her homework? Because she has ADHD. How do we know she has ADHD? Because she can’t finish her homework.

The brain scans were smaller news than the headlines suggested, too. The lead researcher on the large 2017 ENIGMA study later said the brain volumes of people with and without ADHD are almost identical. And a Harvard study found that August-born children, the youngest in their class, were about 30% more likely to be diagnosed.

Know what you’re taking

Stimulants sharpen attention in people with and without a diagnosis, a bit like coffee. If medication helps you, there’s no judgment. Just know the long-term research, like a Swedish study linking each extra year of use to about a 4% relative increase in heart disease risk. And never stop any medication suddenly. Work with your doctor.

Swap the label for a description

Finish this sentence: “I can’t ___ because I have ADHD.” Now take the label out and describe what’s happening. “I can’t finish reports because people keep pinging me while I work.” A description gives you something you can change.

Then, for seven days, write down where your attention held and where it slipped, plus what happened in the 20 minutes before. Did you sleep? Had you eaten? Did you just have a hard conversation? Was your phone in your hand? Most people find their attention holds under some conditions and slips under others.

Your mind was directing your attention long before anyone gave your struggle a name. It still is.