Agree mostly, but will recommend one consideration that was not obvious to me at first.

I agree that some cultures in some societies are today routinely testing human biological limits as you describe, down to the availability of neurotransmitters, what is required to sustain them at sufficient levels where they’re needed, and that it’s difficult to tell the difference between this and “actual” ADHD.

Consider however that the clinical guidelines for diagnosis depend largely on questions about how many and/or how often certain symptoms occur and, more importantly, whether they’ve become a problem for the patient (in school, at work, etc), and answers to these questions are greatly affected by whether the patient belongs to the cultures described above.

That is, the clinical boundaries are not so globally absolute, even though it’s a spectra we now recognize and can help with. Often a more flexible program or job would be the preferable prescription, but it’s an option available to few.

So these days the common complaint is that ADHD is overdiagnossd. While abuse exists, such as the online script mill in the news recently, the criticism is usually less helpful — since it implies misjudgment on the part of clinicians and parents attempting to help a child keep up, stigmatizes the ones who succeed, delays diagnosis for many others — but also is not precisely the intent. Instead they mean to question (rightly, as you did) society’s increasingly narrow definition of when someone’s best efforts are considered “enough.”