It's especially bad for things which are defined by "at least n of these m things", including depression, addiction, and a ton of other psychological diagnoses. Are we getting any wiser from such definitions at all?
(But there's the issue of insurance, or rationing assistance more generally, which compels us to keep using these non-explaining diagnoses.)
However, when it comes to research, its because delineating the various causes of X is very very very hard and long research process.
Ideal for patients would be receiving the attention of a non-specialist who can be very broad in understanding what sequence of specialist attention is needed, when to pull the plug on that attention, and how to track the overall health and well being of a particular patient especially in regards to anything psychiatric. Virtually no MDs/GPs are going to do that.
But it's bad if we have to pretend we understand something better than we do for people to get the help they need.
No psychologist I've spoken to or read a book from has claimed to have a firm grasp on what ADHD is. They even admit the diagnosis is very much done "by feel", requiring as much history and cross-reference of family and friends' experiences to be certain.
The pathogenesis of ADHD isn't completely understood, but hard evidence of consistent anatomical, neuronal, and chemical differences is only increasing. There is something real happening without much doubt - the task now is to figure out what and why.
Maybe I'm misunderstanding you when you say social construct, though. I'm not sure if you mean "ADHD isn't real" or "It's a bucket we throw similar types of disorders into". If you mean the latter, I'd agree - I wouldn't be surprised if in 10-15 years we see that sub types can be distinctly identified in some way. I have no idea if at that point we'll need to overhaul these categorizations, but, I suspect we will at least understand the pathology better.
[1] https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...
The idea that ADHD is some abberant way of being that ought to be medicated into a teleological more ideal way of mental being is also, completely, a human construction - you can't get that conclusion just by looking at brain blood flow or anything like that.
I do agree about it not inherently being a problem that needs to be medicated. I personally only use meds when I need to be more “normal” and cut through the fog that daily life and tasks seems to generate for me. Sometimes I will develop a backlog of tasks and it’s helpful to cut through it.
I get the feeling that I was born in the wrong place at the wrong time, so to speak. It seems ADHD is present but much more tolerated in some cultures such that it doesn’t cause the person with ADHD as much stress or anxiety as they grow older. Like you suggest, these people are just people and though they’re different in some ways, it’s still within the bounds of normality.
It seems to be once you put ADHD brains into uncomfortable environments that it becomes problematic. Otherwise there is plenty of potential for it to be advantageous in many ways.
There is a staggering amount of progress and recovery to be made, or damage to be avoided, by diagnosing ADHD. I'm all for a wide net so long as people getting caught in it are treated properly on an individual basis.
One of the worse example is schizophrenia, which is attributed if you have at least two symptoms out of a list of five (meaning that people with totally distinct symptoms end up with the same diagnosis). There were genome-wide association studies in the 2010's that identified 7 or 8 distinct transcription factor networks with polymorphisms associated with a risk of schizophrenia. Every network is associated with the same symptoms.
In other words schizophrenia is likely at least 7 distinct diseases that are so orphaned they don't have a name.
Another example is eating disorders, where both bulimia and anorexia are probably underpinned by the same pathology that involves an auto-immune response following a cross-reaction to a bacterial protein that mimics a satiety hormone.
This is the case with I believe probably the majority of psychological illnesses that have not yet been nailed to a clear biological cause.
Schizophrenia definitely has a bunch of sub-types. As does anxiety. As does whatever is sociopathy/psychopathy. ADHD included.
Over time, individual types of each of these mental illnesses will be carved out from the general type and tied to specific biological causes, thus making the vague categories even smaller.