Modernity is kind of nuts. The pace, the stress, the demands, the separation, the isolation, the loneliness, the hours, the lack of sleep, the quality of food and the financial pressure all enter the life in which ADHD is being experienced. The world can be goddamn hard. We cannot understand a person's functioning while treating the conditions they live in as incidental background.
When I say that ADHD is not a disorder in and of itself, I am asking us to examine the meeting between a particular pattern of traits and a particular way of life. Where does that meeting become disabling? What is the person being asked to do, under what circumstances and with what support? Their difficulty becomes clearer when we look at the demands, the available resources and the experience of trying to participate.
Consider a working day built around sitting still, managing administration, answering repeated messages and returning to an interrupted task. It asks the person to keep an intention active, remember where they were, resist competing demands and re-enter an activity whose purpose may feel distant. Another working day may involve practical problems, movement, changing situations and visible results. A person can experience these settings very differently. Research into adult working life describes how strongly interest and occupational context can shape that experience.
These differences have practical consequences. If someone works well in an urgent situation and repeatedly struggles with routine follow-through, we need to understand both activities. What gives urgency its grip: a clear priority, another person's involvement, immediate consequences or a task with an obvious ending? Which of those conditions could be provided earlier? What organisational demand remains difficult even when the person is engaged? This kind of enquiry turns a familiar complaint into something we can work on.
We also have to examine the body carrying the demand. The person may have slept poorly, missed lunch, remained indoors all day and used caffeine to continue. They may reach home with little energy for the tasks that have accumulated. Hunger, fatigue, stress and sensory overload enter the next beginning. A plan that assumes a fresh, well-fed, rested person may repeatedly fail because it bears little relationship to the actual hour in which it is supposed to happen.
The wider systems around that hour matter too. Transport can consume time that might otherwise allow walking, cooking or sleep. Housing cost can leave little choice over noise, space or working hours. Artificial light and continuous access to content can stretch activity late into the night. A neighbourhood may offer few convenient opportunities for movement or ordinary contact with others. We need to ask how these conditions operate in the person's life, and what room there is to change them.
Isolation is especially important. Many changes are easier when daily life includes another person, practical help and a sense of belonging. A person living alone may carry every decision, reminder and household task themselves. Someone who has been repeatedly criticised may also avoid asking for the help they need. Support can therefore change both the demands of the activity and the meaning of trying it. An OT or therapist can help establish a place to begin without turning difficulty into another personal judgement.
This is easy on paper and a different ball game in practice. Knowing that sleep, movement and food matter does not create the time, money, planning and confidence required to change them. We have to bring implementation into the clinical work. Which meal can actually be available? Where will movement fit? What happens at bedtime? What makes the reminder easy to miss? The plan needs to meet those conditions closely enough that the next action is possible.
Understanding causes and conditions gives us a way to take ownership without feeling personally bad. We can acknowledge that a habit is costing something, examine what maintains it and decide what we will do next. Some work involves our own repeated actions. Some involves asking for support, negotiating an accommodation or changing a demand. Ownership becomes concrete when we identify a place to act and arrange the conditions that allow the action to be repeated.
The SEEDS model helps hold these relationships in view. Start with a particular difficult moment: avoiding paperwork after work, scrolling through dinner or being unable to stop a project at night. Look at what happened before it, what is happening in the body, what the activity asks and what the surrounding systems provide. Also ask what already helps. A clearer first step, a meal, company, less interruption or a realistic stopping point may each change part of the pattern.
I want care to include changes in circumstances and systems, together with support for attention, planning and emotional experience. A diagnosis can help explain the pattern; the person's daily life shows us how it is being expressed. We can start where they are, build confidence through workable actions and make room for abilities that have been obscured by constant struggle. The person and the conditions belong in the same clinical view.
The evidence behind the article
Research notes and references
The argument that traits become disabling through their meeting with conditions is the author’s clinical and philosophical framing; ADHD remains a recognised neurodevelopmental classification. Adult occupational interviews, ecosocial work, stress, loneliness and financial studies provide different kinds of support for attending to the person’s setting. Associations and personal accounts do not establish that modern circumstances alone cause ADHD. The MTA longitudinal findings associated remission with higher demands at some ages, so fit includes meaningful challenge as well as changes to burdens. The foraging experiments show task-specific consequences of exploration. Examples about transport, light, housing and daily schedules are clinical questions about individual circumstances, rather than universal measured effects. The adult SEEDS approach extends the published framework; practical changes require individual assessment and support.
References: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19.
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Faraone, S. V., et al. (2021). The World Federation of ADHD International Consensus Statement: 208 Evidence-based Conclusions about the disorder. Neuroscience and Biobehavioral Reviews, 128, 789–818. doi 10.1016/j.neubiorev.2021.01.022.
Read source 1 Study notes
Broad evidence synthesis supporting the validity and biological basis of ADHD and evidence for treatment. It does not imply that environment is irrelevant.
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Adamou, M., et al. (2021). Recommendations for occupational therapy interventions for adults with ADHD: a consensus statement from the UK adult ADHD network. BMC Psychiatry, 21, 72. doi 10.1186/s12888-021-03070-z.
Read source 2 Study notes
Expert consensus about OT assessment and intervention. A practice framework, not a trial showing that all proposed strategies improve ADHD symptoms.
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Lauder, K., McDowall, A., & Tenenbaum, H. R. (2022). A systematic review of interventions to support adults with ADHD at work—Implications from the paucity of context-specific research for theory and practice. Frontiers in Psychology, 13, 893469. doi 10.3389/fpsyg.2022.893469.
Read source 3 Study notes
Adult review identifies a shortage of research specifically testing workplace support. Examples of adjustments in the articles are suggestions to discuss and evaluate.
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Nordby, E. S., Guribye, F., Nordgreen, T., & Lundervold, A. J. (2023). Silver linings of ADHD: a thematic analysis of adults’ positive experiences with living with ADHD. BMJ Open, 13, e072052. doi 10.1136/bmjopen-2023-072052.
Read source 4 Study notes
Qualitative adult accounts support including strengths in discussion. Self reports do not establish that all adults with ADHD share a strength or that dopamine causes creativity.
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Bal, N. The Seeds OT Model — an introduction. Seeds Occupational Therapy. Accessed 10 October 2026.
Read source 5 Study notes
Source of the organisation's reasoning framework, currently written for paediatric practice. Adult application here is an adaptation, not a validated ADHD protocol.
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Bal, N. The Seeds OT Model — Part 5: The formal structure. Seeds Occupational Therapy. Accessed 10 October 2026.
Read source 6 Study notes
Supports mapping conditions and recurring patterns. The adult worksheets are original examples developed for this draft.
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Hirvikoski, T., Lindholm, T., Nordenström, A., Nordström, A.-L., & Lajic, S. (2009). High self-perceived stress and many stressors, but normal diurnal cortisol rhythm, in adults with ADHD. Hormones and Behavior, 55(3), 418–424. doi:10.1016/j.yhbeh.2008.12.004.
Read source 7 Study notes
Primary comparison of 28 diagnosed adults and 28 controls. ADHD participants reported greater stress and more stressors; overall diurnal cortisol did not differ. Small observational study. Abstract checked; no claim that cortisol is globally abnormal.
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Stickley, A., Koyanagi, A., Takahashi, H., Ruchkin, V., & Kamio, Y. (2017). Attention-deficit/hyperactivity disorder symptoms and loneliness among adults in the general population. Research in Developmental Disabilities, 62, 115–123. doi:10.1016/j.ridd.2017.01.007.
Read source 8 Study notes
Primary cross-sectional analysis of 7403 people aged 16 and over. Higher ASRS scores were associated with loneliness after adjustment. Symptom screening is not confirmed ADHD diagnosis; causal direction was not established. Abstract checked.
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Beauchaine, T. P., Ben-David, I., & Bos, M. (2020). ADHD, financial distress, and suicide in adulthood: A population study. Science Advances, 6(40), eaba1551. doi:10.1126/sciadv.aba1551.
Read source 9 Study notes
Primary Swedish registry study with population mental-health data and credit records from 189267 people. ADHD was associated with worsening financial outcomes into midlife after adjustment. Observational evidence, not proof that modern financial pressure causes ADHD or that medication has no clinical benefit. Institutional abstract checked; article indexed findings cross-checked.
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Lasky, A. K., et al. (2016). ADHD in context: Young adults’ reports of the impact of occupational environment on the manifestation of ADHD. Social Science & Medicine, 161, 160–168. doi:10.1016/j.socscimed.2016.06.003.
Read source 10 Study notes
Primary qualitative interviews with 125 young adults originally diagnosed as children. Fifty-five percent described context-dependent ADHD experiences; interest, hands-on work and stimulation sometimes supported functioning. No randomised environment intervention. Full methods and results checked.
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Ruse, J. N., & Rhodes, P. (2026). Adult ADHD in Cultural Ecosocial Niches: Exploring the Rise of Adult ADHD in Context. Culture, Medicine, and Psychiatry, 50, article 3. doi:10.1007/s11013-025-09958-9.
Read source 11 Study notes
Primary qualitative interviews and photo-voice work with seven Australian women recently diagnosed with ADHD. Supports attention to person-context interaction and socially supported functioning. Small selected sample with self-reported diagnoses and an explicit interpretive framework; cannot establish a general causal theory. Publisher full text checked.
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Sibley, M. H., et al. (2024). Characteristics and Predictors of Fluctuating Attention-Deficit/Hyperactivity Disorder in the Multimodal Treatment of ADHD Study. Journal of Clinical Psychiatry, 85(4), 24m15395. doi:10.4088/JCP.24m15395.
Read source 12 Study notes
Primary follow-up of 483 participants from childhood to mean age 25. Remission and recurrence fluctuated; remission was associated with higher environmental demands, especially at younger ages. This challenges a universal more-demand-means-worse rule. Observational associations cannot resolve direction or quality of demands. Publisher results and institutional abstract checked.
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Barack, D. L., Ludwig, V. U., Parodi, F., Ahmed, N., Brannon, E. M., Ramakrishnan, A., & Platt, M. L. (2024). Attention deficits linked with proclivity to explore while foraging. Proceedings of the Royal Society B, 291(2017), 20222584. https://doi.org/10.1098/rspb.2022.2584
Read source 13 Study notes
Preregistered online virtual berry-foraging experiment, 457 US adults, mean age 45.63. ADHD screen-positive participants left depleting patches earlier and earned higher reward rates. More exploratory behaviour was closer to optimal patch-leaving timing in this setting. Screen-positive status was unusually common: 206/457 (45%); these were symptom screens, not verified clinical diagnoses. Supports a context-dependent advantage for exploration. Adaptation, evolutionary selection and real-world occupational advantage remain interpretations rather than experimentally established conclusions.
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Hargitai, L. D., Laan, E. L. M., Schippers, L. M., Livingston, L. A., Fairchild, G., Shah, P., & Hoogman, M. (2025). The role of psychological strengths in positive life outcomes in adults with ADHD. Psychological Medicine, 55, e278. https://doi.org/10.1017/S0033291725101232
Read source 14 Study notes
Matched cross-sectional online study: 200 UK adults reporting a formal ADHD diagnosis and meeting symptom-screen criteria, versus 200 controls. ADHD participants endorsed ten strengths more strongly, including creativity, hyperfocus, humour, spontaneity and broad interests. Groups had similar strengths knowledge and use. Greater knowledge of personal strengths was associated with better wellbeing, quality of life and fewer mental-health symptoms in both groups. Self-reported strengths and correlational outcomes; not objective proof of superior creativity or a strengths-treatment trial.
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Schnorr, I., Siegl, A., Luckhardt, S., et al. (2024). Inflammatory biotype of ADHD is linked to chronic stress: a data-driven analysis of the inflammatory proteome. Translational Psychiatry, 14, 37. doi:10.1038/s41398-023-02729-3.
Read source 15 Study notes
Baseline primary analysis of 126 diagnosed adults from PROBIA, selected for high irritability/moderate impairment. Protein clustering identified higher/lower inflammatory profiles; chronic perceived stress correlated with one inflammatory composite (rho=.30, p<.001). No significant association with ADHD rating severity or subtypes. No healthy controls, site differences and cross-sectional design; neither stress causality nor lifestyle-treatment effects established. Supports including bodily stress/immune processes in clinical reasoning. Full methods, results and limitations read. Uses the PROBIA synbiotic-trial cohort; these analyses are not independent replications.
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Atkinson, A. L., Pinheiro Sanchez, B., Warburton, M., Allmark, H., & Allen, R. J. (2025). The ability to direct attention in working memory is not impaired in adults with symptoms of ADHD. Journal of Attention Disorders, 29(9), 684–705. https://doi.org/10.1177/10870547251330039
Read source 16 Study notes
Two online experiments analysed 65 and 68 UK adults aged 18–35. Symptom groups combined self-identification and ASRS screening; 27/70 reported formal diagnoses. Valuable visual-memory items were prioritised similarly across groups, with and without trial feedback, at a cost to less-valued items. Points were notional, not monetary rewards. This establishes a specific preserved allocation process, not intact overall memory or every attentional function. Selection, mixed diagnostic status and short laboratory tasks limit generalisation. Full primary methods and results read.
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Bowen, A., & Horlin, C. (2026). Absorbed, trapped, or lost? A qualitative investigation of hyperfocus experiences in ADHD adults. Neurodiversity. Published online 8 August 2026. https://doi.org/10.1177/27546330261469762
Read source 17 Study notes
Interviews with seven UK adults aged 21–58, four formally diagnosed and three considering or awaiting assessment; collected November 2023. Accounts linked interest and sometimes urgency with intense absorption, limited control over onset/cessation and subsequent physical, psychological or social costs. Helps distinguish engagement from the ability to regulate and release it. Very small convenience sample, subjective retrospective accounts and theory-informed analysis cannot estimate prevalence or prove mechanisms. Full primary methods and analysis read.
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Kallweit, C., Paucke, M., Strauß, M., & Exner, C. (2021). Adult ADHD: Influence of physical activation, stimulation, and reward on cognitive performance and symptoms. Journal of Attention Disorders, 25(6), 809–819. https://doi.org/10.1177/1087054719845050
Read source 18 Study notes
Within-person manipulations in 36 clinically diagnosed adults and 36 matched controls. Monetary reward/feedback increased reported motivation but did not improve inhibition-task performance; brief cycling did not improve selective-attention performance. Subjective responses differed from objective performance, and a stress-ball arousal manipulation failed. Small, mostly nonsignificant effects, task ceiling and mixed medication status limit inference. Useful contrary evidence to assuming incentives or stimulation reliably remove executive difficulty. Full primary methods, results and limitations read.
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Orban, S. A., Blessing, J. S., Sandone, M. K., Conness, B., & Santer, J. (2026). Why are individuals with ADHD more prone to boredom? Examining attention control and working memory as mediators of boredom in young adults with ADHD traits. Journal of Attention Disorders, 30(1), 8–22. Published online 29 July 2025. https://doi.org/10.1177/10870547251356723
Read source 19 Study notes
Cross-sectional comparison of 31 young adults with high ADHD traits and 57 without, mean age 19.1. Greater boredom proneness accompanied weaker attention-control and working-memory factors; statistical mediation accounted for small portions of the association. Symptom-defined university sample, extreme-group selection and simultaneous measurement limit causal interpretation and can inflate group effect size. Supports investigating cognitive demands as well as task interest. Primary publisher abstract verified; full paper was paywalled. Online publication was in 2025, final volume in 2026.
