Most of the listed symptoms are characteristic of an executive function disorder, of which adhd is the most well known. Very few people have "perfect" executive function without drugs. In other words, it's pretty normal for most people to experience some form of executive dysfunction and it's usually something one learns to manage. Executive functioning is skill just like anything else.

From what I understand, ADHD and other executive function disorders are Defined by having extreme enough of an executive function deficit (relative to peers of a similar age and development) that it has a significant impact on their day-to-day life (because if it didn't, why would you be going to a psych to be diagnosed?). But just because it's relatable also doesn't inherently mean that you have ADHD.

If you think of executive function as being a spectrum, and executive function ability being a normal distribution, the line for adhd is some arbitrary point on that upslope.

Of course, there are people making the argument that phones and social media and the internet and instant gratification might be contributing to executive dysfunction, but this is the kind of thing that's really hard to measure against some objective scale.

Your response perfectly sums up why ADHD confuses me.

It seems to be very poorly defined, and from what I understand being diagnosed is practically still self-diagnosis because the doctor will ask you questions about your behaviour and judge whether you have ADHD or not based on that.

Looking at the CDC website on ADHD [0] and without trying to force things to fit, I easily meet the criteria for inattention. Yet a lot of the things I struggle with like the parent comment listed I don't view as being related to executive function (Ex: rejection sensitivity and maintaining friendships).

[0] https://www.cdc.gov/ncbddd/adhd/diagnosis.html

> It seems to be very poorly defined, and from what I understand being diagnosed is practically still self-diagnosis because the doctor will ask you questions about your behaviour and judge whether you have ADHD or not based on that.

This seems pretty par for the course. A doctor asking you questions and then deciding whether or not you meet some threshold based on the answers to those questions is a large part of medicine and a huge portion of psychiatry.

To add onto this there’s also lengthy cognitive testing (usually about 6-8 hours of tests) that is much more precise. My understanding from talking to my psychiatrist is that there are certain traits, such as reaction speed, that are correlated extremely strongly with ADHD. Usually patients with ADHD will test averagely on most of the cognitive tests and then perform several standard deviations below average on exactly those tests.

They don't only ask you questions, but will also ask your friends or parents for a second opinion on what you're like or how you were as a child. This happens more often if you are a child, of course.

Like the other commenter said, unfortunately psychology and psychiatry is in a state where it's hard to get good objective criteria for diagnosing any mental illness; it's mainly reliant on self-reported data/surveys or observations of behavior. I think this is a big driver of the replication crisis in psychology.

I don't know you well enough to give a decent hypothesis, so I'm just going to guess and babble a bit: Generalizing adhd/executive function as being composed of attention, self-regulation, and motivation. My first thought is that rejection sensitivity could be emotional regulation thing, which might have some interplay with general self-regulation. My followup thought is something along the lines of rejection sensitivity involving paying too much attention to the negative and not enough to the positive. Re: maintaining friendships, I don't have enough information. Personally sometimes I struggle with motivating myself to reach out, make plans, etc. Other times I feel bad because I feel like I have trouble focusing on what my friend is saying or asking them to repeat themselves or otherwise being a bad listener in the moment.

Self-regulation is something improvable without medication, I think meditation is pretty effective. And Self-regulation can play a big part in helping manage attention and motivation issues.

Some of this might resonate, some of it might not. If you'd like support tackling your struggles, you can contact me at me @ my website name (but a good therapist might do a better job xP)

They’re basically all related to having deficient or broken reward reactions, the primary emotional reaction to dopamine. Willpower is hard to achieve if you expect to be disappointed. Pretending is a social necessity to avoid disappointing others, and the rejection that you could expect from that. Failing to muster willpower or follow through manifests that disappointment. Emotions swing when the little burst of reward that might sustain someone else is gone, and then you scrutinize your ability to even appreciate what you do have. Maintaining friendships is hard if you need to tend to yourself, and then again if you feel guilty for neglecting your friends. It compounds if your guilt makes it harder to reach out after some time being a “bad” friend. People questioning your reality makes you question it too. Now it’s your fault, in your mind. But if you’re incapable of fixing it you’re just... at odds with everything. If you are medicated... those other waking hours you’re dealing with all of this not only without the chemical benefits but with the crash that comes after which can amplify everything else.

Apologies for the giant wall of text. I just sat here on my phone swiping back and forth relating how I’ve experienced each item and didn’t pay any attention to formatting or structure.

On the contrary, walls of text are greatly appreciated

All of them are related to the executive functioning subsystem in the brain, located in prefrontal cortex.