This is a follow-up to:
There are points in the New York Times article, “Have We Been Thinking About A.D.H.D. All Wrong?” (April 13, 2025) where the author, Paul Tough, seems to recast ADHD as a problem of boredom in today’s educational and work environments and implies that stimulant medications primarily help people by making that boredom tolerable. These things are implied in the context of a broader argument that ADHD is not a discrete medical disorder (“a distinct, natural category,” which, yes, ADHD isn’t), that the symptoms exist on a continuum (true), and that ADHD symptoms are not indications of neurological deficits but a misalignment between a person’s biological make-up and their environment (true to an extent and in a qualified sense).
Tough quotes qualitative research with adults who had been diagnosed with ADHD as children. Many of these individuals, reflecting on their own lives, described how their symptoms receded once they found environments aligned with their interests and strengths: film school, hairstyling, auto mechanics, etc. They now wondered if their struggles in classrooms had always been an issue of a mismatch between their attentional style and the rigid structures of schooling. Many of them now thought of ADHD as a personality trait, a difference rather than a defect. In this reframing, medication took on a new meaning for them: it was something to help them tolerate environments that were ill-suited for them.
Tough writes:
“Seen through this lens, the problem for John and Cap and many other adolescents becomes a much more mundane one than a brain disorder. Their problem is the simple fact that high school can be really boring, and without medication, they have a low tolerance for boring stuff. For some children, a different school, or a different kind of school, might produce the same profound shift that the M.T.A. subjects experienced when they enrolled in film school or began studying hair styling. For others, a prescription for Ritalin or Adderall might help make school feel like a better fit. But for them and their parents, the experience of taking medication might feel quite different if it was presented to them not as a medicine to fix their defective brain but as a tool to make an inhospitable environment more tolerable.”
Tough links this with research on the effects of stimulants: students who used stimulants in the absence of an official ADHD diagnosis would often describe stimulants in terms of sharpened focus, but what they were really articulating was an emotional shift. Without medication, tasks felt dull and pointless; with it, even tedious assignments felt compelling. Historically, this has often been why the drug has been misused or recreationally used. From WWII soldiers enduring monotonous watch shifts to housewives navigating repetitive chores and truckers facing endless highways, amphetamines have long been used to make boredom tolerable. College students using stimulants to get through boring assignments was just another example of tedium made bearable by chemistry.
“Farah directed me to the work of Scott Vrecko, a sociologist who conducted a series of interviews with students at an American university who used stimulant medication without a prescription. He wrote that the students he interviewed would often “frame the functional benefits of stimulants in cognitive-sounding terms.” But when he dug a little deeper, he found that the students tended to talk about their attention struggles, and the benefits they experienced with medication, in emotional terms rather than intellectual ones. Without the pills, they said, they just didn’t feel interested in the assignments they were supposed to be doing. They didn’t feel motivated. It all seemed pointless…
Historically, this is one of the main reasons people have taken amphetamines: They make tedious tasks seem more interesting. During World War II, the American military distributed tens of millions of amphetamine tablets to enlisted men for use during the many boring stretches of war. The pills were given to Air Force pilots flying long missions and to Navy sailors who had to keep watch all night. In the 1950s, suburban housewives took amphetamines to get through the boredom of endless days of housework and child care. Long-distance truckers have for decades used them to tolerate the tedium of the road. For the college students Scott Vrecko interviewed, term papers were just as boring as laundry or a long-haul truck route — but they became more bearable with the help of stimulants.”
There is something true but also overly simplistic about the idea that the problem with many ADHD kids is “that high school can be really boring, and without medication, they have a low tolerance for boring stuff.” This becomes evident when we look at our scientific understanding of the relationship between ADHD and boredom-proneness (i.e. the tendency to become bored easily).
Boredom is a state of wanting but being unable to engage with something meaningful. Researchers distinguish between state boredom (a temporary, situational experience) and trait boredom (a relatively stable tendency to become bored across contexts, measured with tools such as the Boredom Proneness Scale), also called boredom proneness or boredom propensity. Boredom in its more intense forms has been associated with depression, anxiety, suicidal thoughts, and self-harm. Individuals prone to boredom are more likely to experience accidents in jobs requiring vigilance, show poorer grades and test scores, and struggle with workplace dissatisfaction and absenteeism. Clinical observation and patient reports, as well as research, indicate that individuals with ADHD tend to experience boredom more frequently and intensely than those without ADHD.