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Picture a young person who walks out of my office with a new ADHD diagnosis and feels relief. There is finally a name for years of missed deadlines and unfinished paperwork.

A few weeks later, they use that name to end an argument at home about an unmade bed and a pile of unopened mail, saying, "I can't do that, I have ADHD."

In another scenario, a student asks me for a medical note excusing them from a written assignment. Not extra time, not a quieter room, not help breaking the work into steps: They want the assignment dropped.

I often see both situations in my Mexico City clinic. They raise the same question: Does a diagnosis of attention-deficit/hyperactivity disorder explain why a task is harder? Usually, yes. Does it settle which tasks the person should stop attempting? Rarely.

I am a liaison psychiatrist at the National Medical Center "20 de Noviembre" in Mexico City and a professor of medicine at the National Autonomous University of Mexico. My work deals with how psychiatric diagnoses land in a person's daily life, including how anxiety and ADHD can mask each other. I sign several of those school and work notes every week.

Researchers have started to measure something I see constantly in the clinic: how much room a diagnosis takes up in how a person sees themselves.

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