Case Study: Reorienting the Attention Dilemma

Context

By the mid-2020s, public awareness of ADHD skyrocketed. In the United States, prescription rates for stimulants like Adderall doubled between 2006 and 2016. Among very young children aged 2 to 5 years diagnosed with ADHD, about 75% received medication.

The surge in diagnoses and prescriptions has been accompanied by a booming push to “optimize mental performance.” Mindfulness apps promised calm at scale. VC firms poured $3.7 billion into mental health startups in 2021. Employers offered mental health days and coaching as benefits. Governments launched awareness campaigns. The response apparatus was vast—yet the sense of overwhelm persisted.

Despite the flood of intervention, outcomes barely shifted. In some cases, they worsened: ADHD medication shortages, growing dependency concerns, and rising rates of burnout, depression, and anxiety, particularly among youth. On the biomedical side, there was a 299% increase in ADHD-related medication errors from 2000 to 2021, indicating pervasive issues in medication management.

The dominant logic had calcified: if people are struggling, the answer is faster diagnosis, faster prescriptions, faster fixes.

But what if the struggle wasn't just internal? What if the very environments shaping attention—our digital ecosystems, educational systems, and economic systems—were misaligned with how cognition actually thrives?

Analogue Intervention

Analogue approached the ADHD surge not by asking how to improve access or scale treatment, but by questioning whether “ADHD” itself was always the right frame to explain what's going on.

We backed an exploration into the deeper dynamics beneath the rise in diagnoses, prescriptions, and cultural narratives around attention and distress. Rather than funding a solution in search of a problem (e.g., “more efficient ADHD screening” or “mindfulness-for-kids apps”), we asked:

Is this really a mental health epidemic—or a deeper attentional and sensory mismatch between human biology and modern life?
What systems—educational, digital, economic—are shaping the context in which distress is being pathologized?
Why has the concept of “attention” narrowed to mean something we must optimize or medicate, rather than cultivate?
Where are we mistaking collective adaptation for individual disorder?
What alternative models of attentional development have existed across cultures and histories—and why were they abandoned?

This approach required crossing the boundaries of psychology, neuroscience, media theory, learning science, education policy, and cultural anthropology—fields that rarely speak to each other in traditional grantmaking contexts.

We weren't searching for a better app or drug. We were searching for a better question.

Findings and Reframing

Our exploration surfaced a deeper misalignment: the surge in ADHD diagnoses was not simply a reflection of rising pathology—but of environments increasingly inhospitable to sustained attention, and institutions unequipped to respond with nuance.

Several patterns became clear:

Environmental mismatch: Classrooms, workplaces, and media environments have grown noisier, faster, and more fragmented—yet we still expect attentional coherence as if those conditions haven't changed.
Diagnostic inflation: In contexts with limited time or tools for differentiated care, ADHD became an umbrella term for many forms of distress—from sensory sensitivity to trauma to boredom.
Institutional incentive loops: Schools under pressure to show performance gains, clinicians facing short visit times, and overstretched parents often turned—understandably—to the fastest available intervention.
Neglected scaffolding: Historical practices that cultivated attentional capacities—through ritual, movement, silence, play, and intergenerational presence—have been stripped from most public institutions.

This changed how we thought about intervention. The most meaningful leverage wasn't found in scaling access to treatment, but in redesigning the upstream systems that were producing the distress in the first place. What if instead of optimizing individuals to better tolerate their conditions, we asked what kinds of conditions help attention naturally emerge, deepen, and hold?

Instead of pouring money into mental health tech that optimizes for “access” as a catch-all, the deeper leverage might lie in:

Architecting attention-respecting environments (e.g. schools designed for contemplative focus)
Media slow-zones: Public digital spaces structured for depth, not speed
Experiential education: Cultures of practice (like philosophy-for-children or communal silence) that retrain awareness
Embodied cognition research: Exploring how physical, social, and sensory systems shape mental wellbeing

What the Data (and Diagnostic Drift) Actually Suggest

The dominant ADHD narrative—rising diagnoses = rising awareness—misses key complexities. A closer look suggests we're not simply getting better at spotting a disorder, but that the frame itself has drifted:

A 299% increase in ADHD-related medication errors (2000–2021) highlights a system stretched thin—not just in overdiagnosis, but in operational safety.
Youngest kids in a classroom are up to twice as likely to be diagnosed with ADHD compared to their older peers—indicating that relative age and behavioral expectations, not pathology, drive many diagnoses.
Most ADHD drug trials exclude participants with trauma, anxiety, or co-occurring learning differences, even though these are common in real-world populations. The clinical category is tidy; lived experience is not.
Short clinical visits + high-pressure school systems + cultural expectation of productivity = structural conditions that favor fast-path labeling over nuanced intervention.
Neurodivergence ≠ disorder: Some traits commonly labeled as ADHD—novelty seeking, pattern scanning, nonlinear thought—may be mismatches in a system built for compliance, not creativity.

In other words: attention is not a fixed quantity—it's a social relationship. And right now, that relationship is strained.

Comparative Case Snapshots

To reframe attention, we need to observe not just diagnoses but the conditions in which different attentional patterns are cultivated, pathologized, or sustained:

Japanese Hikikomori & Honor Cultures
In Japan, social withdrawal among youth—hikikomori—is often interpreted through cultural lenses of honor, shame, and pressure. Though rarely labelled ADHD, many present with attentional and affective traits that would be diagnosed in Western systems. The difference isn't the brain—it's the cultural infrastructure for distress.
Indigenous Pedagogies
In many indigenous cultures, children learn through observation, unstructured play, and intergenerational immersion—not sit-still compliance. What Western schooling frames as “inattention” may actually be the clash of two epistemologies: one oral and ecological, the other industrial and standardized.
Mindfulness Industrial Complex
Billions have been poured into mindfulness apps, digital detox retreats, and breathwork platforms. But outcomes remain uneven. These often optimize individual regulation rather than redesigning attention-hostile environments—treating symptoms, not systems, leaving the upstream causes untouched.
Pharmaceutical Feedback Loops in the U.S.
In the U.S., faster stimulant access combined with diagnostic inflation created a self-reinforcing loop: more diagnoses → more prescriptions → more normalization of meds → less institutional reform. The system now treats compensatory medication as a substitute for structural design.

Strategic Learnings

This Expedition helped surface several key principles that continue to inform how we scout and support paradigm-shifting work:

Crisis signals ≠ diagnostic truths: Widespread struggle doesn't always mean a disease is spreading—it might mean our environments are incompatible with basic human needs.
Don't intervene at the level of the label: Starting with the most visible diagnosis often distracts from upstream causes. The deeper question is: why this pattern, now, at this scale?
Attention is not neutral: It is shaped, trained, and captured by infrastructure. And like all infrastructures, it can be redesigned.
Narrative precedes policy: How we talk about a problem—whether we frame it as a disorder, adaptation, or systemic mismatch—shapes what kinds of responses are possible or legible.
Cross-disciplinary synthesis unlocks non-obvious leverage: The most powerful insights emerged when we stepped beyond psychology and brought in media theory, architecture, pedagogy, and cultural history.

Field Signals and Live Probes

Reframing ADHD is not just a conceptual exercise—it's an ongoing, field-sensitive inquiry. Recent cultural events and reporting have both mirrored and reinforced our core hypothesis:

Media as Mirror: In April 2025, The New York Times Magazine published a widely-shared feature on how ADHD diagnoses—and stimulant use—have surged not because of clear-cut pathology, but because the diagnostic and pharmaceutical machinery scaled faster than institutional reflection. The article echoes a key tension: are we treating the person, or the system that produced the distress?
Feedback Loops and Normalization: With faster drug manufacturing, looser gatekeeping, and social media-fueled self-diagnosis, the U.S. has drifted into a pharmaceutical default. We now risk equating human variation with disorder—pathologizing adaptation rather than redesigning misaligned environments.
Lived Documentary Insights: A prior documentary exploration into Japanese educational and cultural systems revealed that what looks like “inattention” or social withdrawal in one context may have entirely different roots in another—historical, intergenerational, and deeply encoded in honor-based social structures. The insight: attention cannot be divorced from culture.
Next Probe: Socratic Salon
To deepen and test these hypotheses, we're convening a cross-disciplinary salon. Participants will explore whether ADHD is a neurobiological condition, a cultural artefact, or a signal from misdesigned systems. The aim isn't consensus—it's epistemic friction. We treat these conversations as instruments, not performances.

What emerges when we stop asking how to tolerate attention collapse—and start asking what kinds of worlds attention wants to grow in?

Emergent Possibilities

Rather than fund another wave of diagnostics or mindfulness apps, this Expedition pointed to deeper, less legible interventions:

Attentional architecture: Designing physical and digital spaces that support depth, quiet, and pacing.
Educational reconfiguration: Reviving models of schooling that center embodied learning, unstructured time, and attention as a skill, not a compliance metric.
Cultural scaffolding for slowness: Supporting rituals, narratives, and aesthetic forms that make stillness and presence aspirational again.
Cognitive equity: Framing attentional diversity as a systems challenge—not a personal deficit—with policy and design responses to match.
Tradition-informed practices: Adapting historical methods of attentional cultivation—from contemplative traditions, indigenous pedagogies, and slower societies—for modern contexts.

These don't slot easily into mental health, education, or tech—but they signal a shared opportunity: to treat attention as a condition we shape, not just a capacity we fix.

This wasn't just an investigation into ADHD. It was an attempt to ask: what kind of attention does the future need—and what kind of environments help it grow?

If attention is shaped more by structure than by willpower, then the question isn't “how do we fix distracted people?”
It's: what would it take to build a world where attention doesn't have to be medicated into existence?

What if attentional depth was treated not as a personal achievement, but a public good?
What if slowness wasn't a privilege—but a design principle?
What if we stopped asking how to tolerate collapse, and started asking how to reorient the conditions that produce presence?

This isn't just a mental health story. It's a systems story. And the frontier isn't diagnosis—it's design.