Clinical psychologist here. You just wrote word of wisdom far beyond most psychiatrists, psychologists, counselors of all kinds, and (American) ADHD specialists.

I don't care what diagnosis someone has. If they personally feel the medication is helping them, I never would argue with them.

But I ALWAYS at least suggest what you wrote - try lifestyle changes (including, especially, looking at ways to live a deeply caring ,ethical life, connected to other people,). Since good therapy is hard to find, and for many, hard to afford, I give them a lot of suggestions on how to make these changes.

if that doesn't work, add therapy. And then try medication as a last resort.

If someone is incapacitated by severe depression, trauma, or incapable of functioning due to severe ADHD, etc, I might recommend medication right away, BUT I always urge them to continue to make lifestyle changes, seek out therapy (good therapy!), and CONSIDER monitoring their condition and perhaps trying - in 3 months, 6 months, or whenever is appropriate - working with their psychiatrist to SLOWLY reduce medication.

Thanks for such a clear wise comment!