In my clinical experience adults with ADD are frequently so accustomed to having attentional problems that they don’t even realize they have an easily treated condition. They think it is their personality to lose things, run late, have trouble cleaning up, avoid finishing projects, fail to return phone calls and emails, leave bills unpaid and so forth. They are usually more prepared to have extensive psychotherapy for these issues than to try a stimulant as a test: if it makes the problem go away, how psychodynamic could the problem have been?
Psychoanalytically trained colleagues often point out to me that ADD can function as a defense mechanism – in particular, it can be a way of annoying others (eg, a way of expressing passive aggression) and erasing others (it can be a way of tuning out legitimate interpersonal demands). I think this is true, and am aware that ADD covaries with narcissistic traits. However, it is prudent to at least identify the syndrome, and to at least consider medicating it away – particularly because medication can do in weeks what psychotherapy typically takes years to achieve – even if the psychotherapeutic achievement is more profound. There’s no harm in trying both, and certainly none in knowing your diagnosis.