This is where the problem is and what I argued above as well. People handwave the efficacy and use of medication by arguing "we don't understand". That is exactly what you are doing. A lot of my knowledge comes from when I was able to work with surgeons at the local university hospital in order to do signal processing on data collected from electrodes that were installed into patients who suffer from Parkinson's, for DBS.
I would urge you to look into the recent advances in neuroimaging.
https://www.biomedcentral.com/collections/advances-in-neuroi...
https://www.additudemag.com/neuroimaging-adhd-findings-limit...
The reality is the news tools for research are still in their infancy. It's not close to the maturity that the diagnosis of diabetes and other diseases are at. But there is a very clear path forward, it's no longer theoretical.
There is still no clinical definition of insulin resistance.
And as far as ADHD and Diabetes go, yes I can confidently say the current medications and therapies that are available for Adhd can address most cases similar to how insulin does for diabetes. Treating metabolic disorders is as complex as treating ADHD. Stimulants don't "fix" ADHD any more than insulin does for diabetes.
The complication doesn't come from the lack of science, it comes from the fact that behavior and cognition is affected directly by the stimulus people are exposed to. I can't play music that will distract a kidney but I can distract a child very easily the same way.
I did read the article you listed,
"In McNally's view, there's little danger that mental health professionals will forget the importance of environmental factors to the development of mental illness. "I think what's happening is not a battle between biological and non-biological approaches, but an increasingly nuanced and sophisticated appreciation for the multiple perspectives that can illuminate the etiology of these conditions," he says.
Still, translating that nuanced view to improvements in diagnosis and treatment will take time. Despite decades of research on the causes and treatments of mental illness, patients are still suffering. "Suicide rates haven't come down. The rate of prevalence for many of these disorders, if anything, has gone up, not down. That tells you that whatever we've been doing is probably not adequate," Insel says."
He argued exactly what I am still arguing. Specific to how far out he thought these tools of diagnosis were, I would absolutely disagree. Having a Nobel prize doesn't mean his predictions are prophetic.
It's not just the field of neuroscience, the last 10 years of technology have reshaped the entire landscape of medical diagnosis and treatment. If I said that AI will be able to help diagnose cancer in the next 10 years in 2012, most people would think I was being optimistic to a fault, but that's where we are now. The fMRI was invented in 1991.
From APA, if you clicked on neuropsychology and scrolled down, you would have seen Michael Treadway’s fantastic work at Emory on the relationship between inflammation and stress and how it links to depression.
https://www.apa.org/monitor/2021/09/career-lab-depression
"“What I’m seeing with my research, and that of others, is that there are many types of depression, schizophrenia, or any number of mental illnesses, each with its own source,” Treadway said. “I would really like to get to the point where we have discrete definable pathologies that are measurable, using objective tests, for different types of depression, for example, or even different symptoms of depression. That could really open up a world of new treatment possibilities.” "
I can only hope you gain some of my enthusiasm after reading some of these.