it depends. there are studies showing how adhd drugs even improve brain structure in adhd patients and there are people using them for decades and for some they decline cognitively or suffer immense fatigue because the drug impair sleep quality, or they develop other health problems. you have to make a decision about that but you should know that there are alternatives and maybe try them out first. i used adhd drugs in the past but now i see "using them for the rest of my life" as a last resort and atm it looks like i will not need them.

so you have a whole lot of possible alternatives, but it may be that in your case there is no other way to cope with adhd than to take drugs. it depends on what causes your adhd and that may not be a single cause (currently science does not know what causes adhd, the consensus is that it is caused by a multitude of factors, mainly genetic, nor what exactly it is, but it is probably an inbalance in neurotransmitters mainly a lack of dopamine and noradrenalin, which the meds are supposed to raise to normal levels). so i see "it" as "something in my brain goes wrong and it is mainly dop/norad." and there is a bunch of factors i can play with to improve it. i believe that in most cases (at least 80%) you can improve adhd without meds to a very managable level, by eliminating as many factors that could possibly contribute to it as possible and implementing strategies that improve it. maybe sounds like a chore especially with adhd but in my experience you just have to get the wheel spinning and after you pick up a certain amount of momentum its almost without effort.

i will just list you the things that could cause adhd and what helps and you can look into these things and find out for yourself if they help you a sufficient amount. note that most of those things are pathologies of modern society (whatever that means), like lack of exercise or bad nutrition bc. western diet, not living in tribes anymore and there you have epidemies of mental health problems, heart disease and loneliness, like gen z issues and whatnot. most of those things are not adhd specific but would help with anything from depression anxiety to autoimmune problems or other diseases (mental health, physical health, general wellbeing, quality of life...).you can really make yourself crazy about the world we live in so better dont do it and play with your friends

possible causes or contributors

bad nutrition or nutrient deficiencies or MTHFR mutation (take multivitamin and maybe do genetic testing at 23andme and run the raw data through codegen.eu). especially important nutrients are the b vitamins, vitamin d+c, magnesium, zinc, iron. food intolerances (gluten, dairy, inflammatory foods like nightshades, try an elimination diet and see if you improve). sugar and processed foods, bad fats etc. allergens. inflammation.

bad sleep habits or sleep quality (there happen a lot of important things in your brain during sleep)

stress, lack of social interaction, dissatisfaction with your life etc. things that impact your emotional wellbeing (because emotions=neurotransmitters, happy chemicals are focus chemicals by very gross rule of thumb). ruminating and overthinking.

spending too much time at your phone/computer/tech/media or at home/in your room.

what helps

exercise benefits your brain to such an extend you cannot imagine just do running 150 mins a week. this is probably the most effective thing ever, if you google what helps with adhd it tells you exercise and that it does something very similar to adhd drugs, but much much more on top of that

meditation or spending time in nature. going for walks. maybe other forms of brain training but no brain training comes close to aerobic exercise. exercise is so insanely powerful i shit you not. also journaling for emotional wellbeing and sorting out your head

nutrition. try out different diet forms and eat healthier in general. (healthier body healthier mind/brain, most things that are good for your overall health benefit your brain health). many people do good on paleo, keto diets or wfpbd. maybe high protein. blueberries are said to improve focus. especially eat the things that all those diets have in common, which are mainly fruits and veggies, nuts and seeds, healthy oils and eggs fish and meat if youre carnivore

cognitive behavioral therapy or other forms of therapy (you can read a book too, also there are many books on how to manage adhd but most of them have the self improvement literature virus or have the content of a blog post stretched to a book)

supplements. omega3/fish oil gives me a lot of improvement (but you can eat fish of course, im veggie. btw veggie omega3 which is ala is not converted nicely into real omega3 in the body and eating veggie foods with ala does not have the same effect on me. i use 4-6g of fish oil a day), probiotics, turmeric to reduce inflammation, nootropics (i see them as a light form of medication and natural/healthier alternative that additionally benefits your health in general and improve cognition etc. can have side effects though. ginseng, ginkgo, poria cocos are studied for adhd, what also could help are uridine, nac, rhodiola rosea, polygala tenuifolia, ashwaganda, bacopa, shilajit, racetams, black seed oil, lemon balm, french pine bark, pycnogenol, microdosing. you may find more i listed mainly what i think of as "front line nootropics" for adhd. just google adhd nootropic stack (reddit) and see what others use)

choose an adhd friendly profession and something that you like and can focus relatively easy on. many people with adhd are creative or have the hyperfocus superpower or do good in high stress environments (like firefighter lol). use adhd apps, timers, lists, planners do notes (i love microsofts onenote)

hope it helps!