Dr Russell Barkley, a respected researcher in the field of ADHD, basically states that there is a chemical deficiency in your brain that makes it physically impossible for it to simply 'be' better, and that things like behavior modification have been shown to be helpful... almost exclusively when the subject is also on medication. And even when environmental changes can make a difference, it tends to fall on those close to the ADHDer to help set up those accommodations, at least with children. However, with adults there exist the same struggles, just to a /slightly/ lesser extent.