Overselling A.D.H.D. • Hacker News Board

Re: Overselling A.D.H.D.

#91

Post by panglott » Tue, Aug 23, 2016, 5:22 PM UTC

forgotpwtomain wrote: post #19

rayiner wrote: post #9

The point about changing the kid instead of the environment is an important one. If attention deficit is defined as a kid having trouble coping with the standard 7-hour school day (more like 9-10 including homework) where he is expected to sit still and work on boring and non-essential worksheets, then the condition isn't over diagnosed at all. And if we're not willing to change that environment--and I don't think we…

> And if we're not willing to change that environment--and I don't think we are--then we should medicate the kids so at least the experience is tolerable and they can have some success with it And as a result traditional response has been amphetamine-salts for children as you say. But I completely disagree that this is something we should do . For one I think we don't have good enough science to know how potentially…

One thing that has definitely changed is the level of academic expectations for young kids. Working with educators, it's apparent how much expectations have changed even in the last 10-15 years.

Things that children were once expected to know in 1st grade are now expectations of children in kindergarten or even pre-kindergarten. Kindergarten is the new 1st grade, in terms of reading, and that means children have to spend more time sitting and copying letters and words.

In kindergarten, some children will be a year older than other children, and a year is a massive amount of time, developmentally speaking, when you're talking about 5-year-olds.

The biggest risk factors for an ADHD diagnosis are being in the youngest quartile of your grade and being male. Neither of those are actual medical problems.

Re: Overselling A.D.H.D.

#92

Post by prashnts » Tue, Aug 23, 2016, 5:23 PM UTC

I got my diagnosis for ADD (and a few other stuff) a little more than a year ago when I was 19. For me, it's always been really "weird". I suppose I could share this personal anecdote here, in a hope that people stop seeing everything as binary. Sure, there is "big pharma" problem. I buy 150 USD worth meds on my own to know that (insurance does not cover it). But that doesn't/shouldn't hinder those who genuinely are in need of help, be it in form of medication, therapy, or just plain ol' family support.

Without and before the stimulants, absolutely nothing was urgent to me. Not showering, eating, getting work done, studying. Nope. It always came as a surprise when I used to see other folks deciding to do something, and then _actually_ getting it done! How is that even normal! Now, though, I realise that that's what "normal" is.

But that's just probably what others see as laziness? I don't know. Perhaps it is Executive dysfunction? But I am glad that I managed to get help, and ever since that, actually able to get myself together.

Having lived in India, mental illness is still taken as a taboo, at large. Nobody at my family, myself included, knew about even the existence of ADHD, let alone see a psych!

I remember my parents always being told: "Your kid can do better, but he doesn't study! If only." And this went on all the way till my second year at University, when the night before my end-term exam, I ended up with a breakdown because I __just could not__ manage to focus and study the material. I ended up barely passing the paper.

Not everything has been bad, though. There's always this phase of "super focus" for me -- I find something interesting, and then obsess over it until it isn't interesting anymore. Channelled in right direction, I managed to learn a lot in math, computer science and of course programming.

I do think that a lot of mass-education is needed with this regards.

Re: Overselling A.D.H.D.

#93

Post by forgotpwtomain » Tue, Aug 23, 2016, 5:25 PM UTC

panglott wrote: post #91

forgotpwtomain wrote: post #19

Earlier quoted context omitted.

> And if we're not willing to change that environment--and I don't think we are--then we should medicate the kids so at least the experience is tolerable and they can have some success with it And as a result traditional response has been amphetamine-salts for children as you say. But I completely disagree that this is something we should do . For one I think we don't have good enough science to know how potentially…

One thing that has definitely changed is the level of academic expectations for young kids. Working with educators, it's apparent how much expectations have changed even in the last 10-15 years. Things that children were once expected to know in 1st grade are now expectations of children in kindergarten or even pre-kindergarten. Kindergarten is the new 1st grade, in terms of reading, and that means children have to s…

> One thing that has definitely changed is the level of academic expectations for young kids. Working with educators, it's apparent how much expectations have changed even in the last 10-15 years.

Really, I think this needs a reference/citation?

We didn't read a classic English book until 7th or 8th grade when I was in school. In contrast to say my parents education in Russia where they read Pushkin in ~2nd grade. Math education was several years behind what they were taught as well.

Re: Overselling A.D.H.D.

#94

Post by scottmf » Tue, Aug 23, 2016, 5:26 PM UTC

sevenless wrote: post #89

scottmf wrote: post #79

Earlier quoted context omitted.

>It's far from clear why having the symptoms of ADHD should be considered a disease, in any objective sense. We have children facing social rejection, failing/dropping out of school, becoming dependent on drugs, suffering from depression/anxiety and other mental illnesses, committing suicide, etc. In a perfect world we don't have to change our lives to fit into society at all! Unfortunately, the world isn't perfect.…

This analogy doesn't really work, because obesity is caused by living a modern sedentary lifestyle, whereas I'm suggesting ADHD is what we're labeling kids with for not living , or rebelling against, that sedentary lifestyle. Obesity is a disease in an objective sense because it directly causes ill health. There's lots of studies to show that. The symptoms of what we call ADHD seem to simply be caused by unhappiness…

It's a perfectly fine analogy. They're both problems which are problems because of our society.

You're suggesting physical illness is more "real" than mental illness.

>We're demanding kids do something that makes them unhappy, and any reaction to it, is labeled a disease.

It's far more than kids not being able to pay attention in class. ADHD affects many aspects of a person's life—and adults too. Living independently with unmedicated ADHD can be incredibly difficult. Everything from social life, working, to driving, is harder/riskier.

The argument against treating ADHD is based on unfounded fears of psychiatry and medication. "What if this, what if that". Well this and that isn't happening, peoples lives are being improved, and people are suffering because of dangerous FUD like this.

Re: Overselling A.D.H.D.

#95

Post by NovaS1X » Tue, Aug 23, 2016, 5:26 PM UTC

riprowan wrote: post #47

I was diagnosed ADHD when I was 7 and the doctors put me on Ritalin. This was the early 1970s when very little was known about how to prescribe the drug to children. The doctors put me on a dose of 20mg 3X per day. It almost killed me. I remember having an overdose in 2nd grade (at least now I know that it was a Ritalin overdose). 60mgs of Ritalin is high even for an adult much less a 7yo. The teacher was required to…

I know exactly how you felt.

I was diagnosed with ADHD, OCD, and tourettes quite young, my mother and father separated when I was very young, and my mother had the habit of moving to a new town every 2 years. All of this lead to a less-than-stellar experience in school. I eventually made it onto the short-bus. As you were ridiculed as an individual in class, I was ridiculed by group association.

I don't know if my "IQ" was up there , but I was the kid making web-pages while my class-mates were doing the word-processing class. Obviously this meant I'd get terrible marks in class as I'd never get around to doing the work but that's the over-reaching theme of my experience in high-school.

So. Bored. Every. Day.

Except I didn't listen. Nope. When I was interested in something you could bet I'd be in the top-of-the class. If I wasn't, I'd probably not even finish it. Unlike you, who got though it, between my home life and everything else I didn't even finish. I dropped out in grade 10.

However I never really did have trouble focusing. I focused on what was important to me and now I'm in a place in my life where I'm happy and working in a skilled, knowledge-based career making great money for my age and I'm doing the things I've always wanted to.

Re: Overselling A.D.H.D.

#96

Post by Vraxx » Tue, Aug 23, 2016, 5:27 PM UTC

sotojuan wrote: post #28

6stringmerc wrote: post #7

Earlier quoted context omitted.

One thing that has troubled me as a self-taught "dietician" (re: for fitness, using PEDs effectively, etc) is wondering how much the pronouncement of ADHD might correlate with dietary and lifestyle habit changes over the past couple generations. Basically, I have a hunch regarding general population and dietary overlap. I was a "hyper" kid for a lot of my formative years, and didn't undergo medication for it, but won…

When I was a kid (6-12~) I had to take Ritalin everyday—sometimes during school the teacher had to give it to me (this was in South America were casually asking a teacher to give me meds was ok). When we suddenly moved to the US and I started middle school here I stopped taking it. I've always suspected I was and am still "hyper", because I have trouble focusing and always have to fidget or walk around the office. I…

I had a similar experience where my 3rd grade teacher was pretty much solely responsible for getting me medicated. I took Adderall every day from 3rd grade to about Sophomore year of high school, when I convinced my parents that I was capable of managing myself without it. At the time, I detested it because it subdued my extroverted nature, for instance, I would read books at recess instead of playing kickball or talking with friends. After graduating undergrad just fine and landing a software engineering gig, I looked the medication again, and it's a lot more helpful than I remember giving it credit for. My personal hypothesis is that the dose I had as a kid was a bit too strong, but the one insight I gained from taking it after being off of it for so long is that I don't absolutely need it to function, but it sure makes things a hell of a lot easier for me.

Obviously, this is just anecdotal, but my experience seemed similar enough to yours that I thought I might share a hypothetical answer to your question.

Re: Overselling A.D.H.D.

#97

Post by leereeves » Tue, Aug 23, 2016, 5:27 PM UTC

Vraxx wrote: post #87

leereeves wrote: post #61

Earlier quoted context omitted.

The article briefly mentions the issue then moves on. But is it true that "it’s too expensive to modify the kid’s environment" or simply that established powers make more money by "modifying the kid"?

In a way, those can both be true simultaneously. Just from the assumptions that the "established powers" make more money by modifying the kid implies that even if modifying the kid's environment cost $0, it would "cost" them lost profits of modifying the kid. Costs are relative, and I think the point remains that the kid's parents are relatively powerless to alter the kid's environment significantly enough to solve t…

By "established powers" I meant the people with enough political power to influence educational and medical policy.

As long as everyone with significant influence is comfortable with the status quo, there's little pressure to search for other options, even if many parents might prefer another option.

Re: Overselling A.D.H.D.

#98

Post by throwanem » Tue, Aug 23, 2016, 5:30 PM UTC

sevenless wrote: post #89

scottmf wrote: post #79

Earlier quoted context omitted.

>It's far from clear why having the symptoms of ADHD should be considered a disease, in any objective sense. We have children facing social rejection, failing/dropping out of school, becoming dependent on drugs, suffering from depression/anxiety and other mental illnesses, committing suicide, etc. In a perfect world we don't have to change our lives to fit into society at all! Unfortunately, the world isn't perfect.…

This analogy doesn't really work, because obesity is caused by living a modern sedentary lifestyle, whereas I'm suggesting ADHD is what we're labeling kids with for not living , or rebelling against, that sedentary lifestyle. Obesity is a disease in an objective sense because it directly causes ill health. There's lots of studies to show that. The symptoms of what we call ADHD seem to simply be caused by unhappiness…

I seem to find myself recommending Gatto's The Underground History of American Education on a reasonably regular basis, and indeed here I am doing it again. The Internet Archive has it in various formats at https://archive.org/details/TheUndergroundHistoryOfAmericanE.... While its conclusions are far from incontrovertible, the author does a good job of sourcing and supporting his argument, and I think you might find it worth your while.

Re: Overselling A.D.H.D.

#99

Post by forgotpwtomain » Tue, Aug 23, 2016, 5:30 PM UTC

scottmf wrote: post #71

forgotpwtomain wrote: post #19

Earlier quoted context omitted.

> And if we're not willing to change that environment--and I don't think we are--then we should medicate the kids so at least the experience is tolerable and they can have some success with it And as a result traditional response has been amphetamine-salts for children as you say. But I completely disagree that this is something we should do . For one I think we don't have good enough science to know how potentially…

>we don't have good enough science to know how potentially dangerous or helpful ADHD drugs really are. We have nearly a century of usage which suggests these drugs are incredibly safe. We medicate a lot of problems which are caused/worsened by society. We need a solution: Either we fundamentally restructure society, or we medicate. Since we're not fundamentally restructuring society any time soon, medication is our b…

> We have nearly a century of usage which suggests these drugs are incredibly safe.

Non-industry funded long term study (30+ years) citation needed.

> We medicate a lot of problems which are caused/worsened by society. We need a solution: Either we fundamentally restructure society, or we medicate.

I think this is a false dichotomy, not backed by any credible research and is a clever way for the pharmacy industry to sell drugs instead of society expending effort on alternative solutions.

edit (To clarify): Specifically you are jumping from "lot of problems which are caused/worsened by society" to a polarized choice of "medicate" or "fundamentally restructure society". But it should be clear that there is a whole field of available approaches which aren't "fundamental restructuring" which can attempt to alleviate such problems and unless research has enumerated and depleted all other available gradual options, this again, is a bogus dichotomy.

Re: Overselling A.D.H.D.

#100

Post by [deleted] » Tue, Aug 23, 2016, 5:31 PM UTC

anexprogrammer wrote: post #58

As someone in my 5th decade, with lifelong ADHD (though given my age it did not exist in my youth, and was only diagnosed relatively recently), I'm wary of backing away from treatments until we actually do have real viable alternatives. It took far too long to get ADHD widely recognised, and even now it's often more likely to be received with humour than real recognition. Much more research, especially on other possi…

[deleted]