Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Overselling A.D.H.D.

nytimes.com

Post reply on HN
Print view View original

141–150 of 235 posts

Re: Overselling A.D.H.D.

#141

Post by metaphorm »

falcolas wrote: post #116
metaphorm wrote: post #106

Earlier quoted context omitted.

I'm glad amphetamine treatment is effective for you. I hope you can recognize that your situation (an adult, in full control of your own care, with informed consent at all stages) is very very very very very different than putting 6 year olds on ritalin because they're fidgetting at their desk in class. This is really done in America.

No, it's not done that way - there are more factors than "fidgeting in class" that psychiatrists take into account when diagnosing ADHD. And frankly, if they're put on Ritalin and stop fidgeting and start paying attention, then it's probably a valid diagnosis in the first place. People without ADHD would end up fidgeting more, not less, if given amphetamines.

these are children we're talking about. you're endorsing drugging children.

Re: Overselling A.D.H.D.

#143

Post by flogic »

jordanlev wrote: post #48
flogic wrote: post #22

I'm generally not fond of this sort of article and this one is no exception. They present a case that drug companies like selling drugs but we knew that. What they don't do is present a good case that ADHD is actually overdiagnosed. The world in general is not very good at accepting psychological conditions. ADHD is commonly regarded as "youth", "laziness", or "lacking discipline". Watching a loved one fight to focus…

This is a book review, not an article per se. I'd assume the book goes into much more detail. Also, from the review: > Schwarz has no doubt that A.D.H.D. is a valid clinical entity that causes real suffering and deserves real treatment, as he makes clear in the first two sentences of the book: “Attention deficit hyperactivity is real. Don’t let anyone tell you otherwise.” But he believes that those who are disabled b…

The fact it's about a book rather than a scientific article makes me suspicious. Finding people who are untreated and struggling is common. So what's the point of it being a book? Other than cashing in on the "it's all in your head" sentiment? Claiming it's real in a small aside just seems like ass covering.

Re: Overselling A.D.H.D.

#144

Post by discordianfish »

I don't want to add anything further beside asking people who are about to comment how it's not a real disease to read the comments here, written by people who have ADHD or which friends and relatives struggle. Listening to them and whether it helps is much more relevant than any opinion or vision of a world without need for Ritalin.

Re: Overselling A.D.H.D.

#145

Post by anexprogrammer »

engx wrote: post #120
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…

Why do people on meth enjoy cleaning? There is little difference between meth and Adderall. Taking any type of stimulant even coffee helps people do menial tasks and be more optimistic while doing them. Maybe millions of people are effected by some problem of distraction and lack of focus. But to suggest there's some biochemical reason for this that's cured by amphetamines seems like pseudoscience to me. Drugs do wor…

16 million Americans seems to correlate fairly well with the medical consensus that around 5% of adults have some degree of ADHD. Perhaps it's not as widely over-diagnosed as sometimes claimed?

" But to suggest there's some biochemical reason for this that's cured by amphetamines seems like pseudoscience to me."

A pseudo science that very strongly runs in families.

A pseudo science that's strongly linked with dopamine transmission.

A pseudo science that has some medical evidence pointing to it being an under development of the frontal lobes.

I suggest you google the field a little.

Re: Overselling A.D.H.D.

#146

Post by sseal »

I am kind of disappointed with the people reporting that they have been "suffering" with adhd or add. I was prescribed add/adhd medication from 5th grade until 12th. It wasnt until I started practicing yoga was I able to make myself focus.

I had always, my entire life, HATED taking "my medicine". It changed me, it made me just like everyone else. Now that I am in my later 20's I take pride in the fact that I am "ADD". It is disappointing that people with this gift listen to society and somehow think they are not normal. Take some time and read about benefits of having add/adhd, it will surely put you in a better state of mind.

I will say there are edgecases of people that truly have issues, but I beleive your average add/adhd patient could do without it.

Another thought. We are bashing these kids that have problems conforming to or being a part of our schooling standards. Why do they have to conform, why are more schools not conforming to the add/adhd children? Why must we have to change our natural state of mind? It doesn't make sense to me that we have to take drugs and alter the natural way we were made because we are outspoken in class, or dont want to listen to a teacher lecture.

Rant is over.

Re: Overselling A.D.H.D.

#147

Post by yfhsjjskc »

leereeves wrote: post #103
jrapdx3 wrote: post #86

Since I've had the responsibility of managing the treatment of at least a thousand adults and adolescents with ADHD, it's a subject I've studied quite a bit. And as the medical literature attests ADHD is probably among the most researched of all medical conditions and its reality is unquestioned based on the scientific literature. When people say "I don't believe in ADHD" I point out it's not like believing in Santa…

If I could ask a question that may sound like a challenge but it is not meant as one: How does ADHD lead to divorce, motor vehicle accidents and injuries, and greater rates of general health conditions? Is this correlation still present after controlling for confounders like education and economic status?

Have you ever gotten distracted and started thinking about some random bullshit during sex, after only a few minites, despite being very attracted to and in love with your sexual partner? Imagine if that happened every time and how it would affect your relationship. What would your partner say? Now imagine it happened again while you and your partner were discussing the issue.

Re: Overselling A.D.H.D.

#148

Post by dragonwriter »

metaphorm wrote: post #141
falcolas wrote: post #116

Earlier quoted context omitted.

No, it's not done that way - there are more factors than "fidgeting in class" that psychiatrists take into account when diagnosing ADHD. And frankly, if they're put on Ritalin and stop fidgeting and start paying attention, then it's probably a valid diagnosis in the first place. People without ADHD would end up fidgeting more, not less, if given amphetamines.

these are children we're talking about. you're endorsing drugging children.

Yes, so what? My son had a bladder infection, and I certainly endorsed the use of drugs to treat that. If there is a real and identifiable condition interfering with a child's quality of life for which there is concrete reason to think that a drug is an effective and remedy for which the risk of other side effects is mild compared to the expected benefit, why shouldn't responsible adults endorse drugging children in that circumstance?

Re: Overselling A.D.H.D.

#149

Post by panglott »

scottmf wrote: post #90
panglott wrote: post #83

Earlier quoted context omitted.

We simply don't know what the impact is of administering powerful amphetamines to children upon their development. Is there a population of children that would "age out" of the ADHD spectrum and develop coping mechanisms, if they were not given pills that prevent that? In such a case, the medication is actually hampering their development.

We have 80 years of data from giving children low doses of stimulants. >In such a case, the medication is actually hampering their development. Again, the actual data say otherwise. Medication tends to help children develop proper coping mechanisms. Not medicating is more likely to result in social rejection, drug abuse, depression, dropping out of school, and so on. Most of this anti-medication sentiment is unscient…

You're conflating "not medicating" with "not treating", which is exactly the sort of thing that feeds the criticism that U.S. overdiagnosis rates are being driven by the pharmaceutical industry. Behavioral therapy is also effective, and avoids some of the negative impacts of medication. There are studies that compare medicated ADHD patients to untreated ADHD patients over the course of adolescence; but people who are skeptical over the over-prescription of ADHD drugs aren't actually advocating for non-treatment and non-intervention. Almost no one doubts that ADHD is a real problem for some children that requires medication. The question really is about the extent of overdiagnosis in the US, and the long-term use of medication for children, especially very young children. Stimulant drugs are not recommended for children under 6, and yet still something like 1% of US children under 6 are taking them. Both ADHD diagnoses and pharmaceutical treatment is far, far more prevalent in the US than other developed countries, and it is certainly a good question as to why. Parents naturally have a lot of anxiety about their children's schooling, and the marketing of ADHD plays upon and exacerbates that anxiety (to the extent that if you mention any hiccups in your child's adjustment to school, people immediately begin talking about ADHD). It is also true that kindergarten is the new first grade in terms of literacy expectations, which means more long, boring desk work for young children who are frequently seeing their exercise time reduced or eliminated. Those are problems also.

Re: Overselling A.D.H.D.

#150

Post by jrapdx3 »

leereeves wrote: post #103
jrapdx3 wrote: post #86

Since I've had the responsibility of managing the treatment of at least a thousand adults and adolescents with ADHD, it's a subject I've studied quite a bit. And as the medical literature attests ADHD is probably among the most researched of all medical conditions and its reality is unquestioned based on the scientific literature. When people say "I don't believe in ADHD" I point out it's not like believing in Santa…

If I could ask a question that may sound like a challenge but it is not meant as one: How does ADHD lead to divorce, motor vehicle accidents and injuries, and greater rates of general health conditions? Is this correlation still present after controlling for confounders like education and economic status?

This whole subject is challenging, believe I know! :)

The correlation is between diagnosis of ADHD and outcome parameter. IOW among adults with ADHD divorce rate is much higher, IIRC around 2 times the non-affected population rate.

The "causal" pathway is obviously complex, but bear in mind ADHD has a broad impact on functional domains, so an individual afflicted with ADHD will fail relationally, in education, employment, health and so on, one adversity compounding others.

For example, a married man loses his job because he can't get paperwork done, or keep schedules organized, which puts a strain on marriage due to financial stresses, eventually producing enough discord that the wife bails on the marriage.

The research on functional deficits has been going on a long time, and is well-vetted in peer reviewed journals. The confounds have been accounted for.

Post reply on HN