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Overselling A.D.H.D.

nytimes.com

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Re: Overselling A.D.H.D.

#161

Post by panglott »

falcolas wrote: post #113
panglott wrote: post #76

Earlier quoted context omitted.

The thing is, diagnosis rates in the U.S. are something like 3-4 times as high as in most countries in Europe, which are themselves 3-4 times as high as a country like France, which is averse to ADHD diagnoses. The main treatment for ADHD is lifelong maintenance of powerful amphetamines, when we have no idea what the long-term consequences of that would be, nor what proportion of children would normally develop out o…

> Overdiagnosis at that rate means that millions of children are being given amphetamines, when they shouldn't be! Only if you define overdiagnosis as "diagnosis relative to other countries" and not "diagnosis relative to the percentage of people with the ailment". If you use the first, we probably overdiagnose cancer, since countries like Mali have a much lower diagnosis rate... > children would normally develop out…

When similar standards of diagnosis are used across countries, they find similar rates of ailment. The difference is that the criteria for diagnosis in the US catches a much larger percentage of the population. Moreover, the US is also much more likely to use pharmaceuticals as the front-line treatment to any ADHD diagnosis.

Really, my concern isn't about children who would be diagnosed either way, or who unambiguously need pharmaceutical treatment (who exist in all areas). It's about the marginal cases where pharmaceuticals may not be warranted.

It would be dreadful to administer chemotherapy drugs to patients who got a false-positive on a cancer screening (cancer is not a spectrum, but I'll run with your analogy).

And as I said in another comment, skepticism of the long-term use of this medication in young children does not at all mean advocacy of non-treatment, non-intervention, or lack of support for children at the margins of the ADHD spectrum.

Re: Overselling A.D.H.D.

#162

Post by dnh44 »

carlmcqueen wrote: post #78
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…

This comment made me think of Aaron Schwartz's article on schools just being instruments of corporations preparing us to be drones in eight hour jobs. [1] I don't know where I stand on it, but I found myself realizing I believe it a little more when I read your article of preparing kids to work for 9-10 hours and keep focused. [1] https://newrepublic.com/article/127317/school

This book also deals with similar themes.

https://en.m.wikipedia.org/wiki/Lies_My_Teacher_Told_Me

Re: Overselling A.D.H.D.

#163

Post by [deleted] »

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…

[deleted]

Re: Overselling A.D.H.D.

#164

Post by sevenless »

saosebastiao wrote: post #138

I'm really glad that there is a bar for psychiatric expertise that ignoramuses like you are in no danger of passing.

Indeed. Here's to psychiatry, the one medical specialty with a consistent record of creating more diseases for themselves to treat every year.

Re: Overselling A.D.H.D.

#165

Post by sevenless »

yfhsjjskc wrote: post #133
sevenless wrote: post #114

Earlier quoted context omitted.

Like I said elsewhere - does that mean that being ugly/unattractive is a disease? Or having an awkward personality, or having a low IQ? Or for that matter, being a member of any discriminated-against minority? It seems unjust and coercive to tell people they have a disease and should be medicated simply because society demands it.

Before we talk about forcing people to go on drugs they don't want, let's get to a place where society lets everyone who could benefit from treatment at least have the option of receiving it.

The problem with this is that offering people the treatment can create the disease, in some sense.

Re: Overselling A.D.H.D.

#166

Post by sevenless »

ergothus wrote: post #155
sevenless wrote: post #69

Earlier quoted context omitted.

I'm sure some people's school grades benefit from taking amphetamine-like drugs, but that still doesn't imply they are suffering from a disease in the first place. It's far from clear why having the symptoms of ADHD should be considered a disease, in any objective sense. If kids are suffering because school is boring or society is restrictive, that doesn't mean there's something wrong with them .

I have no diagnosis of ADD/ADHD. I have recently, however, started to wonder. I'm an adult (39), and recently things that have just always been true for me are getting more rigid and interfering with my life. Things like: I need an exact amount of input: too little and I get bored/distracted, too much and I can't focus and get irritable. This has a huge impact on my ability to do work, to socialize with friends, or e…

Shorn of all pretense you're essentially wondering if you'd benefit from or enjoy taking drugs. This is quite possible. People take drugs for all kinds of reasons. What I object to is calling this a disease.

Re: Overselling A.D.H.D.

#167

Post by panglott »

jrapdx3 wrote: post #126
panglott wrote: post #76

Earlier quoted context omitted.

The thing is, diagnosis rates in the U.S. are something like 3-4 times as high as in most countries in Europe, which are themselves 3-4 times as high as a country like France, which is averse to ADHD diagnoses. The main treatment for ADHD is lifelong maintenance of powerful amphetamines, when we have no idea what the long-term consequences of that would be, nor what proportion of children would normally develop out o…

Some of these questions have been studied. When the same criteria are used, prevalence is comparable in Germany, Brazil and other locations. The recognition of the condition is affected by cultural factors but that's true for many conditions. ADHD by definition is a condition that originates in childhood and persists into adulthood in about 1/2 or more of cases. In adults ADHD is indeed a chronic condition that often…

> ADHD by definition is a condition that originates in childhood and persists into adulthood in about 1/2 or more of cases.

Right, and all of this is a question about under what conditions it persists or fails to persist. Does ADHD medication, relative to say behavioral therapy or nontreatment/nonintervention, make it more or less likely that ADHD will persist in adulthood? This is a very important question of those who fear ADHD medication is overused, and may be encouraging ADHD to persist past adolescence.

Re: Overselling A.D.H.D.

#168

Post by panglott »

scottmf wrote: post #108
panglott wrote: post #76

Earlier quoted context omitted.

The thing is, diagnosis rates in the U.S. are something like 3-4 times as high as in most countries in Europe, which are themselves 3-4 times as high as a country like France, which is averse to ADHD diagnoses. The main treatment for ADHD is lifelong maintenance of powerful amphetamines, when we have no idea what the long-term consequences of that would be, nor what proportion of children would normally develop out o…

>we have no idea what the long-term consequences of that would be Perhaps you have no idea, but we actually have a pretty good idea from 80 years of stimulant medication usage. Do you have data suggesting negative consequences of decades of stimulant usage? No? Then it's surely the best decision to ignore this FUD and continue treating people of all ages with stimulants which have been shown to be safe in such low do…

The main question is whether medication-based treatment encourages ADHD to persist past adolescence. Non-medication-based treatment, of course, does not necessarily imply non-treatment or non-intervention.

Re: Overselling A.D.H.D.

#169

Post by metaphorm »

dragonwriter wrote: post #148
metaphorm wrote: post #141

Earlier quoted context omitted.

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…

bladder infection is an infection by a microbial disease. it's a pathogen caused by another organism that shouldn't be present in a healthy body. what exactly is ADHD? what is being treated, anyway?

this is medicating for "normality", which is another way of saying our society is defining and enforcing (with mind-altering drugs) a very narrow band of acceptable personalities and behavioral responses to environmental situations.

if chemical enforcement of "normal" is ok with you, then go ahead and drug your kids.

Re: Overselling A.D.H.D.

#170

Post by saosebastiao »

sevenless wrote: post #164
saosebastiao wrote: post #138

I'm really glad that there is a bar for psychiatric expertise that ignoramuses like you are in no danger of passing.

Indeed. Here's to psychiatry, the one medical specialty with a consistent record of creating more diseases for themselves to treat every year.

That argument is literally one of the oldest in the books, applied in equivalent fashion by detractors of every field that has ever existed. Surely you can do better than that. Then again, considering your complete disregard of empirical understanding and rhetorical techniques on display thus far, I wouldn't be surprised if that's the best you've got.
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