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Doctor: ADHD, as currently defined, does not exist

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Re: Doctor: ADHD, as currently defined, does not exist

#31

Post by DanielBMarkham »

JohnBooty wrote: post #15

This article is so potentially harmful, even if it's more nuanced than the hyperbolic "ADHD Doesn't Exist" title would suggest. The reality is that -- whatever the underlying cause -- a lot of people struggle with attention span issues, and that these issues cause a lot of pain and unfulfilled potential. Even if ADHD medications are overprescribed Band-Aids, people benefit from them. We should try and find better dia…

So I'm with you. I also suffer from attention span issues. It's been a terrible thing to have to live with at times.

But I have to ask an honest question: do you have a deficiency for which you need treatment? Or do you have a personality type which might make you unsuited for certain types of work? Or -- more likely -- do you have a tendency for a type of personality attribute expression which varies depending on various external stimuli?

I think it's perfectly fine that something like ADHD is a naturally-occurring personality trait and/or state of mind for which we might need medication to overcome. At the same time, I'm not too happy with characterizing it as a disease or dysfunction. I think we are taking people who are acting in a completely normal fashion and telling them something is broken about them. That ain't right.

In other words, you both might be right. It's not an either-or situation. As we continue to develop our knowledge of the brain, it's a terrible mistake to create some artificial "perfect" personality and mind that any deviation from is a disease. Very. Bad.

Re: Doctor: ADHD, as currently defined, does not exist

#33

Post by Millennium »

It might be better to say that the current definition of ADHD is grossly inadequate. The problems start from issues as basic as treating ADHD as one monolithic "thing," when in fact it is a symptom that can arise from many different diseases, some of which respond better to different medications than others, and some of which do not respond to medication at all. By treating them all as a single disease, we do almost all of their sufferers a grave disservice.

Re: Doctor: ADHD, as currently defined, does not exist

#34

Post by richardlblair »

Some folks are missing the point.

Both the definition of ADHD and the treatment plan for it (in North America) are broken. In France, just 0.5% of children suffer from ADHD (opposed to ~5% in North America), and with those children they find the root cause of the issue and deal with that. They tend to shy away from medication. This is, more often than not, the proper treatment option for behavioural issues.

People need to realize the DSM, in its current state, is a massive cash cow for Big Pharma. When it comes to ADHD specifically, they needed a bigger market, welcome Adult ADHD.

Finally, I realize a lot of people suffer from attention issues. I don't disagree that these things need to be dealt with, but a catch-all diagnosis isn't really the way to do that. I'm much more interested in finding the actual problem, and fixing that.

Re: Doctor: ADHD, as currently defined, does not exist

#35

Post by ChikkaChiChi »

Experts like this jackass and Andrew Wakefield should be held accountable for criminal misconduct when the publish crap like this.

Sensationalistic 'findings' that lack a concise scientific method that have an ulterior motive are harmful to those people that expect information from experts to be presented without bias.

Re: Doctor: ADHD, as currently defined, does not exist

#36

Post by batoure »

vincetogo wrote: post #25
Pxtl wrote: post #2

I feel like this headline is terribly irresponsible. People with mental health issues suffer from a stigma associated with them, as well as denial of their suffering. Going out with both guns blazing to say their condition does not exist - not that it's a symptom of a larger problem, or that it's a gross oversimplification of a number of unrelated diseases, but instead the crude headline "doesn't exist" - that only m…

This guy is putting on his white overcoat and trying to look like a scientist, but he doesn't actually cite any real research in favour of his claim, and instead uses anecdotal evidence ("Usually, once the original condition is found and treated, the ADHD symptoms go away" and such) rather than statistics to support his conclusion and sell his book. This isn't to say he's incorrect in his conclusion, he just isn't su…

Yes I agree, in fact I think it is particularly concerning that these op'eds are getting picked up by more recognized news outlets. He wrote an almost identical piece for the daily mail last week.

http://www.dailymail.co.uk/health/article-2577814/The-eminen...

this is clearly just self promotion

Re: Doctor: ADHD, as currently defined, does not exist

#37

Post by skywhopper »

The author appears to have a philosophical issue with the DSM itself, more than a useful argument. One could make the same complaint about many of the conditions defined in the DSM. The DSM faces an insurmountable challenge in attempting to taxonomize mental issues. In "reality" next to none of the syndromes and disorders there "exist", except in terms of collections of symptoms and treatments, and assumptions about what's "normal".

Honestly nothing he says goes against anything anyone who's done even a cursory study of ADHD will already know. But he leaves out a lot that folks without much familiarity with ADHD won't already know, such as that many people with ADHD take medicines other than stimulants: anti-depressants, blood pressure medicines. A lot of drugs have been found to address the underlying problems, and each class works differently in different people.

The fact is that, like every other aspect of brain chemistry and function, we understand very very little about ADHD. That doesn't mean that it doesn't exist or that people with the disorder should stop taking medicine that works for them. It means we need to study it more to find out how to better describe and explain all the intricate connections between behavior, diet, genetics, environment, sleep, screens, family, school, work, weather, vitamins, and drugs interplay to create what we now call ADHD.

Re: Doctor: ADHD, as currently defined, does not exist

#38

Post by jaggederest »

DanielBMarkham wrote: post #31
JohnBooty wrote: post #15

This article is so potentially harmful, even if it's more nuanced than the hyperbolic "ADHD Doesn't Exist" title would suggest. The reality is that -- whatever the underlying cause -- a lot of people struggle with attention span issues, and that these issues cause a lot of pain and unfulfilled potential. Even if ADHD medications are overprescribed Band-Aids, people benefit from them. We should try and find better dia…

So I'm with you. I also suffer from attention span issues. It's been a terrible thing to have to live with at times. But I have to ask an honest question: do you have a deficiency for which you need treatment? Or do you have a personality type which might make you unsuited for certain types of work? Or -- more likely -- do you have a tendency for a type of personality attribute expression which varies depending on va…

I would argue that the vast majority of people diagnosed with ADHD don't fit the DSM V criteria for a disorder. They're experiencing "an expectable response to common stressors", and probably not "reflecting an underlying psychobiological dysfunction" - they're human, humans are often distracted, this is not a disease until it gets to the level where it absolutely begins to destroy your life, and even then it's probably reflective of something else going on rather than a primary disease.

The key to anything as a disorder in the DSM is that it:

Features

A a behavioral or psychological syndrome or pattern that occurs in an individual

B the consequences of which are clinically significant distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning)

C must not be merely an expectable response to common stressors and losses (for example, the loss of a loved one) or a culturally sanctioned response to a particular event (for example, trance states in religious rituals)

D that reflects an underlying psychobiological dysfunction

E that is not solely a result of social deviance or conflicts with society

F that has diagnostic validity using one or more sets of diagnostic validators (e.g., prognostic significance, psychobiological disruption, response to treatment)

G that has clinical utility (for example, contributes to better conceptualization of diagnoses, or to better assessment and treatment)

Other Considerations

H no definition perfectly specifies precise boundaries for the concept of either “medical disorder” or “mental/psychiatric disorder”

I diagnostic validators and clinical utility should help differentiate a disorder from diagnostic “nearest neighbors”

J when considering whether to add a psychiatric condition to the nomenclature, or delete a psychiatric condition from the nomenclature, potential benefits (for example, provide better patient care, stimulate new research) should outweigh potential harms (for example, hurt particular individuals, be subject to misuse)

Re: Doctor: ADHD, as currently defined, does not exist

#39

Post by skywhopper »

jptman wrote: post #24
JohnBooty wrote: post #15

This article is so potentially harmful, even if it's more nuanced than the hyperbolic "ADHD Doesn't Exist" title would suggest. The reality is that -- whatever the underlying cause -- a lot of people struggle with attention span issues, and that these issues cause a lot of pain and unfulfilled potential. Even if ADHD medications are overprescribed Band-Aids, people benefit from them. We should try and find better dia…

I think the article is trying to say that ADHD is an umbrella term used for a range of symptoms, rather than 1 disorder. I can imagine this being true for at least some of the cases, but it didn't provide much in the way of evidence. Although it does have a sensationalist headline, it's asking for a better look at ADHD rather than saying it should be ignored.

If you do any reading on ADHD, I think you'll find that everyone who knows anything about it would agree with this. ADHD is defined as a collection of related symptoms, with the full admission by everyone involved in the definition that the causes are varied, that most of the symptoms are exhibited by everyone to some degree, and that effective treatments likewise vary greatly.

In other words, ADHD is no different than any other mental disorder, except that the drugs have effects people like, even if nothing's wrong with them.

Re: Doctor: ADHD, as currently defined, does not exist

#40

Post by visarga »

chimeracoder wrote: post #30
JohnBooty wrote: post #15

This article is so potentially harmful, even if it's more nuanced than the hyperbolic "ADHD Doesn't Exist" title would suggest. The reality is that -- whatever the underlying cause -- a lot of people struggle with attention span issues, and that these issues cause a lot of pain and unfulfilled potential. Even if ADHD medications are overprescribed Band-Aids, people benefit from them. We should try and find better dia…

> After four years in college, which were a mix of promise and opportunities torpedoed by procrastination, I worked 10, 12, 14-hour days to finish work that I was more than talented enough to finish in 5 or 6 hours. My happiness suffered, health suffered, and relationships died. > Then I finally admitted that maybe it was a little more than a willpower issue. If it a matter of lacking willpower, why was I at the damn…

I don't like that it's classified as a disorder. It's a different style of cognitive activity, with its advantages and disadvantages.
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