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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

#71
In my research, ADHD seems to be basically inflammation[1] of the brain. Think: bacteria, free radicals, active immune response, underactive detox and circulation, etc.

Some approaches which are most useful seem to be: Magnesium, Green Tea &/OR L-Theanine, GABA, SAMe, Milk Thistle, Fish Oil, Cholesterol, Vitamin D (Sunlight), etc.

I would say there is no silver bullet. But I would say unambiguously that vitamins and minerals and occasionally herbs are low hanging fruit compared to a pharmaceutical approach. Drugs aren't used as "building blocks" in cells or biochemistry. Drugs modulate various activity in our body which can help but typically is not without some kind of side effect or not as affective as providing enough of the "raw materials" our body needs.

Attention Deficit Hyperactive Disorder definitely exists although the way it's predominately treated really doesn't help solve the deeper causes of the disorder.

[1] http://www.ncbi.nlm.nih.gov/pubmed/24240495

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

#72
QUOTE "For my second group of patients, who have severe attention issues, I make them undergo a full evaluation to find the source of the problem. Usually, once the original condition is found and treated, the ADHD symptoms go away."

And, when the original condition is the required 14 or so traits of ADHD, which using your "over 20" treatments do not solve, do you decide this is non-ADHD with ADHD Symptoms ?

asshole.

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

#73

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 agree this article is kind of a mess, the title misleading. This is the nature of ADHD. It's a magnet for people wanting to cry "overdiagnosed"! However, tolerance is a big question. Taking an ADHD medicine for the first week or so after not taking any for months prior is a pretty profound experience. But that tapers off. And leaves one to wonder... is my condition still improved? I have seen very few studies (t…

  > I've heard of doctors prescribing drug holidays to 
  > minimize tolerance (and also heard this was no longer current 
  > practice from an expert in the field).
When you say "drug holiday" do you mean temporarily reducing your dosage, or temporarily stopping the medication entirely?

I can't speak for current practice in general, but I've had a couple of doctors and a nurse practitioner recommend tapering down my dose a bit on days when it's possible (ie, days off from work, etc) in the last few years.

I don't know if everybody would respond this way, but a lot of feel doing that helps stop tolerance/dosage creep, which was definitely a thing I experienced in the beginning. After some experimentation it seems like the way to go for me. I've been steady at a prescription of 15mg/day for a few years. Some days I take ~10mg and some days I take ~20mg.

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

#74

Earlier quoted context omitted.

What are the advantages?

It's hard to generalize, but when paired with intelligence and so forth, ADHD symptoms like restlessness, curiosity, "not fitting in" etc. can work as positives. It's often been said that these can be beneficial traits in entrepreneurs.

> when paired with

No. The other traits are themselves beneficial. Do not confuse their success in spite of their ADHD with success because of their ADHD.

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

#75
post #65

Earlier quoted context omitted.

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 th…

But isn't that a problem? Shouldn't we try to split ADHD up into smaller more specific disorders so that we can better study/treat it? If lumped all together, that seems to only help cause over-diagnosis (because the symptom list is so large) and makes it harder to study (because two very different conditions may be manifesting in very similar ways).

Actually, it is split. There are three types of ADHD - predominantly hyperactive-impulsive (PH), predominantly inattentive (PI), and combined (C). There is also Sluggish Cognitive Tempo, which seems to be related to ADHD-PI, but there is less research on it.

Additionally, people who may seem to have ADHD may in fact have OCD, anxiety, depression, or other disorders. And vice versa. Or they may have a combination of one or more of these with ADHD.

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

#76
post #40

Earlier quoted context omitted.

> 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.

Sorry but that sounds like an after-the-fact rationalization rather than a sensible statement, especially given the piles of evidence that inflammation causes ADHD. I mean, sure, a chronic infection can teach you something but that doesn't mean we shouldn't fix it.

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

#77

Earlier quoted context omitted.

I've personally known someone who has taken Ritalin type meds for 20+ years and did extremely well on it. In addition, my research indicates that tolerance to ADHD meds is uncommon and typically a person can be kept on one dose for years.

See, I'm under long-term medication myself, for an incurable, but treatable condition. Long term medication is a last-ditch remedy and that's for a reason. It's generally speaking a PITA. Where ever you go, you need to take your medication with you. Depending on what you get, you might have to take it on schedule. Depending on what you get, the pharmacy round the corner needs to order it and the stuff needs a prescri…

I think medication for ADHD should be avoided unless it is necessary.

I also have read statistics on how ADHD is treated in children which very much trouble me - there it seems to be highly overdiagnosed and treated.

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

#78

Earlier quoted context omitted.

> 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 think the only real problem is that ADHD has always been improperly named[0]. The actual condition itself has very little to do with attention. I think it should be called "executive function disorder."

Too broad; Asperger's is also considered an EF disorder. While there are many similarities (people in support groups for either tend to call the other "cousins") they are very different in presentation.

Yes, it is an EF disorder, but one of many on the spectrum of EF disorders. That said, I can think of no better name at the moment.

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

#79
post #65

Earlier quoted context omitted.

But isn't that a problem? Shouldn't we try to split ADHD up into smaller more specific disorders so that we can better study/treat it? If lumped all together, that seems to only help cause over-diagnosis (because the symptom list is so large) and makes it harder to study (because two very different conditions may be manifesting in very similar ways).

Actually, it is split. There are three types of ADHD - predominantly hyperactive-impulsive (PH), predominantly inattentive (PI), and combined (C). There is also Sluggish Cognitive Tempo, which seems to be related to ADHD-PI, but there is less research on it. Additionally, people who may seem to have ADHD may in fact have OCD, anxiety, depression, or other disorders. And vice versa. Or they may have a combination of o…

I was not aware of that.

As someone outside all of this (I've never had to deal with it, so I only have a passing familiarity) it sounds like the term ADHD needs to be removed from use as it's only causing more confusion. The various facets should have their own name.

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

#80
post #40

Earlier quoted context omitted.

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

What are the advantages?

People with ADHD tend to be very fast thinkers -- indeed this is part of the "problem" because while we're having a conversation with someone, we've thought through every consequence of what you just said before you finish your sentence. Because of this, we tend to get to "outside the box" type solutions much more quickly than others because we can effectively execute parallel tasks in our minds and come up with an answer to a complex problem quickly. The issue then comes in translating the issue in a way that can be communicated with others; so much so that when someone with severe ADHD seems to be very pensive in thought, they're likely just trying to work through how to verbalize what they've been thinking since before you finished talking.

Another hallmark of ADHD is actually the ability to "hyperfocus", which is almost an autistic-like quality. If I'm working on something I'm intensely interested in, I can work on it all day long and not notice that I forgot to eat both lunch and dinner. This happens whether stimulants are involved or not. It comes off as a lack of attention because, well, you ignore everything else unconsciously. When "hyperfocus" happens, you can lose tracks of large periods of time (we're talking 6 hours go by and it legitimately feels like 15 minutes.)

I do agree that it's not so much a "disorder" as it is just a different way of functioning. It's advantageous in some lines of work (a lot of software developers tend to be ADHD because of the hyperfocus) and disadvantageous in others. There are coping strategies, but it's no different than the types of things non-ADHD people have to learn how to do -- the strategies just end up being a little different and focused more on reminding us to do things.

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