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Overselling A.D.H.D.

nytimes.com

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Re: Overselling A.D.H.D.

#111

Post by forgotpwtomain »

atemerev wrote: post #104
forgotpwtomain wrote: post #93

Earlier quoted context omitted.

> 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. Ma…

Pushkin wrote quite a lot of child books, easily accessible for 2nd grade. It's not like Tolstoi or Dostoyevsky (those had to wait until grade 10).

There are also great children's authors in English - A.A. Milne, Oscar Wilde's stories, Mark Twain, Kipling, Baum (Wizard of Oz). All of these could be accessible at various stages within grades 2-5.

Re: Overselling A.D.H.D.

#113

Post by falcolas »

panglott wrote: post #76
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…

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 of the ADHD spectrum with time.

And until they normally develop out, they would be behind in every measurable attribute as what we expect in their growth through school. Avoiding administrating a treatment which works because of our fear of the treatment is measurably bad for those affected. See, again, cancer and chemotherapy.

Re: Overselling A.D.H.D.

#114

Post by sevenless »

smelterdemon wrote: post #102
sevenless wrote: post #50

Earlier quoted context omitted.

But what does "real" mean , exactly? That it's a recognizable pattern of behavior? That doesn't necessarily mean it should be treated as a disease.

You can make that argument for most if not all mental disorders (cf. Erving Goffman). The fact is that persons with ADHD face significant difficulties functioning in modern society and suffer as a result, which is our best criteria for treating a mental issue as a disease.

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.

Re: Overselling A.D.H.D.

#115

Post by atemerev »

forgotpwtomain wrote: post #111
atemerev wrote: post #104

Earlier quoted context omitted.

Pushkin wrote quite a lot of child books, easily accessible for 2nd grade. It's not like Tolstoi or Dostoyevsky (those had to wait until grade 10).

There are also great children's authors in English - A.A. Milne, Oscar Wilde's stories, Mark Twain, Kipling, Baum (Wizard of Oz). All of these could be accessible at various stages within grades 2-5.

Yes, of course. I just wanted to explain that reading Pushkin at 2nd grade is not as impressive as it might sound in English. :)

Re: Overselling A.D.H.D.

#116

Post by falcolas »

metaphorm wrote: post #106
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…

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.

Re: Overselling A.D.H.D.

#117

Post by scottmf »

forgotpwtomain wrote: post #99
scottmf wrote: post #71

Earlier quoted context omitted.

>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…

We have real data which heavily backs the case for medicating.

You have emotion and conjecture.

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

What do you want? You're suggesting all these studies are funded by pharma cos and the scientists are falsifying data?

If you're not going to believe any of the data and stick to your own emotions on the subject there's no point discussing this.

Until you have anything besides personal feelings and unfounded beliefs we should obviously stick to what we're doing. Anything else is dangerous and unscientific.

Re: Overselling A.D.H.D.

#118

Post by falcolas »

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?

The two biggest factors that I can come up with would be the lack of ability to control attention, and the inability to consider the long term repercussions of actions.

If you can't force yourself to keep attention on the road, you're going to crash. If you can't think about how that daily pint of ice cream will affect you beyond "it tastes good now", you're going to gain weight.

Re: Overselling A.D.H.D.

#119

Post by Diederich »

Broken_Hippo wrote: post #101
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…

I looked, and it seems to be about double (though figures disagree). And I wonder if this isn't simply a difference in educational systems and expectations of children. I'm in Norway, and children play quite a bit, even in school. They take frequent breaks, have outdoor recess (in nearly all weather), and have no homework. The general attitude is that kids should be kids and not have to worry about stuff. Sure, there…

This is pretty important stuff, thank you for posting.

Often times, 'a problem' exists largely because a person's behaviour and/or performance exists outside of the local norm.

Given this, then by definition the amount and types of such problems are largely driven by the norm.

As you said, I don't have anything at hand to back this up, but this seems like a very reasonable way to explain some of these big diagnosis deltas.

Re: Overselling A.D.H.D.

#120

Post by engx »

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 work. If you want to take amphetamines to improve your work performance, go for it. But to suggest that it's a disease seems disingenuous.

There's something like 16 million Americans who take Adderall, which has drastically increased in used (300%+ from 2008-2012). Another poll said 35% of college students had said they'd tried Adderall.

The science of ADHD is ambiguous. The science of moderate uses of amphetamine or methamphetamines for improving work performance is easier to understand.

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