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Overselling A.D.H.D.

nytimes.com

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Re: Overselling A.D.H.D.

#151

Post by whamlastxmas »

barrkel wrote: post #128

You're amazingly invested in this topic for an account with so few historical comments. I counted 11 comments on this topic out of 20 comments total. I'm not saying you're a shill, but it's suspicious.

Yeah a shill for big-amphetamine. That's like saying he's a shill for big-chicken. They're both common commodities that have a wide range of specific to generic versions. The idea that amphetamine producers gather to plan covert operations to pay people to spread propaganda on the internet is ridiculous.

Re: Overselling A.D.H.D.

#152

Post by sseal »

ajones05 wrote: post #42

In the U.S. we force children to sit still through hours of classes, wonder why they get distracted, and then medicate them. In other countries kids get more breaks to expend energy and are then more attentive - e.g., http://www.theatlantic.com/education/archive/2014/06/how-fin... "In every one of the experiments, students were more attentive after a break than before a break. They also found that the children were l…

I agree. How do you expect children to sit in a class room for 7 hours a day?

Re: Overselling A.D.H.D.

#153

Post by AStellersSeaCow »

crack-the-code wrote: post #72

While I do think that ADHD is a real condition, I don't think that the solution is to medicate children with a very serious life changing drug that alters the core aspects of a child's personality and behavior. The true solution is to revamp our country's education system and provide a framework that can accommodate the wide variety of personalities that come into the classroom. Instead of forcing children to think o…

"I don't think that the solution is to medicate children with a very serious life changing drug that alters the core aspects of a child's personality and behavior. ... Instead of forcing children to think one way, we should let them think the way they NATURALLY think, and flourish with their native mindset."

This is wildly inaccurate and ignorant, and basically perfectly sums up why the problem isn't being treated effectively.

1) The drugs aren't serious and life changing and they don't alter core aspects of your personality. People seem to confuse the effects of mild stimulants like ritalin and adderall with the effects of powerful antidepressants like prozac (I blame South Park, et al). Stimulants can have negative side effects, but they're more along the lines of what you'd expect from too much coffee: loss of appetite, hyperalertness and sleep problems, in extreme cases twitchiness and cardiovascular problems. These are well-understood, and any doctor would adjust/halt the drug if they got worrying. In terms of personality, the person is just getting a boost to their deficient executive function. The net result could be that they're less likely to do things impulsively, but not that they're less likely to do things, period.

2) I'm all for letting children think how they're going to think, and agree that our education system is far too constraining and cookie-cutter. But there's a huge and meaningful difference between "let kids think how they want" and "don't treat problems that are preventing kids from thinking lucidly". Some excellent research has shown that even if parents and teachers bend over backwards to facilitate kids with ADHD, unless they get some kind of treatment (and medication is both much more effective and far less expensive than behavioral therapy) they're still going to struggle.

So what people who advocate "let (kids) think the way they NATURALLY think" are effectively saying is "let some non-negligible fraction of kids have a dramatically lower chance of success and happiness in life rather than acknowledge that they have a disorder and treat it".

Re: Overselling A.D.H.D.

#154

Post by PhasmaFelis »

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…

> 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.

I've heard people from France say that many French doctors absolutely will not diagnose ADHD in anyone, no matter what their symptoms, preferring to tell sufferers that they're lazy. It may be possible that the US overprescribes and Europe in general is a happy medium. France is systemically failing to treat people with a genuine medical need, and it ruins lives. If it has to be one or the other, I'd prefer to err on the side of helping people in need.

Please see my other post on the effects of ADD: https://news.ycombinator.com/item?id=12345969

Re: Overselling A.D.H.D.

#155

Post by ergothus »

sevenless wrote: post #69
scottmf wrote: post #53

Earlier quoted context omitted.

Why not? People are suffering and we have safe medications which improve their lives. Not treating ADHD is far more dangerous. People with unmedicated ADHD are more likely to do poorly in school, abuse drugs/alcohol, suffer from depression etc.

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 even have a serious conversation.

If someone could give me a pill to "fix" this, that sounds awesome. Now, real medication means balancing the side-effects, etc, so even if I were to get a diagnosis I'd have to do a lot of research and consideration. But I think outright saying "No, people should suffer without consideration" is not an full answer.

(And I'm allowing that I may be having completely different issues - getting a proper diagnosis/understanding is an important things that's not part of the above debate)

Re: Overselling A.D.H.D.

#156

Post by sseal »

PhasmaFelis wrote: post #137
engx wrote: post #120

Earlier quoted context omitted.

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…

Imagine this: you're an adult professional, sitting at your desk looking at a freelance work assignment that needs to be done by tomorrow, weeping with frustration because you've been staring at it for eight solid hours, trying and trying to begin, and you can't because focusing on anything important is like trying to grip a handful of water. Because you ran out of your meds. This is what my life is like. If that doe…

three things:

1. You do not enjoy your work, and thus have no motivation.

2. Maybe you should not do the work and suffer the consequences.

3. You have built a mental dependency that you must take amphetamines to "focus", and this hinders your real ability to focus.

All of those things ^^^ I have experienced at one point or another in my life. You can focus, you have to make yourself. There is no other way. You do not need medication... But maybe you do, I highly doubt it though.

Re: Overselling A.D.H.D.

#157

Post by jrapdx3 »

yfhsjjskc wrote: post #147
leereeves wrote: post #103

Earlier quoted context omitted.

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.

The marital issues most frequently revolve around the affected partner (if there is only one) acting in disorganized, ineffective, irresponsible ways in the view of the unaffected spouse or partner.

A frequent pattern is that the "normal" individual becomes demanding that the affected partner performs better, which arouses the affected person's opposition and irritation.

Ultimately they become constantly angry at one another. Episodic or constant "warfare" is corrosive to the relationship which ultimately can't sustain the stress, resulting in failure of the relationship.

Re: Overselling A.D.H.D.

#158

Post by PhasmaFelis »

phkahler wrote: post #36
reactJS wrote: post #15

I challenge someone to provide evidence enough to scare me into stopping. Go ahead, save my life

>> I challenge someone to provide evidence enough to scare me into stopping. Go ahead, save my life From TFA: Schwarz traces the Icarus-like trajectory of Richard Fee, an aspiring medical student who fakes the symptoms of A.D.H.D. to get access to drugs that will help him cope with academic pressure. When he eventually descends into amphetamine psychosis, his father tells his doctor that if he doesn’t stop furnishing…

I've been taking ADD meds my whole life and I've never had anything like withdrawal symptoms. If I don't take the pills, I don't get the effect of the pills: that's all that happens. In fact I regularly skip them on weekends/vacations/etc. to help keep my tolerance low; I've never had any problem doing that.

Someone who's getting amphetamine psychosis off of ADD meds is seriously abusing them. That absolutely does not happen with proper clinical doses.

Re: Overselling A.D.H.D.

#159

Post by blocktuw »

PhasmaFelis wrote: post #137
engx wrote: post #120

Earlier quoted context omitted.

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…

Imagine this: you're an adult professional, sitting at your desk looking at a freelance work assignment that needs to be done by tomorrow, weeping with frustration because you've been staring at it for eight solid hours, trying and trying to begin, and you can't because focusing on anything important is like trying to grip a handful of water. Because you ran out of your meds. This is what my life is like. If that doe…

I agree that there are people who will benefit from the use of prescription medications to treat different life issues. I too suffer from hours of staring at work, unable to start or finish. I don't think I have a learning disability or a disease that needs treatment. But I think there are many alternatives to help people who cannot start and finish work tasks.

I can usually find a quiet and productive work environment free from distractions. I can usually adjust my caffeine intake levels. I can usually adjust the amount of personally stress in my life. I can usually adjust the amount of sleep. I can usually break up my work into small enough chunks to get started. I can block certain computer activities which are distracting.

Yes everybody is different. No, we should not throw out the baby with the bathwater. Yes, we should be exploring alternative treatments besides powerful amphetamines which can cause addiction and health issues. I don't believe having a problem justifies all the cost that go along with treatment. Sometimes the solution is worse than the problem.

I don't want to have to do drugs at work to keep my career from those who want to take a pill and work for 12 hours a day.

Re: Overselling A.D.H.D.

#160

Post by MichaelGG »

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.

As a parent it's very hard. Our governess mentioned our one daughter was having difficulty focusing. So I did a trial with just 5mg/day Ritalin. Week on, week off. The difference is huge.

It's a really hard call. I'm worried about the effects long term, but she does so much better with it. If she was in a school instead of with a private tutor, I'm guessing she'd be way worse off.

FWIW I used to think giving meds to an 8yr old was horrible. It's not so clear anymore.

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