Earlier quoted context omitted.
> only the catastrophic is worth addressing This is a very privileged view of the mind. I have ADHD (and autism). But I also have a quite high IQ, if one cares about such things. I'm pretty successful, professionally. But it took until around 40yo to get the ADHD diagnosis and get a prescription for medication that has been life-altering. Was I suffering from catastrophic failures? Absolutely not: married, have kids,…
Hold on.. did you just say there is a drug I can take that will making talking to people less boring and doing housework fun?
Undisclosed financial conflicts of interest in DSM-5 (2024)
151–160 of 225 posts
Re: Undisclosed financial conflicts of interest in DSM-5 (2024)
#152Earlier quoted context omitted.
If you look into the history of psychiatry I think you’ll find quite a lot of examples when diagnosis and treatment was forced on people who didn’t want it. It’s not hard to find contemporary such examples either.
Yes, that did unfortunately happen in the history of psychiatry. I am talking about modern American psychiatric practices (say, the last 10-20 years). If the proposition here is that mental health disorders are fabricated maliciously in order to sell more medication or enforce some sort of social order, then I don't see how the very rare court-ordered enforcement of short-term stays at psychiatric institutions could…
That's true, but that's not what the parent comment claimed. They didn't say a majority receive psychiatric care involuntarily, they said it's not hard to find examples who receive it involuntarily, and that's true. Lots of people are forced to take psychiatric medication right now, in developed countries including the US.
Re: Undisclosed financial conflicts of interest in DSM-5 (2024)
#153I have particular issue with “diseases” defined as done for osteopenia. Rather than define an objective measure of the problem, they (by definition) effectively define the percentage of the population affected. In other words, osteopenia is defined in such a way that it is not curable, preventable, etc. What is the point saying, “disease X affects 5% of the population by definition”. It’s like throwing away half the…
As a heuristic for identifying when something deserves attention?
Re: Undisclosed financial conflicts of interest in DSM-5 (2024)
#154Earlier quoted context omitted.
> only the catastrophic is worth addressing This is a very privileged view of the mind. I have ADHD (and autism). But I also have a quite high IQ, if one cares about such things. I'm pretty successful, professionally. But it took until around 40yo to get the ADHD diagnosis and get a prescription for medication that has been life-altering. Was I suffering from catastrophic failures? Absolutely not: married, have kids,…
Hold on.. did you just say there is a drug I can take that will making talking to people less boring and doing housework fun?
For those with ADHD they turn on the prefrontal cortex which reduces or removes the feeling of utter torture and pain from doing chores.
It's sort of like taking a drug that takes away the fear and almost physical inability to to touch a hot stove most people have. Normally that'd be bad. Except here the hot stove is actually harmless and useful to touch.
Re: Undisclosed financial conflicts of interest in DSM-5 (2024)
#155Earlier quoted context omitted.
>I bet if you knew your house would burn down if you didn't do "normal" things you would have done them no problem Getting yourself to do things in a boring situation that you might only do in an exciting situation is a big challenge in ADHD management If everything was a "house on fire" level emergency, many ADHDers would get more done but would eventually collapse from running around on adrenaline for days These pr…
The point is it's obviously a problem of perspective. Things are not important because they aren't considered important. If the stakes are higher they are elevated in importance and more demanding of attention. To pretend that humans are hedonic beasts incapable of cognitive adaption is ridiculous. We do not operate purely on impulse save for pharmaceutical intervention. We can force ourselves to give things more or…
Re: Undisclosed financial conflicts of interest in DSM-5 (2024)
#156Earlier quoted context omitted.
> only the catastrophic is worth addressing This is a very privileged view of the mind. I have ADHD (and autism). But I also have a quite high IQ, if one cares about such things. I'm pretty successful, professionally. But it took until around 40yo to get the ADHD diagnosis and get a prescription for medication that has been life-altering. Was I suffering from catastrophic failures? Absolutely not: married, have kids,…
Hold on.. did you just say there is a drug I can take that will making talking to people less boring and doing housework fun?
Re: Undisclosed financial conflicts of interest in DSM-5 (2024)
#157Earlier quoted context omitted.
But people do. Psychology courses do, with a similar "tool to help standardize communication" line recited robotically and then practically ignored. Most practicing psychologists do as well, to only a somewhat lesser degree. You cannot have an authoritative textbook proscribing definitions, and then expect people to treat them as just "a self-described ontology" with all the nuances and caveats around that just becau…
I’ve had a bunch of neuro/psycho classes and this was always well understood. This stuff is complicated. People are going to get it wrong. That sucks. But if you’re going to judge the book, judge it by how it presents itself, don’t judge it by how a third party misrepresents it.
> But if you’re going to judge the book, judge it by how it presents itself
Quite so. I just as we judge people by their actions, not their words, I judge the DSM by how it's actual content is structured, not by its introductory quip.Re: Undisclosed financial conflicts of interest in DSM-5 (2024)
#158Earlier quoted context omitted.
That’s not accurate in the case of osteopenia. It’s defined by a T score. The quantile of the distribution of bone density measurements of young, healthy people that matched the bone density of this patient. Treatments for osteopenia are basically making sure you’re getting enough calcium, vitaD, and high impact exercise…if everyone did all those things (and they worked), the rate of osteopenia would drop to zero.
Yeah, and the T score doesn’t seem to have any medical basis. Between 1.0 and 2.5 standard deviation is something like 15% of the population. “1.0” and “2.5” are ridiculously round number. What is the medical significance of such? Sure, at some point, it will be correlated with fragile bones. Adult male height is roughly 5’9” with standard deviation of 2.8”. We DON’T say adult males under 5’2” are diagnosed as having…
People are, on average, fucking shitty people.
Re: Undisclosed financial conflicts of interest in DSM-5 (2024)
#159Earlier quoted context omitted.
>I bet if you knew your house would burn down if you didn't do "normal" things you would have done them no problem Getting yourself to do things in a boring situation that you might only do in an exciting situation is a big challenge in ADHD management If everything was a "house on fire" level emergency, many ADHDers would get more done but would eventually collapse from running around on adrenaline for days These pr…
The point is it's obviously a problem of perspective. Things are not important because they aren't considered important. If the stakes are higher they are elevated in importance and more demanding of attention. To pretend that humans are hedonic beasts incapable of cognitive adaption is ridiculous. We do not operate purely on impulse save for pharmaceutical intervention. We can force ourselves to give things more or…
People with ADHD cannot all just "force themselves" to function. Novelty, excitement and interest can help, some of the time, but the rest of the time it's disaster. Depending on severity, the result of not getting the treatment they need can often include things like an inability to keep a job, homelessness, prison sentences, and accidents/injury. Those kinds of outcomes are pretty damn important to avoid, extremely stressful (exciting) to experience or be in imminent danger of, and certainly more than enough to motivate people to do the best that they can, but some percentage of people will never be able to avoid those outcomes by trying to will themselves into "cognitive adaption".
Others may be able to stave off the absolute worst outcomes without medication, but only through exhaustive efforts that prevent them from accomplishing the things they want in life. Why should someone constantly and needlessly push themselves to their absolute limit just to accomplish what comes easily for most people? For what? Bragging rights about how they reshaped their brains by sheer force of will? If medication for a mental condition can make people's lives better they should be free to take it.
To whatever extent you've been able to function without medication, that's great. Don't assume that what worked for you is applicable to everyone else, or even to most other people.
Re: Undisclosed financial conflicts of interest in DSM-5 (2024)
#160Earlier quoted context omitted.
But conceptually in the DSM most disorders are defined by whether they cause hardship in the patient's life. Whether that means some disorders would not have to be considered disorders in an ideal society is irrelevant for this context, because people need help navigating the society we have.
Remember that in the US slaves wanting freedom was a mental disorder that made it past peer review: https://en.wikipedia.org/wiki/Drapetomania
https://pmc.ncbi.nlm.nih.gov/articles/PMC3480686/
> Fate, which takes away healthy, free, young people, never pardoned me once. It has let me live all this time, quite lucid, but closed up in here ... since I was ten years old .... eighty years in psychiatric hospital for a headache
Take modern medicine with a grain of salt.