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Overselling A.D.H.D.

nytimes.com

41–50 of 235 posts

Re: Overselling A.D.H.D.

#41
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…

What's the problem here? Someone fakes symptoms to get medication, abuses it, goes crazy, kills self.

If you read the article about this guy you'll see he was incredibly manipulative and lied to multiple doctors to get prescriptions.

The problem here is Richard Fee, no one else.

Re: Overselling A.D.H.D.

#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 less attentive when the timing of the break was delayed—or in other words, when the lesson dragged on."

Re: Overselling A.D.H.D.

#43

Earlier quoted context omitted.

I'm far from an expert on this, but I've always thought that the symptoms (inattention and/or impulsivity and hyperactivity) are only maladaptive in modern culture, where young people are expected to spend long hours sitting quietly at attention in school. Is that a disease, or a flaw in modern culture?

It would be interesting to know if length of school day correlates with diagnosis rate (controlling for confounding covariates), or if, e.g., Montessori schools have fewer diagnoses than public schools (again controlling for confounding covariates like family income, etc.).

Controlling for confounding factors in a study like this would be very close to impossible. Income is one factor, but parental involvement, household stability, discipline methods (I don't have data to support this, but I have a feeling that the average discipline methods differ greatly between Montessori kids and public school kids), and many others come into play. It'd be interesting if someone could pull it off, but this would be an unbelievably difficult study.

Re: Overselling A.D.H.D.

#44
post #38

I get really skeptical whenever someone uses the term "Big Pharma". 99% of the time the person using it is selling something (hey, look, a $28 book). How dare a pharmaceutical company sell a product? How dare doctors decide to prescribe medicine? While that was slightly melodramatic, here is a quote from the article: Schwarz has no doubt that A.D.H.D. is a valid clinical entity that causes real suffering and deserves…

The quote says: > a wider range of treatment options than an endless litany of stimulants Notice the "than an endless litany of stimulants" part. Saying something like: > so it all boils down to the pharma companies not creating enough drugs for ADHD? afterwards almost seems like you are intentionally misconstruing this. Is it not possible that the author wants "Big Pharma" to spend time researching alternative treat…

> Is it not possible that the author wants "Big Pharma" to spend time researching alternative treatments

Or society to do that; relying on Big Pharma to spend money directly contrary to Big Pharma's interests doesn't seem like it makes a lot of sense.

Re: Overselling A.D.H.D.

#45
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…

To be honest that's stereotypical of someone who was taking far, far more of their pills than prescribed. Most people, while they're prescribed a 30 day supply, skip pills on the weekends and vacations to maintain lower tolerances. They typically "save" those pills for one of three reasons:

1) The pharmacist at your pharmacy randomly decides you're a tweaker and you have to spend 2 weeks finding a new pharmacy.

2) PARTY TIME!!!

3) Pulling an all nighter and surviving the next day.

Without the book handy and the whole medical school bit, I'd say it was 3, except it was more like a couple-dayer without sleep.

Re: Overselling A.D.H.D.

#46
Why single out ADHD? What about over-diagnosis of depression and other mental illness? This kind of nonsense is fodder for those who believe ADHD and other disorders aren't a serious problem. What's the solution to overprescription which doesn't deny safe, life-changing drugs to those who need it?

"People deserve a wide range of treatment options"? Insightful. There is a wide range of options, but stimulant medications are significantly more effective than anything else.

If faking symptoms for drugs is the concern here... why? How much effort should we really put into weeding out fakers at the expense of those in need? Stimulant medications used properly are incredibly safe and improve attention/focus in healthy people. Maybe it's time certain people stop forcing their outdated moral ideals on the rest of us.

Re: Overselling A.D.H.D.

#47
I was diagnosed ADHD when I was 7 and the doctors put me on Ritalin.

This was the early 1970s when very little was known about how to prescribe the drug to children. The doctors put me on a dose of 20mg 3X per day. It almost killed me. I remember having an overdose in 2nd grade (at least now I know that it was a Ritalin overdose). 60mgs of Ritalin is high even for an adult much less a 7yo.

The teacher was required to distribute the pill to me mid-day. She would stop class, and say, "Rip, come up front and take your 'hyper pills.'" Thusly singled out, I would sheepishly trudge up to the front of the classroom and get my medication to the snickers off all my classmates. It was scarring.

Also my nighttime dose was usually enough to keep me awake all night. At that age I had night terrors which were exacerbated by the drug and lack of sleep. I'd return to school wiped out like a zombie.

I'm sure I did present with all the classic symptoms of ADHD: inattentiveness, restlessness, talkativeness, inability to complete tasks, constant need for interaction, etc.. I am still this way to a degree.

I'm pretty sure that nobody really bothered to try to understand what my home life was like. I was the only child of two raging alcoholics. They would get drunk and fight for hours 3-5X per week until all hours of the night. I was a terribly depressed, anxious child. And since the underlying cause of the anxiety (my horrible home) was never addressed, I've no doubt that to this day I carry around a form of PTSD from my childhood.

I'm sure there are many people from great homes with no external factors driving their ADHD. However, I know in my case, I suffered greatly from an untreated trauma, and was simply medicated so that I wouldn't disrupt my peers at school. It also didn't help that I have ~140IQ and found school absolutely tortuously boring until I finally got into an honors program in my high school. My peers were still struggling to read books aloud while I was knee-deep in LoTR.

How can we blame young children because they can't sit still and quiet day in and day out while absolutely nothing interesting ever happens? How is it that after years of being unable to complete homework assignments, nobody ever really started questioning what was happening at home?

Looking back, it is absolutely shameful how this was handled.

Treating behavioral problems in small children must begin with understanding and treating the possible behavioral problems of the adults first, otherwise it's just compounding the damage.

Interestingly when I got old enough to start using marijuana I quit the Ritalin. I found myself quite able to study on weed and my grades in college positively reflected my increasing marijuana consumption. My first year in college I used none, thinking that this would be best for my schooling, and I performed poorly. Thus discouraged, I figured that if school was going to go badly I might as well get high. My grades went from Cs and Bs to Bs and As and onto the Deans Honor Roll. I took my senior final in probabilistic modelling thoroughly blazed and broke the curve for the whole class.

Also interestingly, I cannot take other typical anti-anxiety meds. Anything in the benzo class, for example, causes terrifying complete amnesia even at low doses.

All anecdotal, I know, but I also know a lot of other people with more or less my same story.

Re: Overselling A.D.H.D.

#48
post #22

I'm generally not fond of this sort of article and this one is no exception. They present a case that drug companies like selling drugs but we knew that. What they don't do is present a good case that ADHD is actually overdiagnosed. The world in general is not very good at accepting psychological conditions. ADHD is commonly regarded as "youth", "laziness", or "lacking discipline". Watching a loved one fight to focus…

This is a book review, not an article per se. I'd assume the book goes into much more detail.

Also, from the review:

> Schwarz has no doubt that A.D.H.D. is a valid clinical entity that causes real suffering and deserves real treatment, as he makes clear in the first two sentences of the book: “Attention deficit hyperactivity is real. Don’t let anyone tell you otherwise.” But he believes that those who are disabled by the condition deserve a wider range of treatment options than an endless litany of stimulants with chirpy names like Vyvanse and Concerta.

Re: Overselling A.D.H.D.

#49

Earlier quoted context omitted.

One thing that has troubled me as a self-taught "dietician" (re: for fitness, using PEDs effectively, etc) is wondering how much the pronouncement of ADHD might correlate with dietary and lifestyle habit changes over the past couple generations. Basically, I have a hunch regarding general population and dietary overlap. I was a "hyper" kid for a lot of my formative years, and didn't undergo medication for it, but won…

When I was a kid (6-12~) I had to take Ritalin everyday—sometimes during school the teacher had to give it to me (this was in South America were casually asking a teacher to give me meds was ok). When we suddenly moved to the US and I started middle school here I stopped taking it. I've always suspected I was and am still "hyper", because I have trouble focusing and always have to fidget or walk around the office. I…

Same, I had lots and lots of outdoor activities (unstructured) mostly revolving around riding my bicycle. I'm sure I got lots of energy out that way. I rode to and from elementary school, and would ride after school, then also was an active swimmer. Not sure some of those are everyday options for young people (generally speaking in urban/sprawl suburban/helicopter parenting places). Mostly I think my home discipline helped me 'focus' on doing school and those things, to allow things to get channeled...like picking up guitar seriously at 14.

Not going to get good at guitar without focusing and practicing, if I'm honest. So, in a time when I would've been out riding my bike, I was concentrating on the instrument and tiring out my brain daily I think. Well, and the whole "don't do well in school don't get to play guitar" thing hanging over my head (for the best).

I kind of think I'd be, well, maybe a less creative person today because I like to let my mind wander. A person recently asked "How do you remember so much erratic & tangential information so fast?" and my only reply was thinking my brain is like a giant orb-spider-web-thingy that can fire stuff all around really fast and bring it back. I like to think my wandering mind made the most of spending time in the local library as a kid too - pick up book, read for a while, get another one, etc.

Re: Overselling A.D.H.D.

#50
post #22

I'm generally not fond of this sort of article and this one is no exception. They present a case that drug companies like selling drugs but we knew that. What they don't do is present a good case that ADHD is actually overdiagnosed. The world in general is not very good at accepting psychological conditions. ADHD is commonly regarded as "youth", "laziness", or "lacking discipline". Watching a loved one fight to focus…

This is a book review, not an article per se. I'd assume the book goes into much more detail. Also, from the review: > Schwarz has no doubt that A.D.H.D. is a valid clinical entity that causes real suffering and deserves real treatment, as he makes clear in the first two sentences of the book: “Attention deficit hyperactivity is real. Don’t let anyone tell you otherwise.” But he believes that those who are disabled b…

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.
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