The Drugging Of The American Boy

That's why I used the word 'inherently'. People telling you you're abnormal is not inherent to those conditions.

Only if society has defined as valuable the ability to do only one thing, without distraction, for whatever period of time. Therefore, anyone who cannot do this must be 'broken' somehow.

ADHD doesn't interfere with your life because other people are making fun of the fact you can't sit still. It interferes with your life because it's very difficult to be productive in any way if you can't concentrate for whatever period of time and being productive is what's valuable to society.

I have mild myopia and I don't feel any resentment to my optometrist for labeling me broken. I'm just happy he augmented/fixed me so I can read signs at a distance. And unless/until we have proof that prescribing Adderall is so dangerous that it's not worth the gains, then I don't see a problem treating it the same as contact lenses.

I'm not suggesting that ADHD isn't a problem. Merely that we should exercise some caution before we label some things (people?) as broken, when perhaps they are not.

Well, clearly they thought they were broken somehow when they went to the doctor with concerns about their attention spans, no?

Secondly, even if you are convinced that these correlates are causal, if you do not actually test for them, then you have to show that the diagnosis method correlates strongly with the biology. I have bothered to look. I can't find such data. Are you saying you have?

The last part of what you are saying seems to be combination of an appeal to authority and affirming the consequent: "Because the scientific community currently recommends pharmaceutical treatment, the problem must have an organic cause."

Having worked closely with psychiatrists, I can assure you that recommending a pharmaceutical treatment is rarely done because they understand the mechanism of action. It is rarely even done because they think the cause is organic rather than environmental. It is done because it is the only effective option available to them.

Psychiatrists don't have the power to change schools or parenting, but they can prescribe drugs which may improve the outcome, and so have a duty to do so. This doesn't mean that the problem is a lack of medication, or even that the cause is biological. It's that doctors can't change the environment.

Consider PTSD - which can be treated using drugs and therapy, and clearly has neurobiological correlates. The cause is war and violence, not the lack of drugs.

Wait, what?

What this means is that you get a lot of studies that have conclusions such as "well this drug worked for 70% of the test subjects but danged if we know why the other 30% were unresponsive, after all, they have been diagnosed with ADHD!"

If you really want to dive deep, I suggest this talk by Russell Barkley, https://www.youtube.com/watch?v=q3d1SwUXMc0, it does an excellent job of covering why the hell the current literature on ADHD is such a mess.

He also provides lots of compelling evidence for ADHD, but also discusses various symptom (and treatment!) clusters that defy explanation if you think of just "ADHD". There is also discussion different causes of ADHD, suffice to say the symptom rate for children born to mothers who drink during pregnancy is, to say the least, way above the norm, with ADHD in those cases being co-morbid with other disorders[0]. Finally there is some slides about genetics as well.

On a related note, it is funny, the term ADHD-PI is being used by some people to basically describe an entirely different disorder with a completely different treatment mechanism. Stimulants do nothing, but there are treatment programs that do help. On ADHD support forums, those of us who are regular contributors try to do our best to educate ourselves about ways to help people who both have "ADHD" and also "ADHD-PI".

As for the entire "ADHD isn't real" crowd, well, those of us who have it get rather pissed off. I have been reduced to tears because I wanted to do something with every fiber of my being but was unable to focus on it for more than seconds at a time.

Even with a well tweaked treatment regimen, ADHD is still a daily struggle. It is a literal fight to maintain control of myself, from pushing back against a constant all consuming addiction to anything that resembles a dopamine reward cycle[1] to having a reserve of will power[2] that resembles a water pump sitting out in the dry desert heat.

One thing people without ADHD don't realize is that for those with ADHD, the drugs work very differently. Someone without ADHD can take ADHD stimulants and stay up for 2 days straight and have razor focus. Someone with ADHD who takes the same meds, well, going back to my previous metaphor, it is like priming the pump, even with drugs it still takes a slew of self control techniques learned through years of therapy to maintain control over my life.

To live my daily life, I carry an organizer around wherever I go that I write everything down in. I then have calendar events for everything I need to do. On top of that I have my life carefully arranged such that everything I need to do is within instant quick reach, because if I have to spend even a modicum of effort to achieve what I want to do, I will get distracted on my way and forget what the hell I am after.

Thankfully little details help establish some sort of normality. My keys, wallet, laptop, badge, glasses, notebook, all sit next to each other stacked in a nice pile that I can put into/on my pockets/back/face within seconds. If I get interrupted, I will forget one of those.

Side effects of this? I pretty much have to live close to work because I'll forget my laptop at home roughly 60% of the time. (I don't carry my laptop home every day so I do not have the same years of routine built up that allow me to remember the other things I need.)

Heck yesterday I went to a friend's house to make waffles and I forgot the bloody waffle mix. (Sorta the one thing required to make waffles.)

Any one set of these symptoms in of itself is not unusual. Some people have a poor memory, meh. Some people are easily distracted, sure. But when a cluster of symptoms all comes together and has a serious negative impact on the quality of someone's life, then there is a real problem that needs investigation and help.

I guess what it comes down to is, I've both struggled with ADHD myself, and seen undiagnosed, untreated, ADHD completely destroy people's lives.

Finally, there are a variety of diagnostic criteria that can be used for testing ADHD. A full suite of psychological evaluation tests will include sections on attention and focus. People with ADHD will basically fail bomb those parts of the test. (Said tests tend to take multiple days and cost thousands of dollars to administer...)

[0]ADHD's co-morbidity with bi-polar disorder is tragically high. Thankfully this is a topic which has recently gotten a lot more awareness in the medical community, so patients are finally being properly diagnosed. Of course there is a huge stigma around bi-polar disorder, much more so than ADHD, so a lot of people who are willing to admit that they have ADHD may very well turn away or refuse to believe a diagnose of bi-polar. This typically doesn't end well...

[1]I avoid MMOs and mobile gaming like the plague. I've gotten almost addicted to MMOs a couple of times, thankfully both times I was able to write a bot to play for me and then lost interest.

[2]http://www.wired.com/wiredscience/2012/10/mf-willpower/