5 ms·

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 t

by flogic 10y ago

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 continually is just heartbreaking. We still have quite a number of cases where people are stuck fumbling without help.

jordanlev 10y ago
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.
- sevenless 10y ago
  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.
  - scottmf 10y ago
    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.
    - sevenless 10y ago
      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.
      - scottmf 10y ago
        >It's far from clear why having the symptoms of ADHD should be considered a disease, in any objective sense. We have children facing social rejection, failing/dropping out of school, becoming dependent on drugs, suffering from depression/anxiety and other mental illnesses, committing suicide, etc. In a perfect world we don't have to change our lives to fit into society at all! Unfortunately, the world isn't perfect. We have an obesity epidemic because people sit in an office working all day. One treatment I'm sure you'll approve of is going to the gym. Unfortunately gyms are pretty unnatural. Why should obesity be considered a disease in any objective sense? People are suffering because modern life is sedentary. It doesn't mean there's something wrong with them. —We change our behaviors to make up for the personal problems that come with society. We do unnatural things like go to gyms and take medication to help our bodies (which were made for a world where we live in caves and hunt wild animals) function properly in this society, because we agree its advantages vastly outweigh its disadvantages.
        sevenless 10y ago
        This analogy doesn't really work, because obesity is caused by living a modern sedentary lifestyle, whereas I'm suggesting ADHD is what we're labeling kids with for not living, or rebelling against, that sedentary lifestyle. Obesity is a disease in an objective sense because it directly causes ill health. There's lots of studies to show that. The symptoms of what we call ADHD seem to simply be caused by unhappiness and boredom with the way we live today. We're demanding kids do something that makes them unhappy, and any reaction to it, is labeled a disease. > take medication to help our bodies [...] function properly in this society, because we agree its advantages vastly outweigh its disadvantages. This seems like a problematic kind of statement, because the implication is that people who don't fit into society should somehow be coercively medicated. What about their rights and bodily autonomy?
    - panglott 10y ago
      We simply don't know what the impact is of administering powerful amphetamines to children upon their development. Is there a population of children that would "age out" of the ADHD spectrum and develop coping mechanisms, if they were not given pills that prevent that? In such a case, the medication is actually hampering their development.
      - scottmf 10y ago
        We have 80 years of data from giving children low doses of stimulants. >In such a case, the medication is actually hampering their development. Again, the actual data say otherwise. Medication tends to help children develop proper coping mechanisms. Not medicating is more likely to result in social rejection, drug abuse, depression, dropping out of school, and so on. Most of this anti-medication sentiment is unscientific unfounded FUD.
        panglott 10y ago
        You're conflating "not medicating" with "not treating", which is exactly the sort of thing that feeds the criticism that U.S. overdiagnosis rates are being driven by the pharmaceutical industry. Behavioral therapy is also effective, and avoids some of the negative impacts of medication. There are studies that compare medicated ADHD patients to untreated ADHD patients over the course of adolescence; but people who are skeptical over the over-prescription of ADHD drugs aren't actually advocating for non-treatment and non-intervention. Almost no one doubts that ADHD is a real problem for some children that requires medication. The question really is about the extent of overdiagnosis in the US, and the long-term use of medication for children, especially very young children. Stimulant drugs are not recommended for children under 6, and yet still something like 1% of US children under 6 are taking them. Both ADHD diagnoses and pharmaceutical treatment is far, far more prevalent in the US than other developed countries, and it is certainly a good question as to why. Parents naturally have a lot of anxiety about their children's schooling, and the marketing of ADHD plays upon and exacerbates that anxiety (to the extent that if you mention any hiccups in your child's adjustment to school, people immediately begin talking about ADHD). It is also true that kindergarten is the new first grade in terms of literacy expectations, which means more long, boring desk work for young children who are frequently seeing their exercise time reduced or eliminated. Those are problems also.
  - smelterdemon 10y ago
    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.
    - sevenless 10y ago
      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.
      - smelterdemon 10y ago
        Those certainly could result in some mental disorder. An awkward personality and to some degree low IQ could be symptomatic of a mental disorder as well. It's definatly possible to make a convincing case that all mental illness is a manufactured construct [1]. But I don't think you can reasonably say ADHD is not a disease and still believe, say, depression or anxiety disorders are diseases. [1]https://en.wikipedia.org/wiki/The_Myth_of_Mental_Illness https://en.wikipedia.org/wiki/The_Myth_of_Mental_Illness
        sevenless 10y ago
        Interesting link, thank you.
      - deleted 10y ago
        [deleted]
      - yfhsjjskc 10y ago
        Before we talk about forcing people to go on drugs they don't want, let's get to a place where society lets everyone who could benefit from treatment at least have the option of receiving it.
  - falcolas 10y ago
    So don't call it a disease. Call it a Snuffleupagus. Just don't stop treating patients affected by this particular Snuffleupagus because it doesn't meet your definition of a "disease".
    - sevenless 10y ago
      We aren't morally obliged to treat people for things that aren't diseases.
      - yfhsjjskc 10y ago
        You aren't morally obligated to do anything, you can go live in a hut in the plains of Montana if you want. But people with ADHD who seek treatment appreciate the efforts of the medical professionals who help them.
- flogic 10y ago
  The fact it's about a book rather than a scientific article makes me suspicious. Finding people who are untreated and struggling is common. So what's the point of it being a book? Other than cashing in on the "it's all in your head" sentiment? Claiming it's real in a small aside just seems like ass covering.
deleted 10y ago
[deleted]
soylentcola 10y ago
Yep. Dealt with this my entire life. Teachers, doctors, and counselors suggested I see someone regarding a possible ADD diagnosis all through school as my supposed "brilliance" (their words, not mine) came along with a seemingly unbeatable tendency to zone out in class, constantly talk to other kids when I knew I was supposed to be listening, and flat out forget to do major assignments while I just sort of daydreamed or got sidetracked the moment something else came along. But my father didn't believe in ADD or at least thought it was overdiagnosed. By god, when he was a kid, there was a name for my behavior and it was lazy, careless, or just plain selfish. So all of those recommendations were ignored. It took me dropping out of college, going off to work in dead-end, unrewarding and un-challenging jobs while avoiding contact with my folks out of a mixture of shame, resentment, and anger to finally motivate me to see a counselor who eventually referred me to a psychiatrist. Got put on a mild dosage of stimulant medications, got myself about $15k in loans to enroll at another state university, finished my degree with no lower than a B in any class, and finally got myself into something of a career path. It's been weird because I always felt like I'm 10-15 years behind where I should be but then I remind myself that there is no "should" and I'm thankful that I've improved my quality of life. Medication (and stimulant medication) isn't a panacea and there are obviously tradeoffs but I think that for a very real subset of people, the avoidance of it out of some misplaced ideas of pill-pushers or lack of "grit" is a real shame that causes some very real problems.
- jordanlev 10y ago
  Thanks for sharing your experience. I'm curious (after reading the book review): when you saw the psychiatrist, was the medication the only treatment? Or was it combined with other (non-medicinal) treatments as well?
- koverstreet 10y ago
  And these kinds of experiences are why ADD deniers fill a lot of us with rage. Their willful ignorance is hugely destructive and damaging to the people they're able to influence.

by flogic 10y ago

jordanlev 10y ago

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.

sevenless 10y ago
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.
- scottmf 10y ago
  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.
  - sevenless 10y ago
    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.
    - scottmf 10y ago
      >It's far from clear why having the symptoms of ADHD should be considered a disease, in any objective sense. We have children facing social rejection, failing/dropping out of school, becoming dependent on drugs, suffering from depression/anxiety and other mental illnesses, committing suicide, etc. In a perfect world we don't have to change our lives to fit into society at all! Unfortunately, the world isn't perfect. We have an obesity epidemic because people sit in an office working all day. One treatment I'm sure you'll approve of is going to the gym. Unfortunately gyms are pretty unnatural. Why should obesity be considered a disease in any objective sense? People are suffering because modern life is sedentary. It doesn't mean there's something wrong with them. —We change our behaviors to make up for the personal problems that come with society. We do unnatural things like go to gyms and take medication to help our bodies (which were made for a world where we live in caves and hunt wild animals) function properly in this society, because we agree its advantages vastly outweigh its disadvantages.
      - sevenless 10y ago
        This analogy doesn't really work, because obesity is caused by living a modern sedentary lifestyle, whereas I'm suggesting ADHD is what we're labeling kids with for not living, or rebelling against, that sedentary lifestyle. Obesity is a disease in an objective sense because it directly causes ill health. There's lots of studies to show that. The symptoms of what we call ADHD seem to simply be caused by unhappiness and boredom with the way we live today. We're demanding kids do something that makes them unhappy, and any reaction to it, is labeled a disease. > take medication to help our bodies [...] function properly in this society, because we agree its advantages vastly outweigh its disadvantages. This seems like a problematic kind of statement, because the implication is that people who don't fit into society should somehow be coercively medicated. What about their rights and bodily autonomy?
  - panglott 10y ago
    We simply don't know what the impact is of administering powerful amphetamines to children upon their development. Is there a population of children that would "age out" of the ADHD spectrum and develop coping mechanisms, if they were not given pills that prevent that? In such a case, the medication is actually hampering their development.
    - scottmf 10y ago
      We have 80 years of data from giving children low doses of stimulants. >In such a case, the medication is actually hampering their development. Again, the actual data say otherwise. Medication tends to help children develop proper coping mechanisms. Not medicating is more likely to result in social rejection, drug abuse, depression, dropping out of school, and so on. Most of this anti-medication sentiment is unscientific unfounded FUD.
      - panglott 10y ago
        You're conflating "not medicating" with "not treating", which is exactly the sort of thing that feeds the criticism that U.S. overdiagnosis rates are being driven by the pharmaceutical industry. Behavioral therapy is also effective, and avoids some of the negative impacts of medication. There are studies that compare medicated ADHD patients to untreated ADHD patients over the course of adolescence; but people who are skeptical over the over-prescription of ADHD drugs aren't actually advocating for non-treatment and non-intervention. Almost no one doubts that ADHD is a real problem for some children that requires medication. The question really is about the extent of overdiagnosis in the US, and the long-term use of medication for children, especially very young children. Stimulant drugs are not recommended for children under 6, and yet still something like 1% of US children under 6 are taking them. Both ADHD diagnoses and pharmaceutical treatment is far, far more prevalent in the US than other developed countries, and it is certainly a good question as to why. Parents naturally have a lot of anxiety about their children's schooling, and the marketing of ADHD plays upon and exacerbates that anxiety (to the extent that if you mention any hiccups in your child's adjustment to school, people immediately begin talking about ADHD). It is also true that kindergarten is the new first grade in terms of literacy expectations, which means more long, boring desk work for young children who are frequently seeing their exercise time reduced or eliminated. Those are problems also.
- smelterdemon 10y ago
  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.
  - sevenless 10y ago
    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.
    - smelterdemon 10y ago
      Those certainly could result in some mental disorder. An awkward personality and to some degree low IQ could be symptomatic of a mental disorder as well. It's definatly possible to make a convincing case that all mental illness is a manufactured construct [1]. But I don't think you can reasonably say ADHD is not a disease and still believe, say, depression or anxiety disorders are diseases. [1]https://en.wikipedia.org/wiki/The_Myth_of_Mental_Illness https://en.wikipedia.org/wiki/The_Myth_of_Mental_Illness
      - sevenless 10y ago
        Interesting link, thank you.
    - deleted 10y ago
      [deleted]
    - yfhsjjskc 10y ago
      Before we talk about forcing people to go on drugs they don't want, let's get to a place where society lets everyone who could benefit from treatment at least have the option of receiving it.
- falcolas 10y ago
  So don't call it a disease. Call it a Snuffleupagus. Just don't stop treating patients affected by this particular Snuffleupagus because it doesn't meet your definition of a "disease".
  - sevenless 10y ago
    We aren't morally obliged to treat people for things that aren't diseases.
    - yfhsjjskc 10y ago
      You aren't morally obligated to do anything, you can go live in a hut in the plains of Montana if you want. But people with ADHD who seek treatment appreciate the efforts of the medical professionals who help them.
flogic 10y ago
The fact it's about a book rather than a scientific article makes me suspicious. Finding people who are untreated and struggling is common. So what's the point of it being a book? Other than cashing in on the "it's all in your head" sentiment? Claiming it's real in a small aside just seems like ass covering.

deleted 10y ago

[deleted]

soylentcola 10y ago

Yep. Dealt with this my entire life. Teachers, doctors, and counselors suggested I see someone regarding a possible ADD diagnosis all through school as my supposed "brilliance" (their words, not mine) came along with a seemingly unbeatable tendency to zone out in class, constantly talk to other kids when I knew I was supposed to be listening, and flat out forget to do major assignments while I just sort of daydreamed or got sidetracked the moment something else came along. But my father didn't believe in ADD or at least thought it was overdiagnosed. By god, when he was a kid, there was a name for my behavior and it was lazy, careless, or just plain selfish. So all of those recommendations were ignored. It took me dropping out of college, going off to work in dead-end, unrewarding and un-challenging jobs while avoiding contact with my folks out of a mixture of shame, resentment, and anger to finally motivate me to see a counselor who eventually referred me to a psychiatrist. Got put on a mild dosage of stimulant medications, got myself about $15k in loans to enroll at another state university, finished my degree with no lower than a B in any class, and finally got myself into something of a career path. It's been weird because I always felt like I'm 10-15 years behind where I should be but then I remind myself that there is no "should" and I'm thankful that I've improved my quality of life. Medication (and stimulant medication) isn't a panacea and there are obviously tradeoffs but I think that for a very real subset of people, the avoidance of it out of some misplaced ideas of pill-pushers or lack of "grit" is a real shame that causes some very real problems.

jordanlev 10y ago
Thanks for sharing your experience. I'm curious (after reading the book review): when you saw the psychiatrist, was the medication the only treatment? Or was it combined with other (non-medicinal) treatments as well?
koverstreet 10y ago
And these kinds of experiences are why ADD deniers fill a lot of us with rage. Their willful ignorance is hugely destructive and damaging to the people they're able to influence.