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my therapist tells me ADHD is a real thing. But, it's hard for me not see through the lines that a psychiatrist is only prescribing medicine because they can bi

by _RPM 9y ago

my therapist tells me ADHD is a real thing. But, it's hard for me not see through the lines that a psychiatrist is only prescribing medicine because they can bill the insurance a ton of money and make bank.

ganoushoreilly 9y ago
It's definitely a real thing. You don't have to take medications, but they can certainly help some.
roflc0ptic 9y ago
It's real in that there are a set of behaviors which correlate reliably with each other that are described as ADHD. It's not "real" in the sense that there's a single mechanism underlying ADHD. It's not real in the sense that "people with ADHD are affected differently by amphetamines, so it's okay for them to take them." The way I think about it is that attention is a bell curve, and that at some point on the left of that curve, symptoms interfere with happy, economically productive lives. Psychiatrists try to help those people with stimulant drugs, whose efficacy have been proven in the short term, but are basically unproven in the long term. There are companies making bank on this arrangement. In summary, I guess it's complicated. You're right, but maybe your therapist is, too. Por que no los dos?
- falcolas 9y ago
  Differently, perhaps not. But the benefits for relatively small doses (5-15mg) are tremendous for those with ADHD. ADHD is, ultimately, as real as climate change. The experts say it's real; have been saying it's real for many years. The people who disagree don't trust those experts.
  - roflc0ptic 9y ago
    Oh, to be sure I’m not saying people shouldn’t take amphetamines. They improve my life substantially. There’s just an artificial line drawn between “ok to take performance enhancing drug” and “not okay to take performance enhancing drug.”
    - smittywerben 9y ago
      Non-stimulants work too! The performance enhancers sometimes work a little better though. These drugs aren't perfect. Just don't fight genetics, they're much older than you :-)
jjeaff 9y ago
Tell that to someone with adhd who went from unproductive and basically a poor student to highly productive and studious after receiving medical treatment for adhd. As for the psychiatrist, they don't make any extra money from prescribing. They could make more money if they kept you coming in each month or week for behavioural therapy (which doesn't have great results for adhd anyway, but it's something).
- jeffmould 9y ago
  I had almost this exact conversation a couple weeks ago with a friend of mine who is a highly recognized psychologist. We got talking about medicating for ADHD and anxiety (I have a friend who is struggling with her son in this department). Basically, you are right, psychiatrists could make more money doing therapy, but therapy is more for psychologists and not psychiatrists. Most psychiatrists make money off of volume of patients. So it is in their best interest to prescribe more and consult less. The more patients that come through their office and they prescribe meds to the more money they make. He used the example of the psychiatry department at the public hospital next door to his office. On average, one doctor in that office can see upwards of 30 patients a day. With my friend, he can see at most 6 patients a day. For my friend though, as a psychologist doing one-on-one therapy he can charge more and see less patients. In regards to medicating versus therapy, like many other things, people react differently to different things. Some individuals may do better with therapy over meds and vice-versa. The downside of meds is that typically becomes a lifetime treatment. Therapy on the other hand, when it works, is easier to reduce over time (although most people will continue, even at a significantly reduced interval).
  - falcolas 9y ago
    Most people I know with moderate to severe ADHD require meds to even concentrate enough to enact any behaviour modification. That said, medication alone will not resolve all issues that crop up as part of having ADHD - many will need both.
John_KZ 9y ago
I had to reach the bottom of the page to find the only 2 commentors that understand that ADHD is an umbrella diagnosis and medication is often a crime. And of course both are downvoted to hell and about to be flagged and deleted. Who the fuck would medicate a 5 or 10 year old child for being "too active"? This is like the 50s shock therapy for unruly teenagers, but done with chemistry instead. Less blood and morbidity, more mental castration. Many people who take up Ritalin and Adderal, especially from a young age, have issues with mental development and end up addicts for life. If/when they finally take off their meds, they find themselves 10x worse because of the long-term withdrawal. This thread is filled with reddit-tier pseudoscience about ADHD being some kind of evolutionary trait relating to hunter gatherer communities. What a load of bullshit, I don't know if I should be laughing or not. It's worrisome that even serious people and many psychologists believe that shit.
- smittywerben 9y ago
  > end up addicts for life This is an archaic idea, you sound like an older individual. Am I right on that? > reddit-tier pseudoscience... downvoted to hell We can test for ADHD just like we do breast cancer. > medication is often a crime... ADHD [is an] evolutionary trait... What a load of bullshit Impulsivity is a sin, right? I'm not some puppet for your chuch, pal.

by _RPM 9y ago

ganoushoreilly 9y ago

It's definitely a real thing. You don't have to take medications, but they can certainly help some.

roflc0ptic 9y ago

It's real in that there are a set of behaviors which correlate reliably with each other that are described as ADHD. It's not "real" in the sense that there's a single mechanism underlying ADHD. It's not real in the sense that "people with ADHD are affected differently by amphetamines, so it's okay for them to take them." The way I think about it is that attention is a bell curve, and that at some point on the left of that curve, symptoms interfere with happy, economically productive lives. Psychiatrists try to help those people with stimulant drugs, whose efficacy have been proven in the short term, but are basically unproven in the long term. There are companies making bank on this arrangement. In summary, I guess it's complicated. You're right, but maybe your therapist is, too. Por que no los dos?

falcolas 9y ago
Differently, perhaps not. But the benefits for relatively small doses (5-15mg) are tremendous for those with ADHD. ADHD is, ultimately, as real as climate change. The experts say it's real; have been saying it's real for many years. The people who disagree don't trust those experts.
- roflc0ptic 9y ago
  Oh, to be sure I’m not saying people shouldn’t take amphetamines. They improve my life substantially. There’s just an artificial line drawn between “ok to take performance enhancing drug” and “not okay to take performance enhancing drug.”
  - smittywerben 9y ago
    Non-stimulants work too! The performance enhancers sometimes work a little better though. These drugs aren't perfect. Just don't fight genetics, they're much older than you :-)

jjeaff 9y ago

Tell that to someone with adhd who went from unproductive and basically a poor student to highly productive and studious after receiving medical treatment for adhd. As for the psychiatrist, they don't make any extra money from prescribing. They could make more money if they kept you coming in each month or week for behavioural therapy (which doesn't have great results for adhd anyway, but it's something).

jeffmould 9y ago
I had almost this exact conversation a couple weeks ago with a friend of mine who is a highly recognized psychologist. We got talking about medicating for ADHD and anxiety (I have a friend who is struggling with her son in this department). Basically, you are right, psychiatrists could make more money doing therapy, but therapy is more for psychologists and not psychiatrists. Most psychiatrists make money off of volume of patients. So it is in their best interest to prescribe more and consult less. The more patients that come through their office and they prescribe meds to the more money they make. He used the example of the psychiatry department at the public hospital next door to his office. On average, one doctor in that office can see upwards of 30 patients a day. With my friend, he can see at most 6 patients a day. For my friend though, as a psychologist doing one-on-one therapy he can charge more and see less patients. In regards to medicating versus therapy, like many other things, people react differently to different things. Some individuals may do better with therapy over meds and vice-versa. The downside of meds is that typically becomes a lifetime treatment. Therapy on the other hand, when it works, is easier to reduce over time (although most people will continue, even at a significantly reduced interval).
- falcolas 9y ago
  Most people I know with moderate to severe ADHD require meds to even concentrate enough to enact any behaviour modification. That said, medication alone will not resolve all issues that crop up as part of having ADHD - many will need both.

John_KZ 9y ago

I had to reach the bottom of the page to find the only 2 commentors that understand that ADHD is an umbrella diagnosis and medication is often a crime. And of course both are downvoted to hell and about to be flagged and deleted. Who the fuck would medicate a 5 or 10 year old child for being "too active"? This is like the 50s shock therapy for unruly teenagers, but done with chemistry instead. Less blood and morbidity, more mental castration. Many people who take up Ritalin and Adderal, especially from a young age, have issues with mental development and end up addicts for life. If/when they finally take off their meds, they find themselves 10x worse because of the long-term withdrawal. This thread is filled with reddit-tier pseudoscience about ADHD being some kind of evolutionary trait relating to hunter gatherer communities. What a load of bullshit, I don't know if I should be laughing or not. It's worrisome that even serious people and many psychologists believe that shit.

smittywerben 9y ago
> end up addicts for life This is an archaic idea, you sound like an older individual. Am I right on that? > reddit-tier pseudoscience... downvoted to hell We can test for ADHD just like we do breast cancer. > medication is often a crime... ADHD [is an] evolutionary trait... What a load of bullshit Impulsivity is a sin, right? I'm not some puppet for your chuch, pal.