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1. Undiagnosed adults: This is a big issue because it can be hard to diagnose "primarily inattentive" subtype (common in girls), which fly under the radar. Thes

1. Undiagnosed adults: This is a big issue because it can be hard to diagnose "primarily inattentive" subtype (common in girls), which fly under the radar. These are "spacey" kids who may just stare or daydream, not so disruptive compared to kids literally jumping on their chairs and screaming due to hyperactivity + other issues (happened multiple times to me as a teacher). 1a. Also, the disorder was MUCH less well known by teachers, parents, and doctors 20-30 years ago, which is resulting in more undiagnosed adults today at ages 50+ 2. Multiple comorbidities: This is very true, good point. A person may be anxious, depressed, bipolar, or OCD, and these can share symptoms with ADHD, thus part of the DSM-V diagnosis of ADHD includes ruling out other disorders. 3. Spectra: All mental health disorders exist on a spectrum from "No symptoms" to "Many/All symptoms". There are mild, moderate, and severe diagnoses of ADHD, for instance, and that may warrant different treatment approaches.

aidenn0 6y ago
> 1. Undiagnosed adults: This is a big issue because it can be hard to diagnose "primarily inattentive" subtype (common in girls), which fly under the radar. These are "spacey" kids who may just stare or daydream, not so disruptive compared to kids literally jumping on their chairs and screaming due to hyperactivity + other issues (happened multiple times to me as a teacher). Right, this is kind of what I'm talking about. A kid jumping on his chair and screaming might have ADHD, ODD, RAD, PTSD, ASD, &c., or some combination of them (one of the more bizarre stories I have is a kid with dyslexia who would stand up on her desk to get sent to the principle's office to avoid her school work when she couldn't crib off of the kid next to her) . What happens in too many schools is the school psychologist diagnoses them with ADHD and sends them to a psychiatrist. What happens next depends on the quality of the psychiatrist and the means of the parents. In, what qualitatively seems to be a large minority of the cases (I have no hard data to back this up, just a collection of anecdotes), the psychiatrist does little or no additional screening and prescribes a sequence of medications (Ritalin, then Adderall, ...) until something works or the parents stop bringing their kid in. Meanwhile the majority of the "primarily inattentive" ADHD kids either fly under the radar, or do so badly academically that they get more generalized interventions involving tutors or assistants who either bug them to stay on task, or do 90% of the work for them. I (also the "spacey" type, told by every therapist I've been to that my symptoms are quite severe) was only diagnosed when I got sent in for a generalized intervention due to terrible performance, and maxed out the WISC. If my symptoms were slightly less severe, (or I were born 5-10 years earlier) I probably would have just been the "lazy kid." Again this is because the majority of the kids who enter the mental health "system" are due to behaviors observed by teachers in the classroom. As an aside, I should note that at least in my lifetime, and possibly longer, we've asked teachers to take on a lot more jobs, while simultaneously eroding their autonomy to do any of their jobs, so I'm not blaming teachers for this, just noting what I've observed.

aidenn0 6y ago

> 1. Undiagnosed adults: This is a big issue because it can be hard to diagnose "primarily inattentive" subtype (common in girls), which fly under the radar. These are "spacey" kids who may just stare or daydream, not so disruptive compared to kids literally jumping on their chairs and screaming due to hyperactivity + other issues (happened multiple times to me as a teacher). Right, this is kind of what I'm talking about. A kid jumping on his chair and screaming might have ADHD, ODD, RAD, PTSD, ASD, &c., or some combination of them (one of the more bizarre stories I have is a kid with dyslexia who would stand up on her desk to get sent to the principle's office to avoid her school work when she couldn't crib off of the kid next to her) . What happens in too many schools is the school psychologist diagnoses them with ADHD and sends them to a psychiatrist. What happens next depends on the quality of the psychiatrist and the means of the parents. In, what qualitatively seems to be a large minority of the cases (I have no hard data to back this up, just a collection of anecdotes), the psychiatrist does little or no additional screening and prescribes a sequence of medications (Ritalin, then Adderall, ...) until something works or the parents stop bringing their kid in. Meanwhile the majority of the "primarily inattentive" ADHD kids either fly under the radar, or do so badly academically that they get more generalized interventions involving tutors or assistants who either bug them to stay on task, or do 90% of the work for them. I (also the "spacey" type, told by every therapist I've been to that my symptoms are quite severe) was only diagnosed when I got sent in for a generalized intervention due to terrible performance, and maxed out the WISC. If my symptoms were slightly less severe, (or I were born 5-10 years earlier) I probably would have just been the "lazy kid." Again this is because the majority of the kids who enter the mental health "system" are due to behaviors observed by teachers in the classroom. As an aside, I should note that at least in my lifetime, and possibly longer, we've asked teachers to take on a lot more jobs, while simultaneously eroding their autonomy to do any of their jobs, so I'm not blaming teachers for this, just noting what I've observed.