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How do you reconcile this with the observation that seemingly every single child in the United States is diagnosed with this condition and prescribed drugs to t
by jasonkester 6y ago
How do you reconcile this with the observation that seemingly every single child in the United States is diagnosed with this condition and prescribed drugs to treat it? Watching from Europe, where roughly nobody is diagnosed with it nor prescribed drugs to treat it, I’m always baffled, fascinated and horrified watching Americans talk about it.
- bendmorris 6y agoI suspect that by: >People thinking it’s not a real condition. the person you're responding to meant statements like yours: >Frankly, the symptoms you describe apply to pretty much everybody, and are just the things one deals with in life. According to the NIH, prevalence of severe ADHD in children is around 4% [1]. This differs by degree from "the things one deals with in life" for most people - it's an extreme version that can be debilitating without treatment. [1] https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd.shtml#part_154904 https://www.nimh.nih.gov/health/statistics/attention-deficit...
- jasonkester 6y agoYou’re right. I didn’t like that bit of my comment, and was in the process of lopping it off when you were composing your reply. Apologies for not getting the edit done in time. Mostly I’m alarmed that so many parents are happy to put their small children on a lifetime supply of medicine for something that’s not immediately life threatening.
- bendmorris 6y agoAs a parent who has made this decision myself, I certainly wasn't "happy to" do it. But it's very clear to me that without medication, my child lacked control over his thoughts and actions, and it was affecting his life - school, friendships, etc. - to a degree that was very frustrating for him. He's happier and more successful now. And, it's not a "lifetime supply" for sure - many kids do grow out of it and stop requiring medication by the time they reach adulthood. Some don't, and they can decide where to go from there.
- RHSman2 6y agoI have two children with ADHD and myself (non medicated). Having a child with ADHD is extremely hard. All we try and do is workout the way for them to navigate life with out destroying everything around them. We haven’t had to medicate them yet but the decision would be a very considered one and weighed up to if it would change their lives for the better.
- deleted 6y ago[deleted]
- astrange 6y agoADHD medication is perfectly safe and not addictive (at prescribed doses). If you don't want to take it, just don't do it. Since the US makes it so hard to get (you have to renew your prescription every month) it's actually very likely you'll stop it.
- kgwgk 6y agoFor some values of “perfectly safe”. From TFA: Qelbree "may increase suicidal thoughts and actions in some children with ADHD, especially within the first few months of treatment or when the dose is changed," https://www.psychiatryadvisor.com/home/topics/adhd/stronger-warnings-about-suicide-risk-with-adhd-drugs-in-canada/ https://www.psychiatryadvisor.com/home/topics/adhd/stronger-...
- astrange 6y agoTylenol is widely considered a safe drug even though overdose of 4x the normal dose is near certain death. You do have to watch out for these things. In this case, medication tends to report silly things as side effects because they report every single thing the patients are experiencing. There's no frequency of reports here, but it could be just a few reports with no causation established.
- LocalH 6y agoI also have great hope for the psychedelic research that is starting to happen again. Anecdotally, I have highly improved focus control when under the influence of low doses of LSD or mushrooms (I prefer mushrooms because they feel more "organic", if that makes sense). I am preparing to begin a regular mushroom microdosing regimen, because that focus control does fade in-between experiences when I take 1g weekly. I'm not after the reality-altering properties of psychedelics (except the very rare use of DMT for a "kickstart", as the last big trip I had with that gave me six months of focus control and ADHD mitigation). I plan to take a quarter gram every other day.
- ericb 6y ago> Mostly I’m alarmed that so many parents are happy to put their small children on a lifetime supply of medicine for something that’s not immediately life threatening. I don't think you get it. My son can either be on medicine, or he can fail middle school, and high school and be uneducated. If you're volunteering to sit next to him, and redirect him to his work every 3 minutes, or pay for someone to do it, by all means, let me know. At the same time, he's brilliant, and can solve any problem he puts his mind to, and he can do the actual work, if he can focus on it. Maybe re-think this without the judgement--good parents aren't happy about doing this. They are just less unhappy than the alternative.
- deleted 6y ago[deleted]
- sjg007 6y agoThis is exactly what it is like.
- YinglingLight 6y agoIt's a shame most can't afford homeschooling.
- LocalH 6y agoADHD can be indirectly very life threatening. Untreated, it can affect every single aspect of a person's life. Even just society being a bit more forgiving of ADHD can improve that situation greatly. We really need to have a class of mental handicaps that are every bit as protected as physical handicaps. A sort of "mental ADA". This would obviously not include self-assessment simply because that would be too easy to game. But, for example, I was formally diagnosed with ADD/ADHD at the age of 8. Others in similar situations should absolutely be given affordances that others who don't need them don't get, because those affordances could actually be harmful to those who don't need them (similar to how stimulant medication is like speed to "neurotypical" people, yet it slows down those with ADHD). However, in the drive for "fairness", some insist that means treating everybody identically, in a "one size fits all" mentality, which disadvantages everyone who isn't neurotypical.
- j-pb 6y agoI heavily suspect that it's overdiagnosed in the US, but heavily underdiagnosed in the EU. I have adult ADHD, and even though I tried to get help when I was turning 20 and started to fail university (I had an average of 1.3 for the classes that I did finnish, I just couldn't commit to anything) it took me 3 years until I got a diagnosis (due to ridiculously long waiting times for doctors appointments). In the end I only got a doctors appointment because I got diagnosed with multiple sclerosis, and my neurologist, who is also a psychyatrist was like "btw I also think you have ADHD, ever tried to get help for that?".
- luckylion 6y ago> due to ridiculously long waiting times for doctors appointments This is amazing to me. I've never seen as bad of a situation as with neurologists/psychiatrists. I called some a while ago and it was essentially either "we don't do any new patients" or "yeah, we have a wait list, if a spot opens up, we'll call everyone and the first person to answer gets it; expect it to take half a year though". Unless it's an emergency, you just won't even get to see a doctor.
- kayodelycaon 6y agoIt took me two months to get an appointment with a psychiatrist. Many of them never returned calls. I had to leave a lot of voice mails while having severe anxiety using phones.
- nullserver 6y agoNeurologist was the one me try adderall. I have autoimmune disorder Sjogrens, but didn’t know it at the time. At time it felt like he was trying random things to see what helped. It was amazing for focus and energy. Enough that I could work for a time. Course it left me in horrific agony most of the time.
- barsonme 6y agoYes, every child in the United States is diagnosed and given stimulants for fun, unlike enlightened Europe. It might be over-diagnosed in the United States. I sure think so. But that does not make the effects of the disorder any less damaging. At any rate, perhaps you might consider whether Europe is under diagnosing disorders like ADHD? Or, perhaps your have an incorrect understanding about ADHD diagnoses in the US?
- herbst 6y agoTo be fair i have adhd (as child and adult now) but my doctors always agreed that stimulants arent necessary. I think this is the main cultural difference, not that its underdiagnosed
- gremlinsinc 6y ago> my doctors always agreed that stimulants arent necessary Is this because it's looked down on? Are you able to function perfectly as a normal adult? i.e. all the symptoms from the top posts are in check through habits, etc? If so, what's your secret? Because just living is very difficult and that's WITH vyvanse+2 energy shots per day with l-tyrosine, taurine, b6, b12, b3 and at least a little l-theanine per day.
- herbst 6y agoNo not really. More because i dont really like getting hyper and there is no job i have to wake up for everyday to unholy times. In my last real job i took amphetamines (dextro*) but that made my general mindset worse. Ritalin made me straight up dont like myself anymore. I too take l-theanin, b-stack and ashwagandha everyday these days. I am far from a perfectly normal adult. I never tried getting there tho
- zaarn 6y agoI've heard this so often, even from family. "It sounds like things everybody has to deal with". It's infinitely more difficult with ADHD. I use phone apps to remind myself of everyday things and track my shopping lists. This may sound normal but it's a coping strategy and when it's gone I am unable to function as a normal human being. I cannot go shopping without a shopping list because I will grab things I think I need but that I actually do not need (which is why I have 3 glasses of chocolate spread for bread and 3 packs of cereal, but no bread or milk on most weekdays). And I will point out that children in Europe are regularly treated for ADHD. I was treated for ADHD. As an adult however, it's impossible to be prescribed ADHD medication (all of which requires a prescription). In a lot of cases, coffee or other stimulants can help but aren't always available and don't fix it all. Without suffering from ADHD, I'd say it's impossible to even comprehend the mental strain one experiences even for menial everyday tasks like remembering to brush your teeth (I require an app to remind me of doing that when it is not a workday, as my usual routine of going to work and going to bed early for a workday involves it. On weekends or vacation, I do not remember on my own to do basic things like that).
- scns 6y agoCaffeine can make it worse
- zaarn 6y agoCan but in my experience, most ADHD-affected persons will self-medicate with caffeine in atleast low doses.
- spiralx 6y agoI took amphetamines daily (week-daily at least) on and off for a decade before my diagnosis and the realisation that I was medicating with it was a large part of seeking my diagnosis. For me speed was calming and focussing and a tool to help me manage my life, not a fun thing for going out.
- 6y ago
- garmaine 6y agoA quick google search show that diagnosis rates in Europe are only half the USA. That’s not that big a gap, and easily explained by cultural and institutional differences. For example, a lot of parents do not treat their ADHD kids with medication. However getting the diagnoses allows for the kid to get an Individualized Educational Plan setup with their school district that makes exceptions to cater for their needs, like special counseling services. A medical diagnosis of ADHD, especially if untreated, is how you get into these special programs.
- spiralx 6y agoThere are large cross-cultural differences in groups seeking and getting diagnoses, so it could be the case that white middle-class boys are being over-diagnosed while lower-class black girls are almost certainly being hugely under-diagnosed. In Europe acceptance of ADHD has lagged behind the US but you'd expect stronger institutional health-care systems to reduce cultural differences somewhat.
- garmaine 6y agoIn many parts of the US, school nurses and teachers are critically involved in identifying kids that might have ADHD and getting them on the track for treatment (whether that treatment is medicinal or purely behavioral intervention). In my experience they don't push it, but they let parents know what resources are available, and have contact info for low-cost or cost-deferred pediatric clinics that can give the actual diagnosis. Europeans tend to gasp with horror that the school system is "pushing drugs on kids." But it's really more that through the school system the kids and their families have access to free medical advice and social services. So whereas in Europe you might have to remember to ask your general/family practitioner when you see them once a year, in the US there's a team of professionals working through the school system that are making sure kids have everything they need to succeed. Usually that's things like free food so they're not hungry or school bus transportation, but in ~5-10% of the cases it means ADHD diagnosis and treatment. So while this a bit less than double the percentage of kids that get ADHD diagnosis in Europe, it makes a bit more sense in context.
- iovrthoughtthis 6y agoyou’re insinuating that adhd (or, executive functions disorders) don’t exist. 1. there is lots of evidence showing that “something” is wrong with lots of peoples executive functions and that this observed problem is hereditary. 2. this is pretty insensitive. everybody does have these symptoms to some extent as you executive functions can’t be running 100% all the time. just like everyone has varying degrees of sight. it’s only a problem when it negatively impacts your life. for someone with an executive function disorder the symptoms happen often enough and with enough severity to materially impact their ability to; do work, have friends, be organised etc. not like, oh i forgot the milk (though, that happens) but like: “oh, i forgot i was brushing my teeth and now i’m searching for rubber gloves to replace the ones with a hole in from the kitchen, where did i leave my tooth brush?” the meds impact people with an executive function disorder little differently too, they return executive function to normal. so, while you maybe amped up on amphetamines to some degree your head is clear , your ability to pick which questions to answer, which rabbit holes to explore, to maintain more than 1 thing in your head at a time is restored. for 4-8 hours a day you get to be somewhat like your peers.
- esyir 6y agoThat's a pretty uncharitable take of his view. Rather, he seems to be claiming that it's heavily overdiagnosed. Looking at the numbers, I'm leaning towards that too. 9.4 percent of children are diagnosed with ADHD, and that's just the confirmed cases, nothing about estimated prevalence. Either we're screwing up the diagnostic criteria and overlabelling people (or worse, we're diagnosing them out of convenience), or we've seriously fucked our own society in ways that aggravate this, and medication is at best a stopgap.
- jasonkester 6y agoTo be fair, this response was likely written in response to the second paragraph of my comment, which I have since removed (since it could be read to mean exactly what the comment in question understood it to). So it’s probably not as uncharitable as you think from reading it in its current context.
- 6y ago
- watwut 6y agoKids do get diagnozed with ADHD in Europe, it is real thing. Following are my speculations. I think that threads from few days ago where basically all Americans found it normal and expected to for 5 years old to learn reading might have to do with that. If you expect too much of kids too soon, a lot of them wont be able to cope. You can then either adjust expectation or claim those kids sick. The other difference I noted is much less physical freedom Americans give to their kids and much bigger obsession with physical safety. Their kids do a lot of organized sport, but seemingly less of "run around as you please right now on whim". Which might have been related.
- raverbashing 6y agoWell by reading a lot of stories here to be fair this seems like a mix of: - parents not actually caring for their children. Not putting them through the motions of life. Boundaries, schedules, motions, etc. How many of those have dinner in front of the TV? Don't "eat their vegetables"? You raise a kid on overprocessed food and no exercise, what do you think is going to happen? (not saying absolutely this is the only issue, far from it) - Overmedicalization, sure, up to a bit. I can sympathize with people that need the medication to feel better and be productive, but how many of those have a legitimate problem and how many of those "just need a nudge". Learn to manage emotions and priorities is also part of growing up. - "Somebody elses problem", If school is boring is the problem with the school or the kid? Not saying that ADHD is not a real issue, but if you took a look at all aspects of that person's life, I bet you would find lots of things to fix.
- bluecalm 6y agoComing from Europe (Poland) I hate the politicians for it. My school experience was a nightmare. My friendships went away. My apartment was always a mess. I couldn't hold to any project for more than a few weeks. I was struggling with simple everyday thing like paying bills (had electricity cut off several times because of missed bills), keeping any kind of commitment, making any kind of change in my life. I think the best description of it is executive function disorder. I was even diagnosed as a child (very rare back in the day) but all they focused on was the hyperactive part. They made me attend useless therapy sessions, blamed me for everything and labeled a lazy not caring child. No one ever even mentioned medication. The hyperactive part went away when I was around 13. I was healed or so they thought. Still lazy, still wasting my potential, still couldn't learn to sit quietly in place but not stirring trouble anymore. My life was a disaster since graduating high school. I dropped from university. Lost contact with most friends, started gambling for living - I was good at math and reasoning and it was easy back then to make living at it. I never had any kind of job nor hold any kind of marketable skill. And then I met someone who gave stimulants to me. It was night and day difference instantly. My apartment was suddenly clean. My bills were paid. I started learning programming again. I founded a small software company which got very successful. I started a relationship, reconnected with some friends. Started doing sports, stopped missing appointments. I even got officially diagnosed with ADHD in my thirties. It took a while to find about one place in my country that diagnoses adults. Most doctors didn't even want to talk to me as they thought I just want to get stimulants to get high. It's a humiliating experience when you hear a doctor after doctor telling you it doesn't exist, that I just want stimulants or that maybe I should get a calendar and organize my life. It's still not perfect. The only stimulant I can legally get here is Ritalin which has very unpleasant side effects. I can get Modafinil on black market which is too mild but doesn't have sides and makes things a bit better. Trying to get Adderall can land me in jail. It's usually a mix of small doses of Modafinil and either caffeine or very small Ritalin dose. This way I can get a few productive hours a day. Maybe 4. If I can get 4 I am happy. It was a good day and I don't hate myself after. I have one thing to say to self righteous moralizing politicians and doctors in Europe. Go fuck yourself. I am lucky to be born with above average IQ and not trusting you much. To do my reading and being able to get stuff on the black market. You still caused my life to be a constant struggle for 2 decades. I know there are people who never realized the change is possible and their suffering is to satisfy your moral convictions. So why exactly are you horrified? Is there a pleasure in watching people struggle and being able to get help? Is it some kind of God given destiny they have to deal with? Are you horrified when people get insulin to treat Diabetes as well or TRT to treat androgen deficiency? I have heard such comments a lot and all I hear is: "you should suffer your destiny, we don't help people here".
- roel_v 6y ago" Watching from Europe, where roughly nobody is diagnosed with it nor prescribed drugs to treat it" And here is yet another victim to the 'Europe is a homogenous country-like entity' fallacy. Where in Europe are you talking about, and what age category? Because I can tell you that in the Netherlands this is very much wrong.
- emteycz 6y agoThe same is true with the US.
- Bjartr 6y agoJust because everyone sneezes doesn't mean hay fever doesn't exist.
- __s 6y agoIt only makes matters worse I was diagnosed with ADHD, prescribed ritalin. My mother opted me out of being medicated. It wasn't necessary for me, because I shouldn't've been diagnosed with ADHD. This was in early 2000s when ADHD was being applied to any kid with today's spectrum-like behavior But that doesn't mean others don't have a real struggle with this
- kitsune_ 6y agoI'm from Europe. Europe is a moralising backwater when it comes to ADHD. ADHD is one of the most impairing "disorders" out there. Around 5% of people have it. Once you know its symptoms more intimately, the behaviour of a lot of your people in your life suddenly will make sense. If you happen to be from Germany or France, watch this: https://www.arte.tv/en/videos/096295-000-A/psycho-attention-deficit-disorder/ https://www.arte.tv/en/videos/096295-000-A/psycho-attention-... If you have more time, watch this: https://www.youtube.com/watch?v=dVDhYtQkuO8 https://www.youtube.com/watch?v=dVDhYtQkuO8 This one is "fun" as well: https://pubmed.ncbi.nlm.nih.gov/30526189/ https://pubmed.ncbi.nlm.nih.gov/30526189/ "Results: Childhood ADHD-C was associated with a 9.5-year reduction in healthy ELE (estimated life expectancy), and a 8.4-year reduction in total ELE relative to control children by adulthood. The persistence of ADHD to adulthood was linked to a 12.7-year reduction in ELE. Several background traits accounted for more than 39% of variation in ELE."
- emteycz 6y agoI'm in Europe, have severe ADHD and I never got the help I needed, only punishment. I'm horrified of the incredible amount of ruined people that statistically must exist in Europe.