4 ms·

> Most of the disorders are just collections of symptoms without any solid research tying those symptom collections to concrete issues in neurological circuits

> Most of the disorders are just collections of symptoms without any solid research tying those symptom collections to concrete issues in neurological circuits or biochemical signaling pathways. This isn't true for autism, ADHD, bipolar or schizophrenia since some biological mechanisms are understood (even if these labels aren't perfect), so what are you talking about and what do you base it on?

whalesalad 5y ago
The illnesses you mentioned are misdiagnosed all the time. DSM-V is a joke and so are most mental health professionals. They’re just fitting a list of symptoms to another list of symptoms based on what amounts to Levenshtein distance. Anyone can be diagnosed with ADHD these days. And for all intents and purposes the patient might have 9/10 symptoms. But do they really have ADHD or is it something else? We don’t even have the capacity to figure that out right now because our understanding is so limited.
- DarylZero 5y ago
  And if you think diagnoses are bad, wait 'til you see what passes for treatments.
- bratwurst3000 5y ago
  True. A friend of mine got diagnosed with adhd and it was like 15 questions( mostly the same kind) et voila adhd. I got adhd since a kid and i the test was the same. Only they asked the parents and not me. But i think i rly got it… Its like the south park episode where kids got diagnosed because the bible bored them…
  - novok 5y ago
    If you want to, you can spend 2 or 3 days and $5000 to get properly assessed by a neuropsycholoist to figure out what your issues actually are. That is laborious, time consuming and doesn't fit the 15 minute doctor visit medical billing model, so it comes down to a 15 question screener test for many.
    - deleted 5y ago
      [deleted]
    - bratwurst3000 5y ago
      Living in germany i got good healthcare and did allready some deeper analyses as a adult and its apartantly adhd. In the first message I meant as a child the test was not enough. But thank you for this hint :)
      - novok 5y ago
        Often this deeper analysis is done on children and the 15 minute thing a quick initial screener :) I had a bunch of assessment in early childhood but I didn't figure out what exactly my set of issues were until I got assessed by a very good neuropsych later in life. I really wish I knew about this stuff in late childhood, would've explained a lot more! It's also sad that there are not many good neuropsychs out there and it's hard to evaluate who is good for most people. One thing for the other intelligent people out there, your intelligence can often mask that you are not performing to your full potential, because it compensates and makes you perform 'good enough'. Unfortunately our medical system is more orientated towards fixing the people who's lives are in a mess vs people who are just OK, so those who hobble along often don't get the help they need. Sometimes wish there was an equivalent of doctor that focuses on making people perform their best vs. good enough sometimes, kind of like a coach.
- meiji163 5y ago
  Not only is the diagnostic framework a joke, it's the basis of immense amounts of iatrogenic harm [0] [0] "Anatomy of An Epidemic", Robert Whittaker
- MrMan 5y ago
  probably lying to get amphetamines, which enhance performance
- oaktrout 5y ago
  Saying most mental health professionals are a joke is perhaps a little harsh in my opinion, after all they are trying to understand and treat the most mysterious and complex things known to man. We don't diagnose diabetes with a list of symptoms because we have a lab test (where we have picked an arbitrary value, but that's another story). We have no lab test for add. That is frustrating, and I think that adhd is probably overdisgnosed, but I think most are doing the best they can.
netizen-936824 5y ago
Our knowledge of schizophrenia is primarily based on what medications alleviate the symptoms, this is something I learned from pharmacology and biopsychology textbooks. Same with ADHD. Autism, I'm not aware of any solid research pointing to overarching mechanisms so please do cite some if you are. I would love to read it. Just because some symptoms are alleviated by a medication does not mean that must be related to the underlying mechanism. Many times medications are altering symptoms far removed from the initial cause. Under the "mechanism" section in wikipedia there are multiple theories discussed: https://en.m.wikipedia.org/wiki/Schizophrenia https://en.m.wikipedia.org/wiki/Schizophrenia
Nasrudith 5y ago
A steelmanned accurate take is that they are not biologically objectively confirmable. Which is more of an actual problem in psychiatry than other areas of medicine. Looking at say past x-rays and noting a tumor that went uncommented upon at the time on malpractice lawsuits for instance. But notably also not done the majority of time in practice. It is seldom done to the level of say verifying your flu strain, let alone other more expensive and/or invasive tests which do not serve the patient's medical needs.
albedoa 5y ago
Maybe you should start by telling us what you are talking about.

whalesalad 5y ago

The illnesses you mentioned are misdiagnosed all the time. DSM-V is a joke and so are most mental health professionals. They’re just fitting a list of symptoms to another list of symptoms based on what amounts to Levenshtein distance. Anyone can be diagnosed with ADHD these days. And for all intents and purposes the patient might have 9/10 symptoms. But do they really have ADHD or is it something else? We don’t even have the capacity to figure that out right now because our understanding is so limited.

DarylZero 5y ago
And if you think diagnoses are bad, wait 'til you see what passes for treatments.
bratwurst3000 5y ago
True. A friend of mine got diagnosed with adhd and it was like 15 questions( mostly the same kind) et voila adhd. I got adhd since a kid and i the test was the same. Only they asked the parents and not me. But i think i rly got it… Its like the south park episode where kids got diagnosed because the bible bored them…
- novok 5y ago
  If you want to, you can spend 2 or 3 days and $5000 to get properly assessed by a neuropsycholoist to figure out what your issues actually are. That is laborious, time consuming and doesn't fit the 15 minute doctor visit medical billing model, so it comes down to a 15 question screener test for many.
  - deleted 5y ago
    [deleted]
  - bratwurst3000 5y ago
    Living in germany i got good healthcare and did allready some deeper analyses as a adult and its apartantly adhd. In the first message I meant as a child the test was not enough. But thank you for this hint :)
    - novok 5y ago
      Often this deeper analysis is done on children and the 15 minute thing a quick initial screener :) I had a bunch of assessment in early childhood but I didn't figure out what exactly my set of issues were until I got assessed by a very good neuropsych later in life. I really wish I knew about this stuff in late childhood, would've explained a lot more! It's also sad that there are not many good neuropsychs out there and it's hard to evaluate who is good for most people. One thing for the other intelligent people out there, your intelligence can often mask that you are not performing to your full potential, because it compensates and makes you perform 'good enough'. Unfortunately our medical system is more orientated towards fixing the people who's lives are in a mess vs people who are just OK, so those who hobble along often don't get the help they need. Sometimes wish there was an equivalent of doctor that focuses on making people perform their best vs. good enough sometimes, kind of like a coach.
meiji163 5y ago
Not only is the diagnostic framework a joke, it's the basis of immense amounts of iatrogenic harm [0] [0] "Anatomy of An Epidemic", Robert Whittaker
MrMan 5y ago
probably lying to get amphetamines, which enhance performance
oaktrout 5y ago
Saying most mental health professionals are a joke is perhaps a little harsh in my opinion, after all they are trying to understand and treat the most mysterious and complex things known to man. We don't diagnose diabetes with a list of symptoms because we have a lab test (where we have picked an arbitrary value, but that's another story). We have no lab test for add. That is frustrating, and I think that adhd is probably overdisgnosed, but I think most are doing the best they can.

netizen-936824 5y ago

Our knowledge of schizophrenia is primarily based on what medications alleviate the symptoms, this is something I learned from pharmacology and biopsychology textbooks. Same with ADHD. Autism, I'm not aware of any solid research pointing to overarching mechanisms so please do cite some if you are. I would love to read it. Just because some symptoms are alleviated by a medication does not mean that must be related to the underlying mechanism. Many times medications are altering symptoms far removed from the initial cause. Under the "mechanism" section in wikipedia there are multiple theories discussed: https://en.m.wikipedia.org/wiki/Schizophrenia https://en.m.wikipedia.org/wiki/Schizophrenia

Nasrudith 5y ago

A steelmanned accurate take is that they are not biologically objectively confirmable. Which is more of an actual problem in psychiatry than other areas of medicine. Looking at say past x-rays and noting a tumor that went uncommented upon at the time on malpractice lawsuits for instance. But notably also not done the majority of time in practice. It is seldom done to the level of say verifying your flu strain, let alone other more expensive and/or invasive tests which do not serve the patient's medical needs.

albedoa 5y ago

Maybe you should start by telling us what you are talking about.