3 ms·

It is correct to a degree. ADHD is just a short hand for "mild brain impairment/damage of unknown cause" It's not a single disease but a collection of dysexec

It is correct to a degree. ADHD is just a short hand for "mild brain impairment/damage of unknown cause" It's not a single disease but a collection of dysexecutive syndromes that impact higher cognitive functions: strategic planning, organization, etc. This could be due to low oxygen during birth, infections (not necessarily CNS invasive), neck/head injuries, chronic pain, sleep disorders, genetics, vitamin deficiencies and a myriad of other causes, pretty much anything. The same medication is utilized as in traumatic brain injury: amphetamines. They are quite effective in both ADHD and TBI, and as been in active use for nearly a 100 years. Both can be often diagnosed by the same psychometric tests, and can be pretty much indistinguishable. Of course, finding mechanisms to cope with impaired executive function can help reduce the need for medication later in life. If you can find the underlying condition, and it happens to be reversible, as is often the case in case of vitamin/mineral deficiencies or some sleep disorders, it can be often eliminated entirely. However, due to paranoia around stimulants in our society there is some laymen hysteria about giving essentially lifelong access to stimulants to adults. It is an extremely harmful attitude, as medication is nothing but just a tool.

SamoyedFurFluff 5y ago
Minor correction: ADHD may be largely attributable to genetics (it had a heritability of 74%!) https://www.nature.com/articles/s41380-018-0070-0/ https://www.nature.com/articles/s41380-018-0070-0/
- inter_netuser 5y ago
  It could be, but I'm rather distrustful of such high numbers backstopped by nothing but the same exact set of MZ twins they've been using for lab rats for decades now in various studies. How many monozygotic twins can you find with a robust diagnosis of ADHD, and how much money can you afford to spend to thoroughly exclude every other possible cause (TBI, sleep breathing disorders, deficiency, thyroid, autoimmune, neuropathies)? Quite expensive, nobody gonna do that. Science is about finding evidence to support a hypothesis, not some quaint notion of "truth". All that's needed from such studies is to support the "biological cause" conclusion so that you can substantiate the need for a pharmacological as opposed to talk therapy intervention. Those studies certainly support that, but all they really say "ok this is biology". Given a disorder is usually defined by being outside the normal range, as defined by two sigma interval, 5% of people have ADHD by definition. How many of those are due to bad genes, and other causes is actually very hard to say, as there isn't that much profit to be made in discerning this any further.
- 8note 5y ago
  Note: earrings hare also quite heritable, but unrelated to genetics
tailspin2019 5y ago
> "mild brain impairment/damage of unknown cause" Is ADHD not a developmental disorder, causing an underdevelopment or delayed development of the frontal lobe? It seems incorrect to refer to this as "brain damage"? Edit: I guess I'm referring to the official "medical narrative" as it stands. I do happen to believe that the DSM-5 criteria is wildly out of date for ADHD diagnosis and at odds with the findings of a lot of more recent research. But I'm just questioning the "brain damage" terminology - I've never heard it described in that way before. Most medical professionals that I've encountered stick firmly to the line that ADHD is a lifelong condition that develops in very early childhood and is not currently curable. You can almost entirely alleviate symptoms. But this is != a cure. My current understanding is that if your ADHD is "curable" by eg. vitamins or a change in sleep pattern then it is unlikely to be considered to have been ADHD in the first place (but the symptoms may well have been indistinguishable). That's not to say that the symptoms of ADHD can't be greatly reduced by these things. However, I'm not a doctor. Happy to be corrected by anyone who is.
- deleted 5y ago
  [deleted]
- BirdieNZ 5y ago
  > It seems incorrect to refer to this as "brain damage"? Some people have car crashes or other traumatic head injuries and receive an ADHD diagnosis after the event, so it is usually from childhood but sometimes from brain damage.
  - tailspin2019 5y ago
    > Some people have car crashes or other traumatic head injuries and receive an ADHD diagnosis after the event Interesting. I don't know enough to have an opinion on how prevalent this is, but I have read that people with ADHD have a higher risk of being involved in a car crash in the first place, so there is an interesting causation/correlation discussion to be had there! Eg: A new study reports that the risk of being involved in car crashes increases for those diagnosed with attention-deficit/hyperactivity disorder (ADHD). The study looked specifically at the rate of car crashes by adulthood, which was 1.45 times higher in those with a childhood history of ADHD compared to adults with no ADHD. https://www.sciencedaily.com/releases/2020/08/200818142135.htm https://www.sciencedaily.com/releases/2020/08/200818142135.h...

SamoyedFurFluff 5y ago

Minor correction: ADHD may be largely attributable to genetics (it had a heritability of 74%!) https://www.nature.com/articles/s41380-018-0070-0/ https://www.nature.com/articles/s41380-018-0070-0/

inter_netuser 5y ago
It could be, but I'm rather distrustful of such high numbers backstopped by nothing but the same exact set of MZ twins they've been using for lab rats for decades now in various studies. How many monozygotic twins can you find with a robust diagnosis of ADHD, and how much money can you afford to spend to thoroughly exclude every other possible cause (TBI, sleep breathing disorders, deficiency, thyroid, autoimmune, neuropathies)? Quite expensive, nobody gonna do that. Science is about finding evidence to support a hypothesis, not some quaint notion of "truth". All that's needed from such studies is to support the "biological cause" conclusion so that you can substantiate the need for a pharmacological as opposed to talk therapy intervention. Those studies certainly support that, but all they really say "ok this is biology". Given a disorder is usually defined by being outside the normal range, as defined by two sigma interval, 5% of people have ADHD by definition. How many of those are due to bad genes, and other causes is actually very hard to say, as there isn't that much profit to be made in discerning this any further.
8note 5y ago
Note: earrings hare also quite heritable, but unrelated to genetics

tailspin2019 5y ago

> "mild brain impairment/damage of unknown cause" Is ADHD not a developmental disorder, causing an underdevelopment or delayed development of the frontal lobe? It seems incorrect to refer to this as "brain damage"? Edit: I guess I'm referring to the official "medical narrative" as it stands. I do happen to believe that the DSM-5 criteria is wildly out of date for ADHD diagnosis and at odds with the findings of a lot of more recent research. But I'm just questioning the "brain damage" terminology - I've never heard it described in that way before. Most medical professionals that I've encountered stick firmly to the line that ADHD is a lifelong condition that develops in very early childhood and is not currently curable. You can almost entirely alleviate symptoms. But this is != a cure. My current understanding is that if your ADHD is "curable" by eg. vitamins or a change in sleep pattern then it is unlikely to be considered to have been ADHD in the first place (but the symptoms may well have been indistinguishable). That's not to say that the symptoms of ADHD can't be greatly reduced by these things. However, I'm not a doctor. Happy to be corrected by anyone who is.

deleted 5y ago
[deleted]
BirdieNZ 5y ago
> It seems incorrect to refer to this as "brain damage"? Some people have car crashes or other traumatic head injuries and receive an ADHD diagnosis after the event, so it is usually from childhood but sometimes from brain damage.
- tailspin2019 5y ago
  > Some people have car crashes or other traumatic head injuries and receive an ADHD diagnosis after the event Interesting. I don't know enough to have an opinion on how prevalent this is, but I have read that people with ADHD have a higher risk of being involved in a car crash in the first place, so there is an interesting causation/correlation discussion to be had there! Eg: A new study reports that the risk of being involved in car crashes increases for those diagnosed with attention-deficit/hyperactivity disorder (ADHD). The study looked specifically at the rate of car crashes by adulthood, which was 1.45 times higher in those with a childhood history of ADHD compared to adults with no ADHD. https://www.sciencedaily.com/releases/2020/08/200818142135.htm https://www.sciencedaily.com/releases/2020/08/200818142135.h...