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That's true. And it's also true that ADHD is overdiagnosed and overtreated, and the rate is non-negligible. That is a problem that both the public and the medi

That's true. And it's also true that ADHD is overdiagnosed and overtreated, and the rate is non-negligible. That is a problem that both the public and the medical community are aware of. I agree with maintaining awareness of that, but I strongly disagree with going to the extremes and stigmatizing ADHD medication and everyone involved. Look at the comment I objected to. Does it read like a rational, polite way to maintain awareness of that problem? Or does it look like a knee-jerk judgment that's parroting a popular trope?

ALittleLight 4y ago
I wrote that it is horrifying so many children are drugged to be more complacent in school. I saw you objecting to that and assumed I'd need to come back and support the idea that ADHD is over diagnosed and over medicated (e.g. the diagnoses have about doubled in the past couple decades in the US and are substantially higher than in European countries and US pharmaceuticals have a history of being over prescribed). Yet now I find that you are already aware ADHD is overdiagnosed and overtreated - so what exactly are you objecting to in my original comment? You don't think it's horrifying that parents, teachers, and doctors are basically conspiring to drug kids to keep them from acting up in schools? School is a pretty boring and restrictive place. Children are notoriously poor at dealing with boring things and young boys in particular are particularly prone to the kind of misbehavior that will get them in trouble and drugged.
- CodeMage 4y ago
  I've already expressed what I object to: that it's a pithy, kneejerk, judgmental trope-parroting that does more to stigmatize the majority who want to help their kids, than to help combat the abuse perpetrated by the minority of bad parents. It is remarkably difficult to find any figures even estimating the overdiagnosis and overmedication rates for ADHD. Most of the talk around this issue tends to make a big deal out of the rising rate of ADHD diagnoses. Those who talk about it responsibly and rationally recognize right away that this doesn't necessarily mean we have an overdiagnosis crisis on our hands, and seek additional information. The best study I've been able to find about this [1] does indicate that there may be some overdiagnosis and overmedication going on, but even there it's not framed as "parents, teachers, and doctors are basically conspiring to drug kids to keep them from acting up in schools", nor does it lend any credibility to that claim. Are there bad parents who don't want to deal with their kids' behavior and try to get them "drugged into complacence"? Yes, definitely. Do we know how many and how that number compares to other kinds of parental abuse? No, we don't. Is it a problem of epidemic proportions? There's no evidence for that, and the onus is on those of you who make that claim. More importantly, if we distance ourselves from the sensationalist tropes about "drugging kids into complacence", we can ask a better question: are there currently any perverse incentives in the medical community to overdiagnose ADHD and overprescribe medication? This might be the case, but it remains to be proven and it should be dealt with just like any similar case of perverse incentives. So what do I object to? I object to the sensationalist "Will Nobody Think Of The Children" overstatement and hyperbole. I object to people bringing up the same trope over and over again, out of ignorance, and doing their best to stigmatize the vast majority of us who are doing our best to provide our kids with the best life we can. I object to not trying to constructively work to slowly evolve the best approach to dealing with a concrete, real and potentially debilitating problem that was discovered too recently to have a perfect solution to it, just because drumming up outrage and spreading FUD is easier and more gratifying. And yes, school can be a pretty boring and restrictive place, but that's just the tip of the ADHD iceberg. Reducing the whole problem space to just that is not helping, either. [1]: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778451 https://jamanetwork.com/journals/jamanetworkopen/fullarticle... EDIT: I realized that I forgot to provide the link for [1], so I'm adding it now. My apologies for the oversight.
  - ALittleLight 4y ago
    To me you're coming across as defensive when you make these insults and assert that I'm ignorant and don't know what I'm talking about (when, ironically, you have no way of knowing and are therefore ignorant to my level of exposure to the topic). I understand being defensive - you've made a significant decision about your child's health and I hope for your, and his, sake that it's the correct one. Your defensiveness aside - it's actually not a "trope" or a kneejerk reaction to notice that the rates of ADHD and ADHD medication have doubled in the past couple decades in the US and are significantly higher in the US than in Western Europe. The US has a pattern of over prescribing medications - the current opiod epidemic is an example. My understanding of this is that it's most likely there is over-diagnosing, and therefore overmedicating, of ADHD, and that's bad. "Are there bad parents who don't want to deal with their kids' behavior" - there are, sure, but that's not what I think is most common. My intuition is that bad parents would just not care what their kids are doing and leave it to the school to handle. If I had to guess, I would guess that the modal problem parent is one who, understandably, wants what is best for their kids and is concerned about what the schools are telling them. The schools, for their part, want kids who don't overly disturb the system. The doctors hear about a problem that they have the pharmaceuticals to treat. I don't think the people involved are evil and acting out of malice or laziness but I do think that this group works together to create a system where a fundamentally boring place (school) has a problem managing people who are fundamentally bad at being bored (boys) and they, in part, solve that problem by giving them drugs (ADHD medication). I've been thinking about my choice of the word "complacent" from earlier, and maybe it's not quite right - I originally meant it in the sense that the natural state of the boys is to think of school as a problem and rebel against it and their medicated state is to not rebel against school as much or to the same extent.
    - CodeMage 4y ago
      If I'm coming across as defensive, then I haven't been clear enough. I'm not defensive, I'm furious but I'm trying to channel it into rational discourse. There's nothing "defensive" about wanting to stop the propagation of this trope. And yes, it's a trope. I said very clearly that this is not about rising rates of ADHD diagnoses and medication. The trope I'm referring to is the tendency to not only jump to a conclusion that it means we have an overdiagnosis crisis, but to present that conclusion as a fact and a significant problem. The reason why I'm furious about it is because this narrative has been pushed for years and it has a negative impact on those of us who wish to help our children. In my personal case, it created a strong urge to avoid addressing the issue and just hope it would go away with "better parenting". If it hadn't been for the stigma of "you just want to drug your kids into submission", I would have started helping my kid earlier -- not with medication, but by finding a psychologist to help us. Again, the focus on "school is boring and kids misbehave, so they get drugged" is too narrow and damaging to those who are affected by ADHD. Imagine being interested in many things, but not being able to advance in any of them beyond initial interest because your brain doesn't let you overcome simple obstacles that require concentration and it only lets you do so if you become somewhat obsessed by a particular random thing it settled on. Yes, the study I (belatedly) linked in my previous post does indicate that there might be some overdiagnosis and overmedication of milder ADHD cases. And yes, that's something that we need to be aware of and work to improve. I'm not objecting to raising that awareness. I'm objecting to the utterly irresponsible and damaging way to do so.
luckydata 4y ago
who told you it's over-diagnosed? Science generally agrees ADHD is under-diagnosed. Read the statement of consensus. There's some sort of moral panic cause the beautiful souls of a bunch of people can't fathom stimulants can be used for medical purposes cause "all drugs are bad and Concerta is essentially meth" which is absolute BS. There's no need to spew hearsay and lies when you know next to nothing about a medical condition that affects 5% of the population.
- CodeMage 4y ago
  I based what I said on the study by Kazda, Bell, Thomas, et al [1], although there's always a chance that I might have misunderstood it. From what I understood, it seems that there's a certain degree of overdiagnosis in milder cases of ADHD. Again, it's perfectly possible that I either misunderstood it or that they're wrong. If you look at the rest of my comments in this discussion, you'll see that I'm not pushing the moral panic you mention -- on the contrary, I'm pushing against it strongly -- and that it's definitely not true that I "know next to nothing" about this condition. It wouldn't surprise me to find that ADHD is being simultaneously over- and under-diagnosed, because it's new enough that we're still discovering more and more about it. That's why I don't dispute that there's probably some degree of overdiagnosis, but I strongly object to pushing the narrative that it's some kind of an overmedication epidemic or crisis. [1]: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778451 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

ALittleLight 4y ago

I wrote that it is horrifying so many children are drugged to be more complacent in school. I saw you objecting to that and assumed I'd need to come back and support the idea that ADHD is over diagnosed and over medicated (e.g. the diagnoses have about doubled in the past couple decades in the US and are substantially higher than in European countries and US pharmaceuticals have a history of being over prescribed). Yet now I find that you are already aware ADHD is overdiagnosed and overtreated - so what exactly are you objecting to in my original comment? You don't think it's horrifying that parents, teachers, and doctors are basically conspiring to drug kids to keep them from acting up in schools? School is a pretty boring and restrictive place. Children are notoriously poor at dealing with boring things and young boys in particular are particularly prone to the kind of misbehavior that will get them in trouble and drugged.

CodeMage 4y ago
I've already expressed what I object to: that it's a pithy, kneejerk, judgmental trope-parroting that does more to stigmatize the majority who want to help their kids, than to help combat the abuse perpetrated by the minority of bad parents. It is remarkably difficult to find any figures even estimating the overdiagnosis and overmedication rates for ADHD. Most of the talk around this issue tends to make a big deal out of the rising rate of ADHD diagnoses. Those who talk about it responsibly and rationally recognize right away that this doesn't necessarily mean we have an overdiagnosis crisis on our hands, and seek additional information. The best study I've been able to find about this [1] does indicate that there may be some overdiagnosis and overmedication going on, but even there it's not framed as "parents, teachers, and doctors are basically conspiring to drug kids to keep them from acting up in schools", nor does it lend any credibility to that claim. Are there bad parents who don't want to deal with their kids' behavior and try to get them "drugged into complacence"? Yes, definitely. Do we know how many and how that number compares to other kinds of parental abuse? No, we don't. Is it a problem of epidemic proportions? There's no evidence for that, and the onus is on those of you who make that claim. More importantly, if we distance ourselves from the sensationalist tropes about "drugging kids into complacence", we can ask a better question: are there currently any perverse incentives in the medical community to overdiagnose ADHD and overprescribe medication? This might be the case, but it remains to be proven and it should be dealt with just like any similar case of perverse incentives. So what do I object to? I object to the sensationalist "Will Nobody Think Of The Children" overstatement and hyperbole. I object to people bringing up the same trope over and over again, out of ignorance, and doing their best to stigmatize the vast majority of us who are doing our best to provide our kids with the best life we can. I object to not trying to constructively work to slowly evolve the best approach to dealing with a concrete, real and potentially debilitating problem that was discovered too recently to have a perfect solution to it, just because drumming up outrage and spreading FUD is easier and more gratifying. And yes, school can be a pretty boring and restrictive place, but that's just the tip of the ADHD iceberg. Reducing the whole problem space to just that is not helping, either. [1]: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778451 https://jamanetwork.com/journals/jamanetworkopen/fullarticle... EDIT: I realized that I forgot to provide the link for [1], so I'm adding it now. My apologies for the oversight.
- ALittleLight 4y ago
  To me you're coming across as defensive when you make these insults and assert that I'm ignorant and don't know what I'm talking about (when, ironically, you have no way of knowing and are therefore ignorant to my level of exposure to the topic). I understand being defensive - you've made a significant decision about your child's health and I hope for your, and his, sake that it's the correct one. Your defensiveness aside - it's actually not a "trope" or a kneejerk reaction to notice that the rates of ADHD and ADHD medication have doubled in the past couple decades in the US and are significantly higher in the US than in Western Europe. The US has a pattern of over prescribing medications - the current opiod epidemic is an example. My understanding of this is that it's most likely there is over-diagnosing, and therefore overmedicating, of ADHD, and that's bad. "Are there bad parents who don't want to deal with their kids' behavior" - there are, sure, but that's not what I think is most common. My intuition is that bad parents would just not care what their kids are doing and leave it to the school to handle. If I had to guess, I would guess that the modal problem parent is one who, understandably, wants what is best for their kids and is concerned about what the schools are telling them. The schools, for their part, want kids who don't overly disturb the system. The doctors hear about a problem that they have the pharmaceuticals to treat. I don't think the people involved are evil and acting out of malice or laziness but I do think that this group works together to create a system where a fundamentally boring place (school) has a problem managing people who are fundamentally bad at being bored (boys) and they, in part, solve that problem by giving them drugs (ADHD medication). I've been thinking about my choice of the word "complacent" from earlier, and maybe it's not quite right - I originally meant it in the sense that the natural state of the boys is to think of school as a problem and rebel against it and their medicated state is to not rebel against school as much or to the same extent.
  - CodeMage 4y ago
    If I'm coming across as defensive, then I haven't been clear enough. I'm not defensive, I'm furious but I'm trying to channel it into rational discourse. There's nothing "defensive" about wanting to stop the propagation of this trope. And yes, it's a trope. I said very clearly that this is not about rising rates of ADHD diagnoses and medication. The trope I'm referring to is the tendency to not only jump to a conclusion that it means we have an overdiagnosis crisis, but to present that conclusion as a fact and a significant problem. The reason why I'm furious about it is because this narrative has been pushed for years and it has a negative impact on those of us who wish to help our children. In my personal case, it created a strong urge to avoid addressing the issue and just hope it would go away with "better parenting". If it hadn't been for the stigma of "you just want to drug your kids into submission", I would have started helping my kid earlier -- not with medication, but by finding a psychologist to help us. Again, the focus on "school is boring and kids misbehave, so they get drugged" is too narrow and damaging to those who are affected by ADHD. Imagine being interested in many things, but not being able to advance in any of them beyond initial interest because your brain doesn't let you overcome simple obstacles that require concentration and it only lets you do so if you become somewhat obsessed by a particular random thing it settled on. Yes, the study I (belatedly) linked in my previous post does indicate that there might be some overdiagnosis and overmedication of milder ADHD cases. And yes, that's something that we need to be aware of and work to improve. I'm not objecting to raising that awareness. I'm objecting to the utterly irresponsible and damaging way to do so.

luckydata 4y ago

who told you it's over-diagnosed? Science generally agrees ADHD is under-diagnosed. Read the statement of consensus. There's some sort of moral panic cause the beautiful souls of a bunch of people can't fathom stimulants can be used for medical purposes cause "all drugs are bad and Concerta is essentially meth" which is absolute BS. There's no need to spew hearsay and lies when you know next to nothing about a medical condition that affects 5% of the population.

CodeMage 4y ago
I based what I said on the study by Kazda, Bell, Thomas, et al [1], although there's always a chance that I might have misunderstood it. From what I understood, it seems that there's a certain degree of overdiagnosis in milder cases of ADHD. Again, it's perfectly possible that I either misunderstood it or that they're wrong. If you look at the rest of my comments in this discussion, you'll see that I'm not pushing the moral panic you mention -- on the contrary, I'm pushing against it strongly -- and that it's definitely not true that I "know next to nothing" about this condition. It wouldn't surprise me to find that ADHD is being simultaneously over- and under-diagnosed, because it's new enough that we're still discovering more and more about it. That's why I don't dispute that there's probably some degree of overdiagnosis, but I strongly object to pushing the narrative that it's some kind of an overmedication epidemic or crisis. [1]: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778451 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...