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Your comment feels like it’s well intentioned, but questioning if ADHD exists (it does) perpetuates a myth that has harmful impacts on people. ADHD in my opini

Your comment feels like it’s well intentioned, but questioning if ADHD exists (it does) perpetuates a myth that has harmful impacts on people. ADHD in my opinion is one of the worst named disorders. It’s name and the previous lack of accessible information about it, contributed to me not getting diagnosed for a decade after I first seriously though I may have it. You’re right that for a lot of the symptoms everyone could at some stage of their life fall along a spectrum. The key diagnostic criteria is that it’s been present since childhood and causes significant disruption to you life. If you can get by without medication that’s great. It’s also not a universal experience. I agree having a more defined pathology would be incredible, but there’s millions of us who report a similar enough set of symptoms which are greatly improved with medication that you can refute the existence of something there. > Furthermore, in more "natural" environments, "ADHD" doesn't really show up. I wasn't that noticeably different on the soccer field or working in the community garden over the summer, but with 7 classes worth of work piled on me over a semester it showed up in blazing letters. You may be surprised by how many people with ADHD find meaningful careers working outside. Two of the best non medical supports for an ADHD brain is exercise and sleep. Its generally accepted that in an ADHD brain some neurotransmitters like dopamine are retaken by the brain before it’s done with them, resulting in significantly lower levels of dopamine and other neurotransmitters in the brain. Exercise releases a lot of dopamine, and has a noticeable effect. Combine that with something interesting like a soccer game, and I’d be surprised if someone with ADHD wasn’t giving it everything. The first time people take medication some people experience a dramatic improvement, others it’s much more subtle initially. For me, within 40 minutes it was like my brain had put on glasses. My perpetual brain fog disappeared, so fast I was lost for words for a few hours as I came to grips with what most people felt as “normal”. How do I know that was normal, while before wasn’t? It’s a bit hard to explain, but imagine sitting in a stuffy room for 30 years and then getting fresh air.

faeriechangling 4y ago
There are a group of people who correlate together, who report facing distress, who tend to be treated in the same way, called people with ADHD. I acknowledge this. However I don't acknowledge that ADHD is simply a binary where you either have it or you don't, it's a heterogeneous condition when you do have it, and people who can't get a diagnosis may literally meet 5/8 criteria. The binary cutoff has absolutely nothing to do with scientific evidence and everything to do with organisational practicality.
- elcritch 4y ago
  Of course ADHD isn’t binary. There’s degrees of effects as with any complex physiological condition. ADHD diagnosis according to the DSM (1) requires the symptoms to effect a person in two areas out of work, school, relationships. At least as I understand it. There’s bound to be some people with full blown “ADHD” physiologically but who’ve not been drastically impacted by the symptoms. Many ADHD’ers have their ADHD problems “disappear” with the right job, stimuli, social structure, etc. Another way of looking at it would be people who are, say, legally bling because they’re a bit over the DMV limit. It’s not a magical cutoff but there needs to be some limit. There are also physiological and neurological differences that can be measured. fRMI can readily show metabolic differences between people with ADHD to those without. Here’s a recent study (2) showing differences in left/right hemisphere balances and particularly different balances of attention between visual vs verbal processing. 1: https://psychiatry.org/psychiatrists/practice/dsm https://psychiatry.org/psychiatrists/practice/dsm 2: https://www.frontiersin.org/articles/10.3389/fpsyt.2014.00081/full https://www.frontiersin.org/articles/10.3389/fpsyt.2014.0008...
  - quacked 4y ago
    > Of course ADHD isn’t binary. There’s degrees of effects as with any complex physiological condition. But that's exactly my point. We know that "Malaria" exists because we can point to a parasite that causes predictable symptoms. We know that there's something called "COVID-19" because a virus exists that we call "SARS-COV-2" whose presence we can test for. But there isn't any parasite or molecule or virus or bacterium or lesion that "causes" "ADHD", because "ADHD" is just a result of how our brains came together, not a real on-off condition that someone can have due to a cause like "Down's Syndrome". You cannot arrange real conditions on a spectrum; they are binary. Either you have them, or you don't. When you start measuring arbitrary "degrees" of a "condition", you're just assigning parameters to naturally occurring results based on variations in biology. Using the same logical premise that allows for "ADHD" to exist, I can make up any amount of "conditions" that someone can be diagnosed with. I can diagnose people with Tonal Mismeasurement Disorder (people with bad intonation), Height Growth Disorder (short people), Hand-Eye Coordination Disorder (people who aren't good at precision sports), etc. etc. But these aren't "disorders" or "conditions", they're just arbitrary labels slapped on people who are less able to perform a certain human-invented task due to their genes and how they were raised. The fact that you and I can focus better if we take amphetamines doesn't prove that ADHD "exists". We accept that some people are naturally stronger than others; well, naturally weaker people could take anabolic steroids in order to catch up to naturally stronger people. Does that mean that "Strength Deficit Disorder" exists? When you talk about how an inability to focus has caused you difficulty, what you're Actually observing is that the economy, school systems, and bureaucracies have been set up by people that have a relative surplus of focus and determination, and this method of organizing society disadvantages you. It's as if the economy was set up by people who made every transaction hinge on how much you could lift unassisted, and you and I are naturally weak people. The fact that drugs help us perform better doesn't mean that "Strength Deficit Disorder" is real, it just means that our relative shortcomings can be remediated by using certain chemical cocktails. I understand that the dopamine shortage and metabolic effects can be measured, but they're not sure ways to prove that someone has attention problems. For every "ADHD" person who has less dopamine, there's someone on the other side of the spectrum who has more dopamine. It's not as if ADHD people are uniquely lacking dopamine and the majority of people have "normal" levels. When you take amphetamines, you're experiencing what a 50th-25th percentile person experiences when they focus on something. You're not experiencing the other side of the bell curve, what I called "ASRB" experience, which is unparalleled clarity of mind and memory. I am more amenable to something like your "legally blind" example. If we called it "legally focus-impaired", that would reveal the fact that we're selecting arbitrary definitions based on a spectrum of performance.

faeriechangling 4y ago

There are a group of people who correlate together, who report facing distress, who tend to be treated in the same way, called people with ADHD. I acknowledge this. However I don't acknowledge that ADHD is simply a binary where you either have it or you don't, it's a heterogeneous condition when you do have it, and people who can't get a diagnosis may literally meet 5/8 criteria. The binary cutoff has absolutely nothing to do with scientific evidence and everything to do with organisational practicality.

elcritch 4y ago
Of course ADHD isn’t binary. There’s degrees of effects as with any complex physiological condition. ADHD diagnosis according to the DSM (1) requires the symptoms to effect a person in two areas out of work, school, relationships. At least as I understand it. There’s bound to be some people with full blown “ADHD” physiologically but who’ve not been drastically impacted by the symptoms. Many ADHD’ers have their ADHD problems “disappear” with the right job, stimuli, social structure, etc. Another way of looking at it would be people who are, say, legally bling because they’re a bit over the DMV limit. It’s not a magical cutoff but there needs to be some limit. There are also physiological and neurological differences that can be measured. fRMI can readily show metabolic differences between people with ADHD to those without. Here’s a recent study (2) showing differences in left/right hemisphere balances and particularly different balances of attention between visual vs verbal processing. 1: https://psychiatry.org/psychiatrists/practice/dsm https://psychiatry.org/psychiatrists/practice/dsm 2: https://www.frontiersin.org/articles/10.3389/fpsyt.2014.00081/full https://www.frontiersin.org/articles/10.3389/fpsyt.2014.0008...
- quacked 4y ago
  > Of course ADHD isn’t binary. There’s degrees of effects as with any complex physiological condition. But that's exactly my point. We know that "Malaria" exists because we can point to a parasite that causes predictable symptoms. We know that there's something called "COVID-19" because a virus exists that we call "SARS-COV-2" whose presence we can test for. But there isn't any parasite or molecule or virus or bacterium or lesion that "causes" "ADHD", because "ADHD" is just a result of how our brains came together, not a real on-off condition that someone can have due to a cause like "Down's Syndrome". You cannot arrange real conditions on a spectrum; they are binary. Either you have them, or you don't. When you start measuring arbitrary "degrees" of a "condition", you're just assigning parameters to naturally occurring results based on variations in biology. Using the same logical premise that allows for "ADHD" to exist, I can make up any amount of "conditions" that someone can be diagnosed with. I can diagnose people with Tonal Mismeasurement Disorder (people with bad intonation), Height Growth Disorder (short people), Hand-Eye Coordination Disorder (people who aren't good at precision sports), etc. etc. But these aren't "disorders" or "conditions", they're just arbitrary labels slapped on people who are less able to perform a certain human-invented task due to their genes and how they were raised. The fact that you and I can focus better if we take amphetamines doesn't prove that ADHD "exists". We accept that some people are naturally stronger than others; well, naturally weaker people could take anabolic steroids in order to catch up to naturally stronger people. Does that mean that "Strength Deficit Disorder" exists? When you talk about how an inability to focus has caused you difficulty, what you're Actually observing is that the economy, school systems, and bureaucracies have been set up by people that have a relative surplus of focus and determination, and this method of organizing society disadvantages you. It's as if the economy was set up by people who made every transaction hinge on how much you could lift unassisted, and you and I are naturally weak people. The fact that drugs help us perform better doesn't mean that "Strength Deficit Disorder" is real, it just means that our relative shortcomings can be remediated by using certain chemical cocktails. I understand that the dopamine shortage and metabolic effects can be measured, but they're not sure ways to prove that someone has attention problems. For every "ADHD" person who has less dopamine, there's someone on the other side of the spectrum who has more dopamine. It's not as if ADHD people are uniquely lacking dopamine and the majority of people have "normal" levels. When you take amphetamines, you're experiencing what a 50th-25th percentile person experiences when they focus on something. You're not experiencing the other side of the bell curve, what I called "ASRB" experience, which is unparalleled clarity of mind and memory. I am more amenable to something like your "legally blind" example. If we called it "legally focus-impaired", that would reveal the fact that we're selecting arbitrary definitions based on a spectrum of performance.