4 ms·

As time has gone on the less sympathetic I've gotten to labels like "ADHD" and the more I've thought we should just make amphetamines not require a dx, although

As time has gone on the less sympathetic I've gotten to labels like "ADHD" and the more I've thought we should just make amphetamines not require a dx, although they should probably still require a doctors supervision. The whole concept that a doctor has to say there's something wrong with you to get drugs I find to be very patronising. If somebody has trouble focusing, they can just take some drugs and fill out some planners, they don't need to be labelled using an acronym. I'm not convinced ADHD is an illness either, but this isn't really specific to ADHD, I'm pretty sceptical of the entire DSM model and our need to give people a label or a combination of labels. I was diagnosed with ADHD in the aftermath of the most extreme abuse of my life because I didn't focus in class. I think a lot of the point of the label was making the adults feel like they were "helping me with an illness" rather than making an abused kid swallow strong drugs in order to keep up in this unforgiving world. In the entire diagnostic process nobody so much as asked me what had happened in the previous year. Even when I hear arguments like this, it's pleading practicality and nessecity. We need the label so he can get these drugs. We need the label so we can do X and Y. Only the label can give me true understanding of who I really am. But the label is incidental to all of this stuff, there's no reason you actually need this specific label. I'm almost certain the main reason we have these labels at all is so present the labelled as pathetic enough to be worthy of insurance coverage.

buffington 4y ago
> I'm not convinced ADHD is an illness either Do you believe you have ADHD now? I was fortunate to have some FMRI (I believe that's the tech) work done years ago, shortly after I was diagnosed with ADHD. The imagining made it so blatantly obvious that my brain was different than normal brains. Where a normal brain would light up like crazy for a given stimulus, mine looked like a black hole. There are certainly bio/physical differences. That said, I came into this comment thinking I'd take the stance of "of course it's a disease," but I think I've warmed up somewhat to what I think is your argument: lets stop with the labels. What holds me back from getting on board is that it's not like a headache. I can't just be like "oh, I'm feeling scattered" and take a pill when I need to. That "I'm feeling scattered" is 100% of the time. So I'm still in the "it's for sure a disease" camp. But I really don't care all that much in the end - I just want to make sure people stop hogging what allows me to even have a job and family.
- autoexec 4y ago
  > Where a normal brain would light up like crazy for a given stimulus, mine looked like a black hole. There are certainly bio/physical differences. I'd be careful about this. I've never seen anything to suggest that we could screen every child with FMRI scans to catch blatantly obvious indicators of ADHD or use scans as a definitive test for who should get medications. I honestly wish it really worked that way because it'd end all the hand-wringing about overprescribed medications and prevent a lot of kids from struggling unnecessarily, but unless something's changed pretty recently there's no one test that can identify someone as having ADHD.
  - buffington 4y ago
    Thank you for catching me on that. I neglected to mention that the imagining I'd done was actually unrelated to my ADHD. A pretty important detail that I hadn't considered.
- faeriechangling 4y ago
  Do I believe I still have ADHD now? Sure I "have it" based on how the word is commonly understood. The thing is at this point I've had doctors write down me having about 6 different conditions in the DSM, recurring or continual, no one doctor having given me more than 3 dx at a time. I've been prescribed over a dozen psychiatric meds over the years, all discontinued. So what am I supposed to think, am I just that unique and special and statistically rare? Or am I an edge case which is poorly described by the status quo diagnostic nosology? Is it useful for me to go to a doctor or friend or authority figure and describe myself as having the kitchen sink? But in practice almost everybody I talk to from friends to doctors to family has a different set of labels they think of me as having, and I change which labels I use to describe myself to accomplish different goals, and deep down I don't think anybody really has a clue what they're talking about.
autoexec 4y ago
> there's no reason you actually need this specific label. Would you feel the same way about appendicitis? Like, there's zero reason for a diagnosis or a "label" and if your side hurts you should just be able to get whatever you want cut out of you until you feel better? Labels are important for a lot of reasons. It's human nature to classify things and it's a whole lot easier when we do. By taking a list of symptoms and assigning one or more labels to it we can differentiate between the various causes of a person's symptoms. Someone might improve their symptoms by popping stimulants all day long, but it's possible that by identifying the cause of their symptoms and finding the right label a doctor could make taking all those pills and dealing with their side effects unnecessary. A diagnosis helps doctors select the most effective treatments without nearly as much trail and error. The diagnosis is also extremely helpful for the patient! It helps them to explain (to themselves and others) why it is that they are different, it sets expectations for what problems their condition might bring them, and helps them identify others who struggle similarly so that they can commiserate and gain insights and strategies for dealing with those problems. It's terrible if you were misdiagnosed once and that the experience has soured you to the entire idea of diagnostic medicine but as imperfect as that science is, it's still the best we've managed to come up with, it solves a lot more problems than it causes, and those solutions help with a lot more than just sorting out the billing. ADHD is absolutely a mental illness. I can't say if you actually have it or not. It is possible that your problems were entirely from your recent abuse and ADHD was total misdiagnosis, or maybe your recent abuse exacerbated your ADHD symptoms to the point that they became unmanageable. Either way the label you were given matters very little compared to how well your executive functioning is working today. If you're functioning to your satisfaction then the label doesn't matter much. If you're still struggling, your doctor can use your label or assign new ones to help guide you towards the best treatments to get you where you want to be. People shouldn't fear a label any more than they should let one become their identity or blind them to other possible causes for their problems.
- faeriechangling 4y ago
  It's wasn't that I thought I was misdiagnosed, I agreed with the diagnosis, it's that I felt mistreated. I remember coming into that office that day and thinking "I'll make sure I won't get diagnosed with something else" because a fair amount of my past abuse was a result of institutional discrimination caused by school policies that mandated certain treatment of certain children with labels to the point of stupidity regardless of the child's consent or protests. The issue was, I had the same label as what had previously typically been a more severe disability, and thus was treated as mentally incompetent by policy. I didn't want to be diagnosed, I didn't want the treatment (And it never did end up helping), and none of this actually got to the root of my problems. I ran an experiment soon after diagnosis. I gummed my medication one week, and told the teacher I took it, and asked them how I thought I was doing. They thought I was doing great! I then took it, and said I stopped taking it due to side effects. They said I was really struggling. I stopped taking the drug after that, and got an angry response in return, as now that I was diagnosed, I had a moral obligation to treat myself. Do recall I was a recent victim of severe abuse when I say all this. I got another label later, I took one psychiatric medication, I reacted to it badly right away and called the doctor to report this in 2 days, something I virtually never do. He just told me to tough it out for a month to see if it worked. It was a month of hell I felt I was morally obliged to go through to "Get better" because as my doctor says, the evidence says I have to give it time. My issue isn't being misdiagnosed, it's being correctly diagnosed and the prescribed approaches not working. I've grown to see these labels as just packages of prejudices and I've had quite a bit of distaste for. I wish I could just be misdiagnosed, but it was only two years ago a coworker approached me and confided in how they had ADHD and thought I did too, so I don't have any ability to truly convince people I don't have these labels anyways. So long as this system is useful for other peoples purposes, my opinion and my experiences don't matter. You know what my username is a reference too? It's a reference to folklore about stolen children. At first children would appear normal, but when the faeries "stole" the child in early childhood, they would start exhibiting bizarre traits like obsessively counting seeds, jumping and dancing about, and unusual intelligence for their age. The people of the time figured these children must not really be human, but changelings, replaced by faeries. Martin Luther of protestant fame figured they were children replaced by satan who could only be cured through murder. So that's what my username is, a reference to a label for children who acted differently which justified their murder.

buffington 4y ago

> I'm not convinced ADHD is an illness either Do you believe you have ADHD now? I was fortunate to have some FMRI (I believe that's the tech) work done years ago, shortly after I was diagnosed with ADHD. The imagining made it so blatantly obvious that my brain was different than normal brains. Where a normal brain would light up like crazy for a given stimulus, mine looked like a black hole. There are certainly bio/physical differences. That said, I came into this comment thinking I'd take the stance of "of course it's a disease," but I think I've warmed up somewhat to what I think is your argument: lets stop with the labels. What holds me back from getting on board is that it's not like a headache. I can't just be like "oh, I'm feeling scattered" and take a pill when I need to. That "I'm feeling scattered" is 100% of the time. So I'm still in the "it's for sure a disease" camp. But I really don't care all that much in the end - I just want to make sure people stop hogging what allows me to even have a job and family.

autoexec 4y ago
> Where a normal brain would light up like crazy for a given stimulus, mine looked like a black hole. There are certainly bio/physical differences. I'd be careful about this. I've never seen anything to suggest that we could screen every child with FMRI scans to catch blatantly obvious indicators of ADHD or use scans as a definitive test for who should get medications. I honestly wish it really worked that way because it'd end all the hand-wringing about overprescribed medications and prevent a lot of kids from struggling unnecessarily, but unless something's changed pretty recently there's no one test that can identify someone as having ADHD.
- buffington 4y ago
  Thank you for catching me on that. I neglected to mention that the imagining I'd done was actually unrelated to my ADHD. A pretty important detail that I hadn't considered.
faeriechangling 4y ago
Do I believe I still have ADHD now? Sure I "have it" based on how the word is commonly understood. The thing is at this point I've had doctors write down me having about 6 different conditions in the DSM, recurring or continual, no one doctor having given me more than 3 dx at a time. I've been prescribed over a dozen psychiatric meds over the years, all discontinued. So what am I supposed to think, am I just that unique and special and statistically rare? Or am I an edge case which is poorly described by the status quo diagnostic nosology? Is it useful for me to go to a doctor or friend or authority figure and describe myself as having the kitchen sink? But in practice almost everybody I talk to from friends to doctors to family has a different set of labels they think of me as having, and I change which labels I use to describe myself to accomplish different goals, and deep down I don't think anybody really has a clue what they're talking about.

autoexec 4y ago

> there's no reason you actually need this specific label. Would you feel the same way about appendicitis? Like, there's zero reason for a diagnosis or a "label" and if your side hurts you should just be able to get whatever you want cut out of you until you feel better? Labels are important for a lot of reasons. It's human nature to classify things and it's a whole lot easier when we do. By taking a list of symptoms and assigning one or more labels to it we can differentiate between the various causes of a person's symptoms. Someone might improve their symptoms by popping stimulants all day long, but it's possible that by identifying the cause of their symptoms and finding the right label a doctor could make taking all those pills and dealing with their side effects unnecessary. A diagnosis helps doctors select the most effective treatments without nearly as much trail and error. The diagnosis is also extremely helpful for the patient! It helps them to explain (to themselves and others) why it is that they are different, it sets expectations for what problems their condition might bring them, and helps them identify others who struggle similarly so that they can commiserate and gain insights and strategies for dealing with those problems. It's terrible if you were misdiagnosed once and that the experience has soured you to the entire idea of diagnostic medicine but as imperfect as that science is, it's still the best we've managed to come up with, it solves a lot more problems than it causes, and those solutions help with a lot more than just sorting out the billing. ADHD is absolutely a mental illness. I can't say if you actually have it or not. It is possible that your problems were entirely from your recent abuse and ADHD was total misdiagnosis, or maybe your recent abuse exacerbated your ADHD symptoms to the point that they became unmanageable. Either way the label you were given matters very little compared to how well your executive functioning is working today. If you're functioning to your satisfaction then the label doesn't matter much. If you're still struggling, your doctor can use your label or assign new ones to help guide you towards the best treatments to get you where you want to be. People shouldn't fear a label any more than they should let one become their identity or blind them to other possible causes for their problems.

faeriechangling 4y ago
It's wasn't that I thought I was misdiagnosed, I agreed with the diagnosis, it's that I felt mistreated. I remember coming into that office that day and thinking "I'll make sure I won't get diagnosed with something else" because a fair amount of my past abuse was a result of institutional discrimination caused by school policies that mandated certain treatment of certain children with labels to the point of stupidity regardless of the child's consent or protests. The issue was, I had the same label as what had previously typically been a more severe disability, and thus was treated as mentally incompetent by policy. I didn't want to be diagnosed, I didn't want the treatment (And it never did end up helping), and none of this actually got to the root of my problems. I ran an experiment soon after diagnosis. I gummed my medication one week, and told the teacher I took it, and asked them how I thought I was doing. They thought I was doing great! I then took it, and said I stopped taking it due to side effects. They said I was really struggling. I stopped taking the drug after that, and got an angry response in return, as now that I was diagnosed, I had a moral obligation to treat myself. Do recall I was a recent victim of severe abuse when I say all this. I got another label later, I took one psychiatric medication, I reacted to it badly right away and called the doctor to report this in 2 days, something I virtually never do. He just told me to tough it out for a month to see if it worked. It was a month of hell I felt I was morally obliged to go through to "Get better" because as my doctor says, the evidence says I have to give it time. My issue isn't being misdiagnosed, it's being correctly diagnosed and the prescribed approaches not working. I've grown to see these labels as just packages of prejudices and I've had quite a bit of distaste for. I wish I could just be misdiagnosed, but it was only two years ago a coworker approached me and confided in how they had ADHD and thought I did too, so I don't have any ability to truly convince people I don't have these labels anyways. So long as this system is useful for other peoples purposes, my opinion and my experiences don't matter. You know what my username is a reference too? It's a reference to folklore about stolen children. At first children would appear normal, but when the faeries "stole" the child in early childhood, they would start exhibiting bizarre traits like obsessively counting seeds, jumping and dancing about, and unusual intelligence for their age. The people of the time figured these children must not really be human, but changelings, replaced by faeries. Martin Luther of protestant fame figured they were children replaced by satan who could only be cured through murder. So that's what my username is, a reference to a label for children who acted differently which justified their murder.