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I have a friend who is a Nurse Practitioner. In Canada this is pretty close to a doctor in that they can order tests, diagnose patients and prescribe treatments

I have a friend who is a Nurse Practitioner. In Canada this is pretty close to a doctor in that they can order tests, diagnose patients and prescribe treatments and medications. She was in private practice for a while. She talks often about how the most common complaint she saw by far is gut distress with no medical cause. It is so common that the medical professionals call it SLS: Shit Life Syndrome [1]. She argues that the vast majority of the people who come in with this complaint have an undiagnosed mental problem. Our systems aren't built to handle this kind of situation. We find and treat acute problems and we don't really address holistic life-style issues. In fact, it is frowned upon. What she usually wants to say is: your life sucks, fix it and you will feel better. Go out for a walk, eat healthier food, make some supportive friends, engage in some self-care, meditate, etc. I personally believe that a lack of purpose in people's lives is manifesting as pain in our bodies. But that is dangerously close to woo-woo New Age thinking and most people will just reject it off-hand. Instead they will try magnesium pills, apple cider vinegar, avoiding gluten, anti-inflammatory diets, micro-dosing lsd or mushrooms. As a side note, she also mentioned that the newest fad (not quite at gut distress levels yet) is middle-aged men insisting they have ADHD, demanding diagnosis and prescriptions. 1. https://en.wikipedia.org/wiki/Shit_life_syndrome https://en.wikipedia.org/wiki/Shit_life_syndrome

voisin 3y ago
> What she usually wants to say is: your life sucks, fix it and you will feel better. Go out for a walk, eat healthier food, make some supportive friends, engage in some self-care, meditate, etc. It’s almost like we haven’t collectively created a society that aims to increase human flourishing and instead of created a living nightmare with the illusion of progress due to shiny new technologies.
- broguinn 3y ago
  This, so much this. My family often jokes about how I'm the health and fitness "freak", because I care about my wellbeing and stress levels. However, this is very normal in my social circle - and I would argue - in my class and generation. A few examples come to mind: - The rise of social/fitness loci. Young people socialize through sports, cycling groups, climbing gyms. - The advent of data-driven fitness. So many people have wearables, sleep trackers, follow the science behind health (Huberman podcast, Rhonda Patrick, etc.). - More people are opting for healthier living, generally (regular bedtimes, stopping or greatly limiting drinking, removing stigma from mental health diagnoses). It feels like this generation is the first to really prioritize physical wellbeing as a primary driver of overall quality of life. I sincerely hope this trend sticks, and we look back 20 years from now and are surprised that so many people for so long neglected the fundamentals of health.
CharlesW 3y ago
> As a side note, she also mentioned that the newest fad (not quite at gut distress levels yet) is middle-aged men insisting they have ADHD… The reason for this "fad" is straightforward — there are a lot of middle-aged humans who are undiagnosed because ADHD was effectively "not a thing" when GenX were kids. > …demanding diagnosis and prescriptions. Great! People of all ages should advocate for themselves and pursue health care that might improve their quality of life.
- 0xcde4c3db 3y ago
  > The reason for this "fad" is straightforward — there are a lot of middle-aged humans who are undiagnosed because ADHD was effectively "not a thing" when GenX were kids. Or to the extent that it was, they only knew of it through narrow or outright inaccurate stereotypes. It's become a somewhat common story over the past few years in online ADHD communities for Gen X and older Millennial parents to get their kid diagnosed and have a "wait, that's not normal?" reaction to the explanation of how the condition actually tends to manifest.
  - roundandround 3y ago
    But I think it was normal. Would modern undiagnosed children have flourished in less institutional settings? I think being on the dangerous edge used to be safer than being insufficiently experienced in dangers that were unavoidable and in many cases predatory.
  - rightbyte 3y ago
    ADHD have symtoms that could fit anyone. It is about a threshold.
- zoogeny 3y ago
  I think "advocate for themselves" can be reductive. There is a spectrum of advocacy. One approach is to work with a medical team over time to document symptoms and impact on your life, experiment and document attempted treatment alternatives, escalate to appropriate specialists as necessary, etc. Another approach is to spend a weekend reading blog posts, forums and chatting with your bros, then convincing yourself of a particular syndrome/disease you must have, urgently scheduling an appointment with a brand new medical practitioner, refusing to discuss your medical history or symptoms since you already know everything, demanding a particular and specific treatment, refusing to discuss alternatives and then becoming hostile and aggressive when that practitioner doesn't immediately write you a prescription for the particular medication or expensive test that you have already decided that you need. That second approach is a caricature that unfortunately approaches a modern reality, and it isn't what I'd term as "Great!" for anyone involved. The first approach is equally horrible since our system is so back-logged that the amount of time and personal effort between starting the process and receiving the help you need is onerous. Note that this applies equally well to gastro-intestinal distress as it does to ADHD or any other chronic condition.
hirvi74 3y ago
> middle-aged men insisting they have ADHD, demanding diagnosis and prescriptions. My opinions on the matter, as someone with ADHD, is that I do not personally believe that treatments that can improve one's life should be gatekeeped (gatekept?) sheerly by disorders. In other words, if people have symptoms and medicine has the tools to treat said symptoms, then such tools should be used regardless of the condition. If one is struggling to achieve a life that is within their potential, then why should they be denied something that can assist them? It would be like saying, "only paraplegic people are allowed to use wheelchairs. It doesn't matter if your legs are broken, they still technically work, thus you don't deserve to use a wheelchair." It's not like various psychostimulants commonly used for ADHD weren't used for 70+ years prior to being indicated for ADHD and other conditions. Personally, I have always hated the false dichotomy of either one having ADHD or not. I do not think it's that simple, and it is surely not a binary condition. The condition is nothing more than a label assigned to an arbitrary set of symptoms. Even the diagnostic criteria is not all encompassing of the many symptoms people with the condition struggle with. Just thinking about the various people I know in my life, I would confidently say not all them have equal attention spans, executive functioning, etc.. So, what's the arbitrary cut-off? Another issue that ADHD (and many other conditions) is that there is absolutely no way beyond a reasonable doubt to prove who has the condition and who does not. There is not a single biomarker -- no gene test, no urinalysis, no blood marker, no fMRI brain scan, etc. that can be used to definitely diagnose the condition in a clinical setting. The diagnosis is just a professional and clinically informed opinion using heuristics. How was I diagnosed? I went through a gauntlet of exhausting interviews and somewhat pseudo-scientific psychometrics -- WAIS IV IQ test, Stop/Go test, and plenty of others that I cannot remember the name of. It's about as legitimate as one can hope for currently... or at least a decade ago. With all the being said, I definitely think it's a completely real condition, I just think we are operating on a model similar to the Plum Pudding Model of the atom -- it's not completely wrong, but definitely not correct -- but it's the best we have at the moment. The question I often ask myself is that, "Is there something actually wrong with me, or is something wrong with the world we live in?" For me personally, this disorder has no negative health affects other than making me completely incompatible with this world. I mean, I'm within in the range of average height for adults males. My height causes me no issues in my life. However, if I were to play in the NBA, it would cause all kinds of issues. Does that mean I would have a height deficit disorder? One more thing about the medications, people have no idea what they are messing with. Sure, stimulants would help a majority of people be more productive (caffeine/nicotine are common for a reason), but nothing in life is without a cost. They absolutely help me live a life that I would unlikely be able to without them. That doesn't mean they are sunshine and roses. In some ways, I feel like I made a deal with the Devil. I have had many friends with ADHD and many friends without ADHD that lied to get access to the medications too. I've seen these medications help people reach the heavens, and I have seen these medications drag people through utter Hell. Anyway, sorry if this is all over the place and somewhat pointless. I do have ADHD after all. ;)
southwesterly 3y ago
Middle aged man with ADHD here. Just found out. Didn’t want it. Although it explains a lot of my almost 50 previous years. I am now sad.
- Viliam1234 3y ago
  > Although it explains a lot of my almost 50 previous years. I am now sad. It's a matter of perspective. I find it a relief that many things I thought were my moral failings were simply predictable consequences of a common problem.
aSockPuppeteer 3y ago
Newest fad, trying to get legal amphetamine.

voisin 3y ago

> What she usually wants to say is: your life sucks, fix it and you will feel better. Go out for a walk, eat healthier food, make some supportive friends, engage in some self-care, meditate, etc. It’s almost like we haven’t collectively created a society that aims to increase human flourishing and instead of created a living nightmare with the illusion of progress due to shiny new technologies.

broguinn 3y ago
This, so much this. My family often jokes about how I'm the health and fitness "freak", because I care about my wellbeing and stress levels. However, this is very normal in my social circle - and I would argue - in my class and generation. A few examples come to mind: - The rise of social/fitness loci. Young people socialize through sports, cycling groups, climbing gyms. - The advent of data-driven fitness. So many people have wearables, sleep trackers, follow the science behind health (Huberman podcast, Rhonda Patrick, etc.). - More people are opting for healthier living, generally (regular bedtimes, stopping or greatly limiting drinking, removing stigma from mental health diagnoses). It feels like this generation is the first to really prioritize physical wellbeing as a primary driver of overall quality of life. I sincerely hope this trend sticks, and we look back 20 years from now and are surprised that so many people for so long neglected the fundamentals of health.

CharlesW 3y ago

> As a side note, she also mentioned that the newest fad (not quite at gut distress levels yet) is middle-aged men insisting they have ADHD… The reason for this "fad" is straightforward — there are a lot of middle-aged humans who are undiagnosed because ADHD was effectively "not a thing" when GenX were kids. > …demanding diagnosis and prescriptions. Great! People of all ages should advocate for themselves and pursue health care that might improve their quality of life.

0xcde4c3db 3y ago
> The reason for this "fad" is straightforward — there are a lot of middle-aged humans who are undiagnosed because ADHD was effectively "not a thing" when GenX were kids. Or to the extent that it was, they only knew of it through narrow or outright inaccurate stereotypes. It's become a somewhat common story over the past few years in online ADHD communities for Gen X and older Millennial parents to get their kid diagnosed and have a "wait, that's not normal?" reaction to the explanation of how the condition actually tends to manifest.
- roundandround 3y ago
  But I think it was normal. Would modern undiagnosed children have flourished in less institutional settings? I think being on the dangerous edge used to be safer than being insufficiently experienced in dangers that were unavoidable and in many cases predatory.
- rightbyte 3y ago
  ADHD have symtoms that could fit anyone. It is about a threshold.
zoogeny 3y ago
I think "advocate for themselves" can be reductive. There is a spectrum of advocacy. One approach is to work with a medical team over time to document symptoms and impact on your life, experiment and document attempted treatment alternatives, escalate to appropriate specialists as necessary, etc. Another approach is to spend a weekend reading blog posts, forums and chatting with your bros, then convincing yourself of a particular syndrome/disease you must have, urgently scheduling an appointment with a brand new medical practitioner, refusing to discuss your medical history or symptoms since you already know everything, demanding a particular and specific treatment, refusing to discuss alternatives and then becoming hostile and aggressive when that practitioner doesn't immediately write you a prescription for the particular medication or expensive test that you have already decided that you need. That second approach is a caricature that unfortunately approaches a modern reality, and it isn't what I'd term as "Great!" for anyone involved. The first approach is equally horrible since our system is so back-logged that the amount of time and personal effort between starting the process and receiving the help you need is onerous. Note that this applies equally well to gastro-intestinal distress as it does to ADHD or any other chronic condition.

hirvi74 3y ago

> middle-aged men insisting they have ADHD, demanding diagnosis and prescriptions. My opinions on the matter, as someone with ADHD, is that I do not personally believe that treatments that can improve one's life should be gatekeeped (gatekept?) sheerly by disorders. In other words, if people have symptoms and medicine has the tools to treat said symptoms, then such tools should be used regardless of the condition. If one is struggling to achieve a life that is within their potential, then why should they be denied something that can assist them? It would be like saying, "only paraplegic people are allowed to use wheelchairs. It doesn't matter if your legs are broken, they still technically work, thus you don't deserve to use a wheelchair." It's not like various psychostimulants commonly used for ADHD weren't used for 70+ years prior to being indicated for ADHD and other conditions. Personally, I have always hated the false dichotomy of either one having ADHD or not. I do not think it's that simple, and it is surely not a binary condition. The condition is nothing more than a label assigned to an arbitrary set of symptoms. Even the diagnostic criteria is not all encompassing of the many symptoms people with the condition struggle with. Just thinking about the various people I know in my life, I would confidently say not all them have equal attention spans, executive functioning, etc.. So, what's the arbitrary cut-off? Another issue that ADHD (and many other conditions) is that there is absolutely no way beyond a reasonable doubt to prove who has the condition and who does not. There is not a single biomarker -- no gene test, no urinalysis, no blood marker, no fMRI brain scan, etc. that can be used to definitely diagnose the condition in a clinical setting. The diagnosis is just a professional and clinically informed opinion using heuristics. How was I diagnosed? I went through a gauntlet of exhausting interviews and somewhat pseudo-scientific psychometrics -- WAIS IV IQ test, Stop/Go test, and plenty of others that I cannot remember the name of. It's about as legitimate as one can hope for currently... or at least a decade ago. With all the being said, I definitely think it's a completely real condition, I just think we are operating on a model similar to the Plum Pudding Model of the atom -- it's not completely wrong, but definitely not correct -- but it's the best we have at the moment. The question I often ask myself is that, "Is there something actually wrong with me, or is something wrong with the world we live in?" For me personally, this disorder has no negative health affects other than making me completely incompatible with this world. I mean, I'm within in the range of average height for adults males. My height causes me no issues in my life. However, if I were to play in the NBA, it would cause all kinds of issues. Does that mean I would have a height deficit disorder? One more thing about the medications, people have no idea what they are messing with. Sure, stimulants would help a majority of people be more productive (caffeine/nicotine are common for a reason), but nothing in life is without a cost. They absolutely help me live a life that I would unlikely be able to without them. That doesn't mean they are sunshine and roses. In some ways, I feel like I made a deal with the Devil. I have had many friends with ADHD and many friends without ADHD that lied to get access to the medications too. I've seen these medications help people reach the heavens, and I have seen these medications drag people through utter Hell. Anyway, sorry if this is all over the place and somewhat pointless. I do have ADHD after all. ;)

southwesterly 3y ago

Middle aged man with ADHD here. Just found out. Didn’t want it. Although it explains a lot of my almost 50 previous years. I am now sad.

Viliam1234 3y ago
> Although it explains a lot of my almost 50 previous years. I am now sad. It's a matter of perspective. I find it a relief that many things I thought were my moral failings were simply predictable consequences of a common problem.

aSockPuppeteer 3y ago

Newest fad, trying to get legal amphetamine.