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> 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

> 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. ;)

zoogeny 3y ago
I really appreciate this response. > I do not personally believe that treatments that can improve one's life should be gatekeeped (gatekept?) sheerly by disorders In my most libertarian moments I totally agree. But I also accept (even if I don't agree) that a large number of people believe that the detriments to society as a whole (including to some individuals in particular) caused by the misuse of powerful and addictive substances outweighs the benefits of un-controlled access. > 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. The "fad" I was talking about was individuals showing up to a medical professional and having the totally unrealistic expectation that after a one hour consultation they would be diagnosed with a severe mental disorder and that they would walk out that same day with a prescription for a controlled stimulant. The real path to treatment in our system is much more difficult. You have to demonstrate and document a history of symptoms and their effects on your life. It can take 6-12 months in many places to get into a specialist like a psychiatrist. Then it can take many more months of experimentation with alternative treatments before being prescribed medications. That path is, frankly, atrocious. We are so starved for qualified resources that the system purposely slows things down. If you are able to work and live life even minimally - you are low on the priority list in many cases. There are enough truly horrible cases (severe schizophrenia, bipolar, etc.) that involve people unable to function at all that those who are merely suffering can get ignored. Front-line medical workers gate-keep access to specialists out of necessity, not out of malicious intent. The patience you demonstrated to get the help you need is commendable but also proof that the system delivers for those who need it. The alternative path that many choose to take is to become hostile, aggressive or abusive. They refuse to push through the system or to even attempt alternatives. They demand a specific diagnosis and a precise medication and they get angry when they don't get it. > In some ways, I feel like I made a deal with the Devil. This is is one reason why the system pushes people to try every alternative possible before going down the route of medication. If someone can find any alternative to medication to manage their symptoms - they ought to avoid the diagnosis and avoid the medicine. It is just the case that many possible alternatives, including life-style changes, are explicitly forbidden to talk about. So while the medical practitioner may want to say: you need better friends, a better job, a better life in general ... they often cannot. Nor are some aggressive and hostile people willing to listen even if they could.

zoogeny 3y ago

I really appreciate this response. > I do not personally believe that treatments that can improve one's life should be gatekeeped (gatekept?) sheerly by disorders In my most libertarian moments I totally agree. But I also accept (even if I don't agree) that a large number of people believe that the detriments to society as a whole (including to some individuals in particular) caused by the misuse of powerful and addictive substances outweighs the benefits of un-controlled access. > 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. The "fad" I was talking about was individuals showing up to a medical professional and having the totally unrealistic expectation that after a one hour consultation they would be diagnosed with a severe mental disorder and that they would walk out that same day with a prescription for a controlled stimulant. The real path to treatment in our system is much more difficult. You have to demonstrate and document a history of symptoms and their effects on your life. It can take 6-12 months in many places to get into a specialist like a psychiatrist. Then it can take many more months of experimentation with alternative treatments before being prescribed medications. That path is, frankly, atrocious. We are so starved for qualified resources that the system purposely slows things down. If you are able to work and live life even minimally - you are low on the priority list in many cases. There are enough truly horrible cases (severe schizophrenia, bipolar, etc.) that involve people unable to function at all that those who are merely suffering can get ignored. Front-line medical workers gate-keep access to specialists out of necessity, not out of malicious intent. The patience you demonstrated to get the help you need is commendable but also proof that the system delivers for those who need it. The alternative path that many choose to take is to become hostile, aggressive or abusive. They refuse to push through the system or to even attempt alternatives. They demand a specific diagnosis and a precise medication and they get angry when they don't get it. > In some ways, I feel like I made a deal with the Devil. This is is one reason why the system pushes people to try every alternative possible before going down the route of medication. If someone can find any alternative to medication to manage their symptoms - they ought to avoid the diagnosis and avoid the medicine. It is just the case that many possible alternatives, including life-style changes, are explicitly forbidden to talk about. So while the medical practitioner may want to say: you need better friends, a better job, a better life in general ... they often cannot. Nor are some aggressive and hostile people willing to listen even if they could.