3 ms·

ADHD is a neurodevelopmental disorder. The symptoms of this disorder are caused by physical differences in the brain, right there in the prefrontal cortex where

by krono 3y ago

ADHD is a neurodevelopmental disorder. The symptoms of this disorder are caused by physical differences in the brain, right there in the prefrontal cortex where those responses to inputs are generated. It sometimes happens that I just physically can't bring myself to complete some simple but important chore. That's not because I'm mentally weak, but because my ADHD brain does not provide the right amount of dopamine which everyone else with a more typical brain would get.

gmadsen 3y ago
ADHD is diagnosed by the occurance of defined symptoms. like most things in the DSM. Many things can manifest psychologically to give the collection of symptoms. Its not purely or even needs to be structural differences in the prefrontal cortex
- btilly 3y ago
  I prefer the procedure from 20 years ago. Where ADHD was defined by having the systems, and then testing every other thing that it could be. It took my son 2 months to be officially diagnosed. A real pain? Sure. But a heck of a lot better than the situation today where kids with chronic sleep deprivation are given an ADHD diagnosis, then sent home with a medication that masks the sleep deprivation while giving them insomnia.
  - throwaway60707 3y ago
    My ADHD medication (yes, stimulants - and a pretty high dosage in my case) causes me to slow down and sleep. Then I wake up about an hour or so after taking it and am a normal person. I was diagnosed as an adult, but this was always the case for me - as a teen I drank 3 redbulls in the evening and went to sleep, because I finally could as my brain stopped keeping me awake with millions of thoughts.
    - sgarland 3y ago
      I would drink about a pot of coffee per day as a teenager, throughout the day. Never had any impact on my sleep either, which I always assumed was just tolerance. Turns out once medicated, if I have caffeine after about 15:00 I’m in for a bad night. Brains are extremely weird.
- krono 3y ago
  The specific set of symptoms and the diagnosis they would lead to according to the DSM, are in fact rooted in a set of interconnected structural neurological differences in the prefrontal cortex. The ability to recognise when someone might be thirsty, doesn't mean dehydration no longer exists. They go together.
  - flir 3y ago
    > in a set of interconnected structural neurological differences in the prefrontal cortex. Can you prove that? Because my understanding is that ADHD isn't diagnosable by imaging the brain. If there was a structural difference, presumably it would show up on scans? Or at least post-mortems?
    - throwaway60707 3y ago
      My brain exhibits significant differences on EEG that the neuro-doctor said are suggestive of ADHD or ASD. AFAIK it is visible on fMRI, but doing so is incredibly expensive and taxing on the person - you'd need to keep them in the fMRI for very long time, repeatedly, and watch them doing different tasks. But I've seen papers about this where they did that with some people. The brain simply doesn't fire up like a normal brain does. The structural difference itself might be too small (on cellular or even molecular level) to see with current resolution, but the effect is clearly visible - as well as that medication makes the brain behave more like normal brains, as opposed to normal brains on stimulants (which puts them into overdrive). Quick search: - https://www.medicalnewstoday.com/articles/315884 https://www.medicalnewstoday.com/articles/315884 - https://bmcmedimaging.biomedcentral.com/articles/10.1186/s12880-021-00579-3 https://bmcmedimaging.biomedcentral.com/articles/10.1186/s12...
      - flir 3y ago
        Oh, that's interesting. Thank you.
    - acchow 3y ago
      ADHD brains operate differently, which is clearly visible on imaging. However, this is not sufficient for a diagnosis because you still need impairment in your life.
- throwaway60707 3y ago
  The diagnosis is a continual process. My psychiatrist first did many questionnaires with me to determine whether it might be ADHD or something else, and then prescribed ADHD medication (first Strattera but that gave me significant side effects, now I'm on Concerta). But this doesn't end with the prescription - I visit the doctor every 2 weeks and he continually questions me about the effects the medication has on my life, and tries to see whether it matches the expected outcome for a person with ADHD. If it did not, they would change the diagnosis. In my case, everything fits - the stimulants make me slow down or even sleep, I'm less angry and overall more emotionally stable, less impulsive, and finally able to work on a task that I choose for an extended period of time. If this was not the case, I'm sure the doctor would be looking for a different diagnosis.
scns 3y ago
> ADHD is a neurodevelopmental disorder. At first i wanted to disagree, then i realized why. Disorder means wrongly ordered or sickness. ADHD is classified as such, and if you want treatment, you need to get yourself diagnosed. I really dislike the pathologizing of every neurotype that deviates from the imaginary normal person. I'm pretty sure, if you look closely you'll find something "broken" in everybody. Other perspectives are possible. ADHD can be an advantage. A survey in a network of CEOs found over 60% have it: https://www.youtube.com/watch?v=XdT4DIiX7Nk https://www.youtube.com/watch?v=XdT4DIiX7Nk Some become a Rockstar: https://www.youtube.com/shorts/ElaL9Zo_Oes https://www.youtube.com/shorts/ElaL9Zo_Oes
- throwaway60707 3y ago
  ADHD can also be totally debilitating and I - a person with strong ADHD - don't think this talk of "it's an advantage" is helping anyone. Yeah in very few cases there are some positives, but usually not. In my case, I was hyper-focused on computers since I was a child, and that got me my career/business and that probably saved my life -- because I was totally unable to do anything in school and wasn't able to finish first year of high school and dropped out of it. I wouldn't call it an advantage even though it's probably the reason why I'm so good with computers. In many cases like the CEOs you speak of, you see the surface - their success - but you ignore the problems they have in day-to-day life, the ruined childhood and the ruined relationships in adulthood. Many would trade all their success for normal life. It's definitely a disorder. A weird one that might give you above average abilities in some very specific cases and areas of life, but still a disorder. You wouldn't say autism isn't a disorder just because there are few autistic savants. Also consider - ADHD is much more often present in highly intelligent people. What you see might be a person that was able to overcome their disorder through their intelligence, but their life would be much better and they'd be way more successful had they not have the disorder. And now imagine how a person of average intelligence with ADHD must struggle with their life.
  - skjoldr 3y ago
    ADHD really doesn't correlate with IQ, I think what you meant is that adults with ADHD who can get their life together enough to get diagnosed are more likely to also be intelligent, which is true, and those with ADHD and cognitive deficits on top are far more likely to be forgotten and to end up in a prison, which is also sadly true. I have an IQ of 136, which is considered to be very gifted, but my performance and life success thus far are decidedly average. It's a debilitating condition if it's not detected in time and not managed.

by krono 3y ago

gmadsen 3y ago

ADHD is diagnosed by the occurance of defined symptoms. like most things in the DSM. Many things can manifest psychologically to give the collection of symptoms. Its not purely or even needs to be structural differences in the prefrontal cortex

btilly 3y ago
I prefer the procedure from 20 years ago. Where ADHD was defined by having the systems, and then testing every other thing that it could be. It took my son 2 months to be officially diagnosed. A real pain? Sure. But a heck of a lot better than the situation today where kids with chronic sleep deprivation are given an ADHD diagnosis, then sent home with a medication that masks the sleep deprivation while giving them insomnia.
- throwaway60707 3y ago
  My ADHD medication (yes, stimulants - and a pretty high dosage in my case) causes me to slow down and sleep. Then I wake up about an hour or so after taking it and am a normal person. I was diagnosed as an adult, but this was always the case for me - as a teen I drank 3 redbulls in the evening and went to sleep, because I finally could as my brain stopped keeping me awake with millions of thoughts.
  - sgarland 3y ago
    I would drink about a pot of coffee per day as a teenager, throughout the day. Never had any impact on my sleep either, which I always assumed was just tolerance. Turns out once medicated, if I have caffeine after about 15:00 I’m in for a bad night. Brains are extremely weird.
krono 3y ago
The specific set of symptoms and the diagnosis they would lead to according to the DSM, are in fact rooted in a set of interconnected structural neurological differences in the prefrontal cortex. The ability to recognise when someone might be thirsty, doesn't mean dehydration no longer exists. They go together.
- flir 3y ago
  > in a set of interconnected structural neurological differences in the prefrontal cortex. Can you prove that? Because my understanding is that ADHD isn't diagnosable by imaging the brain. If there was a structural difference, presumably it would show up on scans? Or at least post-mortems?
  - throwaway60707 3y ago
    My brain exhibits significant differences on EEG that the neuro-doctor said are suggestive of ADHD or ASD. AFAIK it is visible on fMRI, but doing so is incredibly expensive and taxing on the person - you'd need to keep them in the fMRI for very long time, repeatedly, and watch them doing different tasks. But I've seen papers about this where they did that with some people. The brain simply doesn't fire up like a normal brain does. The structural difference itself might be too small (on cellular or even molecular level) to see with current resolution, but the effect is clearly visible - as well as that medication makes the brain behave more like normal brains, as opposed to normal brains on stimulants (which puts them into overdrive). Quick search: - https://www.medicalnewstoday.com/articles/315884 https://www.medicalnewstoday.com/articles/315884 - https://bmcmedimaging.biomedcentral.com/articles/10.1186/s12880-021-00579-3 https://bmcmedimaging.biomedcentral.com/articles/10.1186/s12...
    - flir 3y ago
      Oh, that's interesting. Thank you.
  - acchow 3y ago
    ADHD brains operate differently, which is clearly visible on imaging. However, this is not sufficient for a diagnosis because you still need impairment in your life.
throwaway60707 3y ago
The diagnosis is a continual process. My psychiatrist first did many questionnaires with me to determine whether it might be ADHD or something else, and then prescribed ADHD medication (first Strattera but that gave me significant side effects, now I'm on Concerta). But this doesn't end with the prescription - I visit the doctor every 2 weeks and he continually questions me about the effects the medication has on my life, and tries to see whether it matches the expected outcome for a person with ADHD. If it did not, they would change the diagnosis. In my case, everything fits - the stimulants make me slow down or even sleep, I'm less angry and overall more emotionally stable, less impulsive, and finally able to work on a task that I choose for an extended period of time. If this was not the case, I'm sure the doctor would be looking for a different diagnosis.

scns 3y ago

> ADHD is a neurodevelopmental disorder. At first i wanted to disagree, then i realized why. Disorder means wrongly ordered or sickness. ADHD is classified as such, and if you want treatment, you need to get yourself diagnosed. I really dislike the pathologizing of every neurotype that deviates from the imaginary normal person. I'm pretty sure, if you look closely you'll find something "broken" in everybody. Other perspectives are possible. ADHD can be an advantage. A survey in a network of CEOs found over 60% have it: https://www.youtube.com/watch?v=XdT4DIiX7Nk https://www.youtube.com/watch?v=XdT4DIiX7Nk Some become a Rockstar: https://www.youtube.com/shorts/ElaL9Zo_Oes https://www.youtube.com/shorts/ElaL9Zo_Oes

throwaway60707 3y ago
ADHD can also be totally debilitating and I - a person with strong ADHD - don't think this talk of "it's an advantage" is helping anyone. Yeah in very few cases there are some positives, but usually not. In my case, I was hyper-focused on computers since I was a child, and that got me my career/business and that probably saved my life -- because I was totally unable to do anything in school and wasn't able to finish first year of high school and dropped out of it. I wouldn't call it an advantage even though it's probably the reason why I'm so good with computers. In many cases like the CEOs you speak of, you see the surface - their success - but you ignore the problems they have in day-to-day life, the ruined childhood and the ruined relationships in adulthood. Many would trade all their success for normal life. It's definitely a disorder. A weird one that might give you above average abilities in some very specific cases and areas of life, but still a disorder. You wouldn't say autism isn't a disorder just because there are few autistic savants. Also consider - ADHD is much more often present in highly intelligent people. What you see might be a person that was able to overcome their disorder through their intelligence, but their life would be much better and they'd be way more successful had they not have the disorder. And now imagine how a person of average intelligence with ADHD must struggle with their life.
- skjoldr 3y ago
  ADHD really doesn't correlate with IQ, I think what you meant is that adults with ADHD who can get their life together enough to get diagnosed are more likely to also be intelligent, which is true, and those with ADHD and cognitive deficits on top are far more likely to be forgotten and to end up in a prison, which is also sadly true. I have an IQ of 136, which is considered to be very gifted, but my performance and life success thus far are decidedly average. It's a debilitating condition if it's not detected in time and not managed.