5 ms·

I think this is a good example of how we mix up concepts: ADHD is just a phenotype. Then, our society classifies it as a condition because it does not go well w

by mo_42 3y ago

I think this is a good example of how we mix up concepts: ADHD is just a phenotype. Then, our society classifies it as a condition because it does not go well with current circumstances. Although, both are separate things.

gtroja 3y ago
I feel adhd is only a diagnosis beacause society demands to much attention/focus; I've once told my therapist if flying was required to be part of the society my diagnosis would be unwinged
- dartos 3y ago
  It’d probably be more like, most people have wings and not having wings negatively affects the lives of most wingless people, so it’s a disorder.
raccoonDivider 3y ago
Is there an actual consensus on what ADHD _is_, besides a catch-all for some common concentration and hyperactivity symptoms? People online assert a lot of things, such as "it's a dysfunction of dopamine pathways", "it's genetic", "it's a sort of autism", "it's a brain chemistry problem". But never anything that looked like a real definition backed by good science. My own psychiatrist's diagnosis was a bunch of obvious questions that I couldn't answer honestly even if I tried. The conversation boils down to: "I have trouble concentrating and wonder if I have ADHD, I have [common symptoms backed by anecdotal evidence]. - OK, they have to affect your life severely enough to qualify. Do you think they are? - I guess, that's what I'm here to find out. - OK, let's try Ritalin." It was only helpful in that I needed to focus during a semester of studies and the stimulants did it. It feels like I had a cough, got diagnosed with cough syndrome, and went through cough medications until they started helping the cough, and now I can describe myself as a cough syndrome sufferer. Where's the virus?
- navjack27 3y ago
  It's less hyperactivity and concentration and more motivation issues
- luckydata 3y ago
  https://www.sciencedirect.com/science/article/pii/S014976342100049X https://www.sciencedirect.com/science/article/pii/S014976342...
  - raccoonDivider 3y ago
    Thanks for that paper, but I find it weird: - There is no common definition of ADHD, just a list of two hundred unrelated claims made by papers that were found with a search engine. That makes them impossible to compare or relate to each other. This is not a review that concludes anything, just "look at our HUNDREDS of sources!" Basically shock and awe. - What kind of paper brags about how many continents approved of them? Is this some kind of claim to authority? Why do I care that "366 people" agree with it? In particular, why is this the entirety of their "results" summary? - The very first highlight is "ADHD occurs in 5.9 % of youth and 2.5 % of adults." I find it ridiculous to dump such a precise number as their main claim when the rates vary so much depending on whether one uses the DSM or ICD, which country one lives in, and which doctor one see. My personal experience with a recently-minted psychiatrist from a reputable university doesn't give me confidence in any kinds of incidence rates either: the state of the art of diagnostic criteria seems to be a questionnaire a 12-year-old could fake. - In a hypothetical world in which ADHD were known to be an ill-defined "syndrome" with no scientific basis, I would be surprised if "The World Federation of ADHD International Consensus" admitted to it. You don't organize a large international conference to make your subfield less reputable.
- corobo 3y ago
  To answer your question: Not that I know of. To waffle freely: I believe it's lower than normal background levels of dopamine. Obligatory disclaimer I am in no way a doctor or scientist. This is probably wrong. Pinches of salt all round. This is a theory I'm kicking around now and then but I don't have the knowledge to confirm/deny the hypothesis yet. When a normal person tackles a regular task they'll get a little squirt of dopamine leading up to the task (anticipation) and then a corresponding signal when the task is done (I did the thing correctly, woohoo).[0] When a normal person tackles a task and gets a better than expected result, they get a fresh squirt of dopamine upon completion (Oh wow, that went really well! I should consider doing this again!) When someone with the ADHD-type brain wiring tackles a regular task they'll get the initial anticipation squirt, but upon completing the task they'll get a lesser amount (in dopamine language: that didn't go as well as I thought it would) Compound that effect over $age years and you get someone with no real motivation to do anything, often distracted by random things that might be interesting, anxious, depression, imposter syndrome, all that good stuff - they rarely get a "I did good" signal, so nothing feels worth doing and they don't feel like they've had much success in life. Also might explain why a lot of ADHD folks have some sort of dopamine loop going on - alcohol, smoking, drugs, overeating, absolutely covering every meal in salt, etc. Something that brings up their background level of dopamine. You do get positive effects from this - it's not all doom and gloom! - quick learners, jack of all trades, outside the box thinking, anything that might give a better dopamine response than the day to day routines Might also explain all the "ADHD people were great as cavemen" stories that pop up now and then - nothing gives more dopamine than "holy fuck, I survived", the modern day doesn't really have many of those moments. Feels like this would also explain why someone with ADHD can take stimulant medication and not bounce off the walls like a normal person would on the same medication - their background level of dopamine is being brought up to normal levels by the medication which in turn allows the rest of the system works as it does in normal people. [0]: I actually found this theory while looking into AI stuff, haha: https://deepmind.google/discover/blog/dopamine-and-temporal-difference-learning-a-fruitful-relationship-between-neuroscience-and-ai/ https://deepmind.google/discover/blog/dopamine-and-temporal-... The quick summary from https://en.wikipedia.org/wiki/Dopamine https://en.wikipedia.org/wiki/Dopamine > Within the brain, dopamine functions partly as a global reward signal. An initial dopamine response to a rewarding stimulus encodes information about the salience, value, and context of a reward. In the context of reward-related learning, dopamine also functions as a reward prediction error signal, that is, the degree to which the value of a reward is unexpected. According to this hypothesis proposed by Montague, Dayan, and Sejnowski, rewards that are expected do not produce a second phasic dopamine response in certain dopaminergic cells, but rewards that are unexpected, or greater than expected, produce a short-lasting increase in synaptic dopamine, whereas the omission of an expected reward actually causes dopamine release to drop below its background level.
luckydata 3y ago
No it's not. It's a disability with very serious consequences for the lifespan of people affected. Please don't repeat this pointless pseudoscientific bs. This link contains a good starting point to understanding what science knows about it. https://www.sciencedirect.com/science/article/pii/S014976342100049X https://www.sciencedirect.com/science/article/pii/S014976342...
- ryandvm 3y ago
  I mean, I'm sure it could be if it were a serious enough case, but the ADHD that I was diagnosed with is nothing more than the inability to do shit that I find boring. It's a career limiting inconvenience.
- nvarsj 3y ago
  > It's a disability with very serious consequences for the lifespan of people affected. I think this is the case for those with severe ADHD. They can't really function at all in modern society, it's a severe impediment. Vast majority of ADHD (esp. adult adhd cases, where childhood symptoms were not obvious) are nothing like that. I think this is where the idea of it being a phenotype comes in, for the mild/moderate ADHD cases.
  - sudosysgen 3y ago
    There are studies showing a large impact to life expectancy for peopke with ADHD. It is too large to be consistent for the vast majority of people having minimal to no impairment. Indeed, having ADHD that persists into adulthood leads to an average drop in life expectancy of almost 13 years. https://pubmed.ncbi.nlm.nih.gov/30526189/ https://pubmed.ncbi.nlm.nih.gov/30526189/ https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61684-6/abstract https://www.thelancet.com/journals/lancet/article/PIIS0140-6... Even for those who can function in society, ADHD causes greatly increased rates of major depression, suicide, addiction, and accidental death.
  - Yizahi 3y ago
    Is having a chronic rhinitis, or diabetes, or deafness, a block to function in a modern society? No, thousands are living with them mostly normal daily lives. Are they illnesses? Yes definitely, and we treat them with meds issued by doctors. Same with ADHD - it an illness and should be treated as such. I likely have undiagnosed ADHD. I'm ill. I need and want treatment (just afraid because of that same ADHD). What's the big deal with calling illness an illness or mental health disorder? Me being ill doesn't make me a lesser human like some apologists of "new normal" try to describe. Just like my rhinitis doesn't make me a lesser human. Both are illnesses, no big deal.
hnbad 3y ago
That's neurodiversity and the social model of disability in a nutshell. We've defined a very narrow set of neurotypes as normal and treat any divergence from it as a disorder. We've additionally structured society in such a way that only this very narrow set is accommodated and provided affordances, making these disorders disabling to those "suffering" from it. It's worth remembering that ADHD drugs can be an affordance even if we accept a social model of disability and a neurodiverse view of humanity. But the systems we have built drastically exaggerate the degree to which ADHD is "inherently" disabling, e.g. not opening your mail can land you in prison. Yes of course there's more to that than it just being "mail" but the mechanism itself is more dangerous to someone with ADHD traits than someone without them. The same goes for autism by the way: arguably there are many benefits to autistic traits (which seems odd to explain on a site like this when for the longest time programmers online used to joke that we're all autistic and when the "aspie supremacist movement" is literally a thing) but at the same time it can be extremely disabling simply due to "how we do things", e.g. having to use the phone to book an appointment or being in a noisy office full of other people in order to get paid. It's interesting to consider not only what we could do to provide affordances and accommodations more equitably but also who else would benefit from this as a kind of inverse collateral damage.

by mo_42 3y ago

gtroja 3y ago

I feel adhd is only a diagnosis beacause society demands to much attention/focus; I've once told my therapist if flying was required to be part of the society my diagnosis would be unwinged

dartos 3y ago
It’d probably be more like, most people have wings and not having wings negatively affects the lives of most wingless people, so it’s a disorder.

raccoonDivider 3y ago

Is there an actual consensus on what ADHD _is_, besides a catch-all for some common concentration and hyperactivity symptoms? People online assert a lot of things, such as "it's a dysfunction of dopamine pathways", "it's genetic", "it's a sort of autism", "it's a brain chemistry problem". But never anything that looked like a real definition backed by good science. My own psychiatrist's diagnosis was a bunch of obvious questions that I couldn't answer honestly even if I tried. The conversation boils down to: "I have trouble concentrating and wonder if I have ADHD, I have [common symptoms backed by anecdotal evidence]. - OK, they have to affect your life severely enough to qualify. Do you think they are? - I guess, that's what I'm here to find out. - OK, let's try Ritalin." It was only helpful in that I needed to focus during a semester of studies and the stimulants did it. It feels like I had a cough, got diagnosed with cough syndrome, and went through cough medications until they started helping the cough, and now I can describe myself as a cough syndrome sufferer. Where's the virus?

navjack27 3y ago
It's less hyperactivity and concentration and more motivation issues
luckydata 3y ago
https://www.sciencedirect.com/science/article/pii/S014976342100049X https://www.sciencedirect.com/science/article/pii/S014976342...
- raccoonDivider 3y ago
  Thanks for that paper, but I find it weird: - There is no common definition of ADHD, just a list of two hundred unrelated claims made by papers that were found with a search engine. That makes them impossible to compare or relate to each other. This is not a review that concludes anything, just "look at our HUNDREDS of sources!" Basically shock and awe. - What kind of paper brags about how many continents approved of them? Is this some kind of claim to authority? Why do I care that "366 people" agree with it? In particular, why is this the entirety of their "results" summary? - The very first highlight is "ADHD occurs in 5.9 % of youth and 2.5 % of adults." I find it ridiculous to dump such a precise number as their main claim when the rates vary so much depending on whether one uses the DSM or ICD, which country one lives in, and which doctor one see. My personal experience with a recently-minted psychiatrist from a reputable university doesn't give me confidence in any kinds of incidence rates either: the state of the art of diagnostic criteria seems to be a questionnaire a 12-year-old could fake. - In a hypothetical world in which ADHD were known to be an ill-defined "syndrome" with no scientific basis, I would be surprised if "The World Federation of ADHD International Consensus" admitted to it. You don't organize a large international conference to make your subfield less reputable.
corobo 3y ago
To answer your question: Not that I know of. To waffle freely: I believe it's lower than normal background levels of dopamine. Obligatory disclaimer I am in no way a doctor or scientist. This is probably wrong. Pinches of salt all round. This is a theory I'm kicking around now and then but I don't have the knowledge to confirm/deny the hypothesis yet. When a normal person tackles a regular task they'll get a little squirt of dopamine leading up to the task (anticipation) and then a corresponding signal when the task is done (I did the thing correctly, woohoo).[0] When a normal person tackles a task and gets a better than expected result, they get a fresh squirt of dopamine upon completion (Oh wow, that went really well! I should consider doing this again!) When someone with the ADHD-type brain wiring tackles a regular task they'll get the initial anticipation squirt, but upon completing the task they'll get a lesser amount (in dopamine language: that didn't go as well as I thought it would) Compound that effect over $age years and you get someone with no real motivation to do anything, often distracted by random things that might be interesting, anxious, depression, imposter syndrome, all that good stuff - they rarely get a "I did good" signal, so nothing feels worth doing and they don't feel like they've had much success in life. Also might explain why a lot of ADHD folks have some sort of dopamine loop going on - alcohol, smoking, drugs, overeating, absolutely covering every meal in salt, etc. Something that brings up their background level of dopamine. You do get positive effects from this - it's not all doom and gloom! - quick learners, jack of all trades, outside the box thinking, anything that might give a better dopamine response than the day to day routines Might also explain all the "ADHD people were great as cavemen" stories that pop up now and then - nothing gives more dopamine than "holy fuck, I survived", the modern day doesn't really have many of those moments. Feels like this would also explain why someone with ADHD can take stimulant medication and not bounce off the walls like a normal person would on the same medication - their background level of dopamine is being brought up to normal levels by the medication which in turn allows the rest of the system works as it does in normal people. [0]: I actually found this theory while looking into AI stuff, haha: https://deepmind.google/discover/blog/dopamine-and-temporal-difference-learning-a-fruitful-relationship-between-neuroscience-and-ai/ https://deepmind.google/discover/blog/dopamine-and-temporal-... The quick summary from https://en.wikipedia.org/wiki/Dopamine https://en.wikipedia.org/wiki/Dopamine > Within the brain, dopamine functions partly as a global reward signal. An initial dopamine response to a rewarding stimulus encodes information about the salience, value, and context of a reward. In the context of reward-related learning, dopamine also functions as a reward prediction error signal, that is, the degree to which the value of a reward is unexpected. According to this hypothesis proposed by Montague, Dayan, and Sejnowski, rewards that are expected do not produce a second phasic dopamine response in certain dopaminergic cells, but rewards that are unexpected, or greater than expected, produce a short-lasting increase in synaptic dopamine, whereas the omission of an expected reward actually causes dopamine release to drop below its background level.

luckydata 3y ago

No it's not. It's a disability with very serious consequences for the lifespan of people affected. Please don't repeat this pointless pseudoscientific bs. This link contains a good starting point to understanding what science knows about it. https://www.sciencedirect.com/science/article/pii/S014976342100049X https://www.sciencedirect.com/science/article/pii/S014976342...

ryandvm 3y ago
I mean, I'm sure it could be if it were a serious enough case, but the ADHD that I was diagnosed with is nothing more than the inability to do shit that I find boring. It's a career limiting inconvenience.
nvarsj 3y ago
> It's a disability with very serious consequences for the lifespan of people affected. I think this is the case for those with severe ADHD. They can't really function at all in modern society, it's a severe impediment. Vast majority of ADHD (esp. adult adhd cases, where childhood symptoms were not obvious) are nothing like that. I think this is where the idea of it being a phenotype comes in, for the mild/moderate ADHD cases.
- sudosysgen 3y ago
  There are studies showing a large impact to life expectancy for peopke with ADHD. It is too large to be consistent for the vast majority of people having minimal to no impairment. Indeed, having ADHD that persists into adulthood leads to an average drop in life expectancy of almost 13 years. https://pubmed.ncbi.nlm.nih.gov/30526189/ https://pubmed.ncbi.nlm.nih.gov/30526189/ https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61684-6/abstract https://www.thelancet.com/journals/lancet/article/PIIS0140-6... Even for those who can function in society, ADHD causes greatly increased rates of major depression, suicide, addiction, and accidental death.
- Yizahi 3y ago
  Is having a chronic rhinitis, or diabetes, or deafness, a block to function in a modern society? No, thousands are living with them mostly normal daily lives. Are they illnesses? Yes definitely, and we treat them with meds issued by doctors. Same with ADHD - it an illness and should be treated as such. I likely have undiagnosed ADHD. I'm ill. I need and want treatment (just afraid because of that same ADHD). What's the big deal with calling illness an illness or mental health disorder? Me being ill doesn't make me a lesser human like some apologists of "new normal" try to describe. Just like my rhinitis doesn't make me a lesser human. Both are illnesses, no big deal.

hnbad 3y ago

That's neurodiversity and the social model of disability in a nutshell. We've defined a very narrow set of neurotypes as normal and treat any divergence from it as a disorder. We've additionally structured society in such a way that only this very narrow set is accommodated and provided affordances, making these disorders disabling to those "suffering" from it. It's worth remembering that ADHD drugs can be an affordance even if we accept a social model of disability and a neurodiverse view of humanity. But the systems we have built drastically exaggerate the degree to which ADHD is "inherently" disabling, e.g. not opening your mail can land you in prison. Yes of course there's more to that than it just being "mail" but the mechanism itself is more dangerous to someone with ADHD traits than someone without them. The same goes for autism by the way: arguably there are many benefits to autistic traits (which seems odd to explain on a site like this when for the longest time programmers online used to joke that we're all autistic and when the "aspie supremacist movement" is literally a thing) but at the same time it can be extremely disabling simply due to "how we do things", e.g. having to use the phone to book an appointment or being in a noisy office full of other people in order to get paid. It's interesting to consider not only what we could do to provide affordances and accommodations more equitably but also who else would benefit from this as a kind of inverse collateral damage.