4 ms·

If you read the diagnostic criteria that is used, it’s so broad it could easily apply to most of the world’s population…as long as they declare they have troubl

If you read the diagnostic criteria that is used, it’s so broad it could easily apply to most of the world’s population…as long as they declare they have trouble focusing.

corobo 3y ago
Many people probably do have the same brain wiring, or maybe it's a low level of background dopamine, or whatever it turns out to be once science figures it out. The reason most of the worlds population isn't diagnosed[0] is that second D: Disorder. No disorder, no problem, no diagnosis. [0] outside of lack of access to mental health resources, not knowing what they're looking for so never getting referred to a place to diagnose it, not believing in treating mental health issues, self-medicating, avoiding stigma, etc
- hirvi74 3y ago
  I liken it to forgetfulness in old age. A majority of elderly people see a decline in memory as they age. Not every elderly person who is forgetful necessarily has dementia.
dartos 3y ago
Yeah it’s hard to write specific criteria for some mental disorders. They’re not all uniform in presentation or affect. It’d really be up to the therapist. Thankfully, it doesn’t seem like most of the ADHD meds usually have long lasting adverse effects.
- adadadadadad 3y ago
  The brain does adapt to adhd meds and there are studies showing this. The thing I don’t like about adhd is that the premise is the brain doesn’t produce enough dopamine so we return it to normal levels…but the brain always seeks homeostasis so it will adapt by producing more dopamine reuptake cells. There are no conclusive imaging studies or genetic markers for it. The meds certainly do work but if you ask someone to explain their condition to you they have all have the same simplified and erroneous explanation as to why they can handle addictive meds and the general population cannot. I think it’s pretty much a general smart drug but with high risk of addiction.
projektfu 3y ago
I disagree. I think that 6 months or more of 5/9 symptoms of inattentiveness or 5/9 symptoms of hyperactivity, persistently, does not represent most of the world. (And excluding: "The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions." 6/9 symptoms are required to diagnose children) [0] Indeed, surveys show that it's probably under 10% [1]. Mind you, these are surveys of symptoms, not surveys of diagnoses. 0. https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ 1. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/208678 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
- adadadadadad 3y ago
  If you look into how the criteria is chosen its very arbitrary. And this descriptive diagnosis where you pick from list A and B is extremely bizarre from a common sense standpoint. And there is no brain imaging or genetic markers available. > The number of criteria required for a diagnosis of ADHD has been set arbitrarily in DSM-5. No scientific justification has been presented nor method used for deciding how many criteria should be required > https://www.frontiersin.org/articles/10.3389/fsoc.2022.814763/full https://www.frontiersin.org/articles/10.3389/fsoc.2022.81476... and... > For the case of ADHD specifically, this is translated to: “if an individual has attention deficit hyperactivity disorder it is because he is inattentive, disorganized and hyperactive-impulsive, and if an individual is inattentive, disorganized and hyperactive-impulsive it is because he has ADHD. > https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871920/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871920/ It's important to be aware that each percentage point is hundreds of millions of dollars.
  - _yb2s 3y ago
    The set of symptoms are not arbitrary, but are connected logically, by each being the result of a deficit in some type of executive function. ADHD is broadly a disability of executive function. Executive function is historically entirely a psychological concept, although there is starting to be some biological understanding which came later (e.g. which brain regions are involved, etc.).
cloverich 3y ago
This is true about most diagnostic criteria, which is why medical students think they have all the illnesses before they get experience with people who actually have them. Its just very difficult to use words with sufficient precision to capture the bits that are, somehow, more obvious once experienced.

If you read the diagnostic criteria that is used, it’s so broad it could easily apply to most of the world’s population…as long as they declare they have trouble focusing.

corobo 3y ago

Many people probably do have the same brain wiring, or maybe it's a low level of background dopamine, or whatever it turns out to be once science figures it out. The reason most of the worlds population isn't diagnosed[0] is that second D: Disorder. No disorder, no problem, no diagnosis. [0] outside of lack of access to mental health resources, not knowing what they're looking for so never getting referred to a place to diagnose it, not believing in treating mental health issues, self-medicating, avoiding stigma, etc

hirvi74 3y ago
I liken it to forgetfulness in old age. A majority of elderly people see a decline in memory as they age. Not every elderly person who is forgetful necessarily has dementia.

dartos 3y ago

Yeah it’s hard to write specific criteria for some mental disorders. They’re not all uniform in presentation or affect. It’d really be up to the therapist. Thankfully, it doesn’t seem like most of the ADHD meds usually have long lasting adverse effects.

adadadadadad 3y ago
The brain does adapt to adhd meds and there are studies showing this. The thing I don’t like about adhd is that the premise is the brain doesn’t produce enough dopamine so we return it to normal levels…but the brain always seeks homeostasis so it will adapt by producing more dopamine reuptake cells. There are no conclusive imaging studies or genetic markers for it. The meds certainly do work but if you ask someone to explain their condition to you they have all have the same simplified and erroneous explanation as to why they can handle addictive meds and the general population cannot. I think it’s pretty much a general smart drug but with high risk of addiction.

projektfu 3y ago

I disagree. I think that 6 months or more of 5/9 symptoms of inattentiveness or 5/9 symptoms of hyperactivity, persistently, does not represent most of the world. (And excluding: "The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions." 6/9 symptoms are required to diagnose children) [0] Indeed, surveys show that it's probably under 10% [1]. Mind you, these are surveys of symptoms, not surveys of diagnoses. 0. https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ 1. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/208678 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

adadadadadad 3y ago
If you look into how the criteria is chosen its very arbitrary. And this descriptive diagnosis where you pick from list A and B is extremely bizarre from a common sense standpoint. And there is no brain imaging or genetic markers available. > The number of criteria required for a diagnosis of ADHD has been set arbitrarily in DSM-5. No scientific justification has been presented nor method used for deciding how many criteria should be required > https://www.frontiersin.org/articles/10.3389/fsoc.2022.814763/full https://www.frontiersin.org/articles/10.3389/fsoc.2022.81476... and... > For the case of ADHD specifically, this is translated to: “if an individual has attention deficit hyperactivity disorder it is because he is inattentive, disorganized and hyperactive-impulsive, and if an individual is inattentive, disorganized and hyperactive-impulsive it is because he has ADHD. > https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871920/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871920/ It's important to be aware that each percentage point is hundreds of millions of dollars.
- _yb2s 3y ago
  The set of symptoms are not arbitrary, but are connected logically, by each being the result of a deficit in some type of executive function. ADHD is broadly a disability of executive function. Executive function is historically entirely a psychological concept, although there is starting to be some biological understanding which came later (e.g. which brain regions are involved, etc.).

cloverich 3y ago

This is true about most diagnostic criteria, which is why medical students think they have all the illnesses before they get experience with people who actually have them. Its just very difficult to use words with sufficient precision to capture the bits that are, somehow, more obvious once experienced.