5 ms·

> Why do you presume I'm neurotypical and undiagnosed with any psychiatric disorder? Because you talk like one, with no apparent empathy for the neurodiverse,

by KPGv2 1y ago

> Why do you presume I'm neurotypical and undiagnosed with any psychiatric disorder? Because you talk like one, with no apparent empathy for the neurodiverse, except perhaps people with profound issues. "We shouldn't treat any problems except the catastrophically bad." Gross. > I bet if you knew your house would burn down if you didn't do "normal" things you would have done them no problem. This is not arguing in favor of your stance, but rather in favor of mine. You're essentially saying "ADHDers can't get shit done without being in dangerous situations, and THAT IS ACCEPTABLE." And yet you think this supports your idea that non-catastrophic disorders shouldn't be treated.

suggestion 1y ago
[flagged]
- BenjiWiebe 1y ago
  This sounds to me like getting into "You say you're depressed? Come on, snap out of it!" territory. I guess I consider psychological disorders to be a disorder when you aren't able to "snap out of it" or "just do things that are unpleasant". Like yes, I do things that are unpleasant - ADHD doesn't mean I live a life of ease, avoiding unpleasantness all day long.
- dns_snek 1y ago
  > You can accept the discomfort and move through it just like you do when the stakes are actually high. Just like I do. Have you ever considered that the things which you find doable or even trivial might be incomprehensibly more difficult for other people? You mentioned being diagnosed with ADHD higher up, but part of the diagnostic criteria for ADHD is quite literally about severity of the symptoms: DSM-5: "There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning." ICD-11: "Several symptoms of inattention/hyperactivity-impulsivity that are persistent, and sufficiently severe that they have a direct negative impact on academic, occupational, or social functioning" Being capable of pushing through basic adult responsibilities, regardless of discomfort and difficulties (without burning yourself out!), and failing to do so to the degree that it severely negatively affects your life is the defining line between "order" and "disorder". If you have a very demanding job then you might experience symptoms that are consistent with ADHD. That's why the diagnostic process is supposed to verify that there's a clear history of symptoms ranging back to your teenage years (or earlier) and that your symptoms aren't being caused by general life stressors. > The idea that everything in life should induce minimal discomfort or that "it's hard" is an excuse is a completely modern, first world problem, to speak of privilege. No, the idea is that people should receive help if we have a neurodevelopmental disorder that is severe enough to significantly impact our quality of life. Just like with any other medical condition. > Mindfulness and thinking about your thoughts are proven as effective or more effective than medication for a wide range of psychological disorders, including ADHD, or CBT if you want to formalize it. False: > CBT is best used within a multi-modal treatment approach and as an adjunct to medication as current research does not fully support the efficacy of CBT as a sole treatment for adult ADHD [274,[316], [317], [318]]. Most controlled studies have been conducted in patients taking ADHD medication and demonstrate an additional significant treatment effect [313,[318], [319], [320], [321], [322]]. The largest controlled multi-center CBT-study to date has demonstrated that psychological interventions result in better outcomes when combined with MPH as compared to psychological interventions in unmedicated patients [228]. In a systematic review of 51 pharmacological and non-pharmacological interventions [316], the highest proportion of improved outcomes (83%) was for patients receiving combination treatment. https://www.sciencedirect.com/science/article/pii/S0924933818301962 https://www.sciencedirect.com/science/article/pii/S092493381...
  - suggestion 1y ago
    They were incomprehensibly difficult for me, so yes. My mind and body literally entered fight or flight at the thought of not doing a compulsion or forcing myself to focus on doing a task I didn't want to do. "Quality" is an arbitrary definition that means nothing, that's one of the problems we're talking about in psychiatry. The OP clearly mentioned that there was minimal impact on academic, professional, or social functioning other than internal discomfort, for example, yet was prescribed anyway. >False, regarding CBT Wow it's almost like the replication crisis is a real thing and we have no idea what we're talking about. Look at these completely disparate results when examining a different population group. https://www.sciencedirect.com/science/article/abs/pii/S0165178119307437 https://www.sciencedirect.com/science/article/abs/pii/S01651...
    - dns_snek 1y ago
      > "Quality" is an arbitrary definition that means nothing, that's one of the problems we're talking about in psychiatry. Why is that a problem? It's not completely objective but it's the best we have. That criteria is typically combined with more objective neuropsychological testing for a well rounded assessment. > The OP clearly mentioned that there was minimal impact on academic, professional, or social functioning other than internal discomfort, for example, yet was prescribed anyway. They didn't say that, they said that they weren't suffering "catastrophic failures", which is distinctly different from "minimal impact". They also said they had high intellectual abilities which is entirely consistent with the ICD-11 description: > The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning High-IQ can mask ADHD, but that doesn't mean they haven't been experiencing challenges associated with ADHD.
      - suggestion 1y ago
        So you've clearly just restated what I said which is that it was principally a matter of discomfort, not clinical outcomes or justification, which is the defining characteristic for diagnosis in the DSM.
- modo_mario 1y ago
  The stimulants don't alleviate the discomfort. I honestly question whether you have adhd or whether yours and mine are remotely the same. Oftentimes it would be a great relief to do a specific thing...or it's something i actually want to get done and no matter how much i want to I struggle. Getting sleep right helps a lot. Getting sunlight helps a lot. etc But in the end a notable problematic aspect of it remains.
  - suggestion 1y ago
    Yes they do, as the OP said and I myself experienced, they make previously torturous tasks doable with a significantly reduced levels of discomfort and a priori mental resistance.

by KPGv2 1y ago

suggestion 1y ago

[flagged]

BenjiWiebe 1y ago
This sounds to me like getting into "You say you're depressed? Come on, snap out of it!" territory. I guess I consider psychological disorders to be a disorder when you aren't able to "snap out of it" or "just do things that are unpleasant". Like yes, I do things that are unpleasant - ADHD doesn't mean I live a life of ease, avoiding unpleasantness all day long.
dns_snek 1y ago
> You can accept the discomfort and move through it just like you do when the stakes are actually high. Just like I do. Have you ever considered that the things which you find doable or even trivial might be incomprehensibly more difficult for other people? You mentioned being diagnosed with ADHD higher up, but part of the diagnostic criteria for ADHD is quite literally about severity of the symptoms: DSM-5: "There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning." ICD-11: "Several symptoms of inattention/hyperactivity-impulsivity that are persistent, and sufficiently severe that they have a direct negative impact on academic, occupational, or social functioning" Being capable of pushing through basic adult responsibilities, regardless of discomfort and difficulties (without burning yourself out!), and failing to do so to the degree that it severely negatively affects your life is the defining line between "order" and "disorder". If you have a very demanding job then you might experience symptoms that are consistent with ADHD. That's why the diagnostic process is supposed to verify that there's a clear history of symptoms ranging back to your teenage years (or earlier) and that your symptoms aren't being caused by general life stressors. > The idea that everything in life should induce minimal discomfort or that "it's hard" is an excuse is a completely modern, first world problem, to speak of privilege. No, the idea is that people should receive help if we have a neurodevelopmental disorder that is severe enough to significantly impact our quality of life. Just like with any other medical condition. > Mindfulness and thinking about your thoughts are proven as effective or more effective than medication for a wide range of psychological disorders, including ADHD, or CBT if you want to formalize it. False: > CBT is best used within a multi-modal treatment approach and as an adjunct to medication as current research does not fully support the efficacy of CBT as a sole treatment for adult ADHD [274,[316], [317], [318]]. Most controlled studies have been conducted in patients taking ADHD medication and demonstrate an additional significant treatment effect [313,[318], [319], [320], [321], [322]]. The largest controlled multi-center CBT-study to date has demonstrated that psychological interventions result in better outcomes when combined with MPH as compared to psychological interventions in unmedicated patients [228]. In a systematic review of 51 pharmacological and non-pharmacological interventions [316], the highest proportion of improved outcomes (83%) was for patients receiving combination treatment. https://www.sciencedirect.com/science/article/pii/S0924933818301962 https://www.sciencedirect.com/science/article/pii/S092493381...
- suggestion 1y ago
  They were incomprehensibly difficult for me, so yes. My mind and body literally entered fight or flight at the thought of not doing a compulsion or forcing myself to focus on doing a task I didn't want to do. "Quality" is an arbitrary definition that means nothing, that's one of the problems we're talking about in psychiatry. The OP clearly mentioned that there was minimal impact on academic, professional, or social functioning other than internal discomfort, for example, yet was prescribed anyway. >False, regarding CBT Wow it's almost like the replication crisis is a real thing and we have no idea what we're talking about. Look at these completely disparate results when examining a different population group. https://www.sciencedirect.com/science/article/abs/pii/S0165178119307437 https://www.sciencedirect.com/science/article/abs/pii/S01651...
  - dns_snek 1y ago
    > "Quality" is an arbitrary definition that means nothing, that's one of the problems we're talking about in psychiatry. Why is that a problem? It's not completely objective but it's the best we have. That criteria is typically combined with more objective neuropsychological testing for a well rounded assessment. > The OP clearly mentioned that there was minimal impact on academic, professional, or social functioning other than internal discomfort, for example, yet was prescribed anyway. They didn't say that, they said that they weren't suffering "catastrophic failures", which is distinctly different from "minimal impact". They also said they had high intellectual abilities which is entirely consistent with the ICD-11 description: > The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning High-IQ can mask ADHD, but that doesn't mean they haven't been experiencing challenges associated with ADHD.
    - suggestion 1y ago
      So you've clearly just restated what I said which is that it was principally a matter of discomfort, not clinical outcomes or justification, which is the defining characteristic for diagnosis in the DSM.
modo_mario 1y ago
The stimulants don't alleviate the discomfort. I honestly question whether you have adhd or whether yours and mine are remotely the same. Oftentimes it would be a great relief to do a specific thing...or it's something i actually want to get done and no matter how much i want to I struggle. Getting sleep right helps a lot. Getting sunlight helps a lot. etc But in the end a notable problematic aspect of it remains.
- suggestion 1y ago
  Yes they do, as the OP said and I myself experienced, they make previously torturous tasks doable with a significantly reduced levels of discomfort and a priori mental resistance.