4 ms·

> per the DSM two individuals can be diagnosed whilst sharing only 3 of the 9 symptoms, whichs admits that each of the symptoms can have a cause that is not fro

by derefr 1y ago

> per the DSM two individuals can be diagnosed whilst sharing only 3 of the 9 symptoms, whichs admits that each of the symptoms can have a cause that is not from ADHD. To be clear, ADHD, despite having "disorder" in the name, is actually a syndrome: a complex of symptoms that, when recognized together, indicate that a certain set of interventional treatments will likely be applicable. Diagnosing someone with a syndrome does not indicate any knowledge is available on the cause (etiology) of the symptoms. Many different things can cause the same set of symptoms. But if a certain treatment ameliorates anything qualifying as that syndrome, regardless of the upstream cause, then the diagnosis of the syndrome (and so the existence of the syndrome as a concept) is useful, even if it's not informative. The DSM actually covers two very different categories of what we might call "mental" illnesses: neurocognitive illnesses, and neuroendocrine (or neurohormonal) illnesses. Neurocognitive illnesses — structural problems with the brain or its cells (think Parkinson's Disease, or ALS, or Lewy Body dementia) — are usually traceable to specific etiologies, as each one usually has either a very unique presentation of signs and symptoms, or has unique markers that can be assayed/biopsied for. Neuroendocrine illnesses, on the other hand, are almost always syndromes. Many different upstream problems (genetic, toxic, nutritive, auto-immune, etc) can potentially cause the same small menagerie of messenger-chemicals to get out of whack, and due to this, many different upstream problems end up looking like the same few "templates" of symptoms. If you can put the particular out-of-whack messenger-chemicals back into whack with drugs that do that, then you've fixed the symptoms — which doesn't fix the upstream problem (if it even can be fixed), but does fully compensate downstream for the upstream problem.

andoando 1y ago
If we fully admit that the DSM is merely a tool for treatment, a stastical tool to say "this drug might help the issues youre feeling" fine, however this is not the view Ive commonly seen in phycitatric literature, which points at ADHD being a "real disorder", as something definite one "has". Patients also commonly believe they have a definite disorder, saying things like how they finally "discovered" they have ADHd or even that they might "have undiagnosed ADHD". If we agree that the diagnosis is not informative, thst it is merely putting a name to something one already knows about themselves, do we then agree that this kind of talk is invalid? If so, and if this view is really prevalent in psychiatry, somehow it's completely lost on the general public and media.
- watwut 1y ago
  > saying things like how they finally "discovered" they have ADHd or even that they might "have undiagnosed ADHD" This is not in contradiction to something being syndrome. Plus patients usually do not understand and do not have to understand technical nuts and bolts of whatever issues they have. You cant require people to talk in clunky language qualifying every single nuance each time they speak about issues or diagnoses they have. You would just render them unable to express what they need to express. > If so, and if this view is really prevalent in psychiatry, somehow it's completely lost on the general public and media. General public and media are completely lost on eating disorders, OCD, psychosis and pretty much any other psychiatric/psychological problem. They are equally lost on AI, HIV and economic policy.
  - andoando 1y ago
    I don't think I am being pedantic. There is a monumental difference in how you perceive your condition between "I have some troublesome behaviors which these drugs can sometimes alleviate" and "I have an inherently disordered brain that cannot function properly". Perhaps the HN crowd is different, but the latter fits most people's understanding of what Ive seen
    - Fraterkes 1y ago
      What is the qualitative difference between "having some troublesome behaviors" and "having an inherently disordered brain" in your opinion?
      - watwut 1y ago
        Behaviours are what you do - how you interact with the world. Having disordered brain is about how your brain functions. If I yell at you, it is behavior not am "inherently disordered brain". If I feel sad all the time, it is not a behavior. It is a feeling. If I am forgetting a lot, it is a brain function too, not a behavior. Behavior can be used to mitigate the disordered brain, it can be result of it, it can be completely intendent of it. Behavior can be something positive or neutral. Eating is behavior, giving a gift is a behavior.
peepee1982 1y ago
I wish this were more common knowlegdge. Every time I see someone whether ADHD "exists" I think to myself "Dude, we decided that certain traits falling in a certain range on a spectrum warrant their own category because it might facilitate research and treatment. Whether it's real or not isn't even a question." I just want to know whether my issues are normal and I'm gaslighting myself into thinking I'm broken or a loser, or if my specific issues are actually falling outside the norm. This way I know what treatment modalities might help, and which literature I can peruse instead of wasting my time reading up productivity advice meant for neurotypical people that will try to solve the wrong issue for me and just make me feel worse.
- lanyard-textile 1y ago
  There’s no such thing as advice for “neurotypical” people. There’s advice for people. Sometimes it will help you, and sometimes it won’t. Regardless of the number of people it helped and didn’t help, and what labels apply to them.
  - deleted 1y ago
    [deleted]
  - torben-friis 1y ago
    As someone taking adhd meds, I think you’re missing this person’s bigger point. You can be stuck for decades, as I was, taking advice that won’t work for you, until you figure out that you can get a medical solution that instantly enables all of those pieces of advice becoming usable. It is not a coincidence that those pieces of advice weren’t working, they were never going to work unless preceded by medical help. Many people pre diagnosis suffer the equivalent of taking years of running advice and wondering why the stay behind before noticing they’re missing a leg and it won’t work until they get prosthetics.
    - lanyard-textile 1y ago
      If it’s not optimal, it’s useless, isn’t it? You can’t run as fast as the others, so why bother running at all? You just can’t do it. None of the advice about running will ever apply to you unless you can afford a prosthetic that works with your ailment that you can wear all the time. That’s not true, of course. You are not relegated to a category of defunct by simply existing without a leg. You can learn to get by without it — many do — and you can learn to excel without it. When you exclude yourself based on blankets of labels, you miss good advice. Much advice about “running” has little to do with having 2 legs: Breathing, clothing, hydration, nutrition, time of day. Pacing advice can even apply when you run with an implement. For some people this is their entire reality, having to fight against categorizations that split them into complete ability and disability. For some others, they don’t even know there’s a fight to be had. They give up before knowing they had any chance at all. It’s troubling for something like ADHD, where a constellation of symptoms are possible and some do not apply to you personally. You can’t read because you have ADHD? It may be true. It may also be true that you have been forced to read things you’re not interested in, something rendered practically impossible by this disorder, and someone has labeled you as a non-reader due to your differences. It may also be true that you haven’t discovered Terry Pratchett, and you’re actually quite the reader with the right material. For some even more others, they feel able with their medication and useless without. Luckily for them, their medication lasts all day, medication shortages do not exist, and their psychiatrist will always prescribe their medications forever.
andoando 1y ago
Also if its just meant to serve as a stastical tool, isnt manually making up these classifications complety outdated? Why not just feed people's data into a machine and find statsical corrolations for what helps?

by derefr 1y ago

andoando 1y ago

If we fully admit that the DSM is merely a tool for treatment, a stastical tool to say "this drug might help the issues youre feeling" fine, however this is not the view Ive commonly seen in phycitatric literature, which points at ADHD being a "real disorder", as something definite one "has". Patients also commonly believe they have a definite disorder, saying things like how they finally "discovered" they have ADHd or even that they might "have undiagnosed ADHD". If we agree that the diagnosis is not informative, thst it is merely putting a name to something one already knows about themselves, do we then agree that this kind of talk is invalid? If so, and if this view is really prevalent in psychiatry, somehow it's completely lost on the general public and media.

watwut 1y ago
> saying things like how they finally "discovered" they have ADHd or even that they might "have undiagnosed ADHD" This is not in contradiction to something being syndrome. Plus patients usually do not understand and do not have to understand technical nuts and bolts of whatever issues they have. You cant require people to talk in clunky language qualifying every single nuance each time they speak about issues or diagnoses they have. You would just render them unable to express what they need to express. > If so, and if this view is really prevalent in psychiatry, somehow it's completely lost on the general public and media. General public and media are completely lost on eating disorders, OCD, psychosis and pretty much any other psychiatric/psychological problem. They are equally lost on AI, HIV and economic policy.
- andoando 1y ago
  I don't think I am being pedantic. There is a monumental difference in how you perceive your condition between "I have some troublesome behaviors which these drugs can sometimes alleviate" and "I have an inherently disordered brain that cannot function properly". Perhaps the HN crowd is different, but the latter fits most people's understanding of what Ive seen
  - Fraterkes 1y ago
    What is the qualitative difference between "having some troublesome behaviors" and "having an inherently disordered brain" in your opinion?
    - watwut 1y ago
      Behaviours are what you do - how you interact with the world. Having disordered brain is about how your brain functions. If I yell at you, it is behavior not am "inherently disordered brain". If I feel sad all the time, it is not a behavior. It is a feeling. If I am forgetting a lot, it is a brain function too, not a behavior. Behavior can be used to mitigate the disordered brain, it can be result of it, it can be completely intendent of it. Behavior can be something positive or neutral. Eating is behavior, giving a gift is a behavior.

peepee1982 1y ago

I wish this were more common knowlegdge. Every time I see someone whether ADHD "exists" I think to myself "Dude, we decided that certain traits falling in a certain range on a spectrum warrant their own category because it might facilitate research and treatment. Whether it's real or not isn't even a question." I just want to know whether my issues are normal and I'm gaslighting myself into thinking I'm broken or a loser, or if my specific issues are actually falling outside the norm. This way I know what treatment modalities might help, and which literature I can peruse instead of wasting my time reading up productivity advice meant for neurotypical people that will try to solve the wrong issue for me and just make me feel worse.

lanyard-textile 1y ago
There’s no such thing as advice for “neurotypical” people. There’s advice for people. Sometimes it will help you, and sometimes it won’t. Regardless of the number of people it helped and didn’t help, and what labels apply to them.
- deleted 1y ago
  [deleted]
- torben-friis 1y ago
  As someone taking adhd meds, I think you’re missing this person’s bigger point. You can be stuck for decades, as I was, taking advice that won’t work for you, until you figure out that you can get a medical solution that instantly enables all of those pieces of advice becoming usable. It is not a coincidence that those pieces of advice weren’t working, they were never going to work unless preceded by medical help. Many people pre diagnosis suffer the equivalent of taking years of running advice and wondering why the stay behind before noticing they’re missing a leg and it won’t work until they get prosthetics.
  - lanyard-textile 1y ago
    If it’s not optimal, it’s useless, isn’t it? You can’t run as fast as the others, so why bother running at all? You just can’t do it. None of the advice about running will ever apply to you unless you can afford a prosthetic that works with your ailment that you can wear all the time. That’s not true, of course. You are not relegated to a category of defunct by simply existing without a leg. You can learn to get by without it — many do — and you can learn to excel without it. When you exclude yourself based on blankets of labels, you miss good advice. Much advice about “running” has little to do with having 2 legs: Breathing, clothing, hydration, nutrition, time of day. Pacing advice can even apply when you run with an implement. For some people this is their entire reality, having to fight against categorizations that split them into complete ability and disability. For some others, they don’t even know there’s a fight to be had. They give up before knowing they had any chance at all. It’s troubling for something like ADHD, where a constellation of symptoms are possible and some do not apply to you personally. You can’t read because you have ADHD? It may be true. It may also be true that you have been forced to read things you’re not interested in, something rendered practically impossible by this disorder, and someone has labeled you as a non-reader due to your differences. It may also be true that you haven’t discovered Terry Pratchett, and you’re actually quite the reader with the right material. For some even more others, they feel able with their medication and useless without. Luckily for them, their medication lasts all day, medication shortages do not exist, and their psychiatrist will always prescribe their medications forever.

andoando 1y ago

Also if its just meant to serve as a stastical tool, isnt manually making up these classifications complety outdated? Why not just feed people's data into a machine and find statsical corrolations for what helps?