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It's high because overdiagnosis. - TED Talk - Recommend one of the most-watched TED Talks of all time, by Sir Ken Robinson. Gems such as, "If you sit kids dow

by tdpvb 1y ago

It's high because overdiagnosis. - TED Talk - Recommend one of the most-watched TED Talks of all time, by Sir Ken Robinson. Gems such as, "If you sit kids down, hour after hour, doing low-grade clerical work, don't be surprised if they start to fidget." And, "Children are not, for the most part, suffering from a psychological condition. They're suffering from childhood." - Book - Also check out the book, "The Body Keeps a Score". The concept of "pseudocertainty" is a key takeaway: symptomatic labels can be helpful to a point, but they're not explanatory -- it offers a false sense of conclusion, but no root cause analysis. It conflates "diagnosis" with "syndrome". For example cancer is a specific diagnosis, and within it much specificity of dozens of particular types of cancer. Whereas ADHD is a "disorder", or a "pattern of symptoms". ADHD as a pseudocertainty is self-referential: "I have ADHD" "What does that mean?" "It means I exhibit symptoms of ADHD" "okay, so what does that mean?" "it means I have ADHD" "sure but what does it mean? And more importantly, why do you have 'ADHD'? " - DSM - The DSM defines how ADHD is diagnosed by two lists of nine symptoms each, from which a practitioner chooses six symptoms from each, and qualifies them as having "persisted for at least 6 months". That's the definition of medical cherry-picking. Some of the descriptions are, uncomfortably, exactly what one would expect from a small child: "Often fidgets with or taps hands or feet or squirms in seat." "Often blurts out an answer before a question has been completed." "Often has difficulty waiting his or her turn." Scary. - Conclusion - And that's how children in the US, by acting like children, get themselves drugged up and labeled as "having ADHD". Or the poor kids just have mild- to severe trauma, or residual emotional anxiety, and instead of parents/teachers owning up to their part in it, or educating kids on how to self-regulate, or offering children meditation classes, they just drug them instead. It's the kids that are abnormal, surely it's not the adults' faults! $$$ Oh and don't forget, the ADHD therapeutics market size in the US is ~$10B/yr. Good luck stopping that party.

viraptor 1y ago
It's both over and under diagnosed. But you're overplaying some areas like people have no idea what they're doing. For example: > Often fidgets with or taps hands or feet or squirms in seat This is not describing typical kid behaviour, but self-stimulation. They're massively different. There's normally a follow-up discussion about the answers to that basic questionnaire. If you watched that talk, take a moment to follow up with this one from Russell Barkley which addresses what's wrong with Robinson's views https://youtu.be/5jOwjbwU41o https://youtu.be/5jOwjbwU41o > And more importantly, why do you have 'ADHD'? Genetics and occasionally brain damage from accidents. That much has been proven in many studies - it's very much inherited.
- tdpvb 1y ago
  Dr. Barkley's counterargument is essentially "it's preposterous to suggest that ADHD isn't well defined ... because clearly it is well defined," but that's a circular argument -- and still conflates "diagnosis" with "loose pattern of symptoms". He seems to get a bit emotional and take things personally; as if merely questioning the status quo of drugging kids implies that he is a bad person. Though we can't blame individual doctors for doing what they and the system institutionally thinks is best, it's still important to have critical, objective dialogue, even if it's uncomfortable. (Although my favorite de-motivational poster quote seems relevant here: "No single raindrop believes it is to blame for the flood".) He also bristles that "They're only classified as Schedule II drugs!", etc. Let's be explicitly clear, they're amphetamine salts; we're drugging kids with amphetamine uppers. Dr. Barkley is so (pseudo?)certain! Yet it all begs the question: How on earth did humanity survive back when cavepeople had such inadequate access to amphetamines? Re: TBI leads to ADHD -- not saying that subcase is never true, but in the context of this thread, "why more US cases of ADHD vs. the world," unless children in the US suffer from proportionally more incidents of TBI to explain the uptick, then TBI isn't as relevant.
  - viraptor 1y ago
    > and still conflates "diagnosis" with "loose pattern of symptoms" He doesn't, he's really precise about the naming in those cases. For now we don't have a better way to diagnose, but you can follow him review papers which do try to improve the diagnosis. If ADHD is defined in terms of symptoms, the diagnosis has to use those. > He seems to get a bit emotional Oh no, someone cares about their field of work being misrepresented. I'm glad it never happens in places like HN ;) You can listen to the arguments and ignore how he feels about the topic. > Let's be explicitly clear, they're amphetamine salts; we're drugging kids with amphetamine uppers. First, only one part of available drugs are amphetamines - there are other options. Second, they don't work for them the same as others. I've had the most relaxing naps after stimulants, which is not why others use them. I'm not sure what you're specifically against here - improving kids' lives by giving them meds that others can abuse for fun? Is this just about a moral take? Because we know that medication in ADHD lowers the chance of dying from multiple causes https://pmc.ncbi.nlm.nih.gov/articles/PMC10901868/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10901868/ > How on earth did humanity survive back when cavepeople had such inadequate access to amphetamines? Just like we do today. Some people have a bit worse experience with life than others. Is not like ADHD kills you in short term, just lowers the life expectancy.

by tdpvb 1y ago

viraptor 1y ago

It's both over and under diagnosed. But you're overplaying some areas like people have no idea what they're doing. For example: > Often fidgets with or taps hands or feet or squirms in seat This is not describing typical kid behaviour, but self-stimulation. They're massively different. There's normally a follow-up discussion about the answers to that basic questionnaire. If you watched that talk, take a moment to follow up with this one from Russell Barkley which addresses what's wrong with Robinson's views https://youtu.be/5jOwjbwU41o https://youtu.be/5jOwjbwU41o > And more importantly, why do you have 'ADHD'? Genetics and occasionally brain damage from accidents. That much has been proven in many studies - it's very much inherited.

tdpvb 1y ago
Dr. Barkley's counterargument is essentially "it's preposterous to suggest that ADHD isn't well defined ... because clearly it is well defined," but that's a circular argument -- and still conflates "diagnosis" with "loose pattern of symptoms". He seems to get a bit emotional and take things personally; as if merely questioning the status quo of drugging kids implies that he is a bad person. Though we can't blame individual doctors for doing what they and the system institutionally thinks is best, it's still important to have critical, objective dialogue, even if it's uncomfortable. (Although my favorite de-motivational poster quote seems relevant here: "No single raindrop believes it is to blame for the flood".) He also bristles that "They're only classified as Schedule II drugs!", etc. Let's be explicitly clear, they're amphetamine salts; we're drugging kids with amphetamine uppers. Dr. Barkley is so (pseudo?)certain! Yet it all begs the question: How on earth did humanity survive back when cavepeople had such inadequate access to amphetamines? Re: TBI leads to ADHD -- not saying that subcase is never true, but in the context of this thread, "why more US cases of ADHD vs. the world," unless children in the US suffer from proportionally more incidents of TBI to explain the uptick, then TBI isn't as relevant.
- viraptor 1y ago
  > and still conflates "diagnosis" with "loose pattern of symptoms" He doesn't, he's really precise about the naming in those cases. For now we don't have a better way to diagnose, but you can follow him review papers which do try to improve the diagnosis. If ADHD is defined in terms of symptoms, the diagnosis has to use those. > He seems to get a bit emotional Oh no, someone cares about their field of work being misrepresented. I'm glad it never happens in places like HN ;) You can listen to the arguments and ignore how he feels about the topic. > Let's be explicitly clear, they're amphetamine salts; we're drugging kids with amphetamine uppers. First, only one part of available drugs are amphetamines - there are other options. Second, they don't work for them the same as others. I've had the most relaxing naps after stimulants, which is not why others use them. I'm not sure what you're specifically against here - improving kids' lives by giving them meds that others can abuse for fun? Is this just about a moral take? Because we know that medication in ADHD lowers the chance of dying from multiple causes https://pmc.ncbi.nlm.nih.gov/articles/PMC10901868/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10901868/ > How on earth did humanity survive back when cavepeople had such inadequate access to amphetamines? Just like we do today. Some people have a bit worse experience with life than others. Is not like ADHD kills you in short term, just lowers the life expectancy.