10 ms·

The Drugging Of The American Boy

91 points by Larx-3 12y ago

eruditely 12y ago
Why don't you read a fucking ADHD support forum and wonder whether the suffering caused by poor executive functioning/nervous system disorder is real? Why didn't they mention how many more times you are likely to die in a vehicular accident than non-adhd users? http://scholar.google.com/scholar?start=10&q=adhd&hl=en&as_sdt=0,5 http://scholar.google.com/scholar?start=10&q=adhd&hl=en&as_s... Google scholar for ADHD, why don't you realize that these ADHD articles are more akin to anti-vaccination articles?
- jonah 12y ago
  Why don't we try to get to the root causes of these "behavioral issues" instead of treating the symptoms.
  - gizmo686 12y ago
    Isn't that what ADHD medication tries to do. If the root cause is a chemical imbalance, then treating is as a behavioural problem is only treating the symptoms.
    - gress 12y ago
      There is no valid support for the chemical imbalance theory of mental illness. The reasoning is circular - "if chemicals reduce the symptoms, a chemical imbalance must have been the cause" Edit: seriously downvotes? This isn't news: http://en.wikipedia.org/wiki/Chemical_imbalance http://en.wikipedia.org/wiki/Chemical_imbalance
      - dalke 12y ago
        Or read http://www.madinamerica.com/2014/03/psychiatry-admits-wrong-big-ways-can-change-chat-robert-whitaker/ http://www.madinamerica.com/2014/03/psychiatry-admits-wrong-... : > BL: In Anatomy of an Epidemic, you also discussed the pseudoscience behind the “chemical imbalance” theories of mental illness—theories that made it easy to sell psychiatric drugs. In the last few years, I’ve noticed establishment psychiatry figures doing some major backpedaling on these chemical imbalance theories. For example, Ronald Pies, editor-in-chief emeritus of the Psychiatric Times stated in 2011, “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” ... > RW: In a sense, Ronald Pies is right. Those psychiatrists who were “well informed” about investigations into the chemical imbalance theory of mental disorders knew it hadn’t really panned out, with such findings dating back to the late 1970s and early 1980s. But why then did we as a society come to believe that mental disorders were due to chemical imbalances, which were then fixed by the drugs? ... RW then goes on to list a couple of likely reasons.
    - jonah 12y ago
      I'll bite. Where does the imbalance come from? It doesn't come from not taking your medications.
- com2kid 12y ago
  Thank you. As I've stated before, either ADHD is real, or psychologists have found the world's best predictive test for auto accidents. People with untreated ADHD have 3x the likelihood of being in an auto accident. 56% rate of substance abuse. Think about that for a moment. 56%. Holy shit. These are the people who instead of getting help, were told that they are "lazy" and "needed to get up off their asses." Except that advice didn't work, what it does lead to is depression and dependency issues. Oh then there is the fact that there are large structural brain differences. I won't disagree that ADHD is over-diagnosed at times. I am horrified with how easily some people get an ADHD diagnosis, your general MD should not be making that call. There are multitudes of proper psychological tests for ADHD that should be chosen from, a 30 minute patient interview should not be the sole determining factor.
  - gress 12y ago
    Perhaps the tendency to call people "lazy" and "need to get up off your ass", is a personality disorder that should be treated with strong medication.
  - legutierr 12y ago
    > Oh then there is the fact that there are large structural brain differences. Are these structural differences used in diagnosis?
    - com2kid 12y ago
      > Are these structural differences used in diagnosis? Unfortunately testing costs money, I've rarely to never heard of it being used, but my sole experience is in helping people on ADHD support forums.
      - dalke 12y ago
        When you say it is a "fact that there are large structural brain differences", which differences did you mean? I may be focusing on the wrong thing. What I've found (brain size) doesn't have a clear enough difference to be used as part of diagnosis. For example, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859218/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859218/ notes that head circumference and cross-sectional MRI measurements of brain size show that children diagnosed with autism have (on average) a larger brain size. However, looking at the charts (for a head circumference chart, see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869044/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869044/ ), while the data may be statistically significant, there's no clear separation between those diagnosed with autism and those with no indication of autism. Many of those with autism have a size smaller than the average of those without, and many of those without autism have a size larger than those with. This means that head size or simple cross-sectional MRIs can't be used as a reliable diagnostic test. Which structural differences where you meaning?
- sheepmullet 12y ago
  Nobody is saying that ADHD is not a real condition. The article is suggesting a lot of American boys are diagnosed with ADHD when they don't in fact have it. Imagine if 30% of people undergoing chemo for cancer treatment had never even had cancer. I'd like to see what the rates are compared to other western countries. If its 5% in Canada and 20% in the US it suggests something is wrong
- DerpDerpDerp 12y ago
  Your response doesn't actually address the article, which acknowledges that ADHD is a real condition, but suggests that fewer than 1 in 5 boys have it, and that a large number of misdiagnosed cases is bad, considering that they're given serious drugs because of it. In fact, the only number it suggests as being inaccurate (based on an old study) is 25% of cases - that 1 in 4 cases is misdiagnosed. However, given the number of total cases, that means something like 5% of boys are being given serious drugs for potentially no reason. I think that deserves serious consideration, and not your knee-jerk, strawman response.
  - gress 12y ago
    Also it's worth pointing out that if 1 in 5 boys have it, it's not a disorder. It's part of the normal range.
    - epx 12y ago
      Chebychev inequality!
    - joeyo 12y ago
      I'm not sure if it's that black and white. Roughly 25% of deaths in the US are due to heart disease. Should we not intervene because heart disease is part of the normal range?
      - gress 12y ago
        You're affirming the consequent.
      - amirmc 12y ago
        I agree that it's probably not that black and white but a comparison with heart disease isn't a fair one. The grandparent post does make a point. If such a large proportion of the population has a 'condition' is it really a condition or perhaps just how we (as a species) are? Especially in the case of something that's psychiatric/psychological. For example, I've heard estimates that around 10% of the population is homosexual and for many years people wanted to 'fix' them. Around 10%-12% of people are left-handed and (I believe) that historically this was also something that people tried to 'fix'. I doubt many of us think twice about these anymore. To a sibling comment that suggested what if 1 in 5 boys were born deaf, I'd say that the world would be a vastly different place. So different that we may not even entertain such a question. If, instead, 1/5th of boys were beginning to be born deaf, there would be a medical emergency. Unfortunately, in the case of things like ADHD it's difficult to know if we've always been this way or if there's really been a change.
- im_a_lawyer 12y ago
  no one here is saying that ADHD condition is not real.. It's just that some people like me have a problem with the way they decide to treat it. Pretending that this is all "genetics" written in stone and the only way to not go crazy and end up a poor underachiever in jail is by taking these expensive pills and call it "treatment". Your body has absolutely zero need for pharmaceuticals. Drugs are only masking the problem up and as soon as you stop taking it, all your symptoms will come back. How do you people not fucking get it? Why not get to the root cause of this condition instead of taking an easy way out?
andyl 12y ago
A few years ago teachers complained that both my boys were too intense on the playground, 'diagnosed' with ADHD. Docs were eager to prescribe meds to make them conform. There is something in our society wants to redefine normal behavior as pathology. Maybe to get you hooked and build revenue streams, maybe just to make you more pliable. Fuck that. Yes there are legitimate cases. But I've only experienced people who want to mis-apply the meds.
- aidenn0 12y ago
  Count me as a legitimate case. That being said, all the research I've done into it on my own shows that the ability of the system to diagnose ADHD is crap. As in huge numbers of both false positives and false negatives. The over-diagnosis is a huge problem, and it results in not only large numbers of children being prescribed stimulant medication mistakenly, but it causes parents of kids who could benefit from such medication to rightfully have second thoughts when a doctor recommends it. In particular a lot of those who make ADHD referrals kind of have this mapping of "Problem Kid" => "Likely ADHD" when that doesn't seem to be a particularly good mapping. There are even significant downsides to kids with ADHD taking stimulant medication, but in that case, it appears that the likely benefit does outweigh the likely harm. Now that I'm a parent, I also wonder if the increased diagnosis of boys is partly due to the differences in the school system. I see more homework and deskwork at a younger age than when I was a kid, but combined with less of a "boys will be boys" tolerance for destructive behavior than when my dad was a kid. Of course I have no numbers on this, so it may merely be nostalgia thinking that that is the trend.
- eruditely 12y ago
  You've only experienced people who want to mis-apply the meds? What criteria for mis-apply are you using here? "Docs were eager to prescribe meds to make them conform", awkward appeal to malicious agency. It is doubtful that doctors were "Eager to make them conform". "Something to redefine behavior as pathology... maybe to get you hooked and build revenue streams", ah yes. That's it. Never mind the much higher incident of high school drop out, repeated grades, 1/4th as likely as other kids to pass college, more likely to go to jail, and get in a car crash.
- 12y ago
chimeracoder 12y ago
Instead of just talking about the dangers of a false positive, let's talk about the dangers of false negatives - of ignoring ADHD in children who do actually have it. ADHD is very treatable, but untreated, it can easily lead to other comorbidities that are much more difficult to treat (such as depression) The most dangerous part of this is that it seems to imply ADHD is over-diagnosed in men (boys), when it's just as possible that ADHD is under-diagnosed in women (girls). Girls diagnosed with 314.10 (Attention Deficit Disorder, predominantly hyperactive-impulsive) tend to exhibit fewer "traditional" symptoms of hyperactivity than boys with the same diagnosis. This isn't to say that the diagnosis is wrong - it's just that hyperactivity manifests in many ways - physical restlessness, "bouncing off the walls", etc. is only one. > The interesting thing is I never asked any of these people whether ADHD is real. But their defensiveness is understandable. ADHD isn't strep throat—there's no culture, no test. To find out if you have it, or if your son has it, or if your daughter has it, you just need a human being to say so—a physician or a psychiatrist—and that makes some people skeptical This describes the entire field of psychiatry. While there are certainly some people who are who would distrust the field, I would be very wary of throwing the baby out with the bathwater. And of all disorders, ADHD is actually significantly easier to test for systematically than most psychological/psychiatric disorders (such as depression). The main problem is that the tests to do so are very expensive (well into the thousands of dollars), and most insurance plans won't cover it. > Ned Hallowell once famously said that stimulants were "safer than aspirin," a statement he has since backed off of. ("That's almost a preposterous statement for anyone to say," says Saltarelli.) So, we have a complete lowbrow dismissal of what is actually a very reasonable statement. In the end, it's impossible to compare any two drugs for safety because there are so many factors that come into play, but to the extent that one can make a pairwise comparison, this is actually a very well-supported statement.
- foolinaround 12y ago
  > ADHD is very treatable, but untreated, it can easily lead to other comorbidities that are much more difficult to treat (such as depression) This claim needs citation. The overall point is that the cost of the false positive overweighs the cost of the false negative
ryanmarsh 12y ago
Next can we talk about SSRI's? My little brother was prescribed Paxil as an adolescent. Now he's in prison for murder. Now Paxil is not allowed to be prescribed for adolescents and children but my brother will die in prison. He behaved exactly how kids prescribed this medicine behave, in a murderous rage.
- khuey 12y ago
  Wow, that's so tragic.
- Andrex 12y ago
  He killed someone as an adolescent but was still tried as an adult? That's rough, man.
- chewychewymango 12y ago
  So long as the chemical imbalance myth is perpetuated and one in ten Americans are on anti-depressants, all SSRI prescriptions are sacrosanct. Sadly, society isn't ready to have this discussion.
  - fit2rule 12y ago
    True, that. Its really hard to talk down addicts from their high.
    - ErikBjare 12y ago
      It seems the only one who can talk down the addict is the addict itself, and even then the odds aren't great.
curiousDog 12y ago
To me, as an adult, getting a diagnosis on ADHD was a godsend. However, after a couple of years, I see the drug's affects waning. I can also see how damaging this dependency creation can be for children. Fortunately, when I was a child back in India, ADHD was virtually unknown (probably the case today as well). Most of the time, my parents chalked off my inattention to "lack of discipline" and were happy as long as my grades were good. I found the coursework very easy (despite studying for only 1-1:30 hrs a day) and topped most of my classes. University here in he U.S wasn't hard either. My problems started once I started working. Couldn't code continuously for more than 15-20 mins at a time. Things got boring very quickly once I got the "aha". I couldn't hold a lot of program state in my head. I was always searching for that "flow" people often talked about. Adderall really helped me. I use it very sparingly these days (especially on days that I have to code some important pieces) though. Bottomline, looks like this is purely genetic and fixing the dopamine pathways isn't exactly like curing malaria, you can juice things up but the brain will want more. Parents can choose to give it to their children but they'll suffer some time down the road. I'd rather let the kid enjoy childhood and help him in other ways (exercise, note-taking, engaging activities etc) and put him in a reasonably good path to success. Let them take drugs if necessary once they've wised up as adults.
- eruditely 12y ago
  Again vague appeals to solutions that simply do not work as well as stimulant medications. http://www.nami.org/Template.cfm?Section=ADHD&Template=/ContentManagement/ContentDisplay.cfm&ContentID=106893 http://www.nami.org/Template.cfm?Section=ADHD&Template=/Cont... T 1. Thirty two percent of students living with ADHD drop out of high school compared to 15 percent of teens with no mental health diagnosis (UC Davis Health System, 2010) 2.Three times as many adolescents living with ADHD as those living without ADHD have failed a grade, been suspended or been expelled from school. (Barkley, 2000). You're right though, let them exercise and make them note-take, that will work(while you ignore that this simply is not effective, as studied in the current literature) "Fixing dopamine pathways isn't exactly like curing malaria", profound. http://pediatrics.aappublications.org/content/115/6/e749.long http://pediatrics.aappublications.org/content/115/6/e749.lon... (Treatment of Attention-Deficit/Hyperactivity Disorder: Overview of the Evidence) Conclusion: "Other evidence documents the long-term nature of ADHD in children and its classification as a chronic condition, meriting the application of general concepts of chronic-condition management, including an individual treatment plan with a focus on ongoing parent and child education, management, and monitoring. The evidence strongly supports the use of stimulant medications for treating the core symptoms of children with ADHD and, to a lesser degree, for improving functioning. Behavior therapy alone has only limited effect on symptoms or functioning of children with ADHD, although combining behavior therapy with medication seems to improve functioning and may decrease the amount of (stimulant) medication needed. Comparison among stimulants (mainly methylphenidate and amphetamines) did not indicate that 1 class outperformed the other."
davyjones 12y ago
http://en.wikipedia.org/wiki/Vitamin_R_(Leading_Us_Along) http://en.wikipedia.org/wiki/Vitamin_R_(Leading_Us_Along) "The song was written about a friend of the Loeffler brothers, who was misdiagnosed with ADHD, and developed an addiction to Ritalin. As a result, he would often do crazy and odd things, such as drive around aimlessly for hours, determined to hear a specific song on the radio." :-(
deleted 12y ago
[deleted]
joesmo 12y ago
ADHD isn't real. It didn't exist in many previous generations. Surely, the behavior of children hasn't changed much over the last few generations so how come this "disease" didn't exist previous to the current couple of generations and how come it still doesn't exist in many places on the planet? Could foreign kids somehow be better? Of course not. As the article points out, this is a ploy by pharmaceutical companies to get children hooked not only on ADHD drugs but on drugs in the future. What do these kids do when they turn 18? I asked on pediatrician I respected what she does for the children. Does she taper them off? Does she transition them to other doctors? Does she transition them to other medicines? Nope. "That's not my problem," she said. Of course not. In a culture where doctors are not responsible, where making hundreds of dollars an hour is "not enough" to have them actually perform their duties in full, duties such as making a full investigation into their patients' cases, and spending more than 10 or 15 minutes before "diagnosing" them with a condition they do not have and putting them on drugs for essentially the rest of their lives, only in such a culture is ADHD real. When it comes down to it, it's the responsibility of the parents to keep their kids off drugs. The body doesn't care wether you're snorting amphetamine or Adderall because Adderall is amphetamine. Parents who allow their kids to be "diagnosed" with ADHD and allow them to take drugs are encouraging their children to take drugs. They are unconscionable parents. Any child can make a mistake and start doing drugs, but now we have whole classes of drugs that are encouraged. Some drug abuse and addictions have become ingrained in life. Do you think the children will stop because they've now turned 18? Do you think they'll stop at Ritalin or Adderall when those things stop working? Addiction knows no bounds. How many more lives will have to be ruined before people realize the psychiatric industry and the doctors pushing these drugs are only doing it for the money, money they do not need? Talk about about scummy drug dealers. Yeah, we're looking at the multi-billion dollar corporations, the "psychiatrists," the DSM writers, and the rest of the doctors who can't even be bothered to spend ten minutes with a patient before deciding on a horrific fate for them. When will people learn that the medical industry cannot be trusted, that the hippocratic oath is bullshit, and they need to be responsible for their own selves and their own children? Those parents allowing their kids to be put on this should be put in jail next to the child murderers they irresponsibly strive to be.
- sliverstorm 12y ago
wmgries 12y ago
My third grade teacher apparently had every boy in her class tested. As a boy, and frankly as a boy who was independent, mouthy and unlikely to do work in school unless I wanted to, I'm glad I had great parents and a great pediatrician. My pediatrician had my parents and teacher run an experiment: my mom would choose a pill with active ingredient or a pill with nothing in it, and my teacher, without knowing which I took that day, would record notes on my behavior. Turns out, no correlation between the two. I don't doubt there are people in this world for who ADHD is a real thing. But I think we are too quick in the modern age to drug without thinking. Parents demand antibiotics for illnesses which are just small bugs... guess what, now we are having problems with drug resistant bacteria. Lawmakers, administrators, and teachers (in that order) want to turn classrooms in to machines which churn out educated people like clockwork. Turns out, humans are animals, not machines, so we load everybody with some stimulants to make children just sit still. I'm not anti-medicine in any way. I have personally seen Ritalin work on a friend who actually had ADHD growing up. And I have also seen another friend buy Vyvanse illegally so he could study for 15 hours a day. I believe in prescription drugs. I just don't always believe in the prescription.
- prutschman 12y ago
  I like the idea of the experiment! Is it generally accepted that one would see same-day behavior changes when switching between an ADHD drug and a placebo?
  - wmgries 12y ago
    That's a good point, I'm not sure. The friends I've seen use the drug as a study aid certainly respond to it quickly but the scientific rigor of the experiment didn't much matter: I think my parents were skeptical that I really had a problem anyway, and lo and behold, I'm an adult now and I never did actually have a problem. When you tell the parents of every boy in the class their kid has ADHD, the claim becomes pretty weak.
frozenport 12y ago
I don't believe in ADHD but I suspect the drugs do something with utility. How does society confront pills that make people more efficient?
ScottWhigham 12y ago
For those who don't know Esquire, it's basically a supermarket tabloid-for-men style magazine. It's not a science mag, so for anyone to get too upset about it is, well, just not really smart. [0] That said, the horrific FUD writing style is insulting. The comments by HN users - I can't even identify with the people here. Now imagine that he is suffering like this because of a mistake... If you have a son in America, there is an alarming probability that this has happened or will happen to you. Absolute bullshit. Total and utter crap. That does not happen. I have two ADHD kids and it was (a) my choice to take them to a doctor, (b) my choice of which doctor they went to, and (c) my choice as to whether there was a diagnosis of ADHD. It's farcical for me to read the opening paragraphs of this "article" and its presumption that doctors are evil and really just want to incorrectly diagnose kids. Atrocious. [0] http://en.wikipedia.org/wiki/Esquire_%28magazine%29 http://en.wikipedia.org/wiki/Esquire_%28magazine%29
- Camillo 12y ago
  > (c) my choice as to whether there was a diagnosis of ADHD Wait, what?
  - ScottWhigham 12y ago
    Did you not understand or did you have a legitimate follow-on question?
    - Camillo 12y ago
      It sounds like you specifically arranged things so that you got the diagnosis you wanted.

91 points by Larx-3 12y ago

Why don't you read a fucking ADHD support forum and wonder whether the suffering caused by poor executive functioning/nervous system disorder is real? Why didn't they mention how many more times you are likely to die in a vehicular accident than non-adhd users? http://scholar.google.com/scholar?start=10&q=adhd&hl=en&as_sdt=0,5 http://scholar.google.com/scholar?start=10&q=adhd&hl=en&as_s... Google scholar for ADHD, why don't you realize that these ADHD articles are more akin to anti-vaccination articles?

jonah 12y ago
Why don't we try to get to the root causes of these "behavioral issues" instead of treating the symptoms.
- gizmo686 12y ago
  Isn't that what ADHD medication tries to do. If the root cause is a chemical imbalance, then treating is as a behavioural problem is only treating the symptoms.
  - gress 12y ago
    There is no valid support for the chemical imbalance theory of mental illness. The reasoning is circular - "if chemicals reduce the symptoms, a chemical imbalance must have been the cause" Edit: seriously downvotes? This isn't news: http://en.wikipedia.org/wiki/Chemical_imbalance http://en.wikipedia.org/wiki/Chemical_imbalance
    - dalke 12y ago
      Or read http://www.madinamerica.com/2014/03/psychiatry-admits-wrong-big-ways-can-change-chat-robert-whitaker/ http://www.madinamerica.com/2014/03/psychiatry-admits-wrong-... : > BL: In Anatomy of an Epidemic, you also discussed the pseudoscience behind the “chemical imbalance” theories of mental illness—theories that made it easy to sell psychiatric drugs. In the last few years, I’ve noticed establishment psychiatry figures doing some major backpedaling on these chemical imbalance theories. For example, Ronald Pies, editor-in-chief emeritus of the Psychiatric Times stated in 2011, “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” ... > RW: In a sense, Ronald Pies is right. Those psychiatrists who were “well informed” about investigations into the chemical imbalance theory of mental disorders knew it hadn’t really panned out, with such findings dating back to the late 1970s and early 1980s. But why then did we as a society come to believe that mental disorders were due to chemical imbalances, which were then fixed by the drugs? ... RW then goes on to list a couple of likely reasons.
  - jonah 12y ago
    I'll bite. Where does the imbalance come from? It doesn't come from not taking your medications.
com2kid 12y ago
Thank you. As I've stated before, either ADHD is real, or psychologists have found the world's best predictive test for auto accidents. People with untreated ADHD have 3x the likelihood of being in an auto accident. 56% rate of substance abuse. Think about that for a moment. 56%. Holy shit. These are the people who instead of getting help, were told that they are "lazy" and "needed to get up off their asses." Except that advice didn't work, what it does lead to is depression and dependency issues. Oh then there is the fact that there are large structural brain differences. I won't disagree that ADHD is over-diagnosed at times. I am horrified with how easily some people get an ADHD diagnosis, your general MD should not be making that call. There are multitudes of proper psychological tests for ADHD that should be chosen from, a 30 minute patient interview should not be the sole determining factor.
- gress 12y ago
  Perhaps the tendency to call people "lazy" and "need to get up off your ass", is a personality disorder that should be treated with strong medication.
- legutierr 12y ago
  > Oh then there is the fact that there are large structural brain differences. Are these structural differences used in diagnosis?
  - com2kid 12y ago
    > Are these structural differences used in diagnosis? Unfortunately testing costs money, I've rarely to never heard of it being used, but my sole experience is in helping people on ADHD support forums.
    - dalke 12y ago
      When you say it is a "fact that there are large structural brain differences", which differences did you mean? I may be focusing on the wrong thing. What I've found (brain size) doesn't have a clear enough difference to be used as part of diagnosis. For example, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859218/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859218/ notes that head circumference and cross-sectional MRI measurements of brain size show that children diagnosed with autism have (on average) a larger brain size. However, looking at the charts (for a head circumference chart, see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869044/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869044/ ), while the data may be statistically significant, there's no clear separation between those diagnosed with autism and those with no indication of autism. Many of those with autism have a size smaller than the average of those without, and many of those without autism have a size larger than those with. This means that head size or simple cross-sectional MRIs can't be used as a reliable diagnostic test. Which structural differences where you meaning?
sheepmullet 12y ago
Nobody is saying that ADHD is not a real condition. The article is suggesting a lot of American boys are diagnosed with ADHD when they don't in fact have it. Imagine if 30% of people undergoing chemo for cancer treatment had never even had cancer. I'd like to see what the rates are compared to other western countries. If its 5% in Canada and 20% in the US it suggests something is wrong
DerpDerpDerp 12y ago
Your response doesn't actually address the article, which acknowledges that ADHD is a real condition, but suggests that fewer than 1 in 5 boys have it, and that a large number of misdiagnosed cases is bad, considering that they're given serious drugs because of it. In fact, the only number it suggests as being inaccurate (based on an old study) is 25% of cases - that 1 in 4 cases is misdiagnosed. However, given the number of total cases, that means something like 5% of boys are being given serious drugs for potentially no reason. I think that deserves serious consideration, and not your knee-jerk, strawman response.
- gress 12y ago
  Also it's worth pointing out that if 1 in 5 boys have it, it's not a disorder. It's part of the normal range.
  - epx 12y ago
    Chebychev inequality!
  - joeyo 12y ago
    I'm not sure if it's that black and white. Roughly 25% of deaths in the US are due to heart disease. Should we not intervene because heart disease is part of the normal range?
    - gress 12y ago
      You're affirming the consequent.
    - amirmc 12y ago
      I agree that it's probably not that black and white but a comparison with heart disease isn't a fair one. The grandparent post does make a point. If such a large proportion of the population has a 'condition' is it really a condition or perhaps just how we (as a species) are? Especially in the case of something that's psychiatric/psychological. For example, I've heard estimates that around 10% of the population is homosexual and for many years people wanted to 'fix' them. Around 10%-12% of people are left-handed and (I believe) that historically this was also something that people tried to 'fix'. I doubt many of us think twice about these anymore. To a sibling comment that suggested what if 1 in 5 boys were born deaf, I'd say that the world would be a vastly different place. So different that we may not even entertain such a question. If, instead, 1/5th of boys were beginning to be born deaf, there would be a medical emergency. Unfortunately, in the case of things like ADHD it's difficult to know if we've always been this way or if there's really been a change.
im_a_lawyer 12y ago
no one here is saying that ADHD condition is not real.. It's just that some people like me have a problem with the way they decide to treat it. Pretending that this is all "genetics" written in stone and the only way to not go crazy and end up a poor underachiever in jail is by taking these expensive pills and call it "treatment". Your body has absolutely zero need for pharmaceuticals. Drugs are only masking the problem up and as soon as you stop taking it, all your symptoms will come back. How do you people not fucking get it? Why not get to the root cause of this condition instead of taking an easy way out?

andyl 12y ago

A few years ago teachers complained that both my boys were too intense on the playground, 'diagnosed' with ADHD. Docs were eager to prescribe meds to make them conform. There is something in our society wants to redefine normal behavior as pathology. Maybe to get you hooked and build revenue streams, maybe just to make you more pliable. Fuck that. Yes there are legitimate cases. But I've only experienced people who want to mis-apply the meds.

aidenn0 12y ago
Count me as a legitimate case. That being said, all the research I've done into it on my own shows that the ability of the system to diagnose ADHD is crap. As in huge numbers of both false positives and false negatives. The over-diagnosis is a huge problem, and it results in not only large numbers of children being prescribed stimulant medication mistakenly, but it causes parents of kids who could benefit from such medication to rightfully have second thoughts when a doctor recommends it. In particular a lot of those who make ADHD referrals kind of have this mapping of "Problem Kid" => "Likely ADHD" when that doesn't seem to be a particularly good mapping. There are even significant downsides to kids with ADHD taking stimulant medication, but in that case, it appears that the likely benefit does outweigh the likely harm. Now that I'm a parent, I also wonder if the increased diagnosis of boys is partly due to the differences in the school system. I see more homework and deskwork at a younger age than when I was a kid, but combined with less of a "boys will be boys" tolerance for destructive behavior than when my dad was a kid. Of course I have no numbers on this, so it may merely be nostalgia thinking that that is the trend.
eruditely 12y ago
You've only experienced people who want to mis-apply the meds? What criteria for mis-apply are you using here? "Docs were eager to prescribe meds to make them conform", awkward appeal to malicious agency. It is doubtful that doctors were "Eager to make them conform". "Something to redefine behavior as pathology... maybe to get you hooked and build revenue streams", ah yes. That's it. Never mind the much higher incident of high school drop out, repeated grades, 1/4th as likely as other kids to pass college, more likely to go to jail, and get in a car crash.
12y ago

chimeracoder 12y ago

Instead of just talking about the dangers of a false positive, let's talk about the dangers of false negatives - of ignoring ADHD in children who do actually have it. ADHD is very treatable, but untreated, it can easily lead to other comorbidities that are much more difficult to treat (such as depression) The most dangerous part of this is that it seems to imply ADHD is over-diagnosed in men (boys), when it's just as possible that ADHD is under-diagnosed in women (girls). Girls diagnosed with 314.10 (Attention Deficit Disorder, predominantly hyperactive-impulsive) tend to exhibit fewer "traditional" symptoms of hyperactivity than boys with the same diagnosis. This isn't to say that the diagnosis is wrong - it's just that hyperactivity manifests in many ways - physical restlessness, "bouncing off the walls", etc. is only one. > The interesting thing is I never asked any of these people whether ADHD is real. But their defensiveness is understandable. ADHD isn't strep throat—there's no culture, no test. To find out if you have it, or if your son has it, or if your daughter has it, you just need a human being to say so—a physician or a psychiatrist—and that makes some people skeptical This describes the entire field of psychiatry. While there are certainly some people who are who would distrust the field, I would be very wary of throwing the baby out with the bathwater. And of all disorders, ADHD is actually significantly easier to test for systematically than most psychological/psychiatric disorders (such as depression). The main problem is that the tests to do so are very expensive (well into the thousands of dollars), and most insurance plans won't cover it. > Ned Hallowell once famously said that stimulants were "safer than aspirin," a statement he has since backed off of. ("That's almost a preposterous statement for anyone to say," says Saltarelli.) So, we have a complete lowbrow dismissal of what is actually a very reasonable statement. In the end, it's impossible to compare any two drugs for safety because there are so many factors that come into play, but to the extent that one can make a pairwise comparison, this is actually a very well-supported statement.

foolinaround 12y ago
> ADHD is very treatable, but untreated, it can easily lead to other comorbidities that are much more difficult to treat (such as depression) This claim needs citation. The overall point is that the cost of the false positive overweighs the cost of the false negative

ryanmarsh 12y ago

Next can we talk about SSRI's? My little brother was prescribed Paxil as an adolescent. Now he's in prison for murder. Now Paxil is not allowed to be prescribed for adolescents and children but my brother will die in prison. He behaved exactly how kids prescribed this medicine behave, in a murderous rage.

khuey 12y ago
Wow, that's so tragic.
Andrex 12y ago
He killed someone as an adolescent but was still tried as an adult? That's rough, man.
chewychewymango 12y ago
So long as the chemical imbalance myth is perpetuated and one in ten Americans are on anti-depressants, all SSRI prescriptions are sacrosanct. Sadly, society isn't ready to have this discussion.
- fit2rule 12y ago
  True, that. Its really hard to talk down addicts from their high.
  - ErikBjare 12y ago
    It seems the only one who can talk down the addict is the addict itself, and even then the odds aren't great.

curiousDog 12y ago

To me, as an adult, getting a diagnosis on ADHD was a godsend. However, after a couple of years, I see the drug's affects waning. I can also see how damaging this dependency creation can be for children. Fortunately, when I was a child back in India, ADHD was virtually unknown (probably the case today as well). Most of the time, my parents chalked off my inattention to "lack of discipline" and were happy as long as my grades were good. I found the coursework very easy (despite studying for only 1-1:30 hrs a day) and topped most of my classes. University here in he U.S wasn't hard either. My problems started once I started working. Couldn't code continuously for more than 15-20 mins at a time. Things got boring very quickly once I got the "aha". I couldn't hold a lot of program state in my head. I was always searching for that "flow" people often talked about. Adderall really helped me. I use it very sparingly these days (especially on days that I have to code some important pieces) though. Bottomline, looks like this is purely genetic and fixing the dopamine pathways isn't exactly like curing malaria, you can juice things up but the brain will want more. Parents can choose to give it to their children but they'll suffer some time down the road. I'd rather let the kid enjoy childhood and help him in other ways (exercise, note-taking, engaging activities etc) and put him in a reasonably good path to success. Let them take drugs if necessary once they've wised up as adults.

eruditely 12y ago
Again vague appeals to solutions that simply do not work as well as stimulant medications. http://www.nami.org/Template.cfm?Section=ADHD&Template=/ContentManagement/ContentDisplay.cfm&ContentID=106893 http://www.nami.org/Template.cfm?Section=ADHD&Template=/Cont... T 1. Thirty two percent of students living with ADHD drop out of high school compared to 15 percent of teens with no mental health diagnosis (UC Davis Health System, 2010) 2.Three times as many adolescents living with ADHD as those living without ADHD have failed a grade, been suspended or been expelled from school. (Barkley, 2000). You're right though, let them exercise and make them note-take, that will work(while you ignore that this simply is not effective, as studied in the current literature) "Fixing dopamine pathways isn't exactly like curing malaria", profound. http://pediatrics.aappublications.org/content/115/6/e749.long http://pediatrics.aappublications.org/content/115/6/e749.lon... (Treatment of Attention-Deficit/Hyperactivity Disorder: Overview of the Evidence) Conclusion: "Other evidence documents the long-term nature of ADHD in children and its classification as a chronic condition, meriting the application of general concepts of chronic-condition management, including an individual treatment plan with a focus on ongoing parent and child education, management, and monitoring. The evidence strongly supports the use of stimulant medications for treating the core symptoms of children with ADHD and, to a lesser degree, for improving functioning. Behavior therapy alone has only limited effect on symptoms or functioning of children with ADHD, although combining behavior therapy with medication seems to improve functioning and may decrease the amount of (stimulant) medication needed. Comparison among stimulants (mainly methylphenidate and amphetamines) did not indicate that 1 class outperformed the other."

davyjones 12y ago

http://en.wikipedia.org/wiki/Vitamin_R_(Leading_Us_Along) http://en.wikipedia.org/wiki/Vitamin_R_(Leading_Us_Along) "The song was written about a friend of the Loeffler brothers, who was misdiagnosed with ADHD, and developed an addiction to Ritalin. As a result, he would often do crazy and odd things, such as drive around aimlessly for hours, determined to hear a specific song on the radio." :-(

deleted 12y ago

[deleted]

joesmo 12y ago

ADHD isn't real. It didn't exist in many previous generations. Surely, the behavior of children hasn't changed much over the last few generations so how come this "disease" didn't exist previous to the current couple of generations and how come it still doesn't exist in many places on the planet? Could foreign kids somehow be better? Of course not. As the article points out, this is a ploy by pharmaceutical companies to get children hooked not only on ADHD drugs but on drugs in the future. What do these kids do when they turn 18? I asked on pediatrician I respected what she does for the children. Does she taper them off? Does she transition them to other doctors? Does she transition them to other medicines? Nope. "That's not my problem," she said. Of course not. In a culture where doctors are not responsible, where making hundreds of dollars an hour is "not enough" to have them actually perform their duties in full, duties such as making a full investigation into their patients' cases, and spending more than 10 or 15 minutes before "diagnosing" them with a condition they do not have and putting them on drugs for essentially the rest of their lives, only in such a culture is ADHD real. When it comes down to it, it's the responsibility of the parents to keep their kids off drugs. The body doesn't care wether you're snorting amphetamine or Adderall because Adderall is amphetamine. Parents who allow their kids to be "diagnosed" with ADHD and allow them to take drugs are encouraging their children to take drugs. They are unconscionable parents. Any child can make a mistake and start doing drugs, but now we have whole classes of drugs that are encouraged. Some drug abuse and addictions have become ingrained in life. Do you think the children will stop because they've now turned 18? Do you think they'll stop at Ritalin or Adderall when those things stop working? Addiction knows no bounds. How many more lives will have to be ruined before people realize the psychiatric industry and the doctors pushing these drugs are only doing it for the money, money they do not need? Talk about about scummy drug dealers. Yeah, we're looking at the multi-billion dollar corporations, the "psychiatrists," the DSM writers, and the rest of the doctors who can't even be bothered to spend ten minutes with a patient before deciding on a horrific fate for them. When will people learn that the medical industry cannot be trusted, that the hippocratic oath is bullshit, and they need to be responsible for their own selves and their own children? Those parents allowing their kids to be put on this should be put in jail next to the child murderers they irresponsibly strive to be.

sliverstorm 12y ago

wmgries 12y ago

My third grade teacher apparently had every boy in her class tested. As a boy, and frankly as a boy who was independent, mouthy and unlikely to do work in school unless I wanted to, I'm glad I had great parents and a great pediatrician. My pediatrician had my parents and teacher run an experiment: my mom would choose a pill with active ingredient or a pill with nothing in it, and my teacher, without knowing which I took that day, would record notes on my behavior. Turns out, no correlation between the two. I don't doubt there are people in this world for who ADHD is a real thing. But I think we are too quick in the modern age to drug without thinking. Parents demand antibiotics for illnesses which are just small bugs... guess what, now we are having problems with drug resistant bacteria. Lawmakers, administrators, and teachers (in that order) want to turn classrooms in to machines which churn out educated people like clockwork. Turns out, humans are animals, not machines, so we load everybody with some stimulants to make children just sit still. I'm not anti-medicine in any way. I have personally seen Ritalin work on a friend who actually had ADHD growing up. And I have also seen another friend buy Vyvanse illegally so he could study for 15 hours a day. I believe in prescription drugs. I just don't always believe in the prescription.

prutschman 12y ago
I like the idea of the experiment! Is it generally accepted that one would see same-day behavior changes when switching between an ADHD drug and a placebo?
- wmgries 12y ago
  That's a good point, I'm not sure. The friends I've seen use the drug as a study aid certainly respond to it quickly but the scientific rigor of the experiment didn't much matter: I think my parents were skeptical that I really had a problem anyway, and lo and behold, I'm an adult now and I never did actually have a problem. When you tell the parents of every boy in the class their kid has ADHD, the claim becomes pretty weak.

frozenport 12y ago

I don't believe in ADHD but I suspect the drugs do something with utility. How does society confront pills that make people more efficient?

ScottWhigham 12y ago

For those who don't know Esquire, it's basically a supermarket tabloid-for-men style magazine. It's not a science mag, so for anyone to get too upset about it is, well, just not really smart. [0] That said, the horrific FUD writing style is insulting. The comments by HN users - I can't even identify with the people here. Now imagine that he is suffering like this because of a mistake... If you have a son in America, there is an alarming probability that this has happened or will happen to you. Absolute bullshit. Total and utter crap. That does not happen. I have two ADHD kids and it was (a) my choice to take them to a doctor, (b) my choice of which doctor they went to, and (c) my choice as to whether there was a diagnosis of ADHD. It's farcical for me to read the opening paragraphs of this "article" and its presumption that doctors are evil and really just want to incorrectly diagnose kids. Atrocious. [0] http://en.wikipedia.org/wiki/Esquire_%28magazine%29 http://en.wikipedia.org/wiki/Esquire_%28magazine%29

Camillo 12y ago
> (c) my choice as to whether there was a diagnosis of ADHD Wait, what?
- ScottWhigham 12y ago
  Did you not understand or did you have a legitimate follow-on question?
  - Camillo 12y ago
    It sounds like you specifically arranged things so that you got the diagnosis you wanted.