Attention Deficit Disorder

rigorous scientific analysis of the subject coming later

I mean, why does everyone I know wear glasses or contacts? It doesn't seem right that the majority of people CAN'T SEE -- but I doubt their vision problems are misdiagnosed.

I had a worrying sequence of 3s and 4s, though.

Most medical visits are like that too, in my experience -- the doctors (esp. in busy hospitals and clinics) are so busy/indifferent that they'll give you a prescription two minutes after you come in and tell them what's wrong.

I had a worrying sequence of 3s and 4s, though.

If you get to the end of the test, you're probably OK. I lost interest after a minute.

Just the opposite. Its much easier to blame your failure as a parent on ADD than to admit you suck as a parent.

>"Predominantly American" = America is a huge country with a lot of money and a lot of doctors.

Europe and Japan aren't exactly third world, and the number of ADD's diagnosed there are much, much smaller than the US.

I just find it hard to believe that condition unknown 20 years ago is suddenly found to affect some large percentage of the population in one certain country, and, oh yeah, there happens to be a drug to treat it (which the afflicted will have to take for the rest of his or her life). If you look at the history of medicine, you will see that there are many "disease fads", where a certain disease, real or imaginary, is overdiagnosed for a period of time. I suspect ADD is one of these.

I was being treated for it 20 years ago.

Well, same with bipolar disorder -- everyone's like "oh, that's the most misdiagnosed disorder EVER!" and "every 'artist' thinks they're manic depressive!" which may be true but it doesn't mean the people who actually suffer with it have been living a complete lie.

Well, if you actually read what Chris or I wrote, our point was that everyone is clamoring to let the world know there is something WRONG with their precious little children and that they aren't just normal hyper little beasties. Which is the point--it's not that it's a made up disease, it's the half the people who "have it" in the US are basically normal kids. WHICH IS BAD FOR PEOPLE WHO REALLY HAVE THE DISEASE BECAUSE NO ONE TAKES THEM SERIOUSLY. It's like any mental disorder, or for that matter low-level physical disorders as well. Everyone's gone mentalist to go rush and take Claritin, for example, to the point where a couple doctors I know have said that patients get pissed off if a doctor doesn't prescribe it to them, you know, cos they don't have the type of allergies (or any really at all) to warrant use of Claritin. Though I think Claritin has gone nonprescription now so maybe it's a bad example.

Combination of advertising + unscrupulous doctors + money mongering prescription drug industry = nation of people doped up on drugs they do not necessarily need just because it is the easiest way. Whether or not that there are people who honestly have any of these problems is irrelevant to the greater point that, in America, an awful lot of people who don't have these problems are getting prescriptions to treat them.

(xpost) I'm really not sure what your point about bipolar disorder has to do with refuting the point--it's the same exact thing. People who have real problems getting treated like shit because doctors/parents/whomever want to label every single difficult behavior a child/teen ever does as being the fault of a chemical imbalance, NOT just some sort of run of the mill problem that might actually require parenting. No one is saying that if you have a disorder, you are lying, far from it.

My mom has ADD and went undiagnosed most of her life. My sister, on the other hand, doesn't have ADD but was quarantined off as a "stupid" kid because a couple teachers decided she must have it because she was, you know, a normal middle child of average to above average intelligence. It's not fair to either of them.

Fine then, I'm off to take my Ritalin.

Contributing to a thread and evaluating different statements and following certain comments up with others doesn't necessarily = "refuting." This is a complicated issue obv.

the ironing is delicious.

Get over your disorders, get out of your parents' house, etc etc.
-- Dr. Ally, June 23rd, 2003

Says me who's too fucked up to support myself - but that's by the bye and I'm trying to get my act together and I guess if I don't I will eventually die.

http://web.nami.org/helpline/adhd.htm

zzzzzz

Of course: since none of us have any conception of what it's like to not-be-us -- have trouble knowing exactly how abnormal our personalities are -- I'm not sure how sensible that conclusion is. This is the thing I find odd about dignoses of things like ADD. It's the "sensible" approach -- be prepared to treat any child or adult whose attention problems seem to cause them some form of difficulty. But behind that, there's still the question of drawing a normative line of how easy it should be to focus on things and accomplish tasks (as if any of us can know!), whether a given person has "enough" of a problem with it to call for treatment, and surely any problem is "enough," etc (e.g., note how the bar has been lowered on what sorts of emotional problems necessitate treatment with anti-depressants).

Anyway, that doesn't make much sense, but I've been trying to sort out what I mean in my head here for a long time. I can be a very lazy person. That's a "problem" for me, it creates difficult, and I'd venture that it's far more difficult for me to be non-lazy than it is for the average person -- loads of people, for instance, have the opposite problem, and can't stand to not be doing something. There's probably some form of medication that could make me less lazy, like, I dunno, "Cocalin." At what point does something like this cross the line from just being a personal flaw into being a disorder?

Note: I am NOT in ANY WAY trying to equate ADD with something as insignificant as my being lazy. I understand that it comes in very severe forms that have much more debilitating effects on people's lives, and that there is some neurobiological basis for treating it. I'm just wondering about the principle of the thing, and how far it might extend over time.

My first exposure to ADD was the girlfriend of a friend, who, a few years on, became a business partner. She had apparently been diagnosed by a psychiatrist as having ADD at some point (after she got to college, I think), and maintained a steady diet of Ritalin and some other perscription amphetamine for the next six years (and maybe to this day, I don't know, because she got so annoying she destroyed our friendship). In this case I think it may have turned into simple drug abuse more than a psychological disorder; theoretically if you have ADD and you're taking your meds you should be alright, correct? She was the opposite; and of course if you don't have ADD but you're taking Ritalin, you sure as hell are going to seem like you have ADD, while in fact you're nothing but a ferocious tweaker. Her ADD became a very convenient excuse; she would act in the rudest ways imaginable and then later cry 'poor me,' 'so sorry,' 'i'm crazy.' She further really liked to espouse that everyone was crazy and everyone had mental disorders. A real casualty of the psychiatric establishment which, in the case of US universities, is all too happy to throw pills at you if you ask for them.

I'm not going to say that no-one has this problem or that it doesn't exist, obviously it does. But I'm worried that enough time isn't spent diagnosing psychological issues (this is true of more standard physical issues as well, as Jody said; but at least in that case there are often concrete blood tests and xrays that help shed light, even if the doctor isn't paying much attention).

See: mood disorders and "oppositional defiant disorder"

and only when they're heavily medicated

-- Jody Beth Rosen (edito...), June 23rd, 2003.

I take offense.

Unrelated to ADHD specifically, but have you seen the commercials for Zoloft? I find them somewhat troubling... they're very light, humorous, geared towards Lifetime-demographic women (and men with a "softer" edge), basically asking "do you feel down and blue and grouchy?" Which only scratches the surface of what depression is.

And I find this troublesome not because it might lead to misdiagnosis (only the afflicted individual really knows the depths of her own depression, and the subsequent treatment is part of an agreement between the patient and a presumably experienced doctor), but because the drug company itself is marketing its own product as the pharmaceutical equivalent of a pint of ice cream.

This is a whole 'nother can of worms. The marketing of pharmaceuticals directly to consumers is problematic I think.

In defense of the Zoloft, and other depression commercials, any self-screen for depression you see always stresses that the syptoms are persistent (lasting weeks at a time and with recurring episodes)and aren't neccesarily tied to life events.

(oh that self test told me I probably have Adult ADD. Doesn't surprise me. ADD often accompanies bipolar disorder.)

ADD Combined Type
Probable

ADD Inattentive Type
Not Probable

Cingulate System Hyperactivity
Probable

Limbic System Hyperactivity
May be possible

Basal Ganglia Hyperactivity
May be possible

Temporal Lobe System
May be possible

If you find that your being lazy, having a short attn span, etc doesn't affect your ability to live your life and function within that context, then you likely don't have ADD.

Using an illness as an excuse for laziness isn't what being diagnosed is about. Diagnosis is about getting help when you cannot function in your daily life. It is presumed that a person who admits that something may be wrong because they cannot concentrate goes to see a doctor, and the doctor talks to them and asks educated questions and my give them psychological screening tests or observe them. Then the doctor says "You very well may be ADD... Here's how I recommend we proceed, and it includes some medication." or the doctor says "You are just lazy, but there's no indication of ADD. You would probably benefit from short or possibly long-term therapy sessions to help you learn techniques to motivate yourself."

In either case, it's the patient who decides how to proceed, and the doctor is a resource who has more knowledge than the patient on the subject. With some mental illnesses, it is also assumed that the patient is sometimes not able to really understand the situation, and the doctor may be trusted to recognize this and recommend treatment when the patient isn't in a position to be completely rational about their needs.

This is why it is such a common problem for patients to stop taking meds... Ask a relatively uneducated (about their mental illness) Bipolar person at the beginning of a manic phase if they anything is wrong, and they will probably say "no." Because, well, they don't have depression any more, and mania feels good even though it's potentially dangerous to relationships, careers and at times people's lives.

Same reason it's so tough to diagnose kids. Cause a kid just feels like school sucks or feels bad because her parents call her lazy. She doesn't necessarily realize that there's anything wrong with her concentration.

OTM.

I wonder how the rates of illnesses--both physical and mental--would be affected, by the way, if America had a more socialist health system? Just a musing--would the rates be cut down because our health system would be "worsened" or because there is less cause to advertise pharmeceuticals (presumably) if the government is paying flat rates for them?

nabisco, I agree with that re: the grey area. The problem is that a lot of people don't want to take the time anymore and immediately jump to the drug conclusion.

Nabisco, the defining and redefining of normality through classification of psychiatric disorders (see the old classics "Madness and Civilization," and Elaine Showalter's "The Female Malady") troubles me too. As does the way some people seem to need to take on an illness and make it an identity. Whatever works for you! Depression as identity is particularly boring and tedious and not romantic in the least, I found, so I put away my Nine Inch Nails albums and made myself take more walks in the sun. :) Seriously, I am quite disgusted by the overemphasis on medication as the primary form of treatment for so many mental illnesses. Why not emphasize additional, super-cost-effective treatments such as a good diet, exercise, sunlight, a sense of humor, and resourcefulness + adaptiveness toward some of the most entrenched symptoms?

Jody Beth, incidentally, I've seen those Zoloft ads. I find them terribly sad, somehow, perhaps the saddest thing I can remember seeing on TV in a long time. Reminds me of my mom's stubborn refusal to get treatment & the cute animation is what makes it touching. You know, there are lots of women in that "Lifetime demographic" who retreat just like that into depression, and lots too who cling to childish tastes as kind of a shield against a reality that's too much to handle. (You know, like The Onion's Jean Teasdale, who I also can't laugh at since I find her too sad).

And last. Anyone read/hear lately about the European experiment (is it in the Netherlands perhaps? Belgium?) in which seriously mentally ill people - schizophrenics for instance - live with regular families? It's been a brilliant success thus far, as I recall.

To clear that up, it was a comment made in the "MY MUM IS A FUCKING BITCH" thread, to which I basically was responding to the (probably not even real) girl's very childlish moaning. I wouldn't be so sarcastic towards a person for no good reason. That being said, that attitude for me helped me a whole hell of a lot. Y/M/M/V.

I spent a good several years of my life being put on random drugs for no apparent reason other than they were new and in vogue. I was a severely traumatised teenager--which is all I'm saying in front of certain people about that at this point--not someone in need of, just for example, Paxil. If you have a neurological panic condition, as some ILXors do, Paxil is great thing. If you're being stuck on it because the doctors are lazy and getting a kickback from the corporation, it's a terrible thing.

It's really a question I have no idea on, I've never been to a doctor in a country with nationalized medicine.

OTM about the capping--I was looking into my insurance when I first started my job, and apparently I am allowed like ten visits per year to a psychologist or psychiatrist. But if you go to a regular doctor and convince them to give you a script, you can get those limitless with only a $5 copay. And yes, quite a lot of regular doctors write scripts for these things, which I think is a bit odd; it's like having a psychiatrist write a script for tooth meds.

In a lot of cases like this, meds are necessary to give the person a fighting chance to get anything out of therapy (exercise, psychiatric or otherwise) in the first place.

I'm on meds for Bipolar Disorder. They don't make my life easier necessarily, and I'm in therapy and have to make a point to do things that are good for me like interact with people, exercise, etc. Therapy and life/habit changes are extremely difficult to make, even for someone who is not ill. (How many people try to diet and fail on a regular basis?) Without medication, I can't think straight enough to always know if I'm telling the truth to my therapist (because I don't see the reality of my situation all the time) and as such I don't exactly make progress in therapy no matter how much I think I want to.

Point is, meds are not bad and can be extremely necessary. I absolutely agree with doom-e that letting the drug do the doctoring is common, although I don't think it's always the doctors doing it. I think it's also the patients who don't understand or want to accept that a drug won't fix them if they've developed years of bad habits or poor relationship skills as a result of not being treated. The drugs will make it possible for them to function in life and to be able to put energy into and get something out of therapy and behavioral changes, but the drugs aren't going to fix the bad habits or heal the wounds caused by living without treatment before the meds.

Totally, totally agreed, but the problem I think people are focusing on is not that kind of first-step medical treatment but rather that it's kind of the only step OR that it's the first choice even when people in question are not that far gone. As you said very correctly, taking drugs isn't going to fix bad habits/wounds magically...

On the other hand, there are of course cases of people for which non-drug treatments just aren't going to work because it is purely a physiological issue.

Sure, there are insurance/money/ethical/moral things here and I'm totally over-simplifying, but if you take your car to a garage and the mechanic fixes it and it still drives funny, it's up to you to take it back and say "try something else because you got it wrong" (if you trust the guy and think he made a mistake) or take it to another mechanic altogether. And it's up to you to ask any mechanic what he thinks it is, what he plans to do and why, etc.

(Whew. Okay I'm done.)

It's often the case that someone has gotten bad enough untreated that they don't have the strength or the self-esteem to even do the non-medical treatments such as exercise, diet changes, sunlight, etc.
Absolutely true. I only discovered the strong positive effects of this because I had this romantic idea of Paris, see, and it's not that romantic at all when you're basically unhappy, but it does have a lot of cheap fresh unprocessed food and you have to walk absolutely everywhere, and usually up and down ten flights of stairs each way.
Still, I do not see why, if there are a thousand freakin 12-step organized programs and ten thousand different diet groups, there can't be some organization out there that helps depressed people with a little care of the self on a regular daily or weekly basis. It's like, we do a half-hour of group therapy, and then we're all going to go for a nice walk in the park/around the neighborhood together! And you're already out of the house, so come along, why don't you!

The thing is, when you go back and say, "This isn't right" and the doctor says, "It takes a while to kick in, be patient", it's like, where do you go?

Obvious you go to another doctor etc but it just is a time consuming process, it is totally up to the person seeking treatment to find the right treatment for them but on the other hand it doesn't stop the fact that the culture of handing out scripts like prizes harms the process of "curing" a person. I guess that's what annoys me about the whole industry, why I just kind of avoid doctors and stuff. Too many misdiagnosed illnesses throughout my life, and funnily every bloody time I got put on the newest drug on the market which had a suspicious amount of paraphenalia and free samples lying about the doctor's office...Ugh.

Never mind, I'm rambling now too :)

Believe it or not, I've been in this position, and I just happen to have found a doctor I like and trust, and it was very hard to feel things still weren't right and be patient, but I did what he said, and it did take a while, and it did kick in.

I know that makes me lucky, and I don't know if it makes me in the minority or not. The whole thing is problematic and discouraging and difficult, and the doctor I mention in the preceding paragraph is by no means my first, and I am feeling now that treatment is starting to make it possible to get my life back... And I was diagnosed and first treated over three years ago and probably should have been diagnosed and treated at least 5 years before that.

The car analogy isn't quite as bad as you say (though sure it's not perfect at all), because I've seen plenty of experiences where someone just adds fluid to a transmission that's got a bad bearing and tells you the reason it's slippin out of 4th is because the fluid was low. And yeah, a month later it's still slippin out of 4th, and the bearing goes completely, and you have to replace or rebuild the whole fucking transmission.

In fact, you'll never guess what just happened to me and my car today...

Judging by the fact that I was able to complete Basic Training and the Korean course at DLI with flying colors I suspect that whether I do have it or not doesn't really matter, unless somebody plans to force me to sit in a lecture hall ever again, in which case, fuck you!

If I'm conversing with someone a foot or two away from me, and that person is saying something not totally boring, I can listen without problem even if there are other people talking in the room. Someone with ADD, on the other hand, will have a much harder time not being distracted by the other conversations and, depending on the severity of the condition, by sounds from the streets, radiators, fluorescent lights, building hums, and so forth. Also, if I'm watching TV, and someone says, "It's time to go," I understand that as a clear instruction, whereas someone with ADD, especially a child without a lot of experience, will not, and will have to be told, "Turn off the TV, put on your jacket, and come to the car." Or if I ask someone if they'd like more food, and he says, "I'm full," I understand with 100% certainty that he doesn't want any more, whereas to someone with ADD it isn't necessarily clear whether the person is full and therefore doesn't want any more, or is full but wants more nonetheless. And so forth. Now, a small percentage of people with undiagnosed ADD actually learn to think hard about what others are asking, and in learning to compensate become very good at reading others' intentions and so forth. But for most people, ADD can be very debilitating. Imagine a child in the classroom who keeps getting distracted and therefore "isn't paying attention." Well, after a while, after much criticism from teachers and peers, the child may well give up and stop trying to pay attention, and become "lazy." So the cognitive disorder is aggravated by the social response to it. And if all questions seem like trick questions, and all instructions have to be decoded, and if one's failure to follow the (to oneself) unclear instructions is punished as "defiance," then a defensive reaction to this punishment may well be to become defiant. So, for someone who genuinely has ADD, whether drugs like Ritalin help or not, or some form of counseling, it's crucial that s/he and the people around understand the condition.

That is what I've been told. Maybe there's no such thing. I sure notice differences in people's behavior in the evening when the Ritalin wears off and to take more is not healthy because it would keep one awake at night.

The increasing diagnoses are no doubt partially a fad, partially the result of greater awareness - and maybe the condition is increasing as well, as seems to be happening with autism.

(b.t.w. I'm undergoing the medication and cognitive therapy route at the moment to see if it helps, i.e. to see if there are underlying medical reasons for being this way, or if I am just a miserable antisocial lazy git)

Spelling's no problem for me (I've always been good at seeing things in their totality before my mind breaks them down into smaller parts, and this applies to the way I deal with language). But I can't follow directions for the life of me -- someone'll say "turn left here, then walk four blocks this way, then turn right" and I'll stop paying attention by the third word even though my mind is desperately trying to focus.

I take Adderall, and it surprisingly does help some. Not in all situations...I still drift off occasionally...but the amount of focus and motivation it gives me is pretty surprising. However, it also makes me EASILY irritated, and I often find myself yelling at the top of my lungs at the people who mean the most to me in my life. I also get dizzy occasionally, although it's infrequent and pretty mild.

It's a really tough decision, though; to be honest, I STILL don't know what to do.

My constant debate is:

1. Keep taking Adderall, pick up some motivation in my life - to be able to start writing songs and reading books at a regular basis - two of my main interests. Be able to focus at almost all times. This, of course is at the expense of some of my happiness and also that of those around me.

2. Stop taking Adderall, and therefore be a very pleasant person to be around...however, come home from school, stare at my computer, eat dinner, stare at my computer some more, and go to bed. Stare into space during school, and not even consider getting any work done at home.

That second option is a really horrible way to go through life. The first, however, I'm not sure is any better - I'm constantly yelling at my girlfriend, for example, and then defending myself instead of apologizing. When I'm not on it, we're always happy and get along fine.