Again and again and again. Psychiatry is an epistemic mess.
Psychiatrists are touristic guides of the Paris catacombs that orient themselves with a map of the subway.
Perhaps this Brave New World, as opposed to the more agrarian one our species had been accustomed to, pushes many of us over that threshold.
I was surprised by how cleanly our results came together,” said Pan, a neuroimaging expert with the West China Hospital of Sichuan University and the Turner Institute for Brain and Mental Health at Monash University in Australia. “We used no clinical information whatsoever in the clustering, and yet the three biotypes that emerged mapped well onto clinically recognized ADHD presentations.
Really cool that this worked out. Now I want to get my brain scanned...As if questionnaires and slot-machine prescription medicine treatments are accurate. I don't want to generalize for lack of statistical data, but reports of psychiatrists 'just phoning it in' while providing little actual patient engagement are widespread.
The meltdowns stopped, but I still have issues spiralling into thoughts of failure and being a horrible person when I feel like I’ve disappointed family or friends.
Guanfacine has helped though. Tried a bunch of medications and this is the only one that seems to have made an impact.
Here's a similar study from some years back which doesn't have that flaw: https://pmc.ncbi.nlm.nih.gov/articles/PMC6880188/
To me it seems that if it’s not „treatable“ the same way ADHD is, I’m not sure if it’s useful to categorize it as such. On the other hand, I’m happy if kids with this disorder can get a diagnosis and treatment that actually helps them sometime in the future due to this research.
Another interesting thing that's not in the DSM - very high likelihood of balance / motor control problems (clumsiness, falling).
I don't have a solution, as its an inherently hard problem with a lot of risks (like giving medicine to the wrong person). But I also think this desire to have nice categories for things can be counterproductive in a lot of cases.
I personally think rebranding aspergers + Autism to the autism spectrum was a mistake, as there's a huge difference between someone who's really good at their job but weird and despises certain workplace nonsense - and someone who can't take care of themselves.
ADHD is another great example of a bucket that makes non sense. We were evolved to be hunter gatherers that get many hours of walking or running, and other physical activity every day. Then we act surprised when 11 year olds don't want to sit still 6 hours a day, or getting people like me to write a JIRA ticket is like pulling teeth.
I think separating out these large categories into smaller ones is a good step, but ultimately I think the categories are a counterproductive solution to our human urge to find a logical explanation to things.
And a bit of nature, a bit of nurture.
It’s a real double edged sword for me.
On one hand relationships and “boring” tasks feel insurmountable. When I say boring I don’t even mean boring in the traditional sense, I just mean “not novel” - so even something like playing my favourite ever video game gets extremely difficult once the novelty is gone.
On the other hand, as a software developer, working on novel concepts or exploring novel concepts or ideas is basically like crack-cocaine, I literally can’t stop or put them down.
Double edged sword is struggling with most basic tasks, but excelling at the peripheries.
...
> For children with this extreme form of ADHD, standard behavioral strategies may fall short. DelBello said that widely used approaches such as positive reinforcement — like giving prizes or other trinkets, or extra recess for good behavior — do not always have the intended effect.
I'm a former foster parent who adopted kids from foster care. Two of them were diagnosed with RAD[1]. This "extreme form" of ADHD aligns with both my personal experience of RAD and a subset of the symptoms described by clinicians. Attachment issues in general are either commonly comorbid with, or misdiagnosed as ADHD and ODD[2] (the latter of which also somewhat matches the symptoms from TFA).
I don't really have a point here, just an observation I wanted to make.
1: https://en.wikipedia.org/wiki/Reactive_attachment_disorder
2: https://en.wikipedia.org/wiki/Oppositional_defiant_disorder