Having not yet clicked on the first link, also the not-so-hidden cause behind various other mental health epidemics, including probably autism, as well as the not-so-hidden cause in the dramatic decrease in diagnoses of other mental illnesses that aren't funded as well.
You should repost this one at the top of the page tomorrow. It has been unjustly ignored. (I must also ignore it in favor of work for the rest of the afternoon.)
Ironically, I missed this earlier because, after starting on stimulants, I spend much less time distracted by Unfogged.
First you need to see the school doctor, Moby.
My school never even had a nurse. They'd just hire one for the day as needed (lice, scoliosis checking). We didn't have any drugs except chewing tobacco and liquor.
I think Di linked elsewhere something like "Do you have ADHD? A Checklist" and it was amazing to read down it and verify that nope, in no way do I have anything like ADHD.
Which was odd because lice don't even have a spine.
Not "amazing". Maybe "convincing".
I'm pretty sure I have something like ADHD. The continual leg bouncing is a bit of a tell.
Maybe you just have a leg squirrel.
I would actually be happier if you (or, more to the point, I) could get ADD drugs without a stupid "diagnosis" by a "doctor" or whatever. They're so handy.
I'd be happier if I could buy wine in the grocery store.
I have the bouncing leg thing. I don't think that's related.
I'm in that frazzled mode where you read on FB that someone is headed in for surgery and you all hear is "They get to take a forced vacation, in a bed, and people are going to bring them food for a couple days."
15: Wouldn't that fall under the 'H' part of things.
10: I sort of figure I do too, but I'm also too firmly committed to the belief that all my problems are the result of bad character to actually look into whether getting drugs is appropriate.
I have had colleagues come pretty close to admitting they obtained bogus diagnoses of learning disabilities for their children in order that the kids would have extra time to take tests. The implied justification was that a very large percentage of the students at the kids' competitive private school had similar diagnoses/accommodations. Having their child take drugs would be a completely justifiable next step in their minds I am sure.
6: I'm still a little bitter that no one noticed my scoliosis during those tests. I was anorexic and bony and there's a full S curve and my ribs are off by well over an inch. So what gives? (Secretly I blame myself and my own anorexia, that I must have been fine and then done something that messed up my back but no one noticed, but I doubt this is true since a few bumpy bone edges of my tailbone used to rub the skin raw against my desks and I doubt people who had theirs in the right place had that happen.)
That does seem like a big miss. I got culled for further review with just one little bend, as opposed to a full "S", caused by one leg being less than 1/2" shorter than the other.
I would actually be happier if you (or, more to the point, I) could get ADD drugs without a stupid "diagnosis" by a "doctor" or whatever. They're so handy.
No, no, you were right the first time. Meeeee.
All I want is a sleeping pill that lets me keep my eyes open while I sleep and that wake up when somebody says my name. Just the second part would be great, because conference calls.
Thorn, on an utterly frivolous note - how did the ringlets work out? And have you tried curlformers? If her hair isn't too thick they are great, and no heat. Also, they look amazingly ridiculous when in, highly amusing.
I want to be as productive at home as I am at work. I just can't seem to pay attention to my own life with the same attention to detail and speed.
27: For Nia? Total disaster, but they won prizes for dancing and tumbling nonetheless. I probably should have used some heat to get them to hold, but I'm really not sure. Everyone else had the kind of curlers where you clip on the little mesh thing on the outside, whereas ours were with clips and I'm not sure if that had an impact. I did use a hair dryer on her, but nothing much happened. She just had a coily afropuff, and I think so did the other black girl.
With Selah, just about the only style her hair takes easily is finger coils, which leaves her looking like a tiny Shirley Temple. I have tried those on Nia and still may next time we detangle her hair. Right now she's just looking forward to getting out of cheerleading season and being able to do something that doesn't involve a ponytail. And I could do curlformers on the full length of her hair (and have been tempted) but once it's in a ponytail, the longest parts are only maybe 6 inches stretched and that didn't seem worth it for buying curlformers.
7: ha. I took one of those almost a decade ago and it said something like "if you score this high, you should immediately seek help." So I laughed and did nothing.
The test scores model suggests that, assuming the disorder is real, it would take forever for academically successful kids with ADHD to get diagnosed and treated, if it's seen as treatment for not being demonstrably good at school. Not that I have any stake in, uh, um, sorry what? I didn't have time to finish reading the OP article last night because I was memorizing more album tracklists, but the above point may already have been made there.
When I did one of those ADHD checklists in highschool I basically aced it. Every once in a while I consider trying drugs, but based on my disliking caffeine, I doubt I'd be into Ritalin.
Does the increase in test scores caused by Adderall correlate with ADHD symptoms? Or does everyone get roughly the same boost?
7 Someone else here posted an article on "ADD is Different in Girls" and it was remarkably (and somewhat embarrassingly) familiar. Awareness and education--I'm getting used to making mire checklists and setting alarms/reminders, e.g.--are probably more helpful than the stimulants. But stimulants definitely help.
it would take forever for academically successful kids with ADHD to get diagnosed and treated
My doc made the same point. Hyperactive kids get noticed because it is a problem for the teachers/class. Inattentive kids who do well on tests are a pleasure to have in class and who would want to mess with that?
Or does everyone get roughly the same boost?
They're performance enhancing for everyone.
Yeah, Adderall is really just speed. Speed works pretty well for everyone on the assumption that you actually do the work after taking it. Erdös, for instance, probably didn't have ADD.
33, 34: Interesting. We had some discussion of Adderall in a faculty meeting Monday and this question came up, and several people asserted with great confidence that it only helps people with ADHD and impairs performance in everyone else. I assumed they knew what they were talking about, because who ever heard of a physicist confidently making assertions about something they don't actually know anything about?
I'm not saying I can tell you from personal experience but, no really, it's just thoughtfully designed speed. It's entirely possible that it does something qualitatively different for people with ADHD, but if you need to, for instance, crank out a dense manuscript in very little time, it's great.
Huh. Maybe I should suggest at the next meeting that we keep an Adderall dispenser next to all the coffee machines.
The discussion was supposed to be about academic integrity, and someone asked whether we should view performance-enhancing drug use as an academic integrity problem. I was about to ask them whether they shun caffeine, but then I remembered that it's best to hide quietly in the corner at these meetings and hope no one notices I exist so I don't somehow get put on a committee.
And since I'm through a quiz that I've been stressing about for four days, and have been rewarding myself with watching The Good Wife, let me further reward myself by bitching about one of my favorite things to bitch about:
Which is not to say that A.D.H.D. is a made-up disorder. In fact, there's compelling evidence that it has a strong genetic basis. Scientists often study twins to examine whether certain behaviors and traits are inborn. They do this by comparing identical twins (who share almost 100 percent of the same genes) with fraternal twins (who share about half their genes). If a disorder has a genetic basis, then identical twins will be more likely to share it than fraternal twins. In 2010, researchers at Michigan State University analyzed 22 different studies of twins and found that the traits of hyperactivity and inattentiveness were highly inheritable. Numerous brain-imaging studies have also shown distinct differences between the brains of people given diagnoses of A.D.H.D. and those not -- including evidence that some with A.D.H.D. may have fewer receptors in certain regions for the chemical messenger dopamine, which would impair the brain's ability to function in top form.
GAAAAAH. So much fallacy. ADHD is not rendered "a real disease" by the existence of biological correlates of being diagnosed with ADHD. Many, many personality variables will have detectable biological correlates. It is a decision by society when and whether to label the extreme on a personality trait as pathological, and where the cutoff should be. Neuroimaging studies are relevant to understanding the biological underpinnings of variation in attention and hyperactivity, but they are totally irrelevant to whether something is a "disease" or should be treated as one, which is a social decision. It's of course true that rates of diagnosis of ADHD are strongly influenced by cultural factors and incentive structure, but it's not the case that this inflates the diagnosis rate beyond some putative "true" rate. The criteria for diagnosis in California and North Carolina are both social conventions, as is the idea that inattention and hyperactivity are diseases that should be treated. That doesn't mean it's a bad idea to give people Adderall; the utility of the disease label is a function of its consequences in context, and its consequences for the context. That's what needs to be evaluated in the decision about whether an individual "has ADHD" and whether rates of diagnosis of ADHD are too high. I actually think I meet DSM IV (not sure about V) criteria for ADD w/o hyperactivity, including the rarer "a reporter will say you had problems before you were six" criterion, but whenever I say that, I make sure to add: a diagnosis is an arbitrary social convention and when I bring this up it's only to say that I'm interested in considering whether using a disease model to understand these issues would help me adapt and perform in context.
|| 8-1 is a pretty good way to start. |>
39: okay, but come on, the "diagnosis is a social convention" thing, while evidently true and useful to understand when it comes to mental illness, is much harder to fit to, say, diabetes and really dogs the disease model of mental illness in ways that, frankly, might actually serve to discredit that model if it can't be reconciled with what people usually mean when they say "disease".
(I know it's more complicated than that, but you can't just blow off people saying "wait, I need a stronger causal case for the existence of this thing" because as noted, it's more complicated than that.)
There's an interesting analogy to "intellectual property" in there but SO BANNED.
rewarding myself with watching The Good Wife
Watching Sunday's episode now. I always love an episode with Elsbeth Tascioni.
I think I need some Vasopressin. I think that liver spot stuff has been building up in my brain for awhile now. I'm just not as clever or inventive or intrigued by things as I used to be, even when I'm not depressed. I dunno, maybe it's all for the best. If I live much longer, I'll probably have to get a job as a greeter at Wal-Mart or something, wouldn't pay to have too much mental acuity left at that point.
I think the most effective way to use drugs to help me concentrate would be to render everyone who knocks on my office door unconscious so I could get time alone to work.
I don't claim to be able to say anything about non-mental illness. The disease model of mental illness is also not so precious to me that I'm concerned about it being discredited. At the moment it's pretty overly reified and I don't think it is 100% consistently a perfectly salutary way for people to understand their own issues.
Anyway, of all mental illnesses, ADHD has about the worst claim to be a disease the way cancer is a disease. I can't think of any that works more transparently like: look, here is a personality trait. Here is a trait we'd like to remedy when it becomes extreme because these people adapt poorly to their current context. We will choose a cutoff.
Further, while I think diagnosis is a social convention, it's a separable point that the heritability of a trait and our ability to detect biological correlates of it don't do anything to establish it as a "disease" or "not a disease."
I have strong opinions about this subject, but I can't remember what they are. I'm kind of sleepy.
40 gets it exactly right. Shouldn't Rob the Masshole be in here celebrating, too?
He seems to have mysteriously disappeared in the last day or so.
Typical arriviste Red Sox fan.
I'm just not as clever or inventive or intrigued by things as I used to be, even when I'm not depressed.
Nat, you may just be less depressed than your normal when you think you're not depressed.
several people asserted with great confidence that it only helps people with ADHD and impairs performance in everyone else
I hope you responded appropriately with a forceful kick to the groin while yelling something about "let me Google that for you". Seriously, it's not exactly recent news. In WWII amphetamines were given out like candy in both Axis and Allied powers precisely because they work very well.
There is no joy, only less pain. One conviction keeps me from the abyss: literally everyone who is a Cardinals fan is a total racist.
That particular condition is pretty common among Sox fans as well.
52: My stupidly snarky question at a division safety meeting in 1988. "Given Ben Johnson's results at Seoul, are we going to reconsider our position on performance-enhancing drugs?'
Where are the scrappy white guys of yesteryear?
I'd say the benefits to the general population are pretty well recognized.
They're not as athletic as players today.
Nat, you may just be less depressed than your normal when you think you're not depressed.
This seems extremely plausible to me.
I actually think I meet DSM IV (not sure about V) criteria for ADD w/o hyperactivity, including the rarer "a reporter will say you had problems before you were six" criterion,
Huh. Come to think, I've got that one too.
whether we should view performance-enhancing drug use as an academic integrity problem.
Dang it, I've got a post in my queue that's very close to this.
In short: Friend's boyfriend is in grad school, has been on ADD meds forever. He doesn't believe he needs them anymore, but his productivity plummets when he goes off them, so he feels trapped to stay on them.
My basic fear is that our societal obsession with productivity will normalize speed-based productivity. I want us to reduce our expectations of productivity, not increase them.
Now to figure out something else to post.
Sorta kinda related: We Are All Criminals
My basic fear is that our societal obsession with productivity will normalize speed-based productivity. I want us to reduce our expectations of productivity, not increase them.
Right, and this is one of the many problems with "[X mental illness] is a disease," at least when it's incorrectly understood as some kind of revealed scientific fact as opposed to a model to adopt or reject flexibly. It suggests that problems in adaptation are problems in the person, rather a problem with how the person is interacting with a situation. Similarly, "depression is a disease," when interpreted rigidly, turns an interpersonal and social problem into a problem that exists in an isolated brain, and discourages looking at a person's immediate context and the larger social organization as causes of depression. So when I think of saying, "I have ADHD," what I really mean is, "I think I would get something useful for my goals from taking Adderall," but I recognize that there may be a problem with my goals, and that given my goals stem from fully internalized social values about productivity, I'm not even fully equipped to critique them.
So what do people do post-Bupropion? SSRIs do not seem like a good bet -- lots of side effects (in me) and problems with a "serotonin crash" every day. The Welbutrin has been treating me pretty well, but I feel like I've built up a tolerance to it now, and it is only minimally effective at smoothing things out.
65: Pristiq, maybe? If you figure out an answer, it might be useful here.
FWIW, I've had good results with Viibryd. It's not on my formulary and I can't get a pre-auth, but my shrink is hooking me up with sample packs in order to cover me. Augmented by Abilify and regular exercise, I'm actually pretty up these days.
65: Abilify+Wellbutrin is working wonders for me. Also exercise helps a lot. Given my ongoing job uncertainty I'd be a wreck if it wasn't for the meds and exercise.
A question, in case anyone sees this in the next few minutes: is there any correlation between ADD and lower reading(-with-full-comprehension) speed? Those of you who have or think you have the disorder: do you read as fast as you'd like to? I find my reading slowness very frustrating and can't seem to speed it up; suddenly wonder if it's related.
66-68: Thanks! I'll talk to my doctor about those options.
69 That depends on the material you're reading. If you find it interesting you may well read it at a much higher than normal reading speed but if you find it tedious you're reading speed will be much slower than normal with reduced levels of comprehension. Of course, most people experience something like this, it's just with ADHD the tendencies are exaggerated.
is there any correlation between ADD and lower reading(-with-full-comprehension) speed?
I am quite certain that this is what is going on (at some sub-clinical level) with my son's reading. He was reading below grade level for a long time. Now he is reading at grade level, but it is still very slow. He's never been diagnosed ADD/ADHD, but he has always been at least one notch more hyper than every kid in his class.
I sit down to read with him and his eyes dart all over the page. He reads the first half of a sentence, and then the second half of a sentence two lines down.
The problem isn't just that he can't sit down to read a book because LOOK A SQUIRREL! Even when he is focussed on the book, he can't focus on one line at a time.
So there's an anecdote in place of data for you.
If you find it interesting you may well read it at a much higher than normal reading speed but if you find it tedious you're reading speed will be much slower than normal with reduced levels of comprehension.
The problem I'm seeing goes well beyond this. Joey is obsessed with the Origami Yoda books. He loves it when we read them. It takes him forever, though, because the words to not enter his brain one at a time in proper order.
73 Wait till he finds something that truly fascinates him and he'll rip right through it and you will be awed by his concentration. ADHD hyper-focus can be a wonderful (and terrifying) thing. Unfortunately, he won't have much control over just what that topic is.
74. That sounds like something other than or in addition to (co-morbid with?) ADHD.
Well, he doesn't have an official diagnosis of anything. He's just squirmier than all the other kids his age and I've decided this relates to his inability to stick with a line of text for very long.
You have my sympathies. How old is he?
I think the problem is that a) I'm somewhat slower than fast readers I know, and/or the typical humanities ABD, and b) I get distracted easily, sometimes by the very slowness of my progress through a text. I think I mentioned once before that reading is very auditory and that, while I can read French, I read it in my own bad spoken-French accent in my head and it's totally disheartening. (Can I not at least get Isabelle Huppert as a plugin?)
rob, you've ruled out dyslexia?
On the greater topic of disease, I found this suspiciously succinct and clarifying, via a long discussion of ADHD and bipolar disorder. Of course these are bad pictures of underlying function, and maybe better maps will come along, but they're not worthless pictures, and there's clearly some normal/pathological distinction.
"reading for me is very auditory"
rob, you've ruled out dyslexia?
No, and in fact that that is the diagnosis they basically gave me when I was his age (8). These days they almost certainly would have given it, because special attention now requires some sort of official diagnosis. With me they were willing to tiptoe around things.
This is partly why I was interested in the discussion we were having earlier with Sifu about whether dyslexia is a problem in visual or phonological processing. I'd really like to know what is going on in my head and in Joey's head.
To this day I have one reading speed--slow. I read everything like I'm deciphering Hegel, which is why I'm lucky to be in a job that includes things like reading Hegel.
FWIW, I was diagnosed with ADHD as an adult. And when I write diagnosed, I mean I went to several different big name specialists including a clinic which specialized in testing for attention related disorders in adults. No bipolar (thank the gods), but I have had some fairly severe depressive episodes in the past. I was too old for ADD to have been recognized when I was a kid but the comments on my elementary school report cards that my parents saved were classic. Can't sit still, can't finish tasks to completion that don't interest him. I remember when my first doctor mentioned I might have it (being in my second year of a PhD program which I did not finish largely on account of this) and going down to the local bookstore and getting a bunch of books down off the shelf to read about it - Until then I'd thought it was a crock from the things I'd read in the news about it- and being reduced to tears in the aisle of the bookstore because it had me pegged.
I have experience of a variety of medications for ADHD although I haven't been taking anything for it for about the last 5 or 6 years (which may be a mistake as I attempt to complete this second master's degree - we'll see...). There was a time in my life when I was actually grateful for it, you do tend to make connections that others don't and to notice things that go unnoticed by most people anyone who has taken a walk with me in the woods can attest but it really interferes with trying to have a normal functional life and at this point if I could get rid of it without medication I'd do it in a heartbeat.
Speaking of being distracted, does anyone else have trouble training junior people because every sentence turns into "Here's a ten minute digression on something you should know about but probably don't yet." It's got to be maddening to listen to, and I'm not really expecting them to retain it all, but I figure if I spew relevant but not immediately necessary information incontinently at people, they'll at least have a sense of what sorts of things it might be productive to ask me about in the future.
Speaking of being distracted, I keep looking through the list of dogs at the rescue where we got our dog. I want six more, including our dog's brother, who got returned.
If you glue them together it only counts as one dog for tax purposes.
does anyone else have trouble training junior people because every sentence turns into "Here's a ten minute digression on something you should know about but probably don't yet."
Oh god yes.
Today I gave the first half of an hour-long talk, and it took me 90 minutes because I threw in two extended digressions on things I thought everyone in the audience should know but maybe didn't.
I have no junior people to train, but this is my traditional way of giving advice to younger grad students or undergrads. We should start a support group or something.
A guy I once knew praised a beloved ex-girlfriend for various virtues, including "efficiency." I remember it to this day because, upon reflection, I realized I was basically a human Rube Goldberg machine, the exact opposite of this girl. But have you ever heard anyone, much less a romantically interested person, describe someone else as "efficient"? It was so odd.
In a certain sense, premature ejaculation is efficient.
I threw in two extended digressions on things I thought everyone in the audience should know but maybe didn't.
Generally before I do something like this, I confirm that there are at least two people in the audience who actually don't know the thing in question.
It took me a while to learn to do this.
88: Wait, this is the male half of LK? I can never keep you guys straight.
rob and lk, I have two good friends (both guys) who have a similar ADD-slow reading link. Same story with elementary through high school where they really struggled doing assigned reading. Both are extremely smart and ended up as really solid researchers, but neither likes to read. One told me he hates thinking of the potential time investment (as in, 100 pages per week if he really works at it) to read a book for fun. In fairness, both read plenty of short nonfiction articles and turned out to be lovely and interesting people.
91: Christ, I can't write today; it must be my hopeless lady brain. The guy was talking about his own beloved ex-girlfriend, not my ex-girlfriend. (I do for the record have ex-girlfriends of my own, although rumors suggest that the girl I dated in high school later became a guy-- so you can't infer anything here, sadly. Or happily. Or neutrally.)
79: hm. I didn't find that link so succinct or clarifying, but I did really like this sentence: "Throwing away the diagnostic labels, then, can be the key to recovery. But first, we have to play with the diagnostic labels. Be smart. Question everything ..."
It's exactly the approach to diagnosis that I think is helpful; it's something to use, one way to understand the problem, sometimes a very helpful one, particularly if it gets you on a medication regimen that improves your life.
Anyway, it's not that I don't think there's a normal/pathological distinction. I just think we choose where it is, the choice is a complicated output of the person's behavior what we want and expect from people, in many cases the person's behavior may be manifesting in an unhappy way because of their milieu, and in another environment with a different developmental trajectory they may have been okay, and finally, these biomedical labels focused on individual pathology do a lot to mask interpersonal and social causes of mental illness (and the existence of those causes is very well supported by data!).
I further think it's very confused to say "these brains are different from these others, ergo the difference is disease." I wonder if this confusion doesn't stem in part from Thomas Szasz arguing that you'd never find a biological signature of mental illness, which from a present day perspective looks just crazy, since you can find all sorts of biological signatures of not just things we're calling "mental illness" but all kinds of mental variation. It's hard for me to understand what people were thinking even then. I get that they didn't have our technology, but what did they think do the work of instantiating personality, if not people's brains and bodies? Why did they not imagine at least the theoretical possibility that we'd invent assays to see more of what our bodies were doing? But anyway, maybe because there was this influential critic of psychiatry who claimed that mental illness was not a disease because you'd never find a biological cause or correlate, people take the existence of biological sources and correlates of variation as proof that it is a real disease. But both arguments are bad. If personality variation that we call non-pathological correlates with differences in brain function, and it does, then showing a differences in brain function doesn't establish something as "a disease."
Just noting that "Viagra Professional" is some amazing branding. For when you need a little help getting inappropriate erections in a corporate setting.
96: now just look what you've done
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