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Comment by wpietri | Hacker News Reader

It seems to me that this study proves something I have long suspected: whatever the neurological reality of this disorder in people who actually have it, the diagnosis is often in effect something like "Teacher Inconvenience Syndrome". And the practical upshot is that rather than build an educational system suitable to children, we are willing to drug them for the convenience of the current system.

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I was diagnosed ADD in 6th grade, took medication and it greatly helped me, so a bit biased

I was told the disorder is not just about not being able to concentrate or sit down. It’s more about lacking executive control that helps you to focus, stay sitting down, or keeping your mouth shut. Makes you more prone to all sorts of behavior that loses you friends and makes life generally miserable.

During my diagnosis a lot of discussion happened around non-focus things, and possible alternative solutions (including CBT through a school program, which was pretty good now that I think of it)

This was 15-odd years ago. I think that popular culture goes along the axis you say, but the reality is professionals are trying hard at the diagnosis phase I think? But meanwhile this comment means I get the “lol so you can’t concentrate? Not a real illness” BS that plagued people with clinical depression forever if I ever discuss this with certain people.

That being said, the school system is uniquely challenging to all children who have executive control difficulties. Almost nobody’s adult life is as complicated as “trying to fill the demands of 10 different teachers in a week + also grow as a human”.

But at least for me, discussion during diagnosis went beyond just school, because it does affect all parts of life in nasty ways.

It doesn't help at all that the common medications are mild, situational nootropics with grossly inflated PR. Usually you say something like "I got a prescription for X and, instead of overdosing and dying, stopped having episodes" and people immediately realize that you're not making things up. Unless the prescription that fixed your brain was Adderall, in which case they just accuse you of being addicted to speed and try to lecture you about drugs.

I've started saying that I have a neurological issue that interferes with memory and concentration. Having been diagnosed at age 27 also helps. People react much better when they're not being blind, bigoted asshats.

How does this reconcile with wampingwillows original comment, (must have shown symptoms by age 7)? If you don't mind my asking.

You can show symptoms and not be diagnosed. For example, "at his parent's request, had his hearing tested 4 times before age 8 despite there not being any difficulties" could be evidence that inattention was evident, even though it was mis-diagnosed at the time. They may have been labeled "lazy" or "space-cadet" without being offered any practical support: especially among women who grew up in the 80s, it's pretty common to have not been diagnosed despite having a clear history of symptoms.

> They may have been labeled "lazy" or "space-cadet" without being offered any practical support

Yep. For the longest time I just thought that I was lazy and disorganized and that all the "brains" everyone said I had were useless because I just made stupid mistakes continually. Everyone knew I had issues, including myself, but because everyone just thought I was forgetful and lazy the only help I got was well-meaning advice from friends and self-help books.

The really fun part: other people have stated in this thread that therapy, absent pharmaceutical assistance, has effectively no value for ADD. I believe it. All of the advice I got and tried, over a decade and a half of real effort, had about as much of an effect as spitting into a hurricane. People's personal organisational tricks are woefully insufficient for ADD, just like with every other real mental health problem in existence.

I understand that.

The parent for example had a gap of 20 years. It just seems strange to be relying on 20 year old notes, rather than what you see before you.

I don't know anything about the subject, and not saying anyone is wrong or anything.

It just seems very strange to me, how many parents didn't bother taking their children to the Dr X number of years ago either because of money, or just because ADHD wasn't a thing, so the parents thought the child was just naughty? Unless you start relying on the 20 year old recollections of random family members, which doesn't seem better in any way better than diagnosing them based on the here and now, which is ultimately what is important. I would far rather we treat people that have ADHD now, rather than had it 20 years ago.

I wasn't diagnosed until half way through college. I got mostly As until sixth grade, then a gradual decline began. I graduated high school with a 2.something GPA. I think the decline was gradual enough that I guess it didn't set off any alarm bells in the guidance office.

Also I was much more the inattentive type than the hyperactive type.

During my diagnosis I was able to bring a bunch of report cards from my entire school career. That was useful. I empathize with parents who face the dilemma of having a child evaluated, without so much data to go on but with the pressure of not wanting to wait too long in case there is an issue.

The form of hyperactivity I had was mostly fine to the teachers during my first years of school, but my inattentiveness made me unable to complete writing tasks and this was clear from my first year at school. Medication helped a great deal with this and more importantly it showed me what I could be capable of and I think it helped me develop coping strategies.

I wasn't long on the medication, even in the 1980s there was a backlash against the overprescription and side effects of Ritalin so my mother took me off it. Later during my school years my hyperactivity was a problem, in a different school where the teachers were more strict. I received beatings for things like not sitting still on my chair and for messy handwriting. Medication could probably have helped here and also with my academic performance, though the school and the teachers really should have been more accommodating and understanding around what are rather trivial behavioural differences in the greater scheme of things.

Thank God, I don't have to deal with different people constantly giving me random sheets of paper I have to use and hold onto for 6 months at a time.

It makes me wonder what role overstimulation at home plays in diagnosis when kids are dropped into an environment where they must abide by certain structure. I am not qualified to comment on the disorder itself but part of me thinks kids are exposed to vastly different environments today than they were for example 20 years ago. At home you have all sorts of things - devices and increasingly complex games & toys that stimulate the mind, and when you're put into a school environment, you're supposed to all of a sudden conform into that "sit still and learn" mold? To what degree is this accounted for in the diagnosis? I grew up in a totally different time where stimulation was somewhat consistent from home to school, but I can't even imagine what kids are dealing with these days when they are exposed to high tech devices, games that interact on a whole new level than they have before, liberal parenting to controlled environments - that must count for something?

5-6 years old don't really play those increasingly complex games. They play games on simple level. When I was young, ADHD was blamed on tv.

There is big difference between ADHD and bored neurotypical child. It is not just walking instead of sitting, it is jumping on the table running around hitting kids so wild that other kids are scared - and kid is unable to control it. The same kid can be in control and all good and then suddenly loop to out of control mode in second.

There are behavioral issues related to games in my observation, but those are temporal and milder. Mostly that kid act like a jerk right after playing or during playing. Also there is ... not so great culture around gaming streams that makes kids think that being jerk is cool. It however does not cause ADHD like behavior (nor violence it seems to be).

In the disability rights movement, disability is defined basically as having a trait that the social and built environment discriminates against: a disability is something the society is doing to you, not a flaw in yourself.

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