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Comment by 908B64B197 | Hacker News Reader

With shrinking recess time and PE disappearing from some schools, I also wonder if a lot of this is caused by boys having more energy and needing more movement than girls. Energy has to go somewhere so it ends up manifesting itself in behaviors that are deemed "disruptive" (really, not sitting still and being unable to concentrate on tasks).

Maybe it's something that female administrators and teachers fail to understand.

It would also explain the current epidemic of ADHD and especially ADHD medication prescribed to young boys.

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Future generations will consider us barbarians for dosing our young boys with drugs because we providing them with physical education/exercise was inconvenient to us. They'll also be able to datamine the internet from this time period and use our own words to hang us.

That's a rather utopic view.

Roko's Fitness Trail?

It'll be a long time yet. We haven't even moved past cutting pieces of them off for cosmetic reasons.

What? religion has been doing that for thousands of years.

Indeed. My point is that we haven't matured to the point of respecting our children enough to not mutilate them, which is a far more basic accomplishment than respecting their psychological needs. We force teenagers to adhere to the sleep schedules of adults despite numerous studies indicating doing so damages their health and academic performance. There are a lot of steps between where we are now and a society that will condemn us as barbarians for not providing boys extra PE.

Depends on the medication. If they're on stims in particular, and the meds actually improve their behavior, then the cause most likely isn't insufficient PE time.

Non sequitur

But it is, because we're talking about persistent deficiency of certain neurotransmitters in the brain, that's most likely[0] due to different brain makeup. You can't do enough PE to mitigate this and have enough energy left for everything else.

[0] - I say "most likely" because I didn't investigate the claims that MRI can pick up on the difference. But from my initial difference, the effect is still hereditary, in at least large part genetic.

The effect of amphetamines on kids with ADHD is to improve school performance.

The effect of amphetamines on kids without ADHD is to improve school performance.

The effect of amphetamines on kids without ADHD but who've been diagnosed with ADHD because they're not getting enough exercise is... to improve school performance.

Amphetamines aren't magic. There are qualitative differences in response between people with and without ADHD, that manifest across the board, not just on few school metrics - and a psychiatrist will be able to see them.

The "young unruly boys without enough PE" is a well-known trope, and modern school is very much kid torture - but I'm not willing to say yet that we're medicating children too much, when the world is only slowly waking up to the fact that we've been underdiagnosing ADHD by at least factor of 2 - this stereotype of unruly boys means the Primarily Inattentive subtype of ADHD is being frequently ignored (vs. the Primarily Hyperactive that creates all the stereotypes), that girls suffering from ADHD are not being diagnosed, not to mention adults.

"By high school, nearly 20% of all boys will have been diagnosed with ADHD."

Either 1. we are medicate children too much and schooling is very screwed up or 2. 20% of boys defective to extent that they require amphetamines. I am not see third option. I am not believe 20% of boys defective to such extent. So I believe we are medicate children too much.

[0]: https://www.esquire.com/news-politics/a32858/drugging-of-the...

Well, yes. About ~10% of US kids.

How about 3: schooling is increasingly good at exacerbating symptoms of a problem that's considered to be strongly genetic[0] (a point curiously omitted in the article you linked) and widespread in the population. And the numbers seem less surprising if you consider that adult life is also good at making the symptoms apparent - except we brush them away with labels like "lazy", "unorganized", "chronic procrastinator", "rude", etc. and let people figure out coping mechanisms on their own, which often include substance abuse, or on the lighter end, self-medicating with coffee and cigarettes.

[0] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3245028/#__sec1... points to "strong genetic influence on ADHD with estimated heritability ranging from 75% to 91%".

20% is how many boys that age were ever diagnosed with ADHD. 89% of children ever diagnosed have a current diagnosis. Only 62% of children with a current diagnosis take any medication.[1] So much fewer than 20% take a specific medication probably.

Almost 40% of boys that age need vision correction.[2]

[1] https://www.tandfonline.com/doi/full/10.1080/15374416.2017.1...

[2] https://www.cdc.gov/mmwr/volumes/66/wr/mm6644a12.htm?s_cid=m...

Which are absolutely insane numbers compared to very similar societies all around the world. I doubt there is some sort of truly unique illness doing rounds only in America.

America isn't an extreme outlier. And most of the variation around the world can be explained by different diagnostic criteria.[1] Look for numbers around the world to jump as countries adopt ICD-11.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994964/

84% of total world wide ADHD meds are eaten in the USA. There is a difference between identifying symptoms and thinking stimulants are the answer or just not paying any attention. Just like in Europe the medical consensus is that people have to learn to live with pain rather eating oxy's. It doesnt meant the doctors pain didn't exist in their patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261411/

I know you don't intend it this way, but it does come across as cruel when confronted with realities.

> 84% of total world wide ADHD meds are eaten in the USA.

That's of course because US is ahead of the curve in medicine.

> Just like in Europe the medical consensus is that people have to learn to live with pain rather eating oxy's.

This isn't a medical consensus. We just don't push opioids for everything so early. We start with paracetamol and ibuprofen, upgrade to ketoprofen and other NSAIDs in more specialized or severe cases, and continue as needed. But living with pain is not an acceptable answer here either.

Stimulant meds work very well on ADHD and are very safe, both short and long-term; it's a much better story than say SSRIs and depression. The main problem here is the combination of stigma (oh no, amphetamines!) and fears of abuse by people not suffering from ADHD (oh yes, amphetamines!) - both of which are in large part fueled by the US War on Drugs, the unending source of pathologies and suffering worldwide.

Stimulants also work very well on people without ADHD, so why not give them to everyone!?

It seems crazy that we've made it this far as a species without medication; so why should it be required now? Maybe the issue isn't the children, but the environment they are in?

Because 50 years ago:

- teachers had a lot more options when it came to disciplining kids

- many left school for work at age 15 - 16

Do you want the good old times back?

(Another thing is many countries have changed the curriculum to be even more heavy on theory than it used to be. That I would like to change, both for the kids and for future employers: broad practical experience probably increases someones chances in engineering and probably other disciplines as well.)

Says in the article 7 times more likely to get adhd meds in the US than UK. America is wealthy but these numbers are way off compared to similarly developed nation.

Could you point out where the article claims that? It's padded extensively with selective and often irrelevant factoids and speculation about ADHD diagnosis, recreational drug use, etc.

> the US (<5% of the world’s population) was responsible for > 92% of the world spending on these agents [35].

92% of spending doesn't imply 84% of consumption. The same drugs cost more there than the rest of the world. And new drugs start there often.

Given the opiate situation, I have no doubt there is a massive kickback scheme going on over emotional conformity drugs

The United States most definitely has a unique illness. It’s convinced the masses freedom is being tethered to corporatism.

We need a less militaristic and autocratic 1984

“40 hours a week for deflated earnings is freedom. Quarterly gains for the aristocracy is how we beat ‘them’.”

> There are qualitative differences in response between people with and without ADHD, that manifest across the board, not just on few school metrics - and a psychiatrist will be able to see them.

I was under the impression that this "it works differently on people with ADHD" thing was essentially a pleasant myth. If you've got solid citations that stimulants do somehow work differently on people with ADHD I'd be interested in reading them. My understanding was that the effect is broadly similar, with the only meaningful distinction being that ADHD-diagnosed individuals have been judged as needing those effects, and others have not.

The effect of stimulants on the brain is to stimulate it.

For those who need it it makes mind-numbingly boring stuff such as homework (as opposed to reading history books or creating elaborate formulas etc etc) less painful.

I don't know about you but I personally have seen some examples that have gotten significantly improved lives because of it.

If you don't know this stuff first hand, please refrain from making broad statements about it.

BTW, I'll give you this: one of the most interesting explanations I saw was that ADHD is very overdiagnosed - and at the same time underdiagnosed.

Some people get ADHD meds that shouldn't have, others struggle for years because some people have irrational fear against stimulats.

Can we try to avoid moving that needle and instead try to lower the errors on both sides?

> If you don't know this stuff first hand, please refrain from making broad statements about it.

Unless all the kids illegally buying ADHD meds to do better in school when they have not been diagnosed with ADHD (and adults doing the same, for that matter, to do better at work) are doing that for no reason, I'm pretty sure I'm correct that amphetamines improve performance for most everyone, and that distinguishing between ADHD-and-improved-on-meds and not-ADHD-and-improved-on-meds is not trivial.

I was replying to a post that read:

> If they're on stims in particular, and the meds actually improve their behavior, then the cause most likely isn't insufficient PE time.

I object to that being proof of much other than amphetamines making most people perform better in school, without commenting on whether ADHD is a "real" thing (I'm not even sure what it would even mean for it not to be "real", given the state of our understanding and diagnosis of mental disorders). "We gave the kid amphetamines and they improved, must have had ADHD" is dangerously misguided.

I hope that's what will happen. It means that the future will not need to dose people with drugs. We'll have created a world where people's natural physique is mostly enough for living a happy life.

In a darker vision, the future society will be more heavily dependent on drugs, regardless of age.

It will not, because it doesn't impact the genetic/hereditary factors in any way. Getting your body in shape does not cure actual ADHD. Exercise makes it at best manageable for the low-severity cases.

> In a darker vision, the future society will be more heavily dependent on drugs, regardless of age.

It's kind of a given, until we transition to post-drug era, where we inject our bodies with nanobots that fix what wasn't already fixed by genetic engineering of the gametes.

Until then, I think it's worth re-evaluating this view while replacing "ADHD" with "diabetes" or "hypertension" or "rheumatism" or "asthma" or... insert any persistent and disruptive condition a person may suffer from regardless of the shape in which they keep their body. We should apply drugs where they help more than they harm, until we have better alternatives.

Runnning around does not make a child with ADHD more sedate or perform better in the classroom. "Just go do some exercise" is like telling depressed people to "just cheer up".

Yes, exercise definitely helps. But it doesn't make one's mind less noisy internally. Buddhists talk of monkey minds. ADHD is like having a zoo of minds.

This anti-medication bias is causing a lot of stigma in society for children who actually need them.

My understanding of the parent and grandparent comments are that they are lamenting that boys are being diagnosed and/or dosed with ADHD medication just because they aren't given time and space to work out their energy. So schools and society are dealing with fidgety unfocused boys by giving them false diagnosis and inappropriate medication.

This is all distinct from people who actually really have ADHD and in which case medications can be appropriate.

I have properly clinically diagnosed ADHD- for me in HS there was a definite correlation between time spent exercising and grades- when the sports season ended, there was almost always a dip in my grades from tests and the like two weeks later. Call it anecdata if you will, but there's got to be at least some sort of correlation between exercise and mental state- I doubt it's just a thing for people with ADHD, either.

> Runnning around does not make a child with ADHD more sedate or perform better in the classroom. "Just go do some exercise" is like telling depressed people to "just cheer up".

You are completely right.

What I meant is that I have a feeling that often ADHD is diagnosed out of convenience rather than a real illness. I certainly didn't mean that all ADHD diagnosis are a scam.

There is a anti medication bias because these psychotropics medications were not designed to be used longer term. I’ve tried medication, it warped me into a shell of my creative self. We’ve got to stop using psychotropic drugs to fit people to society. And starting helping people integrate.

We’ve had risings rates of mental illness for years. And these method of diagnose and prescribe is only making it worse.

There’s obviously benefits to medicine but we’ve gone insane with how we’re describing the mass amount of personal mental variance in the world as illness and trying to eliminate it.

These medications have lasting long term effects that are unknown. If kids that are the brightest are struggling to succeed change the rules not the kids. I learned more when I dropped out and studied what I love instead of following curriculum. We've got to have more varied paths towards success.

To me (and a lot of other people), most ADHD diagnosis is clearly not something that should be medicated, especially at such young ages. So this is not a general anti-medication bias, but something that is specifically related to ADHD, and how it is over-diagnosed and over-medicated.

I don't have any stigma against medication, but I do think our current understanding of treating things like ADHD is primitive. I have a kid that's too young for a formal diagnosis, but has a genetic predisposition for it and has a lot of signs. His sensory input issues might be unrelated, but making sure he gets proper proprioceptive and vestibular input help him regulate (a sensory diet--or exercise). As does nightly melatonin to make sure he's sleeping properly. These are things others in his family never had the attention paid to.

A lot of the complaints and stigma I've seen are from people who took medication growing up. They saw the need and value, but loathe the side effects.

My daughter has a lot of energy and without some exercise, my wife thought she was demonstrating signs of ADHD; thanks FB Moms, you ignoramuses.

Signed her up for gymnastics and ballet and she calmed down a whole lot and did better in the classroom as well.

More likely people will make excuses for us and say 'well it was a different time' even though comments like yours and articles like this are clear exceptions.

There is a certain condescending sympathy that we afford to people just because they lived in the past. It comes from a misplaced desire to avoid anachronism, but ends up committing anachronism anyway.

> They'll also be able to datamine the internet

We are such barbarians that I assume that tech will not exist to future generations.

It is good to mention that it this is not a global phenomenon. I am from Czechia, of course there are some kids diagnosed with ADHD and taking medication, but I would guess it is a very low number compared to USA.

> It would also explain the current epidemic of ADHD and especially ADHD medication prescribed to young boys.

It's a common trope, but AFAIK ADHD has a big hereditary component and currently is deemed to be extremely underdiagnosed in girls and adults in general, so I think this cliche isn't holding water. I will agree that modern schooling is extremely good at surfacing the symptoms (but then so is adult life in general, if you know what to look for).

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