ADHD is just a short hand for "mild brain impairment/damage of unknown cause"
It's not a single disease but a collection of dysexecutive syndromes that impact higher cognitive functions: strategic planning, organization, etc.
This could be due to low oxygen during birth, infections (not necessarily CNS invasive), neck/head injuries, chronic pain, sleep disorders, genetics, vitamin deficiencies and a myriad of other causes, pretty much anything.
The same medication is utilized as in traumatic brain injury: amphetamines. They are quite effective in both ADHD and TBI, and as been in active use for nearly a 100 years. Both can be often diagnosed by the same psychometric tests, and can be pretty much indistinguishable.
Of course, finding mechanisms to cope with impaired executive function can help reduce the need for medication later in life.
If you can find the underlying condition, and it happens to be reversible, as is often the case in case of vitamin/mineral deficiencies or some sleep disorders, it can be often eliminated entirely.
However, due to paranoia around stimulants in our society there is some laymen hysteria about giving essentially lifelong access to stimulants to adults. It is an extremely harmful attitude, as medication is nothing but just a tool.
Is ADHD not a developmental disorder, causing an underdevelopment or delayed development of the frontal lobe? It seems incorrect to refer to this as "brain damage"?
Edit: I guess I'm referring to the official "medical narrative" as it stands.
I do happen to believe that the DSM-5 criteria is wildly out of date for ADHD diagnosis and at odds with the findings of a lot of more recent research. But I'm just questioning the "brain damage" terminology - I've never heard it described in that way before.
Most medical professionals that I've encountered stick firmly to the line that ADHD is a lifelong condition that develops in very early childhood and is not currently curable. You can almost entirely alleviate symptoms. But this is != a cure.
My current understanding is that if your ADHD is "curable" by eg. vitamins or a change in sleep pattern then it is unlikely to be considered to have been ADHD in the first place (but the symptoms may well have been indistinguishable). That's not to say that the symptoms of ADHD can't be greatly reduced by these things.
However, I'm not a doctor. Happy to be corrected by anyone who is.
Some people have car crashes or other traumatic head injuries and receive an ADHD diagnosis after the event, so it is usually from childhood but sometimes from brain damage.
Interesting. I don't know enough to have an opinion on how prevalent this is, but I have read that people with ADHD have a higher risk of being involved in a car crash in the first place, so there is an interesting causation/correlation discussion to be had there!
Eg:
A new study reports that the risk of being involved in car crashes increases for those diagnosed with attention-deficit/hyperactivity disorder (ADHD). The study looked specifically at the rate of car crashes by adulthood, which was 1.45 times higher in those with a childhood history of ADHD compared to adults with no ADHD.
https://www.sciencedaily.com/releases/2020/08/200818142135.h...
How many monozygotic twins can you find with a robust diagnosis of ADHD, and how much money can you afford to spend to thoroughly exclude every other possible cause (TBI, sleep breathing disorders, deficiency, thyroid, autoimmune, neuropathies)?
Quite expensive, nobody gonna do that. Science is about finding evidence to support a hypothesis, not some quaint notion of "truth".
All that's needed from such studies is to support the "biological cause" conclusion so that you can substantiate the need for a pharmacological as opposed to talk therapy intervention.
Those studies certainly support that, but all they really say "ok this is biology".
Given a disorder is usually defined by being outside the normal range, as defined by two sigma interval, 5% of people have ADHD by definition. How many of those are due to bad genes, and other causes is actually very hard to say, as there isn't that much profit to be made in discerning this any further.
That being said, I come from a farm/vineyard and I've lived most of my life in a village, so my perception is certainly skewed. But I do know that you can't force a kid to do what they don't want to. I never liked vegetables so whenever we had a vegetable soup I didn't eat it, which made my mother angry. Her solution was, that I'm not allowed to leave the table until I eat everything that's on my plate. That gives you two options, either eat the food and be done with it... Or just sit there until the evening and then go to bed.
What I'm trying to say is, if a child is full of energy, go outside with them and let them run around, don't give them medication to suppress that energy.
I'm not certain what it's called but, it's better to prevent then to cure. It's better to prevent getting cancer then to cure cancer. Or in other words, would you rather prevent getting cancer or get cancer and then cure it?
You must then accept that you are ignorant. By comparison, I have seen and experienced children and adults who, without medication, would be unable to live remotely functional lives.
> What I'm trying to say is, if a child is full of energy, go outside with them and let them run around, don't give them medication to suppress that energy.
You demonstrate a lack of understanding of ADHD, so I would recommend further research before commenting in the future. It used to be a common misconception that ADD/ADHD was just being full of energy, but that's not remotely accurate. Briefly, there are two dominant classifications: primarily inattentive and primarily impulsive (or hyperactive). There is also a combined impulsive/inattentive. I am inattentive. Among my numerous issues likely related to ADHD, I have trouble falling asleep and waking, I will stay up far too late reading. I make bad decisions when unmedicated, and I am unable to effectively wield the concept of time. Letting me run around as a child would accomplish nothing.
> I'm not certain what it's called but, it's better to prevent then to cure. It's better to prevent getting cancer then to cure cancer. Or in other words, would you rather prevent getting cancer or get cancer and then cure it?
Sure? But you're now assuming that ADHD is environmental, which I don't believe to be the modern understanding. It's likely hereditary.
In any case, I found your comment quite disheartening.
How often is ADHD misdiagnosed as a result? If it is hereditary, have we found the gene(s) which would enable us to pinpoint the diagnosis, possibly even before birth?
I also have trouble falling asleep and have made bad decisions in the past. I have effective strategies to mitigate. Do I actually have ADHD and need to take amphetamines? I am not saying this of you, but I find it disheartening when people say "it is just my genes, nothing I can do about it". It's fatalistic and a self-fulfilling prophecy. If there actually are unknown environmental factors, that attitude seems to be ignoring them outright. For instance, exposure to large doses of lead as a child might instead be incorrectly diagnosed and interpreted as "just my genes I guess". There are so many poorly understood chemicals swimming around our water supplies, food systems, cosmetics, etc. I wouldn't be surprised if we're taking drugs to bandaid something much deeper to blame.
> I also have trouble falling asleep and have made bad decisions in the past. I have effective strategies to mitigate. Do I actually have ADHD and need to take amphetamines?
This is a huge tell that you don't have ADHD. Effective strategies! My kingdom for even a somewhat effective strategy.
If you're a child and adults are making decisions for you, obviously without some sort of physical genetic or blood or radiological test there's a fundamental and significant margin of error.
For adults who have spent most of their lives suffering ignorantly to put together the pieces and obtain a diagnosis is basically a triumph. The sort of problems many people face on a regular basis are serious enough challenges that without medical intervention, they would be jobless or homeless or their friends and family would leave them or worse.
Most people don't share unprompted how many times they've been fired, how many tests they failed or classes they flunked out of, flights they missed, bills they didn't pay, gifts they didn't buy, family members they indirectly harmed emotionally or physically (ever put off buying food for you kids?)
The problem is that we have reduced executive function. It's like sitting on a train track with a train approaching head on and thinking "I know I should get out of the way but I think I'll just wait a little longer". Relying only on a fight-or-flight response to progress through life is dangerous.
Finally, yes, sure, it's all a band-aid, but if you're able to tell me what I can do to stop taking drugs I will literally throw money at you. You'd be rich. They're not fun. The side effects are not fun. They don't make you feel good. Don't confuse prescribed amphetamines for recreational drug use. They're not equivalent.
It’s also not at all what is being described here; it’s actually a neurodevelopmental disorder, not “full of energy”. The medication doesn’t suppress energy; the medications are actually amphetamines! If it wasn’t being used to an ADHD brain, they’d be considered recreational stimulants.
https://www.nytimes.com/2013/12/15/health/the-selling-of-att...
Go to a local support group and tell people on disability their problems were invented by multibillion pharma business.
You are absolutely free to drop out of the "rat race", aka the evolutionary process, which admittedly can be quite stressful. Just have to accept the consequences first, every choice comes with trade offs.
The diatribes against well established condition as some sort of a pharma conspiracy is just the defence mechanism to avoid facing the disability. Not an uncommon strategy, but probably not very productive.
ADHD is most effectively treated with basic 100 year old generic drugs, as well many thousand old remedies like nicotine. What's next, common cold is the aspirin lobby conspiracy?
Guess what, some people manage to live happy lives, have happy families and success in business (that you call rat race) despite being fully paralyzed waist-down, and some even with limbs severed.
I know some of those personally. I also know others, that chose instead to do nothing but complain. I'm sure you can guess the outcomes easily.
Best of luck in the new year.
Your comment made me think of that.
Modern American Education is not ‘the evolutionary process’. If anything it is quite the opposite. More like forced domestication.
good luck. i'm sure you'll do great either way.
You seriously think the modern American education system represents ‘the evolutionary process’ or that the only option is to drop out?
Education in its current form is relatively new, but also outdated, having been developed to train workers for an industrial society that no longer exists.
There is no reason we can’t be intelligent about this, and recognize that as a society we can do better if we understand its problems. We do that by discussing it.
If you think it’s perfect, that’s ok, but then it’s odd that you choose to come here and engage.
Kinda hard to say how many of them were adhd, but it is quite likely some were.
ADHD can very often be due to undiagnosed conditions, or comorbidities that aggravate it.
To put in perspective: there are billions walking around with undiagnosed hypertension, which is trivial to diagnose and treat.
When was the last time you took your blood pressure?
> I wasn’t able to leave table a few times. One in particular- I used my absent father’s pepper mill and put too much in my mashed potatoes. It burned my mouth and they wouldn’t let me leave until I ate it all. Which I couldn’t do. Crying. Furious. Humiliated. Trapped.
> It got late and I started to fall asleep at table. I was greeted with the potatoes as breakfast. Then when I opened my lunchbox at school- there they were. At least I could throw them away. That was the day my anorexia began. There were incidents after where I didn’t eat enough, where I took too much and wasted it- stuck at table in a power struggle I did not understand nor could I win.
> My Mom did thuis with with my brother. If food is left out overnight, it is a trigger for him. He sees the food, and immediately thinks he has to eat it. I was forced to eat foods that made me sick, or I just didn't like. So, I would eat while dry heaving, and throwing back up into my mouth. I didn't dare not eat after seeing what my brother went through. That was the start of my eating disorder. I'm completely disconnected from my fullness/hunger cues. To eat mindfully is incredibly difficult because my brain is so used to dissociating while eating. My ED is binge eating because I used to eat a lot of anything I liked to get me through eating small amounts of anything I didn't like. I over-salt everything because I used to use salt to cover the taste of things, and need everything overcooked because my mom would undercook meat.