Teens turn to TikTok in search of a mental health diagnosis
nytimes.com
nytimes.com
It's perfectly possible that the environment that manifests something like social phobia can change, and a person who previously felt uncomfortable doing something can feel again comfortable.
However, if having social anxiety becomes part of your identity, it becomes the lense that you see the world. TikTok makes it easy, but social media as a whole is identity obsessed by its nature, and as the article illustrates is making this problem worse.
For the vast majority who I taught, the diagnosis became their identity, rather than a way to understand their behaviour. Any disagreement with them was answered with "that's because I'm X". I can only recall one who approached it as a way to identify and understand their behaviour and experience of the world, and as a way to deeper understanding.
The desired outcome is an enlightenment mindset. “Ah, so that’s why I act that way. Well now that I know that and have x, y and z methods for addressing it, I can overcome/adapt”. As you can imagine it’s a lot more work to achieve this mindset.
I say this not as some sort of holier than thou proclamation. I struggle with this daily myself. Posting on hacker news helps reinforce what I should do to help myself :)
Spend some time to think about that sentence. The diagnosis is not a "scapegoat", it's literally an explanation for the symptoms.
Why should they have to try to "escape" the diagnosis?
Actually, I do wonder. Are these independant variables, or is the search for victimhood driving the "mental illness" trend?
They must have had some sense of relief when they got diagnosed. Perhaps they thought they would be given a little bit of a break by those who expected them to act like people who are literally not like them.
Perhaps they found, though, that despite finally being able to show others that they weren’t just lazy, or stupid, or that they didn’t care, or they weren’t interested in paying attention, or they were just being weird, they were still expected to somehow ‘snap out of it’ and be like people who weren’t like them.
After not being able to explain your behaviour for so many years, and then being expected to just somehow ‘identify and understand’ and gain some ‘deeper understanding’ would sound to them exactly like ‘you can just try to stop being yourself now you have a label, right?’
It’s exhausting. Even with - and especially with - those you love and who you see every day, including those who are on the spectrum themselves, there is still a lack of understanding and a pressure to just ‘fix’ yourself, and do so consistently.
No wonder some, as soon as they get a diagnosis, default to saying ‘I did that because I am X’ and don’t want to have to bow and promise to work on themselves so that they can be a better - different - person. They are doing this every day because they feel the weight of society. They don’t need to have those closest to them be the nagging voice of that society.
So much unnecessary bullshit I had to go through because shrinks were too eager to label me as a kid. In the end my only fault was a general aversion to authority, only further intensified by this experience.
I also wasn't arguing for early diagnosis, as I understand the dangers of this, not simply because it's difficult to get right, but I am worried that handling the label in a useful way does seem like it could be more difficult at a younger stage of development.
I was commenting on what appeared to be an assumption - by the commenter I replied to - that those they had dealt with were lazily (!) using their diagnosis label as some kind of excuse for their behaviour or to avoid challenge.
The original commenter could, of course, be entirely correct, but some of the most difficult aspects of ADHD to deal with are:
Not being believed - the assumption that you're actually just lazy, or otherwise morally defective
Constant pressure to 'get over' your ADHD, never letting it influence your actions (or inaction)
It's difficult to relate how much these two pressures can cause agony within the family - with _or_ without any knowledge or understanding of ADHD, and with or without any diagnosis.
The intent of my comment was to ask for patience and understanding for those affected, not to advocate for or against any position on diagnosis.
Now that's just silly, though. "Fixing yourself" is a ridiculously hard problem even for those who don't have the benefit of a formal diagnosis - the ones anyone would simply dismiss as lazy, stupid, uncaring, weird etc. etc. That's basically what wisdom is. It's not clear that the formal choice of getting a diagnosis is changing anything substantial beyond the picking of an arbitrary label for some known cluster of behaviors, perhaps with varying amounts of personal or social adaptiveness.
It might be useful to actually talk to people who receive these diagnoses. In my personal experience I have seen people benefit greatly from formal diagnoses (even if initially it takes time to make sense of it). But even if there are people who are hurt by a formal diagnosis, their numbers are absolutely demolished in comparison to the numbers of people who would benefit by help for mental health issues but never seek it out.
Complaining about people who might not be responding perfectly to a diagnosis seems like a drastically minor issue relative to people who have undiagnosed mental health issues.
"lazy and unmotivated" are mental health symptoms, not causes.
Why do you think someone would want to be lazy and unmotivated? Wouldn't people prefer to simply be able to accomplish things, being lazy and being unmotivated is very detrimental to one's well-being in today's society.
And from this perspective then maybe you would think: okay, why are these people making everything harder for themselves? Could it be that, maybe, there's something else behind that behavior? Maybe being lazy is a natural trait on some people, in which case, should they be blamed for it?
These are not simple questions. I think dismissing people's struggles is very problematic. I mean, any struggle is worth taking a look at. I think a lot of people don't really understand what it means for someone to be mentally ill because it's not something that is so evident. But I don't think you would ever tell someone that was born without their legs to "stand up and walk like everyone else does, sometimes my legs hurt too, and look at me running a marathon". So why would you do the same for people with mental illness? Why would you assume that laziness and lack of motivation is simply a momentarily ailment?
ADHD and depression are very much real, and we need to take mental illness seriously and a big part of this means not just going "get up and walk like i do" but actually trying to understand another person's struggle.
But it is suspicious generality - there are also a lot of cases where people being labelled is an action that harms them. Especially since all the sciences involving the human mind have long histories of quackery, failure and discrimination to draw on. The results are rarely clear and the goals of the people involved are cloudy.
There is probably some balance between the perspectives here and finding it is the real question here.
I know that's an anecdote, but can anyone imagine that she would have gained more from 20 hours per week of being told she has special problems with a special name, and needs professional help to overcome her many, many obstacles? I certainly can't.
i said what my dad wanted to hear WRT if i had had more classes to cope, “a total waste” i agreed.
in the end i spent half a decade in these classes learning how to understand what the other person is trying to say, not what their actions and subtext scream out. i did this as an adult, against my father thinking it was needed.
after five years i can finally manage my emotions well enough and with enough expertise that it no longer causes me to loose friends and ostracize coworkers.
think about the impact that your clear disdain for the “condition” and down playing of the value if the courses. imagine your daughter not “still struggling” and instead “able to deal with emotions in a non familial situation”.
your fear is harming your perspective
Here are two things that I have commonly seen: 1: getting labelled often leads to negative outcomes, in particular when others judge by a person’s label and not the person, and 2: psychologists and counsellors can sometimes create victims, trained codependency, and a variety of very negative outcomes. In this case the OP judged the cost of 20 hours per week of professional help to be high cost/risk, and they tentatively said it seems to be a reasonably good outcome (fantastic - given the diagnosis).
Professional “help” can easily be harmful, and I think you should acknowledge that fact. Of course the opposite can happen when people ignore help, or deny problems, and then hurt themselves or others.
The key point is that there is no golden standard where you can predict if professional help will work, or harm.
It is entirely possible that, had she not improved, parent would have gone back, or found another source of treatment. I didn't see anything at all in the parent's post to indicate that they have a `disdain for the "condition"`.
You might be projecting your own experiences a little too much.
I know this is a total sidebar: Do you mind sharing a little more about these classes?
Not knowing anything about this, my reaction on reading this was the exact opposite.
As a kid, I was always naively trusting of people's words, and I would expend huge amounts of empathy on trying to understand them based on what they were saying. I feel like a large part of growing up and understanding people is being able to look past that — trust what they do, rather than what they say.
The worst part of it was that he was convinced that his academic failures in life were due to his ADHD. Now we are both successful people in general. He's a software engineer in a major company. But since he couldn't figure out some simple math shit that was obvious to me, he thought he was being handicapped by his disorder. He refused to listen to my claim that everyone has a lot of stuff in math they just do by the rules they were taught and only realize later in life that there's an underlying concept. It is kinda the point of our education system because our young brains take more time to grasp the basics so we cram the rules and wait for the rest of cognition to catch up before teaching the basics.
He stopped taking the meds a while ago when he realized it wasn't doing him much good and realized that there's a limit to how smart people get and it is ok to not be born as next Terry Tao or something.
You're probably misinterpreting "refusal" as "unable". After a lifetime of being told "if you would just apply yourself...", you start to get a distorted impression on what the average experience is. Obviously, he's just coming to understand something that everyone else had appreciated since they first learned it, because they applied themselves.
Maybe I'm projecting -- I'm in a similar spot, but I've been diagnosed since high school, and it wasn't exactly a shocker then.
What you're describing really sounds like the secondary depression[0] that usually comes with adhd. That is, he's probably is being handicapped by the disorder -- it can be a real slog to read math, and very hard to practice it, even when it's interesting. But it sounds like you were coming face to face with depression caused by a lifetime of not feeling good enough. Frustration that you can't apply yourself harder. Being gaslit into believing that you weren't trying.
But I understand why people have an achilles heel about certain aspects of their life that they have been scolded about constantly. I have those issues too but in certain areas I overcame them entirely like in academics.
ps: not helped by online groups or bubbles (twitter, discord) where they can all reinforce their own beliefs in a joyful mayhem.
> However, if having social anxiety becomes part of your identity, it becomes the lense that you see the world. TikTok makes it easy, but social media as a whole is identity obsessed by its nature,
I think this is as much a feature of that stage of personal development as it is of social media. Adolescence and early adulthood are periods in life when there's naturally a lot of focus on identity formation. I think the issue with diagnosis being taken as identity formation comes out of that background more than it does the nature of social media or out of medical diagnoses themselves.
It also (imo) comes from a scientistic approach to psychology: it starts with the premise that the diagnostic categories one finds in diagnostic manuals all correspond to real conditions in the world (realism) which divide the population into kinds of people (essentialism). But that forgets the purpose of those diagnostic manuals and their contents (to help mental health clinicians guide treatment plans) and the nature of the science and clinical practice here, which is driven almost exclusively using hypothetical entities we can't directly observe. The DSM's purpose is not to provide an ontology, or to identify essential features of the human mind, and certainly not to do so in a way with any kind of finality.
The other thing to think about is the kind of profound validation and relief that can come with gaining a ‘label’ for one's struggles, a framework for thinking about them, and references to communities where you can learn from other people dealing with the same things. That is huge, and it's really important to a lot of people when they first get diagnosed (whether with mental health or a chronic physical condition, for that matter). And it's natural for that to push one to see their diagnosis or the label associated with it as defining part of who they are.
That said, there are psychologists and psychiatrists who are also troubled by this, who are critical of ontologizing or essentializing approaches to their own fields. Go in with an attitude that you're looking for labels that are useful regardless of whether they're true, with an understanding that mental health exists not just in the patient but in their social relations to the whole of their society, that our diagnostic categories in 10 or 50 or 100 years will likely be quite different from the ones we have now, that many conditions with similar symptoms may be related or distinct in ways we don't yet understand, that as you work on things you might shed just enough symptoms of this or that thing to go from qualifying for diagnosis to no longer qualifying (despite the clear continuity in who you are, your personality and traits, etc.) and so on. You can find therapists who are comfortable taking an anti-realist, anti-essentialist approach which resists that mental habit of reification.
The two-continua model is somewhat distinct but related. It doesn't argue that the diagnosis categories are flawed, but that they miss a large part of the picture. See: https://search.informit.org/doi/pdf/10.3316/informit.2614206... https://link.springer.com/article/10.1007/s10804-009-9082-y https://psycnet.apa.org/doiLanding?doi=10.1037%2F0022-006X.7...
Then they paid to get a private assessment and sure enough got diagnosed with ADHD. Do I think they have ADHD? Nope, not at all.
So why the official diagnosis and treatment with pharmaceuticals? He learnt everything he needed to know to easily fool the doctor assessing him. He knew every test they would use and exactly how to respond. And as he is an intelligent guy he didn't go in there and flag every single thing but just enough to look like a legitimate person struggling with attention and executive function. He told me before the assessment he wants the medication and he got exactly what he wanted.
My son was diagnosed with ADHD a couple of years ago so I have seen first hand how the assessments work and it is a joke how much "flexibility" there is. It isn't like a blood or culture test where you can detect the presence or lack of some substance. It is mostly voodoo for want of a better word.
One question I ask myself is does he genuinely think he has ADHD or did he just want the meds and figured out a way to get them while looking genuine?
IMO for disorders like this it’s almost better to view it through the lens of the available treatments. Is the treatment, on net and relative to other possible strategies, going to be a positive impact on this person? If yes, then whether they have apparent Disorder X (a figment of imagination) versus actual Disorder X (which is itself also a figment of our collective imagination) isn’t super relevant. Obviously in the case of ADHD the prescription drugs are pretty intense and have pretty severe negative consequences, so this framework in that case would probably even yield that people with actual ADHD but mild forms shouldn’t have those drugs pushed on them either.
Very possible. To me it is just very suspect given my near 30 years of knowing them and other events in their life not long before all of this started.
They have never presented any ADHD traits until recently when suddenly they went from 0 to 100. From being a successful engineer to being unable to concentrate on a crossword.
My personal opinion is they have untreated PTSD following a violent animal attack in early 2020 that caused life-long damage to their dominant hand. This in turn led to them suffering panic attacks around animals, anxiety due to the Covid lockdowns making treatment/physio complicated, furlough leading to isolation at home and being unable to do many of their hobbies from the physical injury (unable to play video games, the guitar, drums, etc)
Tangentially related but they have a history of drug misuse and when I asked if they just wanted the medication their response was "Absolutely". I have mentioned seeking therapy as I suspected PTSD (I myself have C-PTSD from childhood abuse) but he made it clear he has no interest in therapy and just wants the medication which to me is not a great sign.
Of course I could be wrong but I know him well and my worry is they will happily throw medication at him which will do nothing to help him deal with what I believe are the actual issues he is suffering from.
There might be a tighter correlation than it seems. What makes drugs addictive is that they work on the dopamine pathways. ADD medications do this directly.
Drug abuse causes damaged memory and executive function because drug use downregulates and sometimes damages dopamine receptors.
> Thus, in addition to reward, addicted individuals can experience severe disruptions in learning (memory, conditioning, habituation), executive function (impulse inhibition, decision making, delayed gratification), cognitive awareness (interoception) and even emotional (mood and stress reactivity) functions.
You answered your question. I was diagnosed later in life, as a successful engineer. I am not and never was at the "unable to concentrate on a crossword" level, but you seem to have some misunderstanding about what ADHD is. It is not the inability to concentrate on things. It is the inability to concentrate on _appropriate_ things. It's perfectly possible for them to just be completely disinterested in the crossword, yet able to be engrossed for hours in something which interests them. The medication levels this out so you are able to keep your attention on mundane tasks and complete them after the "interesting" part is over, or to start on mundane tasks at all instead of procrastinating until it's do-or-die.
Fundamentally, there's a strong intersection with the dopamine reward system, and a "history of drug misuse" and poor impulse control is completely in line with a diagnosis.
Personally, I went through a close family member's suicide, followed rapidly by moving across the country to an isolated town where my spouse developed a problem with alcohol, a couple years of abuse, a divorce, another move to a different area of the country, then all of the lockdown stuff. All of my (and their) unconsciously constructed support structures, reward activities, and safety nets evaporated. Stop.
I appreciate you taking the time to reply and clarify things but I would like to say I have a pretty good understanding of ADHD. As I have mentioned my son was diagnosed with ADHD a couple of years ago. I go with him to every appointment and support groups we are in. I have spent dozens of hours with his doctor, psychologists, etc. to try and learn as much as possible about ADHD to support him as best I can and to ensure I can get the support he needs in school.
My comment about the other family member not being able to concentrate on a crossword was more a summation of the issue not a specific example. He has always been an intelligent guy, he wasn't gifted nor did he need to push himself extra hard to succeed. He never had issues concentrating on "boring" tasks for all the time I have known him (30+ years at this point). Sure he was never super engaged with them (who would be?) but he didn't get lost in procrastination.
What I mean is these are all very new things for him. Even for things he used to love such as games he cannot find the "mental energy" (as he puts it) to play. To begin with I put this down to his injury and while his hand will never be as good as it was he can use it "fine" for such things now. He just has no interest. No interest in anything. Basically all he wants to do is just sit on the computer and mindlessly consume. He stopped coding, stopped playing games, stopped reading, not taking his drone out, stopped doing some 3D stuff in Blender, stopped watching the kind of shows he used to love, etc. Pretty much the only thing he does still do that he did before is go to gigs. And perhaps this is unfair of me but I suspect that is because he always takes some drugs while there.
What I mean is he had a large change in personality over the past two years since the attack, not just his executive functioning.
Now it is very possible he always had ADHD but like many he managed to cope with it via systems he developed and perhaps the attack (or the pandemic) caused those systems to fail him and maybe just medication will help him. My worry is that he has some other issues and for one reason or another he convinced himself it is ADHD and only ADHD.
This is a concern his wife also shares and we have discussed. When she has suggested therapy he dismisses it as "not something that works for him" (even though he has never actually had any to validate that claim). It is a tricky subject and he is now sure he is "fixed" as his concentration is indeed better as he is taking some kind of amphetamine 4 times a day, however his wife has told me there is no improvement in any other areas which she is worried will lead to a crash at some point.
The energy level in childhood, brain development, behavioral expectations in school, and everything else is very different. I'm old enough that ADD (now ADHD) wasn't really a thing when I was growing up. People had to learn to manage, without medication. Doing it with medication is different, but being a functioning adult is not the same, and the same knowledge should not applied.
Everything you are saying is from an outside point of view. He sounds depressed, but he went through a traumatic incident. That doesn't mean he cannot have both.
It's not even a little surprising that he had a change in personality. You sound extremely judgmental, to be honest. Your friend went through trauma. He may not have PTSD (that word is used a bit too freely these days), but it was a traumatic experience which sounds like it literally crippled his ability to do half of the things your'e saying he doesn't "want" to do.
He suffered "life long damage to his dominant hand". The hand he presumably uses to help fly the drone, to play music, to use the controller playing games, to use the mouse in Blender (maybe). It may be painful constantly, especially if the rehab/physio was hard to manage during lockdown. You would also have a "large change in personality".
There isn't a lot of psychiatric care which can be done in isolation. People who have ADHD/ASD are also more likely to be depressed, but you can't "root cause" this to a single issue, and saying "well, he's depressed/has trauma, so he should deal with that" doesn't mean he does not also have ADHD.
He is trying to tell himself to "fake it until he makes it" after a traumatic experience, and he does not want to relive the trauma in therapy, he does not want to risk whatever potential side effects from antidepressants.
He is trying to accept that this is his life now. This life of lifelong damage in his dominant hand which has forever put the thing he loves out of his reach, and _maybe_ dragging him out of the house to do new things would introduce him to something new he loves which does not remind him of the life he cannot have anymore. _Maybe_ doing that instead of gossiping with his wife about it and wondering why he no longer does his old hobbies would help.
It sounds as if he is living in limbo between a life he lost and finding new fulfillment. The thing about very traumatic experiences as an adult is that the medication he is currently on (and again, which he probably needs) has made his life somewhat bearable again. He doesn't sound happy, and he doesn't sound like he knows what will make him happy, but the current state of things is so much better than it was two years ago that he doesn't think it's bad, or he worries that making more changes would make it worse again.
Be your friend's friend instead of whatever you're doing now. Monday morning psychiatrist on HackerNews is definitely not.
AIUI, therapy is not really about "reliving trauma". It certainly sounds like this person could benefit from assistance by a professional wrt. managing his stress reactions. Medication is a crutch.
The only people I've ever known to have said this, were not qualified therapists, councillors, or psychologists. Isn't that interesting?
He and his wife are childhood sweet hearts, they have been together since they were teenagers. I have known his wife since they first started dating so more than 15 years now. His wife and I are not "gossiping" about him behind his back as you put it. We are concerned for him and worry he is fixating on one possible problem while dismissing outright every other possibility.
One thing I would like to clarify a bit is when you say "forever put the thing he loves out of his reach", this is not true. While he may never play the guitar quite as well as he used to he can still play, far better than anyone else I know personally. When I said life long damage to his dominant hand I was referring more to visual scars than anything else. He did struggle for about a year but he is perfectly able to play the guitar and use his hand much as before. Perhaps not quite as good as before but it is not like he lost his hand or it was horrifically damaged to the point it is useless.
Unfortunately I am unable to edit my previous comment. When I wrote "unable to do many of their hobbies from the physical injury (unable to play video games, the guitar, drums, etc)" I meant they were unable to do those hobbies at the time (i.e. in the 6-12 months post injury) due to them being in recovery not that they were permanently unable to do those hobbies for the rest of their life.
>Be your friend's friend instead of whatever you're doing now.
We are all trying to be there for them. Me, his brother, his wife, his parents. We're all worried about him and while I may come across as being judgemental I promise you that is not the case.
How many of those years have you been a mental health professional?
> We are all trying to be there for them. Me, his brother, his wife, his parents. We're all worried about him and while I may come across as being judgemental I promise you that is not the case.
No, you're on the internet invalidating his diagnosis.
Everything got much easier after getting the diagnosis and medication as a 33 year old.
This is me. Looking back at my school days, it is very obvious I had ADHD but neither my parents and I, nor my teachers knew such a thing existed to get diagnosed.
In adulthood, others might think I am doing well, but they don't know the constant struggle my life has.
> but don't see that you put in three times the effort.
This is on point. Sure, I am getting my work done, but they don't see how my constant procrastination, zoning out means it takes me 3x the time to get something done, and it makes me feel 24 hours aren't enough to have my life in order.
Just about every human being operates better on amphetamines. It increases dopamine and adrenaline, increasing attention span and motivation significantly while decreasing the need for food or rest. Medication simply improving performance is not really a working metric in this case
I do understand what you're getting at, but tests and assessments will always be gamed by some people. Yes, he may have cheated, but until there is a more objective way to diagnose disorders like ADHD, something like this is simply part of the whole thing.
Consider him a false positive. You certainly wouldn't prefer having false negatives instead.
I should note he never had any concentration problems before 2020 and even he agrees with this.
I replied to another comment with additional details you may be interested in.
* I paid for an assessment from a neuropsychologist that came back negative. I dug into their assessment and it was basically just wrong (self contradicting and extremely biased, I.e. I was "too smart" to have it). I went to someone else and they picked up on it immediately.
Agreed, I do think there is something wrong I am just not convinced it is ADHD and my worry is now he has his diagnosis and some pills it won't help him in getting him the help he actually needs which I believe is more related to trauma from an animal attack combined with the pandemic.
I know it sounds like I am just disagreeing with his ADHD diagnosis and that I am in some way against ADHD diagnosis but that is not the case at all. As I said my son was diagnosed with ADHD not too long ago. I have no issue with ADHD as a diagnosis I just worry it is the wrong one for this person because they became so obsessed with getting adderall as some kind of fix for everything and when other options such as therapy are suggested they dismiss them instantly as "too much talking".
But it's not a magic drug which undoes ADHD and has completely different effects on the non-ADHD population.
According to him yes, he can concentrate well now. He doesn't talk about his other issues and when I bring them up he doesn't say anything.
According to his wife yes his concentration is improved but not his anxiety, depression or anhedonia.
That is really hard. Your son may have to figure that one out on his own.
If I can give some unsolicited advice:
Make sure your son knows that you feel his problems are real and that he has important things to learn from others who have ADHD, because they do struggle with so many similar things. If it's ‘you're barking up the wrong tree’, he might be likely to reflexively dismiss you. But if it's ‘I see why you think this is a good place to look for help, but don't limit your search for tools to deal with this to things associated with ADHD’, it might be something he can better receive.
Also, as someone who has been diagnosed with ADHD and takes stimulant medication for it:
- there are aspects of ADHD that stimulant medication just doesn't help with
- there are aspects of ADHD that stimulant medication can make *worse*, if you're not careful
- ADHD can be closely related to anxiety, even when ADHD is almost certainly part of the picture— when you have ADHD traits and behaviors, it's natural to fall into a habit of *leaning into those ADHD traits and behaviors* in order to cope with your anxiety, as a form of avoidance
Perhaps I am wrong but reading your reply I got the impression you thought I was talking about my son in my original reply? I just wanted to clarify that is not the case, I was talking about an adult family member not my son :)
As for my son it is quite clear he has ADHD and I indeed support him in every way I can. Currently that is not via medication however not because I object to it but because he only has one kidney and all of the doctors we have seen agree that we should try to avoid medication for now. Especially as he does not present hyperactivity. I am sure it is something he will try when older but for now we are trying to help develop tools (both mental and physical) to provide a supportive environment for him and it seems to be working quite well.
Regarding you point on anxiety and ADHD, this is very relevant to my son as he has developed some anxiety over the past few years (moving to a country where he had to learn a new language and of course the pandemic). We certainly notice[d] an increase with inattention when he is anxious. For example when my wife had to travel for work recently his anxiety was much higher. As you mentioned I ensure I do not use dismissive terms when he talks to me about how he is feeling. We have built a good, open way of communicating so when he feels anxious or overwhelmed he knows he can talk to us without issue.
I have to admit I have huge anxieties of my own as to whether I am doing a good job in supporting him but I am trying to do everything I can. Again I appreciate you taking the time to share your experience and knowledge.
> As for my son it is quite clear he has ADHD and I indeed support him in every way I can. Currently that is not via medication however not because I object to it but because he only has one kidney[.] [...] [F]or now we are trying to help develop tools (both mental and physical) to provide a supportive environment for him and it seems to be working quite well.
FWIW I think the non-medical tools are the harder things to get going and the more essential. And because stimulant medication's efficacy is affected a lot by how structured the environment is, it tends to be a less decisive tool in college and in professional life than it is in elementary school or high school. So if you're having success and seeing progress without meds, I think that's likely to continue and to help make sure he has the right habits to make the meds actually effective for him in adulthood if that's what he needs.
> I have to admit I have huge anxieties of my own as to whether I am doing a good job in supporting him but I am trying to do everything I can.
To me you sound thoughtful, flexible, and caring in your approach to understanding and supporting your son. I think that is sure to make a huge, positive difference, no matter what.
I think the problem that most people in life that suffer from some sort of mental problem – be it depression, ADHD, Autism, axiety or any number of other issues – encounter throughout their entire life are hundreds of well meaning and otherwise people all with their own personal opinions about what's wrong with them. At best these people are doing nothing but adding noise, but at worst they're contributing to a life of hurt and unhappiness with being unable to be "normal". When these people find something that resonates with what's going on, they will latch onto that thing, whether or not it's the right thing. But for those people (and frankly for their well being) if it's wrong, that's often still better than having nothing at all.
The curse of having a mental disorder is that until you're diagnosed, no one believes anything is wrong with you they just think you're an asshole. After you're diagnosed, EVERYTHING in your life gets filtered through that disorder. But the important thing is people no longer think you're an asshole, which means they're more open to looking at something else.
Your friend has a much better chance of getting the help they need by someone looking at their diagnosis and going "hey, I can see where the docs got this, but these other things don't quite fit and maybe you've been mis-diagnosed or have some other thing" than they probably ever did before the diagnosis. So sometimes even the wrong diagnosis is helpful.
But you need to keep in mind that you're almost certainly not the only other person telling them the diagnosis must be wrong. And at a certain point when you know something is wrong with you and everyone keeps shooting down things around you, you become resistant to listening to ANYONE who wants to shoot you down, no matter how right. If you're worried about your friend, your best bet is to encourage them to keep digging, keep learning and keep checking rather than trying to encourage them to stop thinking they have ADHD. Because in the end, continued evaluation will either confirm the diagnosis or get them on a path to finding a better answer. Where as fighting them on it will just encourage tuning you out and digging in.
The reason I went looking for the diagnosis was 10+ years of utter misery. I had been on various treatments for depression & anxiety, but found them minimally effective. I was getting by but was pretty apathetic about life. Over the years I'd investigated various other mental illnesses, but never came across one that seemed to fit me. I came across ADHD purely by chance, when an acquaintance was diagnosed and I looked it up. Previously I had probably ignored it assuming that it was just for hyperactive kids.
This one did seem to fit, and frankly I was desperate. The though of a pill that could actually fix some of my issues made it worth a try at the very least.
For the past two years I've been happier than any other time in my life that I can remember. Life was just easier. The most telling point for me was when I realised that I was no longer apathetic about life, I actively wanted to live, I had things that I wanted to do, goals to achieve - and I was actually able to do them.
I don't know if I actually have ADHD, I still question the diagnosis. It worries me sometimes that maybe I don't have it and that instead I'm just not very good at life. The truth is that it doesn't really matter, the diagnosis and treatment worked - If I payed for a placebo I don't really care.
Perhaps your family member is the same - maybe they have ADHD, maybe they just needed something to help them through life, maybe they had run out of alternatives - it just gets to a point where you wonder 'how much does it matter even if I'm wrong?'
I’m quite literally desperate for any answers at this point, my teen years and 20s were on the whole, an absurd nightmare.
The only thing that worries me is they’ll tell me I have it because that’s the easy thing to do. I don’t want a diagnosis unless they’re 100% sure and I worry that paying for the assessment will bias the outcome.
And secondly just to say that things definitely can get better (which I found very hard to be believe for a very long time, no matter how many people would say it)
Whatever happens, best of luck to you!
Thanks for the well wishes, I really hope in a few months from now I can look back and see some progress.
[1] https://www.amazon.com/Taking-Charge-Adult-ADHD-Second/dp/14...
Also, gotta say, as much as I hate TikToxic there are even worse places to look for mental health advice. :looks at some of the other threads:
What do you mean? Methylphenidate is not a placebo no matter how you look at it.
i.e. The outcome is important to me regardless of the how and why.
I wonder if there's a term for that? Feels like there must be.
I'm paraphrasing from "Taking Charge of Adult ADHD" which I highly recommend. Unfortunately I don't have it on hand so its not a very good paraphrase.
[1] https://www.seasidepalmbeach.com/addiction-blog/what-does-ri...
The linked article, for example, is unsourced and undoubtedly biased (as an addiction treatment center).
this is my first google hit for the search phrase "methylphenidate in non adhd vs adhd"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489818/
this is referencing several clinical studies in that vein.
and the search result has several more results, some just clinics which make the well founded claim in simpler terms, others more clinical papers.
I'm sure you find more going to Google scholar with your search.
https://en.wikipedia.org/wiki/Attention_deficit_hyperactivit...
it's actually kind of hard to find an array of good medical sources googling for the second claim because there is so much anti-abuse stuff flooding results for a non-medical professional like me, but its somewhat intuitive in that raising dopamine levels from low to normal will have a different perceived effect than raising them from normal to high. There is perhaps a philosophical argument to be had but from a clinical standpoint my understanding is that there is a world of difference in the outcomes.
It is an industry. At the time this happened, wealthier parents were often taking their kids to these people so they would give a diagnosis for extra time on school exams (this is presumably why he diagnosed me with something, iirc my mum told him he was wrong, he said "what do you want me to do?"). Obviously, the medication is an incentive for some kids now too. And the industry does affect how people cope, everything is medicalised and diagnosed, that isn't very helpful. The fact that kids have so much knowledge is also impacting diagnoses because they know what to say (and their parents are concerned too, and maybe say "I think you have this" and they want to validate that).
Unfortunately, I don't think anyone is really getting helped. More resources are going towards the trendy stuff, normal emotion is getting "diagnosed", and it is the same old stuff if you actually have something wrong with you (unemployment rates for people with autism are 80%, "mental health awareness").
The doc would encourage moving up to powerful doses in follow ups, even though I was barely taking the initial dose... I've since learned these professional drug peddlers often thrive on pushing habit forming drugs that require routine office visit to get a fix (refill).
If you've had a diagnosis in the past, you need to be off the medication for at least 90 days and go through an evaluation and drug test as well as submit some extra documentation to show that you have been able to function since stopping treatment (or in general if you never received medication).
Given the prevalence of ADHD diagnoses where the individual ends up being able to function without medication, most organisations have protocols carved out to allow prior and even currently diagnosed individuals the ability to join/get certified provided you can get off medication.
Another commonly cited reason to avoid a diagnosis is commissioning in any of the military branches as an officer. You can still get a med waiver to commission as long as you show proof you've been off meds for a year.
Source:
https://www.faa.gov/about/office_org/headquarters_offices/av...
the "never" makes it sound like "never will you ever", not like "while you have symptoms and need treatment for..."
It’s a lot easier, and to an extent cheaper, to purchase black market drugs. Yet people are always sceptical when people say they have an ADHD diagnosis, as if they’re just a meth fiend who wants a socially accepted reason to get high all day.
This line of thinking falls apart pretty quickly once you realise that ADHD isn’t socially accepted, as demonstrated by these kinds of comments you get whenever someone talks about it.
In practice, the number of clients/patients complaining that their diagnosis was changed something like 10 times, with an ever longer list of ever more serious problems, while treatments don't work, but DO interfere with life. And then there are mandatory treatments that keep being researched as worse than doing nothing.
And, of course, there is the famous study of
https://en.wikipedia.org/wiki/Rosenhan_experiment
And it's more recent, less dramatic, but probably more valid cousin:
https://www.sciencedaily.com/releases/2019/07/190708131152.h...
Add to that that everyone feels capable of making such diagnoses themselves anyway. In every ended relationship these days, it seems, the relationship ended because the woman was schizophrenic and the man nacissist ... or vice versa.
It used to be the case that if a person is "functional", which usually means able to hold down a job for at least a couple of months at a time, they were psychologically healthy.
So why not make mental health diagnoses on tiktok, in bars, in ... everywhere? Yes it's not very valid, but everyone's doing it anyway ... and the official way to do it is not much more valid than doing things that way. This way, hopefully, people can see mental health diagnosis as what it really is: 99% bullshit.
Its natural the pros will get things wrong cause of the complexity and dynamic nature of the issues, but don't kid yourself that your SO or family members or friends or work mates are going to do a better job.
If they have never handled the issue before it's almost guaranteed they will create new issues and then cry about or hide behind their good intdntions after things blow up in their face.
I would expect "professionals" to do a better job. They don't. Otherwise ... one might point out Kenny Rogers is a professional: he's always been paid for his role (I doubt much acting was involved) in MTV's show "jackass". Being a "pro" means nothing, and certainly does not mean you beat amateurs.
Plus, this is hacker news. In CS most amateurs, by virtue of actually liking what they do and putting in more effort, beat most professionals. Certainly on an individual level.
> If they have never handled the issue before it's almost guaranteed they will create new issues and then cry about or hide behind their good intdntions after things blow up in their face.
This is exactly the behaviour we keep seeing from professionals. Specifically, mental health has nothing remotely like the medical profession's responsibility, they do not accept the consequences of what they do, and they always hide behind their "good" intentions (scare quotes because: pros are by definition paid for their good intentions)
Here's a story of situations mental health "professionals" created: https://elan.school/83-keyed-up
The history of psychology and psychiatry is full of lies, deceit and, more than anything else: abuse. Mostly of underage girls. One might point out:
https://en.wikipedia.org/wiki/The_Freudian_Coverup
What was the best-selling product of dr. Sigmund Freud? I will point out his name is still revered by current psychologists. That product was: testifying in court how girls (and boys, though much less often) wanted to be raped, and thereby caused and carried guilt for being raped. In addition to this he silenced victims ... with violence. Not for free, of course. Also with drugs, therapy, making them doubt themselves, ... whatever he could.
Current psychologists largely still do not see a problem with either his theories (they'll say they're "superseded") or his actions. One can only assume his status as the best earning psychologist ever has something to do with that.
The brain is understood well enough to totally discredit 90% of psychology. It has just never been the intention of psychologists to be accurate. That's literally not what the science entails. They want to change the world for the better. Lying to accomplish that may be a grey zone, but it is quite well accepted this is part of how psychology works. It's like political science. Whether some claim is true or not is, at best, considered secondary to its effect on people. Perhaps not ideal, but let's say useful.
For example, a claim that you will find well supported, but not in psychology is that abused people ... are very likely to abuse others. It's of course a controversial claim, but it's pretty well supported. Psychologists will not accept it. Now this, I guess, can be valid position, because if you want to change the world for the better, then perhaps not accepting this claim is the right thing to do. But none of that has any bearing on the truth of it.
Are you sure you're referring to the right person? The only "involvement" Kenny Rogers had with Jackass was being portrayed in a MADtv sketch, afaik.
[citation needed] -- a hobby of mine is watching Psychology and Neuroscience courses on youtube. One from 12 years ago that I rewatched semi-recently, the professor explicitly called out Freud as a fraud, but needed to talk about his one theory anyway.
The only people who give a shit about Freud are laymen, honestly. It's just that we've already had 2 or 3 decades where a lot of publications disproved Freud, nobody gives a shit to do that all over again, and most things that can be said about a guy from 100 years ago, have been said.
> The brain is understood well enough to totally discredit 90% of psychology. It has just never been the intention of psychologists to be accurate.
[citation needed]
In the case of ADHD, neuroscience and neurochemistry feed into and complement Psychology. They aren't all done in a vacuum, and many colleges for... many decades now, have neuroscience courses as mandatory for psychology undergraduates.
> For example, a claim that you will find well supported, but not in psychology is that abused people ... are very likely to abuse others. It's of course a controversial claim, but it's pretty well supported. Psychologists will not accept it.
Err... what? This is taught on Therapy/Counselling 101 courses.
Call it bullshit all you want. I can climb on the rooftops and scream “mental health diagnosis is bullshit!” and at the end of the day I still legally have the diagnosis’s I have, I get social and tax benefits from being disabled, people whisper about (correct) rumours of me being disabled, I still belong to the disabled identity group regardless of the scientific validity of grouping us.
I’ve had similar “it’s all bs so why care about self-diagnosis” and there are good reasons. First physical health conditions can be misdiagnosed as developmental disabilities. It fucking alarms me the people with no childhood history of a mental disorder will self-diagnose themselves with it as adults. The second is there are some people who clearly aren’t all right upstairs and there is a risk of diluting resources. I honestly am fatalistic about the issue though and think eventually the mental health status quo will implode
Also since they are clinical psychiatrists I always 100% encounter them in a clinical setting where I already suffer from "white coat syndrome" so that just factors into the mess.
Labels can be useful if you actually understand what they mean but most people have no training to do so. It would be better if we focused on symptoms that negatively impact people's lives than illness labels.
Nothing stupid ever comes out of there.
Besides, kids today are just naturally smarter, just ask one and theyll tell you.
The last few years have been very rough. Then Covid came and made it way worse, destroying kids worlds.
Tons of people needed help. But that made everything worse if you tried to find help. At least in my area there weren’t enough psychiatrists and counselors before Covid. After it could be months to get an initial appointment if you could even find someone willing.
And cost is a huge issue. They’re teens. Care and meds are expensive. And many insurance plans don’t help as much as they would for normal issues.
So what are they going to do? Turn to what they know. Online stuff, especially TikTok.
I’m not saying any of this is good. But it seems symptomatic of much more systemic failures.
Isn’t this a bit like complaining homeless people keep sleeping on benches or GoFundMe has too many medical donation requests?
Here in Canada you need a referral from a doctor (hard to get on its own), then you have to wait many months to years to see someone. Alternatively you can go private and spend quite literally thousands of dollars like I have.
Teens may recognize something is wrong, but simply not have access to the systems they need. We don’t want people to self diagnosing, but we as a society don’t enable them to get the help they need, so they turn to social media.
But who are their peers? Sometimes having a word for how you are can help you find other people you'll vibe with, even if it's technically a misdiagnosis. I've seen it both with neurodivergence and LGBTQ, with kids who arguably don't even fit the label but find and return great value in those communities anyway. I'm sure people here can appreciate how sometimes results matter more than adherence to inflexible rules laid down in some book.
No one is "binary". Even the voltage levels inside electronic circuits, that everyone calls binary, are not binary. What's up with this contemporary obsession for seeing everything in pure black-and-white terms and dismissing the power of the rare, mysterious and unknown liminal states of being, acknowledged since time immemorial by countless traditions?
They observe that in the world around them (media, etc.), “gender A” implies X, Y, and Z traits, and “gender B” implies W, R, and T traits.
The subject does not feel they exhibit exclusively X Y and Z traits nor exclusively W R and T traits, but rather some mixture of the two.
The subject then has two options. Reject the worldview claiming A=>XYZ B=>WRT, in flavor of a more dynamic classification scheme; or introduce a new category, C, which maps to their experienced subset of XYZWRT.
I’ve seen no evidence to support one approach being more valid than the other.
It is a banable offense from disability communities to doubt somebodies diagnosis. I was told nobody lied about faking a diagnosis, so I faked a diagnosis under extremely suspect circumstances, was believed, revealed my deception, and was permanently banned. Regardless of the morality of my actions, the point is that people want to truly believe that everybody they meet that self-diagnose themselves with disabilities is valid, and anybody who attacks this delusion is an enemy to be expelled from the community, even if such a person is doubtlessly disabled. The way I see it, ideology has become more important for membership in these communities than actually having a disability, because somebody ideologically misaligned is a threat to “safety” or whatever.
I’ve seen people call for moderators to be taken out over “fakeclaiming”. I find the entire ideology espoused in TikTok to be deeply naive and grounded in a false implicit assumption that a label of disability will make peoples lives better and thus to deny them that label is some sort of cruelty. I’ve been in conversations where somebody asks “am I diagnosed”, they will describe something that disqualifies the diagnosis, I point out no they can’t be they don’t fit the criteria, and others in the thread will start saying “oh they must not have meant that they must have meant this” and I’ll just sit there stone cold fucking baffled. I wonder how many people will suffer untreated illnesses because strangers on the internet talked them into thinking they had a developmental disability when they really had hypothyroidism or something because they treat not having a diagnosis like failing to catch a Pokémon.
A lot of people arrive at these communities due to their insecurities and personal pain, and it's not helpful to go around pointing fingers saying "you're not part of this group".
They're support groups, not medical boards.
This TikTok thing is a fantastical world where the more visibly and stereotypically disabled you act, and the more diagnosis's you have, the more people give you positive attention. The presumption is though that it would be a terrible burden to impose on somebody to tell them they aren't disabled is what has brought us to the status quo in the article.
My experience is that a lot of the time, being diagnosed doesn't help people, and in fact subjects them to stigma, it does result in reification. I've seen people react to labelling themselves with a disability with significant self-destructive personality changes caused by self-victimisation. Mostly I feel resentful towards the medical system who really caused this nonsense to be inevitable by making people feel nobody will help them unless they apply some unflattering label to themselves first thus making them insurable.
The labels aren’t the problem per se, but how we go about treatment, communication and building healthy psyches and ego is.
This, in and of itself, would seem to warrant some sort of mental illness. Victim complex, perhaps?
I had interpreted this trend as something different. Kids wanting to be outliers because being an outlier is cool. Claiming some, realistically debilitating, mental illness makes you special (at least in the "different" sense). This gives lonely teenagers a sense of belonging and something that differentiates them. Most of them could probably be diagnosed with narcissistic personality disorder but I am not doctor. I suppose this isn't new. When I was a kid the kid in class that showed up with a cast was pretty cool for the time they had the cast. Everyone loves an outlier.
As someone who has struggled with a mild-to-medium form of ADHD, only getting a formal diagnosis late in life, I am baffled anyone would want to pretend to have a mental illness. Yet, here we are.
Teenagers are, by nature, trying to fit in. Because of the internet (and TikTok) they try to find themseves belonging to specific mental/physical disorder groups by faking the symptoms.
People develop the weirdest "alter" systems (faking DID), everyone seems to have self-diagnosed ADHD and depression or is on the autism spectrum. Tourettes is another faker staple.
For many it's just a phase and they figure out who they are (as teens do), but some go down the deep end and actually develop mental issues from faking having mental issues so long... Or it becomes a part of their identity and they find friends in the scene so they need to keep doing it.
Given the number of mental disorder that first show major symptoms in later childhood, early teen years, I sometimes wonder how you would distinguish someone with a "real" disorder, and someone who "faked it til they made it".
I also find it sort of weird how much as a society we're hung up on hunting down fakers. It's oddly pervasive once you start looking around, and I worry that in many cases we're doing more harm than good. Our obsession with finding people that are fakers about pain has led to immense pain and suffering for those that need pain treatment (and like my question above, it's amazing how many "signs of addiction" look exactly like "signs of someone in pain and being un(der)treated. Fears of fakers makes any government assistance program a nightmare to get into, and a nightmare to navigate, never mind the number that are held back.
In the end, I wonder what is worse, for 100 teens to be over diagnosed, to go through life thinking they have a disorder and being medicated when they don't need it, but for 100 other teens to get the help and support they need for real problems. Or for those teens to be untreated. To go through life convinced they're just lazy, or stupid or just not trying hard enough. But at least their normal peers aren't being overmedicated or convinced they have something wrong with them that they don't.
Sure in an ideal world, 100 teens would be treated as they need, and 100 others would not as they don't. But in the real world, it feels like we often lean towards preferring some suffer so that those that might be faking don't get their way. And I'm not convinced that's a good thing.
Are there other mental health issues being spurred on by TikTok? If so, which ones?
And then the followup:
Is it more beneficial to the individual to affirm OR challenge the TikTok-driven self diagnosis?
You can watch a video, paired with written material, but in my experience the best way to learn is assigned readings and/or exercises, then circling back to discuss them with a subject matter expert if you truly don't understand how to perform the attack or math problem or whatever.
I don't have a Tik Tok, but I've used enough social media to say I don't think I'd want my kids getting their mental health information from there.
Now, if an existing institution uses Tik Tok or Facebook or Myspace or whatever to share their content, that's one thing, but the combination of "new network" with "new content creator" where neither side seems to care about the health of society as a whole... creates problems IMO.
(Then again, the same assholes who used to wander around Scott Township every Halloween handing out fifty cent pieces to children still haven't threat modeled basic things like "if your plan for a cyberpunk future was to run away in a submarine like the president from 24, you didn't social engineer the science center well enough, they'll tell you it doesn't work anymore")
Anyways, thanks for the link OP -- enjoy spooky season!!