Hacker News Reader

Comment by Eumenes | Hacker News Reader

Seriously. There are "doctors" offices in NYC that operate in 5 minute appointment intervals. The entire waiting room is full of white collar professionals or college students with this terrible disease, ADHD. Anyone who wants it can get it, you just gotta find a pill mill. You self diagnose by saying "I can't concentrate" or "I get distracted" and the shrink writes you a legal script for speed. Some places may have you answer a questionnaire, which is self fulfilling prophecy. Seriously, look at these questions, its laughable this qualifies you for legal meth - https://add.org/wp-content/uploads/2015/03/adhd-questionnair...

View on HN

ADHD is real, it deeply damages people's lives and it is usually treatable with stimulants, with an unusual degree of effectiveness. My psychiatrist told me up front that his diagnostic process was not directed towards ADHD and that he might end up with some other diagnosis or none at all. In the end he diagnosed me with ADHD after a process of interviews, tests, evaluation of historical evidence, and submissions by my family regarding my life and behaviour. I have a fat file of the documentation involved.

You are talking about greedy irresponsible doctors and bad faith "patients".

These are not the same thing.

Stimulant's are effective at improving mood and productivity. There is no question there. I'm highly skeptical of a "disease" or "disorder". Having worked in investment banks where the majority of people were on adhd meds, college where most students were on adhd meds, and seeing all these mid-life diagnoses - is troubling, esp. when prescribing these drugs to children. Its becoming normalized, and even celebrated. Sitting in a classroom for hours everyday, glued to your seat, demanded to shut up and pay attention, is not an ideal environment for kids. If you deviate from that, you could be a candidate for adhd. Once you start these drugs, its difficult to stop and you develop a dependence. I took them for years in my youth and deeply regret it, because it was simply a bandage for addressing areas of self improvement that I ignored. I wish I had someone around back then to play devils advocate.

My revelation came when I observed my oldest child in kindergarten (which was nothing like being glued to a seat). My child was the large and obvious behavioural outlier. Then the unbelievable process in grade 3 of coaching their attention to and completion of simple homework, with much emotional distress and sobbing and feelings of inadequacy. Same with participation in sports. There is no such thing as “an ideal environment” where my kids would function in some kind of parity with their peers.

You have no clue because you have no pertinent experience.

You have to look out for your own kid and do what's best, not my place to speak, but I think we can agree on different approaches to these problems. Not all have to be involved with diagnosis or medicine.

I shared these articles in another comment, but this is what I fear is taking over the 'mental health' diagnosis situation atm:

https://unherd.com/2022/11/who-decides-if-youre-mentally-ill...

https://mentalhellth.xyz/p/the-buzzfeed-ification-of-mental

I will agree that you are conflating and grossly oversimplifying a number of related but different issues. As a result your conclusions are just not valid.

Does the educational system make age-inappropriate almost inhumane demands on children? Yes. Do many kids have attentional and behavioural issues that are not ADHD? Yes. That can be improved without medication? Yes. Should these be distinguished from true AHDH and treated differently? Yes. Should kids with ADHD try non-medical interventions first? Yes. Should kids who have clear diagnostic markers for ADHD and who respond well to stimulants be prescribed stimulants? Hell yes. Should psychiatrists try to weed out non-ADHD people looking for legal sources of speed? Hell yes. Are the fields of psychopathology and psychotherapy problematic? Somewhat. Are they "right"? Not exactly, no. Are they "wrong"? Not exactly, no. Do they relieve suffering? Sometimes, Do they create unintended consequences? Yes, more often than we'd like. Is the whole field conducted in bad faith? No! Is it a work in progress? Yes. Are there bad faith practitioners? Yes. Are there incompetent practitioners? Yes. Are there competent practitioners acting in good faith? Absolutely yes. Are there reliable signals to tell these apart? No, unfortunately, no. Is there an epidemic of performance-enhancing prescription drug abuse in the circles in which you run? Apparently so, and I've heard this elsewhere. Is there performance-enhancing prescription drug abuse in the circles in which I run? Not to my knowledge.

Life is complicated. You do no good by mashing all this stuff together and disposing of it with simplistic conclusions.

> I'm highly skeptical of a "disease" or "disorder".

Well, it’s you versus the entire medical community. Who do you think is more likely yo be right?

Your bad experience is unfortunate but does not reflect that of most people with ADHD. It’s the only disorder which responds incredibly well to treatment by stimulants, and you’ll find that fact proven out by medical science.

Psychology/psychiatry has a dark past and seems to change its mind on things very often (often because of political correctness). Borderline a pseudoscience.

Until there's a blood test or concrete psychological proof, its just simply not a disease. These articles were great reads on this phenomenon of self diagnosis:

https://unherd.com/2022/11/who-decides-if-youre-mentally-ill...

https://mentalhellth.xyz/p/the-buzzfeed-ification-of-mental

> Until there's a blood test or concrete psychological proof, its just simply not a disease

Again, you versus the entire medical community. I am saddened to see you making such strong claims from a position of such ignorance.

You're talking about self-diagnosis, and I'm talking about medical professional diagnosing the disease.

My claims are from a position of experience - myself, seeing friends/family all diagnosed with disorders out of nowhere, seemingly around the same time. Seeing colleagues and peers suddenly "neurodivergent". Looking for temporary solutions to permanent problems in the form of a pill. Using these substances to lose weight, get ahead at work, study, clean their homes, become more social/personable, etc. I digress, adults can calculate the risks for themselves.

If you take a peek at those articles, you'll notice that there's a big trend in people (usually young adults/teens) self diagnosing on the internet, whether its joining a forum/reddit/discord, then going to a doctor, saying, "I HAVE X" and more often than not, they get what they want. This takes away a good chunk of credibility of the 'medical community'. You can even get "diagnosed" via telehealth services now. No need to go into an office! How many people are they turning away? Hmm.

Yep and this ends up hurting everyone who legitimately suffers from it.

Both from people who do this, then decide the meds just get them high, so they must get everyone high—they don’t.

And from those who see this and use it as fuel attempt to discredit the condition itself.

> writes you a legal script for speed.

ADHD meds aren’t street drugs. There’s stimulant and non-stimulant options, that work for different people.

> its laughable this qualifies you for legal meth

Desoxyn is a rare treatment option, valuable to those who really need it.

Methamphetamine may be _very_ close to other amphetamines, but the methyl group unlocks access to other parts of the brain. It’s a different drug, with different effects.

I fully agree with you that this shouldn’t be happening, but the comparisons to street drugs only work in favour of operations like the one you describe in NYC.

Reply on news.ycombinator.com