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Comment by andoando | Hacker News Reader

If we fully admit that the DSM is merely a tool for treatment, a stastical tool to say "this drug might help the issues youre feeling" fine, however this is not the view Ive commonly seen in phycitatric literature, which points at ADHD being a "real disorder", as something definite one "has". Patients also commonly believe they have a definite disorder, saying things like how they finally "discovered" they have ADHd or even that they might "have undiagnosed ADHD". If we agree that the diagnosis is not informative, thst it is merely putting a name to something one already knows about themselves, do we then agree that this kind of talk is invalid?

If so, and if this view is really prevalent in psychiatry, somehow it's completely lost on the general public and media.

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> saying things like how they finally "discovered" they have ADHd or even that they might "have undiagnosed ADHD"

This is not in contradiction to something being syndrome. Plus patients usually do not understand and do not have to understand technical nuts and bolts of whatever issues they have.

You cant require people to talk in clunky language qualifying every single nuance each time they speak about issues or diagnoses they have. You would just render them unable to express what they need to express.

> If so, and if this view is really prevalent in psychiatry, somehow it's completely lost on the general public and media.

General public and media are completely lost on eating disorders, OCD, psychosis and pretty much any other psychiatric/psychological problem. They are equally lost on AI, HIV and economic policy.

I don't think I am being pedantic. There is a monumental difference in how you perceive your condition between "I have some troublesome behaviors which these drugs can sometimes alleviate" and "I have an inherently disordered brain that cannot function properly". Perhaps the HN crowd is different, but the latter fits most people's understanding of what Ive seen

What is the qualitative difference between "having some troublesome behaviors" and "having an inherently disordered brain" in your opinion?

Behaviours are what you do - how you interact with the world. Having disordered brain is about how your brain functions. If I yell at you, it is behavior not am "inherently disordered brain".

If I feel sad all the time, it is not a behavior. It is a feeling. If I am forgetting a lot, it is a brain function too, not a behavior. Behavior can be used to mitigate the disordered brain, it can be result of it, it can be completely intendent of it.

Behavior can be something positive or neutral. Eating is behavior, giving a gift is a behavior.

I understand what behaviours are, but "having troublesome behaviours" implies something kinda systemic right? Something that someone does habitually (otherwise you probably wouldn't seek out medication for it). What is it that causes that habit, and if it is a mental cause, how does that differ from having a "disordered brain"?

Having troubles in your life does not imply something systemic no. The qualitive difference is one a name for a group of symptoms, the other claims to be a cause of those symptoms.

You may be losing things often because your place is a complete mess. You may not keep attention in conversations because you spend all your time playing video games and cant relate to anybody, or because regular people simply bore you and you need to find your own crowd.

These kind of explanations are far different than "My brain is inherently and permanently incapable of 'proper executive function'. and the REASON Im like xyz is because of ADHD". Take a look at /r/ADHD if you get a chance. I saw a top thread that read "Does anyone else have trouble keeping eye contact during sex?" with everyone going "wow me too! I didnt know this was an adhd thing!"

Right, but both ADHD and Autism don't have clear neuromarkers, we diagnose people largely based on their symptoms (or the results of their symptoms). The stuff you describe (being bored by regular people, your place being a complete mess) can have "ordinary" reasons, but can also themselves be symptoms of neural disorders. If you have a bunch of symptoms that you've dealt with for years and that you also (succesfully!) take the same medication for that people with the disorder take, I think it can actually be difficult to clearly delineate what is causing it.

Also your example is kinda dumb! You don't have to have Alzheimers to be forgetful, it's actually quite common. But if you post "anyone else here keep forgetting things?" on r/Alzheimers obviously people on there are going to be like "yeah me too".

I am not sure what your point is. Mine is precisely that there is no clear definition nor diagnostic criteria for ADHD, and that merely having more than an average collection of these otherwise ordinary behaviors, does not automatically constitute a new neurological disorder.

>Also your example is kinda dumb! You don't have to have Alzheimers to be forgetful, it's actually quite common. But if you post "anyone else here keep forgetting things?" on r/Alzheimers obviously people on there are going to be like "yeah me too".

What I was trying to demonstrate is that people DO have the belief that ADHD is a causative thing in itself, and not merely a name for a collection of symptoms used to make treatment easier, as was suggested is the case.

Yes, and it's likely due to low-intensity disorder showing up as something one can control, manage, compensate for, and find a place for oneself in society, but if somehow the dial gets fiddled with, things start to fall apart as we move up the sigmoid curve, positive feedback loops turn negative, and a state sponsored suite soon seems sensible.

In other words people with mental illnesses/conditions/disorders/syndromes doubt their own diagnosis, because sometimes it "just feels like an adorably tiresome behavioral `oh you` that everyone laughs at", and other times the wolves are howling inside and suddenly you understand every and all kinds of disability, escapism, compulsion, and serial killers, as you are trying to cancel plans, make up excuses, ask for help, while - by definition - fail to do any and all of those as a headwind of hurt hurls heavy and hopeless.

I think you should re-read the parent comment, and try to read what is written instead of what you are looking to read.

First and foremost, DSM is a classification tool. It is to set up the jargon and coding of the disorders

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