Scientists are starting to understand how autism and ADHD can overlap
5d 1h ago by lemmy.dbzer0.com/u/Aatube in longreads@sh.itjust.works from www.nationalgeographic.com
an overview of "AuDHD"
Is it just me or is the Diagnostic and Statistical Manual of Mental Disorders 10 - 20 years behind the state of research?
hmm, what makes you think that?
Maybe it's just my observation bias because i'm affected and actively analyze it with my psych (but each case is slightly different according to him), but this is all already familiar to me.
I feel like that's kind of to be expected in a field that has a half life of knowledge of only around 7 years. I doubt many psychologists/therapists actually follow the manual to the letter. If yours does I would definitely find a new one!
Oh hey this is me. Got my diagnoses like a month ago. Feels nice to be seen.
Shhhh! RFKJR will hear you..!
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So is there a point where, as a society, we decide to stop medicalizing and diagnosing everything and just work with individuals the ways that work best for the individual without regard to neurology etc? The more we study it, the more complex it seems to get, the more ways there are to justify a diagnosis, a highly subjective process.
I'll also add that there are a lot of parents desperate to get their kids whatever diagnosis they can to give them an advantage in taking tests.
I'd also say that trauma and stress are still often ignored in preference of a developmental diagnosis that can lead to the easy solution of a prescription.
I always took tests really easily. It was the homework that was a problem.
just work with individuals the ways that work best for the individual
the core of the neurodiversity hypothesis has always been that there’s nothing wrong with the individuals themselves and that treatment is for helping them adapt to a (probably not the canon word) neuronormal-assuming society. the pathological explanation is the competing hypothesis.
so the answer is: that’s exactly what the “hip” neurodiversity care is doing right now.
of course, you still have to understand the neurology, and there’s no reason not to work on that.
https://en.wikipedia.org/wiki/Neurodiversity
trauma and stress are still often ignored
sauce?
Not to speak for the other guy but i guess i think it's just not a medical issue. Im diagnosed autistic and adhd but honestly I don't think there's anything wrong with me, i just dont like certain things that are very popular and i get bored by certain things that other people find fascinating. But like they prescribed me adderall and duloxetine and idk they kinda numbed me a little bit and let me focus on boring stuff more, but it didn't change that i didn't like those things and i think im allowed to just not like large crowds and intense eye contact. I dont need a doctor to find a cocktail of drugs that will make me someone im not.
So yeah im a grown man and i decided I didn't want treatment anymore, but if i wasn't as grown or as willing to take doctors advice with a grain of salt, id just be a drugged out zombie that was chemically forced to live a life i dont want.
yeah, i think that's the essence of the neurodiversity paradigm i've been talking about.
Well sure but this article is talking about disorders and treatment. My point is i dont have a disorder and i don't need treatment, but the medical profession sees my likes and preferences as something that requires powerful drugs.
Yes, I guess the issue is if everyone is a complex individual with diverse presentation if it makes sense to have a binary “you have it” / “you don't have it” diagnosis.
Here's one article on anxiety vs adhd: https://childpsy.org/anxiety-or-adhd-the-diagnostic-confusion-that-derails-childrens-mental-health/
It's pretty obvious that psychiatric diagnoses follow trends, going from underdiagnosed to overdiagnosed; with the possible exception of the rise in bipolar disorder, which is probably due to a boom in anti-depressant medications “revealing” mania, which at least some doctors are beginning to acknowledge.
that’s why even the pathological paradigm does not use a binary diagnosis for autism. it’s called autism spectrum disorder.
the article isn’t what the other evidence says. i could find no good sources for the phenomenon it describes. in fact, most evidence points to the opposite:
Often, it is the comorbid conditions that are recognised and the symptoms of ADHD that are missed. https://www.cambridge.org/core/journals/bjpsych-advances/article/misdiagnosis-and-missed-diagnosis-of-adult-attentiondeficit-hyperactivity-disorder/FF6646643B2BC02FFE7D20BBB4967950
there are lots of differential diagnosis problems across mental healthcare. i don’t see any reason adhd and anxiety is the disproportionately prevalent one instead of just the one politics are converging on atm. all this reminds me of claims that transgender children overwhelmingly “desist”.
one article
that is one hella sketchy website. compare the dates on the front page. phrases like “the comorbidity reality” and the parentheticals on the differential equations section suggest LLM content farming to me.
there are lots of differential diagnosis problems across mental healthcare
And there always will be, because people are complex and there are multiple ways to look at them; why is the medical model [edit: in this area, in psychiatry] so highly valued when it's just a series of failed and incomplete models propped up by drug company research? Medicine got its prestige by being able to diagnose definite problems with definite tests and offer definite treatments with definite results. Mental health medicine is largely absent those traits.
The landmark theory of depression, serotonin deficit, has been thoroughly disproven, and the drugs that theoretically addressed that deficit turn out to be very slightly better than an active placebo.
My conclusion is that society never stopped needing priests and witch doctors.
Medicine got its prestige by being able to diagnose definite problems with definite tests and offer definite treatments with definite results
"definite" tests are extraordinarily the rarity across all medicine. the rest of the body combined is more complex than the brain, and you often need to look at how the rest of the body interacts when you're solving a problem, and sometimes you even need to factor in the brain because stress can cause physical symptoms, everything interacts and you can't just separate one aspect and disproportionately scream at it.
it's simply that we've been studying the rest of the body for a bit of a longer time than we have mental stuff. in the '60s, aspirin was in a similar place as SSRIs are right now.
my conclusion is that science is never a clear thing because it is science. we document what we get in and then what we get out of it. we can experiment to show there's a result, and that doesn't mean we have anywhere close to a complete model of it. there's always pretty uncertain areas to explore, and it's often just better than nothing.
Yes, I may be being too generous to body medicine, but there sure seem to be a raft of objective tests to interpret; such a thing does not exist in psychiatry, except maybe for some recent genetic testing which is even less conclusive than a cholesterol test. And then you give a treatment and run more objective tests to see if anything's budged. Psychiatry has nothing siimilar.
I'm willing to give psychiatry a chance, but my problem is that it hasn't really done anything to deserve its current status. Just about every psychiatric drug started for another use and people noticed its psychological effects. Then they tried to come up with a reason the drug worked, then they marketed it. SSRIs are the classic example. "These drugs make you happier. What do they do? They manipulate serotonin. Therefore: depression is caused by a serotonin imbalance." Completely and absolutely wrong.
There is a long list of similar failures in psychiatry; schizophrenia used to be a passing thing in the past, now people are dx and treated for schizophrenia for life.
The entire approach of looking at the brain in isolation is problematic. Because, really, the brain is just a reflection of everything we experience. If you're monitoring someone's brain activity, you might notice a spike in chemicals associated with joy. "Hm. Looks like there's been a spike in the brain chemistry associated with pleasure," you'd say, and make a note of it somewhere. Whereas if you talked to the person, you'd realize that what (also) happened is that they got the good news that their wife survived the surgery. Which of those two approach, followed more assiduously, will get you closer to the human truth of existence?
Another factor against psychiatry is that we are highly suggestible. There's a reason that so much woo works with pain. Because pain is a subjective experience, as long as someone thinks they're getting an effective treatment, they'll have a placebo effect. The problem with medicalizing something like anixety is it suggests that the person has a problem with anxiety, and they must fix it; this causes an obsessive loop. Same for depression--people learn they have a BRAIN DISORDER making them depressed and they both lose hope and dedicate their effort to "fighting the depression."
One thing that seems very healing across the board across almost any illness is investing in your life, learning about your dreams, and going for what you want in life and relationships.. My problem is that medicalization and (to a large extent) therapy foregrounds an abstract diagnosis that disempowers people, violating the very first line of the Hippocratic Oath: do no harm..
I came to most of this largely through long and painful personal experience, but I've done plenty of reading and research and met quite a few people who've had the same struggles with the system and only got better once they got out..
But, anyway, to bring it back to the article.... I do think there's been good work on understanding and appreciating autism and ADD, but I'm wondering why we have to draw lines around THESE problems and not others. For instance, why does a student with ADD automatically get extra time for a test but a student who is going through a personal crises does not?
And as far ASD, I did just see a comic say she failed two tests for autism, and the second doctor said, "You were really close, but the tag on your shirt doesn't bother; you don't have the sensory issues, therefore you don't have ASD." The joke she had was that being annoyed by a tag on a shirt is the difference between someone being rude and someone having autism.
But the joke just points back to what I'm saying, If someone doesn't like making eye contact, why do they need a diagnosis so they don't get fired for being "anti-social"? The reason, of course, is the ADA and only people in protected classes have ADA protection. I'm asking why can't we just treat people the way they like to be treated in an environment that's best for them, regardless of anything?
I failed Autism Video: https://youtu.be/4JnlN6exqhI
why is the medical model so highly valued when it’s just a series of failed and incomplete models
I've seen people with a stroke lose complete loss of their arm & leg. Get thrombolysed then the next day their main symptom being pins and needles. Seems a pretty good reason to value it..
My conclusion is that society never stopped needing priests and witch doctors.
Hmm priests around my area aren't exactly know for healing people.
I took the trouble to re-read my comment to give you the bad news with a high confidence interval that you fundamentally misunderstood it. Feel free to read it again and replay again if you'd like.
Edit: Editted the original comment for clarity.
Fair enough re:edit , I don't know enough about the mental health medical practices to comment
You're so close, too! 🫡 Prescription means medication means profit. Simple as.
Yeah, I'm not a knee-jerk anti-pharma guy, but the research for psychiatric medicine is absolutely not good.
Good for profit, yes. People? Very few.
edit: thanks for the driveby, anon. guess you didn't catch the subtle "few" as in "1%" —via profiting off half-measures and pay-to-stay-sane human trials? my bad.
“Prozac is like insulin for diabetics,” wasn't even the first clue.
I just downvoted you for whining about a downvote, doesn't add to the discussion.
Ah, yes, the ol' "Who downvotes the downvoters" schtick. Cute. Move along.