Introduction
Earlier this year, Alan Schwarz, an investigative reporter for the New York Times, published his latest book: ADHD Nation.
The blurb on the jacket states:
“More than 1 in 7 American children get diagnosed with ADHD—three times what experts have said is appropriate—meaning that millions of kids are misdiagnosed and taking medications such as Adderall or Concerta for a psychiatric condition they probably do not have. The numbers rise every year. And still, many experts and drug companies deny any cause for concern. In fact, they say that adults and the rest of the world should embrace ADHD and that its medications will transform their lives.
In ADHD Nation, Alan Schwarz examines the roots and the rise of this cultural and medical phenomenon: The father of ADHD, Dr. Keith Conners, spends fifty years advocating drugs like Ritalin before realizing his role in what he now calls ‘a national disaster of dangerous proportions’; a troubled young girl and a studious teenage boy get entangled in the growing ADHD machine and take medications that backfire horribly; and Big Pharma egregiously over-promotes the disorder and earns billions from the mishandling of children (and now adults).”
And who could argue with any of that? But the blurb continues:
“While demonstrating that ADHD is real and can be medicated when appropriate, Schwarz sounds a long-overdue alarm and urges America to address this growing national health crisis.”
And there, of course, is where we must part company.
When I first read the jacket blurb, I was curious as to what kinds of arguments Alan Schwarz would marshal to support the contention that ADHD is “real”, and that it sometimes warrants “medication”. And let us be clear as to the meaning of the word “real”. Nobody is denying that inattention, hyperactivity, and impulsivity can be real problems. The issue at stake, however, is whether it makes any sense to conceptualize this loose cluster of vaguely-defined problems as an illness. Usually when people say or write that ADHD is “real”, they mean that this cluster of problems listed in the APA’s catalog (DSM) is a genuine, bona fide illness – just like diabetes; and that people who “have” this so-called illness must take their “medication” in the same way that diabetics must take insulin. So, the promise on the jacket that Mr. Schwarz would demonstrate that ADHD is a real illness seemed significant, and as I said earlier, I was particularly interested in whether he had anything new to add to this debate.
Here’s the opening page of the introduction.
“Attention deficit hyperactivity disorder is real. Don’t let anyone tell you otherwise.
A boy who careens frenziedly around homes and busy streets can endanger himself and others. A girl who cannot, even for two minutes, sit and listen to her teachers will not learn. An adult who lacks the concentration to complete a health-insurance form accurately will fail the demands of modern life. When a person of any age has a combination of these struggles—severely enough to impair his daily functioning—with no other plausible explanation for them, then he could very well have a serious, if still somewhat mysterious, condition that medicine has decided to call ADHD.
No one quite knows what causes it. The most commonly cited theory is that the hypractivity, lack of focus, and impulsivity of classic ADHD result from some sort of dysfunction among chemicals and synapses in the brain. A person’s environment clearly plays a role as well: a chaotic home, an inflexible classroom, or a distracting workplace all can induce or exacerbate symptoms. Unfortunately, as with many psychiatric illnesses, such as depression or anxiety, there is no definitive way to diagnose ADHD, no blood test or CAT scan that lets a doctor declare, ‘Okay, there it is’—all one can do is thoughtfully assess whether the severity of the behavior warrants a diagnosis. (After all, we all are distractible or impulsive to varying degrees.) One thing is certain, though: There is no cure for ADHD. Someone with the disorder might learn to adapt to it, perhaps with the help of medication, but patients young and old are generally told that they will deal with their abnormal brains for the rest of their lives.” (p 1)
And there is it. Let’s take a closer look.
“Attention deficit hyperactivity disorder is real. Don’t let anyone tell you otherwise.”
The reality or otherwise of “ADHD” is the fundamental issue of this entire debate, and it is clear from this opening statement that Mr. Schwarz has not approached this question with anything resembling the kind of open-mindedness that one expects from an investigative journalist.
But it gets worse.
“A boy who careens frenziedly around homes and busy streets can endanger himself and others.”
Mr. Schwarz is clearly trying to create the impression that this kind of behavior is fairly typical of children who “have ADHD”, and he is also pointing out that the behaviors are serious. What he doesn’t mention, however, and perhaps isn’t even aware of, is that physically dangerous activity – including running “into street without looking” – was one of the specific criteria for ADHD in DSM-III-R, but was diluted to “runs about or climbs excessively” in DSM-IV. And in DSM-5, the word “excessively” was dropped. Here are the actual items from the three editions:
DSM-III-R (1987):
“(14) often engages in physically dangerous activities without considering possible consequences (not for the purpose of thrill-seeking), e.g., runs into street without looking” (p 53)
DSM-IV (1994):
Under the sub-heading Hyperactivity:
“(c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)” (p 84)
DSM-5 (2013):
Under the sub-heading Hyperactivity and impulsivity:
“c. Often runs about or climbs in situations where it is inappropriate. (Note: in adolescents or adults, may be limited to feeling restless.) (p 60)
So, a boy who careens frenziedly around homes and busy streets would probably meet the standard in all three editions, but – and this is the critical point – there is no requirement in the latter editions of such extreme behavior to score a “symptom” hit. Contrary to Mr. Schwarz’s implied assertion, a child does not have to engage in such extreme or dangerous behavior to meet any of the APA’s criteria for this so-called illness. And it needs to be noted particularly that since 1994, the only requirement under this item for adults and adolescents is that they experience feelings of restlessness!
. . . . . . . . . . . . . . . .
“A girl who cannot, even for two minutes, sit and listen to her teachers will not learn.”
How can Alan Schwarz – or anyone else, for that matter – deduce that a girl who doesn’t pay attention to her teachers, can’t pay attention. This is an invalid inference, but is standard procedure in psychiatry.
. . . . . . . . . . . . . . . .
“When a person of any age has a combination of these struggles—severely enough to impair his daily functioning—with no other plausible explanation for them, then he could very well have a serious, if still somewhat mysterious, condition that medicine has decided to call ADHD.”
This again is standard psychiatric patter: the flaw is contained in the phrase “…with no other plausible explanation for them…”
Anyone who has had even the slightest experience working with children and families can attest to the fact that there are always alternative psychosocial explanations, if one is prepared to look for them. The reality, however, is that within the practice of psychiatry, these alternate explanations are almost never sought.
And the reason they are not sought is because psychiatry has effectively closed the door on these kinds of deliberations. Within the psychiatric framework, if a child (or adult) meets the arbitrary and inherently vague criteria listed in the DSM, then he has a brain illness called ADHD. So the notion of even looking for psychosocial explanations not only doesn’t happen, but would be seen within psychiatry as ridiculous.
In real medicine, if a person has pneumonia, then that is the explanation of his persistent cough, nasty phlegm, weakness, etc. The notion of a physician in such circumstances casting around for an alternative psychosocial explanation would be pointless. Similarly, psychiatrists, firmly wedded as they are to their spurious illness perspective, don’t look for ordinary human explanations of the problems they encounter. The difference, of course, between psychiatry and real medicine is that the latter’s diagnoses are indeed genuine explanations of the presenting problems. In psychiatry, the “diagnoses” are merely labels that psychiatrists assign to the loose clusters of vague problems, and have no explanatory value whatsoever.
To demonstrate this, consider the two following hypothetical conversations.
Client’s parent: Why is my son so distractible; why does he make so many mistakes in his schoolwork; why does he not listen to me when I speak to him; why is he so disorganized?
Psychiatrist: Because he has an illness called attention-deficit/hyperactivity disorder.
Parent: How do you know he has this illness?
Psychiatrist: Because he is so distractible, makes so many mistakes in his schoolwork, doesn’t listen when you speak to him, and is so disorganized.
The critical point being that in psychiatry, the only evidence for the “illness” is the very behavior it purports to explain. In other words: your son is distracted because he is distracted.
Contrast this with a similar conversation in real medicine.
Patient: Why am I so tired; why did my temperature spike; why am I spitting up such dreadful-looking phlegm?
Physician: Because you have pneumonia.
Patient: How do you know I have pneumonia?
Physician: Because I can hear characteristic sounds through the stethoscope; your chest X-ray shows large quantities of fluid in both lungs; your sputum labs are positive for pneumococcus; and because everything you have told me is consistent with this diagnosis. I can show you the X-rays if you like.
In this conversation, there is no circularity to the reasoning. The pneumonia is the cause of the symptoms and constitutes a genuine and useful explanation.
. . . . . . . . . . . . . . . .
“No one quite knows what causes it.”
Well actually, lots of people know what prompts children to “careen frenziedly around homes and busy streets”. It is very simply that the discipline and self-control to refrain from this kind of activity has not been instilled at an appropriate age. And it’s not “somewhat mysterious”. It’s something that parents and grandparents have been dealing with probably since prehistoric times. And the same goes for the other ADHD behaviors, misleadingly called “symptoms” in the DSM.
. . . . . . . . . . . . . . . .
“The most commonly cited theory is that the hyperactivity, lack of focus, and impulsivity of classic ADHD result from some sort of dysfunction among chemicals and synapses in the brain.”
And just when we thought that the long-discredited chemical imbalance hoax was about to die! Mr. Schwarz seems unaware that most leading psychiatrists are at the present time busy distancing themselves from this particular inanity, which was a mainstay of the psychiatric hoax for decades. The very eminent and highly prestigious Tufts psychiatrist Ronald Pies, MD has even gone so far as to claim that psychiatry never promoted this hoax – an assertion that adds an entire new dimension to academia’s allegorical ivory tower.
Then Mr. Schwarz gets to the point:
“Unfortunately, as with many psychiatric illnesses, such as depression or anxiety, there is no definitive way to diagnose ADHD, no blood test or CAT scan that lets a doctor declare, ‘Okay, there it is’—all one can do is thoughtfully assess whether the severity of the behavior warrants a diagnosis. (After all, we all are distractible or impulsive to varying degrees.)”
So despite the earlier vagueness, and despite Mr. Schwarz’s condemnation of what he describes as the over-diagnosis of ADHD, he is clearly a firm supporter of psychiatry’s contention that inattention, impulsivity, and general gadding about constitute an illness, if the behaviors cross some ill-defined threshold of severity.
This is another of psychiatry’s core fallacies, routinely promoted, not only in the successive editions of the DSM, but also in the defensive writings of psychiatry’s most prestigious promoters: if a problem of thinking, feeling, or behaving crosses some arbitrary and vaguely defined thresholds, of severity, duration, or frequency, it becomes, through some alchemy known only to psychiatry, an illness. The fact that no organic pathology has ever been identified is of no consequence. If the problem is severe enough, then it’s an illness.
And the reason for this travesty is that within the looking-glass realm of psychiatric diagnosis, the cause of the problem is irrelevant. This is the essential point of Robert Spitzer’s phenomenological approach as embodied in his DSM-III and in subsequent editions. Why a person exhibits a problem is of no consequence. If, in the case, say of “ADHD”, a child is inattentive, overly active and impulsive to the degree specified, albeit loosely, in the text, then he has the illness. Whether he emits these behaviors because of lax parenting, inconsistent parenting, indulgent parenting, sibling rivalry, emotional abuse, or some other cause, makes no difference to the “diagnosis”. In marked contrast to real medicine, where diagnosis and cause are virtually synonymous, in psychiatric diagnosis, the cause of the problem is immaterial. If the child emits the behaviors in question, for any reason or cause, then he “has the illness”. The “illness” in fact is nothing more than the presence of the vaguely-defined problem behaviors. There is no requirement of neurological pathology, nor any evidence that the behaviors in question entail a neurological pathology. DSM-III describes this approach as “…atheoretical with regard to etiology or pathophysiologic process except with regard to disorders for which this is well established and therefore included in the definition of the disorder.” (p xxiii), which is not the case with ADHD.
Far from acknowledging the obvious dishonesty of this “atheoretical” approach, DSM-III-R actually makes of it a virtue:
“The major justification for the generally atheoretical approach taken in DSM-III and DSM-III-R with regard to etiology is that the inclusion of etiologic theories would be an obstacle to use of the manual by clinicians of varying theoretical orientation since it would not be possible to present all reasonable etiologic theories for each disorder.” (p xxiii)
In reality, however, by ignoring etiological questions, the APA created the context in which “mental disorders” could be created at will on the basis of any human problem, and these “disorders” could be, and indeed are, morphed readily into “mental illnesses”, and, of course, as we see in Mr. Schwarz’s text, neuro-chemical imbalances. Psychiatry has conveniently abandoned the notion that new diagnoses must be grounded on proven organic pathology. Real doctors discover new illnesses through painstaking research and study – often taking years or even decades. Psychiatry just makes them up and confirms their ontological validity by a committee vote.
For decades, psychiatry, confident in the knowledge that few people read the DSM, simply lied with regards to the absence of organic pathology. They told their clients, the public, and the media the blatant lie that the “chemical imbalances” existed and were the cause of the problems. And – the biggest whopper of all – that the drugs corrected these non-existent imbalances. They also routinely asserted that their “patients” would in many (or perhaps most) cases have to take the drugs for life. And here again, Mr. Schwarz follows his psychiatric mentors, lock step.
“One thing is certain, though: There is no cure for ADHD.”
Again note the dogmatic arrogance. Children who are inattentive, unruly, disobedient, and disruptive to the inherently vague degree specified in the DSM are incapable of acquiring an age-appropriate level of discipline! How in the world could Mr. Schwarz know this? As early as 1973, Huessy, Marshall and Gendron (Five hundred children followed from grade 2 to grade 5 for the prevalence of behavior disorder, Acta Paedopsychiatrica, 39(11), 301-309), showed that hyperactivity is not a stable pattern across time. There is also an abundance of research going back to the 60’s that demonstrates clearly that children who are habitually inattentive, impulsive, and hyperactive even to an extreme degree, can be trained readily to behave in a more productive and less disruptive fashion. In fact, prior to the mid-60’s, no such research was needed, because parents and teachers routinely and successfully trained children to control their movements, and to pay attention to their studies and to their chores. Indeed, parents and teachers accepted that this was an intrinsic part of their responsibilities. But in 1968, with the publication of DSM-II, psychiatry’s “top experts” decreed that these problem behaviors constituted an illness that required specialist attention. This “illness” was labeled hyperkinetic reaction of childhood. The description ran to four lines:
“308.0 Hyperkinetic reaction of childhood (or adolescence)*
This disorder is characterized by overactivity, restlessness, distractibility,
and short attention span, especially in young children; the
behavior usually diminishes in adolescence.” (p 50)
. . . . . . . . . . . . . . . .
“…patients young and old are generally told that they will deal with their abnormal brains for the rest of their lives.”
Despite decades of lavishly funded and highly motivated research, and despite the numerous enthusiastic, and subsequently discredited, claims to the contrary, there is not one shred of evidence that people who have been given the ADHD label have any brain pathology whatsoever. In fact, no edition of DSM, including the present DSM-5, has ever included any kind of brain pathology as a criterion item for this so-called illness. DSM-5 does include ADHD in the Neurodevelopmental Disorders section, but all that this entails is that the onset of the problem was in the developmental period. There is no requirement of neurological pathology. “The neurodevelopmental disorders are a group of conditions with onset in the developmental period. The disorders typically manifest early in development, often before the child enters grade school, and are characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning.” (p 31) Describing “ADHD” as a neurodevelopmental disorder strikes me as extraordinarily deceptive, in that most people would interpret the term “neurodevelopmental disorder” to entail some kind of neurological pathology. What the APA has done here is convey the impression that there is a neurological pathology involved in “ADHD”, without having to produce evidence that this is the case.
The “Over-Diagnosis” of ADHD
Then Mr. Schwarz gets to the main theme of his book: that ADHD is being grossly over-diagnosed, a theme incidentally that many psychiatrists have adopted in recent years in an attempt to rescue their crumbling profession from the criticisms of anti-psychiatry. Watch how Mr. Schwarz does this:
“The American Psychiatric Association’s official description of ADHD, codified by the field’s top experts and used to guide doctors nationwide, says that the condition affects about 5 percent of children, primarily boys. Most experts consider this a sensible benchmark.
But what’s happening in real-life America?
Fifteen percent of youngsters in the United States—three times the consensus estimate—are getting diagnosed with ADHD. That’s millions of extra kids being told they have something wrong with their brains, with most of them then placed on serious medications. The rate among boys nationwide is a stunning 20 percent. In southern states such as Mississippi, South Carolina, and Arkansas, it’s 30 percent of all boys, almost one in three. (Boys tend to be more hyperactive and impulsive than girls, whose ADHD can manifest itself more as an inability to concentrate.) Some Louisiana counties are approaching half—half—of boys in third through fifth grades taking ADHD medications.
ADHD has become, by far, the most misdiagnosed condition in American medicine.
Yet, distressingly, few people in the thriving ADHD industrial complex acknowledge this reality. Many are well-meaning—they see foundering children, either in their living rooms, classrooms, or waiting rooms, and believe the diagnosis and medication can improve their lives. Others have motives more mixed: Sometimes teachers prefer fewer troublesome students, parents want less clamorous homes, and doctors like the steady stream of easy business. In the most nefarious corner stand the high-profile doctors and researchers bought off by pharmaceutical companies that have reaped billions of dollars from the unchecked and heedless march of ADHD.” (p 2-3)
But what Mr. Schwarz doesn’t mention, and perhaps isn’t even aware of, is that 69% of those “top experts” in psychiatry who “codified” the criteria for ADHD for DSM-5, and whose prevalence estimates Mr. Schwarz accepts implicitly, were also in the pay of pharma.
Nor does Mr. Schwarz seem to be aware that these same “top experts” who codified the criteria for ADHD have progressively liberalized the criteria for this so-called illness. I have listed the DSM-IV (1994) relaxations in an earlier post. The relaxations for DSM-5 (2013) were:
– the number of inattention “symptoms” required for adolescents and adults reduced from six to five (p 59)
– the number of hyperactivity/impulsivity “symptoms” for adolescents and adults also reduced from six to five (p 60)
– DSM-IV specified that some symptoms of ADHD had to have been present prior to age 7 (p 84). DSM-5 relaxed this age-of-onset criterion to 12 (p 60).
It needs to be stressed that none of these relaxations were, or indeed could have been, based on empirical evidence or science. There is no definition of ADHD other than that set down in successive revisions of the DSM. The notion that the pharma-paid “top experts” compared ADHD-as-it-really-is with the description in the DSM, and found discrepancies, is simply not possible. There is no ADHD-as-it-really-is. There is no definition other than the one that the APA made up, and they can, and do, change it at will. And, so far, the vast majority of the changes have been in the relaxation direction.
. . . . . . . . . . . . . . . .
And this is the central point. To bemoan the over-diagnosis of ADHD is an empty, futile exercise. Given the facts that:
– the criteria are impossibly vague and subjective, and
– pharma makes more money the wider the net is cast, and
– psychiatry shares in these profits through a variety of avenues, and
– the drugs are addictive, and
– schools receive additional funding for every ADHD child on their rolls,
“diagnosis” creep is inevitable. “Diagnosis” creep is not some accident or some pharma-produced sabotage that has befallen psychiatry despite its best efforts to remain pure and undefiled. “Diagnosis” creep is an integral component of the monster that psychiatry has consciously and deliberately created. “Diagnosis” creep is an integral part of psychiatry’s expansionist agenda, and was facilitated enormously by Robert Spitzer’s atheoretical, phenomenological approach in DSM-III (1980). Though, incidentally, in the case of “ADHD” it was occurring prior to 1980. Here’s a quote from Ullmann and Krasner’s A psychological Approach to Abnormal Behavior, Second Edition, (1975):
“The treatment of children who have received the label of ‘hyperactive’ has been a source of further controversy in both psychology and pediatrics…Drug therapy, particularly stimulants such as amphetamines, have become the popular form of treatment including up to 10% of all students in some school districts…” (p 496)
And even then, forty-one years ago, there were clear dissenting voices:
“The label plus the drug treatment brings the child into the mentally ill or sick category and the social and self-labeling that follow…The use of drugs enhances the belief in the efficacy of outside agents rather than attribution of change to one’s own efforts (an important element in the development of self control in children and responsibility in teachers).” (Op. Cit. p 497)
If should also be noted that the relaxation of criteria is not confined to “ADHD”. DSM-5 also relaxed the APA’s definition of a mental disorder, effectively expanding the net for all their so-called diagnoses.
The definition of a mental disorder in DSM-IV (1994) was:
“… a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability or an important loss of freedom. In addition, this syndrome or pattern must not be merely an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one. Whatever its original cause, it must currently be considered a manifestation of a behavioral, psychological, or biological dysfunction in the individual. Neither deviant behavior (e.g., political, religious, or sexual) nor conflicts that are primarily between the individual and society are mental disorders unless the deviance or conflict is a symptom of a dysfunction in the individual, as descried above.” (p xxi-xxii)
This definition can, I think, be accurately paraphrased as: any significant problem of thinking, feeling, and/or behaving. And indeed, it is extremely difficult to think of a significant problem of thinking, feeling, and/or behaving that is not listed within DSM.
The definition of a mental disorder in DSM-5 (2013) is similar to that quoted above, but contains additional verbiage, and one enormous relaxation of the definition. To enable readers to judge this for themselves, here’s the DSM-5 definition:
“A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflicts results from a dysfunction in the individual, as described above.” (p 20) [Emphasis added]
The word usually on the fourth line expands the potential range of psychiatric “diagnosis” enormously. One might even say that it becomes so wide as to embrace the entire population. The point being that in DSM-IV, the problems had to reach a certain level of significance or severity. But in DSM-5, that requirement was effectively dropped. Admittedly, both phrases are vague, but DSM-IV’s requirement that distress or disability be present, is obviously a more stringent standard than DSM-5’s assertion that distress or disability is usually present. In effect, the severity threshold has been abandoned, and there is a clear invitation to practitioners to assign “diagnoses” to individuals with increasingly milder presentations. And it needs to be stressed that this change was not based on any kind of scientific information or discovery. This change was simply a decision by the APA to expand the prevalence of their so-called illnesses to virtually everyone on the planet. It also needs to be stressed that this is not an empty issue, but has already been implemented in the case of “ADHD”. Compare the severity criterion for ADHD in DSM-IV with that in DSM-5:
DSM-IV:
“D. There must be clear evidence of clinically significant impairment in social, academic or occupational functioning.” (p 84) [Emphasis added]
DSM-5:
“D. There is clear evidence that the symptoms interfere with , or reduce the quality of, social, academic, or occupational functioning.” (p 60)
Here again, both statements are vague, but significant impairment in… is obviously a tighter standard than interfering with, or reducing the quality of….
Given all of these considerations, it’s extremely difficult to avoid the conclusion that the APA not only supports the wide expansion of this so-called diagnosis, but has actively pursued and facilitated this expansion for decades.
. . . . . . . . . . . . . . . .
Conclusion
Mr. Schwarz has done a good job of exposing pharma’s tactics and strategies. Although much of this story is well-known and has been told before, he does present the scam in a detailed and readable form. He also addresses the problem of parents pushing to get their children “diagnosed” and on drugs, and the undeniable fact that people do become addicted to these products. He also exposes the link between CHADD and pharma.
Perhaps now he can take a look at the even bigger scam: psychiatry’s spurious and destructive medicalization of literally every problem of thinking, feeling, and/or behaving, including childhood inattention, impulsivity, and general lack of discipline.
Pharma does indeed push their products using very questionable methods. But they couldn’t sell a single prescription for methylphenidate or for any other psychiatric drug without psychiatry’s bogus and self-serving “diagnoses”. And they couldn’t have increased their sales to the extent that they did, without the commensurate relaxation of the “diagnostic” criteria, that psychiatry knowingly and willingly provided. Bemoaning the use of hurriedly-completed facile checklists is empty talk, unless one is also willing to turn one’s criticism against the DSM’s equally facile “symptom lists”, of which the checklists are simply mirrors.
Psychiatry is nothing more than legalized drug-pushing. There is not one shred of intellectual or scientific validity to their so-called taxonomy. They invent these so-called illnesses to expand their turf, and then liberalize the criteria to expand it further.
Under the guise of medical care, they routinely rob people of their sense of competence, their dignity, and in many cases, their lives. They have radically undermined the concept of success-through-disciplined-effort, and have ensnared millions of people worldwide in their ever-expanding web of drug-induced dependency and self-doubt. They are not the thoughtful and expert codifiers of genuine illnesses, as Mr. Schwarz contends. Rather, they are drug-pushing charlatans and hoaxsters who have systematically and deliberately deceived their clients and the general public to enhance their own prestige and their incomes.
If there was ever a subject that called for thorough investigative journalism, psychiatry is it.
Great article! Neurofeedback treated my “so-called ADHD.” It can be a lifesaver for a lot of people. Much better option than medication: http://www.optimallivingdynamics.com/blog/the-revolutionary-video-game-that-healed-my-mental-illness
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Jordan, are you saying that you were cured of ADHD, or do you believe as I do that there is no such thing as ADHD?
So then did neurofeedback perhaps cure you of the effects of emotional child abuse? Did it cure you, or was it just another way to shift the focus on to the survivor and away from the perpetrators?
Nomadic
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Are you replacing the fear behind ADHD with that of emotional child abuse. Really a stretch if you are.
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Fear behind? Don’t even know what that would mean.
But I do know that for a parent to start taking a child to doctors to try and fabricate an illness is what used to be called Munchausen’s Syndrome By Proxy. Today they just call it Medical Child Abuse.
Trying to make a child believe that they have something wrong with them is most certainly emotional child abuse.
As far as it being ADHD, that would be impossible because ADHD does not exist.
Nomadic
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What if the child is unable to pay attention in school or in sports?
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“In short term studies, ADHD medications have been shown to be effective in reducing core ADHD symptoms, such as task irrelevant activity (e.g. finger-tapping, fidgetiness, and and off-task behaviors), and classroom disturbance.” MIA
MIA recognizes ADHD exists and that the core symptoms respond favorably to medication. That is a bold thing to do.
So, it is! and can be managed initially, through the use of medication. Unfortunately, they don’t mention what else is is included in the list of the core symptoms that improve: the child’s ability to pay attention. Most likely for the first time in her life! For The First Time in Her Life!
The secondary benefits of medication are that the child’s behavior improves. Just like that, with no training, without instructions or anything else. That is certainly impressive, but again that is not what we hope to achieve ultimately for the child. Those are secondary matters. What MIA omits is by far the most important result, that is that the child’s brain starts to work. We are not drugging anyone. That is a perverse notion. We are giving the child the ability for the first time in her life to use her brain as intended, not to make her incoherent. Just the opposite. He can sit still and calmly participate in the school setting Because his brain can focus on what it is supposed to. That, to me, is miraculous. Nothing else is known to give that ability to anyone who cannot function due to ADHD. If someone is diagnosed with ADHD but does not need chemical intervention to gather, to focus on and to process information in order to manage her daily life within reasonable guidelines, they don’t need medicine.
What MIA has made clear at the beginning is as follows. ADHD is.
ADHD untreated is a nightmare.
Treatment for ADHD works.
Forget all the rest for a minute. For one minute concentrate your attention on what MIA just acknowledged! What MIA has just stated clearly, officially, and formally, is just this: ADHD responds to proper medical intervention.
That is an excellent place to start a discussion and an analysis of what we can and need to do now. Children await our decisions. Their futures are are at stake every day.
(When I go to edit my comments, the content shows up in a square outline and it doesn’t include the margins. They get cut off and I can’t see everything I’ve written.)
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I acknowledged early on in our discussion that short-term symptoms can be improved by stimulants. I point out that long-term outcomes are NOT improved. How do you deal with that conundrum? Pretend that it doesn’t exist?
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Statements here are from MIA’s paper on long term impact of ADHD drugs.
The “Reply” button is not available often when others are directing questions my way. I cannot respond directly. I mentioned this before.
“However, the drugs have not been shown to improve classroom performance…”
Source, please
“The APA first created a diagnosis called Attention Deficit Disorder in 1980, when it published the third edition of its DSM.”
It was discovered and called something else, MBD, over one hundred years ago.
“Given that there is no biological marker for the disorder”
there is now
“there is an obvious subjective element to making the diagnosis. What may be seen as a problem in one setting—by a parent, teacher, or pediatrician—may be considered normal behavior in another situation.” for example?
“whereas 13% of elementary-school children in the United States are said to have ADHD…”
Who says that? It is not the majority opinion.
“only about 2% of children in the UK are seen as exhibiting attention-deficit type problems”
reference please
“The long-term effects of ADHD drugs on the brain are not well understood, or even well studied” You see, there are a range of opinions on this.
“Is there long term benefit from stimulant treatment for ADHD?
Thus the answer to the question “Is there long-term benefit from stimulant treatment for ADHD” is a definite “Yes!” Department of Psychiatry, UT Health San Antonio, San Antonio, Tex.Sep 1, 2019”
Steve, I run across your opinions occassionally. I don’t know when you respond to something I’ve said to someone else. I notice you have not answered several questions I asked. People disagree about the long term benefits of treatment with meds.
Why do you believe your kids needed (and received, thank heavens) extraordinary care?
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“Mad in America hosts blogs by a diverse group of writers.”
You mean background, geographic areas where they were raised, their occupations, ages, things of that nature, I believe. There is no diversity as far as holding psychiatry responsible for the “epidemic” at least that I’ve noticed. Is there one psychiatrist, is there anyone at all, ever, who writes for Mad who supports psychiatry?
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“Trying to make a child believe that they have something wrong with them is most certainly emotional child abuse.”
Do believe millions of parents have done just that? How many parents did not accuse their children of having fake illnesses? 10? 5? Any? out of millions?
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Munchausen syndrome by proxy is an illness according to DSM-5
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The proper diagnosis of ADHD requires the input of more than 1 person involved in the life of the individual being diagnosed and in more than 1 major life setting, like school and sports, or home and girls scouts.
“The caretaker of a child, most often a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick.” Munchausen
Munchausen syndrome by proxy – MedlinePlushttps://medlineplus.gov › Medical Encyclopedia
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The “proper diagnosis” of ADHD requires the subjective evaluation of “traits” with pseudo-scientific foundations. Such concrete and measurable things as “loses and/or misplaces items needed to complete activities or tasks” and “Appears to be ‘driven by a motor’ or is often ‘on the go'” or “is overly talkative.” You know, the kind of things that a Scientist can Measure with his “Talk-o-meter” and such.
It is also very obvious from my own observation that these criteria are almost never consulted. Most doctors simply go with what their “impressions” are, usually based on parent and/or teacher report. The main reason more and more kids are “diagnosed” is not because we’re looking better or there are more kids developing this “disorder.” It’s called “diagnostic drift” – when subjective criteria are used to establish a boundary, over time, that boundary gets pushed so that more and more people “meet the criteria” due to pressure from parents and/or teachers to “diagnose.” This was very clearly seen in autism as well as “ADHD.” I have also NEVER in my entire career seen a doctor document “more than one person” providing evidence in “more than one setting.” To the contrary, I’ve seen dozens, probably more like a couple of hundred cases where the school was the only source of “information” and where parents agreed to the stimulants under pressure from the school. I’ve also seen some where one parent decides to “get him/her diagnosed” when another (usually non-custodial) parent disagrees completely. I’ve seen kids who ONLY take stimulants for school time because they “don’t need it” at home. According to you, these kids should not be “diagnosed.” Yet they are, by the wonderful, caring, competent medical professionals you speak so highly of in your next post.
I get the impression that you really want us to believe that all or most mental health professionals are competent, caring and thorough, and track closely on family history and the success of their interventions as well as the potential side effects. I would bet big money I’ve seen a hundred times as many “ADHD” cases as you have in my career, and I can tell you that those assumptions are very, very wrong.
I recall one girl who had graduated from an eating disorder clinic. Shortly afterwards, she was put on Ritalin for “ADHD” by her caring and competent medical professionals. Oddly enough, she started eating less, an obvious and very well documented side effect of the stimulants which started almost immediately after their administration. They started talking about her “relapsing” in her “eating disorder!” It took my VOLUNTEER, LAY-PERSON advocate, about 5 minutes to figure out what was going on, and we eventually convinced them to stop the stimulants. Lo and behold, the “eating disorder” went away! Her argument was, “What’s more important, eating or finishing homework?” But the professionals were apparently unable to make that value judgment.
I also saw many cases where kids became aggressive when taking Ritalin or other stimulants, a fairly common adverse effect that is noted on the patient handout for every one of the stimulant drugs. Very frequently, instead of stopping the stimulant, such kids were put on antipsychotics, like Risperdal. Now antipsychotics, as you may or may not know, have the primary action of increasing dopamine uptake to lower the amount of dopamine between the brain cells. While stimulants have the effect of reducing dopamine reuptake and increasing the amount of dopamine floating around in the brain. It doesn’t take a neuroscientist to figure out that if giving something to INCREASE dopamine leads to aggression due to TOO MUCH DOPAMINE, the right thing to do would be to STOP INCREASING THE DOPAMINE SO MUCH! Why would it occur to ANYONE to give ANOTHER drug to decrease the dopamine you’re increasing with the stimulants???? Again, these are the same competent, caring mental health professionals who are trying their best to provide good service. But a high school student could figure out what’s going on in a 15-minute internet search. And this was not an outlier, Thomas. This happened ALL THE TIME. Probably seen a hundred or more such cases over 20 years, maybe a lot more than that.
I could give you a lot more stories, but you get the drift. I’m not saying the medical professionals are all incompetent or don’t care, I’m saying they are operating on FALSE INFORMATION which warps their decision making in very bad ways. It’s not a matter of incompetence – the basic assumptions of the system are faulty, and unless you luck out and get a maverick who does his/her own thinking, the training in those basic assumptions turns potentially good clinicians into feckless authoritarians copying behavior they don’t really understand but feel compelled to repeat because their boss/trainer/insurance company says that’s what they’re supposed to do.
I will allow that I did run into some really competent clinicians in my 20 years working with foster youth, some of them quite impressive. But they were very much in the minority. The majority, as anyone would expect, followed their training and pretty much locked up and stopped thinking when their training let them to poor results.
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Presenting scientific evidence that the child isn’t to blame for his/her concentration deficits renews the child’s faith in himself.
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Actually, stimulant treatment has not been shown to increase self-esteem in the longer term in “ADHD”-diagnosed children.
https://www.additudemag.com/impostor-syndrome-adhd-treatment/
“However, they also found a negative effect on the youth’s sense of self with youth reporting that they no longer felt like themselves, were happier off the medication and noticed a change in their personalities.”
https://link.springer.com/article/10.1007/s40474-015-0039-5
“Studies have demonstrated only marginal improvements in adult outcomes following a period of treatment in childhood.”
https://pubmed.ncbi.nlm.nih.gov/16623654/
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POSTING AS MODERATOR:
Bill aka Thomas Schnell,
I have warned you several times by email that failure to respond to email communication is a violation of the posting guidelines. As of now, I have heard nothing from you. Nothing you post will be published until you email me directly at [email protected] or [email protected] and agree to abide by the posting guidelines and respond to feedback given to you via email. This is not in opposition to posting viewpoints that are supportive of the mainstream psychiatric model, it is due to constant disrespectful posts and other violations of the posting guidelines which can’t be addressed without direct email communication with the moderator. Until I hear from you via email, your posts will all be blocked, no matter the content or form. This is the last time I will talk to you about it. The next step is to simply block all communications from the email you are using. It’s up to you to decide.
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I taught a targeted riding program to these “ADD & ADHD” kids for 35 years; BEFORE the term was coined to sell drugs. My initial clientele brought to me by a dear friend was many of the top shrink’s kids in Scottsdale ,AZ. Even back in 1972 all but one of these kids was medicated; mainly because they were acting out. When the parents saw me having some success ; word got out.
Later by comparing hundreds of kids & their parents disclosure of medical issues & professions I discovered that nearly all of them were likely poisoned, either by massive vaccinations [in the 80s forward] or mouths full of mercury amalgams or mothers who were environmentally exposed [ like working as a hygienist while pregnant; breathing Hg vapor all day]. This was especially striking when the 2nd child would be normal because mom had to quit her job to care for the “crazy one”. There were also several women who had babies after adopting because they had their amalgams removed & one who had two normal girls & then after having massive amalgams placed got pregnant & had a boy with severe learning disability & very pronounced cleft palate [ #1 cranial facial disorder from Hg poisoning]
Metal poisoning causes many chemical imbalances including mineral derangement, enzyme blockage & receptor confusion. This is a testable condition but difficult to get done. It continues to horrify me that there is rarely even preliminary blood work [liver,kidney,thyroid etc] done on these kids before they get drugged & labelled.
Since I was not a doctor [though I have now studied toxicology for 26 years ] the parents only cared about results not my opinions. My most interesting case was the girl who would jump out of the car & run into traffic. Her heavy schedule of meds at age 9 had caused her to stop growing, sleeping & eating, but not helped her attention span. She loved animals though. After convincing them to cut most of the meds [at least before lessons]; in one year she was competing in 3Day events [jumping ,endurance & dressage] on her own pony & placing in the ribbons. Why? Because of two things. The instinct to survive MAKES them pay attention [ we start on a safe lunge line in round pen] and second I learned that most of these kids learn by touch/feel NOT verbal or visual. Very taxing for the instructor but also very rewarding if you have the patience & guts to do it. I only wish they all would have had the knowledge to chelate the toxins out to avoid the problem in the first place.
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You’re probably right about your kids having heavy metal poisoning. If they were poor, they’d be exposed to lead instead of the dental mercury. They wouldn’t see any ponies, but they’d be just as hyperactive and get a lot of speed as their presumed treatment.
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My other problem with the ADD & ADHD paradigm is that not only are eliminative tests NOT being done to rule out other disorders or causes, but a large portion of these drugs are being prescribed at the behest of parents by general practitioners for months on end with no follow up blood work to check for damage which even the drug company warns should be done.
What if they can’t pay attention because their parents are fighting all night & they can’t sleep? What if no one sees that they get proper nutrition? What if they really have PTSD or suppressed anger issues from abuse? What if they are low thyroid or have mineral derangement or low blood sugar? Non of the kids I know on these meds have been tested & when requested the docs often refuse stating it is not necessary or insurance won’t pay; despite the fact that most of these head meds were never approved for kids in the first place & all state on the product package insert that they have only been tested for periods of 6 – 8 weeks. Yet doctors prescribe them for years keeping patients in the system until the side effects require more drugs & eventually they have a worse “mental disorder” or at the very least CAN’T stop taking the drugs without major withdrawals.
A proper history of environmental exposures by a toxicologist usually reveals poisoning from industry ,farming,or the pharmaceutical community. This can be reversed & should be tried BEFORE a label & meds are rolled out. Recent MRI studies of young children put on ADHD meds showed a 15 % smaller brain size than unmedicated children. That alone should give parents pause.
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Would you mind citing the name of the institution where you helped those kids? Can you say which drugs the child was on that stopped her growth? You had the parents cut back on her meds at least before lessons, which they did. Then, her life turned around wonderfully. Therefore, after each lesson, she was medicated just as before, cutting back only before one lesson, at a time, weekly? That information suggests her meds were still working and indeed, helped her.
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Excellent writing as always.
if a problem of thinking, feeling, or behaving crosses some arbitrary and vaguely defined thresholds, of severity, duration, or frequency, it becomes, through some alchemy known only to psychiatry, an illness.
This is something most people can understand if properly explained. My veterinarian, when the topic was broached, volunteered that psychiatry takes the very wide parameters of human behavior and shrinks them down to a very narrow size, then labels anyone who falls outside these artificial boundaries. I would suggest in addition that the definition of “normal” behavior is predicated on its value to the pursuit of capitalist expansion.
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Oldhead,
Isn’t it amazing that a veterinarian can see, and pinpoint so clearly, this basic perspective that seems to elude psychiatrists so completely. Of course, the veterinarian has no stake in the game!
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The diagnosis rests upon a careful history taken from the identified patient as well as at least one other person. This could be a parent, spouse, sibling, or close friend, as well as, if possible, teacher comments.
“And it needs to be noted particularly that since 1994, the only requirement under this item for adults and adolescents is that they experience feelings of restlessness!” Dr. Hickey.
That is incorrect. See below
That is one of 5 symptoms and the symptoms of hyperactivity and impulsivity must have been present for at least 6 months, and they are inappropriate for developmental level. Also, they be present by age 12.
As children grow older, they often develop strategies to help them control some of the more elementary forms of hyperactivity, but that uncomfortable urge to squirm and move about burns inside. Aerobically demaning activities often soothe that desire.
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Many brilliant, hard working, devoted, honest and fair individuals comprise the medical industry and do their best to bring relief to the suffering, IMO.
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You are absolutely right, there are a lot of honest, hard-working individuals in the medical industry (though I hope you will concede that like any profession, there are also plenty of dishonest, lazy ones as well). The problem is, when you work in a SYSTEM that is designed poorly around false assumptions and is corrupted massively by financial conflicts of interest, even the best people will end up mostly doing damage control, and the bad ones will do massive destruction.
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For example?
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See my later post for examples.
At this point, Thomas, I’m not sure you’re really willing to engage in a meaningful conversation. Are you here to discuss different people’s realities and to learn from each other, or to promote your own viewpoint? I’m not sure I want to waste more time trying to present an alternative viewpoint if you’re seriously not open to hearing alternative viewpoints. Are you?
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I have yet to meet them. No, the ones that entered the system are quickly part of the cog. There are a LOT of opinions in medicine, NOTHING to do with science. Opinions are not medical, and labels always leave the victim of labeling vulnerable to slander. And many opinions by the MD professions are no more than slander.
One is not talking about people being different from each other, but rather how we label those differences as “disordered”. This is not new. It has been around forever. We “treat” those things we find disruptive to the present rule.
We don’t treat someone’s inability to walk, we try to become smart enough to build ramps.
Obviously if you have not experienced slander and abuse by med system, You will ALWAYS just see it through what your experience has been.
So for you, there are a lot of great people in med system. Privileged and lucky.
That is all it comes down to
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Yes, Thomas, and NONE of those you describe are psychiatrists….
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The Salk vaccine. Orthopedic surgery, orthotics, braces, whirlpools, aspirin, anti-inflammatories, physical rehabilitation experts, to name few, help people to walk. I know two guys who contracted polio and survived and walked again through the use of “chemicals”. Millions of lives saved through the use of chemicals. Our bodies consist of chemicals. Radioactivity has its place in dxing illness. Brain surgery to remove deadly surgeries rely on chemicals to induce unconscious and survive excruciating pain. Tryptophan helps some to sleep.
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I know wonderful, ethical, hard working, compassionate psychiatrists.
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I have as well. I’ve also known insensitive, thoughtless, means-spirited psychiatrists. And I’ve known compassionate and intelligent psychiatrists who have done a lot of harm by following “protocols” instead of getting to know the patient. I’ve seen psychiatrists who insist on increasing the dosage of something that has harmed their patient or not been helpful.
I have also noticed something about you, Thomas. I notice that when I ask a challenging question, you don’t answer it.
Why is it so important for you to convince everyone here that your viewpoint is correct? At least, that’s how it seems to me. I see little to no effort to understand others’ feelings, experiences, and logical objections, and a lot of effort to promote your own viewpoint. Is that why you came here?
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Yes, “many” meaning “as much as 10, 20, maybe even 30% wonderful, ethical, compassionate…”….
So, well OVER HALF of psychiatrists are BAD, and ALL are fraudsters….
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Back at ya. I see the same in you. Best wishes. Carry on.
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I have responded many times directly to comments you have made, and asked you questions to clarify your position. If you ask me a question, I will always respond to it if we are engaged in a discussion. I have acknowledged points that you have made that seem to be supported by the literature. I simply have a different set of experiences than you. So far, I have not seen any interest from you in finding out why I hold the beliefs I do, nor have I gotten responses to clarifying questions I have asked you, nor do I recall having gotten any response to the research data I have provided regarding ADHD kids doing better in open classrooms or outcome measures not being improved in the long term by stimulant treatment alone. I don’t think it is at all true that I have not listened and responded to your comments. I don’t see you listening to or responding to mine. I don’t expect agreement from you, but I would hope some kind of acknowledgement would be forthcoming when I take the time to respond to your comment. If you don’t want to, that’s up to you, but I don’t appreciate being judged as unresponsive when the facts say otherwise.
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You see what I believe and I see what you believe. We disagree. Nothing personal.
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That restlessness, those urges to move about unconstrained, to fidget, to get out of his seat, to blurt out comments or questions without thinking them through, as one gets older manifest in being unable to concentrate.
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As I recall, Mr. Whitaker established this website so that we who have varying points of views about psychiatry could express our points of view unhindered by fear of ridicule or personal attack.
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Posting as moderator:
It is. If you feel any specific post has been allowed that has personally attacked you or your character, please either hit the “report” button or better yet, email me and explain what you are seeing.
However, as I have said before many times, disagreeing passionately with a person’s viewpoint is not considered a personal attack, it is simply disagreement. It is important for folks to keep this in mind when evaluating whether a comment constitutes a “personal attack.”
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“Psychiatry is nothing more than legalized drug-pushing. There is not one shred of intellectual or scientific validity to their so-called taxonomy. They invent these so-called illnesses to expand their turf, and then liberalize the criteria to expand it further.” Dr. Hickey
You accuse psychiatry of illegal, immoral, deceptive, racketeering, interstate conspiracy to defraud, and premeditated conspiracy to commit mass murder.
Dr., where is the evidence? Would you mind presenting it? From what you say all psychiatrists are wanted felons. Any psychiatrist could substitute her name for psychiatry. How do you condemn all of them, repeatedly, when you don’t know all of them?
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We generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents.
Conclusions: Many findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.
Stephen V Faraone 1, Tobias Banaschewski 2, David Coghill 3, Yi Zheng 4, Joseph Biederman 5, Mark A Bellgrove 6, Jeffrey H Newcorn 7, Martin Gignac 8, Nouf M Al Saud 9, Iris Manor 10, Luis Augusto Rohde 11, Li Yang 12, Samuele Cortese 13, Doron Almagor 14, Mark A Stein 15, Turki H Albatti 16, Haya F Aljoudi 17, Mohammed M J Alqahtani 18, Philip Asherson 19, Lukoye Atwoli 20, Sven Bölte 21, Jan K Buitelaar 22, Cleo L Crunelle 23, David Daley 24, Søren Dalsgaard 25, Manfred Döpfner 26, Stacey Espinet 27, Michael Fitzgerald 28, Barbara Franke 29, Manfred Gerlach 30, Jan Haavik 31, Catharina A Hartman 32, Cynthia M Hartung 33, Stephen P Hinshaw 34, Pieter J Hoekstra 35, Chris Hollis 36, Scott H Kollins 37, J J Sandra Kooij 38, Jonna Kuntsi 39, Henrik Larsson 40, Tingyu Li 41, Jing Liu 42, Eugene Merzon 43, Gregory Mattingly 44, Paulo Mattos 45, Suzanne McCarthy 46, Amori Yee Mikami 47, Brooke S G Molina 48, Joel T Nigg 49, Diane Purper-Ouakil 50, Olayinka O Omigbodun 51, Guilherme V Polanczyk 52, Yehuda Pollak 53, Alison S Poulton 54, Ravi Philip Rajkumar 55, Andrew Reding 56, Andreas Reif 57, Katya Rubia 58, Julia Rucklidge 59, Marcel Romanos 60, J Antoni Ramos-Quiroga 61, Arnt Schellekens 62, Anouk Scheres 63, Renata Schoeman 64, Julie B Schweitzer 65, Henal Shah 66, Mary V Solanto 67, Edmund Sonuga-Barke 68, César Soutullo 69, Hans-Christoph Steinhausen 70, James M Swanson 71, Anita Thapar 72, Gail Tripp 73, Geurt van de Glind 74, Wim van den Brink 75, Saskia Van der Oord 76, Andre Venter 77, Benedetto Vitiello 78, Susanne Walitza 79, Yufeng Wang 12
[International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder].
Özgen H, Spijkerman R, Noack M, Holtmann M, Schellekens ASA, van de Glind G, Banaschewski T, Barta C, Begeman A, Casas M, Crunelle CL, Daigre Blanco C, Dalsgaard S, Demetrovics Z, den Boer J, Dom G, Eapen V, Faraone SV, Franck J, González RA, Grau-López L, Groenman AP, Hemphälä M, Icick R, Johnson B, Kaess M, Kapitány-Fövény M, Kasinathan JG, Kaye SS, Kiefer F, Konstenius M, Levin FR, Luderer M, Martinotti G, Matthys FIA, Meszaros G, Moggi F, Munasur-Naidoo AP, Post M, Rabinovitz S, Ramos-Quiroga JA, Sala R, Shafi A, Slobodin O, Staal WG, Thomasius R, Truter I, van Kernebeek MW, Velez-Pastrana MC, Vollstädt-Klein S, Vorspan F, Young JT, Yule A, van den Brink W, Hendriks V.
Z Kinder Jugendpsychiatr Psychother. 2021 Jan;50(1):54-67. doi: 10.1024/1422-4917/a000828. Epub 2021 Aug 16.
PMID: 34397296
The research, the commitment, the top notch scientists, the varied approaches, the steadfast efforts to scour the field to hone in on the answers, cause me to rejoice.
A day may come, soon, when no child will be confined to the prison of a dead classroom, one in which he cannot breathe, one of hours of uninterrupted torture and humiliation, all alone, without a single soul, not one, on his side to soothe, to comfort, to love him, assuring him he is not to blame.
Martin, I too, have a dream that one day all children who need help because they suffer from this nasty disorder, will have it. That no child will suffer alone for years because ADHD isn’t recognized and treated. I HAVE A DREAM
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Consensus of “experts” has absolutely nothing to do with science, Thomas. Scientists agreed at one time that formula feeding was as good or better than nursing, that Thalidomide was safe and effective, that DDT had no harmful side effects, that Valium was not addictive, that Xanax was not addictive, that Benzedrine was not addictive, that Tardive Dyskinesia was a consequence of “schizophrenia” rather than the drugs given to “treat” it, that Viiox was safe and effective, and that SSRIs had a mild side effect profile and no withdrawal effects at all. None of these things that “experts” agreed to proved to be true in the long run. “Experts” have lots of conflicts of interest these days, making the problem even worse. You can hire an “expert” to claim almost anything these days.
And we already have a means to help these children that is drug free and proven by actual scientific research. It’s called an OPEN CLASSROOM. “ADHD” kids are indistinguishable from “normal” kids in such an environment. The only thing stopping us is laziness, narrow vision, and the financial conflicts of interest mentioned above.
I continue to notice that you tell other people what you think they should believe but do not respond to my comments relating to your assertions. Again, I ask you, are you here to have a conversation or to try to get others to agree with your pre-determined viewpoint? A failure to answer this will indicate the latter, and I will no longer bother trying to have a conversation with you, though I may still post scientific evidence to counter any claims about “experts” agreeing as some sort of proof of anything.
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Hi Steve, read a few of your comments, and I couldn’t agree more with your very sensible thoughts on open classroom, parenting, creating a more stimulating / engaging learning environment, etc.
Also, I’m reading that yet so many sources will insist biological causes. Like this below, do you know this to be true? It does that sound worse than what is actually is?
“ADHD is caused by multiple factors, both genetic and environmental. It is related to cognitive and functional deficits that are linked with abnormalities in the brain structure. The anterior cingulate gyrus and dorsolateral prefrontal cortex are found to be smaller in people who are affected by ADHD”
Also, curious what your stance is when a psychiatrist, may agree with your stance upfront, but yet still thinks there should be a diagnosis or “treatment” being if the issue is “pervasive”
https://www.topdoctors.co.uk/medical-articles/is-adhd-real-a-top-psychologist-explains-the-truth
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Some have claimed that “ADHD” brains are smaller on the average, but those studies did not take into account medication use, which shrinks the very parts of the brain they say are smaller, particularly the cingulate gyrus. Additionally, even if these studies were accurate, they are AVERAGES, which means that lots of people WITHOUT “ADHD” diagnoses have smaller brains and lots of people WITH “ADHD” diagnoses have larger brains. It is obvious that if these were “causes,” it would apply to all of them. There is no evidence that everyone with “ADHD” has any kind of similarity in brain structures, so that claim is BS.
Of course, a lot of psychiatrists will tell you that your kid needs “treatment.” That’s just what they do. Until and unless they have some evidence that this “disorder” is actually a disease state, you are safe ignoring them. It’s also VERY important to note that kids who are “treated” with “ADHD” drugs do not do any better in the long run, academically, socially, or physically, than those who are “diagnosed” but don’t receive any stimulants. So the “treatment” is not worth anything much in the long run on the average, even if some seem to do better taking the drugs.
My final point is that even if the “ADHD” child is in some way biologically different, difference is not the same as disease. Species survival depends on genetic diversity. There is no reason to think that being less patient with boring stuff and wanting to move around and not follow rules is evidence of anything “wrong” with the child. I think the main problem is that we try to expect kids to do things that are abnormal to expect kids to do. The strong evidence of this is that fully a THIRD of kids diagnosed “ADHD” in Kindergarten prove NOT to get that “diagnosis” if they wait a year later to enroll in school. A third grow out of it in one year. That’s not a “disease,” that’s a problem of inappropriate developmental expectations.
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Hi Steve this reply is to your last comment. Not sure if my last one got through, as I can not locate it. But to clarify, you mentioned even if those studies were accurate, it just means we’re biologically different. So are you saying that just because those areas are ‘different’ that it does not make the brain any less effective, intelligent, vs another etc?
Also brains do change, heal, etc as one ages / matures? Im not sure if these studies were on children either.
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I am saying all of those things. When “ADHD” is defined by a set of behaviors, most of which are based on school behavior, and none of which are even slightly objective observations, you’re going to get a group that has little to nothing in common with each other except the behavior. It could be totally normal for that child at that age and stage of development. It could be the result of nutritional deficiencies, particularly iron, or sleep problems. It could be an indicator of problems in the home that are not addressed, particularly domestic abuse. It could be an indicator of prior trauma and possible “PTSD” symptoms, where there is a huge overlap with “ADHD.” It could be an incompetent teacher who doesn’t know how to manage a class and provokes resistance from the more sensitive or the bolder kids. It could be the child is bored to death because s/he is way ahead of the class and isn’t being challenged at all. All of the above considerations could cause the “symptoms” described as “ADHD.”
Here are a few of these “symptoms:”
making careless mistakes – for example, in schoolwork
appearing forgetful or losing things
being unable to stick to tasks that are tedious or time-consuming
appearing to be unable to listen to or carry out instructions
excessive physical movement
excessive talking
being unable to wait their turn
acting without thinking
interrupting conversations
Not one of the above is in any way objectively measurable, and none require any kind of medical “explanation.” Most are just ways that kids act when they are young and less mature. Ever know a kid who acts without thinking, or interrupts conversations, or had a hard time waiting their turn? More importantly, how many kids do you know who do NOT engage in these behaviors at least some of the time? How could you possibly tell when a kid “interrupting conversations” reached some critical level that it becomes a “symptom?” And why would we assume that any of this is caused by some sort of “brain problem?”
A very interesting study shed some light on the advantages this “ADHD” behavior actually conveys on kids and on society. They took groups of three kids and gave them a set of three problems to solve. One bunch had two “normal” and one “ADHD” kid in each group. The control groups had three “normal” kids in each group, no “ADHD” kids. They measured how often the group was “on task,” working on solving the problems. The control groups did significantly better on this measure, while the “ADHD” groups goofed off or screwed around more and spend a good deal less time working on the problems. But NONE of the control groups solved any of the problems, while all of the “ADHD” groups solved at least one and I believe a couple solved all three! So their goofiness and off-task behavior allowed for more creativity and outside the box thinking and meant these problems got solved.
Now if they’d had groups with THREE “ADHD” kids, it’s quite possible nothing would have gotten done at all! But it shows that we NEED these “ADHD” types to help us solve problems, and that having ALL conventional thinkers in our society will most likely lead to stagnation and failure.
It takes all kinds to make a world, as they say, but apparently psychiatry has no idea what that means, as they want to make all kids act in ways that keep the adults happy. And that’s what I believe “ADHD” is really all about.
Notice there is no “Hypoactivity” disorder? I think that says a lot!
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Hi Steve, thanks. Also, if I’m understanding correctly the studies are not trying to suggest that those with symptoms — have smaller brains in those areas that would definitely effect normal healthy functioning? Just an average? Which would be utterly ridiculous. Especially when making such a claim about those with ADHD.
Also I’ve seen some say that PTSD or a tough environment, etc can cause “ADHD behavior”, as traumas can ‘rewire the brain’, (whatever that means) etc. but then again, I’ve seen many that when things settle down, or removed from the tough environment… And or deal with it, all the “ADHD aspects drastically improve.
I’m no expert but I’ve read certain areas of the brain can shrink in size, in the context of ptsd, etc. but only temporarily, and as it heals goes back to size, and even can use different parts as the brain is very resilient.
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That’s the other good point – we know that healthy relationships can “heal” whatever changes to the brain occur as a result of trauma, at least to an extent. Why we waste time on all these biological cause studies when we KNOW that social conditions can be improved and result in improved outcomes is quite puzzling. Unless we postulate that those providing “treatment” aren’t really that concerned with people’s outcomes being improved?
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Yes, it is quite puzzling. I actually stumbled here as I kept running into ‘disorders’, in plain search results, and thought it was odd how vague some of the definitions of disorders were, and thinking sheesh if this is the case we all have something haha. Always thought it was bit odd how so much of what is just normal human behavior often as a result of tough times, grief, etc was medicalized.. without hard evidence of physical abnormality being the “cause” of it.
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Exactly. It seems a gradual narrowing of “normal” is happening, and instead of “normal” we now have “acceptable” or “appropriate.” Which is of course defined by the authorities in charge. I think it crosses the line from puzzling into evil.
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[Duplicate Comment]
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Hi Steve, well what’s perplexing to me is that in all of the DSM, from what I understand most of the “disorders” lack any scientific basis, yet when often diagnosed would indicate some sort of drug treatment. And the issue with that is often times those don’t do well at all with those drugs, and or at least long term.
And in this particular instance of ADHD you’ve shown adequately how the stimulants weren’t all what they were cracked up to be.
Now don’t get me wrong, if a person could really benefit in certain situations taking them sensibly, responsibly, while proactively making healthy changes, ok fine)
But all in all, I do wish there was more of focus on other approaches (like the ones you mentioned, esp when dealing with children) vs getting hung up on labels and often drugs to “treat” it.
But I am curious if you agree with Dr. Pies thoughts on the DSM, and what he says about psychiatrist. Hopefully this isn’t to far outside the scope of this article.
https://www.psychiatrictimes.com/view/poor-dsm5-so-misunderstood
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I never have agreed with almost anything Dr. Pies has said. He’s a marketing agent for psychiatry.
What he’s saying in the article is technically true, but he is not taking into account HOW the DSM is used. The fact that someone has a “medical diagnosis” opens the door to stigmatization, which has been proven over and over again to be greater the more medically the causes of these “diagnoses” are viewed. A lot of the text he includes are from the introduction and clinical guidelines, which I’m sorry to say most clinicians don’t bother to read, or if they do, fail to put into practice. Pies also fails to give any reason, and in facts argues AGAINST it, for putting people into these “fuzzy categories” in the first place. Any reasoning he uses is more sociology/anthropology than medical in nature. By admitting there is no clear boundary between one “disorder” and another, and between having a “disorder” and having “no disorder,” he acknowledges that the whole house of cards blows down with the slightest puff of air.
Here is an example in his own words: “When a patient presents with the complaint, “I hear threatening voices in my head,” we simply must diagnose—a word whose etymology means, “knowing the difference between.” For example, we must know the difference between “threatening voices” stemming from combat-related trauma, on the one hand, versus schizophrenia or anti-NMDA receptor encephalitis15 on the other. Otherwise, our treatment is likely to be misguided.”
Note he gives NO real reason why he “MUST DIAGNOSE,” and defines diagnosis as “knowing the difference between.” But he just admitted above that the DSM itself asserts no ability to “know the difference” between being disordered or not, or between having one diagnosis or another! So giving a DSM diagnosis does NOT provide “the difference between,” it actually confuses such efforts by lumping people with widely differing problems into the same “diagnosis!”
Notice also in his example that he is NOT talking about differentiating between “mental disorders,” but between causes (Combat trauma, encephalitis, or the mysterious and undefined “schizophrenia,” which is such a vague “diagnosis” that the Japanese are not even using it any longer.)
In short, Pies and company talk a good game, but when you look at what he’s REALLY saying, it’s simply more marketing of ideas that don’t have any scientific basis at all.
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Hi Steve, Thank you again for such a thought out reply. Curious if you feel that in order to make a diagnosis of sorts there should have to be a substantial and proven biological cause, uniform to a large group of others? Or are you of the thought of dismissing labels altogether, or perhaps outside a very few for the sake of simplicity?
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I think any medical diagnosis needs to be able to differentiate between a “normal” and a “diseased” state, objectively and consistently. Medicine is to treat the BODY. “Psychiatry” and “Psychology” are supposed to deal with the “psyche,” aka the Human Spirit. Attempts to treat spiritual issues with drugs and surgery and electric-shock-induced seizures are doomed for failure. So I think the “treatment” of any spiritual/emotional condition does not belong in the realm of medicine, and therefore the idea of “diagnosis” in the medical sense is irrelevant, and likely unavoidably destructive.
I much prefer the use of descriptive language. “Mary hears voices speaking to her that others can’t hear. She is feeling very anxious and worried that the voices are going to tell her to kill herself, as they have done in the past. She feels safest at her sister’s house, who is good at calming her down.” That sort of thing is a LOT more helpful than saying, “She’s got schizophrenia!”
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Experts? We create a one style of school, then we take those who cannot cope with it, and deem them “disordered”. We then seek out these same traits in others, and then call it a condition, disease, disorder. WE THEN look for “scientific” similarities, and further cement the ideas into the parents, culture as a whole, that indeed these are disordered persons who would benefit from having drugs.
We then talk about how bringing all this wealth of knowledge into public arenas will help to stop “STIGMA”. The magic words, make the public think there is only stigma out in the public.
THE ONLY STIGMA comes from the people that decided these kids are abnormal. It is THEY who are picking them out as being affected. It is THEY who are drugging kids for being “different”. not ill.
When do you think we should drug kids for not being as physically endowed as other more athletic kids? if 50 kids have good physique, does it make the other 10 weaklings “disordered”?
Why are you not busy trying to create a system where ALL children benefit” Where all children fit in somewhere? You really think that ALL children should learn the same crap? So you do not believe in diversity? The child suffers because he is not fitting in and so he should be drugged.
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I couldn’t learn indoors, outdoors, sitting, standing, riding my bike, standing on my head.
Now I can.
“The child suffers because he is not fitting in and so he should be drugged.”
That isn’t true and it is so far afield, it isn’t worth taking the time to refute it most of the time. Like John McEnroe said, U can’t be serious”.
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What an excellent article about another hoax by Big Pharma and the psychiatric community to sell more drugs. The DSM-IV and 5 definitiions of mental illness are so vague that anyone can be “mentally ill” at any moment. Inteesting that both editions include this phrase: “An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder.” Expectable by whom? And just because a “culture” approves of a response, that doesn’t make it healthy or right. That passage provides some potent weapons for medicalizing – and disempowering – anyone who doesn’t behave in expectable or culturally approved ways.
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JeanM,
Yes, the psychiatric edifice is riddled with these kinds of inane inconsistencies.
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If I’m not mistaken, your belief, your theory, that ADHD is actually a function of the lack of proper parenting, isn’t based on double-blind, controlled and peer reviewed research. Or, is it and I am unfamiliar with it?
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Of course, the theory that “ADHD” is caused by a genetic malfunction is also not based on double-blind, controlled studies, despite what we’ve been told. Let’s not set a double standard. Of course, the idea that something so nebulous as “having difficulty paying attention” or “being overly active” is ALWAYS caused by the same thing is absurd. But here is one article supporting that poor parenting DOES have an effect on attention span and hyperactivity in some kids:
https://www.chicagotribune.com/lifestyles/health/sc-adhd-critical-parents-health-0224-20160211-story.html
Other causal factors that have been identified include poor diet, low iron levels, high lead/heavy metal concentrations, and sleep apnea. And trauma has also been implicated, particularly kids who have “PTSD” symptoms have a huge overlap with “ADHD,” and a study I recall said that family doctors in particular are more reluctant to diagnose “PTSD” over “ADHD” even when children clearly meet the criteria for the former.
https://life-care-wellness.com/how-childhood-trauma-could-be-mistaken-for-adhd/
This in my mind is the inevitable result of having such sketchy, subjective criteria for “diagnoses.” Kids can meet the criteria for both “ADHD” and “PTSD,” and there is not a clinician in the world who can objectively tell the difference. All we have is their opinion on the matter, because the “criteria” don’t make the distinction for us, do they?
We all know there is no definitive cause of “ADHD”, despite decades of research. I’m not holding my breath that there ever will be, because it’s obviously caused by a whole lot of different things, since the only thing these kids have in common is that they have a hard time paying attention to things they aren’t very interested in, and similar subjective “criteria,” not all of which they have to even share with others with the same “diagnosis.”
From the DSM: “[In DSM]… There is also no assumption that all individuals described as having the same mental disorder are alike in all important ways.”
So we can’t assume that all “cases of ADHD” are “alike in all important ways.” This strongly suggests that the assumption all such cases are CAUSED by the same phenomenon is completely inappropriate.
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ADHD is bunk, but labeled and drugged children often grow into labeled and drugged adults. (Outcomes, I read, are notoriously negative.)
“One thing is certain, though: There is no cure for ADHD.”
~Alan Schwarz
“An adult who lacks the concentration to complete a health-insurance form accurately will fail the demands of modern life.”
~Alan Schwarz
What kind of legitimate investigative reporter accepts without question so much expert OPINION as fact?
What’s new in the DSM? Adult ADHD for one thing.
Given an epidemic of adolescent ADHD, I would expect an epidemic of adult ADHD could be plausible before long.
Wow! Invest in a disorder for childhood, and your children grow up, creating a future market for treatment (i.e.. psychiatrists and drug companies). How convenient is that?
Great post, by the way.
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Frank, do you agree with me that when a doctor is presented with one of these cases that he needs to comply with mandatory reporting, or he should be subject to mandatory arrest?
Nomadic
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Not really, Nomadic. “Mental health” work is in large measure paper-work because what we’re dealing with here is a bureaucracy. I don’t think more paper-work for people in the field is an improvement at all. I think if you’re going to arrest doctors, you should do so for harming patients, and not for neglecting to fill out forms. Not unless, of course, such neglect results in injury. Adding to “mental health records” being used for “surveillance and monitoring” purposes is problematic in itself, and I am not one to encourage it. Psychiatry is vulnerable for not being real medicine, however more paper-work is not going to make the field any more valid or less valid than it is at present.
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Frank, the reason we have mandatory reporting laws is to prevent any type of doctors or others who work with children from becoming accomplice child abusers. This is the original intent. I would say that as it stands now, going by the letter of the law, a doctor who sees a child who is clearly displaying signs of extreme emotional abuse, but does not report, is committing a felony. And this applies whether they treat the child or not.
I know someone with our county hospital and she teaches the class on mandatory reporting. She says, “You report *EVERYTHING*”, that is they err on the side of compliance. And you don’t know, your small complaint could be the one which, added onto others, prompts action.
Thing is, the private practice doctors seem to take a much lighter attitude towards reporting. Their business model requires that the parents always be held blameless. And often they make this interpretation clear in their promotionals. Otherwise they would get no patients.
The middle-class family has always revolved around hiring doctors. And so doctors seem to be involved in a majority of middle-class child abuse cases.
Our federal law since 1974 was intended to prevent this. But here we have this ADHD hoax, and it seems to be the creation of the FixMyKid doctors.
One problem is that there is vagueness in the mandatory reporting laws. And as it stands today, the authorities already get more complaints of suspected child abuse than they can do anything at all with.
But the intent of the law is that doctors cannot become accomplice child abusers, and that if they do they are committing a felony.
Excellent Book:
https://www.amazon.com/Childism-Confronting-Prejudice-Against-Children/dp/0300192401
You see my point, that if the doctors actually had to comply with the law, then this industry would vanish, as would all of its hoax ailments and the drugging of children.
Nomadic
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There was a time when children weren’t diagnosed and drugged the way they are today. I think we should return to such a time. Children are innocent as a rule. Psych-diagnosis and drugging is just, in the main, sins of the parents being visited on the child. Ritalin is not a good baby sitter, nor is it a good educator. It’s bad enough that doctors find excuses to drug adults, they should not be drugging children. Psych-drugs are not medicinal. There is little difference, to my way of thinking, between giving children drugs and giving them substances that you can’t legally imbibe under the age of eighteen. It should be illegal for people to give the same drugs that doctors are handing out like candy to children. I don’t think it is a matter of filing out forms and making reports. I think it is more a matter of unacknowledged child abuse.
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To further clarify, the problem isn’t non-compliance with the law. The problem is rather that mental health law itself is a way around what otherwise is the law.
Children can be taken away from their parents because they don’t do the state’s bidding, that is, drug their children. The psychiatrist is not the problem here for filling out a prescription pad. The state is the problem for taking control away from parents, and for not permitting safe options. Psychiatric opinion is required, but it would not matter if it didn’t have legal sanction. The psychiatrist is entirely within the law, and that’s what the problem is, often, just like the science, it’s bad law.
Protecting a person from psychiatry now is a matter of protecting a person from the state because the psychiatrist is there to serve what are seen as the interests of the state, NOT the interests of the person or persons being treated. If the patient’s interests were foremost, refusing treatment would not be an issue.
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Say a child cannot pay attention in class and is failing terribly. The parents are beside themselves, caring deeply that their child succeeds in school and they have tried everything. Mom stays at home and works with the child. Dad goes all out trying to assist the child with flash cars, reading to the child, filtering too much sugar out of his diet, hiring tutors, in constant contact with teachers, the principal, special ed staff, even tried team teaching in an open school, montessori and other special schools. Nothing helped.
What would you do, Frank? Nomadic, your thoughts/advice, please. Everyone, anyone, Phil, Robert Whitaker? Specifically, share your best advice as to what you would do or recommend. Time flies by and the child has lost huge chunks educational material due to the inability to concentrate, large portions of information necessary to do future work, gone.
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Exactly. Based on Dr. Hickey’s well researched, informed accusations many/every psychiatrist in the United States must be arrested for attempted murder and conspiracy to commit First Degree Murder and First Degree Murder. Intentionally, with malice aforethought, conspiring across state and international lines and borders, is terrorism. Murder, of millions of innocents, in the first degree during non-war time is among the worst crimes of all. The World Court has at least partial jurisdiction, I believe.
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“To further clarify, the problem isn’t non-compliance with the law. The problem is rather that mental health law itself is a way around what otherwise is the law.”
Frank B.
Heir Himmler had a similar problem with the evidence of Josef Hartinger from Dachau. That is he needed a means to get around the law. Allowing people to be ‘treated’ as ‘potential threats’ to the stability of the State made this possible. It allowed them to step over the laws protecting people from arbitrary detentions, and to be punished (or executed) for that ‘potential’.
So in my State, by allowing anyone the State wishes to incarcerate and ‘treat’ against their will, they simply have a Community Nurse change the status of the citizen to “Outpatient” (no examination/diagnosis necessary, just fill out the paperwork for an Outpatient and then lie to Police) and then have Police ensure their compliance by inducing an “acute stress reaction”.
https://www.youtube.com/watch?v=oZ9UQKBUrsg
Most are ready to comply/confess by this point. And if not mental health services are more than happy to assist with a ‘verbal’ on the Forms, and a ‘chemical restraint’ which has no standards [thus the issue of ‘overmedicating’ being a form of torture is NEVER an issue. See the “induced coma” in the above video, commonly referred to as a ‘snowjob’ by those in the know]. What a joke these supposed legal protections actually are when the State simply begins uttering with the fraud produced by public officers. Have the proof of the ‘verbal’ “edited” out of the legal narrative, and then start slandering the victim as a madman for speaking the truth.
There are of course laws protecting against this type of conduct [needed to create the appearance they are complying with International agreements regarding human rights], but when Police can’t find their copy of the Criminal Code and simply refer the complainant back to mental health to be, and I quote, “fucking destroyed” well…… Safety in numbers? Tell that to the people who didn’t escape the ‘treatment centers’.
And the World Court? well, if this was an African Nation we were talking about. Of course being able to ‘spike’ citizens with date rape drugs before State interrogations is a distinct advantage. Especially when you can “edit” the documents and make what was an act of torture into a paranoid delusion by removing the proof of the misconduct. Then start ‘treating’ the victim for speaking the truth.
I must say I found it fascinating how many people were “just doing their job” when they were fully cognizant of the criminal nature of what it was that was being done. Most quite happy to turn a blind eye, particularly if their funding (for example the Law Centre ‘advocates’, or two of the three ‘pillars of protection’ being derelict in their duty to report under mandatory reporting laws. Why would you? Documents “edited” and the victim ‘outcomed’, witnesses and their families threatened by Police) was increased significantly for their negligence.
Can’t prove the link of course because of the amount of “editing” the State is doing to legal narratives before anyone is allowed to examine their own medical records. And it being a crime to have your own medical records (“I can arrest you for having these” IO was told by a Police Officer when presenting the proof of the ‘spiking’ to him in a Police Station, before he made a referral for my “hallucinations” [that is being drugged without my knowledge with a date rape drug before interrogation by Police, and having the documented proof that this occurred].
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Frank,
Thanks. The extent to which journalists accept psychiatric PR as factual is truly alarming.
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A vague set of loosely defined….
Not a all. Scientists can track a person’s brain functioning. They can assess how long we pay attention to a variety of stimuli. They follow eye movements, brain waves, blood concentrations in different locations in the brain.
It can’t be so vague Phil when you describe it as the fault of the parents.
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Sorry, Thomas, but even the most mainstream of psychiatrists will tell you that there is NO brain measurement, PET scan, SPECT scan, MRI, or other objective measure that is diagnostic of ADHD or any other “psychiatric disorder.” The DSM itself admits that these “diagnoses” group together people who may have little to nothing in common physiologically – they are grouped based entirely upon subjective and unmeasurable criteria like “Acts like driven by a motor.” How would you measure THAT?
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But, 2 of your sons had all the classic symptoms of ADHD.
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Correct.
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It is more common than many thought. It isn’t bunk. If you couldn’t concentrate as you need to and tried everything and still couldn’t function as you do today, what would you do?
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You can imagine an infinite number and variety of “what if” scenarios, and even if somebody answered ALL of them, ALL of the answers would still be empty, meaningless rhetoric. Because the TRUTH is that psychiatry is a pseudoscience, and a drug racket. Yes, if literally MILLIONS of American school children are dosed daily with legal PhRMA drug version of METH-(AMPHETAMINE), sure, lots of them will SEEM to “concentrate more better in school.” Seems the child’s body actually metabolizes the METH/SPEED differently than adult bodies do. But that in NO WAY means that any of those kids “have ADHD”, nor does it mean that “ADHD drugs work.”…. Your entire argument is thus specious.
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I’m not imagining. That’s part of the problem.
A child sits in a classroom unable to follow along. He has the ability to learn, but he cannot. His mind wanders constantly. His attention span lasts, on average, about half a second. Nothing works to help him.
What would you do for this child? Nothing? Try everything again? What? Specifically? This is a real life, concrete situation. What do you do?
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I’d be very interested in hearing the author’s precise definition of an illness. Without that, it is very difficult to evaluate the argument.
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You should take some time to read some of the many other articles written by Dr. Hickey, to comprehend his rational perspective. His concepts of real illnesses do agree with mine, that none of the current DSM disorders have any scientific validity. And my experience is based upon my own experience of the ADRs of the psychiatric drugs, and seeing the massive drugging of children. This greed inspired insanity needs to stop.
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I think he does answer that question, if indirectly, with his pneumonia example. He is saying that an identifiable disease is something where the cause is known or at least knowable, that some kind of specific test will indicate the presence of said cause, and that the cause is distinguishable from a recitation of symptoms. His critique of ADHD, and I think it is quite valid, is that the symptoms define the “disease,” hence, “He has ADHD because he’s hyperactive and impulsive and lacks focus,” when the very definition of the disorder is “he’s hyperactive and impulsive and lacks focus!” We could just as easily say that someone is picking his nose because he has nose-picking disorder, or that his knee is swollen because he has swollen-knee disorder. The diagnosis is neither explanatory, nor specific, and doesn’t distinguish for the likelihood that these same “symptoms” could be caused by a wide range of different factors.
ADHD is at best a syndrome, a set of “symptoms” that tend to occur together and are troubling, but for which no known cause has been determined (as the author of the original article clearly states himself). If the definition of a disease is “anything that is uncomfortable or difficult to deal with,” perhaps it would qualify, but the purpose of medical treatment is supposed to be to differentiate between causes rather than just treat symptoms.
My best example is a rash. Any rash could be “treated” with calomine lotion or with corticosteroids, but you’d REALLY want to know if you have poison ivy, prickly heat, or syphilis. Syphilis is a disease. A rash is a condition or syndrome that may or may not be caused by a disease state. ADHD is much more like the rash. Except that in some cases, the behavior is an entirely normal reaction to abnormal circumstances. So treating the symptoms is both cowardly and ineffective, and we really should be looking for the cause, be it poor diet, lack of discipline in the home, boredom, or an overly rigid school environment, or whatever. If there ARE odd cases of purely physically determined “ADHD”, we should be trying to distinguish them from the various other causes, rather than lumping together everyone who acts a certain way into a huge, heterogeneous group and trying to suppress the “mysterious” (again from the original article) manifestations with a drug “treatment” for a “disease” when we haven’t the vaguest comprehension of what we are “treating,” let alone what the long-term impact of “treatment” might be.
— Steve
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But there are plenty of serious medical diseases with unknown etiology. Surely having unknown causation isn’t enough to disqualify an illness. Or do you mean something like an unknown pathogenesis? Even in that cases, there are diseases that no one disputes for which the pathogenesis is poorly understood. There has to be something more to the criteria by which we distinguish disease from non-disease.
Being a ‘normal reaction to abnormal circumstances’ also isn’t enough. If you get stabbed and start bleeding, that’s a normal reaction to abnormal circumstances. Doesn’t mean you couldn’t benefit from medical treatment.
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Good point, also normal and abnormal are subjective unless graded according to the norms of a particular milieu.
However, if one accepts the rules of language and the traditional definition of disease, intangible abstractions such as the “mind” cannot have physical attributes, be they colors, textures or diseases.
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But what do you mean by the “traditional definition of disease”? The old classical/medieval view of humoral balance? There are quite a few modern definitions of disease, most of which are not grounded in physiology (which was particularly important because for a long time we did not understand the etiology or pathogenesis of most diseases).
There are “diseases” in the modern sense that don’t have physical symptoms, e.g., “high cholesterol” or “high blood pressure,” which are really just risk syndromes for heart disease (among others). There are pain disorders that can only be measured by the subjective pain experiences of the patient, with no biological test. My point is that there is no easy definition of disease that would exclude mental illnesses but include everything else we generally include in the category of illness.
Nor does it seem to me to be a good idea to exclude things for which people are actively seeking help. If a patient comes to me with crippling high anxiety, should I turn them away because anxiety isn’t a problem some deem worth solving?
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DrStrait, please don’t forget a big flaw with the psychiatric industry is they are force treating people, not just treating people who come to them for help. This should be made illegal. And there is an enormous problem with the psychiatric industry misdiagnosing the known adverse and withdrawal effects of their drugs, as the “serious mental illnesses.”
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A disease is a defect in a bodily process or body tissue. Some dictionaries say “body or mind” but that’s because the common language has been permeated by psychiatric concepts.
Who says anxiety isn’t a problem worth solving (or a warning of such a problem)? It’s not a medical problem, that’s the issue here.
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@SomeoneElse – Certainly I would agree that any forced treatment is problematic, whether in psychiatry or any other field of medicine. Here I’m exclusively talking about dealing with help-seeking adults. I think there is a good critique to be made of pediatric psychiatry, as well as other coercive uses of psychiatry with adults — but you can take the rhetoric too far and start undermining the efforts of help-seeking adults to gain relief.
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@oldhead – Why isn’t anxiety a medical problem? Is chronic pain a medical problem? Those are mediated similarly in the central nervous system. There is no such thing as a mind that exists independently from the body — everything that happens in the mind happens in the brain. The mind is *epiphenomenal* of the brain. And beyond that, as I’ve argued, there are institutional problems with saying that anxiety isn’t a medical problem: if so, people can no longer be reimbursed by their health insurance. To take away treatment from patients with panic disorder, or to suddenly make it too expensive to receive treatment, is astonishingly cruel.
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There is no such thing as a mind that exists independently from the body
This is a quite unproven assumption and in my view an invalid one which highlights the subjective and philosophical nature of this realm of inquiry.
everything that happens in the mind happens in the brain
The brain may mediate the activity of the mind in a material, 3 or 4 dimensional construct but that doesn’t mean the mind isn’t active and manifesting in other spheres imperceptible to the physical senses. Nor does it necessarily mean that this activity originates in the physical brain, or ceases when the physical body succumbs to entropy.
However none of the above is essential to an understanding of how language is manipulated by psychiatry to equate behavior with disease.
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You think it is unproven that the mind is the product of activity originating in the physical brain? That sounds like some kind of mysticism; I’m coming at this as a scientist, so we might not be speaking the same language.
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He is absolutely correct. There is no proof that the mind is the product of activity originating in the physical brain. It is a philosophical assumption that many “modern” people make, and there is a tendency to dismiss anyone who doesn’t automatically agree as “superstitious” or “mystical” as you have. However, I defy you to show us any specific proof of that postulate. I know you can’t, because there is no way to prove what “mind” really is. What you’re saying is that you believe there IS no possibility of non-material existence, therefore the mind must originate in material reality. But there are many, many cultures and individuals who would disagree with you, and you have nothing less mystical than their assumptions to fight them with. You believe that because you believe it – what other proof can you provide other than “It has to be because it can’t be anything else?”
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Which leads me to believe that rather than psychiatric disorders, they should be referred to for the most part as “psychic injuries.”
I do agree that some form of “treatment” can be proposed for things that aren’t understood (though bleeding is not a good example, as we know VERY clearly why a person is bleeding and what we can do to help), however, treating SYMPTOMS is not the same as treating a DISEASE. For instance, a person whose knee is swollen for no reason we know of might benefit from pain killers or antiinflammatories or some kind of drainage to reduce the pressure. But we would be extremely remiss to call a swollen knee a DISEASE and stop looking for a cause just because the antiinflammatory reduces the swelling. Psychiatric diagnoses are very much like saying someone has a “swollen knee.” You can describe what’s happening and try to reduce the “symptoms,” but only an idiot would assume that all swollen knees are caused by the same thing or needed the same treatment. Hence, a swollen knee is NOT a disease, even if it is amenable to symptomatic treatment.
You also have not addressed my rash analogy. Is a RASH a DISEASE? Or is it a condition that could be caused by many things, some disease states and some not? No one’s saying you shouldn’t help a person in distress, but it is presumptuous in the extreme to tell people they “have bipolar disorder” when bipolar disorder is simply a description of how they are acting. If that’s an OK way to define a disease, what is to stop us from diagnosing people with “nose-picking disorder” or “excessive digital-nasal insertion disorder” if you want something more erudite? After all, nose-picking is something that disturbs social functioning and leads to bullying and exclusion. Why not diagnose and “treat” anything that people find annoying?
Thanks for the civil exchange!
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@Oldhead — “high cholesterol” isn’t a defect in a bodily process. It is perfectly normal, and nothing is defective. But we treat it because it is a risk syndrome for various cardiovascular disorders.
One could argue that panic disorder and other cases of crippling anxiety are ‘defects’ in the nervous system’s anxiety response, perhaps due to upregulated glutamate receptors or downregulated GABA receptors. If you come up with a definition of ‘defective’ that excludes this, you will be excluding quite a few disorders treated by other fields of medicine that I’m not sure you want to exclude.
In general, I’m very suspicious of this Cartesian dualism that says that body and mind are utterly distinct. We know that the mind is epiphenominal of the brain, and that it is ultimately grounded in materiality.
Then there are institutional problems. If you say anxiety disorders are a problem, but not a *medical* problem, then all those people who seek help will not be able to obtain insurance reimbursement for therapy and/or anxiolytic medication. I really don’t think we should be making it more difficult for help-seeking individuals to obtain help.
@Steve — Yes, we know why bleeding occurs. But the point is that bleeding is a “normal reaction” to being punctured. What makes it a medical problem then, if you’ve defined medical problems as exclusively abnormality? Certainly, we should address the cause (by removing sharp objects that pose such a danger), but that doesn’t mean we shouldn’t also treat the effect (the bleeding). Similarly, if there is a help-seeking patient with crippling anxiety, and there is an identifiable external cause, we should address that, but that doesn’t mean we shouldn’t also consider anxiolytic treatment. We also understand the neurobiological pathogenesis of anxiety fairly well, so we can explain what is happening subjectively in terms of measurable physiological processes. This is less true of some other mental disorders, of course, but I picked anxiety since people are challenging the entire category.
A rash is a symptom. Ever since Thomas Sydenham, we have defined discrete disease entities as syndromes that consist of constellations of clinical signs and symptoms that co-occur. But some “rashes” are themselves a disease, or at least are the central pathological element to a disease, e.g., perioral dermatitis. Other times, the rash is a reaction to an offending agent like poison ivy, to use your example. And in that case, the rash is a “normal reaction to abnormal circumstances” — and yet you surely would agree that it is perfectly appropriate to treat someone afflicted with a rash from contact with poison ivy. In fact, it is often appropriate to treat the symptoms even when we either don’t know the causes or can’t do anything about the causes. For example, if someone has a cold, decongestants are perfectly appropriate even though they do nothing about the underlying virus. Similarly, if I have a help-seeking patient with severe ADHD, that is seriously interfering with their ability to function at work or with their spouse or some other significant aspect of their life, I think it is perfectly appropriate to prescribe a psychostimulant even though I know it doesn’t treat the underlying cause (which is not well understood). The idea that physicians should turn away those seeking this kind of help is, from my point of view, shocking and abhorrent.
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Also, regarding your last question, there’s nothing to stop us from defining any problem as a disease — but we only do so when it is useful. Given the realities of insurance reimbursement, it is often useful to define something as a medical problem. Even when insurance isn’t on the table, it can be useful when there is medication that helps with a problem because of the institutional logics of the state’s regulatory apparatus. For example, male pattern baldness used to be thought of as a cosmetic problem. But now that we have medication that works for it, we call it alopecia and treat it medically. We do so entirely because it is useful in terms of providing aid to help-seeking individuals. Generally, the threshold is that the issue causes significant distress and/or significantly interferes with basic functioning.
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In general, I’m very suspicious of this Cartesian dualism that says that body and mind are utterly distinct. We know that the mind is epiphenominal of the brain, and that it is ultimately grounded in materiality.
Again, this is more of a spiritual/religious declaration than anything. Or maybe anti-spiritual.
Maybe you would be more comfortable with E.F. Torrey’s description of the mind as a “function” of the brain; nonetheless it remains an abstraction which cannot have material qualities such as color, texture or disease.
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I think your argument is rational, and I don’t object to defining “disease” in that way. What I object to is psychiatrists and other doctors or professionals telling people that they are depressed “because they have a chemical imbalance” rather than admitting they have no idea exactly what is happening biologically or psychologically and they are treating symptoms. It’s obviously idiocy to tell someone with a rash that they have “irritated skin disorder” that is caused by an “overactivity of the immune system” and that suppressing the immune system response is the only answer. And I would still submit that calling “anxiety” a mental disorder leaves the door open to “nose-picking disorder” or “ball scratching disorder.” Where is the line in your view? How insipid and subjective and culturally bound does a condition need to be before the definition of a disease becomes absurd?
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No psychiatrist should be using the phrase “chemical imbalance.” It is unfortunate that such language made it into pharmaceutical marketing copy. Certainly no psychiatrist actually thinks in those terms, even if they use such language with lay folks in a misguided attempt to convey the neurobiological basis of affective disorders. That said, it is true that the hippocampus loses mass during episodes of severe depression or mania, and it is also true that effective antidepressant treatment (whether medication, omega-3 fatty acid supplementation, cognitive therapy, light therapy, excercise, etc.) produces neurogenesis in the hippocampus through BDNF which produces measurable increases in mass. Obviously we can’t talk about causation, but this is a well established correlation. The idea that neurotransmitters are out of “balance” is a throwback to medieval medicine…
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I don’t actually see anything wrong with what you’ve described re the skin disorder — that’s exactly what happens and how we deal with it. The line is really anything that interferes with functioning or well being that can be helped in some cases by physiological intervention. I’m not naive about the dangers of medicalization — but given the institutions we have, it is useful to treat many problems like this. The trick is to have a physician who is willing to pursue a variety of treatment modalities and who has a strong sense of discretion, and also the influence of pharmaceutical companies needs to be confronted. But, at the end of the day, if your vision for how the world should work doesn’t have a practical way for a patient with panic disorder who happens to really need anxiolytic medication to get that medication (and for it to be reimbursed), I simply can’t get on board. There are tens of thousands of help-seeking patients who are truly suffering in ways that would shock most people. Anything that interferes with their ability to obtain the help they seek is, in my view, cruel.
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Certainly no psychiatrist actually thinks in those terms, even if they use such language with lay folks in a misguided attempt to convey the neurobiological basis of affective disorders.
Or, in layman’s terms, “lie”?
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No physical basis, no disease (i.e. no pathology). Even a skin rash has a physical basis. You are in the business of telling people that there’s something wrong with them. I figure it’s time to get into the business of telling them that there’s something right with them. To sell “treatment”, you must first sell “disease”. I would remind you, Dr. Strait, that many people are still “treated” against their will and wishes. It is not MY job to convince them that they NEED “treatment”. I’d rather agree with them when they say they don’t need such “treatment”, and especially when it is, to all intents and purposes, maltreatment.
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SO you really do think that it’s OK to say someone has a “nose-picking disorder” if nose picking is getting in the way of their social success???? That’s a very weird way of defining “disease.” Seems to me like you are perhaps invested in defending the current paradigm rather than really listening to how/why people find this medicalization of normal behavior disturbing and destructive.
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I think that if someone comes to me and asks for help with a problem that is making their life a nightmare, I should try to help them rather than turn them away because some people debate whether or not the Platonic Ideals of ‘illness’ and ‘disease’ are inclusive of their problem. I think instead of throwing up artificial barriers to help seeking patients getting help, we should be trying to help people who ask for it.
And, respectfully, I think it is silly to assert that mental illness has no biological correlate. I don’t know how you can be so certain of that, or why, even if true, that would be a good reason to refuse to help someone improve themselves or eliminate some problem in their life.
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You seem to be suggesting that the only way to help someone with a problem is to diagnose them with a disease. I have helped hundreds, probably thousands of people professionally over many years without feeling the need to diagnose a single one of them. The only purpose psychiatric diagnosis served for me is to get insurance to pay for people to get certain kinds of help, and whenever I did so, I clearly explained to the person that the diagnosis was simply a description of what is going on with the purpose of getting insurance reimbursement, but that their conception of the problem is the only thing I was really concerned with.
Psychiatric diagnosis, in my experience, tends to invalidate people’s own experience and takes away their ability to define their own problem and potential solutions, and is therefore extremely disempowering. It puts people in the position of having some “expert” tell them what’s wrong with them and what they have to do. This is particularly egregious when the “expert” has no real clue what is going on.
As for “biological correlates,” well gosh, we all inhabit bodies and there are biological correlates for everything we do. So what? Are you intending to say that anger is “caused” by “excessive adrenaline and other neurotransmitters?” Or is it caused by someone deciding that something pisses them off and the body responds to their thought by preparing to fight?
As for not diagnosing someone with “Nose-picking disorder” being somehow a barrier to helping him/her with that problem, you have now descended into the extremes of absurdity. I am thinking you are being perhaps intentionally obtuse in order to be “right” about your point. Perhaps you are suffering from “Irrational Need to Win an Argument Disorder.” It seems to be interfering with your ability to hear others’ viewpoints. Do you think there are biological correlates for your condition? Perhaps I can offer some kind of treatment?
I hope you get my gentle jest above. Not meaning to be insulting, just to point out the absurdity of taking any condition you consider undesirable and labeling it as a disease. At a certain point, it reduces to total absurdity.
— Steve
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Removed for moderation.
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Steve,
Nicely put.
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Thanks!
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I’m assuming you’re already familiar with the works of Thomas Szasz?
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Yes, very familiar. I think he makes some very important arguments about coercion and also is an important voice concerning forensic applications of psychiatry. But I think he vastly overstates his case, and his tendency toward polemic interferes with his ability to deal with arguments in a scholarly way sometimes.
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Yeah, well, those issues you mention are mere corollaries of his main work, which was the deconstruction of psychiatric mythology, including the “Myth of Mental Illness.” You probably need to reread this if you haven’t already.
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Prozac would be an excellent choice to relieve the OCD symptom of Involuntary Public Displays of Digital Nostril Repeated Entrance and Exist Syndrom (IPDDNREES) like washing hands excessively
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It is a good and difficult question.
My five cents: The term ‘Illness’ is nothing in itself but becomes meaningful through the context and functional intent of its use. Sometimes illness is used to alleviate someone of (perhaps perceived) painful responsibility, sometimes it is used to ascertain power by professionals. Sometimes it is used carefully in order to indicate functional problems, sometimes it is used to market drugs or therapy and sometimes it is used to indicate the need to allocate resources to an individual. Sometimes it is used to (illusory or not) suggest that we understand the nature of some problem or other. Sometimes it is used to point out the inexplicable or alien.
Illness is just a name – and what’s in a name, really? By any other context, it could mean something completely different.
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DrStrait,
I’ve discussed this issue in many previous posts on my website (http://behaviorismandmentalhealth.com), including these two:
http://behaviorismandmentalhealth.com/2013/10/01/the-concept-of-mental-illness-spurious-or-valid/
http://behaviorismandmentalhealth.com/2013/05/07/mental-distress-is-not-an-illness/.
The essential feature of illness is that there has to be biological pathology. Problems that do not stem from structural or functional biological pathology might be serious problems, but they are not illnesses.
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How do you define “pathology”? Surely everything that happens in the mind is mediated by the brain. So whatever it is that someone is feeling or experiencing or doing tracks with something happening biologically. So the key issue is what biological phenomena do you consider to be ‘pathological.’ Do you use some kind of medieval humoral ‘too much/not enough’ of x criterion? Perhaps you are trying to compare the functioning of an organ to some idealized ‘normal’? Or perhaps you are looking for anatomical lesions of some kind? That would exclude quite a few legitimate medical disorders.
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Hi DrStrait,
Your reasoning about the connection between brain and mind is not a proven fact. Epiphenomenalism, which states that the material organization of the brain causes experience, is a philosophical position not based on empirical science per se. There are alternatives to epiphenomenalism which nevertheless also retains a materialistic worldview. The area of systems theory holds several alternatives. For example work in the line of Gregory Bateson points to the interactional characteristics of complex systems – such as brain, body, culture, family, dyadic constellations etc. – and holds, that mind is immanent not in the brain per se but in the-organism-in-the-world. This of course is a challenging way of thinking because it involves not only the complexity of the brain but also of psychological, social and cultural occurrences and their patterns of interaction – and further more it entails a circular view of causality in contrast to the more simple linear view usually assumed.
If you see your search for a clear definition of brain illness or brain pathology in this light, it might lead you to question how you delimit the object in the first place. I think few will disagree that psychiatry holds a special position compared to the different branches of medicine in that its way of delimiting ‘illness’ to a very high degree is a cultural process. But if the systemic, or bio-psycho-social, nature of psychiatry is denied in favor of a solely biomedical self-presentation then terms such as ‘brain disease’ risks serving an effort to leverage power – often by insinuating a deeper understanding than actually exists – rather than pursuing genuine understanding of the complexity involved.
I understand from your comments that you are a physician, and that you find it abhorring not to prescribe stimulants to a person presenting him- or herself to you with symptoms similar to that described under the ADHD-diagnosis because not doing this would be to deny this person help. But there are other ways of helping – for example based on learning theories or by addressing the milieu – that may be more appropriate (either alone or in conjunction) but are often eclipsed by pharmacological solutions.
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Epiphenomenalism, which states that the material organization of the brain causes experience, is a philosophical position not based on empirical science per se.
Exactly. As for the notion of “science vs. mysticism,” science generally offers proof of its conclusions. So, in lieu of such, Dr. S must be employing his own form of mysticism (in addition to using metaphor and literalism interchangeably).
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What is the difference between physics and metaphysics? One difference is that physics is a matter of measure and mathematics. Infinity is metaphysics. Thomas Szasz used Rudolf Virchow’s definition of “disease” as a “lesion in an organ”. Clearly, psychiatric disorders are not “lesions in organs”. Perhaps, if one were to take a break from one’s infinite growing one could learn to stop growing. More probably, growing ceases whether one wishes for it or not. Imaginary “healing” is quite interesting. Invariably one doesn’t necessarily arrive at “healed” through it.
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The essential feature of humanity is to try to allieviate the suffering of people.
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“The essential feature of illness is that there has to be biological pathology. Problems that do not stem from structural or functional biological pathology might be serious problems, but they are not illnesses.”
ADHD is an illness according to Birk. It is a disorder if nothing else, it is destructive, and it lasts for years, and most often responds to the introduction of powerful chemicals.
No matter what how you classify ADHD, how would you help a third grader who no longer tries in school? He cannot follow along. He’s had excellent training and is of normal intelligence. His folks have sat next to him in class. First and second grade were wonderful experiences. In third grade the work became considerably more demanding. Nothing has worked. He is not disruptive. He is polite, sits still and isn’t learning. He is way behind. If he doesn’t turn this around immediately, he will never catch up.
Please be specific if you don’t mind, or at least give guidelines that you’ve found helpful with other children.
Thanks
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Something extremely painful to another human being needs no label for us to do our best to try to help
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Among men, the crime rate
was reduced by 32% (P<0.001) during treatment
periods, and the rate reduction ranged from 17 to
46% in all nine sensitivity analyses (in which the
comparison was significant in eight). We observed
a similar association among women, with a reduction in the crime rate of 41% (P<0.001) during
treatment periods.
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A Destructive Psychiatric Hoax
Dr. Phil,
Please name say 100 people who were destroyed by ADHD. Thanks
Left undiagnosed it is destructive.
Who is destroyed, if we take it seriously?
There are many good, decent, intelligent, hardworking, well-informed psychiatrists who believe the evidence proving it is a bio-chemical problem, is overwhelming.
I introduced evidence that it is biochemically based. It is undeniable.
It responds to treatment. Long term studies done properly, which are very expensive and difficult to do, show its efficacy. Many LT studies lack credibility. Many participants dropped out. Many were hard to find. Many did not continue to take their meds as prescribed and the long-term outcomes, of tests performed according to high standards, though favorable, have nothing to do with the fact that ADHD is real.
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As I’ve already demonstrated, long-term studies show no difference between “treated” or “untreated” subjects on all major outcome measures, including academic test scores, high school graduation rates, delinquency rates, college enrollment rates, social skills, and even self esteem, which is the one even I would expect to be affected. I was actually quite stunned when I first discovered this fact way back in about 1989 or so, when I first started researching this topic for my own son’s needs. Stimulant treatment is simply not a major factor in long-term success in “ADHD” – diagnosed children. Other factors appear to completely overwhelm any benefits of temporarily paying more attention to or completing more school work. Stating that certain psychiatrists “believe the evidence proving it is a bio-chemical problem, is overwhelming” is absolutely irrelevant. The data speaks for itself, and saying otherwise over and over doesn’t change the science.
https://journals.sagepub.com/doi/abs/10.1177/000992287801700112 (This is Barkley and Cunningham’s study, where Barkley, one of the biggest ADHD advocates around whose income depends greatly on accepting ADHD as a valid construct, states that the VERY slight improvement in test scores for the “treated” groups was easily explainable by the subjects simply reading the questions a little more carefully than the control group. He called the long-term results “Disappointing.” But that has not stopped him claiming later on that anyone NOT putting their child on stimulants for “ADHD” is committing child abuse!)
“Jacobvitz et.al. acknowledged the short-term benefits outlined earlier but focused on the same limitations of stimulants noted by Schrag and Divoky
(1975), McGuiness (1989), and Kohn (1989). As a conclusion, Jacobvitz et al. urged “greater caution and a more restricted use of stimulant treatment” (p. 685). In contrast, Stevenson and Wolraich acknowledged the limitations outlined here but focused on the temporary suppression of symptoms.”
https://escholarship.org/content/qt4jr2777t/qt4jr2777t.pdf (Swanson et. al, 2003)
““Good quality evidence … is lacking” that ADHD drugs improve “global academic performance, consequences of risky behaviors,
social achievements” and other measures.
What is absolutely fascinating is that they revised the report later to eliminate ANY MENTION of long-term outcomes, as if this conclusion were NOT drawn from the study. I think that says more than a bit about the desire of the psychiatric profession to cover up this embarrassing conclusion. (In fairness, they DID find one study of decent quality that showed a reduction in accidents for stimulant users. That was the only positive long-term outcome they found.)
https://www.iacaf.org/assets/Uploads/Documents/DERP.pdf (OSU Medication Effectiveness Study)
“Our results are silent on the effects on optimal use of medication for ADHD, but suggest that expanding medication in a community setting had little
positive benefit and may have had harmful effects given the average way these drugs are used in the community.”
https://www.nber.org/system/files/working_papers/w19105/w19105.pdf (Quebec provincial study)
“No significant differences based on medication-use were noted for the following
measures taken at 14 years of age: depression, self-perception, and socialfunctioning.
• Whilst no statistically significant results were noted, a trend toward slightly higher
depression scores was noted with the use of medication.
• A trend toward slightly lower self-esteem and social functioning was also noted with
medication use at one time point or two time points. However, consistent medicationuse at all time points, including at 14 years, trended toward slightly improved selfperception and social functioning.” There was also a finding of a MUCH higher percentage of grades repeated for those taking stimulants.
https://ww2.health.wa.gov.au/~/media/Files/Corporate/Reports-and-publications/PDF/MICADHD_Raine_ADHD_Study_report_022010.pdf (Raine study from Australia)
I can’t find the USA/Finnish comparison study right now, but it showed that medication rates were MUCH lower in Finland, yet outcome measures like delinquency and school failure were no different in these comparable populations.
The studies referenced above involved MANY THOUSANDS (probably more) of “ADHD” diagnosed children in the USA, Canada, Finland, and Australia. The OSU study looked at every single reference they could get their hands on at the time that had to do with stimulants and ADHD. There is a mass of strong evidence that stimulants don’t alter long-term outcomes, and at this point, most research psychiatrists have accepted this as factual.
This Web MD article is most significant in what it does NOT say about long-term outcomes. If there really WERE known benefits in the long term, don’t you think they’d mention them right here? But they don’t, do they? I wonder why?
“Long-term effects. Some children continue taking ADHD drugs as adults. Decades of research has found no major negative health effects from taking them for a long time. Some studies have suggested that children who keep taking stimulants into adulthood may grow up slightly shorter. But other studies have found no link between medication use and adult height.”
https://www.webmd.com/add-adhd/childhood-adhd/adhd-kids-med-use
The lack of long-term benefits from stimulant drugs for “ADHD” diagnosed children is an open secret. It is known but not talked about. Anyone claiming there IS some benefit for any of these long-term outcome measures has a big hill to climb. Simply stating that “I believe that” or “Dr. So-and-so says that…” is not going to come CLOSE to cutting it in this case.
For those who actually believe in unbiased scientific analysis, the jury is IN on this question. The burden of proof is now on anyone claiming some long-term benefit. Stimulants are effective in short-term suppression of “ADHD” symptoms in the majority of children so diagnosed. That’s about all that can be said. Depending on one’s philosophy of education, and to some extent, on available educational options, this may or may not be considered beneficial. But claims of long-term benefits are mythological, not scientific.
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It doesn’t matter what it is called, at least not compared to the fact that IT IS.
And, IT IS.
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Medicated kids are growing up to be addicted adults, just go to any treatment center or 12 step alcohol addiction meetings start a conversation about psychiatry to open the door then ask the young people if they were drugged in school for ADHD , the majority say yes.
Psychiatry inadvertently taught a whole generation the thing to do is to take drugs to regulate how you feel and since so many were started at a young age that’s all they know how to do to regulate feelings.
Some day in the future people are going to look back at today’s child drugging and say how stupid that was the same way we look back at how stupid it was to put toothpaste in lead tubes.
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The_cat,
I agree, except with the word “inadvertently”. Psychiatry pursued their fraudulent agenda with their eyes wide open. It was turf-expansion and money – plain and simple.
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A child cannot pay attention. He’s in third grade. He doesn’t do any of the work. He is well behaved and his parents are devoted to his education.
What would you do, Phil?
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I have and found nothing of the kind.
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Philip, some have posted that once they meet the parents, why the child might be behaving strangely becomes obvious.
Do you think these alleged cases of ADHD ( bogus illness ) are simply cases of familial conflict, and going so far that we could say that it constitutes emotional abuse?
And so do you agree with me that following both the letter and intent of the Child Abuse and Neglect Act that doctors and therapists are required to report such cases, whether they treat them or not, and that failure to do so constitutes a felony?
Do you also agree that the intent of mandatory reporting was to stop doctors from continuing to be complicit in child abuse?
Do you agree that simply enforcing mandatory reporting would put an end to this ADHD Hoax, and then lot of similar things as well?
Nomadic
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Nomadic,
In my experience, the parents of “ADHD” children are a heterogeneous group. Some, frankly don’t care about their children. They see them as burdensome, and afford little or no attention to them other than screaming at them when they misbehave.
Others are more or less benignly interested in the children, but more interested in other things. So parenting is neglected.
Others are passionately interested in their children’s welfare, but utterly clueless as to how to train them.
And so on. These are just general categories. In reality, each family is unique, and has to be regarded as such.
In some cases, the neglect of training responsibilities is so glaring that mandatory reporting might be appropriate. In other cases, a referral to a parenting training program would be great, except there aren’t many of these.
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“Others are passionately interested in their children’s welfare, but utterly clueless as to how to train them.” Dr. Hickey
Dr. Hickey, where can parents find the information you rely upon which will make them better parents? What sources do you recommend? Why did dedicated, educated parents like Mr and Mrs Mcrea have to work so hard to train their children?
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Does anyone have information or experience regarding a suicide that could be related to ADHD? My nephew committed suicide last April. To the best of my knowledge, he had been diagnosed as a child; but, I think that as an adult he went without medication or any help. I’ve read a few articles with the link between ADHD and suicide. Thank you…
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The ADHD drugs are amphetamines:
http://emedicine.medscape.com/article/289973-overview
And an adverse side effect of amphetamines can be suicidal thoughts:
http://amphetamines.com/5-common-amphetamine-addiction-symptoms/
And in as much as my expertise is in the ADRs and withdrawal effects of the antidepressants and antipsychotics, not the amphetamines. I will say I doubt the “two week” withdrawal rule mentioned in the medscape article is actually valid in regards to how long the withdrawal symptoms can last, since the doctors have basically the same rule in regards to the antidepressants and antipsychotics, and I know the withdrawal symptoms from those drug classes can occur over years, not just “two weeks.”
Hope that helps a little, my condolences on the loss of your nephew.
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Debmarci,
I’m sorry to learn of the loss of your nephew.
There are many reasons that people take their own lives, and we need to be wary of taking general links/trends, and applying them to individual cases.
In general, “ADHD” is essentially a lack of personal discipline. And people who lack personal discipline often struggle with the demands of life. So, again in general, they might be more vulnerable than average to bouts of despair and discouragement. But in the absence of a detailed suicide note, we can never know with certainty the issues in any individual case.
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After I recovered I still suffered from some dysregulation ; and direct control and effort didn’t get me far. But I found solutions within the non drug approach that were helpful. So even if a person is sure they are beyond self discipline – there can still be a means!
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In general, “ADHD” is essentially a lack of personal discipline. And people who lack personal discipline often struggle with the demands of life.`
I challenge that conclusion and I’ll raise several. There is not a single drop of evidence proving that statement is true. Further, there isn’t a shred of evidence that in general tems parents are to blame across the board as Dr. Hiclkey claims. Parents are not to blame, though they can make an environment which is toxic and that makes everything more difficult for children. It is pure speculation on his part that a lack of training during a child’s youth is the basis overall for ADHD. Mcrea’s kids grew up in a wonderfully nurturing and structured environment, yet they posed enormous problems. Why? Obviously, we are born with predispositions.
Explain, Doctor, if you don’t mind, the results of Birk’s work.
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“In general, “ADHD” is essentially a lack of personal discipline.” Dr. Hickey
Doctor, would you explain to us how you came to this conclusion? I know people with ADHD symptomatology who are self-disciplined and it made a huge difference for them. They were very bright and had very mild symptoms. Others I’ve known couldn’t organize themselves no matter how hard they tried–until they took medication.
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Dr. Hickey, I’ll give you a tip. Start with the 3/15/2015 Newsweek issue and this article:
Water Fluoridation Linked to Higher ADHD Rates
BY DOUGLAS MAIN ON 3/10/15 AT 2:44 PM EDT
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A glass of tap water in New York.
SHANNON STAPLETON / REUTERS
ENVIRONMENTAL HEALTH
New research shows there is a strong correlation between water fluoridation and the prevalence of Attention Deficit Hyperactivity Disorder, or ADHD, in the United States.
It’s the first time that scientists have systematically studied the relationship between the behavioral disorder and fluoridation, the process wherein fluoride is added to water to prevent cavities.
The study, published in the journal Environmental Health, found that states with a higher portion of artificially fluoridated water had a higher prevalence of ADHD. This relationship held up across six different years examined. The authors, psychologists Christine Till and Ashley Malin at Toronto’s York University, looked at the prevalence of fluoridation by state in 1992 and rates of ADHD diagnoses in subsequent years.
“States in which a greater proportion of people received artificially-fluoridated water in 1992 tended to have a greater proportion of children and adolescents who received ADHD diagnoses [in later years], after controlling for socioeconomic status,” Malin says. Wealth is important to take into account because the poor are more likely to be diagnosed with ADHD, she says. After income was adjusted for, though, the link held up.
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Take Delaware and Iowa, for instance. Both states have relatively low poverty rates but are heavily fluoridated; they also have high levels of ADHD, with more than one in eight kids (or 14 percent) between the ages of four and 17 diagnosed.
In the study, the scientists produced a predictive model which calculated that every one percent increase in the portion of the U.S. population drinking fluoridated water in 1992 was associated with 67,000 additional cases of ADHD 11 years later, and an additional 131,000 cases by 2011, after controlling for socioeconomic status.
“The results are plausible, and indeed meaningful,” says Dr. Philippe Grandjean, a physician and epidemiologist at Harvard University. This and other recent studies suggest that we should “reconsider the need to add fluoride to drinking water at current levels,” he adds.
Thomas Zoeller, a scientist at UMass-Amherst who studies endocrine disruptors—chemicals that interfere with the activity of the body’s hormones, something fluoride has been shown to do—says that this is “an important observation in part because it is a first-of-a-kind. Given the number of children in the U.S. exposed to fluoridation, it is important to follow this up.” Since 1992, the percentage of the U.S. population that drinks fluoridated water has increased from 56 percent to 67 percent, during which time the percentage of children with an ADHD diagnosis has increased from around seven percent to more than 11 percent, according to the Centers for Disease Control and Prevention (CDC).
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NACHO DOCE / REUTERS
Others felt more strongly. “The numbers of extra cases associated with a one percent increase in the 1992 artificial fluoridation [figures] are huge,” says William Hirzy, an American University researcher and former risk assessment scientist at the Environmental Protection Agency, who is also a vocal opponent of fluoridation. “In short, it clearly shows that as artificial water fluoridation increases, so does the incidence of ADHD.”
But scientists were quick to point out that this is just one study, and doesn’t prove that there is necessarily a causal link between fluoridation and ADHD. They also noted a number of important limitations: Individual fluoride exposures weren’t measured, ADHD diagnoses weren’t independently verified and there may be other unknown confounding factors that explain the link.
Dr. Benedetto Vitiello, a researcher at the National Institutes of Health, says that the link between the two may not be a causal one and could be explained by regional or cultural factors. Charles Poole, an epidemiologist at the University of North Carolina, says that this research suggests fluoride should be more carefully studied, but doesn’t show much of anything by itself. “I think the authors were quite cautious in their interpretation… and [accurate] in their statement of the study’s limitations,” he says. “So it would be ludicrous to draw a strong conclusion based on this study alone.”
Nevertheless, previous research has suggested that there may be several mechanisms by which fluoride could interfere in brain development and play a role in ADHD, says Dr. Caroline Martinez, a pediatrician and researcher at New York’s Mount Sinai Hospital.
Animal studies in the 1990s by researcher Phyllis Mullenix, at the Harvard-affiliated Forsyth Research Institute, showed that rats exposed to fluoride in the womb were much more likely to behave in a hyperactive manner later in life. This could be due to direct damage or alteration to the development of the brain. (Mullenix’s adviser told her she was “jeopardizing the financial support” of her institution by “going against what dentists and everybody have been publishing for fifty years, that [fluoride] is safe and effective,” and she was fired shortly after one of her seminal papers was accepted for publication, according to Grandjean and a book by investigative journalist Christopher Bryson called The Fluoride Deception.)
Multiple studies also suggest that kids with moderate and severe fluorosis—a staining and occasional mottling of the teeth caused by fluoride—score lower on measures of cognitive skills and IQ. According to a 2010 CDC report, a total of 41 percent of American youths ages 12 to 15 had some form of fluorosis. Another study showed structural abnormalities in aborted fetuses from women in an area of China with high naturally occurring levels of fluoride.
There have also been about 40 studies showing that children born in areas home to water with elevated levels of this chemical (higher than the concentrations used in U.S. water fluoridation) have lower-than-normal IQs. Grandjean and colleagues reviewed 27 such studies that were available in 2012, concluding that all but one of them showed a significant link; children in high fluoride areas had IQs that were, on average, seven points below those of children from areas with low concentrations of the substance.
One recent small study of fewer than 1,000 people in New Zealand suggested that water fluoridation didn’t decrease IQ. But that study had some serious errors, according to Grandjean, who writes that “a loss of 2-3 IQ points could not be excluded by their findings.” And only a small percentage of people in the study actually lived all their lives in areas without fluoridation, and even less didn’t use fluoride toothpaste, severely limiting the validity and relevance of the findings, he says.
About 90 percent of the fluoride that is added to the water takes the form not of pharmaceutical grade sodium fluoride but of a chemical called fluorosilicic acid (or a salt formed using the acid). This material is a byproduct of phosphate fertilizer manufacturing, according to the CDC. Several studies have suggested that this form of fluoride can leach lead from pipes, says Steve Patch, at UNC-Asheville. Other work shows that children in fluoridated areas have elevated blood lead levels, and fluoride may also increase the absorption of lead into the body, says Bruce Lanphear, an epidemiologist at Simon Fraser University. Lead itself is a potent neurotoxin and has been shown to play a role in ADHD, Lanphear adds.
There is also good evidence the fluoride impairs the activity of the thyroid gland, which is important for proper brain development, says Kathleen Thiessen, a senior scientist at the Oak Ridge Center for Risk Analysis, which does human health risk assessments for a variety of environmental contaminants. This could indirectly explain how the chemical could impair attentional abilities, she says.
Philippe Grandjean is an adjunct professor at the Harvard School of Public Health. (Philippe Grandjean)
New research finds exposure to fluoride in drinking water and several other common chemicals in early life diminishes brain function in children. Study lead author, Philippe Grandjean, tells host Steve Curwood fluoride, flame retardants, pesticides and and fuel additives may be affecting children’s intelligence.
RELATED STORIES
Water Fluoridation May Increase Risk of Underactive Thyroid Disorder
Just last month, a study was published in the Journal of Epidemiology & Community Health, which found that there were nine percent more cases of hypothyroidism, or underactive thyroid, in fluoridated versus non-fluoridated locations in England.
“Fluoride appears to fit in with a pattern of other trace elements such as lead, methylmercury, arsenic, cadmium and manganese—adverse effects of these have been documented over time at exposures previously thought to be ‘low’ and ‘safe,'” Martinez says.
Grandjean concurs, citing a 2014 study he co-authored with researcher Philip Landrigan in The Lancet that characterizes fluoride as a developmental neurotoxin. Others, like Lanphear, prefer to call the chemical a “suspected developmental neurotoxin.” One problem, he says, is that there is no formal process for determining whether or not something is toxic to the brain.
The CDC declined to comment on the study, but maintains the fluoridation is “safe and effective,” and calls fluoridation one of the “ten great public health achievements” of the twentieth century for its role in preventing tooth decay. The American Dentistry Association says that the process reduces decay rates by 25 percent. It should be noted, though, that in recent decades rates of cavities have declined by similar amounts in countries with and without fluoridation—and the United States is one of the few Western countries besides Ireland and Australia that fluoridate the water of a majority of the populace.
Limitations aside, the study suggests that there is a pressing need to do more research on the neurotoxicity of fluoride, Lanphear says. In fact, every single researcher contacted said that fluoridation should be better studied to understand its toxicity and low-dose effects on the brain. Some deemed the lack of research on the chemical concerning and surprising, given how long it’s been around—fluoride was first added to water supplies beginning after World War II.
Regarding whether or not fluoridation is a sound public health practice, he says that he “can’t make that decision for the public, but I’d certainly recommend that more studies are done, in an urgent fashion.”
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Thanks for sharing this – it includes some good information that is new to me.
I would pose this question to you: if, as you show above, fluoridation of the water supply can significantly effect the rates of “ADHD” in the population, how does that jibe with your earlier researcher’s claim that it is entirely caused by a mutation in a certain gene? Does this not suggest that the environment can and does have a huge impact in the expression of one’s genetic inheritance? Does it not suggest that people who do NOT present as “ADHD” to begin with can BECOME “ADHD” cases due to environmental influences?
Taking this further, could there not be “psychologically toxic” environments that might “cause” a person to “become ADHD” when they otherwise would not have presented that way? Does it not similarly follow that there might be “psychologically healthy” environments that, if applied systematically, would REDUCE the likelihood that someone would present with “ADHD” syndromes or would reduce the severity of these “symptoms?”
Doesn’t it make more sense to suggest that a person may inherit a “vulnerability” or a “tendency” to engage in this kind of behavior, but that the expression of this tendency is strongly affected by the environment they are forced to contend with? That it is not a “nature vs. nurture” situation, but rather a combination of nature/nurture, as most behavioral syndromes (and even major physical health problems, like heart attacks and diabetes) appear to be?
If this is the case, which do we have more control over, nature or nurture? Genes or environment?
I would ask why do we spend so much of our time and money focusing on the one element in the equation, the genetics, that can’t be changed? If we really want to help these kids, why would we not focus our energies and attention on altering the environment to improve these kids’ lives?
Examples might include NOT fluoridating the water, creating open classrooms for kids who find them more workable, teaching parents how to handle these kids without accidentally reinforcing negative behavior, valuing and taking advantage of the kids’ strengths, and even holding kids out of school for an extra year to allow additional maturation?
(Did you know that there is a 30% reduction in “ADHD” diagnoses for kids who start in school one year later? THIRTY PERCENT! We could avoid a THIRD of “ADHD” diagnoses by keeping kids who aren’t ready out of school for a year! Why aren’t we doing this?)
I am not and have never been arguing that some kids don’t often “come that way.” My own kids are a good example – their personalities reflected an intensity, a need to be active and busy, an intolerance of boredom, that were certainly not a result of anything we did or did not do that we are aware of. My point here is that genetic diversity is the key to species survival, and being genetically “different” does not imply being genetically “disordered,” and genetics is in any case the one part of this equation that is completely unchangeable. Why don’t we acknowledge that both nature AND nurture are involved, and spend more time addressing environmental things (like water fluoridation and classroom structure and parent training) that CAN be changed to give these kids a better chance at survival?
I hope everyone will consider the full implications of these findings. Something that is completely genetic in origin (like, say, eye color) would not be so variable depending on environmental impacts. It’s got to be both. Let’s accept that differences most likely exist, but spend our energies on trying to control the environmental variables that we CAN control!
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You have no evidence it is a problem of discipline. Steve, please don’t answer for Phil. It is the height of hypocrisy to make statements like that.
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This really offends me as someone with ADHD. Yet again this is another person that thinks everything was better in the 60s when teachers and parents “believed in discipline and control.” If you think the 60s and before were so great you clearly are not thinking about the thousands and thousands of people that could NOT learn in the traditional educational environment because they were told they were “stupid” of a “behavior problem.” So, they quit school and had low self esteem which probably led to a terrible life. Most of these people probably didn’t come from the background of the author who believes “discipline and control” worked for him. Thus creates the cycle of parents and educators who only want to believe in “discipline and control” to pat themselves on the back as more children get lost in the system or are even abused. As a child I had plenty of discipline and control. I was only given extra time on tests and if I dropped the ball in any way I blamed for “laziness.” It was only through my love of learning did I survive. It has been proven again and again that people with ADD have “different” brains and literally cannot pay attention to certain stimuli no matter what they do. If you don’t want to give a child medication don’t, but there are literally hundreds of other plans and strategies that you can use to help people with ADD. The first and foremost of these strategies is to understand people with this learning disability ARE doing their best and so are their parents and families. What is needed is to drop the unrealistic expectations and accept different learning styles.
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I do agree 100% that different learning styles should be respected, and that more discipline to force “ADHD” kids into regular classroom environments is stupid. Of course, the real purpose of “medication” is to do exactly that, to force kids who don’t fit to modify their personalities and learning styles so as to be less inconvenient for the adults involved.
I raised two of my three boys who had this range of behavior, and we used home schooling and alternative schooling with a child-centered approach, where they were allowed more room to explore and pursue their own interests at their own pace. They both did much, much better in this kind of environment, to the point that both graduated high school with honors, without a milligram of stimulants passing their lips. They DID require some unique approaches to discipline as well, but more or tougher discipline wasn’t the issue, it was more a matter of adjusting disciplinary techniques to their unique needs, most specifically, to take their need for stimulation as an opportunity to be smart and effective, rather than continuing to do what doesn’t work and expect that more of the same will somehow magically change the situation.
Thanks for your comment!
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“I do agree 100% that different learning styles should be respected, and that more discipline to force “ADHD” kids into regular classroom environments is stupid. Of course, the real purpose of “medication” is to do exactly that, to force kids who don’t fit to modify their personalities and learning styles so as to be less inconvenient for the adults involved.” Steve Mcrea
That is insulting, unfair and nasty. You are condemning scores of people you’ve never met who worked just as hard as you and your family to help their children. That is a terrible thing to say.
Medication is intended to help the individual to pay attention. Then, he/she can learn through whatever style he/she may have.
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I am done with this conversation. Please leave it alone.
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It has been proven again and again that people with ADD have “different” brains and literally cannot pay attention to certain stimuli no matter what they do.
That’s absurd. Who told you that?
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Anyone who has gone through different experiences has different brain chemistry. Brain scans prove nothing about a discrete illness called ADHD existing let alone one in which people can never come to concentrate. Indeed, what happens with these brain scans is that research psychiatrists presume a priori that certain individuals “have ADHD”, and then they scans their brains and compared them to “normals'” brain scans, and take the (inevitable) average differences as proof of an illness existing. But this is simply circular logic – average differences in brain chemistry at one point in time between two quasi-experimental groups do not prove anything about an illness called ADHD. As oldhead suggested, one must wonder where you got these ideas…
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Might his name begin with “E.F.” or something like that?
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Matt,
Nicely put!
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people are often offended by arguments on this site.
Being offended does not prove the argument is wrong.
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Don’t know if you’re responding to a particular comment, but yeah. I was riding in a car with someone talking about MIA-type stuff and when I said that “mental illness” doesn’t exist she didn’t want to discuss it, and told me that it was “offensive.” Actually she was being defensive, for whatever reason. I guess the round Earth theory, etc. were offensive in their day as well.
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MamaJ,
There is, in my view, nothing offensive in the article. There is a widespread tendency among psychiatric adherents to confuse offense with disagreement. “I disagree with this” becomes “This is offensive.” If you feel that there is some sentence or passage that is offensive, please point it out and I will gladly take another look.
Personal discipline means doing things that we don’t particularly feel inclined to do for the sake of a greater goal, and refraining from, or at lease postponing, things that we do want to do, also for the sake of a greater goal. It is not something that comes naturally to children. Rather, it needs to be instilled through active training. The label “ADHD” refers to children who for whatever reason, have not received this training to an age-appropriate degree. This is the obvious and most parsimonious explanation for the behavior in question. The term “discipline”, incidentally, should not be confused with harshness.
Are you suggesting that personal discipline as defined above is undesirable? Are you suggesting that parents do not have a responsibility to actively train their children in personal discipline?
You assert that “It has been proven again and again that people with ADD have ‘different’ brains and literally cannot pay attention to certain stimuli no matter what they do.” If you would cite me the references to support this assertion, I would be happy to take a look, and if your assertion is founded, I will acknowledge this in a subsequent post.
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I would have to add, though, that different kids require different disciplinary approaches. Kids who get diagnosed with “ADHD” generally are seeking stimulation, and knowing that does help decide HOW to approach discipline with them. Of course, needing something different does not make someone diseased, especially if what is different is simply behavioral style and personality.
I’d also add that there are kids who have been abused and/or neglected by their parents, or have been injured by society at large, and they may choose stimulation-seeking as a means of coping. So we do have to be careful to posit a lack of discipline as a universal commonality – trauma also plays a role, as can easily be seen by the massively higher “ADHD” diagnosis rates for kids in foster care.
Thanks for continuing to fight this fight – this topic is near and dear to my heart!
— Steve
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“There is, in my view, nothing offensive in the article. There is a widespread tendency among psychiatric adherents to confuse offense with disagreement. “I disagree with this” becomes “This is offensive.” If you feel that there is some sentence or passage that is offensive, please point it out and I will gladly take another look.” Dr. Hickey
You also said this: “You assert that “It has been proven again and again that people with ADD have ‘different’ brains and literally cannot pay attention to certain stimuli no matter what they do.” If you would cite me the references to support this assertion, I would be happy to take a look, and if your assertion is founded, I will acknowledge this in a subsequent post.” Dr. Hickey
I think it is only right that you reference your sources which document that “psychiatric adherents” confuse offense with disagreement. Regardless, she said she was ioffended. You offended her. She Felt offended. A book isn’t going to change how shje felt. Averages, statistics, manuals, theories, intellect, will not change how she felt when she read how you condemned people like her, that most people like her don’t have self-discipline.
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You assert that “It has been proven again and again that people with ADD have ‘different’ brains and literally cannot pay attention to certain stimuli no matter what they do.” If you would cite me the references to support this assertion, I would be happy to take a look, and if your assertion is founded, I will acknowledge this in a subsequent post. Dr. Hickey
ADHD is the inability to focus attention as needed.
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Thanks Philip,
You’re saying it directly – ADHD is a hoax, and you’re explaining why.
The DSMs’ remind me of manuals that try to pass themselves off as legal policy manuals, but are more like “medieval witchfinder manuals” (written by defective people).
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Fiachra
Right, the Malleus Maleficarium. It was such a wonderful manual that led to the deaths of thousands of people; perhaps as many as one million women that this manual identified as witches. One day the DSM will be discarded on the ash heap just as the Malleus Maleficarium, but not before it destroys the lives of countless people.
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The DSM theology has already killed way more than the “one million women that this manual identified as witches.” It’s killing millions and millions, including children, the elderly, women and men.
http://www.naturalnews.com/049860_psych_drugs_medical_holocaust_Big_Pharma.html
Today’s DSM, and the psych drugs it mandates, are infinitely more insidious than the witch hunter’s manual, and the Nazi holocaust, combined. Today’s DSM was confessed to be scientifically invalid and unreliable by the head of the NIMH in 2013. How much longer until the DSM is put out of use? “The love of money is the root of all evil.”
And, if I’m not mistaken, the witch hunters’ goal was to cover up child abuse for the “religious” men, and that’s the primary function of today’s psychiatric industry and it’s DSM today, too, according to the recent medical literature.
https://theconversation.com/hearing-voices-is-more-common-than-you-might-think-66934
https://www.madinamerica.com/2016/04/heal-for-life/
Apparently, the love of profiteering off of covering up child abuse is a long held societal problem, too. It was confessed to me that this historic problem is known as “the dirty little secret of the two original educated professions.”
Perhaps that now that we all live in the information age, it’s time this “dirty little secret of the two original educated professions” should be put to rest? Especially, since doctors profiteering off of covering up child abuse is illegal?
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Today’s DSM, and the psych drugs it mandates, are infinitely more insidious than the witch hunter’s manual, and the Nazi holocaust, combined.
Would you mind defining “mandate” as used is this context?
“A love for money is a root of all kinds of trouble” is more accurate. How do you eliminate this evil?
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And remember, the Roman Church burned and murdered countless thousands of people both as witches and as heretics, all for their own good of course. They did it to save the souls of these people from the supposed fires of Hell.
Sound familiar? We are diagnosed and “treated” against our wills, our lives are destroyed or made unbearable, all “for our own good of course”.
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Thanks Stephen,
We know now that there were no witches and that the witchfinders were the defective people.
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Stephen,
Yes. Millions and millions worldwide.
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I never thought of it before, but what an excellent comparison of texts!
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Fiachra,
They are exactly like witchfinder manuals: facile and unreliable checklists for non-existent conditions.
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…and there’s a defectiveness about the authors…
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There isn’t an ounce of evidence anywhere proving that ADHD isn’t real. Keep that in mind. If the DSM lacks evidence and makes false statements, ADHD stands by itself.
Look at Ohad Birk to see evidence for ADHD.
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Scientifically speaking, there is no need to “prove that ADHD isn’t real.” And the existence of people who fit the description is not proof of anything. It is the responsibility of those claiming it is a disease state to prove that it IS a disease state. Anyone can describe a condition and claim it is a “disorder.” As I’ve said before, genetic diversity is the key to species survival. I’ll remind everyone of the study where groups of three kids having one “ADHD” – diagnosed child were WAY BETTER at solving problems than groups of three who did NOT have an “ADHD” child in their group.
The point is not to prove that people can be identified as “fitting the criteria” that were chosen to describe “ADHD.” The point is to prove that such people a) have significant things in common besides acting a certain way, b) that there is some means of objectively distinguishing those so identified from the general population, and c) that the variation is a malfunction rather than simply a variation in genetic inheritance.
For instance, running slowly has a very large genetic component. Failure to be able to run quickly leads to significant psychosocial distress, as any such person who has had to go to PE classes can testify. Giving stimulants to such people would improve their running speed to some degree in most cases. Is slow running a disease state? Who would need to provide proof of this? Would I have to prove that it WASN’T a disease? Or would someone claiming it was be responsible for the proof?
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This makes too much sense Steve. 🙂
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Hi Dr Hickey, great article as usual.
you write “Psychiatry is nothing more than legalized drug-pushing. There is not one shred of intellectual or scientific validity to their so-called taxonomy. They invent these so-called illnesses to expand their turf, and then liberalize the criteria to expand it further.”
I’d go even further than this. Drug pushers rely on their ‘clients’ to have an addiction which brings them back time and time again to alleviate the symptoms of withdrawal. Psychiatrists have available the use of force to create the addiction in the first place. And not only do they invent the so called illnesses, it is the case that without any National Standard as to what constitutes a “chemical restraint” people who are attending EDs etc are being injected with chemical cocktails with the primary aim of restraint, and which actually cause the very chemical imbalance that they claim later to be curing.
Highly effective for those who wish to throw inconvenient truths down the well, never to be seen again.
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Boans,
This is so true. Neuroleptics cause akathisia in many cases. Akathisia causes people to go crazy. More neuroleptics, etc.
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Well done Phil – it is indeed stunning and distasteful to see the ignorance and presumptuousness of a phrase such as the following:
“One thing is certain, though: There is no cure for ADHD. Someone with the disorder might learn to adapt to it, perhaps with the help of medication, but patients young and old are generally told that they will deal with their abnormal brains for the rest of their lives.”
Few people can believe that the person writing such a phrase is essentially delusional – i.e. that Schwarz has no understanding of how or why problems with attentiveness and focus do not in any way constitute a discrete illness, let alone incurable ones… and that many children could think with more logic and nuance than Schwarz.
As you wrote very cogently,
‘Under the guise of medical care, they routinely rob people of their sense of competence, their dignity, and in many cases, their lives. They have radically undermined the concept of success-through-disciplined-effort, and have ensnared millions of people worldwide in their ever-expanding web of drug-induced dependency and self-doubt. They are not the thoughtful and expert codifiers of genuine illnesses, as Mr. Schwarz contends. Rather, they are drug-pushing charlatans and hoaxsters who have systematically and deliberately deceived their clients and the general public to enhance their own prestige and their incomes.”
This is a great description of what psychiatrists do in general; and really applicable to almost any of their pseudo-diagnoses.
Thank you for continuing to sound the alarm against this nonsense.
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He certainly doesn’t grasp the idea of “ADHD” as a syndrome that has a number of eminently treatable causes, once you know what the offending agent is, like the heavy metal poisonings discussed at the top of the commentaries.
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Matt,
Thank you. Mr. Schwarz’s book was particularly disappointing to me because I believe that genuine investigative journalism could, and should, be focusing on psychiatry; not parroting its nonsense.
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all I can say is psychiatry needs to be destroyed
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I agree 100%.
But I also say that we have to discredit Psychotherapy, Recovery, and Healing, and also prevent people from using any of these on their children.
ADHD, after all, and in my opinion, is a product of the FixMyKid industry.
Nomadic
https://www.youtube.com/watch?v=0d8FTPv955I
http://s3.amazonaws.com/halleonard-pagepreviews/HL_DDS_0000000000460900.png
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Vaccinations , Mercury dental work, food and water with added chemicals , poverty and the elusive living wage, —There’s got to be some social reaction and the ultimate pseudo scientific profit seeking population behavior control catch bag , pharma and it’s psychiatrists, pusher’s of demonically engineered substances from hell shoved down our throats from the cradle to the grave .Hey if it aint them (the psychiatrists) Pharma will still find someone from somewhere to push the stuff for them .Shock and Awe , if the drug don’t get you the fear of prescribers will. We must activate anti-psychiatry better and maybe join it with an anti pseudo science movement . Cause the stuff ( pseudo science that shortens life span and cranks up suffering) is all over the place cause the powerful have converging interests and our well being is not one of them.
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“We must activate anti-psychiatry better and maybe join it with an anti pseudo science movement. Cause … pseudo science … is all over the place … [and these] powerful [for-profit only motivated corporations] have converging interests and our well being is not one of them.” So true, and Thomas Jefferson forewarned us of this day long ago.
https://www.monticello.org/site/jefferson/private-banks-quotation
The root of the problems in this country are so evil, and so much bigger, than just a deluded psychiatric industry. The problems stem from those who financed the miseducation of all the psychiatrists, and the mainstream medical community, for profit.
But waking the psychiatrists up to the reality that maintaining the status quo, which is that the psychiatrists have turned themselves into a bunch of unrepentant defamers, murderers, and thieves, which is an unwise place for any soul to be, is a place to start. And the reality is the globalist bankers and corporations who financed the current murderous US medical industrial complex, in general, are not ‘powers that be’ that deserve to be kept in power.
I’m forgiven, but those still blinded by their miseducation, like the majority of today’s psychiatrists, who are still trying to maintain the status quo, are those who are not yet forgiven, since they haven’t repented and made proper amends to those they’ve harmed. “Don’t say I didn’t, say I didn’t, warn you.” The psychiatric industry needs to mentally comprehend their beliefs are as scientifically invalid as the beliefs of the psychiatrists during the Nazi era, and those who financed their miseducation, are much more evil and insideous than were the Nazi’s alone.
Maintaining the current “status quo” is the problem, since the “status quo” are the globalists who financed our societies’ current miseducation, chaos and problems. It is also sad to notice that historically it’s only evil governments that advocate belief in psychiatry’s spurious theories. And that my government is currently doing this.
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Off the subject but…can anyone explain where those 22,000 views of this article over 2 days came from?
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Hi Oldhead. Yahoo News began linking to this piece soon after it was posted. That’s where most of the views are coming from.
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In college, we read Mad In America. At the time, I thought it was majorly cool. I am all for exposing the shenanigans of the ‘medical’ community, demedicalizing and humanizing society. The integrity of human beings needs to absolutely be respected. De humanizing and medicalizing so-called ills of society is pret much a crime against humanity.
I was one of the few men in America teaching preschool a few years ago. There was a three year young wonderful little girl who stood out as playful and joyful to me. After a few month absence, she came back and was acting like a lifeless zombie. It was tragic! I later learned that some ‘bright’ psychiatrist ‘diagnosed’ her with adhd. My jaw hit the floor!
Meditation has worked well for me to keep an even keel so to speak.
It seems to me that older adult road ragers who can get way out of hand on the road may have adhd of sorts. This could apply to random serial killers, etc. So I think there’s much more to it than looking at it from a medical perspecitve.
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Yod,
Thanks for coming in. In fact, road ragers have their own “diagnosis”: “intermittent explosive disorder”. I kid you not! Though they probably also have “co-morbid ADHD”. You might be interested in my post on intermittent explosive disorder.
http://behaviorismandmentalhealth.com/2015/08/04/intermittent-explosive-disorder-the-illness-that-goes-on-growing/
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I “have” ADD. Diagnosed at 8 and treated with Ritalin for 8 years. Re-diagnosed as an adult. I am a successful, high-functioning adult. ADD/ADHD is not an illness and I disagree with a lot about modern psychiatry and the way “mental illnesses” are perceived and treated. I LOVED Anatomy of an Epidemic and Bob Whitaker’s writings. They were a revelation to me about many things. But dismissing a chunk of the populations experiences and suffering doesn’t help anyone. I got tired of trying to explain my experiences to other people so I wrote and drew a graphic novel (a big comic book) about ADD from the perspective of someone who has actually lived this life. It’s obvious when posts or news articles like this go up that the writer and commenters have little-to-no firsthand experience with ADD. Go to http://www.raisedonritalin.com and read my book online for free or order a hardcopy. Read that whole book and then we can talk.
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Sorry but the whole notion of being raised on Ritalin is too horrific for me to read that. I’m sorry you were “diagnosed” and drugged before you could have possibly understood what was going on. Maybe, hopefully your body has developed a resistance to the Ritalin and it will not be a factor in your future (physical) health.
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@tylerpage “…little or no idea…” about a fungible, malleable concept built by a discipline that makes things up as it goes along? And whose diagnoses are directly tied to one of the biggest profit-making industries of the planet? If I had brought my son (from age three onwards) to psychiatrists he would have been variously diagnosed as ADD, ADHD, IED, ODD, bipolar, or maybe even psychotic (all depending on the psychiatric flavour of the moment). I would have fed him off-label psychotropic drugs whose actions are much less clear and much more dangerous than psychiatry/pharma wants us to know, without his informed consent, and without knowing the effects on his brain decades into the future. Meet my son now, who was successfully raised without diagnoses and psych drugs, and then WE can talk.
If you’re satisfied with your experience, that’s OK. But don’t suggest that because others reject wholesale the lies and omissions of psychiatry, its ridiculous diagnoses, and its deadly chemical cocktails that they somehow know less than you.
Liz Sydney
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Liz (Ourviolent child),
Thanks for this very helpful perspective.
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WE do not dismiss the suffering of people at all. Most of us here are survivors who’ve suffered at the hands of many, especially at the hands of the so-called “mental health system”.
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Tyler,
I believed in my severe diagnosis and I was dependent on medication. But as time went by I found that I responded to psychological approaches.
There’s no debate in it for me, if nondrug methods work, then these are what should be used (and the “illness” idea itself is fraudulent).
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IRONY
If non-drugs approach had any benefit for me, I’d be delighted to use them. I don’t mind what others choose to help them with ADHD. And, as almost everyone here is passionately, vehemently opposed to using drugs as a means to help people with ADHD, that’s okay by me, too.
Sure, experience isn’t everything, however, as M.I.A. makes plain, stimulants have been proven to reduce the symptoms of ADHD in the short term. IOW, M.I.A. acknowledges ADHD is real and it responds well to the use of drugs.
I think it is wise to bear this in mind: M.I.A. proclaims that it is indeed a fact what the vast majority of M.D.s and the public have long held to be true.
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Tylerpage,
First-hand experience is important, but is emphatically not the arbiter of reality. My “first-hand experience” tells me without a doubt that the sun rises in the east each morning, crosses the sky, and sets in the west. But this isn’t true. In addition, almost everyone can remember the inattentiveness, impulsivity, and general gadding about of our childhood years. We can also remember the efforts we made to overcome these tendencies and the efforts our parents and teachers made to help us. I suggest that you are dismissing these experiences, or at least, you are implying that they have no relevance to you. I, on the other hand, am not dismissing anybody’s experiences. My primary point is that ADHD is not a coherent entity of any kind, much less an illness. It is, rather a loose collection of vaguely-defined behaviors. You seem to agree that “ADHD” is not an illness, but in your comic book, you go much further than this: “ADHD is who I am.”
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Dr. Hickey, which treatment modalities have you had most success with as you worked with young children with so called ADHD? Have you assisted children to become more attentive? What worked best, what style or method yielded the best results? Did any of your most severely afflicted kids make significant progress which continues today?
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Thanks. Appreciate all you said, Glad you are thriving. Walking in someone’s else’s shoes can make all the difference.
Unfortunately, I haven’t seen alternatives proposed for the individual who cannot concentrate that make sense. It is easy to criticize, but when it’s time to offer workable options, silence shows up.
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The entire mental health field is based on control, manipulation, and maintaining power at all times. I found every bit of that world to be oppressive, judgmental and uptight. It’s easy to lose focus. I found that to be the cultural norm, no attention span. No space for people in their humanity, only very quick sound bytes, and they think they have you all figured out. To call it a myopic world view is being generous, in my estimation.
And what better way to to control and maintain power than to make up an “illness” which becomes a label intended to brand people in all sorts of mythological ways in order to 1) make tons of money and 2) stay in denial and ignorance of what are the true roots of these issues? Which means people taking responsibility for themselves where they are most reluctant to do so. Scapegoating is alive and well in the 21st century, so the burden of growth and change falls on a mere few, rather than on the collective at large.
Also, it will implicate a lot of people who either pretend they are helping others while only interested in their own gain, at anyone’s expense; or, they truly feel they are helping others when in fact, they are doing more harm than good. Sinister, but clever. Sure has a lot of people good and confused. I think that’s the idea. Lack of clarity is a tool of oppression, keeps people in kind of a daze, and perpetually doubting themselves.
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So Alex, do you agree that in large measure, ADHD is the invention of FixMyKid Doctors?
Some of them use drugs, but some do not. Right now these two groups are competing for share in the FixMyKid market. Of the second type, we’ve all seen their ads.
It was many years ago, reading the works of Salvador Minuchin and the Milan School of Family Systems Therapy:
https://en.wikipedia.org/wiki/Family_therapy
an earlier edition of:
https://www.amazon.com/Working-Families-Second-Guilford-Therapy/dp/1593853475/ref=asap_bc?ie=UTF8
They clued me into something critical, one of the defining characteristics of the middle-class family is that it hires its own private practice doctors. It does not use public agencies which serve the poor. So it is not just the pedagogy and child development manuals which characterize it, it is also the use of all sorts of doctors. And as I see it, mostly it is just that the parents want to be right, as this is why they had children.
Do you agree with me, that these doctors are routinely seeing kids who show sufficient evidence to warrant suspicion of severe emotional abuse, and that likely each one of these hoax ailments like ADHD is really just an excuse for severe emotional child abuse?
And so do you agree with me that these doctors should be made to comply with the letter and intent of our federal mandatory reporting law, or face prosecution?
Of course you know that that would be the end of the FixMyKid industry.
https://www.minnpost.com/community-voices/2009/02/mondale-led-effort-against-child-abuse-now-congress-must-re-engage
Family life in Pittsburg
https://www.youtube.com/watch?v=vjR1PH41Vkg
Does the thought of some of these doctors being charged with felonies, and the entire FixMyKid industry being plowed under, arouse any particular feelings in you?
You know that unless forced to, the doctors would never report, and that it has always been this way.
Nomadic
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Nomadic, I do believe that ADHD is a false and misleading label, based on othering a child who does not conform to the norm in a controlling and narrow-minded environment. Sadly, all too often, parents and the school system match in their desire to control the child rather than to see this as an opportunity for THEM to evolve, as well as the entire community, especially the family. We learn and grow from kids, they are the ones acting as per their true nature.
I’ve observed that usually, the kids that are labeled and drugged are usually far more aware and creative than the adults around them, so the adults end up feeling threatened and that’s where the trouble really begins, leading to labels and drugs, to keep the kid acting “normal” and compliant.
I do think it’s abusive, but not intentionally. I believe people are doing the best they can with what they know. But overall, I do think people need to wake up to a new level of awareness in order to see the consequence and root of their choices for the kid. I believe it’s a matter of education, but it’s hard to get people to listen. This stuff makes people really defensive.
Personally, I hate “mandatory reporting.” it plays into the system and causes all sorts of problems for people. This is pure ego and control and people use it to play God and judge their clients.
I believe the solution here is on a much broader scale. Society, on the whole, is tarnished with scapegoating and corruption. I think it’s a matter of seriously assessing our “leaders” in every regard. Dynamics such as these, which create confusion and chaos for people, start at the top.
To me, the chaos down here in “the trenches” signifies that our leaders are lying, pure and simple, and stressing everyone out in the process. Vampires, in short, draining others for their own gain. Makes it easy to dupe and control others. That’s what I think the real problem is here.
I studied Sal Minuchin in in grad school family therapy class. I used his model to break my family system a few times and spoke my truth. Fascinating process.
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If you don’t have mandatory reporting, then doctors are professional accomplice child abusers. This used to be called Muchausen’s Syndrome By Proxy. Now it is called Medical Child Abuse.
ADHD, ASD, Mental Illness, are clear examples of this. What could be worse than doctors who treat non-existent illnesses and advertise this?
Mandatory Reporting gets it under the supervision of the court, and this is the only entity which has authority over the parents. The doctors market themselves to the parents, and herein lies the root problem. Only the court has the authority to intercede. The court makes the child into a personage.
Nomadic
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Practically speaking, what do you recommend for an 8 year old who doesn’t do her school work and is caught daydreaming throughout most of the school day. Every obstacle which might be a factor has been eliminated except for ADHD.
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An open classroom, as I’ve already stated more than once. You are making the assumption that paying attention to schoolwork is necessary to succeed in life. The long-term studies on stimulant treatment belie this assumption. Kids taking stimulants complete more homework, pay more attention to the tasks at hand, yet don’t learn more as a result. This should raise questions as to whether they may be daydreaming simply because the “work” they are presented with is inherently dull and ineffective as an educational tool.
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An open classroom made no difference. Everything was tried. What do you do now?
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Your premise is contrary to research data. I’m not going to go into agreement with you that everything has been tried when it has not. If an open classroom has not been tried, it should be.
The other thing I’d look into is what kind of family life or conditions the child is experiencing. There is hard data showing that kids in foster care have MUCH higher diagnosis rates, and that the overlapping symptoms between “ADHD” and “PTSD” quite commonly lead to PTSD sufferers being “diagnosed” with ADHD without looking at the underlying trauma, which is often ongoing.
However, it is appears to me that you are not really interested in having this discussion, as I gave you a very legitimate answer to your question, which you intentionally dismissed on speculation without considering it at all. Two of my three kids went to “open classrooms” and did absolutely fine despite moderate to severe “ADHD” symptoms in elementary school. You make no comment and give no credence to the fact that similar results have been observed with many who fit the “ADHD” criteria. It appears to me by this behavior that you are simply selling your viewpoint and trying to invalidate others who have given perfectly rational responses. This is not productive and I frankly find it extremely irritating. I could be wrong, but it appears to me at this point that the only answer you will accept is, “You’re right, Thomas, I’d totally put my kids on Ritalin.” I’ve already faced EXACTLY the situation you described and HAVE come up with an effective plan to handle it without any stimulants at all. So no, I would NOT put my kids on stimulants, because I did not need to, as we came up with a more effective plan.
See my remarks on Thomas Edison. There are other examples (like Einstein) of kids who didn’t do so well in school yet contributed mightily to our society. The ability to apply oneself to concentrating on schoolwork is a massively overrated skill. And you’d have a lot more influence on the people you are so passionately trying to convince of your viewpoint if you’d start by acknowledging the multiple successes of “ADHD” people who have succeeded without “treatment.”
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Two of my three kids went to “open classrooms” and did absolutely fine despite moderate to severe “ADHD” symptoms in elementary school.
How do you know they had moderate to severe ADHD symptoms
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I can read the list of “criteria” as well as anyone. They’re not exactly complicated. And I have an MS and experience as a counselor, and used to diagnose lots of people using the DSM (though I saw it only as a means of getting their insurance to pay, not any kind of scientific “truth” about their condition). It was pretty obvious that if I sent my oldest to a standard school classroom, it would be days before I got “the note” telling us to take him in for an “evaluation”.
Here are my responses for Patrick, our oldest:
Displays poor listening skills (yes)
• Loses and/or misplaces items needed to complete activities or tasks (frequently)
• Sidetracked by external or unimportant stimuli (frequently)
• Forgets daily activities (yes)
• Diminished attention span (Compared to whom? But less than most kids his age)
• Lacks ability to complete schoolwork and other assignments or to follow
instructions (not sure if it was ability or motivation)
• Avoids or is disinclined to begin homework or activities requiring concentration (Absolutely!)
• Fails to focus on details and/or makes thoughtless mistakes in schoolwork or
assignments (yes)
• Squirms when seated or fidgets with feet/hands (yes)
• Marked restlessness that is difficult to control (yes)
• Appears to be driven by “a motor” or is often “on the go” (dumb criterion, but if they mean he didn’t like to sit in one place, absolutely)
• Lacks ability to play and engage in leisure activities in a quiet manner (Are you kidding? No volume control!)
• Incapable of staying seated in class (maybe not incapable, but had a hard time with it)
• Overly talkative (not really – this is the only criterion that did not apply to our oldest)
Symptoms present prior to age 12 years (from birth, more or less)
• Symptoms not better accounted for by a different psychiatric disorder (e.g., mood
disorder, anxiety disorder) and do not occur exclusively during a psychotic disorder
(e.g., schizophrenia) (This is a fascinating criterion, meaning even if ALL the criteria are met, you might NOT have “ADHD” if, in someone’s OPINION, you might have something else. VERY scientific! But no, it wasn’t)
• Symptoms not exclusively a manifestation of oppositional behavior (Again, very silly. How would anyone ever make this determination?)
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Thomas,
You went through a prolonged phase of suffering, took a drug/drugs and it helped you. No problem with that. You’ve also brought up neuroimaging citing X and Y study.
Here is an MRI. My own. Feel free to take it to a neurologist, a psychiatrist or anyone who knows how to read medical imaging. Can they or you identify the problems that I have been through? Don’t go through my posting history. If you do, don’t tell it to the person reading the image. Download the image. Ask them “what issues does this person have?” without telling them anything.
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Something that is not considered here but which is an important consideration, is the potential for turning young children into drug addicts by prescribing them ADHD medications.
Its quite a contraction, to tell children that using street drugs to get high is bad, but then we turn around and hypocritically given them the same drugs to cure them of a disease. When its really a diseased ideology used to make money on them that causes their suffering.
Speed users love Adderall, and consume it just as readily as they consume Meth. Its often sold by those that get the prescription for it, to others.
Then of course they forget about past mistakes and liver failure in young children on now banned types of medications, and the fact that after amphetamines were banned as an over the counter drug, pharmaceutical companies continued to manufacture large quantities of it. They shipped it to Mexico where it could be bought legally, and smuggled back into the United States….
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It is an important problem, and there are related issues of diversion, but the data seem to indicate that children diagnosed with ADHD and prescribed stimulant medication are not more likely to become substance abusers, and, indeed, might be *less* likely:
http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12164/full
“ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57–0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse.
We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients.”
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A “long-term protective effect on substance abuse” by users of psychiatric stimulant drugs. Thank you for my belly laugh of the day! 😀
Liz Sydney
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You neglect to mention that such long-term studies have shown little to no effect on key outcomes like high school graduation/college enrollment rates, academic test scores, delinquency rates, teen pregnancy rates, self-esteem, social skills, or any major outcome that people claim “untreated ADHD” purportedly damaged. If you’re going to quote the long-term literature, your credibility would be enhanced if you told the whole story. Not only does long-term stimulant use not appear to have much impact on substance abuse one way or the other (though you should read Nadine Lambert re: possible connection with stimulants, especially smoking), but it doesn’t appear to have much impact on ANY important outcome measure. The honest conclusion should be that long-term stimulant use makes little to no difference in the aggregate, and should not be supported by doctors. Stimulant use, at best, should be considered a short-term intervention to make kids more manageable while other psycho-social interventions are attempted.
—- Steve
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And just for clarity’s sake, I don’t really support stimulant use at all, as I’ve raised two “ADHD”-type boys using creative discipline and alternative schooling, and they are thriving without any “medical” intervention whatsoever. And they were not “mild cases,” either. My person opinion is that the major cause of “ADHD” is our idiotic insistence on making kids sit still and follow teachers’ directions when they’re not developmentally ready to do so, and don’t benefit from being forced to in any case.
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I was simply replying to the claim that ADHD medication prescribed to children increases the likelihood of substance abuse. That claim seems not to be supported by the evidence. I don’t know why my “credibility” would be enhanced if I cited literature about some issue that we aren’t discussing.
There are scant few studies on the long term effects of stimulant therapy. It is extraordinarily difficult and expensive to do the kind of longitudinal studies that are needed.
I am skeptical about prescribing psychiatric medication to children. But I know quite a few adult patients who have been successfully maintained on stimulant medication for decades. And it has nothing to do with making them more “manageable.” These people are help-seeking and their symptoms are very well controlled by the medication, for years.
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“successfully maintained”
Which, in the end, is what we all aspire to.
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There have actually been plenty of long-term studies, starting back in the 60s. The MTA is the most referred to, but most only refer to the firts 14 months, when the medicated group did slightly better on reading scores. By three years, these advantages had evaporated and those maintained on stimulants actually did slightly worse. Same is true with the Raine study in Australia – no advantage for long-term stimulant use, with worse academic outcomes. Montreal study – no improvements in academic outcomes, worse psychosocial outcomes for girls on stimulants. Finland vs. USA comparison study – Finnish kids much less likely to be on stimulants, no difference in academic outcomes at all. Plenty of other studies have been reviewed, including Barclay’s 1978 review, Swanson’s 1993 “review of reviews,” and the Oregon State University’s Medication Effectiveness Project, which looked at every piece of research ever published on the subject that they could unearth, over 2000 articles. None showed any improvements in long-term outcomes for long-term stimulant users, whether academic, psychological, or social, except for kids taking stimulants being somewhat less likely to get into major accidents as teens (OSU study). True, those not taking stimulants still had significant struggles, but it is clear that assuming the risk of long-term stimulant use did little to nothing in the long term to help with those struggles. Scientifically speaking, long-term use of stimulants to “treat ADHD” is a complete failure and should be abandoned.
Of course, individuals may have different experiences, and I don’t want to invalidate that. But it is absolutely wrong for doctors or teachers or psychologists to say that “untreated ADHD leads to X” when the proposed treatment doesn’t alter those outcomes at all, or maybe even makes them slightly worse in some cases.
Don’t mean to be difficult – this is just an area I’ve studied intensively and I know that what people are told generally is not supported by the literature. If folks said, “Stimulants may help you pay attention in the short term, it is not likely by itself to make any differences in your long-term performance, and we should talk about other strategies to get you (or your child) to where you want to be.”
— Steve
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Ritalin use is not substance abuse? The DEA accounts it a cocaine class chemical. When Ritalin users grow up, too, do they stop using/abusing, or do they “have adult ADHD” instead, sanctioning such use/abuse? The people looking at possible adverse consequences aren’t, as a rule, prescription drug pushers. Does such use lead to the use of other and stronger, more potentially damaging, substances? That’s another question entirely, isn’t it? I would think, all in all, you’re more likely to get a healthier child without Ritalin than with, and from what I’ve read, outcomes tend to agree with me.
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Actually thats a false assumption, because those that are prescribed ADHD medications are in fact substance users there is no difference.
I ran diversion groups for almost 10 years in LA County DAPO certified, lots of people on diversion get scripts to avoid testing dirty…So those who gather stats are actively interviewing biker gangs, who deal meth?
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I’ve worked with substance abusers and I’ve worked with patients who have been taking adhd medication for decades under medical supervision. There is no comparison at all. First of all, a meth abuser can plausibly consumer up to a gram of methamphetamine in a single day. When we use an equivalent drug, desoxyn (d-methamphetamine), they come in 5 mg pills. So it would be like a patient taking more than six months of medication in a single day. As they say, sola dosis facit venenum.
Secondly, look at behavior and functioning. I’ve never seen a stimulant abuser (that is, someone who consumes street stimulants, almost always administered non-orally, using doses orders of magnitude larger than therapeutic doses, and obviously not under medical supervision) who was high functioning and did not suffer terribly from their addiction. The patients that I know who have been taking prescribed stimulants for decades are productive, have normal sleep schedules, do not commit crimes, do not shirk basic responsibilities, and, in short, are stable. To say ‘oh well they are taking the same or similar chemical’ is either to grossly misunderstand how the body responds to different dosing regimes of stimulant medication, or to simply not care about the truth. It would be like comparing a chronic pain patient to a heroin addict. (Chronic pain, btw, often does not have an identifiable physiological cause — I suppose you people would say it isn’t real or worthy of treatment? Cruel.)
As for the ‘but but ritalin is in the same class of drugs as cocaine’ — yes, drugs that have medical uses but are prone to abuse. I suppose you think that a patient who has been administered cocaine as an anesthetic for eye surgery is the same as someone who smokes crack?
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I’ll leave it to Ritalin experts (which includes users and ex-users) to comment on the specific dosing issues you mention. But the administration of any drug as “medicine” for a “disease” which is basically a figure of speech is obviously irrational. If people want to use speed because they like the way it feels, that’s up to them — but it shouldn’t be rationalized as “treatment.”
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I don’t know why you are so hung up on categories. Categories don’t exist. They aren’t real. They are *useful* (or not). That’s it. Do you administer caffeine to yourself when you get tired? Does it matter in the slightest bit whether you want to call your tiredness an illness? Suppose you do, for some strange reason. Does the caffeine no longer help? There is no such thing as a disease except what we want to call a disease. Influenza, or cancer, or chronic pain (you’ve ignored my arguments about letting people suffer chronic pain since often there is no identifiable physiological explanation — I can only assume you would choose the cruel course of action to deny these patients medication that relieves their pain), or Alzheimer’s (or as perhaps you would call it, the medicalization of severe memory loss or some such nonsense) are only diseases because it is useful to call them diseases. That’s it. Forget categories and start thinking about helping people who ask for help. To dismiss insurance issues as ‘vagaries’ is the height of privilege — those ‘vagaries’ make a serious material difference in whether immense personal suffering can be relieved. They aren’t small issues — they are basically the only reason we have a DSM in the first place.
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Your argument is that because certain illnesses (again, you continue to fail to respond to my point about chronic pain etc.) don’t fit your definition of illness, that it is illegitimate for people to ingest certain chemicals that make them feel better. That’s the only reason why the category matters — it matters because of what you can do (or can’t do) institutionally as a result. There is no metaphysical ‘disease’ or ‘illness’ floating around with the forms. All there are are people suffering and you telling them that certain avenues of help should not be available to them.
Let me let you in on a secret. Psychiatrists don’t care in the slightest bit about diagnoses. Generally, there is no good reason to even introduce the label to the patient. They serve the purpose of insurance reimbursement for psychotherapy and medication. A good psychiatrist is not going to “disempower” a person with an explanation or label that isn’t going to help them. On the other hand, some people find immense relief in discovering that they aren’t crazy, they just suffer from x or y. It is actually empowering to those people. They go from being distressed suffering people to becoming mental health consumers.
Finally, I find your premise somewhat silly. When you find out that you have influenza, do you feel disempowered? It is certainly not normal to have influenza. Why would learning that you have high blood pressure (not a disease, incidentally, but a risk syndrome — are you up in arms about medication to “treat” that non-disease?), epilepsy, or parkinson’s, or panic disorder be disempowering? And why would you be seeking help from a professional if you would find that help disempowering? Take people seriously and give them credit. They are stronger than you imagine. They just need people with compassion.
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Hi DrStrait
If there is no specific theory og logic behind the DSM, that helps or guides treatment, then if reimbursement could be arranged some other way you would gladly throw DSM out the window and never think about it again?
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To dismiss insurance issues as ‘vagaries’ is the height of privilege
Enough with the ad hominems, especially when I have to borrow $ to get through the weekend.
Insurance Co. accounting concerns have no relevance to science or medicine. That should be obvious.
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@oldhead — Perhaps you should familiarize yourself with how the institutions of medicine and science actually operate in the modern world. You might be surprised how relevant insurance accounting concerns are. Or pharmaceutical marketing imperatives. Should it be so? Well, no, but no one should ever get sick or suffer. Alas, that isn’t the world we find ourselves in.
@jonathan, In the clinic, sure, but *something* would have to replace it that would provide a common language necessary to do research and to train residents (and clinical psychologists, social workers, nps, etc.). But the DSM is not terribly useful to anyone, and the APA doesn’t really understand what is at stake in various nosological controversies. For example, take something like narcissistic personality disorder. Does it ‘exist’? Well, sure, that constellation of symptoms and signs certainly show up in certain people. But those people are never help-seeking, at least not with respect to their narcissism. So why does psychiatry need the concept of NPD? Criminologists, sure. Just because some set of phenomena exist, are disabling, and are atypical doesn’t mean it is useful to have them appear next to a label in a book like the DSM.
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“For example, take something like narcissistic personality disorder.”
What could be a better example of psychiatry as a social control mechanism?
Because courtrooms everywhere are busy demonizing criminals, and now we have the psychiatric labels with which to help them do so, that doesn’t mean that this is what we should be doing, nor that this or that demonizing label (read insult) has any innate validity (i.e. as in the case of syphilis or pneumonia).
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BTW I moved my comments to a new thread further down that people can more easily respond in.
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I reiterate, why is it important to defend labels that you yourself admit are arbitrary and socially determined, driven mostly by insurance reimbursement and irrelevant to treatment decisions?
It sounds like you see the real point of these labels as justification for getting paid for treatment. That’s the only thing they are useful for, so we agree on that point.
As for disempowerment, you are really not trying very hard if you can’t understand this. Your “good psychiatrist” may not use the labels to define a person’s condition, but if that’s the case, most are not good psychiatrists, because it appears very, very common in the folks I talk with. Best example is from multiple foster youth I’ve spoken with, most of whom have been through hell and back and have understandably difficult emotions and behavior to deal with. These kids are almost always told that the reason they are depressed or angry or anxious is because their brain isn’t working properly, and that medication will help “balance out” their brain chemistry. Psychiatrists as a rule have almost nothing to say or ask them about why they are acting the way they are or what their history is. They medicate based on symptoms and explain away any causal factors. The kids find this confusing and/or downright insulting. And I’m talking multiple examples from a fairly specific sample of people who do NOT respond well to that kind of treatment. So disempowerment is VERY real and damaging both to the kids’ desire to continue treatment of any kind and of their chances of success, since the actual reason for their “condition” is not examined or validated or directly addressed.
Or for another example – my son went off the rails temporarily and was living a dangerous life for a couple of months, including taking drugs and ultimately being assaulted. He went to see a doctor and in a depression screening endorsed suicidality. The doctor went on a lecture about how depression is a “disease just like diabetes” and that “treatments are available” but never ONCE asked him why he might have considered killing himself! And he would certainly have told her what was going on, and it might just have been helpful, but the “MDD” label allowed the doctor to feel like she’d “diagnosed” him without bothering to even find out what was going on.
You’ll try to tell me this is rare. In my experience, it is not. It is, in fact, extremely common, and the labeling process makes that possible for doctors to get away with.
Of course, you are again being intentionally obtuse if you don’t recognize the difference between telling someone they have influenza, which is a verifiable fact that leads to a verifiable treatment that is almost uniformly effective, with diagnosing “Major Depressive Disorder,” which is nonspecific, non-verifiable, and does NOT lead to a uniformly effective treatment plan, since the wide range of people diagnosed with MDD are incredibly heterogeneous, and what works great for one person could actually ruin someone else’s life.
I am afraid you are so committed to your position that you are unable to look at any other perspective. I am not going to bother trying to convince you further that other rational viewpoints are viable and have value. You can remain rigid if you want, but I am not going to accept that you are somehow more knowledgeable about this area than I am, because it just ain’t so.
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Unfortunately, that means you have very little experience of street drug users, some of whom are very high functioning criminals, who learn how to make meth with no back ground in chemistry, elude law enforcement for decades, and steal hundreds pf thousands of dollars
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Unfortunately, that means you have very little experience of street drug users, some of whom are very high functioning criminals, who learn how to make meth with no back ground in chemistry, elude law enforcement for decades, and steal hundreds pf thousands of dollars per year to support their use. Some of whom are medical professionals, doctors and nurses. Of course you won’t admit it, because you don’t really know what your talking about. I’ve worked with medical professionals who have been sent to diversion to keep from losing their license, people like you are one of their biggest assets.
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And we display Playboy on store counters as if nudity and pornography are perfectly acceptable.
Drug users ain’t interested in taking the tiny doses that r prescribed for us. They wouldn’t know they took anything. Excess is often a problem even with eating ice cream.
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Frank and Alex, ADHD is bogus, and in the view of Sami Timimi, so is Autism Spectrum Disorder. So these things being bogus, they are not being caused by parents. They don’t even exit.
But there is what Alex called this “othering”. In other times I have compared it to being made into a leper, like in the Gospels. And then there is what I call Maternal Hatred Syndrome.
Read this, Jayne Lytel, a frightening woman who clearly finds her younger son Leo to be an embarrassment.
https://www.amazon.com/Act-Early-Against-Autism-Fighting/dp/B001OMHUQ0
So as it stands today, a parent can take their child to a doctor and get them diagnosed and drugged. And if for some reason one doctor won’t do it, another will. And there are doctors who advertise this. And then there are some who will make the child more subservient without even needing drugs. What these all have in common is that they legitimate the parents.
https://www.youtube.com/watch?v=vjR1PH41Vkg
So they used to call this Munchausen’s Syndrome By Proxy. But now they are just calling it Medical Child Abuse. Usually they mean situations where the parents are fabricating the child’s illness. But when you have doctors who market their services for treating such bogus illnesses, it gets more complicated.
What will stop this though is outside oversight, someone who is looking out for the rights of the child. Then the doctors will have to report, and the parents won’t be showing up at their door anymore.
Existing law makes it a felony to not report a suspected case of child abuse, its just that the laws have not really been enforced as written. Sure I wish this were not necessary, but it is, as finding ways to establish that the child has a defect, and using doctors to do this, is one of the hallmarks of the middle-class family.
We have to have outside oversight to protect children, otherwise it is all controlled by their parents, and by the doctors who market to them.
And if people here object to Psych Meds, or to Forced Treatments, why aren’t they trying to get these outlawed? State initiatives would in my opinion be the best way.
Nomadic
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@Nomadic, and everybody else: on 09/18/2018, I clicked the links above. The youtube video has been taken down by the BBC and a copyright claim. The Jane Lytal book & story do seem somewhat “frightening”!
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I would give my right arm to have been treated for ADFD when I was a kid. You don’t know what it’s like to burn in hell.
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Let’s try moving this to a new thread.
From “Dr. Srait”:
I think instead of throwing up artificial barriers to help seeking patients getting help, we should be trying to help people who ask for it.
Treating problems in living by labeling thoughts and feelings as symptoms of a disease is what I would call throwing up an artificial barrier to getting help. It’s called mystification.
I think it is silly to assert that mental illness has no biological correlate.
Any thought, feeling or emotion has a biological correlate. Writing the letter “C” and the letter “L” no doubt have their own biological correlates, as do nose-picking and doing calculus.
However you’re putting the cart before the horse, as you have yet to demonstrate that such a concept as “mental illness” is even legitimate.
Incidentally, the vagaries of the insurance industry have no relevance to a scientific/philosophical debate. As for what “helps” people, having a rational understanding of their problem is a prerequisite.
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@DrStrait
Thx for your answer on throwing away the DSM:
“@jonathan, In the clinic, sure, but *something* would have to replace it that would provide a common language necessary to do research and to train residents (and clinical psychologists, social workers, nps, etc.). But the DSM is not terribly useful to anyone, and the APA doesn’t really understand what is at stake in various nosological controversies.”
That is something of a bombshell. We use the ICD-10 in Denmark and it would be unthinkable to throw the diagnostic system away at least among leading figures in psychiatry. In the fight for funding and leverage in the health care system, mental health diagnoses are routinely referred to as discrete, identifiable, specific illnesses which requires specific medication. Research based on ICD (or DSM) categories are used to argue for for example forced treatment. The argument goes something like this: “This person has an illness, he is suffering terribly and it would be unethical not to treat him/her with the medication we know from research works on this brain disease.” The same people, however, at other times acknowledge that, “no, schizophrenia is probably not one disease, but several different conditions.” But they still do category-based research and use simplistic diagnostic arguments.
If you do not find DSM-categories helpful, how do you decide how to treat patients? Different medications are usually researched through the administration to persons in a diagnostic category. If you consider this diagnostic system useless for anything than getting paid, how do you at the same time argue that psychiatry rests on a bona fide scientific body of knowledge?
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ADHD is real. Not legitimate. It takes from you everything it can steal. Too bad you don’t believe me.
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“Dr. Strait”:
Perhaps you should familiarize yourself with how the institutions of medicine and science actually operate in the modern world. You might be surprised how relevant insurance accounting concerns are. Or pharmaceutical marketing imperatives.
You’re actually proving everyone’s point, that we are dealing with political, economic and social problems, not medical ones. And why these “institutions” need to be discarded in favor of actual medicine and science.
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The only point of disagreement is that I think the rest of “medical” problems are also political, economic, and social, and I don’t believe there exists anything like “actual medicine and science” that is not structured politically and economically and constructed socially. Ivan Illich’s Medical Nemesis is especially instructive on this point, and I should note that I’ve mentioned nearly a dozen non-psychiatric “medical” disorders in the comments here, and continually pointed out that you all are systematically refusing to respond to those examples.
I will not defend pediatric psychiatry as it is beyond the scope of my practice and personally much of what happens there alarms me. But no properly trained psychiatrist will ignore the patient’s explanations for their feelings or behaviors. I can’t even fathom how one would conduct a clinical interview without asking those questions. Usually this kind of problem comes when non-psychiatrist physicians attempt to treat mental illness, which they often (but not always) do poorly.
You can’t refer to an illness as a “verifiable fact.” That we call something an “illness” in the first place, and consider it relevant to treat, is a social construction that is not grounded on any kind of non-intersubjective basis. Is male pattern baldness a “verifiable fact”? Is obesity a “verifiable fact”? Is hypoactive sexual desire disorder a “verifiable fact”? Is high blood pressure a “verifiable fact”? Is premature ejaculation a “verifiable fact”? Is chronic pain a “verifiable fact”? Each of these have “verifiable” aspects (much like mental illnesses have verifiable aspects — do you have this cluster of clinical signs and symptoms? Are you behaving in x characteristic way? Something like schizophasia is obvious and can be ‘verified’ in any number of ways), and yet the fact that it is considered an illness in the first place is a *value* judgment. (re schizophasia, we happen to consider it a problem if someone suddenly loses the ability to form sentences. And that problem is in the brain.)
I am open to the fact that sometimes psychiatric treatment is poor, and that many times a diagnosis doesn’t serve a direct clinical purpose. I’ve said as much. You seem not so open to the fact that sometimes, it can be a great relief and reassurance to patients. When you talk about being rigidly committed to my position, we have a word for that: projection.
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A verifiable illness is a verifiable fact. Not so a non-verifiable illness. Most so-called mental illness falls into the non-verifiable category. If you had to file it in somewhere, I’d file it under F for”fiction”. You are being very slippery in your efforts to call what is not, strictly speaking, disease disease. A verifiable figment of the imagination is still a figment of the imagination, that is, not verifiable as fact. Another thing a figment of the imagination isn’t is a disease, not unless, that is, the figment one is imagining happens to be a disease. What is the difference between a psychological injury and a physical injury? Well, one is an actual injury and the other is, how did you put it? Oh, yeah, a construct. This non-verifiable disease business is an awfully tangled web wouldn’t you say? I think so anyway.
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Answer my examples and then we can talk further. I think I have extensively shown that non-psychiatric illnesses are ‘non-verifiable’ in the same way, chiefly regarding their status as illnesses (and not some other kind of non-medical problem).
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“Male pattern baldness”? As if everybody was born to have a full head of hair, and as if a topee or a hair-weave were a “cure”. This is like arguing that one eye color is diseased, and another isn’t. Obesity? Over-eating will kill you, surely, but that doesn’t make it disease. Oh, excuse me. I believe some committee or other may voted it “disease”. Under-eating will kill you, too. “Hypoactive sexual desire”? A lack of imagination is a lack of imagination, just like, when it comes to disease invention, an overabundance of imagination is an overabundance of imagination. Neither bears any resemblance to the flu, tuberculosis, nor even leprosy. “High blood pressure”? This is more a lifestyle thing, isn’t it, and not disease in itself, but something that could lead to disease, if heart-disease is disease. “Premature ejaculation”? Some couples don’t communicate very well, do they? Nonetheless, it is something they can work on. Disease, it isn’t. Chronic pain could have a physical base, surely, but drugs are not necessarily the best nor only answer. There are more than one type of illness, ill at ease, for instance, is not the same as nauseous, and while nauseous may be a symptom, I dare say ill at ease isn’t a symptom. Indigestion is one thing, indignation another. Merely being ill at ease, uncomfortable, is not physical disease, although technically, much like other diseases that are not diseases, we can stretch a point with dis-ease. I think there are some fools who are going to be fools regardless of the amount of effort you spend trying to turn them into sages. What am I saying? The pursuit of folly has to be at least as prevalent as the pursuit of wisdom. Call a fool diseased, and you don’t get a fool. No, you get two fools.
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It may be a relief, but it is misleading, and intentionally so, as you yourself indicate. Sure, it could be a relief for parents to feel like it’s “not their fault,” or for teachers to be told that the kids’ lack of progress in their class is not a result of poor teaching or lack of a stimulating environment or a child’s inappropriate or dangerous home environment, but if it is NOT TRUE, then the parent/teacher/psychologist is being let off the hook, as my son’s doctor was. And if you’re saying that only a “poor psychiatrist” would act upon a person without asking psychosocial screening questions, I would have to say that there are a lot more poor psychiatrists in practice than you seem to recognize.
As for your other examples, you’re correct that “high cholesterol” is not a verifiable illness, either, and that many medical diagnoses are subjective and lack an understanding of cause. However, one IS able to establish that a person DOES have a specific cholesterol level and that all persons can be measured and compared and a standard set above which it is considered “high.” We all know that politics enters into both where that line is set and what recommended treatments are allowable, but that does not excuse psychiatry from engaging in the same unhelpful political nonsense, which again you seem to agree is the case with the DSM. But at least we can measure blood pressure and weight and cholesterol levels. What the heck are we measuring in psychiatry? How can we create “nose-picking disorder” without any measurement of what is supposedly wrong?
And of course, your assertion that there is no such thing as science is completely specious. Science does exist, even if many people practice it in a corrupt or distorted manner. A call for psychiatry to actually respect the findings of their own scientific literature, including, for instance, the fact that “ADHD” diagnosed kids are no better off in the long term whether medicated or not, is certainly not unreasonable, nor is calling them out when they repeatedly ignore known scientific findings in favor of their pet biological theories, which is what the DSM really encourages. We’d be far better off to drop the whole thing and start over if we really care about helping people instead of getting more insurance reimbursement for less time spent with the client.
—- Steve
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(Wherever this ends up in the thread):
many times a diagnosis doesn’t serve a direct clinical purpose. I’ve said as much. You seem not so open to the fact that sometimes, it can be a great relief and reassurance to patients.
So you seem to consistently support lying to make people “feel better,” which is about as helpful in the long run as drugging away someone’s anxiety and other inconvenient feelings.
You routinely conflate metaphor and that which is literal; perhaps you should brush up on your language skills.
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I’m not sure who oldhead is quoting here, but I agree with oldhead.
”
many times a diagnosis doesn’t serve a direct clinical purpose. I’ve said as much. You seem not so open to the fact that sometimes, it can be a great relief and reassurance to patients.
”
Psychotherapy, Psych Meds, and Street Drugs are all sold on the same lie. You are being told that you don’t have to go thru the hero’s journey, you don’t have to vanquish foes, and that the objective of life is to feel better.
It is a dangerous and very destructive delusion.
http://freedomtoexpress.freeforums.org/hero-s-journey-t396.html
Nomadic
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@DrStrait
Old, I now, but somebody posted in the thread. You are right that some problems in medicine are ‘vague’ too. However, you cannot argue that because medical issues can be vague, and mental health issues are vague, then mental health issues are medical problems. It’s a faulty syllogism. What you need to show is that there are processes going on in your medical examples that are the same as the processes going on in particular mental health issues. What you are in some sense adamant about is that discomfort in a broad sense is a medical issue, regardless of the particular processes going on. In medicine, progress is often measured in survival. Cancer treatment has become immensely better in the last decades. However, the survival of psychiatric patients haven’t changed a bit. People with a mental health diagnosis live 15-20 years shorter. One interpretation of this is that the scientific models used in cancer research leads to clinical progress, while the models dominating psychiatric research does not.
You can argue, as you do, that all medical issues involve politics and power. However, if I were diagnosed with cancer I would prefer the tumor be localized and treated, perhaps with chemotherapy, perhaps surgically removed or both. When the disease manifests I would not expect behavioral interventions to work. There are specific cells which multiply, regardless of how I think about them or how my surroundings treat me. In contrast, when a psychiatric diagnosis is made I would expect a much wider palette of treatment options: environmental, psychopharmacological, psychotherapeutic, support through friendships etc. While some of these would be nice to have during cancer treatment (e.g. friendships) they do not treat the localized tumor but rather helps endure the treatment and uncertainty.
One way to understand this is to regard mental health issues as ‘global’ in the sense that they affect the way a person makes sense of and navigates his or her world. Cancer, on the other hand, is a local occurrence in a group of cells that can be delineated precisely. It is local, the opposite of global. Getting a diagnosis of cancer may have global effects in that it changes one’s view of life, the future etc. It is, however, not in itself a global phenomena. You may then suggest that mental disorders also have a local origin in a similar manner. However, you need to detail this not just postulate it, and you need to point to evidence showing that interventions based on this model improves survival or other relevant outcome both short- and longterm. I don’t think this is available.
Perhaps most mental health issues are different from cancer in that it manifests on the global level without any localizable, local first-cause. I think you, DrStrait, in your way of arguing lose the ability to make this distinction between local and global.
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Not only has “mental health” treatment not increased longevity, it has dramatically reduced it.
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“The effectiveness of stimulants in treating ADHD has been well documented in randomized clinical trials.” The NEJM
You are right doctor. The most prestigious medical journal in the world agrees with you..
You have the most articulate, informed, researched point of view and decades of experience. Obviously, you are a very bright man with a top notch education. I am certain you have a large number of grateful and delighted, loyal patients. The NEJM confirms your position and that of many others. The folks I know who take their meds as prescribed (which includes remaining on them without discontinuing them for years on their own) can barely contain their joy and gratitude for the staggering improvements in their lives.
If there wasn’t a flaw of some kind in the biochemistry of the afflicted, the medicine wouldn’t work. It targets neurotransmitters. There is no reason to believe that our brains run perfectly. Every physical component of our bodies is subject to failure and decay.
Have you heard the very latest news? Some brilliant, brilliant Israelis just published the results of their exhaustive research and concluded, “CDH2 mutation affecting N-cadherin function causes attention-deficit hyperactivity disorder in humans and mice” Hallowell basically said, “Of course. It is just further proof of what we already know.”
These people did all the the work: D. Halperin, A. Stavsky, R. Kadir, M. Drabkin, O. Wormser, Y. Yogev, V. Dolgin, R. Proskorovski-Ohayon, Y. Perez, H. Nudelman, O. Stoler, B. Rotblat, T. Lifschytz, A. Lotan, G. Meiri, D. Gitler & O. S. Birk
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Oh, it’s medical. Focus on everything except that, and it will be everything else.
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If a child comes into the doctor’s office and the child is black and blue, then the doctor either gets some clear answers, or he has to report, or he gets charged with a felony.
The law is the same for suspicion of extreme emotional abuse. We just need to enforce it.
1. Strange behavior, is cause to suspect child abuse.
2. Getting hit with strange labels is cause to suspect child abuse.
Either they report or we need to get them prosecuted for felonies. This is the only way to stop these doctors from playing God, from aiding in child abuse, and from profiting from it.
There could still be various types of child therapies and treatments, its just that they would be overseen by the court. And that is the only way children can be protected from further harm.
Nomadic
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ADHD ain’t strange. It is hell.
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The main reason for middle-class child abuse is because the parents are living in Bad Faith, they are not living up to their own values. They have children deliberately in order to use them.
So Alex, the “abuse” which underlies this othering of children, maybe not directly intentional, but the parents are still culpable.
TAKE THEIR MONEY AND ASSETS FROM THEM!
Nomadic
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This is an old thread. I’m aware But the science and tech changes very rapidly. I am constantly researching, learning and unlearning information on this subject, a subject that has effected my ENTIRE life, profoundly. Unfortunately, I haven’t the luxury to deny “ADHD” or whatever you choose to call it, or to entertain the idea that some action, be it meditating, counseling or what have you, will alleviate my affliction. It’s laughable and slightly insulting. I’m sure some can and do. It just didn’t work for me. And before you judge or assume, I had some results with meditation but they were mediocre and fleeting even though I stuck with it long after the positive results faded. And therapy was awful. I was told, in a polite and compassionate way, to just think about my actions and control my impulses. Might as well tell a paraplegic to stand up and dance….. My mother, and then myself when I fledged, went down EVERY avenue available at the time. Every one. Prescription drugs hadn’t even been utilized yet. I was an outrageously active child. Not rambunctious or energetic or any of the common descriptive words used for children. I was absolutely wide open, constantly. I couldn’t function. My mother loved me very much and did her best but there was no denying it and no one did; there was something “different“ about me. Even given the vast array of complexities in behavior in children. No, there was definitely something different. I was described as very intelligent, curious, well mannered but excessively, exceedingly distracted and impulsive and energetic. I was removed from kindergarten and spent 1st grade in the hall and had extreme difficulties in all aspects of my life, even at the age of 4!! To the doctors we went. We’d already been locally but they couldn’t help. They just didn’t know and had never seen a child that dysfunctional with no apparent physiology cause. But my mother, amazing woman that she is, never gave up. Finally, after seeing multiple doctors and pediatricians, this was in 1985, she got in touch with a neuroscientist who specialized in PFC function and neurotransmitter pathways(A subject still in its infancy) . She came with a team and so did others, once the news made it though the networks . For over a year, they studied me. MRI, CAT scans, they covered me in electrodes and even put some under my skin. They injected me with dyes and I don’t know what else. Took blood, urine, fecal sample. They swabbed ever nook of my body and looked into my brain as much as technology would allow. I did countless cognitive, emotional and spatial tests. Countless tests for 14 months or so. These were experts from many areas of the country and outside of it, from several disciplines . I was an anomaly. None of them had seen such an extreme case of dysfunction without definable physiological etiology, we were told. By this time we hadn’t been introduced to ADHD. No, not one doctor suggested it. They were looking elsewhere as my symptoms were extremely severe. They were looking for developmental issues in my brain. Lesions, deformations or anything that might explain my symptoms. They noticed lower Prefrontal-cortex activity compared to control examples of average children. This was the first clue. They continued their research(as I grew more and more comfortable) and that’s when the psychiatrist was brought in. I had a good go with that fool. Even as a 6 year old (Had a birthday in the hospital covered in electrodes doing cognitive puzzles and riddles) I could tell the questions were leading and he was all over the place. My
Memories are fuzzy but the general happening is burned into my brain. He asked my mother very loaded questions about abuse and such and then asked me similar questions. Was I hit often? Touched inappropriately? Was there substance abuse etc…. No to all. Nope, even though I could tell he wanted me to say there was…. And guess what he said? “I don’t know”.. Maybe it is a personality disorder. Borderline or some such” Of course I’m paraphrasing. But every doctor disagreed, having spent time with me. Nope, Didn’t fit the criteria and other than the differences in my PFC activity(a stark difference, enough so that they went looking for damage or deformity) and the evidence for suppressed NE and DA release or uptake(the tech and science was even more archaic and FMRI technologies were nonexistent , I honestly do not know the techniques they used ) and there was nothing apparently wrong with my brain structure. considering my symptoms, the low activity of my PFC, and what they knew of neurobiology(they did know their stuff) they KNEW the issue was centered on my PFC. I must reiterate, up to this point, ADHD hadn’t even been mentioned. The search for my “diagnosis” was long and very involved. They focused on my symptoms, the structures of the brain involved with that neurobiology, and decided that I had a underdeveloped PFC and possibly issues with dopaminergic pathways. It went like this for some time until a doctor specializing in child behavior came on the scene. Then it came. “Perhaps your child is ADHD.” This, only after the investigation and rejection of a multitude of solutions, all the while doing counseling and therapy(both therapist agreed that this was a definite physiological ailment, with physical etiology, if not well understood and both gave a poor prognosis for counseling therapy. I wasn’t traumatized or the like. The connection to the PFC and the symptoms was not an opening into an ADHD diagnosis. It was the actual state of reality. My mother is a very smart lady and immediately hit the books. There wasn’t many a time in these two years, where I didn’t see my mother reading books, pamphlets, ANY literature she could about Child development issues and ADHD. She learned and talked and met and counseled. Only after exhaustive research did they, the doctors and my mother, decide on the ADHD diagnosis. And they prescribed me Ritalin after trying non stimulant drugs. None worked and a few made my genitalia hurt. The very first day on the Ritalin was one of the best days of my life. The first thing I said to my
Mother when I came home from school was “no one yelled at me today”. This was life changing. I could function and not constantly get in trouble. I hated the way the drug made me feel, which faded, but my gods, I was able to focus and function and it was AMAZING!! I didn’t know. I had no clue how GOOD it was to be able to CONTROL myself. If not for this drug and we tried everything that was then recommended for ADHD. Only the Ritalin worked. And this led me to my first real awareness of myself and my condition. My biggest mistake was taking myself off of it. I really do not care what any of you have to say. What I’ve been through and continue to go through is very, very real. It isn’t lack of self discipline or destructive environment. My life and my struggle is real. Now I can’t get my medication. The sentiment expressed here doesn’t just break my heart, It fills me with sadness and regret that people would So belittle another’s suffering and experience. Yes, the practice is corrupt and misdiagnosis is the understatement of the year but to deny a very real and debilitating ailment with this rhetoric and obtuse confusing of the establishment and the afflicted, is deplorable. Sure, my suffering is false and my struggle exaggerated. My course of action inadequate and shortsighted. My triumphs delusions and my experience defunct. Yeah…. You TRULY have no idea. I have this “disease”. No matter your ideas, your conclusions, no matter your stance and it’s reasons, it’s real and no amount of semantics or denial will change that. All it does it make it ridiculously hard to get the help we need and belittle and disregard our suffering. A well educated doctor I once knew said he felt confidant that at least 80% of children diagnosed are misdiagnosed. Now comes the “it can’t be diagnosed because it doesn’t exist” crew, to set me straight. This is so damaging. I hope your proud. You go after corrupt medical practice and Big Pharma but you really just screw us……..
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So ADHD exists. Millions of children “have this”. All drugged without consent. What happened is this. Some children behave differently because by god that is what evolution is.
Then we have a social order, or design made where everyone is supposed to fit into this narrow channel and don’t tell me that our schools were designed with minds/brains in mind. They were NOT designed with diversity in mind.
Mankind is the only species that is aware and able to work with diversity, yet it seems too much work.
So they watch the peculiar behaviour, it just does not fit into this construct and they give that person a name. Next they look at very rudimentary colors of the brain on a screen and notice that an “adhd” brain has different splotches, different whatever happens to be looked at.
And EVEN IF that were ALL true and factual, they still have to pronounce that child’s brain as defective.
And THEN, they still have to create drugs, plus without consent massage this developing brain. If that is not crude, I’m not sure what is.
After a developing brain has been subjected to drugs, the development looks nothing like it would have. Every single child remains an experiment, I don’t care if it makes life easier in school.
This drugging of kids is a very serious issue. It is absolutely tied into an idea that everyone should be the same, and how does that even make sense.
If you give a child a choice of a drug or being yelled at, most likely the child would choose the drug. That is not a reasonable choice.
If there are 5 bald men in a sea of millions, is it defective not to have hair? If millions of children are born without athletic ability WHICH THEY ARE, should we drug them? Why not? Because we did not create a world where athletic ability is the way to get forward.
Yet we need men of strength, we need them to haul shit. So what do we do with all the men that are not strong enough to endure physically?
I am in my 60’s now and I can assure you that I have always been different and felt different. But I was also reminded every single day.
I would LOVE to talk to a “neuroscientist”. Get him to explain to me which parts of my brain were injured and how that played into development and which drugs would have dealt with the defects.
This of course would only be possible if he knew what he was talking about and if he was willing to rewrite the script by collaborating with the client and be willing to entertain that perhaps they really are going about brain research in a completely wrong manner.
But it serves a purpose. To pretend we should be the same and not work really hard at trying to create slots for all the defective ones.
All those physically non athletics, all the ugly ones and all the mental defects.
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ADHD is an illness according to Birk. It is a disorder if nothing else, it is destructive, and it lasts for years, and most often responds to the introduction of powerful chemicals.
No matter how you classify ADHD, how would you help a third grader who no longer tries in school? He cannot follow along. He’s had excellent training and is of normal intelligence. His folks have sat next to him in class. First and second grade were wonderful experiences. In third grade the work became considerably more demanding. Nothing has worked. He is not disruptive. He is polite, sits still and isn’t learning. He is way behind. If he doesn’t turn this around immediately, he will never catch up.
Please be specific if you don’t mind, or at least give guidelines that you’ve found helpful with other children.
Thanks
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So destructive and through lies. Disgusting and perverse, child abusing practice by psychiatry.
First create a design. Create poor families, video games, addictions…….create a disorder manual. Corral people into mainstream. single out those who walk the other way. Call them defected brains. Educate the public, or not.
train teachers.
Train Parents.
Drug the child.
Perfect, the shrink ACTUALLY made money off child labor, no one blinks an eye.
“He has ADHD”
“Oh okay”
Everything explained. A defective brain that does not work like it should.
Because after all, there is a should and if you do not fit, it needs drugs. Those innocent drugs that just make him a “better” kid.
Who cares what kind of adult he becomes, we have drugs or jail for that.
“i’m safe, I’m a shrink”
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Ned Hallowell, who came from money, has ADHD (and dyslexia.)
The person you responded to was thrilled to be able to pay attention. He was shocked by the ability to do that. Shocked and thrilled. Paying attention doesn’t equal turning into what everyone else is anymore than giving glasses to everyone who needs them turns them into the same person.
We now know that ADHD is the result of the roles of certain CDH2 pathways. CDH2 mutation affects N-cadherin function and causes attention-deficit hyperactivity disorder in humans and mice. Familial ADHD is caused by a missense mutation in CDH2, which encodes the adhesion protein N-cadherin, known to play a significant role in synaptogenesis; the mutation affects maturation of the protein.
“CDH2 mutation affecting N-cadherin function causes attention-deficit hyperactivity disorder in humans and mice”
It is not the end of the world that some people need medical help to pay attention. It isn’t disempowering, either. It is an opportunity to thrive.
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Could you PLEASE respond to my very valid points regarding the CDH2 mutation NOT being established to exist in all or most or even any kind of percentage of so-called “ADHD” sufferers? Or help us understand why early childhood abuse and neglect is associated with 4-5 x increase in “ADHD” diagnosis if this is all about the CDH2 mutation? I could add more, but I want to keep it simple so we can see if you have any kind of answer to these key questions. So far, you have avoided them and keep repeating the details of this rather limited study.
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“Could you PLEASE respond to my very valid points regarding the CDH2 mutation NOT being established to exist in all or most or even any kind of percentage of so-called “ADHD” sufferers?”
I did respond. I’ll try again. What difference does it make if the cause of ADHD is reflected in people given that label? If everyone of them was misdiagnosed, how would that alter the known cause? What we do know now is that ADHD has at least one known biological cause. Again, if everyone so diagnosed before this discovery does not have this biological flaw, that would have no bearing whatsoever on the reality of ADHD.
There may be numerous other physical causes. We are just beginning to get a glimpse of all the various components that caused the form of ADHD discovered through this research. There are thousands of different cancers. We discovered one, so to speak. We are merely at the threshold of scientific breakthroughs. We have barely scratched the surface. However, if we never find another medical cause, we know without a doubt that ADHD is the result of flaws within the human organism.
My turn, if you don’t mind. What is the worst possible outcome for mankind and for you knowing what Birk’s research shows? Is there a specific reason that you are not rejoicing over this revelation? What is so awful, so terrible, so shattering for you personally? What difference does it make? The most important issue is applying what we learn to help others who struggle and often fail to concentrate when they need to? Shouldn’t we all be grateful for every piece of information that can be used to help others? Isn’t that what we are all striving for?
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I’m not resisting what Birk shows. Saying that this mutation is ONE POSSIBLE CAUSE of the syndrome called “ADHD” is absolutely fine. Saying it IS THE CAUSE of ADHD is not fine. That’s what it sounded like you were saying. The big problem I’m pointing out is taking a single finding and extrapolating it to everyone, going from a subset of “ADHD”-diagnosed people have this particular anomaly to “ADHD” is a disease state that is caused by this genetic mutation. It presents an interesting template for further study. But there are many other interesting templates for examination, including low iron, sleep apnea, nutritional problems, exposure to abuse/neglect, exposure to domestic abuse in the home, inappropriate expectations set on younger children, maturity at admission to school, classroom structure, skills of parents and/or professionals managing these children, and on and on. As I explained to you earlier, I have two of my three boys who fit the “ADHD” criteria to a tee, and both were successful in high school and one in college with no drug intervention whatsoever. Should we not be grateful that at least some “ADHD” kids can be TAUGHT the skills to concentrate when they need to? Would this not be a topic for investigation? Isn’t that information that can be used to help others? Isn’t that what we are all striving for?
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It is NOT a choice of children. This adhd thing you speak of is NOT an abnormality because you deem it as such. I know enough children that are horrified that adults put them on chemicals.
Those great scans of brains, further proof huh? AFTER you choose people that are one way and another group that is another way but you already decided which group was normal before your scans. And please lets not compare the brain with short sighted people.
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This adhd thing you speak of is NOT an abnormality because you deem it as such.
What is it? What do you deem it as?
What do you recommend are the best ways to help a severely ADHD chikd? Any thoughts? Thanks
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How long to you have? I can write a book on the subject.
Just for starters: what do you know about “ADHD” kids? They need STIMULATION. They can’t stand boredom and routine. They often create behavioral issues in order to get the reward of adult engagement, even if it costs them getting in trouble. Which reinforces their negative behavior.
So why not create a situation where they get intense stimulation for DOING WHAT THEY ARE ASKED TO DO?
Example: My youngest didn’t like to lie still as we got ready for bed (reading time). He’d wiggle around, hide under the covers, smuggle in little toys to play with, and on and on. He was 5 1/2 at the time. I decided to create a program – I bet him a quarter that he couldn’t stay quiet for 1 minute without moving. Of course, he assured me he ABSOLUTELY could do that, NO PROBLEM! The first night, it probably took him 3 minutes to get settled down to the point I could even start the clock. But I waited until he was able to keep some semblance of calm for a minute, then I dramatically expressed GREAT frustration and coughed up the quarter begrudgingly. But I told him, “Tomorrow, we’re going to go for a minute and a half, and I KNOW you can’t do THAT!” We continued this process for a couple of weeks, and worked all the way up to 5 minutes. The last night, he took one deep breath, and completely relaxed, was totally still for five full minutes without a twitch. As I coughed up the last quarter, I said, “Well, I guess I was wrong. You CAN control your behavior, you just have to decide you WANT to do it!”
Several months later, he and a friend (who happened to be diagnosed ADHD and on stimulants, but I did not know this) were jumping on our trampoline. His friend was violating the safety rules (he was older, more like 7, quite bright, and knew and remembered what the rules were). I reminded him of the rules, closed the door, and a minute later saw him doing the same thing! I went outside again and asked him why he kept violating the rules? He said, “I ate red dye this morning, and it cancels my medication, so I can’t control myself.” And Kevin immediately said, “Yes, you CAN control your behavior, you just have to decide you want to!” This was a very real, very deep learning experience for him which he was now applying to his friend. And all for only
a few bucks and less than an hour of my time!
Did this mean he was never wiggly or disruptive or oppositional again? Of course not! But it gave a context to have further discussions and to face bigger challenges building from this solid base. Plus it taught ME an important lesson – he WAS capable of facing pretty significant challenges, if he could WIN at the end, and especially if I got “upset” about his “defeating” me. I used this principle again and again throughout his childhood, and even as he grew older and recognized the “game” behind it, he still was tickled pink when I got “upset” with him for “beating” me, even when he knew I WANTED him to win.
That’s just one short example of the kind of learning that can happen with a highly “ADHD” child when the adults, instead of getting angry at him for doing bad things, get “angry” at him for doing what we want!
So rather than deciding to define my kids’ behavior or actually their entire personality as “wrong” or “disordered,” we spent most of our time validating the strengths of their personalities and identifying and helping them overcome their challenges through fun and challenging reinforcement programs. We regarded every moment as a possible teaching moment, and always had a goal and a focus for what we were working on next. I don’t want to suggest this was EASY – it was a lot of work, me made a lot of mistakes, and there was plenty of yelling and tears and accidental reinforcement of bad behavior. But we had a plan and stuck to it, and it worked. Eventually, Kevin himself started to set his OWN goals and pursue them with the passion he always brings to his life. He continues to this day to challenge himself to do better and to discipline himself to make his life the best it can be.
There was never a need to pathologize their behavior, to label them as this or that, or to provide artificial stimulation through physiological means. We used what we knew about our kids and the behavioral patterns that were common, and we focused on building their strengths and using them to attack their difficulties and challenges.
Does any of that sound irrational, punitive, or harmful to our kids? I think the success we achieved together speaks for itself.
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“There is also an abundance of research going back to the 60’s that demonstrates clearly that children who are habitually inattentive, impulsive, and hyperactive even to an extreme degree, can be trained readily to behave in a more productive and less disruptive fashion”
Please cite 3 documents which demonstrate what you claim, please.
What is meant by “more productive”? For herself or for others she is not disrupting? I am interested primarily in the documentation which shows that extreme examples of children manifesting hyperactivity, a lack of concentration and impulsivity are “readily” trained to be more productive. I would like to see how they quantified, specifically, their increased productivity.
Also, a child can be scared into being quiet. That is true and rather obvious. Remove the immediate threat and what happens? I will state with confidence that those children learned just as much when they were not trained. ADHD is a biological/chemical/electrical/organic malfunction of the brain and training will not and cannot improve concentration. A business advertising that claim got into hot water and had to stop.
In addition, would you cite the supporting research which shows that parents prior to the 1960’s knew how to raise their children better than succeeding generations, please.
Why don’t those “ADHD” children snap out of their funk immediately and permanently? Did something damage the structure of their brains? What is holding them back? Why do the majority of ADHDers respond immediately to the medicinal properties of stimulants and begin to concentrate instantly?
Thank you in advance for any cooperation
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Just to be clear, Judith Rappoport, et. al., showed unequivocally (back in about 1978) that non-labeled people respond exactly the same way as “ADHDers” to stimulants. She called the claim of differential response “an artifact of observation” due to the fact that people are LOOKING for a particular response from the “ADHDers” and so notice and value that response, while the same response from “normals” doesn’t get any attention because no one is trying to “fix” them. So the improved concentration you attribute to “ADHDers” responding instantly to stimulants is the same improved concentration that ANY PERSON would gain as a result of stimulants.
“Since the positive effects of stimulants on disruptive behavior were described (Bradley & Bowen, 1941), further pediatric study has been limited almost exclusively to samples of hyperkinetic school-age children. Because these agents normally were viewed as arousing in their effects on the central nervous system, but were calming in their therapeutic effects on these children, stimulant effects on Attention Deficit Disorder (ADD) were interpreted as being ‘paradoxical.’ Investigation of effects in normal children and adolescents and in those with disorders unrelated to Attention-Deficit/Hyperactivity Disorder (ADHD), as well as in young adult samples, however, indicate that stimulants appear to have similar behavioral effects in normal and in hyperactive children. This brief report is an update (as of August 2002) on studies of stimulants in ADHD and normal children, with particular focus on MPH.”
https://www.researchgate.net/publication/10812795_Responses_to_methylphenidate_in_Attention-DeficitHyperactivity_Disorder_and_normal_children_Update_2002
Since you seem to have respect for researchers in the field, I will assume that we can consider that particular topic closed.
Steve
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I am interested in the views of everyone here not just yours no offense intended. This subject is far from closed as far as I’m concerned. If you are done, thanks for your contribution.
The sgnificance in Rappaport’s study is not that both groups responded in the same fashion. That is irrelevant. What she observed but didn’t comprehend, apparently, is that people who were blind could see!
The “issue” regarding how the stimulants acted upon the different groups means nothing. Why wouldn’t the same chemicals impact most human beings similiarly? Why wouldn’t stimulants improve the mental acuity of everyone? Helping those who struggle to focus isn’t magic. Whatever is present in the brains of “normal” people seems to be in short supply or not working as intended in the brains of those who are really hindered by this problem. By introducing a particular chemical that can pass through the BBB, known to stiumulate “typical” brains, we are only observing what we would expect.
The almost immediate impact of a stimulant on the brain simply makes sense. It only takes a few moments for the chemical to be taken to the brain and into the neurons. Obviously, that is where the action is, or is supposed to be. If the poorly trained children are instructed to, “Sit up. Be quiet. Pay attention!” Why don’t they respond immediately? There’s nothing wrong with them, right? The kids who were inattentive because of “poor parenting” and given a stimulant don’t need to be told anything. (They’ve heard it millions of times before anyway!). Without a word from anyone they ARE paying attention–without even trying. That’s what brains are supposed to do. Infants pay attention. Children, little 2, 3, 4 year old kids learn to speak a language. No one trains them to pay attention so that they can master what adults find nearly impossible–learning a new language. They just do. Their brains are designed to pay attention.
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The point is, response to stimulants is not diagnostic of “ADHD” or anything else except having taken stimulants. Again, if you LIKE the effects of stimulants, you’re welcome to take them. It is completely irrelevant to the question of biological causation.
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You have drifted off the topic. I am not just discussing the origins of ADHD directly.
If training is the answer as explained previously, I challenge that opinion through a few questions and examples. Bear in mind not every one who believes medication can be a valuable tool for many afflicted with this disorder is a cold blooded killer. Some of them love and care about children very sincerely. Not every argument they make in favor of using medication as called for and under the supervision of a competent, experienced, true-blue doct is made by greedy, psychopathic, crimminally minded, worthless, raving lunatics out to destroy children at any cost.
“Drugging children” is a horrible term. It is misleading and wildly inappropriate. I don’t want to send anyone into a stupor. I don’t want to control any one. My hope is that medication can serve like a pair of glasses. That’s all. If someone doesn’t want improved vision, fine. Should every child who has debilitating problems with their eyesight be offered a vision test? Sure. Should all of them be forced to wear glasses? Of course not, but some believe so. They misinterpret the others’ intentions. Ascribing the worst, most immoral motives to just about everyone who views ADHD as a medical matter is a terrible mistake, for the CHILD.
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Poor vision is objectively measurable, and is nearly 100% correctible by lenses. “ADHD” is a social construct “diagnosed” by a list of behavioral characteristics, some of which are, frankly, pretty ridiculous. “Acts like ‘driven by a motor’?” Isn’t that just a BIT different than “Is unable to read letters of X height from a distance of 20 feet?” Additionally, there is a very significant minority of “ADHD”-diagnosed, probably 30%, who don’t even respond positively to stimulants in the short term, some of whom actually get demonstrably worse (aggression, lethargy, psychosis in over 6% – hardly rare, eating problems, growth retardation – the list is pretty long).
Your comment is clearly disrespectful to those of us who choose not to buy into drugs as the solution. And they ARE drugs. They are generally schedule II controlled substances that can be sold on the street for money. Pretending they are NOT drugs in order to preserve middle-class sensibilities is just plain dishonest.
But yes, you are being extremely condescending to anyone who disagrees with your approach. “If someone doesn’t want improved vision, fine.” That implies that I have somehow neglected my children by forcing them to go around unable to see. As you can see from the results, my kids are NOT blind or limited in their capabilities in any way. They are just as capable as you or me, absent any stimulant “treatment” in their lives. It appears you are extremely invested in your idea that stimulant drugs are the only answer for kids who have what is at best a behavioral syndrome that is “diagnosed” by utterly subjective means. It’s insulting in the extreme, and I ask you to stop doing it, to me, and to anyone else you meet. Maybe instead of telling everyone else what is “right,” you could start listening and perhaps expanding your viewpoint. Instead of an analogy that I let my kids go around with poor eyesight, perhaps you can open your mind enough to say, “Wow, that sounds like you did a good job! Maybe there are other options I haven’t considered that could work for some kids.” I am not ascribing ANY immoral motives to you or anyone else who chooses to take stimulants, and I made that point more than once in this thread. I have been arguing ONLY from the scientific perspective that one study on a very limited population does not establish a “cause” for “ADHD” nor that it is a biological phenomenon only, nor that it is even a legitimate entity for scientific study. Your comments have been and continue to be dismissive and disrespectful of other viewpoints, and I’m calling you out on it. If anyone is ascribing ill motives to those who don’t agree with them, it is you who is doing so. You might want to take a very hard look at your own behavior instead of spending all your energy criticizing those who have good reasons to disagree with your assertions.
And I have provided you a VERY concrete example of training that has had proven results. How is that “off the topic?”
If you want to learn anything, you have to open your mind to the possibility that you have not been told the whole story. So far, I don’t see much if any openness to hear anything that contradicts your own preferred narrative.
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I cannot respond to your most recent criticism through the reply mechanism. so I’ll try here. I can see what you mean and I apologize for presenting my viewpoint in a condescending, dismissive fashion.
WE disagree about the nature of this disorder. Your children were not as limited as many are and you did do a great job.
Many children cannot, no matter what anyone else does or doesn’t do, pay attention. They are like legally blind people. Often, they respond to medication when nothing else works.
That’s why I advocate for anything that will work to help them. ADHD is not just a matter of guessing. It is not loosely defined. It is not something that responds significantly, most of the time, to structure and training and carrots or jails.
Many who comment here condemn anyone who doesn’t hate psychiatry and psychiatrists, including you. You are a cheerleader, regularly, for the most nasty and vicious and hateful participants. and You are not open minded. No offense Steve, but you, for some reason believe you have all the answers, but you don’t. No one does. What you accomplished with your kids is astonishing, but most kids are not your kids. I fear you lose sight of that. Many condemn parents who have tried very hard, including you. Many condemn teachers, some who don’t deserve it, you included.
You suggest I like drugs. Caffeine is a drug don’t forget. I’ll tell you what I like best of all: to know that everyone who needs help gets it, whatever it is as long as it doesn’t do more harm than good and I know mant people who are different people today, so grateful for medication that saved their lives. I don’t see that you too are happy they have found such significant help. Why? Remember thius too. I was not directing my opinions at you. I think you are taking too personally differences of opinions, but I do apologize for implying you didn’t care about your own kids. Big oversight. Sorry bro.
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How on Earth do you know that my children were “not as limited as many?” How could you possibly know that without meeting my children, and without attempting a similar intensive behavior program based on the individual needs of other similarly “impaired” children and seeing what the results were? Your comment continues to come across as condescending, as I find quite common with people who are advocates for stimulants, rather than objective observers looking for the best approach and open to new ideas.
Where in my comments have I ever criticized you or said you should hate or disrespect psychiatry or psychiatrists? And I don’t condemn teachers, I am criticizing the SYSTEM of education that requires children to engage in behavior that meets the needs of the adults and not the children. I’ve even given you alternative educational approaches that work for “ADHD” diagnosed children, in which you have shown not the vaguest interest. What would happen to those kids who “can’t learn” in a standard classroom if they were given a different venue to learn in? What if 70% of them suddenly did not “need medication” any longer? Would you consider that a GOOD outcome? Or a BAD outcome?
And if it’s all biological as you claim, why is it that there is a full 30% reduction in kids getting diagnosed “ADHD” if they wait one year longer to enter school, as has been shown in several quality studies? The 30% figure is remarkably stable over these studies, too. What would happen if these kids were given yet another year to mature before enrolling? Could we reduce that figure by 50%? Would you view that as a good thing, or a bad thing? Especially when there is NO evidence that taking these stimulants over the long term has any positive impact compared to kids who quit early or never took them.
Your view of the situation is extremely monochromatic. I’m just trying to broaden your perspective, not tell you that stimulants are wrong or bad. I’m encouraging you to take a wider view, instead of assuming that using chemical means to enable a child to sit still and pay attention in a standard classroom is not only the best but the ONLY way to help kids who are struggling to learn in that environment.
It doesn’t suit you very well to claim you are sorry for condescending and then continue to condescend. But maybe you can’t help it.
This time I’m REALLY done. I’d appreciate it if you did not add more disrespect and condescension to the pile. Maybe best if you just stop trying to convince me of something I very well have established to be a very narrow and ineffective view of “ADHD” to my own satisfaction.
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“How on Earth do you know that my children were “not as limited as many?” How could you possibly know that without meeting my children…”
I’m so glad you asked that question.
Here’s how anyone can come to that conclusion, Steve. No presumption on the part of anyone. It is simple. Your kids were able to respond.
Blind people cannot see. No matter what they do or anyone else does, they cannot see. If a person has ADHD, he cannot improve his capacity to focus. Some suffer from severe ADHD. There is a continuum. Some have it mildly. Some are very intelligent. Some are below average. But, nothing they do changes their inborn neurologic flaw. Training, doesn’t change a thing, nor education, nor anything. Training education, support can make it easier to use whatever capacity the person has, but the flaw in our bodies remains. This is a neurologic deficit which means it is an abnormal function of a body area. This altered function is due to injury of the brain, spinal cord, muscles, or nerves.
Obviously, you disagree strongly. You insist no bio markers exist. That is not true, IMO. That’s why misdiagnosis is common. It is tricky. We know very, very little on the molecular level which disturbances yield.
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Your comments continue tot be insulting. I never said “no biomarkers exist.” I said that your study did not prove that all or even most cases of “ADHD” are biological. I have also proven again and again that there are other alternatives to stimulant “treatment.” You are assuming the outcome and dismissing my example of my own kids because you don’t want to accept that your viewpoint is limited by your own biases. “Misdiagnosis” is common because there ARE NO OBJECTIVE STANDARDS FOR “DIAGNOSIS.” In fact, if there is no way to know who “has it” or doesn’t “have it,” there is no way to determine if someone is “misdiagnosed.” This leaves the door open to biased advocates to decide that anyone who IS helped by non-chemical methods “must have been misdiagnosed” to preserve their preferred belief system.
My kids absolutely fit the criteria to a tee. They were helped to lead productive lives with no stimulants. You apologized earlier for minimizing that accomplishment, yet you continue to do exactly the same. You assert that I was making my blind children go around pretending to be able to see. That is incredibly insulting, and you don’t even realize it.
I don’t “strongly disagree,” I have the best possible example that your generalization, which you repeat over and over again, is not true. I also have presented excellent proof that your insistence that “treatment” with stimulants is essential is absolutely not true, since in the long run, there are no significant advantages to “treatment” over “non-treatment” or “medical treatment” over psychosocial intervention.
Seriously, PLEASE DO NOT RESPOND if you’re going to keep insisting that I’m a child abuser forcing my blind children to pretend to see! If you don’t agree with me, DON’T AGREE, but I don’t want to hear you telling me I’m wrong. If you can’t accept that the world is bigger and more complex than your data to date, you are no scientist and will fail to ever learn anything about why some people find your approach so horribly offensive.
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Steve, why condemn others for insulting and condescending when you cheer on condescending and insulting comments? How do you suppose others feel who disagree with her point of view and when as a moderator you encourage it?
Kids learn differently. But, if they can concentrate, they learn. When you cannot pay attention, you are at a big disadvantage.
A REPLY button does not show up under your comments at times so I try to respond the best way I can
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Or maybe some kids learn differently than is expected of them.
Look, we’re not going to agree on this. It’s a philosophical problem, not a scientific one. You have a set of assumptions, mostly that kids learn best by doing what they’re expected to in a regular classroom, and that being unable to do that is a problem with the child. I have a different set of assumptions – that it is the adults’ job to figure out the best setting for children to learn in and that adapting your approach to the children’s needs obviates the need to come up with ways to get them to fit into the “normal” classroom. Within our own sets of assumptions, we’re both right. And it doesn’t seem that either of us are ready to accept the other’s philosophical assumptions. And it’s starting to get personal.
Let’s just agree to disagree and have done with it. Diversity of perspective is the sign of a healthy community.
All the best to you.
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“Look, we’re not going to agree on this. It’s a philosophical problem, not a scientific one. You have a set of assumptions, mostly that kids learn best by doing what they’re expected to in a regular classroom…”
Learning in a classroom stinks.
“it is the adults’ job to figure out the best setting for children to learn in and that adapting your approach to the children’s needs…” Amen!
I believe in doing everything possible to avoid medication. Special schools, the best teachers, experiential education, all the latest techniques, everything not to resort to meds.
I am a teatotaler, strictly. I hate what drugs/alcohol do to people. I don’t drink, smoke, drug, eat fatty foods, I exercise, blah, blah, blah.
I believe at this very momenbt there is a child somewhere who can’t do his schoolwork. He cannot learn. He fakes paying attention. He nods his head on the inflection of a voice. He smiles when someone nods his head. He smiles when he sees that others smiled at something. He compensates and has no idea what’s going on. He cannot follow directions; he doesn’t hear them. He’s tuned out and drifted off somewhere. He catches a word or two occassionally. He gets by the best he can. He simply cannot pay attention and he’s learning to despise himself. He is bored to death, almost literally. He assumes he must be as rotten as his folks tell him daily and his teachers reinforce constantly. Kids make fun of him and he gets into trouble and he has absolutely no idea, none, what he did wrong. He’s all alone and afraid and desperate.
I want him to know there’s hope. He is not at fault. He’s a good kid. Kids with ADHD often have big hearts and are extremely empathetic.
“People with ADD often have a special feel for life, a way of seeing right into the heart of matters, while others have to reason their way along methodically.”
ADHD AND EMPATHY
The upside of being a person who feels so deeply, with such a high capacity for empathy, is that you’re often the best friend/parent/sibling/colleague, etc. that a person can have. You can read people well and understand what they’re feeling even before they express it.
– Dr. Hallowell
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So why not dedicate yourself to creating better classrooms, rather than trying to pretend that this hypothetical kid can’t learn just because they are too bored and distracted to function well in a so-called “normal” classroom?
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You didn’t answer my questions.
“There is also an abundance of research going back to the 60’s that demonstrates clearly that children who are habitually inattentive, impulsive, and hyperactive even to an extreme degree, can be trained readily to behave in a more productive and less disruptive fashion”
Please cite 3 documents which demonstrate what you claim, please.
What is meant by “more productive”? For herself or for others she is not disrupting? I am interested primarily in the documentation which shows that extreme examples of children manifesting hyperactivity, a lack of concentration and impulsivity are “readily” trained to be more productive. I would like to see how they quantified, specifically, their increased productivity.
Also, a child can be scared into being quiet. That is true and rather obvious. Remove the immediate threat and what happens? I will state with confidence that those children learned just as much when they were not trained. ADHD is a biological/chemical/electrical/organic malfunction of the brain and training will not and cannot improve concentration. A business advertising that claim got into hot water and had to stop.
In addition, would you cite the supporting research which shows that parents prior to the 1960’s knew how to raise their children better than succeeding generations, please.
Why don’t those “ADHD” children snap out of their funk immediately and permanently? Did something damage the structure of their brains? What is holding them back? Why do the majority of ADHDers respond immediately to the medicinal properties of stimulants and begin to concentrate instantly?
Thank you in advance for any cooperation
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“I will state with confidence that those children learned just as much when they were not trained. ADHD is a biological/chemical/electrical/organic malfunction of the brain and training will not and cannot improve concentration.”
I already gave you a clear and thorough demonstration of exactly how this can be done. Your latter claim is not supported by the literature. As I’ve said all along. It appears you already “know” the answers, so why are you bothering to have a “discussion?” It sounds more like you want to force anyone who disagrees with you into submission.
If you really care, do your own research. But I don’t think you’d accept it if the results were right in your face.
And talk about not answering questions – if chemical stimulation to enhance concentration in a regular classroom environment is such a great solution, why is it that study after study shows no improvements in long-term outcomes for medicated vs. non-medicated “ADHD” diagnosed cases? Answer that if you want others to ask your (possibly disingenuous) questions.
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“why is it that study after study shows no improvements in long-term outcomes for medicated vs. non-medicated “ADHD”
“Is there long term benefit from stimulant treatment for ADHD?
Thus the answer to the question “Is there long-term benefit from stimulant treatment for ADHD” is a definite “Yes!” Department of Psychiatry, UT Health San Antonio, San Antonio, Tex.Sep 1, 2019”
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Nonsense. Reviews by Barkley and Cunningham (yes, the same Barkley who makes millions selling the idea that “ADHD” sufferers are being abused if not given stimulants) in 1978, Swanson in 1993 (“Review of Reviews”), and the Oregon State University Medication Effectiveness Project (which looked at EVERY piece of literature on the subject every published in about 2002) ALL concluded that there are no long-term outcomes improved by stimulant treatment when comparing those “treated” and “untreated” who were diagnosed with “ADHD”. Also, long term studies like the Quebec study, the RAINE study in Australia, and the Finnish study (compared kids in the USA with very HIGH “treatment” frequency and duration to kids in Finland with much lower treatment levels, no differences found) ALL found that there was NO long term benefit to those “medicated” vs. “unmedicated.” The highly-touted MTA study showed that the stimulant group had some advantages in reading at the end of a year, but by the three-year followup, that difference had vanished, and later followups showed that those who continued to be “medicated” had DETERIORATING outcomes in comparison.
Here is a more recent revivew:
“In the short term, stimulant medication is effective in reducing the symptoms of ADHD and appears well tolerated with relatively minor side effects. In the long term, much of the benefit of stimulant medication disappears after medication is ceased. Studies have demonstrated only marginal improvements in adult outcomes following a period of treatment in childhood.”
https://www.tandfonline.com/doi/abs/10.1586/14737175.6.4.551
Have you actually READ “Anatomy of an Epidemic?” This is covered in Anatomy, though more data has come in since Anatomy to provide even more support.
Repeating quotes from some guy with a degree does not constitute evidence. The jury is in – long term “treatment” with stimulants DOES NOT improve long-term outcomes. 40 years of studies should be sufficient to prove this point. If you want to pretend it’s not true, that’s your choice, but don’t try to convince me or anyone actually familiar with the literature.
I have the data on this, Enrico. Probably best not to try and argue this point, and instead either retreat or consider the real implications of the REAL science, rather than relying on quotes from “professionals” who probably have a conflict of interest.
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Is There Long-Term Benefit From Stimulant Treatment for ADHD?
Steven R. Pliszka, M.D.
Stimulant medications have been used to treat symptoms of attention deficit hyperactivity disorder (ADHD) for over 80 years, longer than the use of antibiotics to treat infection (1). Based on data from over 6 million individuals in an insurance database, the 2008 annual prevalence for filled stimulant prescriptions was found to be 4.6% for children ages 6–12 years, 3.7% for adolescents (13–18 years), and 1.6% for young adults (19–24 years) (2). These figures are in line with data from other studies (3) and are below the estimated 7% 1-year prevalence of childhood ADHD (4). The short-term efficacy of stimulants in ADHD is well established (5), yet despite eight decades of clinical use, there continues to be angst over it. Reviews call attention to the fact that there have been no long-term studies of stimulant use beyond 1 year (6), and this fact is often brought up by the lay media in discussions of the treatment of ADHD (7).
Previously, the Multimodality Treatment of ADHD study (MTA) found that after 14 months, structured medication management was superior to behavioral treatment alone or treatment as usual in the community (8). After the first year, all participants in the MTA sought whatever treatment was available, and as a result, the exposure to medication treatment was highly variable as the years wore on. The most recent follow-up examined medication usage, ADHD outcome, and growth at age 25 (9). Medication usage was assessed by interviewing the patient or caretakers—always an issue, as patients tend to overreport their adherence to medication regimens. The MTA defined being on “minimal” medication as taking 10 mg of methylphenidate (or its equivalent) per day more than 50% of the time. Based on this definition, the MTA sample was broken down into three groups: negligible (always below the minimum at all time points interviewed), inconsistent (below the minimum in most follow-ups), and consistent (above the minimum at all time points). This latter group consisted of only 35 individuals, or 7.3% of the sample. Not surprisingly, given this very low medication exposure, no relationship was found between ADHD outcome and medication usage.
The MTA could not address the question of the efficacy of stimulant medication use beyond 1 year, so there is a need to reliably establish the long-term benefits of stimulant use in ADHD treatment. There is also the practical clinical question as to how long to maintain a child or adolescent with ADHD on stimulants. A common question that is asked is whether the patient has “grown out of” his or her ADHD, such that the medication can be discontinued. In this issue of the Journal, Matthijssen et al. (10) report on the first double-blind placebo-controlled discontinuation study in ADHD patients who were continuously treated with methylphenidate for at least 2 years. The participants had to be on a stable regimen of either 36 mg or 54 mg of extended-release methylphenidate for the past 4 weeks; they then entered a blinded study in which they were randomly assigned either to remain on this dosage for 7 weeks or to undergo a 3-week taper to placebo followed by 4 weeks on placebo. Teacher, parent, and clinician assessments (all blind to study group) were performed at baseline and at 7 weeks.
Although the design was to enroll a sample of 120 participants, with 60 in each group, only 94 were enrolled, because of recruitment difficulties. As the authors state, “Many patients we approached did not want to participate in our discontinuation trial, as they argued that they ‘knew it still worked,’ based on experiences of stopping briefly or when they forgot to take their medication for a day.” This will not come as a surprise to clinicians, as many parents whose children have more severe ADHD are unequivocal about the medication’s efficacy and maintain their children on medication on weekends and during school vacations. At the end of the 7-week trial, 40.4% of the patients in the discontinuation group worsened, and only 15.9% of those who continued medication worsened. Furthermore, the authors found that the effect of continuing methylphenidate was significant in the younger participants (below the median age of 13.8 years) but not in the older group. This finding might be explained because ADHD symptoms may be more subtle in older patients and it may take longer for relapse to occur. Patients in the discontinuation group had worse scores on the ADHD Rating Scale, as rated by both parents (effect size=−0.23) and teachers (effect size=−0.52). The difference between parent and teacher ratings is also not surprising given the higher cognitive demands of the classroom. It is of note that 16% of the participants who remained on their stable medication regimen worsened, which is likely due to the “nocebo effect” of believing that one might be on a placebo.
Clearly, this study demonstrates that stimulant administration remains generally effective over 2 years of treatment; but what about the fact that 60% of those who were transitioned to placebo “did not worsen”? Will this finding result in headlines announcing that “60% of children with ADHD can be taken off medication after 2 years?” This conclusion would be premature, to say the least. All clinicians have had the experience of parents who have not restarted stimulant medication at the start of the school year, only to be called after the first 6-week grading period to restart medication because their child was failing several classes. The authors are correct in their conclusion that patients with ADHD should be assessed at least annually to see if discontinuation is possible, particularly for adolescents who seem to be functioning well when off medication. The medication should be restarted at the first sign of relapse.
Multiple other studies using large national or insurance databases are beginning to establish the long-term benefit of psychopharmacological treatment of ADHD. Relative to periods off medication, ADHD patients on medication have fewer motor vehicle accidents (11), have a lower risk of traumatic brain injury (12), are less likely to engage in criminal activity (13), have lower rates of suicidal behavior (14), and have lower rates of substance abuse (15). Thus the answer to the question “Is there long-term benefit from stimulant treatment for ADHD” is a definite “Yes!”
Department of Psychiatry, UT Health San Antonio, San Antonio, Tex.
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One study by one person does not begin to compare to 4 long-term naturalistic outcome studies and 4 comprehensive literature reviews. The jury is IN. There is no long-term outcome that is consistently improved by stimulant treatment. It’s a fact.
Just stop now.
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Really? Their “funk”?
So they are not moldable into the design you see as normal?
Best drug them into adaptation to this normal environment.
Is the child “productive”? Sits nicely and co-operates?
Perfect.
So you are telling me that drugs are better than shit scaring a child into submission?
Chemical control is better in your eyes which you understand sounds disturbing.
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Where did I say that?
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Steve, several times I have asked the person who wrote the particular comment for him or her to respond, not you. You are welcome to respond. I point this out for clarification. I hope the ones I asked questions will not be confused. I want their input, too.
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Of course and with absolute certainty children are different from each other. In fact, for some or many kids living in high demand situations, where there is only one way of learning or being, they might indeed get very sad, and it might contribute to their overall world view for the rest of their lives.
These are NOT disorders, except within the environments that they are stuck in like cattle.
Every single animal and I include humans learns differently. Dogs are a good example.
https://www.msn.com/en-ca/news/animals/why-is-your-dog-tilting-its-head-new-study-dives-into-the-adorable-habit/ar-AAQcNfA?ocid=msedgntp
The head tilt of a dog who is processing information. Many cannot learn the names of a toy, so the researchers call the dogs that do learn “GWL” (gifted word learners). So are the dogs that can’t, disordered? Or do they simply have gifts in other areas, or maybe none? So create an environment where the dog is considered ungifted and then you can diagnose.
It is amazing to me that in nature we are seeing millions of kids with disordered brains, but not disordered bodies. Funny that the disorders are located up in the head only and require chemicals.
What about all the millions of kids that can’t do sports like athletic people can? Are they disordered? And why not? Because we don’t have a society that relies on physical prowess.
And if we did, of course the non athlete will be up a creek without a paddle and might feel badly for not fitting the “mold of normalcy”.
Now all we need is chemicals for millions of kids to increase their athletic performances, but giving steroids to kids is considered illegal at this point.
The people who believe in giving chemicals to children, try to pretend that those who are against chemicals are denying differences in people.
The drug makers and psychiatry has gone, always was purely selfish to the point of harming people.
My neighbour has her cats on neuroleptics because one cat started peeing in the house. So now she has nice docile cats, with lethargy.
I get it. We can’t have living beings doing things that are opposite to the way we established lives for them.
So best to use chemicals to accomplish what we desire.
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Very well said!
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Meds work short term. Why?
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They work short term the same on everyone. Judith Rapoport et al showed this way back in about 1978. They gave stimulants to non-diagnosed people to test the “paradoxical effect” theory. She found that non-“ADHD” kids on stimulants had longer attention spans, were harder to distract, and lower motor activity levels, all the same things they do for “ADHD” kids. She said the reason people though the “ADHD” kids were reacting differently was because people were LOOKING for these changes and so found them, but would not notice on kids where they were not trying to “solve” attention problems. This issue was laid completely to rest scientifically at that point, and anyone being honest these days will tell you that you can’t “diagnose” someone by their reaction to stimulants, because most people react the same way, diagnosed or not.H
“However, it is now established that the focusing effects of stimulants in ADHD are not paradoxical; these agents have the same effect in ‘normal’ human subjects (albeit a more subtle response given ceiling effects) (Rapoport and Inoff-Germain, 2002).” https://www.nature.com/articles/1301164#:~:text=However%2C%20it%20is%20now%20established,Inoff%2DGermain%2C%202002).
Also, Rapoport’s original study from 1978: https://www.science.org/doi/10.1126/science.341313
It has come to my attention that this mythology is still promoted by many sites who pretend to be objective about ADHD, but the science has long since proven them wrong. There is no “paradoxical effect.”
As to longer-term effects, I think we’ve exhausted the literature on that point.
Enrico, please give it a rest. You will not convince me by repeating the same things over and over again. I heard you, I read your evidence, I acknowledged your position, I’ve established mine with the necessary evidence. I’m sure I won’t change your mind, and you won’t change mine. Let’s just stop arguing!
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“They work short term the same on everyone…”
Of course! So? They either work on improving attention or they don’t. You acknowledge they work.
How? We may not know exactly, but we do know they work.
Forget the cluster bit for a moment. Talk with people who say ADHD was a nightmare for them. Listen to what they say. Ask them about medication. Ask if it ever worked for them, making it possible to pay attention in school, at work, listening to the radio. Talk openly and listen carefully. You obviously care a great deal about people. I don’t believe for a second you want people to suffer humiliation day in and day out because they cannot concentrate as they need to.
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I have never said that stimulants can’t be effective for people in the short term. My premise, if you will read more carefully, is that the appearance of stimulants “working” doesn’t mean there is something biologically wrong with the subject. Alcohol is an excellent “antianxiety” agent – used to calm me right down in social situations. Why? Because that’s what alcohol does. Not because I had some “diagnosis” that alcohol “treats.”
No one is arguing that psychotropic drugs don’t affect people in certain ways that some people will find helpful. I am trying to separate that easily observable fact from the scientifically tortured concept that we can somehow “diagnose” someone with a “medical disorder” based on a subjective list of behavior, or from their response to certain drugs, as you seem to be claiming is true.
As for humiliation, I want you to consider carefully how much of the “humiliation” that kids experience is based on how others treat them for not ‘fitting in’ with the schools’ expectations rather than because they “cannot concentrate as they need to.” There are kids younger than TWO YEARS OLD being “diagnosed” and “treated.” How on Earth can this serve the needs of the toddler to “concentrate as they need to?” Aren’t we talking about inappropriate developmental expectations at some point? Also, did you know that a couple of good experiments with open classrooms have shown that “ADHD” kids who are put into such an environment are almost impossible to distinguish from “normal” children? Or that a number of good studies in various locations have found that comparing kindergarteners who are 5 vs. almost 6 when entering Kindergarten consistently shows a 30% reduction in ADHD diagnosis rates SIMPLY BY WAITING A YEAR LONGER BEFORE ENTERING SCHOOL! And this finding has been replicated in a range of different geographic settings in different states and countries. That’s what I call a robust finding! Why aren’t we simply delaying the entry of kids diagnosed with “ADHD” for a year, or sending them to open classrooms, when that would give us a 30% cure rate?
If “ADHD” were a detectable biological problem, why would it matter what kind of classroom the kids are in? Why would waiting a year to enter school suddenly eliminate a third of these “biologically deficient” children? Isn’t this proof that maturation and developmental expectations play a huge role in who gets labeled “ADHD?”
Now, if you’re just going for the idea that, “We should be able to give kids stimulants if it makes it easier for them to fit into the classroom, and if they and their parents don’t mind,” that’s a very different argument. But the fact that some kids/adults happen to find the effects of stimulants desirable means absolutely NOTHING about the condition of their brains. It just means they like the effects, just like I like the effects of alcohol. Read some stuff from Johanna Moncrieff on the “drug model” rather than the “disease model” – she describes this WAY better than I can. You don’t have to have a “disease” for a drug to have an effect, and just because a drug HAS an effect doesn’t mean there’s something wrong with you. I hope you can agree to this rather obvious and scientifically unarguable premise.
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Correction, Steve, they APPEAR to “work” short-term….
But then again, when I was a kid, presents from Santa Claus would ALSO APPEAR, usually on a morning in late December…. Well, SOMEbody “worked” for those presents, so I guess drugs “work”, too! Hey, works for me….NOT!….// my vote, unless they are abusive, or really bad, is let Enrico’s comments stay. He’s confused, but at least he comments.
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Yeah, I guess it depends on what you define as “works.” And for WHOM does it “work?”
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Heya Sam,
“My neighbour has her cats on neuroleptics because one cat started peeing in the house. So now she has nice docile cats, with lethargy.”
They are no longer defined as cats, they are now considered door mats with a cat theme to them. 🙂
When does a drug become a medicine and vice versa? I couldn’t even get a sensible answer to that question from a number of pharmacists. When a doctor prescribes it? Because we had one doctor, identified through a register here, who had more than 2000 ‘patient’s’ (in a one year period) he was prescribing stimulants to for ADHD. (a “nice little earner” as Arthur Daly would have it. And the State government dealt with the matter by concealing the register. How clever.)
Minus the license, he’d be called a ‘pusher’.
Like glasses for the blind? If LSD opened my ‘third eye’ would it be considered ‘medicine’?
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“we had one doctor, identified through a register here, who had more than 2000 ‘patient’s’ (in a one year period) he was prescribing stimulants to for ADHD…”
What’s his name? Where was this and when, do you recall? What does that have to do with the topic?
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See Martin Whitley website Psychwatch Aust. Article published 14 Oct 2019.
https://www.psychwatchaustralia.com/
It has quite a lot to do with the topic if you consider these ‘medications’ as being drugs of addiction and abuse.
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I searched and didn’t find it. Can you quote the data you referenced? Thanks
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“I searched and didn’t find it. Can you quote the data you referenced?”
Fairly simple to scroll down the articles by date and go to 14th Oct 2019. Or do a search on the page (ctrl F) for ” Boom time again for Perth’s ADHD Industry as Roger Cook weakens amphetamine prescribing controls”.
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They have 15,600 appointments with patients on average per year. What should the maximum number of scripts she can write for stimulants be each year?
The date was Oct 13 2015.
Writing 2000 plus rx’s for stimulants per year has no bearing on the fact that ADHD is a damnable, confusing, complex, real and most often treatable through medication that I can see. Thank heaven doctors are treating so many people who suffer horribly from it while undiagnosed and untreated. There is hope now that it is being recognized and addressed for the monster it is and people are finding relief for it, building self-esteem and being given a second chance to do all the things they could not do.
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Surely you wouldn’t deny a child iodine.
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If the child asks to be drug him into submission, it would still not be an okay thing to do. It is an abnormal thing to drug children into submission. But it is a quiet thing isn’t it
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I love kids. I want the best for everyone of them. I don’t want any child to be harmed in any way, ever. That’s where I’m coming from. I don’t want all kids to be moulded into a certain type. Last thing on my mind. I do want kids to reach their full potential, whatever that may be. A mind is a terrible thing to waste and if a child or an adult cannot process what is taking place around him, that limits his options to do and to be what he can do and who he wants to become. If orange juice was as effective as meds seems to be, I’d be advocating consuming thousands of gallons!
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So what’s your objection to creating open classrooms, where these “ADHD” kids seem to do so much better without any special “treatment” at all?
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@Steve, Enrico
Just a reference to a blog post with an interview with a philosopher. She distinguishes between two different approaches to intervening in case of mental health issues: local-to-global or global-to-local. This distinction exactly matches your positions. Local-to-global can be psychopharmacological interventions working on neurotransmitters locally before creating a global cascading effect, that influences experience and behavior in some way. Global-to-local can be environmental or psychotherapeutic interventions which through experiential processes creates changes locally by way of learning. It is a logical distinction. This way of thinking does not sit easy with naive-realist views of mental disorders or treatment modalities. Medication, e.g., is not assumed to ‘correct’ anything – rather it disturbs neural processes which then reacts back through their own dynamics. This may be helpful or not depending on person, circumstances etc.
Link: https://www.psychiatrictimes.com/view/sense-making-enactive-turn-psychiatry-sanneke-de-haan-phd
(sometimes psychiatrictimes does react when using google chrome as browser)
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Thank you, Jonathan. As I have said, there are philosophical differences that lead to different approaches. Different approaches are absolutely allowable. Claiming that all kids who present in this way “have a biological deficiency” is NOT scientifically valid at this point. It is VERY important to make the distinction between philosophy, which entertains the possibility and effects of different worldviews, and science, which attempts to discern facts and predict precise outcomes. Confusing one with the other leads to a lot of false conclusions.
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Well, you could also say that philosophy is implicit in science, no matter what you consider science to be. And that there are different ways of doing science that attempts to get a grip on a lively world through different means. One grip on mental health issues is the pharmacological grip, which comes with its set of theories and philosophical assumptions. Another grip is the psychosocial approach, which is underpinned by other theories and philosophical leanings. Thinking this way completely defuses claims of having found THE universal explanation for whatever the problem is. It considers knowledge as situated and local, not as decontextualized and universal. And different ‘grips’ can co-exist just fine as long as none of them develop megalomania and claim to be THE only sensible grip. The trouble really begins, I think, when one type of ‘grip’ or solution starts to reframe the problem in its own picture. Psychopharmacological solutions explain mental health issues as biological disturbances, psychosocial solutions explain them as problems with learning and relationships. And then we end up in different camps, clutching our precious ‘truthy’ knowledge, without realizing that knowledge really flows from practice, and that different forms of practice makes possible different kinds of knowledge. Both camps routinely oversell, in my view. The world and its problems are much weirder than either-or.
(I can really recommend this article making the distinction between understanding knowledge either in a representational or in a performative idiom: https://www.researchgate.net/publication/308968688_The_Ontological_Turn_Taking_Different_Worlds_Seriously)
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Well said. The only caveat, and a big one it is, is that whatever philosophical approach one takes, the results have to reflect some apparent improvement, at least within your own philosophical structure. It becomes a BIG problem when one becomes so committed to his philosophical views that actual data that doesn’t support one’s theories is ignored or minimized or denied.
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Duplicate comment.
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Steve, where did you get the impression I oppose “open classrooms”? In many ways our public school system is a disaster. We need all kinds of improvements.
I built my own house. Had no experience. I read up on it. It was a lot of work but most people have the ability. I wanted to take what I learned and teach it in the field through schools as an experiential classroom. We would build a house together. To the extent that happened, the juvenile delinquents had a ball. They loved it.
I don’t want children or adults to be trapped by a very damaging disorder when there is help. It is painful for me to think that some may never know they had a true disorder. They are not to blame for their endless series of failures. It wasn’t their fault. Two nurses wrote a book, “You Mean I’m Not Lazy, Crazy, Or Stupid?”
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My kids NEVER felt they were lazy, crazy or stupid. Unfortunately, most of the kids I knew (and I knew dozens, probably hundreds) who were “diagnosed” with “ADHD” were pretty sure they were being told they were crazy. Some rebelled against it, some accepted that they were “crazy” or at least “incapable,” none of them I can recall escaped without feeling their “diagnosis” meant they were either dumb or crazy or incapable.
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“Sometimes, we are so sick, we can’t sin.”
“Obviously for any of these behaviors to occur, there has to be corresponding neural activity. But there is no necessity that the neural activity is diseased or malfunctioning in any way.” Dr. Hickey
Neurons become diseased. Damaged neurons take choice away. We see the results all the time
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Keep in mind the great news out of the Middle East. Reseachers there discovered, “Published: 26 October 2021
“CDH2 mutation affecting N-cadherin function causes attention-deficit hyperactivity disorder in humans and mice”
D. Halperin, A. Stavsky, R. Kadir, M. Drabkin, O. Wormser, Y. Yogev, V. Dolgin, R. Proskorovski-Ohayon, Y. Perez, H. Nudelman, O. Stoler, B. Rotblat, T. Lifschytz, A. Lotan, G. Meiri, D. Gitler & O. S. Birk
CDH2 mutation affecting N-cadherin function CAUSES ADHD
Also,
Here we demonstrate familial ADHD caused by a missense mutation in CDH2, which encodes the adhesion protein N-cadherin, known to play a significant role in synaptogenesis;{Synaptogenesis is a process involving the formation of a neurotransmitter release site in the presynaptic neuron and a receptive field at the postsynaptic partners, and the precise alignment of pre- and post-synaptic specializations.} the mutation affects maturation of the protein. In line with the human phenotype, CRISPR/Cas9-mutated knock-in mice harboring the human mutation in the mouse ortholog recapitulated core behavioral features of hyperactivity. Symptoms were modified by methylphenidate, the most commonly prescribed therapeutic for ADHD. The mutated mice exhibited impaired presynaptic vesicle clustering, attenuated evoked transmitter release and decreased spontaneous release. Specific downstream molecular pathways were affected in both the ventral midbrain and prefrontal cortex, with reduced tyrosine hydroxylase expression and dopamine levels. We thus delineate roles for CDH2-related pathways in the pathophysiology of ADHD.
Many already has deduced that a physical flaw was causing ADHD symptoms. It only made sense. More break downs will be discovered as scientists zero in on brain structure due to this breakthrough discovery. The Decade of the Brain continues to reveal astounding information about the most complex 3lbs of matter on earth. We are on the verge of the most exciting science of all time. How the brain works, and doesn’t.
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“Anyone who has had even the slightest experience working with children and families can attest to the fact that there are always alternative psychosocial explanations, if one is prepared to look for them. The reality, however, is that within the practice of psychiatry, these alternate explanations are almost never sought.” hickey
name three alternatives
“And the reason they are not sought is because psychiatry has effectively closed the door on these kinds of deliberations. Within the psychiatric framework, if a child (or adult) meets the arbitrary and inherently vague criteria listed in the DSM, then he has a brain illness called ADHD. So the notion of even looking for psychosocial explanations not only doesn’t happen, but would be seen within psychiatry as ridiculous.” hickey
How do you know?
Things are different today, Phil. Almost everything you have provided over decades to refute ADHD is dead wrong.
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Writing just as me, here, not as a moderator.
Why do you continue to post here if you find the basic premise of the site to be so wrong? Do you really think you’re going to convince your audience? Why not go somewhere else where people who agree with you share their views? I don’t see much interest on your part in hearing anything anyone else says, or learning anything you don’t already believe you know. So why are you posting here? What is your purpose? I’m not being snide, I really want to know what you’re trying to accomplish?
I would bet my bottom dollar you’ve never even read Anatomy of an Epidemic or Mad in America. Am I right?
I don’t believe from my observations here that you really want to engage in a conversation about any of these topics. I assume from your behavior that you mostly want to tell us all that none of us know what we’re talking about and you know better than us. Am I correct?
I predict that you will not respond to this question.
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@Enrico
Here’s former head of National Institute of Mental Health, Thomas Insel’s take on the benefit of genetic and neuroscience research:
“I spent 13 years at NIMH really pushing on the neuroscience and genetics of mental disorders, and when I look back on that I realize that while I think I succeeded at getting lots of really cool papers published by cool scientists at fairly large costs—I think $20 billion—I don’t think we moved the needle in reducing suicide, reducing hospitalizations, improving recovery for the tens of millions of people who have mental illness.” I can see, you think otherwise…
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I never had any doubt what ADHD is.
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Okay – all the best. 🙂
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You too.
I don’t understand what your point is by sharing what Insel said about the failures of NIMH and, why it is that you suspect I think differently. What does what he experienced have to do with me?
I will tell you for what it’s worth that I think what’s been written here, in general and specifically, has been harmful for many people and I’m mad at MIA. Maybe that’s what you sense. I don’t get it.
The human brain is extraordinary. We are just beginning to understand how it works. I believe new discoveries will compare with recognizing how bacteria and viruses were responsible for disease. We are just now getting a glimpse of how the brain produces thoughts. To me, that is one of the most profound mysteries in the universe. That somehow flesh and blood can create one thought. A thought from a lump of cells. How in the world does that happen? What is a thought? How do chemicals form even just a single word, or an A or B or anything abstract like that?
And there are 35 trillion times 10 billion ways for the brain to misfire, or to be lacking in something-maybe a few million proteins, or whatever, that creates all kinds of illnesses or malfunctions.
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How do they, Enrico? You don’t know any more than I do. Nor do you even know that cells DO create thoughts. That’s what you believe. There is no proof or evidence of what thoughts even ARE, let alone what creates them. You believe the brain creates them, because you are a MATERIALIST philosophically. Not everyone in the world is a materialist, and materialism isn’t inherently more “scientific” than any other philosophical viewpoint. There are other philosophical viewpoints that are just as valid as yours.
You are sharing your beliefs, not scientific verities. Which is fine, as long as you allow that every other person here is just as entitled to share their views and beliefs as well, and you don’t somehow entitle yourself to be the arbiter of truth when you’re sharing your personal views. I don’t see you granting others that right very often. I more commonly see you presuming to know more than those who are here, and talking down to others who don’t agree with you. It is not a very respectful way to conduct a conversation, in my personal view. I guess that’s philosophical, too – one philosophy is that conversations to be “won” by trying to overwhelm or dominate the other person until they submit. I don’t take that philosophy. I like conversations to be a sharing of information from different viewpoints so I can learn things and expand my viewpoint to include more data and observations and experiences beyond my own narrow path in life. You have a great opportunity here to open your mind and learn from others who have had different experiences than you have, to actually WANT to know why some people find the very things you consider to be miraculous advances in science to be sketchy, unscientific, and even dangerous and destructive. Do you want to know? Or are you primarily engaged in trying to convince the “misled” or “misunderstood” on this site to the “real truth,” which of course means the “truth” you’ve already decided is “right?”
The point re: Insel’s comments is a case in point. You “don’t understand” the relevance. Do you WANT to understand it? What if you actually asked the poster to HELP you understand it, and tried to put yourself in his shoes and see it from his viewpoint? I’d say the reason is quite obvious: Insel RAN the NIMH for years. He spent lots of time doing the kind of research you seem to value (at least when it fits with your narrative), and at the end of his tenure, states that the DSM approach has led to literally NOTHING of lasting value. That one of the key thought leaders in the psychiatric community would publicly announce this should be of GREAT interest to anyone with a real scientific bent. The fact that he was called on to walk back his comments by that very psychiatric community he is a part of should tell you a LOT more. My read is that the psychiatric community knows that the DSM is not worth the paper it’s written on, but they can’t admit it to themselves, or they don’t want the word to get out. Does it seem POSSIBLE to you that this explanation makes some sense? What is YOUR thought on the significance of the lead psychiatric researcher in the #1 center of psychiatric research in the USA says that the DSM actually makes it harder to make sense of “mental illness?”
I have noticed again and again that you do not respond to solid, well-argued, positions that don’t correspond to your views. Will this again be the case with this one? Will you pretend that I didn’t write this because it’s too uncomfortable to face the truth contained herein?
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Glad you mentioned Tom
:I confess to once having the same bias against medication.
Even after running clinical trials of new drugs and observing dramatic responses to medications in my patients, I was reluctant to use psychiatric medication in my own family. When my son showed every sign of ADHD, my wife and I reached for therapy, a special school, and parent training before we considered a stimulant drug. Our whole grain, no sugar, eight-year old on a psychotropic drug? No way, until a child psychiatrist friend recommended a pilot trial of methylphenidate (sold under the trade name Ritalin). Unlike antidepressants and antipsychotics, stimulants have rapid effects. Within a few hours we watched our whirling dervish slow down, put away his toys, and
begin to listen for the first time.
We were stunned. But our son was unimpressed. We asked him about the medication a week later. His response remains one of the most convincing statements I have ever heard about psychopharmacology. “Doesn’t do much for me, Dad, but it makes everybody else a lot nicer.” insel
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I think that comment is very telling, and it supports my contention that most of the suffering that occurs to the “ADHD” child is due to the unrealistic expectations adults put on them in order to attend school, as I stated above. This comports 100% with the observation that ADHD-diagnosed kids are found to be essentially “normal” in open classroom settings where they are encouraged to move around and have more control of their environment (fewer unreasonable expectations). That approach certainly worked wonders for our kids.
It also helps explain why a third of the ADHD diagnoses go away if kids go to school a year later – they are older and more developed and it’s easier for them to follow the expectations set for them by the school. It also helps explain why so many kids “grow out of it” in their teen years – they are developmentally older and more ready to adjust to outside expectations of the school and others (this was certainly true for my oldest).
More importantly, it also explains why kids who take stimulants over the longer term don’t actually end up with better outcomes, even though their grades and adult approval ratings are better on stimulants. The stimulants make the adults happier and less concerned with the kid. The child’s learning environment is not improved, he is not doing anything different than his non-stimulated ADHD classmates, but “everybody else is being a lot nicer.”
So effectively, stimulants create an environment where the adults are more willing to leave the poor kid alone!
I know this is a perspective that you, Donovan, may disagree with, but I think the logic presented here is very consistent with Insel’s report from his son. The main benefit to his son was not being able to concentrate or learn more, it was that others were nicer to him! I hope you are able to listen and hear this perspective as I have listened to and heard yours.
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They were nicer to him, Steve, because he wasn’t acting like a nut. His father, someone highly respected by anti-psychiatry folks, said his son could LISTEN. Try reading what he said again:
“begin to listen for the first time.” begin to listen for the first time.
For the first time in his life, HE LISTENED. As though he had been deaf and doctors made it possible for him to hear. To hear. To hear. He could follow along. He didn’t know he couldn’t listen. He thought everyone was just the same as he was. He had no idea. Suddenly, since he can actually hear and participate by understanding what he is supposed to do and what he is expected to respond to, he’s accepted. If he had been “drugged” and loaded with a tranquilizing effect, he wouldn’t be listening.
Speak to adults who didn’t grow out of it and ask them what it was like before meds and after meds. Hallowell said his patients often compare the difference to being given a pair of glasses and suddenly they could see, for the first time. It is only fair to find out what these people have to say.
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I have talked to plenty of adults and kids before and after stimulants. Some do talk like you do about it. Of course, these are the success stories. Most in my experience appear to view it as a somewhat helpful intervention in the short term, but complain a lot about the costs. A small number complain that it nearly destroyed their lives. You appear to communicate mostly with people who found it worked for them, so you have clearly decided that this is “reality” and other people who have different experiences are “wrong.” That’s what I’m objecting to. I’ve never said that you or others like you did not have positive experiences. I have said that these experiences are not uniformly positive. I’ve also said that other people have managed to have very positive experiences without drugs. What is wrong with that? Why are you unwilling to hear that viewpoint, if this stuff makes you “listen better?” Not everyone has your experiences.
I’ve also shared hard research with you backing up my viewpoint that a) not everyone benefits, b) most benefits are short term, and long-term outcomes have been shown over and over again not to be altered by stimulants or the lack of stimulants, and c) there are other things that you can do besides/in addition to stimulants that really do help.
Again, what is your problem with any of that? Do you NOT want there to be other ways to help? If some kids can do well without stimulants, why do you begrudge them that opportunity? Why not keep a child back a year and see if they do better after a year of maturity? Why not put your kid in an open classroom if kids like him/her do well in that kind of classroom? Why take the viewpoint that a person (me) who has raised his kids successfully without stimulants has somehow deprived his kids of “clear vision” when it’s obvious they are none the worse for wear? Why can’t you simply allow that what you did worked for you, but others may take different approaches? I have NEVER told you that your approach was wrong, or that people who medicate their kids with stimulants are abusing them or doing them harm. Why am I and others like me not afforded the same decency from you?
Please don’t respond with more insults. I need an acknowledgement that your way is not the only way, and that people who use other approaches are not wrong for doing so. If you can’t manage that, please don’t say anything at all.
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Hi Steve, curious if you feel in the cases where their may be a biological cause, that the stimulant meds would then be the way to go in those cases?
“CDH2 mutation affecting N-cadherin function causes attention-deficit hyperactivity disorder in humans and mice
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Again, this would not be a “cause” of “ADHD,” as the large majority of those so diagnosed do NOT have this mutation, and there are apparently lots of people who have the mutation who DON’T get diagnosed with “ADHD.” There may be a VERY small subset of those diagnosed who have this problem, and I have no objection to folks testing for this anomaly and doing some sort of research on the tiny subgroup. But at that point, they are no longer diagnosed with “ADHD,” they are diagnosed with CDH2 mutation, which has to be made very clear in order to get any useful outcome.
As to stimulant “treatment,” as I indicated earlier, there is little to no evidence that using stimulants in the long term improves overall outcomes for the “ADHD” cohort, and there are notable adverse effects, including growth retardation, loss of appetite, and psychotic symptoms in up to 10% or more of users at “therapeutic” dosages. But one would have to look at the CDH2 subgroup and look at them separately to really answer that question. In my book, if there are risks and no real long-term benefits, I don’t care if there IS a biological cause, there is nothing to recommend assuming the risk of drugging kids without a clear and substantial benefit.
The other problem is who gets to define what is beneficial? If the teachers are telling the story, they might decide that being relatively inert and sitting quietly in a chair all day is a beneficial outcome. But what about from the kid’s point of view? Nobody bothers to ask what THEY find helpful in most cases. It’s an intervention for the benefit of the adults. As I said, why is there no “hypoactivity disorder?”
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Donovan.
What you see is schools being constructed to suit a world we/they built. Kids have to
be made to suit that world curriculum.
Kind of like NOT building ramps for wheelchair users, but instead doing operations on their
bodies to make them walk.
Let’s not change the environment, but try and change people instead. EVEN if the long term result is crap.
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I hope one day, soon, people will come to a better understanding of ADHD. If, IF, you only Knew what it is like and the changes that meds usually make, in one split second you would know beyond a shadow of a doubt, that this monster is real, it is damaging, it destroys children and adults who don’t know they have it, and with meds the changes are truly almost miraculous. We will never go silent. We will never give up. It matters little how long it takes. We who once were blind and now see will continue to shout from the mountain tops, there is help. There is a new beginning and YOU ARE NOT TO BLAME. You do not know what it is like to be put in prison as a child without any explanation. Your parents are disgusted with you and blame you for being lazy, unappreciative, no good, spoiled, on and on and you don’t know what you did wrong. Classmates laugh at you. Teachers remove you from class and you have no idea what you’ve done wrong and everyday in school is a prison and a torture chamber and you don’t know why you can’t learn and you ache and hurt and cry and die and get angry and hate yourself and others. You do not know. And no one is there to listen or to help.
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Thomas said.,”I know wonderful, ethical, hard working, compassionate psychiatrists.”
And? I know LOTS of people who are kind, caring, ect ect and do a LOT of harm in the name of “mental”/health. I think I prefer a mean nasty SOB shrink over a caring one. End result is, they ALL follow the same cow.
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No they don’t.
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What to say….every single drug that psychiatrists prescribe can be abused. Take for example Narcan… Addicts take it to lower their tolerance to opiates so the can get high. Stimulants get you high, there is no such thing as medicating someone for ADHD, your getting children high and making lots of money. Stimulants kill thousands every year, many stimulant users were prescribed AdHD, better known as Obediance pills as children. ADHD is caused by a lavk of EFA’s in diet, Cattle fattened on grain don’t make EFA’s…The used to be fed only by grazing on grass, this changed in the early 1900’s, cattled fattened on grains before slaughter made more money, this is when first cases began. Rehabs have a 1%success rate, people go to rehabs hundredsnof time and never get sober. But they make Rehab owners millions.
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Not exactly sure how we can normalize giving drugs to kids that are rudimentary ways of dealing with.
Do they know the brain, the mind, exactly how the person develops being on these forced drugs? No they know squat about the brain.
People that don’t know squat about the body should not be doling out drugs.
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Steve….totally agree. Except I will call it “drug use” not “medication” 🙂
“medication use which shrinks the very parts of the brain they say are smaller, particularly the cingulate gyrus.”
It would not matter what their little already outdated machinery shows them. I mean obviously the machinery is built and programmed/set up according to what a man thinks about the brain. It is rudimentary equipment at best.
And SO WHAT if my “gyrus” is smaller? What if there is NO brain at all? So what? The system for any kid is built in a very linear no thought put into it, manner. It IS going to see some “succeed” some mediocre, some “failures”.
If we set up to live up to a standard of athletics, do we then drug kids if they don’t measure to a standard? Less muscle mass, less ability to gain muscle, shorter legs, ligaments, tendons?
It is absurd to drug kids no matter the brain size or colour. Those imaginary standards are purely there to make psychiatry look like some kind of science for the good of mankind. They convince the teachers, social workers and the masses that have never entertained to “think”.
How is it that we have so many non thinking people? It has always been like that. The othering and overpowering the vulnerable is as alive as always.
Grown men and women raping kids brains to pretend to make them “better”. I am guessing that to be a teenager who reads and memorizes the psych courses, yet without a hint of all those other qualities of humanity in him, is called a success.
Drugging people with random brain/body changing drugs without their full and knowledgeable consent is criminal.
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You are right, of course, I should have put “medication” in quotes, or used the term “drugs.” “Medication” is a euphemism, especially when the drug is given for no discernible medical indication.
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I am not a fan of of diagnosing kids with certain personality traits with ADHD & prescribing them drugs while they are still growing. I also think these kids should be tested for other problems before even considering ADHD. I was diagnosed with ADHD in 7th grade at age 12 in 1995. Shortly before my diagnosis I began having trouble focusing when I was stressed & was having trouble sleeping because of night terrors. I was sent to be checked for ADHD after getting my first ever C on a report card. I did not want to get in trouble so I told the doctor everything I could think of to make sure he diagnosed me. I was diagnosed with ADHD & was put on Dexedrine. It did seem to help me with school but I hated how it made me feel when it wore off. I only took it on school days. I avoided taking it during the summers & on weekends by flushing it in the toilet. At age 16 it began to cause an afternoon “panic attack” every time I took it. I hid this fact from my parents because I thought I was going nuts. I quit taking it after high school & was prescribed Zoloft for my “panic attacks” my first week of college. It made them worse so I quit taking it & self-medicated until my dad witnessed one of these attacks after I turned 22 & sent me to be checked. When I mentioned to the doc that I also seemed to have vivid deja vu feelings before these attacks, I was sent for an EEG & an MRI. The MRI revealed I was born with a bilateral grey matter heterotopia & the EEG revealed that my panic attacks & night terrors were actually simple partial seizures. I was shocked.
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I am a person with adhd. I don’t think you realise how harmful what you’re saying is, my diagnosis and medication (Ritalin) were one of the best things to happen to me. It enables me to focus in a way I simply can’t without it and my fidgetiness is greatly reduced. I don’t feel different in it or not and my friends are almost always able to tell due to my behavioural differences. I understand you don’t trust professionals so take this antidotal experience.
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