Overdiagnosis is not a problem, but misdiagnosis may be as people are driven into the private sector by long waits, and sadly, missed diagnoses remain common —Tamsin Ford
Experts are warning that far from being over-diagnosed, people with ADHD are waiting too long for assessment, support and treatment.
I’m just sick of being unmedicated because there’s always a shortage of medicine or my insurance wants to be a fuck nugget. I can’t even function properly without mine and have severe anxiety over losing my job because of this shit. Fuck American healthcare, fuck insurance companies.
I have ADHD along with many other learning disorders and trust me, ADHD is really being over diagnosed. Children nowadays spend 12 to 15 hours a day nonstop doomscrolling short form content on TikTok and of course that is gonna impact their ability to concentrate and focus.
Many doctors who diagnose those things are old (in my country, for example, it takes DECADES to be allowed to work in the field) and are so old they’re just not prepared for ts so they just flag everyone as ADHD
I think that it is a combination of better diagnostic practices, diagnostic ambiguities, and ever popular exploitation. I know individuals with ADHD who fit the bill to me, and I know individuals who acknowledge they don’t have it and yet have a prescription. So, there is some unfortunate noise in the statistics, because of abusers.
The experts whose jobs are dependent on over-diagnosis.
the first author on the paper is Samuele Cortese, he’s a tenured full professor who studies sleep disorders, ADHD, and neurodevelopmental disorders - literally nothing about his job is contingent on over-diagnosis of ADHD …
The loudmouth who doesn’t really know anything
This thread somehow brought out some of the most misinformed, boomer-brain takes imaginable and comes dangerously close to anti-intellectualism. We can all agree that labels can be reductive and unhelpful, but as someone with a neurological disability, seeing people debate whether a disorder that makes it incredibly hard to enjoy my life is even real or not is fucking horrible.
Well you’re a severe case, and these people likely are talking about mild cases.
The moral panic of overdiagnosis comes from conservatism’s obsession with hypernormalcy. Basically unless your really-really failed to be normal, you’re not allowed to stray from it, and even then, it would be good if you were normal, because they like the virtue of normalcy, and also thinking is hard, and also also change is bad.
Yes this explains modern transphobia a lot. Some admitted, that it has to be “all undone”, because people stopped trying to be normal first and foremost. This also partly explains gatekeeping in fandoms.
Any diagnosis means someone might demand something of them. It might be consideration, tax money, or some other inconvenience like actually having to apply thought and accommodation to anyone not fitting their idea of conformity. I agree with where you’re pointed, but it isn’t a “moral panic”, it’s their unwillingness to expend anything of themselves for others.
Why is there never any nuance in these discussions? We can both believe that under-diagnosis occurs, and that over-diagnosis occurs. 20% of all pupils in the UK are now classified as so disabled that they require specialised assistance. “SEND” assistance for this can range from free taxi services to and from school (which recently reached £1.2 billion), to support payments, to special assistants in school. The number of ECHP students (those with the highest needs) increasing by 71%, from 253,679 in 2018 to 434,354 in 2024. SEND spending is out of control.
So what happened, exactly? The average child disability rate in Europe is 4.6%. How did the UK end up with 20%? Did the UK suffer a catastrophic nuclear event? A war? Famine? None of the above. It is clear that categorisation has become EXTREMELY loose over time on average. This does not mean that there are not children who are struggling to get diagnosed with ADHD. However ADHD and autism are a spectrum disorder. It is not binary. The UK has drawn the line far closer to the normal side of the spectrum than any other nation on Earth. If costs continue to rise at this rate, it risks destabilising the entire health system. Public sentiment will shift, and we risk undermining children getting any diagnosis at all.
IMHO, this requires at least two tactics at the same time. 1) Invest sufficiently into diagnosis resources. Stringing parents and children along for years while they wait in the system can make the issue much worse than it needs to be. 2) Draw the diagnostic line closer to where the rest of Europe does it. This will mean far fewer children are diagnosed with disabilities, but those who genuinely have a disability are treated much faster and actually receive the resources they need.
This will mean far fewer children are diagnosed with disabilities, but those who genuinely have a disability
You’re going to have to elaborate on what a genuine disability is there chief. Let me help you out:
- lead poisoning.
- microplastics
- plastics in general
- glyphosate (round up)
- air pollution
- mosquito spraying
- etc.
All of those things are at lower levels than the 1970s.
There’s less microplastics now than in the 70s?
Yes.
I’m seeing a lot of people here being supportive of individuals with disabilities and that’s awesome because ability is a temporary condition. We come into this world disabled and most of us leave it disabled. That being said, when you look at the number of Ivy League students in America who have these disabilities, it is very, very questionable for to say it is not being over diagnosed. Overall they’re probably trying to do a good thing, but there is a huge amount of abuse in this system and that actually leads to disabled people being overlooked and instead pharma companies just pursue a profit. Over diagnosis leads to under diagnosis as unintuitive as that sounds.
All ADHD means is that someone doesnt fit into the corporate america greed driven lifestyle. In my opinion, its not natural to live like that anyways, so I dont know that ADHD is real in the way we think of it now.
We shouldnt be trying to conform every person into the same tiny box, because we are all different.
I’ll tell my friend that her Rejection Sensitive Dysphoria is actually fake and she’s just applying the Corporate America Greed Driven Lifestyle to her close relationships, that’s going to be great news for her.
ADHD is a lot of things.
Are we calling RSD ADHD now?
I get it, everything is ADHD. Makes sense.
RSD is a very common symptom of adhd because the effect of adhd on the brain creates RSD by default. There are other ways to develop RSD but it’s a symptom of adhd.
Its similar to how bleeding is a symptom of a cut, there are other ways to bleed but a cut will do it almost every time.
Well now I want to know how else we can bleed without a cut.
Well a cut is a very specific case of a wound. You could for example get a laceration without being cut. Or you get a nosebleeding from dry air or you could get an aneurysm and get internal bleeding
Well then you definitely don’t understand it I guess.
Maybe, I dont think anyone does. I do know the people who think they know for sure the problem and the solution are wrong though. We can keep medicating ourselves though, I’m sure the research is sound and its all been figured out.
It might have a lot of unknowns still, but it’s been figured out a hell of a lot more than “you don’t actually have a differently functioning brain, you just don’t subscribe to American Greed ™️.”
Well I don’t think people are coming to this thread looking for medical advice, so I would hope no one takes anything anyone here says and applies it to their lives without criticism.
I’d be likely to change my mind if someone could show me evidence that ADHD happens in all human populations to some degree. I have doubt’s that there are cases of ADHD among uncontacted peoples, for instance.
I can agree with much of that. I’ve seen people do this whole song and dance with autism, similar to saying people don’t have ADHD because they’re not annoying enough. Then they find out that autism is likely part of a cluster of mutations that always occur with certain deeply-disabiling genetic disorders, but can also stand alone. Self-diagnosis by people left out in the cold should not be necessary. A good treatment system needs to evolve to fit patients’ needs not the inverse lol
No shit. Think how many prisoners just had untreated ADHD, so many preventably ruined lives!
Why? Because the sadistic fucks realized they could easily get away with it, to feed on a prey that no one would or could defend, because ADHD does not easily show in brain scans.
We need objective tests, and to not do the test should be a crime that the parents should go to jail for!
parents should go to jail for!
To get my son’s ASD and ADHD diagnosed I’ve spent over $5k, tens of hours of calls, interviews, meetings and sessions) just in diagnosis costs (and about $21k in occupational and psychological support) in order to prove the bleeding obvious to the state in order order to have him placed in a support school.
And that’s whilst supporting his daily needs and working full time (and God knows how much OT).
It’s not an easy road. The costs are prohibitive and I live in a country where neither private health nor the “universal” healthcare covers the cost of specialists and treatments.
It’s no surprise it’s underdiagnosed let alone treated.
And that’s whilst dealing with my other kid suicide attempts and my partners chronic health condition (lots of neurological specialists).
It’s a hard road
That is why I suggest it be a state-thing, where you are obligated (and covered).
EDIT: Also, how insensitive of me, sorry you had to go through all that, let’s try and make sure no one has to go through it ever again.
tens of hours of calls, interviews, meetings and sessions)
Only tens? Luckyyy… I’d probably be able to clock hundreds just on transit and wait times alone.
It’s the left-handedness chart all over again.
I spent most of my life undiagnosed, because it used to be believed that only boys could have ADHD. But I knew, and was formally diagnosed as an adult only at the insistence of my partner.
Like many adults I just got recently diagnosed in my mid 30s.
For me it was that I can’t have adhd because I was good at school and uni. Then I completely fell apart when I entered work.
I had to go through depression and burn out and bore out and more. Eventually someone said I could have adhd and just been able to deal due to high IQ.
Turns out that’s what it was. I’m really good at learning new stuff. So school and uni. I really suck at repeating the same shit all day. So work. Welp. Helps to know.
Wow, this could have been written by me. I got diagnosed last year in my early 50s after my 4th burnout. I’m currently assessing career options and try to work out what to do next. Unfortunately one has to make money to survive, I’m just trying to find something that won’t break me again. Bonus points if it’s interesting too.
This is where I am too, in my late 30s. Had a really bad year last year reaching burn out and ending up with panic disorder 😵 I wonder if changing to a job that’s more systematic would help, but also the boredom kills me and I need money. I hope you figure it out!
To my understanding it shows up differently in women. What were your symptoms? Also some women get diagnosed with it during perimenopause.
Perimenipause is an absolute nightmare. It makes ADHD much much worse.
If ADHD is common enough to be prelevant in 5% of population… Then to me it seems like its not something we should be drugging people for, but instead adjust the lives to it?
I mean we don’t give “righ-handeness” drugs to left-handed people. We give them left-handed scissors.
Hang on guys, medical intervention is out if an ailment is common enough. Let’s un-laser those eye surgeries and smash those glasses! Time to adjust!
“ 12.0% Estimated percentage of the U.S. population with diabetes”
So, should diabetes not be treated?
10% of women have endometriosis. Would you take away their pain meds? You can make their work life easier (more sick leave) but then it still affects their personal life.
ADHD is so much more than “can’t pay attention in class”. It affects your personal life too. Usually that’s a deciding factor for getting meds.
Well, the real problem is living in a capitalist society that expects everyone to be a good little capitalist and work a 9-5.
The problem isn’t having adhd, its that society expects me to function in a certain way, and the fact that I don’t makes them want to change how I act.
There are other traits I have from trauma that are considered positive by society, so they don’t give a shit, and in fact encourage those behaviors.
Oh, Jesus fucking Christ fuck off with this take
My problem isn’t my job, I am completely fine with that, it’s the way I barely function in my personal life, and a lot of that isn’t related to the structure of our society at all. There could be less friction in a few places yes but that wouldn’t completely fix my issues either.
Sorry but no. 9-5 is hell, but even without that life isn’t pretty. A huge one is rejection sensitivity, that pretty much only affects personal life. Can’t really ask people to accommodate for that.
Thank you for explaining adhd to me. I just wasn’t getting the disorder I have until you came along.
I kinda didn’t? I just don’t buy the “capitalist society is built for neurotypical people”. It’s built by psychopaths and most working class people survive in it, not many are thriving. We’ve got a harder time in it but ADHD would still suck in a healthier society.
My friends and partner are super understanding about my ADHD, I’m unmedicated and there is really no big issue. If you have a culture of understanding and tolerance, it doesn’t feel like a disability. I wish for you to experience that one day, it really is quite amazing.
Left-handed scissors is the perfect analogy. But drugs can be left-handed scissors.
It’s really not.
Not every adhd is equally severe nor do they all affect the same parts of people’s lives. I’m happy this works for you but it does not mean it works for everyone.
I have not said that there is only one possibility. Obviously the tools given need to be adjusted to the individual. But the same way I am not allowed to make general statements and dismiss yours, you are not allowed to dismiss mine. If you treat ADHD less like a disease or something bad, I’m sure it will generally improve outcomes, even if the actual severity is different across people.
If you have a culture of understanding and tolerance, it doesn’t feel like a disability
This is you extrapolating your personal experience to dismiss the difficulties many face that have nothing to do with tolerance and understanding and everything to do with their brain chemistry undermining their social life and ability to engage with hobbies.
Yes. Let’s take your personal anecdote and make it policy. People can just fix the environment to be accepted, change the world for the better and stuff like that.
Your ADHD is not the same as another persons.
“Understanding and tolerance” is an individualized “solution” for decaying welfare states that have lost sight of any political solution other than begging their masters for treats that have been in decline since the end of the Cold War.
Endometriosis is not something that shares symptoms which can be caused by kids being chronically under slept AFAIK. U.S. psychiatrists and therapists are completely incompetent and will not check for basic sleep issues and instead just drug kids. I’m all for finding comprehensive treatment for executive dysfunction of all kinds, but I just don’t think methylphenidate and amphetamines etcetera are suitable for as many situations as believed.
Yes, that’s exactly what the article is about.
Overdiagnosis is not a problem, but misdiagnosis may be as people are driven into the private sector by long waits
No thanks, I’d like to be able to think with a clear head, and do something with my life, not be stuck in one of like 6 suitable work places.
It’s just speed, just stimulants. Caffeine is an example of legal self-titration. When done properly, the doses are not high and it can really help. IMO meth-heads are a symptom of disproportionate availability of the real thing (only sometimes coca-cola).
Having said that, I am not on board with widespread use in developing brains, much as with caffeine
It’s not just speed, just stimulants.
Isn’t it strange how we discovered a lot more stars after inventing telescopes?
Obviously there was an unrelated increase in stars born at that exact time.
Telescopes caused autism.
I have an ADHD diagnosis, and I do think this is 60% just being better at diagnosing it, but I do also believe ADHD is sort of on the rise.
There is an incredible book called Scattered Minds by Gabor Maté, which is the significant book on ADHD in the same way that The Body Keeps the Score is for trauma, which delves into the potential ADHD causes beyond it being hereditary.
Of course modern dopamine-consumerist culture is part of the problem, but it largely makes ADHD symptoms obvious, and various unmet attention needs in early childhood are significantly more linked to developing ADHD, not to fault the parent or other caregiver who may not have the availability or ability to provide that attention due to modern societal demands. It’s been some years since I read it but I really remember one part clearly; it’s basically impossible to test nature Vs nurture in separated-at-birth twins because the act of separating twins at birth spikes the likelihood of having ADHD so much.
But honestly I think the largest contributor to increased ADHD cases is not that we’re better at diagnosing it, it’s that modern society increasingly warrants its diagnoses. 12000 years ago ADHD traits weren’t a disorder, as much as having different physical strength or height to your peers isn’t. Modern capitalist society demands an efficiency of its workforce and ADHD is an inherently inefficient trait, and therefore suddenly warrants treatment.
Don’t get me wrong, medication is incredible, and has turned days I’ve barely been able to get out of bed into productive days, but that’s still valuing being productive.
Erase capitalism from this and it’s still “days I’ve barely been able to get out of bed to hunt/reinforce important relationships/create art”. Inability to focus, relentless forgetfulness, rejection sensitive dysphoria, much of the ADHD experience interferes with non-“productive” life just as much as a job and shit.
Are you under the impression that everyone was required to be functioning at 100% at all times in order to survive or be a meaningfully-contributing member of a society? Because that is so very very far from the truth. The actual labor involved in hunter gather societies amounts to a few hours a day for each individual on average, but that doesn’t mean every individual had something that needed to be done every day in order to be a valued member of their society. Most tasks didn’t happen every day, and those that did didn’t require all hands to do.
Even after the agricultural revolution, many months of the year were much slower, allowing recuperation to prepare for the labor intensive period, a schedule I’ve liked in the modern era similarly; 3-6 mth contracts followed by 6-9 mths of vibing and living off what I saved up during the working phase, supplemented by a variety of projects I find compelling to keep my spending very low or sometimes earn a bit of side money. I find it works very well to keep my adhd symptoms from being crippling during the active work phase, and I’ve been unmedicated. Then I take a month or so to ooze into the ground to recover from the burnout, and I become productive in my personal life again. It’s a decent compromise if money has to be involved, but it’s sometimes a financial struggle because we don’t value paying people properly right now, an entirely late-stage capitalism problem.
Beyond that, knowing a lot of things about a variety of specialties and being curious enough to learn, something ADHD people tend to excel at, makes for a variable worker who can be slotted in to fill different needs for others who were unable, or simply when the labor demanded more bodies. Jack of all trades were also incredibly valuable back before modern transportation, especially for smaller communities. Couldn’t really get an actual expert without months of travel if one didn’t just happen to be around. So they got to feel valuable, like they were actively contributing to the social fabric, because they were, and got to do things that were actively interesting them, and just stop doing those things if they stopped being interesting. Having that sort of self image as well as flexibility would be intensely motivating, at least for me, and help overcome a lot of the inertia and sensitivity.
I genuinely do think a lot of the dysfunction we face from adhd has to do with how we structure our modern societies to optimize for efficiency and shareholder value over the wellbeing of the people. I mean when even non-adhd people are facing extreme burnout and excessive levels of stress, anxiety, and depression, what chance do we really have without meds?
I’ve always liked the left-handedness analogy, but I am definitely stealing the stars one as well. It’s very pithy.
This is actually the most apt analogy for the whole “sudden increase in diagnosis” bullshit line that anti-vaxxers and anti-science people continually vomit out.
A culture where people believe ignoring your mental health issues makes you more strong, more independent, more of a role model… They think people have been fine for generations, and all of a sudden “fine” people are now being diagnosed with all kinds of problems.
I can understand their logic when I first understand their mistakes.
I’m in no way an anti-vaxxer or anti-science (I’m a researcher myself). I still think it can be justified to look closely at the large increase in, and volume of, various mental disorders. First of all: There’s no doubt that a lot more people are being diagnosed due to better diagnosis tools.
However, a major difference between psychological and somatic illness is that the divide between sick and healthy is (typically) a lot sharper in the latter case. Either you have an injury or infection, or you don’t, and we can measure that. In the case of e.g. depression or ADHD, there’s a much wider gray zone from e.g. “healthy person having a bad day” to “clinically depressed”.
The point I’m getting at is this: When a certain percentage of the population is diagnosed with a disorder, you have to ask whether we’ve started diagnosing ordinary human existence as a disease. Alternatively, you have to start looking at a systematic level for why an enormous portion of the population has a certain disorder. Where that limit should be is an open question, but I would argue that when something like 10-20 % of the population has a specific disorder, we’re no longer just looking at individual cases of disease but rather at (a) the possibility that the criteria for diagnosis are two wide, so we’re catching “healthy” people with it, or (b) we have a society-level problem (e.g. an epidemic).
I know of areas with ADHD-rates around 20 %. For a somatic illness, we would never let that kind of infection rate pass without taking a closer look at what’s going on at the societal level.
You cannot equate ADHD and spectrum mental conditions with disease. For one they are not a disease, you cannot catch them and you cannot give them to other people. They are the way people’s brains work. People are just born that way, same way people are born gay or trans, smart or dumb, handsome or ugly. You can’t have an outbreak of ADHD or autism the same way you have an outbreak of the flu or covid.
People have been searching for environmental factors for autism, ADHD, depression, and all kinds of mental conditions for years. Other than crackpot anti-vaxxers and people like RFK Jr who try to throw life saving vaccines and common medications like Tylenol under the bus with literally no literature whatsoever to back it up, there has been no links discovered. Genetics and fetal gestation is weird and people just get born different sometimes. We as a society need to accept that and stop thinking these are diseases that need to be “fixed”.
You cannot equate ADHD and spectrum mental conditions with disease.
I agree, the only way I meant to compare them is that we diagnose and treat both with medication.
We as a society need to accept that and stop thinking these are diseases that need to be “fixed”.
I also agree 100 % with this, and it’s part of what I’m trying to get at with my “option a”. As of today, there are regions where over 20 % of the population are diagnosed with, and treated for, ADHD. At that point, I’m asking the question if we’re creating a problem by treating something that appears to be within the spectrum of how “normal people just are” as a problem that needs to be fixed. My point is exactly what you’re saying here: If a large fraction of the population has this “problem” that needs to be “fixed”, haven’t we just gotten to a point where we have a too narrow definition of what is “normal” and “healthy” human behaviour? Shouldn’t we in that case rather be looking at how we can structure our society in such a way that a larger span of the population is capable of functioning in it without medication, rather that trying to force everyone to conform to the same, ever narrowing, mould?
The minority will never be adequately provisioned for without access to intervention. In theory, that can instead be legal or political. Many schools or workplaces put in provisions for ADHD, mostly because of laws. Society does have a “problem” that needs to be “fixed”. The “mould” problem is a deliberate authoritarian tool, beyond the scope of this discussion.
But you need to understand that this is access to medication, nobody is forcing this down our throats. If people want it, it exists, and it helps reduce scary mental health (we’re talking suicide), ableist restriction of access to interventions is super dangerous.
I honestly have the impression that we agree on pretty much all points here but that we’re talking past each other. I agree to pretty much everything you’re saying, and I’m all for helping as many people as possible live as good lives as possible.
What I’m trying to say is basically that problematising the large volume of (and increase in) psychological diagnoses can be valid, and doesn’t have to be founded in trying to downplay those diagnoses. To take a very concrete example: Kids that are disposed to growing very short or tall can be offered growth (blocking) hormones, such that they grow to a “more normal” height. Today, very few kids are offered, or take, these hormones. Now, let’s say some area suddenly saw a rapid increase where 20 % of kids needed growth hormones to grow to “ordinary” height. I would say that we need to figure out what has happened: Is there something about the environment that has caused stunted growth to become ver common? Has the window for what is “normal” gotten narrower?
Of course, in this example, it’s very was to compare to historical records of human height. The same isn’t true for mental disorders. That doesn’t mean the same discussion isn’t worth having- at its core, this is a discussion about how we can make society as good as possible for as many as possible. That also involves discussing what should be treated as a disorder that disproportionately makes people’s life objectively worse, and what is within the “normal” range that we should rather build society around accepting.
Yeah look if we really are seeing diagnoses suddenly rise, and it’s not just “a better telescope”, maybe it is worth considering exploring environmental causes, diagnostic criteria, societal tolerance of certain traits etc. That’s fair.
But idk about the height example. People can’t self-medicate height. For adhd, people absolutely self-medicate caffeine, nicotine, illicit stimulants, grey-market ADHD meds, etc. That alone suggests there’s a real functional problem exerting pressure that needs immediate addressing. Stimulants do not work the same way on people with adhd.
What concerns me about your responses is that “investigating why diagnoses are increasing” is used all the time to cast doubt on ADHD itself. Obviously there’s a substantial body of neurological and clinical evidence that it’s real, and dramatically affects attention regulation and executive function.
So I think people who legitimately believe in it falling for this mainstream theatre, risk letting us all slide down the slippery slope to believing the condition is mainly a societal construct and we should limit access to medication, whilst people top themselves.
The point I’m getting at is this: When a certain percentage of the population is diagnosed with a disorder, you have to ask whether we’ve started diagnosing ordinary human existence as a disease.
Its pretty mich a known fact that autism and ADHD were a somewhat beneficial trait in our hunting and gathering era. Hypervigilance makes you really good at spotting prey or predators and unsatisfied curiosity pretty mich forces innovation over a long enough time. The side effects that make life aliving hell in modern society weren’t nearly as detrimental back then. People lived in more communal small tribes and being a bit weird didn’t mean you get cast out and left to die alone.
Over time it became less and less useful. When the industrial revolution came along and everyone was supposed to let go of their individuality to instead work 12+ hour shifts pretty much only the negatives prevailed.
So yes, we are diagnosing a normal part of human existence as a disorder because in today’s society it is one. Mind you, its not diagnosed as an illness, something with a cause and potentially a treatment, its specifically diagnosed as a disorder, something that disrupts normal physical or mental function. It doesn’t really matter which genetic marker is the reason for your specific case of serotonin deficite that leads to the inability to concentrate and keeps your brain on 120% to compensate. The symptoms and their treatment are the same either way.
I mean, wouldn’t something like tuberculosis have an infection (not necessarily symptomatic) rate of 20% globally?
To try to explain the increase of stars in the universe without it’s correlation with vaccine rates is just disingenuous. \s
Everyone knows that if the nebula takes paracetamol during pregnancy it increases the chance of K-type star creation.
The nebula: “Cut me sing some slack, i had an astronomical headache”
I will just add one thing perhaps in contrast to this. But inasmuch as I’m offering an analysis of how people think about this, please don’t infer that I agree with them
With some things, ADHD being one, I think the grumbling we hear is not really that there can’t be all these new cases suddenly. It’s that we’re pathologizing something that’s a normal part of being a kid.
Again, I’m not saying ADHD is like that, just that “no one had this when I was a kid” isn’t the most on-point way to characterize people’s incredulity about ADHD. They think we’re over diagnosing it because we want to turn something into a problem, and turn boys into girls, and yadda yadda.
It’s a bit of that too. And also “our attention spans have been stolen”. It’s a mixed aetiology.
My cousin was diagnosed by a brain scan. She signed up to be part of a clinical trial for something else, got kicked out of the trial because her fMRI showed she had ADHD.
So if we can literally scan someone’s brain and diagnose them from a picture instead of all these vague “describe your symptom” guessing… why don’t we?
You can’t get diagnosed with an fmri alone. It’s just one sign, a weak one, so you’d need the professional doing questionnaires anyways. They are way cheaper and faster (in terms of waiting times) than fmris too. Might as well skip it.
Money
It’s quite costly to run an fMRI. Not needed if you can get the same results more or less from a questionnaire.
I prefer objective, unqestionable evidence, since I tend to self-sabotage I guess.
In my professional experience, it can be hard to tell between ADHD symptoms and CPTSD symptoms. The checklist is not a great way to diagnose people. We usually do a lot more assessments, I also use a computerized test to measure reaction time and error commission.
I wish we (therapists) at least had the option to order an MRI or recommend a doctor orders one in difficult cases (I can do the latter but they will just laugh at me).
Aren’t a lot of ADHD (and autism) symptoms trauma responses because of being different , especially the social stuff?
I wish we (therapists) at least had the option to order an MRI or recommend a doctor orders one in difficult cases (I can do the latter but they will just laugh at me).
God, that’s awful. The most common sense thing to do there is is to use what’s availiable (fMRI) when it is, and if availability is the problem, fill the gaps with questionnaires - those who you’re sure about might not need an fMRI, but others might. Which you, as a person who’s supposed to sign off on the diagnosis, should be able to order.
Wait, is there an actual chance to “see” ADHD in an MRI image? I was under the impression that we can’t do that (yet) and the only way to diagnose was through questionnaires, attention testing and such. That’s what I was told by the doctor who ultimately diagnosed me two years ago
Like @yucandu@lemmy.world said, it would need to be an fMRI, which is primarily used in research as far as I know. And while it alone could not tell you definitively “this person has ADHD,” it could help rule out other conditions (like TBI, which can also present similar to ADHD). Ultimately, your doctor is right that a standard MRI cannot diagnose it.
I like to combine the checklist with interviews (like DIVA, Diagnostic Interview for ADHD in Adults) and computerized continuous performance tests, like QBTest. Of course, there is also a lot of observation and sometimes even asking humorous questions, like “Do you have The ChairTM at home?”
The ChairTM
Thank you very much for the insight! I have had The Chair for as long as I can remember :)
Yes except the chair is the floor 😭
Wait, is there an actual chance to “see” ADHD in an MRI image?
Only fMRI, which is different, and even more expensive. It’s basically the same as asking you a bunch of questions but then seeing which parts light up. Brain can’t lie.
Do you know if there any studies on whether the effects of the medicine used for ADHD could have similar positive effects on people with CPTSD?
Great question! To my knowledge, they are just starting to look into it, but with PTSD specifically, not CPTSD. There is this case study (n=1) and this pilot study (n=32) that show promise. They are recruiting people for more testing.
Preliminary evidence shows that it does help - and it makes sense. If cognitive deficits from PTSD are a result of an impaired executive function, then stimulants would help with those particular symptoms, much like in ADHD.
Here’s the thing though - the US healthcare system still doesn’t even have CPTSD as a diagnosis, so there is not too much research happening on the topic here. Considering how ADHD (especially in women) is also very understudied, there are so many variables we just don’t know or understand.
If you are interested in novel treatments of PTSD, I also recommend looking into blue light therapy. There is some promising results showing a reduction in symptom severity within 6 weeks of daily 30-min blue light exposure in the morning. Here is a systematic review that looks at 4 studies.
Ya, it could be better. Maybe a compromise would be to go with EEG machines which are less costly and can probably still differentiate fairly well (maybe).
I would be down with that as long as it’s a viable way to diagnose (I don’t know enough off the top of my head about it).
Basically anything other than self-report and the clinician’s opinion would be nice.
It’s also worth noting that ADHD, as a condition, is mostly a Gordian knot of maladaptations. Built up over childhood (and beyond). While there are a lot of commonalities, you need to do a detailed investigation to pick out what bits are a problem to the individual.
If you’re going to go through that process, then you might as well not tie up an MRI machine for no reason.
Drugs can treat the base problem, but don’t work well without the follow-up care to repair the behavioural damage.
An mri would kill me because my diet includes a tablespoon of 2mm iron pellets daily.
Is this for your shotgun arm
All of this applies to Autism, as well.
Indeed and I still don’t get my diagnosis because I can look people in the eyes and am friendly.
(yes, some ‘expert’ actually said that as a paid diagnosis. This is supposed to be first world but hey… Nobody gives a fuck)
Ugh I’m sorry to hear that, it can be incredibly frustrating and discouraging to seek a professional just to have them dismiss and misdiagnose you.
I wish you the best in your journey to get the answers and help you need and deserve. Please keep looking, the right fit has to be out there.
Thanks! I found most of the answers on my own and all situations in the past I was puzzled about my own behavior ist perfectly clear to me now (esp. reactions due to overload situations and masking).
I actually have no direct use for the diagnosis; it would only be the last confirmation, taking a huge load off my shoulders and providing that last bit of rest. However, I myself and my surroundings don’t need the approval to know.
