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by anigbrowl 3475 days ago
That's because adderall is basically meth. I know it's very hard to grasp the idea of ADHD as a condition but there are lots and lots of mental conditions whose existence cannot be conclusively demonstrated or dismissed by EEGs and the like; we just don't understand the brain as well as we'd like right now.

speaking as someone who has struggled with ADHD since being a small child, having to assert the existence of a sometimes-crippling condition to people who demonstrably don't understand it very well is really, really insulting and I am sick of it. You don't have to believe in my mental illness but unless you have a superior psychiatric model to offer, then please stop stigmatizing it by questioning the reality of something you don't understand.

Do you tell people who are color-blind that they can totally see red (or whatever) color, insisting they're just not looking hard enough? Probably not, because you likely know we can explain color blindness by unusual differences in the retina. But we only gained that knowledge relatively recently in history. You would not have been helping anyone who was colorblind by telling them to 'look harder' before that discovery was made, would you? Then please accept that you're not helping anyone with ADHD by telling them they just need to focus harder/ learn better habits/ etc..

...if for no other reason than that when I'm trying to explain ADHD, having to listen to someone's poorly-informed opinion on a complex medical topic is really distracting. It's very tiring for me in a face-to-face setting to have to stand there waiting for someone to catch up with my substantive arguments. I don't say that to be rude, I just don't know how else to explain what it feels like; to me most people are slow and talking them is about as much fun as driving in a traffic jam.

1 comments

One of the problems is that our models for "physical" nonbehavioral illness don't translate well into neurobehavioral problems.

Something like ADHD is heterogeneous (the AD problems are different from the H problems), but not totally so. Also, attention and behavioral control problems are normally distributed, like the good ol' bell shaped curve. They're fuzzy.

So those who claim it is not a real disease are correct in a sense: it's not like color blindness, or having a missing limb, or Huntington's disease or something like that. They're also right that it's normal to have attention problems at various points in life for various reasons. However, those who claim it is a real illness are also correct: there are people who have very unusual levels or patterns of attention problems, and even though they're not qualitatively different, they're quantitatively different, and they have serious problems as a result, and are not just screwing around or lazy.

Behavior problems are often much more akin to something like blood pressure or weight. So, it's true that you wouldn't say "high blood pressure is a disease." However, it is a state of illness, might reflect a disease, and can lead to death and other problems. Same with excessive weight. Some pudginess is normal, but at some level it becomes medically threatening. The boundary is vague, and arguments about whether or not weight problems are biological or environmental or social or behavioral are misleading: they're all of the above.

The problem is that when people say "I see my neighbor with ADHD, and think they just need to realize that's a normal part of life," part of what happens is that they're assuming that their own experiences with attention problems are the same as theirs, or that their neighbor who might be exaggerating is the same as everyone else with an ADHD diagnosis, or that their neighbor who has mild but clinically problematic attention problems is the same as the person with severe problems.

My favourite analogy, that I can't believe doesn't come up more often in these discussions:

Having a degree of ADHD is like having a degree of nearsightedness. Yes, almost everybody has some. And you know what that translates to? Almost everybody wearing glasses. It's "normal" to be nearsighted... and it's just as "normal" to wear glasses to correct it.

Imagine if people with a small amount of nearsightedness were expected to just struggle through their life without glasses. Wouldn't that be weird?

Thanks for taking the time to write that - I'm going to recycle several of your points in future conversations. This is a frustrating topic for me as I've been through not acknowledging to myself that I had a problem, getting therapy, trying many different medications, investing time and effort to change diet and exercise habits and so on. Many things have led to incremental improvements but it's still An Issue, and explaining things to people from scratch really gets old.