[gmadsen]

ADHD is diagnosed by the occurance of defined symptoms. like most things in the DSM. Many things can manifest psychologically to give the collection of symptoms. Its not purely or even needs to be structural differences in the prefrontal cortex

[krono]

The specific set of symptoms and the diagnosis they would lead to according to the DSM, are in fact rooted in a set of interconnected structural neurological differences in the prefrontal cortex.

The ability to recognise when someone might be thirsty, doesn't mean dehydration no longer exists. They go together.

[flir]

> in a set of interconnected structural neurological differences in the prefrontal cortex.

Can you prove that? Because my understanding is that ADHD isn't diagnosable by imaging the brain. If there was a structural difference, presumably it would show up on scans? Or at least post-mortems?

[throwaway60707]

My brain exhibits significant differences on EEG that the neuro-doctor said are suggestive of ADHD or ASD.

AFAIK it is visible on fMRI, but doing so is incredibly expensive and taxing on the person - you'd need to keep them in the fMRI for very long time, repeatedly, and watch them doing different tasks.

But I've seen papers about this where they did that with some people. The brain simply doesn't fire up like a normal brain does. The structural difference itself might be too small (on cellular or even molecular level) to see with current resolution, but the effect is clearly visible - as well as that medication makes the brain behave more like normal brains, as opposed to normal brains on stimulants (which puts them into overdrive).

Quick search:

- https://www.medicalnewstoday.com/articles/315884

- https://bmcmedimaging.biomedcentral.com/articles/10.1186/s12...

[flir]

Oh, that's interesting. Thank you.

[acchow]

ADHD brains operate differently, which is clearly visible on imaging. However, this is not sufficient for a diagnosis because you still need impairment in your life.

[throwaway60707]

The diagnosis is a continual process. My psychiatrist first did many questionnaires with me to determine whether it might be ADHD or something else, and then prescribed ADHD medication (first Strattera but that gave me significant side effects, now I'm on Concerta).

But this doesn't end with the prescription - I visit the doctor every 2 weeks and he continually questions me about the effects the medication has on my life, and tries to see whether it matches the expected outcome for a person with ADHD. If it did not, they would change the diagnosis.

In my case, everything fits - the stimulants make me slow down or even sleep, I'm less angry and overall more emotionally stable, less impulsive, and finally able to work on a task that I choose for an extended period of time. If this was not the case, I'm sure the doctor would be looking for a different diagnosis.

[btilly]

I prefer the procedure from 20 years ago. Where ADHD was defined by having the systems, and then testing every other thing that it could be.

It took my son 2 months to be officially diagnosed. A real pain? Sure. But a heck of a lot better than the situation today where kids with chronic sleep deprivation are given an ADHD diagnosis, then sent home with a medication that masks the sleep deprivation while giving them insomnia.

[throwaway60707]

My ADHD medication (yes, stimulants - and a pretty high dosage in my case) causes me to slow down and sleep. Then I wake up about an hour or so after taking it and am a normal person. I was diagnosed as an adult, but this was always the case for me - as a teen I drank 3 redbulls in the evening and went to sleep, because I finally could as my brain stopped keeping me awake with millions of thoughts.

[sgarland]

I would drink about a pot of coffee per day as a teenager, throughout the day. Never had any impact on my sleep either, which I always assumed was just tolerance.

Turns out once medicated, if I have caffeine after about 15:00 I’m in for a bad night. Brains are extremely weird.