To think that the ADHD label is masking other things in society?

[comoatoupeira]

Disclaimer this is NOT about being skeptical ADHD is a thing, my brother is diagnosed with ADHD by a doctor as well as a close friend of mine.

Through my job I have been doing a lot of research about the impacts of tech and social media and so on on young people, and also on the elderly who are becoming the first generation of elderly people who are high technology users.

It has all been making me see so many parallels between behaviors associated with ADHD and behaviors that are becoming more and more difficult to control because of the attention-stealing environment we are in, and other aspects of society today like consumerism always available in your pocket, long working hours and both parents working, the difficulty of taking those restorative breaks that are what helps us focus and take a step back.

I'm just feeling like we are looking at some milder cases of ADHD too much as an isolated medical thing rather than a wider societal ill.

I feel like the same thing has happened with depression, framing it as some sort of imbalance that can be fixed by drugs, when it's so much about the societies we live in.

I feel uncomfortable about all of these labels being used especially by young people with mild cases of things, it seems to imprison them in a fixed identity or frame them as having something wrong with them, when none of us a perfect and we all have strengths and weaknesses, and life is about living with them and being open to change.

What do you think?

Plenty of women also hurled themselves into battle.

There is also huge overlap between the impact of developmental trauma/disrupted attachments and ASD.

And this is the difficulty. Trying to categorise and label human experience in terms traits, character, thought and feeling patterns and behaviours, is like trying to name all possible colours of the rainbow.

Of course there is blue, but some blues have a tinge of purple, or a tinge of red etc. it’s actually infinite.

I’ve spent 30 years fully immersed in learning about, understanding and working with those colours.

The human experience is so complex. You can’t really reduce it down to one or two words.

For me though, I’d love to see a world where you don’t need a label or a diagnosis to be valued, validated, accommodated and to get the help/support/intervention you need in order to get the most out of life.

I’ve found (anecdotally of course) that those with ND conditions nearly all have a crossover of certain behaviours, so depending on your focus a child could be diagnosed autistic or ADHD, or even Tourette’s.
My instinct is to suspect that they’re all manifestations (dependent on personality, upbringing, childhood events and school) of a very similar root cause.

Except trauma and autism also have their own traits that don’t meet the overlap and are needed for diagnosis. An autism diagnosis also needs a lot of developmental history going back to very early years and any possible trauma would be examined.

Haven’t RTFT OP sorry but I completely agree with you.
I wonder if children/adults presenting with symptoms of ADHD, for example, might have (in milder cases) symptoms of ‘too much tech’ and seeing as there is no definitive test for ADHD, that is can be mistaken for that.
So, actual cases of ADHD are what they are. Cases of too much screen time and social media can be fixed.
In the same way that having a runny nose doesn’t necessarily mean you have a cold, you could have allergies. Does that make sense?

I also wonder about ASD… you see a great number of very young toddlers with their noses stuck in screens the whole time while out and about with parents. Babies and toddlers develop their social skills by interacting with the world around them and watching how other people interact with each other. They may smile at another adult, for example, and get a smile back. They may watch their parents interacting with the person they’re order their coffee from etc. these micro interactions are all opportunities for development of social skills. They cannot take place if their nose is buried in an iPad the whole time. It just doesn’t compare.

No it doesn’t because there are many adhd traits not explained away by too much screen time.

I agree that it’s easy for a challenge to the medical model dominance can run the risk of it sounding like ‘so it’s not a real problem’ or ‘it doesn’t exist’ and that’s not at all helpful. That is not it all.

It’s that a medical model lens has been applied to understanding and supporting/intervening for so long (due to a complex history that has economic, social and cultural influences) that we find it hard to imagine a different lens. So if it’s not a diagnosis then it’s not real? No. The experience and the struggle is absolutely real. It’s just we could understand it and work with it using a different lens. Or rather many different lenses.

Medical diagnoses of psychological distress or neurodivergence have had some clear benefits, without doubt, but there are downsides.

And, there is an alternative. If we wanted it.

A collaboratively developed formulation that considers genetics, biology, psychology and social context is the alternative. That is unique and bespoke to that individual but draws on the best available research - including medical research. That formulation, along with the persons preference then drives intervention. That can include medication.

Except the adults today being diagnosed didn’t grow up with iPads in their faces. There was no tech in the 70s, 80s, 90s and very little in 2000 and up when my dc were born.

For me though, I’d love to see a world where you don’t need a label or a diagnosis to be valued, validated, accommodated and to get the help/support/intervention you need in order to get the most out of life.

People with even the most profound mental illnesses struggle to get the help they need. While I agree to an extent (I wrote several essays on the merits of diagnoses at university), they're necessary to prioritise by need and to ensure appropriate treatment. Somebody with bipolar disorder could present with depressive symptoms. Without the diagnosis, they could be given antidepressants which could trigger mania, for example. Somebody with ADHD could present with racing thoughts and be prescribed antipsychotics. How could new treatments be developed if researchers didn't know what condition they were dealing with and which participants they needed to recruit? The diagnostic label provides a framework for evidence-based treatments and contraindications for that particular condition that HCPs can follow.

I am wondering if in some cases, mild ASD is diagnosed but it’s actually a lack of development of social skills at a young age. So the examples you use of adults who didn’t have tech at that age are outwith what I have described

Oh ok. Can I ask which ones?

It’s been a few years since I last looked at ASD and attachment/trauma related issues, so it will have moved on, but the few aspects that were classed as ‘unique’ to one or the other diagnosis/label, in mine and many others clinical experience, were that most weren’t unique. Not if you were fully immersed in that work and knew it well.

The difficult is that if you mislabel then that. Child might not get what they really need.

And, there is an alternative. If we wanted it.
A collaboratively developed formulation that considers genetics, biology, psychology and social context is the alternative. That is unique and bespoke to that individual but draws on the best available research - including medical research. That formulation, along with the persons preference then drives intervention. That can include medication.

We don't know enough about the genetics and biology of these conditions for this information to be of any practical value. In any case genetic testing and interpretation is extremely time-consuming and expensive. I'm struggling to imagine a future where a MDT that would sit down and interpret a patient's genome, biology, psychology and social context and somehow put it all together to decide on a treatment when, as it stands, a schizophrenic experiencing an acute episode can't even get an appointment with a psychiatrist.

Google away, you are clearly capable.

Funny the NHS psych diagnosing me and my daughter didn’t delve, dismiss or accuse either of us as having too much screen time. He focused on the vast amount evidence present from a young age.

A decent BioPsychoSocial formulation that was regularly reviewed is just as robust, if not more robust, than a diagnosis.

Nobody gets a “mild autism” diagnosis.

We already use a biopsychosocial model that's regularly reviewed, though.

I agree with this.

I think think there is a hell of a lot of false certainty and binary thinking in this area that is really damaging. You either are ND or you're NT. You have autism/ADHD etc or you don't. The reality of many people's lived experiences are much more complex than this.

People often overestimate how developed the science is in this area. There are no definitive objective medical tests for ADHD or ASD and the tests that we do undertake have artificially imposed thresholds as there has to be a cut off somewhere. The tests will undoubtedly change over time as we understand the brain better and really start to breakdown ADHD/ASD that are currently being used as umbrella conditions.

Moving away from the obsession with labels and diagnosis and taking a more holistic, needs based approach would be better for so many reasons. I feel though that some people have really internalised their diagnosis and see it as a core part of their identity. For these people, moving away from this model is seen as a huge threat so there is likely to be great resistance to change.

@Errors

I am wondering if in some cases, mild ASD is diagnosed but it’s actually a lack of development of social skills at a young age

No because there's no such thing as mild ASD and to meet diagnostic criteria it isn't just about social skills. They have to meet the triad of impairments which also includes restricted and repetitive behaviour and sensory needs.

And the quiet shy ones who don’t do risk taking.

Adhd isn’t just about risk taking. That’s a very male presentation. It’s also about being quiet, inattentive and wanting to keep your head under the parapet as much as possible.

Would people ‘move’ away from diabetes? Or a generic auto immune disease?

Havinga diagnosis is helpful. My Dd would have no wish to ‘move’ away from her diagnosis.

I think much confusion arises from the terminology including words such as trait, characteristics, spectrum etc. These often have very specific and nuanced meanings within a particular field and are often misconstrued among non-specialists and even among professionals.

I am wondering if in some cases, mild ASD is diagnosed but it’s actually a lack of development of social skills at a young age

Girls mask and can be very social. This is why they are diagnosed later. So it’s nothing to do with social skills at a young age. My Dd was very social. Still ASD though.

Physical conditions are often different in nature as there are objectives tests that can be undertaken that can be used to inform a diagnosis. We can test blood sugar levels for example for diabetes. If we were to rely on people reporting their symptoms and observations only then diagnosis of diabetes would become a lot more inaccurate, especially as the symptoms and presentation can overlap with conditions like thyroid disease. Our understanding of diabetes, what causes it and how to treat it is far more advanced than our understanding of ADHD and autism.

You can't run brain scans and diagnose ADHD or ASD. There are no objective physical tests that can do this. Instead we rely on self reporting, observations and subjective assessment. Our understanding of what autism and ADHD is incomplete and has been revised in recent history to remove Aspergers etc. it is very likely to change again as our understanding develops. It's not even consistently understood across countries now, with the USA and other countries diagnosing different levels of autism whilst the UK doesn't recognise these.

Your daughter may well wish to retain her diagnosis but it it is potentially inaccurate and unhelpful then it would necessarily be in her best interests to do this.