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?

I think it's absolutely a think OP.

School is a big issue, there are inappropriate expectations for young kids especially, and I think this has two affects - one is just that kids are seen as "not behaving" when they are being normal.

The other is that the environment causes changes in behaviour and the brain, which is to say there can be real effects but they are iatrogenic.

Screens and lack of time playing and being outdoors is also causing significant changes to brain development, IMO, and I think that a lot of ADHD is actually the visible effects of those changes.

The problem is they are not the same kind of thing.

We know about diseases like cancer because we can observe the causes, see many cases histories and how they manifest, collect information about treatments, and so on.

Some diseases more than others, but we can see quite clearly for example the difference between prostate cancer and lymphoma because they each have their own qualities.

Quite a lot of things in psychiatry are not like that at all. We don't really know the cause, there is not even a clear pathogen or injury or test to diagnose. There are a set of criteria that have been defined somehow, and it's not nearly as objective as a lot of people believe.

That doesn't mean that the observed symptom isn't real, just that it may not be interpreted through the right lens at all. Observers could be grouping things together or making links that are not correct. Rather as if - and this sometimes happens even with conventional diseases - a person thought a set of physical symptoms in patients all related to each other, when in fact they didn't, and so came to completely incorrect conclusions about the disease. Thin of some of the crazy diseased people thought were real at various times in the past - our understanding of the brain is primitive in a lot of ways and our diagnoses are therefore also primitive.

Green space (not just grass but trees and forested areas) are really good for the ADHD brain. But our environments tend to be constantly shifting towards a "concrete jungle" model. IMO, this is because of the cost of land and the pressure to produce. These things constrict people's time and motivate planners to build things closer together so that amenities will be accessible in the small amount of time people have available to do their shopping, get their medications, etcetera.

Just an example. ADHD is a real thing and if you put a group of people with ADHD in a room together they all recognize each other as having similar thoughts and behaviors and problems. So I don't think ADHD is a 'new' thing that society has discovered. I think over time our society has made the liabilities of ADHD more costly than they used to be, and also the advantages of the ADHD brain have become reduced: the novelty-seeking aspect is now virtually useless because it just distracts you from doing the boring rote-work that many jobs (and school) require, and any novelties that might have been advantageous to find, have already been found by the corporate behemoths that put many people to work doing boring rote work to find them.

What is crazy to me is that if you asked people if it was a good idea to let kids use gambling machines, they would say, hell no. They are known to be addictive, deliberately so. Years ago when it was revealed that game makers designed them to be as addictive as possible it was a huge scandal.

Well sm and games are designed on the same principles, based on the same research.

It's not actually controversial that this changes kids'brain development. It does. Why people don't think those changes would have behavioural effects I do not know.

I don't necessarily disagree with your conclusion, but I think there is a common logical fallacy in your argument here.

If you define a set of behaviours or characteristics or tendencies, however you want to call them, give them a name and apply it to people who act that way - yes, when you get them in a room they are going to have things in common.

That would be the case for any lable that you populated with a bunch of tendencies, even pretty random ones.

That's why cheesy personality tests work so well. You say, ok, I'm going to test yo for how extroverted you are, how observant, how emotional, and then you group together all the people who are similar and guess what - they are all very similar.

All you are really saying is yes, there have always been some people with personalities like that. It doesn't tell us much about what that means though.

I have been diagnosed with ADHD and very much resent the implication that it’s a ‘label’ when it’s actually a medical diagnosis given by a professional.

What utter rubbish. The vast majority of children don’t have adhd. I and the many other adults diagnosed had a 60s, 70s, 80s snd 90s childhood. All my children have it and couldn’t have had a more rural childhood with oodles of play opportunities.

After COVID in my LA EHCPs tripped, yes tripled. I've been told by 2 SEN teachers in the area that your unlikely to get an EHCP now without a diagnosis, which I know is wrong but thats the reality of our LA. Apparently it's similar in many other areas. A friend of mine works specifically with pre schoolers with ASD or suspected and all the HCPs are completely baffled by the dramatic increase. These are children with fairly profound needs. Non verbal, poor dexterity, developmentally behind, so the 'its better recognised' argument wouldn't apply. There's no way the numbers of children with profound ASD could increase in such a short time, were talking a few years really. Surely this is an environmental factor at play? I completely agree with the PP that we are seeing the effects of neglect to screens on a massive scale (I see it happening IRL)..not helped by austerity, COL, COVID. It's really impossible to separate children who have true ASD and those who have essentially been neglected, because at pre school age they present very similarly. I don't see why modern tech use in kids wouldn't also be causing symptoms that could be mistaken for ADHD in both children and adults. As for saying the vast majority of children don't have ADHD I agree. But in DCs class there are nearing 50% who are either diagnosed or on the pathway. Most for ADHD, less for ASD. I've heard similar in other schools classes locally. We are in a rural area, fairly small population, no reason I can think of that we'd have higher levels of adhd than the rest of the population.

Indeed. When I didn’t have my nose in a book I was a latchkey kid - school holidays were spent roaming the streets on roller skates or my raleigh grifter. Kicked out after breakfast with 50p in my pocket for a drink and some chips on the seafront and told to be home before dark. Am still AUDHD though.

I think people are still conflating actual cases of ADHD with possible cases of ADHD which could be something else.
There will still be kids around with actual ADHD, but the sheer rise in these diagnoses must surely raise an eyebrow beyond ‘there is more awareness now’
I genuinely think we are seeing the population effects of screens in kids faces too often from a young age.

My DC is about to turn 7. He does have a tablet but I only let him use it for music. He has asked for a Nintendo switch for his birthday. Most of his friends have one. I have people telling me I am being too strict by not allowing it. People are actually telling me it’ll be good for his development and the argument that really makes me laugh is “well you can be really strict with it, set screen time limits and not allow him to purchase extra content and stop it going online and not let him take it out with him”
All that argument does is prove out addictive it’ll be… if I bought him a huge Lego set for the same amount of money, I would not need to restrict how long he spends building it, would I?

I agree with the PP above that compares it to gambling machines! But at least gambling machines are only in certain places and you don’t carry them around with you in your pocket.

I highly recommend reading Focus by Johann Hari. The way tech companies design devices and apps to hook us in is really scandalous.

A diagnosis can be useful for people to make sense of their illnesses. And a lot of the time patients want a diagnosis. They can then research and understand their condition better. I often tell patients that psychiatry is not an exact science. And that diagnoses can also change over time. Occasionally, I tell people that their symptoms do not fit into any neat category although they may have traits of various disorders. Some people accept this, whilst others really push for a clear diagnosis.

Diagnosis is vital for research. We have to categorise illnesses strictly for trials, according to the signs and symptoms in order to do robust research as to how to help people. Whether that is with medication, psychology or a social intervention. There is lots of research going on that is not just about tablets.

Psychiatrists are taught from the first stage to use a biopsychosocial model. But both patients and other clinicians do revert to the medical model when somebody is extremely unwell. They largely want a doctor to diagnose and medicate.

There has been lots of controversy about psychiatry over the years. It is definitely an art as well as a science. Some people do it better than others. But I think that the best development in current psychiatry is that it is meant to be patient-centred. It is important to gauge what the patient wants from a consultation and try and adapt to their wants and needs. Some want a clear diagnosis and medication. Others want something a bit more holistic. Both approaches are okay.

Yes l hate the term ‘label’ too. It’s offensive.

Is flu, or diabetes a label? No they are diagnoses.

And a good assessment will always include some kind of formulation. We hold multidisciplinary team discussions with psychologists and make a formulation together. That is best practice.

Yes. From my experience, most patients want a diagnosis. It feels clear and containing and helps them plan for the future. It is only a ‘label’ when other people stigmatise patients because of their diagnosis. But the problem is with those people not the patient or the diagnosis.

@TempestTost Screens and lack of time playing and being outdoors is also causing significant changes to brain development, IMO, and I think that a lot of ADHD is actually the visible effects of those changes.

I have ADHD diagnosis. I grew up without screens (I wasn't even particularly interested in TV) and I spent absolute hours on end outside, every day, in every season.

I also have a twin with exactly the same upbringing but without the neuro divergence.
We shared a bunk bed and it was me always awake on the top bunk, chatting away into the night, wanting an enthusiastic side kick for my planned adventures, to only be met with a sudden snore from the one in the bottom bunk. I then used to shake the bed in frustration, to get him awake again and talking!

Screens or no screens, my circadian rhythm and peak activity is set for twilight/early hours. Has always been. I was born that way. My twin wasn't.

That's a foolish thing to resent.

All medical diagnoses are labels, they all start with someone defining what the disease is,which is a complicated thing in itself.

Some have much better support than others, some diseases processes are much better understood than others.

It's not at all uncommon in the history of medicine for diagnoses to change, sometimes a lot. This is especially the case when the cause and disease history - how it actually behaves in the body, is poorly understood, but it happens sometimes even with well understood diseases.

A lot of these behaviour diagnoses are in that category. People on this thread and others are talking about theories about these diseases as if they are well established facts, but they aren't. There is a lot of disagreement in the medical community even about how to define them.

These are just realities, if you resent people from talking about them you will be angry unnecessarily and it will also hinder better understanding in the long term.

The fact is that we don't know that all these kids have the same condition. Much like autism which is almost certainly a term that applies to more than one thing.

But it's very silly for anyone to think that because they didn't have screens growing up, and they have ADHD, that means excessive screen use - (and actually it's not screens per se, probably, it's video games and sm) - that means these things aren't implicated in the current problem.

And similarly, just because some people used them a lot and don't have ADHD doesn't mean that either.

That's like saying smokers who don't get cancer, and lung cancer patients who don't smoke, prove that there is no link between smoking and lung cancer.

That sounds very familiar - though book reading was approved of in my teen as it was assumed it would help with my spelling ( it didn't but did help with reading ability despite my dyslexia).

Didn't hurt in my first career - I'd be sat happily coding or finding errors for hours on end.

Actually some of the learning gamified apps suit my DDs especially well. DD2 has her phone out before school while waiting for her friends to turn up but she usually on apps - dulingo, Tassaomi, Senca or even school set educate quizzes.

I think it's like TV when we were young - in UK TV can educate as well as entertain and I learnt a lot though it - same with tech/smart phones - activities do not have the same value/impact.

ADHD predates tech and I'm not saying tech and it's usage isn't causing problems but I do think it's like pervious century blaming novels for wider social trends because they are new and some sections of population highly disprove of them.

I agree with both of these. As a teen (with ADHD) I could spend hours and hours hyper-focused on reading or watching Open University on TV while being inattentive to what I was supposed to be doing (sleeping, set homework).

My Dd was diagnosed at 17.

Shw was always awake until all hours as a baby and child. It was a constant battle to get her to sleep.

She never had screens as as a child.

With you entirely.

Yes, I actually think that a lot of my struggles are down to being unable to be awake when the clocks require and asleep when the general population are.

There is some research published and more ongoing, that seems to show melatonin (the sleep hormone) secretion delay in those with ADHD and independent of light conditions - the darkness doesn't seem to trigger melatonin release.

There's also research evidencing that people with ADHD wake with dopamine deficiency and the body/mind requires a greater stimulus to get it going. I've always said I need a defibrillator to feel awake for the first couple of hours after the alarm goes off! Doesn't matter the time.

I've bought some melatonin tabs to see if I can get sleepy and am veeeery slowly debating if an ice cold shower in the morning could be worth it to get that dopamine hit... 🤔😭

Ah, so because there are one or two cases of diagnosed ADHD on this thread in children that have never had access to screens, then case closed? Relentless screen use obviously isn’t remotely detrimental to kids and we can carry on shoving them in kid’s faces from a young age. Glad we sorted that one out.

Think it’s more a case of dozens upon dozens of cases of ADHD, in people aged 3-60, where diagnosis preceded access to, or the existence of, screens. Of the 6 people in my immediate family all diagnoses fall in this category.

So interesting! I would guess you are in the minority here, though. Especially when you look at reading levels (of whole books, I mean) declining.