• InfiniWheel
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    1 year ago

    Self diagnosed? Definitely

    Actually, properly diagnosed? Probably underdiagnosed actually. Friend of mine had to go through a lot of pricey hoops just to get tested in a reputable place.

    • BestBouclettes@jlai.lu
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      1 year ago

      It’s definitely under diagnosed. 5% of the world population is thought to have ADHD. I know plenty of people around me that show serious signs of it and they have no idea. Granted I’m not a psychiatrist, but I live with an ADHD person and the similarities are striking.

        • BestBouclettes@jlai.lu
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          1 year ago

          Absolutely not, the tricky thing about ADHD is that it’s mostly lots of small things that everyone has or does. (Bad short term memory, executive dysfunction, rejection sensitivity, inattention, difficulty to focus, etc). People with ADHD have a lot of them all at once and that’s the problem. It’s a spectrum with a threshold of issues to have at once to be considered ADHD. That’s why it’s not easy to diagnose, it can vary wildly from person to person.

        • Franzia@lemmy.blahaj.zone
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          1 year ago

          Something I’ve noticed hanging out in online communities is the selection bias. Sometimes everybody in a community really does have the same tendencies and characteristics.

    • blindbunny@lemmy.ml
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      1 year ago

      This feels like the correct answer.

      The amount of people I go on a date with and tell them I’m ADHD and they follow with, “me too” when they are obviously not, is crushing. I’m glad my learning disability is fun to cosplay for you. The juxtaposition of people I meet in wild and tell them I’m ADHD and they are like, “Oh what’s that like?” as they’re looking for the lost keys in their left hand or leg stemming, feels… curious.

      • xkforce@lemmy.world
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        1 year ago

        If I could snap my fingers and not have ADHD I’d do it. People think ADHD is just being scatterbrained and hyperactive and think its at best quirky and at worst annoying but a lot of the hallmarks of ADHD cause a lot of suffering just existing in society. eg. executive dysfunction/impulsivity, emotion dysregulation (seemingly feels like your emotions are harder to control which is part of the rejection sensitivity), difficulty building and maintaining relationships, difficulty holding jobs, being unable to quiet your thoughts late at night (80% of us have insomnia/delayed sleep patterns to one extent or another) and being very prone to boredom that can often feel almost physically painful. And of course, society treats you as if your personality is shit because what people see is someone forgetting things, making bad snap decisions and generally being annoying. So a lot of us dont think highly of ourselves because thats often how we are conditioned. To think we are lazy, uncaring, annoying and thoughtless/impulsive.

        • Blake [he/him]@feddit.uk
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          1 year ago

          I’ve also got ADHD, so I understand the struggle. But personally I think ADHD has a lot of upsides as well. People with ADHD are often really fun to be around, they have often really different perspectives on the world and see things that other people don’t, and tend to take everything in their stride. ADHD people in my experience are better at out-of-the-box thinking, handling stressful and chaotic situations, and extremely capable when they’re interested in something.

          The reason that ADHD feels debilitating is because capitalist society forces us to conform with neurotypical behaviour, because conformity is more important than outcomes. If ADHD people were allowed to work their to own schedules, and allowed to focus mainly on tasks which interest them and offload things that they find boring/tedious, it would go a long way towards getting the best out of people with ADHD. If it’s handled well, they can easily outperform neurotypical coworkers, it’s just very much about harnessing the chaotic energy that we have.

          • xkforce@lemmy.world
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            1 year ago

            ADHD feels debilitating because there are things you have to be able to do to function in any society that ADHD makes more difficult than it is for everyone else. I have to remember to take medication that keeps me alive. I have to put my contacts in or I am metaphorically blind as a bat and it feels a lot better to actually be able to see things. I have to interact with other people in an acceptable manner i.e not blurting out the first intrusive thought that comes to mind. I have to eat and drink when I should. Yeah I literally forget to do that a lot because I am engrossed in some activity or another. I have to go to sleep at a normal hour or I wake up feeling like shit because my circadian rhythm is fucked up. There are just some things you will never ever avoid doing even in a luxury space communist utopia.

            And while there are some advantages to ADHD like creativity, hyperfocus and being less likely to die of obesity related diseases due to hyperactivity, it is not fucking worth all of the other stuff that caused me to want to be tested for it. Not because society forces normality on me but because I want to do a lot of stuff without having a wrestling match with my own brain.

            My wants and needs are important to me and those wants and needs are often incompatible with the ADHD tribe that I was born into.

            • Blake [he/him]@feddit.uk
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              1 year ago

              I’m not trying to say that ADHD isn’t a disability, I’m saying that the worst parts of it come from society being intolerant of our needs. You’re not lazy or selfish, you’re doing the best you can <3

      • cubedsteaks@lemmy.today
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        1 year ago

        god that sucks to hear.

        I’m alarmed at the amount of people I met, mostly women, who are like upset when I tell them I’m not autistic. It’s like they want me to be or something. They insisted I needed to get tested to be sure.

        Like what is with these people wanting this to be common and wanting to get people join in like its a club? It’s a genetic trait. You either have it or you don’t I thought.

        • Blake [he/him]@feddit.uk
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          1 year ago

          If multiple people seem surprised that you’re not autistic and encourage you to seek diagnosis, I dunno, maybe there’s something there? Are you a woman yourself?

          • cubedsteaks@lemmy.today
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            1 year ago

            Well I had the luxury of dating a psychologist who specializes in diagnoses and her brother is autistic - so she is very aware of autism and how it works and what it looks like in different people.

            When I told her that random autistic girls from my comm were making this assumption she gave me the biggest eye roll and a laugh. Because duh, I’m not autistic.

        • xkforce@lemmy.world
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          Other people see you differently than you see yourself. And you wouldn’t necessarily realize you were part of the autism tribe because as far as you were concerned, everyone is in the same tribe as you. You wouldn’t really know what it was like to experience things with a different tribe’s mental wiring. Just like I didn’t really figure out that my brain literally worked differently than 95+% of the population (ADHD) until I was very thoroughly an adult.

          • cubedsteaks@lemmy.today
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            1 year ago

            because as far as you were concerned, everyone is in the same tribe as you

            I definitely don’t think that way. I’m aware that I am different from other people.

            Reposting from my other comment:

            Well I had the luxury of dating a psychologist who specializes in diagnoses and her brother is autistic - so she is very aware of autism and how it works and what it looks like in different people.

            She confirmed I’m not autistic and thought it was hilarious that anyone would assume that about me. She’s known me for years and she has experience in that field. She knows better than just randoms at a meet up group would.

  • krayj@sh.itjust.works
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    1 year ago

    Probably over diagnosed by people self-diagnosing. Probably significantly under diagnosed officially/clinically.

    And the above is true for a LOT of conditions, not just ADHD.

    • Kongar@lemmy.dbzer0.com
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      1 year ago

      My daughter has a learning disability. Dyslexia and some weird kind of error with certain fine motor skills. The diagnosis from everyone? ADHD-put her on drugs. What drugs would you like? If one drugs doesn’t fix her, we’ll try two drugs.

      Thank god my wife and I resisted. Nobody could explain what was going on and how drugs would fix it. I ain’t gonna lie, her elementary school days were rough. But now, straight A college student in her junior year.

      I’m sure there are people looking for it, but my experience was default diagnosis by doctors and schools pushing adhd onto kids where it wasn’t appropriate.

      • bionicjoey@lemmy.ca
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        1 year ago

        Doctors are idiots when it comes to this stuff. ADHD should be diagnosed by a psychologist, just like any other neurodivergence.

        • Instigate@aussie.zone
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          1 year ago

          Psychologists can only really diagnose mood disorders, not psychiatric conditions. Because ADHD is a psychiatric disorder, psychologists absolutely should NOT be diagnosing it. If they suspect ADHD in a client, their job is to refer the client to a psychiatrist who is able to make such a diagnosis and prescribe medicine to manage it.

          Source: bachelor’s degree in psychology

        • Erk@cdda.social
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          1 year ago

          ADHD isn’t particularly hard to diagnose most of the time. If we’re going to wait for psychologists in every bog standard case, good luck with the upcoming twelve year waiting list to get your kid some help.

          People just need to know when to identify confounders and refer out. Takes a few good training seminars.

      • HerbalGamer@lemm.ee
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        1 year ago

        There’s a very vague term called NLD or Neurological Learning Disorder with which I was diagnosed at the time. Iirc a big part of it is issues with fine motor skills because of bad communication between the two brain halves. Also gets misdiagnosed as ADHD quite often.

        • June@lemm.ee
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          1 year ago

          I was diagnosed with Dyspraxia as a kid which was a wildly vague fine motor skills disorder that made me near unintelligible prior to speech therapy. I still have issues slurring words from time to time, but it’s not significant.

          I don’t think anyone knew what was going on with me tbh. But I def have ADHD, and there’s suspicion I’m autistic as well. I’m working on getting a neuropsych eval done now to try and understand better.

      • Mak'@pawb.social
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        1 year ago

        Being acquaintances for a while with someone with OCD was enough to tell me that the vast majority of people with “OCD” do not have OCD.

      • SaltyIceteaMaker@lemmy.ml
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        1 year ago

        I’ve noticed this too. Even people telling me i have OCD because i sort certain things in certain ways. (i do NOT have OCD. I just can’t stand some things if they are not in my order.) But people are very quick to diagnose other’s. wich is okay imo as long as there is reason to believe so, so that you can go to the doctor and check wether that’s true. Problem is people don’t know that they don’t understand the illness/disability/etc. à la dunning krüger effect.

    • beteljuice@lemmy.ml
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      1 year ago

      I don’t have numbers but my personal experiences tends to show me what it’s over diagnosed, at least in California. Got many people around me that are diagnosed, with meds, and they take it as part of their identity, bringing it up all the time.

      My kid talked to a therapist a few times for some minor anger issues, and he’s already talking about getting him diagnosed for ADHD. He’s the top student in his class, can focus for hours building anything he wants, is outgoing, and gets along with all his friends. He just has a few emotional outbursts at home, which don’t affect his functionality or happiness. I don’t understand the point of a diagnosis. It feels like a label would just follow him around and box him in, so we decided not to pursue.

      • nickwitha_k (he/him)@lemmy.sdf.org
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        1 year ago

        My kid talked to a therapist a few times for some minor anger issues, and he’s already talking about getting him diagnosed for ADHD. He’s the top student in his class, can focus for hours building anything he wants, is outgoing, and gets along with all his friends. He just has a few emotional outbursts at home, which don’t affect his functionality or happiness.

        So…your child is exhibiting symptoms of being high-functioning ADHD, according to their therapist?..

        I don’t understand the point of a diagnosis. It feels like a label would just follow him around and box him in, so we decided not to pursue.

        The point of a diagnosis is to allow them to get help with things that are challenging for people with ADHD. It’s not something that is going to do them any harm or cause them to be discriminated against, contrary, if it is a correct diagnosis, it can be of great help. I did but get an official diagnosis until I was in my 30s and had a very similar experience in childhood, with my parents but moving forward with diagnosis. Not having access to resources when I was younger caused measurable harm and issues that I could have otherwise avoided.

        • beteljuice@lemmy.ml
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          1 year ago

          Would you mind elaborating? Understanding what your issues where that were addressed by help could help see what I’m misunderstansing. I obviously want to do what’s best for my child.

          • a_statistician@programming.dev
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            1 year ago

            Not the person you replied to, but I definitely had emotional outbursts but was the top student in my class. I was diagnosed as ADHD in graduate school, at the age of 23. Meds were life-changing for me - I not only had classic ADHD, so I had study patterns to unlearn (studying with music + TV + snacks + distractions) but I also had Rejection Sensitive Dysphoria - basically, I would hyper-focus on any perceived critical comment, rejection, slight, etc. I would contemplate whether I could ever show up in class again after a side comment from a teacher. It took so long to unlearn that (and some antianxiety meds as well). If your kid actually has ADHD, the best thing you can do for them is have them work with a therapist to learn coping skills and the proper way to do things. Meds may enter the picture eventually, but a therapist that works with ADHD and autistic people primarily will be the most helpful. Little things - fidget toys that help you pay attention to auditory stimuli, weighted lap blankets to work at your desk, etc. help so much sometimes, and they’re relatively simple fixes, but if you don’t know to look for the issue, you don’t find a solution.

      • Zoboomafoo@lemmy.world
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        1 year ago

        “He’s the top student in his class”

        With studying, or without?

        In my experience, being top of the class without working for it is a great way to wind up crashing and burning as soon as one gets to college and suddenly isn’t the smartest in the room

        • Naia@lemmy.blahaj.zone
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          1 year ago

          That’s kind of what happened to me. Never needed to study in grade school. Had to scramble and learn how to study in college.

          Still didn’t register why I had so much trouble focusing or remembering stuff until the last year or so.

      • Franzia@lemmy.blahaj.zone
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        1 year ago

        He’s the top student in his class oh no. He’s gifted? Get ready for potential burn out in teen years or college years. These problems can change over time, and its impossible to predict how these conditions will play out, but I’d like to warn a parent your kid might need special attention / support considerations apart from a neurotypical child.

  • rizoid@midwest.social
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    1 year ago

    As medicine advances, most diseases or conditions will be diagnosed more often. With the extreme increase in technology in the past 50+ years I wouldn’t say that cancer is being over diagnosed just because we can find it better. While mental health science is arguably far behind traditional medicine, I wouldn’t say that ADHD as a whole is over diagnosed. Is it probable that there are some bad doctors that will simply hand wave kids away with an ADHD diagnosis? Sure but those cases are far less common than you might think. As someone with ADHD I have seen the sentiment that it is over diagnosed arise in my life as people claiming that what I suffer from isn’t real and I need to pay attention better, or that I’m just “abusing the Adderall to get ahead in life.” So no I don’t think it is over diagnosed and people around the world need to have a better understanding of how mental illness truly affects the people that suffer.

    • JoYo 🇺🇸@lemmy.ml
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      I’ve always been fascinated how ADHD is the disorder that gets singled out for over diagnosis but not ASD.

      AFAIK there’s not much in the way of pharma treatments for ASD so public policy couldn’t care less about it.

      There’s money to be made in demonizing ADHD.

      • Draghetta@sh.itjust.works
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        1 year ago

        Forgive my naivety, how do you get rich off demonising adhd? It would stand to reason that bucks are made by over diagnosing and selling superfluous treatment, what would I sell you after adhd is demonised?

        • Sunstream@lemmy.world
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          1 year ago

          You gotta think diabolically.

          My psychiatrist here in Australia cautioned me when doing online research into different ADHD medications to check the country of origin and avoid American sources where possible, as there is a huge anti-drug bias in US public and medical literature, and to stick to European/Australasian/other resources for more accurate information on mechanism of action and potential side-effects.

          Boy, he was not wrong. If you go on many American websites that talk about the pros and cons of one stimulant or another, it’ll overemphasise its propensity towards abuse and extensively list the side effects without bothering to explain how the drug actually works in the body.

          You’ll think it’s an unbiased source, at first, because the website itself only seem to contain basic drug information (at a cursory glance) only to scroll to the bottom and find that the website is owned/sponsored by a rehab facility, of all places.

          It’d seem like there’s money to be made off of dx and prescribing ADHD meds, but we all know how fucking hard it is to dx’d in the first place, let alone prescribed something that works. It’s not wildly profitable to prescribe drugs with heavy federal restrictions on it.

          What is profitable, however, is to give someone 6 other psychiatric medications to treat ongoing mental health issues from undiagnosed ADHD, and the half dozen other co-morbid issues like substance abuse disorders, PTSD, anxiety/depression, bipolar disorders, body dysmorphia, eating disorders, and so on- none of which you’ll get much traction in treating without also addressing ADHD, and some of which may be misdiagnosed or more effectively treated when identifying the core disorder.

          Why treat 1 condition when you can treat 7 ¯_(ツ)_/¯ Better yet, you can do that in an inpatient facility that their insurance can pay for, where you can convince them that their substance abuse issues are due to moral failing rather than an attempt at self-medicating a (widely speaking) treatable disorder, yet hypocritically prescribe them a cocktail of other psychiatric medications for their “moral failing”.

          That being said, I’m not saying all rehab facilities are bad or operate in this manner, but it is just one of many ways that the medical and pharmaceutical industry inadvertently or directly discourages appropriate ADHD treatment, additionally fuelled by the government’s bigotry-fuelled war on drugs.

        • JoYo 🇺🇸@lemmy.ml
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          1 year ago

          They’re selling another product.

          Conmen like Tate and their ilk would love to sell you on the idea that Adderall is evil.

  • JWBananas@startrek.website
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    1 year ago

    The scientific, peer-reviewed answer is that it is significantly under-diagnosed in adults as well as in those AFAB of all ages. Most sources say up to 80% of adults with ADHD are undiagnosed and/or untreated.

    • TooMuchDog@lemmy.ml
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      I see this rhetoric a lot and I really dislike it and find it actively harmful to people with ADHD.

      ADHD, at least mine, would absolutely still be a mental illness outside of modern society. My doesn’t care if I’m remembering where I put down my phone or where I put down my sandwich, I still misplace them either way. At work being without my medication makes it difficult to keep track of my responsibilities. At home it makes it difficult to keep track of doing laundry, washing dishes, cleaning the house. You don’t suddenly lose all responsibilities and idle tasks without a modern society, your responsibilities and tasks just become different. And my ADHD couldn’t give two shits what those responsibilities and idle tasks are, I’m going to struggle with them either way without medication.

      Dismissing ADHD as not a mental illness but a symptom of modern society is not only incorrect at it’s most basic level, it also implies that people like me could be “normal” IF “x, y, or z” conditions were met. That idea is just blatantly untrue and just perpetuates the dismissive and uncompromising stance that many people take towards individuals with ADHD.

    • mommykink@lemmy.world
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      1 year ago

      You should listen to the album Cave World by Viagra Boys (if you haven’t already). Don’t let the bands name fool you, it pretty much hits on everything in your comment but to the tune of Swedish post punk

    • Buelldozer@lemmy.today
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      That’s awful. Here in the United States you may get harangued trying to fill your prescription but getting in to see someone for a diagnosis generally doesn’t take long at all!

      • IR8@lemmy.world
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        Mental health issues since I was 14. Diagnosed with schizophrenia and depression in my 20s. Been on so many medications which don’t work. Now in my 40s my wife see’s a self diagnostic for ADHD and says “you have every single one of these traits, perhaps you should mention it to your shrink” Ask my shrink who says of course we can refer you but the NHS has a waiting list of 2-5 years for an adult referral unless I go private. I’ve been waiting for a year and a half so far.

        • BallShapedMan@lemmy.world
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          Dude, that really sucks. I wish you all the best! And thank you for sharing!

          I’m not sure what the diagnosis process is wherever you’re at but here is a series of questionnaires for people in your family and yourself and your boss/teacher (depending on age) and that’s it. Super simple. I swear anyone with a photocopier and a pocket calculator could do the diagnosis.

          When I had myself and my kids inspected I was shocked.

  • Skoobie@lemmy.film
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    1 year ago

    For adults, it’s under-diagnosed. Because some of the most common prescriptions for it are stimulants like Adderall, there is a fear that adults are trying to scam the doctor. Additionally, and imo even more infuriatingly, doctors are apprehensive about diagnosing an adult because “you made it this far in life without needing help. You can’t be ADHD/autistic/neurodivergent.” Fuck that mentality. I’m ADHD and autistic and I don’t need a doctor to validate me when they can’t even agree amongst themselves half the time.

  • m0darn@lemmy.ca
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    1 year ago

    I mentioned my adhd diagnosis in a post earlier today so you may be the same inquirer. Regardless here’s a little bit more of my story.

    I was born in 1986 and not diagnosed with ADHD until 2021 (I was 35). I didn’t do anything about about my diagnosis until 2023 when my career started going off the rails. I sometimes fantasize about what my career would have been like if I’d been diagnosed (and acted on the diagnosis) 15 years ago when I started to suspect something was up.

    For me it mostly manifests as struggles to initiate tasks unless they’re interesting or urgent.

    Is it over diagnosed? Maybe. Our brains evolved to hunt, collect berries, and work collaboratively with our clan. If we struggle do so TPS reports so that shareholders know how their incomprehensible riches are being used, is it fair to call that a mental disorder?

    Is paying money to the pharma-man so we can be a better money machine for your bosses shareholders kinda fucked up? Yes.

    But will it also help me better support the things I value? My family? My community? My interests? Yes.

    I think if you want to know if ADHD is over diagnosed you need a scholarly resource, not an internet forum.

    • deathbird@mander.xyz
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      The other thing that makes it tough is that we don’t really have a good grasp of what it is. At least, last i checked.

      Like, are we just pathologizing people on this or the other side of a fuzzy threshold of executive function? Or is there a population that really is physiologically/genetically different? Either way, is there something wrong with society where people within a previously normal range of executive function are now unable to keep up?

      • xkforce@lemmy.world
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        Well its like they said, for 200,000+ years humanity was out foraging berries and hunting gigantic beasts to survive out in the wild and now were expected to sit still and focus while being trapped in a gray cubicle with florescent lighting and a fake plant on a desk doing who knows what boring task 8 hours a day every day 5 days a week 50 weeks a year for 50 years. Out in the wilderness itd be useful to be the one in your tribe that finds new food sources and needs to be physically active and alert often later at night. But in a gray cubicle in some soulless office building? not so much

    • SameOldJorts@lemmy.world
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      Oh my gosh, similar to my story and you’re exactly right. Yeah I could totally be happier running around the forest all day but that’s not feasible when I’ve got kids getting off the school bus who need encouragement to do the things and who need to be fed more than the handful of berries that are likely smashed in my pockets because I was more interested in collecting several cool rocks. Now the kids are crying because it’s stone soup again for dinner. It’s just a damn mess.

  • xkforce@lemmy.world
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    Do you have any idea how hard it is to be diagnosed with ADHD?

    I was diagnosed when I was 32. In order to be diagnosed, I had to go through a series of screening tests that measured intelligence, executive function, behavioral assessments, interviews with family that knew me when I was a kid, “testimony” from my therapist and other tests meant to rule out alternative explanations. eg. sleep deprivation, health issues, depression, anxiety etc. And it was expensive. Thousands of dollars and many hours. Its essentially designed to mentally tax you until the ADHD is detectable through any masking that you do.

    • Jasontheguitarist@lemmy.dbzer0.com
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      I was diagnosed as a kid and was on ritalin and later adderal but stopped taking all that stuff after elementary school. I’m 36 now and I wonder if it’d be a major pain to get on meds again as an adult or if my previous diagnosis would still be good enough.

      • LordTrychon@startrek.website
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        Fwiw, sounds pretty similar to me. Depends on your doc, probably… but I have a good relationship with my Dr. and my ability to discuss my previous diagnosis as well as meds and what worked etc. Was enough for me.

  • Toaster@lemmy.world
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    Yes, and no. This is an unanswerable question.

    Negligence, ineptitude, and mistakes happen in every field and medicine, education, and parenting are no different.

    There is pain in being diagnosed correctly just as much as there is incorrectly. The question we should be asking instead for both sides of the aisle is how do we best deliver knowledge, support, and care in the correct format to those who need it?

  • millie@beehaw.org
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    1 year ago

    Thinking about disgnosis reminds me of some of my experiences on LSD.

    Several times I had these relevatory moments where the ephemeral nature of the universe and its gradual slipping into entropy over time became intimately tangible. When this would happen, I’d usually find it terrifying. I’d feel like the world was falling apart around me, because it literally always is.

    But in these moments, I was so focused on seeing that entropy in a way that felt new that it would take some time to realize it had always been this way. It seemed like the end of the world, but the reality was that it was just a normal day and I was examining aspects of my world that I didn’t normally and making connections. That’s all.

    Some of those connections were silly psychedelic-fueled nonsense, with whatever meaning that might lie beneath lost in some cryptic and half-undestood internal symbolism, while others were perhaps a bit more useful, but none of them were new.

    To me, though, these revelations felt apocalyptic in the moment, and of dire urgency. It felt as though the realization itself presented a dire threat, as if it itself was entropy, but in reality the only thing that had changed was my awareness.

    Diagnosis, to me, is a similar beast. We’re attempting to peel back the falsely self-protective veil of ignorance about our own internal workings, and we see these things as though they were new and should somehow define us. The reality is, though, that we’re just learning how to classify and examine what was already there. We’re not describing something different from what we might have assumed otherwise, we’re looking at the guts of what’s made us who we are.

    For some people making those connections may lead to things that can help improve their lives. For others it can be a way to divorce a person from themselves. We’re taking the huge variety of human experience and trying to pigeonhole it just based on people that share various sets of common characteristics that some of them have found difficult to cope with or to make work with the expectations of their social context. If we’re focused on mental health only in terms of disfunction, that’s all we’re going to see when we start classifying it.

  • fubo@lemmy.world
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    1 year ago

    It can be both overdiagnosed and underdiagnosed! Both these things can be true at once:

    • Some people who would benefit from ADHD treatment do not receive it.
    • Some people receive ADHD treatment who would be better off without it.

    One contributing factor is that people are treated differently in the contexts where ADHD is likely to come up (e.g. in schools) due to things like race, gender, and family income.

    A black boy and a white girl having the same “brain stuff” going on are likely to be treated differently by teachers and parents — not only due to overt sexism and racism, not only hormonal and developmental differences, but also different cultural experiences with medicine (and medical mistreatment), different parental fears, etc.