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- pygy_> Some physicians and researchers have argued for years that emotional dysregulation is not peripheral to ADHD but a central, overlooked part of the condition. Yet this symptom does not appear in the formal diagnostic criteria for ADHD in the manual that doctors use to classify mental disorders. That gap has left clinicians without a clear way to categorize what they’re seeing: Are these children best understood as having severe anxiety, as being on the autism spectrum, or as something else entirely? Or does ADHD itself need to be more broadly defined?Again and again and again. Psychiatry is an epistemic mess.Psychiatrists are touristic guides of the Paris catacombs that orient themselves with a map of the subway.
- smj-edisonIt reminds me that ADHD is really not that useful of a name, executive function disorder would be a more accurate name from when I was looking into ADHD in the past. It's not about attention deficit per se, as that's downstream of struggling with executive functioning. At least it's the definition that lines up with my experience best (I have ADHD). I'll make lists in order to keep track of important tasks (which in theory would help with attention deficit) but then I'll sit down to do the things on the list and... can't. It's such a hard thing to explain, but no amount of attention hacks can get me over the hump of doing the tasks I'm dreading. That seems much more related to executive functioning.
- eutropiaI was surprised by how cleanly our results came together,” said Pan, a neuroimaging expert with the West China Hospital of Sichuan University and the Turner Institute for Brain and Mental Health at Monash University in Australia. “We used no clinical information whatsoever in the clustering, and yet the three biotypes that emerged mapped well onto clinically recognized ADHD presentations. Really cool that this worked out. Now I want to get my brain scanned...
- anigbrowlMelissa DelBello, a professor of psychiatry and pediatrics at the University of Cincinnati, said that while brain imaging holds promise, it is still impractical to conduct such scans broadly in clinical settings because they are too expensive and not yet precise enough at the level of the individual.As if questionnaires and slot-machine prescription medicine treatments are accurate. I don't want to generalize for lack of statistical data, but reports of psychiatrists 'just phoning it in' while providing little actual patient engagement are widespread.
- JKCalhounI recall someone posting that the human brain is essentially "overclocked". I don't recall if that was the phrasing but the gist was that our level of intelligence can only exist by skirting the fringes of sanity. Like some set of dynamic differential equations where, if you bump a coefficient, it spins off into chaos.Perhaps this Brave New World, as opposed to the more agrarian one our species had been accustomed to, pushes many of us over that threshold.
- skissaneI'm always sceptical of studies which look at a single diagnosis rather than pooling multiple related diagnoses, because the boundaries between them are so fuzzyHere's a similar study from some years back which doesn't have that flaw: https://pmc.ncbi.nlm.nih.gov/articles/PMC6880188/
- braeboI’ve always found the evolutionary biology lens very compelling for ADHD — consider hunters and gatherers. Hunters benefit greatly from the ability to quickly and sharply shift attention in an instant. They thrive at night and can hyper-focus on the thrill of the hunt. As civilization progressed, society was optimized for the majority (gatherers), and the hunters are marked as “disordered” for systemic incompatibilities.
- msarnoffI think this is me. I was diagnosed with “regular” ADHD a few years ago, but I’ve had issues with rejection sensitive dysphoria my whole life. As a kid I would have a lot of meltdowns when I couldn’t get something right on the first try or made any kind of mistake.The meltdowns stopped, but I still have issues spiralling into thoughts of failure and being a horrible person when I feel like I’ve disappointed family or friends.Guanfacine has helped though. Tried a bunch of medications and this is the only one that seems to have made an impact.
- sudostephThe DSM seems pretty far behind the research by now, but I'd be surprised if emotional dysregulation was not mentioned in the next one.Another interesting thing that's not in the DSM - very high likelihood of balance / motor control problems (clumsiness, falling).
- bshaughnI've described the field of Psychiatry as trying to describe a building, using only its shadow (projection from high dimensional space to 2d space), with only a handful of choices for the building type. Ultimately only the building (the patient) really knows the full scope of complexity, but a doctor has to be careful in how they get info out.I don't have a solution, as its an inherently hard problem with a lot of risks (like giving medicine to the wrong person). But I also think this desire to have nice categories for things can be counterproductive in a lot of cases.I personally think rebranding aspergers + Autism to the autism spectrum was a mistake, as there's a huge difference between someone who's really good at their job but weird and despises certain workplace nonsense - and someone who can't take care of themselves.ADHD is another great example of a bucket that makes non sense. We were evolved to be hunter gatherers that get many hours of walking or running, and other physical activity every day. Then we act surprised when 11 year olds don't want to sit still 6 hours a day, or getting people like me to write a JIRA ticket is like pulling teeth.I think separating out these large categories into smaller ones is a good step, but ultimately I think the categories are a counterproductive solution to our human urge to find a logical explanation to things.
- SubiculumCodeAnyone know to what paper this article refers? I don't have WaPo
- chrisldgkOne thing that I can’t seem to parse from the article is why the researchers assume that this is an unresearched part of ADHD and not a different disorder entirely. I’m sure they have their reasons, but I don’t think it’s written in the article.To me it seems that if it’s not „treatable“ the same way ADHD is, I’m not sure if it’s useful to categorize it as such. On the other hand, I’m happy if kids with this disorder can get a diagnosis and treatment that actually helps them sometime in the future due to this research.
- purple-leafyADHD is interesting. I think ADHD is mainly an executive dysfunction and reward centre dysfunction, from my own experience.And a bit of nature, a bit of nurture.It’s a real double edged sword for me.On one hand relationships and “boring” tasks feel insurmountable. When I say boring I don’t even mean boring in the traditional sense, I just mean “not novel” - so even something like playing my favourite ever video game gets extremely difficult once the novelty is gone.On the other hand, as a software developer, working on novel concepts or exploring novel concepts or ideas is basically like crack-cocaine, I literally can’t stop or put them down.Double edged sword is struggling with most basic tasks, but excelling at the peripheries.
- aidenn0> “They are simmering volcanoes basically,” Rosen said. “When things go wrong, they explode. These are kids who will have hour-long meltdowns, throw things and hit and break things.”...> For children with this extreme form of ADHD, standard behavioral strategies may fall short. DelBello said that widely used approaches such as positive reinforcement — like giving prizes or other trinkets, or extra recess for good behavior — do not always have the intended effect.I'm a former foster parent who adopted kids from foster care. Two of them were diagnosed with RAD[1]. This "extreme form" of ADHD aligns with both my personal experience of RAD and a subset of the symptoms described by clinicians. Attachment issues in general are either commonly comorbid with, or misdiagnosed as ADHD and ODD[2] (the latter of which also somewhat matches the symptoms from TFA).I don't really have a point here, just an observation I wanted to make.1: https://en.wikipedia.org/wiki/Reactive_attachment_disorder2: https://en.wikipedia.org/wiki/Oppositional_defiant_disorder
- ur-whale
- burnt-resistorThey've basically "reinvented" DSM-IV ADHD-PH, -PI, and -C more or less, but at least someone's examined the organ responsible rather than treat it like a magical black box.
- phantompeacePaywalled/emailwalled
- thesmtsolver2[dead]