| ▲ | cardanome a day ago |
| In fact people with ADHD have also their peculiar walks: https://www.youtube.com/shorts/H1YsnuaYY-g > based on outward behavior Yes, neurodivergence can only be diagnosed based on how you work on the inside. It is not possible to diagnose based on outside behavior as people can show symptoms very differently and can mask their symptoms. And no, you obviously can not diagnose people based on how they walk. If anything it can only give you hints or be a fun thing to talk about. > over-diagnose Both autism are ADHD are vastly under-diagnosed especially in women and adults. The fear of over-diagnosis makes no sense. There are very hard criteria for an diagnosis and it requires that every other explanation for the behavior is excluded before a diagnosis can be made. The reality it that it is a huge struggle for anyone with autism or ADHD to get any form of help or even diagnosis. Medication for ADHD works extremely well. Not for everyone but for like 70% and that is insanely good. Still there is so much fearmongering against it. But anti-depressants that can have much more serious side-effects and don't even work that well? Yes, they giving them like they are candy. Insanity. Struggle mentally in any shape or form? Oh, you must be depressed? What causes the depression? We will not dig deeper. Have your pills and be happy! But stimulants, no those are of the devil! Not to say that some people don't have just depression but the double standard is infuriating and often undiagnosed neurodivergence causes depression. |
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| ▲ | dns_snek a day ago | parent | next [-] |
| > There are very hard criteria for an diagnosis and it requires that every other explanation for the behavior is excluded before a diagnosis can be made. Is this standard truly being upheld? Most stories I've heard from people in US & UK go something like "I filled out some forms, hopped on a call/saw a psychiatrist for 30-60 minutes and walked out with a diagnosis and a prescription". Sometimes people even joke about how their psychiatrist talked to them for 10 minutes and concluded that they definitely have ADHD, and while that might be the case, it doesn't seem like many professionals are being particularly thorough about the differential diagnosis and ruling out other causes. Personally I had to undergo relatively rigorous testing where they went through my entire medical history and administered about a dozen different neuropsychological tests which took about 5 hours total, over 2 months, multiple appointments, and then another month for them to analyze everything and come back to me with the diagnosis. Of course that doesn't mean that ADHD is overdiagnosed or that those diagnoses are wrong, but it doesn't seem like many places are being as rigorous as they're supposed to be? Am I missing anything? |
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| ▲ | cardanome a day ago | parent | next [-] | | I don't really know the situation in the US. Here in Germany it is for sure rigorous. I had three appointments and lots of questionnaires to fill out at home that were designed to exclude all kind of conditions. And with a diagnosis I was still far away from getting a prescription, that is whole other hurdle. As for the US, well the CDC says in the section for conditions that must be met: > The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder. https://www.cdc.gov/adhd/diagnosis/index.html So it is pretty clear on that. | |
| ▲ | dkga a day ago | parent | prev [-] | | “Prescription”? | | |
| ▲ | dns_snek a day ago | parent [-] | | I don't understand the scare quotes, prescription for ADHD medication, typically psychostimulants. | | |
| ▲ | swores 14 hours ago | parent [-] | | They're sometimes used as scare quotes, but they're not scare quote marks they're just quote marks. If quoting a part of somebody's comment to ask about it you're supposed to use them. (That said, I don't know what they were asking about, but you're probably right that they wanted to know what kind of drug was being talked about, or weren't familiar with that word in a medical context at all.) |
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| ▲ | chneu 14 hours ago | parent | prev | next [-] |
| Autism is being over diagnosed in the US for sure. It might be different in Germany but I know plenty of folks who have been diagnosed autistic after just a conversation or two with their therapist. I know multiple therapists who have had parents try to get their kids an autism diagnosis because they think it'll help on admissions to colleges. So be aware that what YOU experience is not what is happening elsewhere. Autism is super cool on social media right now. So while the people who likely should be getting diagnosed likely aren't, many people who don't have autism are happily getting the diagnosis so they can fit in a group or have that label. Be aware that in the US, many people shop around to get the diagnosis they want and many doctors have happy to appease them. That's why antibiotics are massively over rxed in the US. Mental health is no different. |
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| ▲ | cardanome 12 hours ago | parent [-] | | That sounds like the same moral panic trans people face. Oh, the children are turned trans by social media and all that shite. No mentally healthy person is going to pretend to be autistic. There is still a huge stigma against it despite some parts of social media being progressive. I don't think a neurotypical person could even easily "fake" it. If you fit in with neurodivergent people, you probably are yourself. People have always been gay, trans, neurodivergent, whatever. They just had to hide. Once they are tolerated by society, reactionaries will spread moral panic saying "Everyone is X these days". There were always who they were. |
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| ▲ | strken 19 hours ago | parent | prev | next [-] |
| > Yes, neurodivergence can only be diagnosed based on how you work on the inside. I don't think this is exactly true. We don't involuntarily commit people to psych wards after a long and complicated investigation to understand their mental state. Diagnoses can be made extremely quickly and with little understanding of the interior state of a patient. > Both autism are ADHD are vastly under-diagnosed especially in women and adults. I've heard it said that both autism and ADHD are like height, in that it's not clear where the boundary sits. We all agree that some people are tall and some people are short. When someone claims that there are a vast number of undiagnosed tall people, though, to what extent is it because we're not reaching enough people vs because our diagnostic threshold for tallness has lowered? |
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| ▲ | cardanome 13 hours ago | parent [-] | | > because our diagnostic threshold for tallness has lowered? The threshold for being diagnosed as autistic has increased in recent years. As Asperger is not a separate diagnosis anymore but is part of ASD, some people that might have gotten an Asperger diagnosis would not get an ASD diagnosis today. Again, a diagnosis requires that you have care needs. If you don't, you will not be diagnosed. There is no slippery slope of lowering standards. There have always been neurodivergent people. Not long ago, here in Germany autistic children were systematically murdered during the Nazi regime. The difference is that neurodivergent people don't have to hide anymore as much. We finally have at least a bit of a voice. |
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| ▲ | forgotoldacc 21 hours ago | parent | prev | next [-] |
| > The fear of over-diagnosis makes no sense. It feels rational to me, especially coming from a society where everything that's considered a syndrome needs to be treated and washed away with medication. Back in the 90s, every boy who laughed or had any sort of fun in my school was recommended to be put in ritalin and other ADHD meds. I was a quiet kid, but like any child, had a moment of goofiness here and there. And those moments were far less common than my peers. Despite that, my parents got calls from a teacher saying my 10 year old self needs to be put on meds because I clearly have an issue. I'm glad my parents told them to buzz off. But more than half the other boys in my class were drugged up. Even as a kid, I thought that was strange. Looking back, it's horrifying. I think the suggestion amongst some groups that everyone must visit psychologists and psychiatrists and must be evaluated and must be diagnosed is kind of bizarre. Some people struggle and it should be easier to get help. But some people are a bit weird, they grow into it as part of their identity, and being labeled as having some sort of neurodivergence and being told they can fix it is surely more damaging than just letting them be a bit strange. If you've got autism and the biggest thing that stands out is the way you walk... I don't think dragging a kid to a doctor to be told they're not normal is really all that beneficial. |
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| ▲ | cardanome 15 hours ago | parent [-] | | > If you've got autism and the biggest thing that stands out is the way you walk... I don't think dragging a kid to a doctor to be told they're not normal is really all that beneficial. There are very strict criteria on how people are to be diagnosed. More importantly you are NOT getting diagnosed if you are just happy and don't need any help. You can NOT be diagnosed with autism without any support needs. Same as you can not be diagnosed ADHD if it causes you not trouble at all. > being labeled as having some sort of neurodivergence and being told they can fix it is surely more damaging than just letting them be a bit strange. You want to know what going through life without an diagnosis for your neurodivergence looks like? People hate you. You don't know why but they just do. You are wrong. Everyone else seems to know when to say the right thing at the right time but you don't. You are some weird alien that does not belong. You try to memorize things to say, copy how other people act, it works but the mask often slips. You must be hyper-vigilant in every social situation to not let the real you slip out. It becomes so automatic that you don't even remember who you are anymore. It is exhausting, so exhausting and alienating. You crash and burn from time to time. Things that are easy for other people. You can't even fold your laundry. You are lazy. If you would just apply yourself, you could do so much. Achieve so much. But you don't. You lack discipline. Everything you try you just give up after a while. You read a bunch of self-help books, you learn you to organize your time, all the tricks but they never work for you. You are a failure. Not being diagnosed is absolute hell. Just being able to know why you struggle, to learn coping strategies that work with your brain, to talk with people with the same struggles, to finally find people that understand you, is absolutely life changing. And no, it is not about fixing people. You can not fix ADHD, people are born with it and that is how they are. It is about them getting the help they need and embracing that people are different. > I was a quiet kid Quiet kids can have ADHD > my parents got calls from a teacher Teachers don't diagnose children. They don't decide whether you need to get medicated or not. Furthermore, yes people where probably very ignorant about ADHD in your childhood, we understand it much better now. > drugged up That not how ADHD meds work. They can give you the super power to fold your laundry in a single business day, they don't get you high. Some people hate how they feel but for many they work great. Medication is just one option, you can also learn better coping skills through therapy or coaching. > It feels rational to me As someone who was diagnosed late, it seems more like ignorance to me. | | |
| ▲ | hirvi74 2 hours ago | parent | next [-] | | > "Everyone else seems to know when to say the right thing at the right time but you don't. You are some weird alien that does not belong. You try to memorize things to say, copy how other people act, it works but the mask often slips. You must be hyper-vigilant in every social situation to not let the real you slip out. It becomes so automatic that you don't even remember who you are anymore. It is exhausting, so exhausting and alienating. You crash and burn from time to time." This is more of an Autism issue, no? I have ADHD, and this could not be further from the truth for me. I am not well-versed in Autism symptoms nor its various presentations, but I tend to excel in most social situations. I'm in my 30s with golden retriever levels of hyperactivity. Though, difficult to contain at times, I often think people are somewhat attracted to my high-energy presentation. I have no evidence to back up my claim, but I am inclined to believe the more ADHD-PI people suffer from those issues rather than the ADHD-C/-PH folks do. > They can give you the super power to fold your laundry in a single business day, they don't get you high. Stimulant medication can and absolutely get many people with ADHD high. Now, I am not saying everyone taking their prescribed medication as directed automatically gets high, but I believe there is a lot more abuse/misuse than doctors and researchers might be able to conclude. > Medication is just one option, you can also learn better coping skills through therapy or coaching. Everyone is different, but the data surrounding therapy and coaching for ADHD without medication does not really instill confidence in me. For brevity sake, I'll spare you all my opinions on/experiences with therapy. I've medicated for a decade, and it's better than nothing, but it ain't far off from nothing, in my experiences. Though, I think I am just a poor-responder to medication, which sucks because I am basically fucked in terms of help. | | |
| ▲ | cardanome an hour ago | parent [-] | | > This is more of an Autism issue, no? Yeah, first paragraph was more autism, the other more ADHD. Personally, ADHD helps me make friends but also makes me not that great at keeping them. People for sure can experience some social difficulty because of ADHD. Pure impulse control and high energy can also be regarded quite negatively. But in the right context people with ADHD can indeed shine socially. > Everyone is different, but the data surrounding therapy and coaching for ADHD without medication does not really instill confidence in me. Yes, good therapists are hard to find so I am not surprised you had bad experiences. I did not really have much luck myself but still generally urge people to give them a shot. Personally, coaching was a game changer for me. It is not the same as therapy. The main point is you are talking through your problems with someone who has ADHD themselves. They know what it is to have ADHD, they have coached countless people with ADHD. They know what works and what does not. They help you setting realistic and measurable goals and guide you towards reaching them. It is much more outcome and solution focused which can appeal to people more critical towards traditional therapy. Though coaching is also much less regulated so one also needs to careful to find someone decent. If you haven't tried, you might want to give it a shot. Anyway, I hope you find something that helps you. |
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| ▲ | thewebguyd 5 hours ago | parent | prev | next [-] | | I said in an earlier comment that the general population doesn't understand the special hell that being ADHD is when it comes to just trying to function in society, and I have to say I don't think I've ever seen it explained so clearly to the point where I felt like you were describing my life. Thank you for sharing. | | |
| ▲ | hirvi74 an hour ago | parent [-] | | To piggyback on the sentiment a bit -- I think the hardest part about ADHD, at least in my opinion, is that it is one of the handful of disorders in which much of the difficultly and misery originates from outside of the afflicted individual. In other words, ADHD does not really cause me any direct misery, but rather, my ADHD makes others people miserable, and how I am treated because of that is the source of my misery. Honestly, it sometimes feels as if ADHD is just society's way of saying that I am too annoying, unreliable, and unfit to be a part of them, therefore there is something inherently dysfunctional with me. Seriously, if I talk too much, who is more negatively affected, others or myself? If I need more time to complete work than others, then who is more negatively affected, my employer or me? Who is more negatively affected by my fidgeting, others or myself? |
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| ▲ | forgotoldacc 14 hours ago | parent | prev [-] | | I hear this a lot but also know a lot of people who were put on meds when they were young and didn't really understand what was going on. I also have an adult friend put on an antipsychotic to treat their moderate depression. They went through horrifying side effects while doctors kept telling them to stick with it. They're going through even more horrifying side effects during the third week of their withdrawal. There are no strict criteria. Some people need it. A lot of people don't. It's really no different from the opioid crisis America has, where many doctors hand stuff out like candy because, honestly, who cares? Not their problem. But it's a nice paycheck. And the constant downplaying and dismissiveness of it all, with many people who have personal experience saying things are over-prescribed as well as studies showing such[1][2], while also saying things are massively under-dosed, really does not help the image of the psychiatric drug industry trying to find a solution to any divergence being a pill. It's fine if you have actual struggles in life and need help and medicine helps you. It's good, actually. But if we're at a point where we're nitpicking and saying, "Your kid walks on their toes. That's bad. Let's get them diagnosed. Then get some meds", yeah, it's horrifying and absolutely indefensible. And yes. Putting a 10 year old on a prescription drug that makes them sit and fold laundry all day very much fits the definition 99% of people would consider "drugged up." 10 year olds have periods of being little shits. If they're folding laundry all day, and you're giving them medication that makes them do so, you are very much drugging them up. And yes. Teachers did proactively call parents and try to get kids (mostly boys) medicated in the 90s. It was so wild that even South Park had an episode about it. It's unfortunate because people with legitimate issues do get caught up in it and have their issues dismissed. But then children who have no problems are also victimized by being forced to take drugs that make them fold laundry and quit being a kid. [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC11107288/ [2] https://www.rutgers.edu/news/risky-combos-psychiatric-drugs-... | | |
| ▲ | dns_snek 12 hours ago | parent | next [-] | | Neither [1] nor [2] are studies showing that ADHD medication is over-prescribed. [1] isn't a study, it's a glorified blog post. [2] is a study that looked into the rate at which contraindicated medications are prescribed (6%). Prescribing contraindicated medication is a reason to be cautious and weigh the risks against the benefits. It does not indicate that the combination is unwarranted. > But if we're at a point where we're nitpicking and saying, "Your kid walks on their toes. That's bad. Let's get them diagnosed. Then get some meds", yeah, it's horrifying and absolutely indefensible. Nobody is diagnosing anyone with autism based on how they walk, but it might be a sign to seek an evaluation, usually when it's accompanied by other symptoms. Furthermore there's no medication for autism. | |
| ▲ | cardanome 13 hours ago | parent | prev [-] | | > to treat their moderate depression. I criticized depression being too easily diagnosed myself in the post above. Autism and ADHD are clearly underdiagnosed. I have posted some sources here: https://news.ycombinator.com/threads?id=cardanome#44586532 Maybe depression meds are given too easily. Not my area of expertise. Might also specific to the US. Getting medication here in Germany seems to be much harder. However, this has NOTHING to do with autism and ADHD diagnosis. It does not mean that ADHD meds are given too easily. They are a completely different thing. > But if we're at a point where we're nitpicking and saying, "Your kid walks on their toes. That's bad. Let's get them diagnosed. Then get some meds", yeah, it's horrifying and absolutely indefensible. That is not what is happening. That is pure fearmongering. First of all there is no medication for autism. Second of all, no nobody get diagnosed for walking funny. That is not how any of this works. I repeat, they are not getting medicated because medication for autism does not exist and probably can't even exist. And even for ADHD, meds are one option. You don't have to take them. They work exceptionally well for some people but not at all for others. Again, there is therapy and coaching. > hat makes them sit and fold laundry all day This is not how this works. The meds help with executive dysfunction. It when you want to do a thing, know how to do a thing, it is important to do it but you can't do it because your brain just doesn't cooperate. Medication helps you do the things you want to do. If you want to play video games all day, you will play video games all day, with or without medication. Simplified, people with ADHD have lower levels of dopamine. So they are constantly understimulated. Boring tasks hurt to do. Medication helps to get their dopamine level up so they can have the same level of stimulation as a neurotypical person that watches paint dry. They don't get you high, they get you from deficit to base level. And again > in the 90s We were ignorant of many things in the 90s. I don't want to invalidate your experience, surly these problems did exist, I am just saying that you childhood experiences might not be representative for the world in 2025. |
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| ▲ | gcau a day ago | parent | prev | next [-] |
| >Both autism are ADHD are vastly under-diagnosed especially in women and adults. How is this known or proven? |
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| ▲ | yieldcrv a day ago | parent | prev | next [-] |
| kind of like coughing sure, people with the common cold do it but so do people with at least 100 other ailments |
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| ▲ | unethical_ban a day ago | parent | prev [-] |
| Seeing shared experience is one thing, but I don't trust Shorts/Reels to be an authority on anything important like medical diagnoses. It should be like wikipedia: She should have a link to a scientific paper or doctor corroborating her entertainment skit. As I read through your entire comment, I see you might agree. And yes, I've seen that woman on Reels before, some of her observations I can confirm, such as "body double" or whatever it's called where you are more productive when interacting with someone else, even if they aren't helping you with something. Aside: I don't think my PCP is the #1 person to talk to regarding variations in ADHD treatment. I have adderall, which can help sometimes focus me on a task and bypass the anxiety of talking/typing through issues at work. But I loathe using it daily. I wonder if any other medication works differently. Ritalin is different but similar. |
