> Recently I was reading a book on ADHD and the author was quite adamant that you could only be diagnosed with ADHD if your life was worse than "the norm". In this view, if you have symptoms of ADHD but can, for instance, hold down a good job then by definition you don't have ADHD. I deleted the book from my Audible account.
IANAP, but that sounds correct to me. I recall the DSM requiring negative impact on one's lifestyle as one of the criteria for diagnosis of any mental disorder. And even if I'm misremembering that, that's what psychiatrists look for in practice. They not only query what symptoms you're feeling, but also the impact they have on your day to day life.
Which makes total sense. Treatment of any disorder, especially mental ones, carries a (sometimes significant) risk. It would be unethical to subject someone to that risk for no possible benefit.
> It would be unethical to subject someone to that risk for no possible benefit.
Let's take two people, say me and Einstein. Let's say Einstein has super-severe ADHD and thus performs so poorly that he can fairly be compared to me.
Is there really "no possible benefit" to curing that ADHD? Keep in mind that the real Einstein discovered relativity, and uh... I'm just going to say my contributions to science have been a bit less dramatic.
I don't think it's at all unreasonable to posit that there are plenty of people who are gifted enough to compensate for their mental issues, but they'd still benefit if they could fully apply themselves instead of wasting half their talent mitigating such issues.
This is the argument I've been making for years. I used to be _way_ smarter than I am, I have concrete examples of things I used to do with ease that are now major cognitive effort, but I'm still alright in a lot of ways. Most folks meeting me would still consider me pretty smart, although I have profound struggles with memory lately.
And there doesn't seem to be a doctor in the world who considers this a problem. "Yep, it goes 0-60 in 27 seconds, just like a chevette should!" "but doc, it's a bugatti". That would be one hell of an incompetent mechanic.
The same psychiatrist from the hair dryer incident in the link has written about this. He's skeptical about ADHD being a discrete condition, and generally thinks that if ADHD drugs will help you focus, taking them is reasonable whether you're diagnosed with ADHD or not:
> Psychiatric guidelines are very clear on this point: only give Adderall to people who “genuinely” “have” “ADHD”.
> But “ability to concentrate” is a normally distributed trait, like IQ. We draw a line at some point on the far left of the bell curve and tell the people on the far side that they’ve “got” “the disease” of “ADHD”. This isn’t just me saying this. It’s the neurostructural literature, the the genetics literature, a bunch of other studies, and the the Consensus Conference On ADHD. This doesn’t mean ADHD is “just laziness” or “isn’t biological” – of course it’s biological! Height is biological! But that doesn’t mean the world is divided into two natural categories of “healthy people” and “people who have Height Deficiency Syndrome“. Attention is the same way. Some people really do have poor concentration, they suffer a lot from it, and it’s not their fault. They just don’t form a discrete population.
> Meanwhile, Adderall works for people whether they “have” “ADHD” or not. It may work better for people with ADHD – a lot of them report an almost “magical” effect – but it works at least a little for most people. There is a vast literature trying to disprove this. Its main strategy is to show Adderall doesn’t enhance cognition in healthy people. Fine. But mostly it doesn’t enhance cognition in people with ADHD either. People aren’t using Adderall to get smart, they’re using it to focus.
IANAP, but that sounds correct to me. I recall the DSM requiring negative impact on one's lifestyle as one of the criteria for diagnosis of any mental disorder. And even if I'm misremembering that, that's what psychiatrists look for in practice. They not only query what symptoms you're feeling, but also the impact they have on your day to day life.
Which makes total sense. Treatment of any disorder, especially mental ones, carries a (sometimes significant) risk. It would be unethical to subject someone to that risk for no possible benefit.