A lad at the supermarket meat counter in Madison, Wisconsin, greeted me with his best Dick Van Dyke. I asked him (laughing) to please give me a break. He cheekily told me I should do the same. I was about to get formidable when it dawned on him that I'm actually British. He avoids me now.
The first part of psychiatrist-blogger Scott Alexander's post on Adderall risks is worth a read: https://slatestarcodex.com/2017/12/28/adderall-risks-much-more-than-you-wanted-to-know/ He agrees with you that ADHD, insofar as it's a real thing and not just an arbitrary line drawn somewhere on the curve of normal human variation, is both over- and under-diagnosed. Which is what we'd expect from any medical test (Scott has an article on this exact point: https://slatestarcodex.com/2014/09/17/joint-over-and-underdiagnosis/), but the ADHD case is particularly cruel: any hoop you make people jump through to get a diagnosis will disproportionately impact those who actually have ADHD! Speaking for myself (diagnosed by an NHS specialist in my mid-30s), getting a diagnosis was a huge bureaucratic pain and the petty hurdles I need to jump to retain access to my meds seem almost wilfully ADHD-hostile. The meds themselves are somewhat helpful - I find it harder to cope with everyday things when I haven't taken them - but the diagnosis itself was a huge deal: I'm not just scatty and lazy and useless like I've been told all my life, I have a *medical condition* that is *not my fault*, and "just trying harder" won't cut it. Conversely, I now feel I have permission to adopt weird coping mechanisms if they help, because *I have a medical condition*.
Thanks for this, it’s really interesting. I agree with you that being absolved of blame must be a very powerful relief — I feel the same about genetic explanations for over-eating, and I want to strangle people who leave those comments about “have you tried just eating less” when maybe they actually are less hungry and so find that easier?
Suggestions that include the word "just" are almost always rage-inducing. Why yes, I have tried fucking "just". I've started responding to such suggestions with "Yes, but it would take years, and cost millions of lives."
It reminds me of when I was in Chipotle in Philadelphia and a couple of the staff commented on my "amazing British accent" - which was nice, as I'm Welsh 😀
A Times leader urging Labour to execute one of its flagship policies once in office? Owen Jones complaining voters like Starmer’s Labour too much? *Thhhiiinnngggs, can only get beeetttttteeerrr*
Glad you raised the national...ism point. I had begun to think that I was the only one who noticed a certain pattern here, not to mention the Weimar-on-speed economic backdrop. Where to run?
This is such a good analysis of the ADHD over/under diagnosis. Particularly ADHD is such a divisive issue as there is so much pushback that it is "an excuse" for bad behaviour/lack of discipline in children from those who think that naughty children just need a clip round the ear. Private psychiatry is certainly a total Wild West situation, difficult for parents to navigate and needs a good tidy-up. There is a huge amount of judgment against parents who go private when they suspect ADHD or ASD in their child (the symptoms can be hard to unravel from each other) but I don't really blame them for doing whatever they can to get some answers as to why their children are suffering and, you're right, they really are
Yeah, getting an ADHD diagnosis on the NHS is an epic quest even for a neurotypical parent (and since ADHD is largely genetic, if a child has ADHD then there's a decent chance that one or more parents do too). I don't at all blame people for going private if they can afford it, when the alternative is their kid getting no benefit from a year or two of schooling while on an NHS waiting list.
I was diagnosed with mild ADHD last year. I’m having to change medication (and may have to come off it altogether), because although it gives me better focus and more energy, it’s interacting with other medication I’m on to cause a thing called serotonin syndrome. Turns out that too much happy neuro-chemical isn’t a happy thing at all. Who knew?
Matt Levine is wonderful. I highly recommend signing up for his free newsletter, even if you know or care little about finance (no Bloomberg subscription needed).
A lad at the supermarket meat counter in Madison, Wisconsin, greeted me with his best Dick Van Dyke. I asked him (laughing) to please give me a break. He cheekily told me I should do the same. I was about to get formidable when it dawned on him that I'm actually British. He avoids me now.
😬😬😬
I know,, right? I'm waiting for my DBE for my grassroots work over forty years advancing British culture in the US at great personal expense. 😂😂
What’s the collective noun for the frozen-out “thought criminals”. An arctic circle?
The first part of psychiatrist-blogger Scott Alexander's post on Adderall risks is worth a read: https://slatestarcodex.com/2017/12/28/adderall-risks-much-more-than-you-wanted-to-know/ He agrees with you that ADHD, insofar as it's a real thing and not just an arbitrary line drawn somewhere on the curve of normal human variation, is both over- and under-diagnosed. Which is what we'd expect from any medical test (Scott has an article on this exact point: https://slatestarcodex.com/2014/09/17/joint-over-and-underdiagnosis/), but the ADHD case is particularly cruel: any hoop you make people jump through to get a diagnosis will disproportionately impact those who actually have ADHD! Speaking for myself (diagnosed by an NHS specialist in my mid-30s), getting a diagnosis was a huge bureaucratic pain and the petty hurdles I need to jump to retain access to my meds seem almost wilfully ADHD-hostile. The meds themselves are somewhat helpful - I find it harder to cope with everyday things when I haven't taken them - but the diagnosis itself was a huge deal: I'm not just scatty and lazy and useless like I've been told all my life, I have a *medical condition* that is *not my fault*, and "just trying harder" won't cut it. Conversely, I now feel I have permission to adopt weird coping mechanisms if they help, because *I have a medical condition*.
Thanks for this, it’s really interesting. I agree with you that being absolved of blame must be a very powerful relief — I feel the same about genetic explanations for over-eating, and I want to strangle people who leave those comments about “have you tried just eating less” when maybe they actually are less hungry and so find that easier?
Suggestions that include the word "just" are almost always rage-inducing. Why yes, I have tried fucking "just". I've started responding to such suggestions with "Yes, but it would take years, and cost millions of lives."
I wrote about the relief of getting a diagnosis at greater length in - where else? - an Astral Codex Ten comment thread: https://astralcodexten.substack.com/p/open-thread-236/comment/8253118
People aren't really called Critter Fink and Brinton Parker, are they?
Critter Fink would be a great name for a hard boiled private detective in a Raymond Chandler story.
The "bad luck" meme guy's real name is Kyle Craven, which sounds more like the secret daytime identity of a Stan Lee created master Super Villain.
I'm enjoying the irreverent, and cutting short articles
I have named that entire syndrome the “Why don’t you just...?” thing. (Whether someone gets it or not depends on the rest of the conversation.)
It reminds me of when I was in Chipotle in Philadelphia and a couple of the staff commented on my "amazing British accent" - which was nice, as I'm Welsh 😀
A Times leader urging Labour to execute one of its flagship policies once in office? Owen Jones complaining voters like Starmer’s Labour too much? *Thhhiiinnngggs, can only get beeetttttteeerrr*
Love the idea of Matt Goodwin as the populist beat poet - the Allen Ginsberg of the small boats, the Jack Kerouac of the culture wars
Glad you raised the national...ism point. I had begun to think that I was the only one who noticed a certain pattern here, not to mention the Weimar-on-speed economic backdrop. Where to run?
This is such a good analysis of the ADHD over/under diagnosis. Particularly ADHD is such a divisive issue as there is so much pushback that it is "an excuse" for bad behaviour/lack of discipline in children from those who think that naughty children just need a clip round the ear. Private psychiatry is certainly a total Wild West situation, difficult for parents to navigate and needs a good tidy-up. There is a huge amount of judgment against parents who go private when they suspect ADHD or ASD in their child (the symptoms can be hard to unravel from each other) but I don't really blame them for doing whatever they can to get some answers as to why their children are suffering and, you're right, they really are
Yeah, getting an ADHD diagnosis on the NHS is an epic quest even for a neurotypical parent (and since ADHD is largely genetic, if a child has ADHD then there's a decent chance that one or more parents do too). I don't at all blame people for going private if they can afford it, when the alternative is their kid getting no benefit from a year or two of schooling while on an NHS waiting list.
No, me neither. Who wouldn’t want to help their kid? I just wish the conversation was more nuanced about the limits and side-effects of medication.
I was diagnosed with mild ADHD last year. I’m having to change medication (and may have to come off it altogether), because although it gives me better focus and more energy, it’s interacting with other medication I’m on to cause a thing called serotonin syndrome. Turns out that too much happy neuro-chemical isn’t a happy thing at all. Who knew?
Oof, that's tough. I hope you find a path through it.
Thanks.
In the meantime, do let me know if you fancy any serotonin. I can pop some in a Jiffy bag and post it to you c/o The Atlantic.
Matt Levine is wonderful. I highly recommend signing up for his free newsletter, even if you know or care little about finance (no Bloomberg subscription needed).
I have! I loved his pre-twitter Musk ones; he really called that right.