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[Maximum Spin]

That they continue to give her the same medication despite those side effects (for which there actually have been studies demonstrating, if you care to look it up on Pubchem) is a failure of the healthcare system, not the very notion of medicating mental issues.

Only if the medication is not actually helping or other antipsychotics have not been tried with the same result. While he believes that he can still "clearly see the hypomania" and that his mother is subjectively worse off now than before, I'm not going to take his word for it.

Oh, btw, despite the implications of the name, mania is actually the only defining symptom of bipolar disorder, so "it only controls the mania" doesn't actually mean anything with respect to that. Abilify is not an antidepressant and was never meant to be one, but it is, in fact, suitable to control bipolar disorder if the bipolar disorder doesn't present with depressive episodes.

[Dunamisdeos]

I read his thing as though he was talking about the private healthcare system and its bias towards profit over responsible care. Is he talking about all antidepressants or the notion of medicating?

Because yes, it is silly to condemn those things across the board.

[Maximum Spin]

(my brother was diagnosed with ADD and given Ritalin at the age of 3; my parents threw out the pills, and he's demonstrated no symptoms in his adult life)

That... doesn't mean he didn't have it then. That's the normal expected prognosis of a number of childhood disorders that definitely do actually exist. I wouldn't say that a kid at age 3 needs Ritalin - I mean what does he even have to pay attention to at that point - but, on the other hand, if you bother to get a diagnosis for something for your kid, the presumption is that it's affecting his life significantly – that's actually a necessary diagnostic criterion for most psychological disorders, in fact – and therefore that you want to do something about it. If they didn't actually want medication, your parents were really wasting everyone's time by bringing it up in the first place. Oh, and helping to inflate the price of pharmaceuticals by injecting spurious demand.

[martinuzz]

if you bother to get a diagnosis for something for your kid, the presumption is that it's affecting his life significantly – that's actually a necessary diagnostic criterion for most psychological disorders, in fact – and therefore that you want to do something about it. If they didn't actually want medication, your parents were really wasting everyone's time by bringing it up in the first place. Oh, and helping to inflate the price of pharmaceuticals by injecting spurious demand.

Wait, what? So you are saying the only reason people should get a diagnosis for their child is when they want meds for it? Don't you think parents maybe just want a diagnosis to know if and what's wrong with their child? It's not like meds are the magic answer to life, the universe and everything. There's also things like councelling, coaching, extra-scholar training. I think it's a very sick thought to say that "if you don't want to put amphetamines in your kid, you shouldn't have gone for diagnosis in the first place". Unless I misread you, that's what you say there.

[Lord Shonus]

if you bother to get a diagnosis for something for your kid, the presumption is that it's affecting his life significantly – that's actually a necessary diagnostic criterion for most psychological disorders, in fact – and therefore that you want to do something about it. If they didn't actually want medication, your parents were really wasting everyone's time by bringing it up in the first place.

More likely, a caregiver ordered it done. I had that happen to me in 2nd grade - the teacher told my parents that I'd be expelled if I didn't get a Ritalin prescription. The shrink told them there was no basis for one, and prescribed an absurdly low dose that I didn't really need to take.

[smjjames]

Well, I can't recall the exact circumstances, but his reaction to the medication was rather strong (effectively put him to sleep), hence my parents' decision to toss it. It was also done at the behest of his teacher, not my parents- the teacher was concerned that he could not sit in a corner of a room by himself while everyone else ran about, at the age of 3.

Not being able to sit still sounds like a typical toddler to be honest, and the teacher wanting it isn't a good reason, resorting to drugs shouldn't be the first move in that situation.

Also, ritalin somehow gave me stuttering, no idea how, but it did. Got it dealt with via speech therapy though.

if you bother to get a diagnosis for something for your kid, the presumption is that it's affecting his life significantly – that's actually a necessary diagnostic criterion for most psychological disorders, in fact – and therefore that you want to do something about it. If they didn't actually want medication, your parents were really wasting everyone's time by bringing it up in the first place.

More likely, a caregiver ordered it done. I had that happen to me in 2nd grade - the teacher told my parents that I'd be expelled if I didn't get a Ritalin prescription. The shrink told them there was no basis for one, and prescribed an absurdly low dose that I didn't really need to take.

Again, drugs shouldn't be the first resort to fix behavior problems. It speaks more to the lack of the teachers ability to deal with it than the kid.

[Maximum Spin]

Well, I can't recall the exact circumstances, but his reaction to the medication was rather strong (effectively put him to sleep), hence my parents' decision to toss it. It was also done at the behest of his teacher, not my parents- the teacher was concerned that he could not sit in a corner of a room by himself while everyone else ran about, at the age of 3.

Oh, well, yeah, teachers are assholes. That said, I'm given to understand that that kind of paradoxical reaction to stimulants - Ritalin is a stimulant, so it's "weird" if it puts someone to sleep - is actually indicative of ADD. I would guess that the diagnosis was unnecessary but not actually inaccurate.

Wait, what? So you are saying the only reason people should get a diagnosis for their child is when they want meds for it? Don't you think parents maybe just want a diagnosis to know if and what's wrong with their child? It's not like meds are the magic answer to life, the universe and everything. There's also things like councelling, coaching, extra-scholar training. I think it's a very sick thought to say that "if you don't want to put amphetamines in your kid, you shouldn't have gone for diagnosis in the first place". Unless I misread you, that's what you say there.

Literally, according to the diagnostic criteria as laid out in the DSM, there is no mental disorder unless there is a significant impairment of function. In other words, if you're not sure if there's something wrong with your kid, there's nothing wrong with your kid and you should not be seeking a diagnosis because there's nothing to diagnose. So no, unless there's a problem serious enough to medicate, you should not ask for a diagnosis. The medical system is not at fault if parents (or pushy teachers who have no business being involved in the first place) are too afraid that every little quirk might be "something wrong".

More likely, a caregiver ordered it done. I had that happen to me in 2nd grade - the teacher told my parents that I'd be expelled if I didn't get a Ritalin prescription. The shrink told them there was no basis for one, and prescribed an absurdly low dose that I didn't really need to take.

Christ, I'm glad that wouldn't be legal here.

[Dunamisdeos]

So no, unless there's a problem serious enough to medicate, you should not ask for a diagnosis.

I think there are plenty of diagnoses that do not require medication. That's absurd to think that a person cannot manage a condition without medication. Just to confirm, is that really what you are saying? That it's not worth knowing what condition you or your child has sans-meds, and therefore what symptoms are indicative or caused or can be managed without meds?

Because I am severely ADHD, have retained the symptoms well into adulthood, and have found plenty of ways to function without meds throughout my life. I did resort to taking meds occasionally, but they are hardly necessary. I found the diagnosis without prescribed meds empowering, like putting a name to a faceless enemy.

[Lord Shonus]

More likely, a caregiver ordered it done. I had that happen to me in 2nd grade - the teacher told my parents that I'd be expelled if I didn't get a Ritalin prescription. The shrink told them there was no basis for one, and prescribed an absurdly low dose that I didn't really need to take.

Christ, I'm glad that wouldn't be legal here.

It was the early 90s. ADD was the hot new diagonosis of the time, and was the go-to pop-explanation for any aberrant behavior (in this case, I was already at a 5th grade reading and math level, so even though I was on-curve in most of my other subjects (unless something interested me enough to read about it on my own, which was much harder then) I spent a great deal of time being quite bored) - much like autism/aspergers (which I've also had teachers and co-workers insist that I have) seems to have become today.

[martinuzz]

Literally, according to the diagnostic criteria as laid out in the DSM, there is no mental disorder unless there is a significant impairment of function. In other words, if you're not sure if there's something wrong with your kid, there's nothing wrong with your kid and you should not be seeking a diagnosis because there's nothing to diagnose. So no, unless there's a problem serious enough to medicate, you should not ask for a diagnosis. The medical system is not at fault if parents (or pushy teachers who have no business being involved in the first place) are too afraid that every little quirk might be "something wrong".

That's the dumbest thing I've seen in ages. Do you know what missed diagnosis, or late diagnosing costs, in societal costs at a later time, and human suffering?
Whatever happened to better safe than sorry?
But oh hey, I forgot, that's long term thinking, at that's forbidden in policy making.

Besides, how are laymen parents supposed to be sure there's something wrong with their child or not? If they could accurately diagnose that, we'd need to diagnosticians at all.

DSM is such a silly, silly book. It's with good reason that those in the healthcare professional field who actually work with patients on a day to day basis hate it with a passion. I have yet to meet a social worker / elderly care nurse / field psychologist who does not want the DSM thrown down a paper shredder, because it's only purpose is to appease health insurance companies, and make it near impossible to approach a patient with a personalised and holistic viewpoint.

EDIT: maybe that's not completely fair. Maybe that's not the original intent with which the DSMs were compiled, but it's most certainly how they are being abused.
Treatments slightly outside the narrow box provided by the DSM simply won't be paid for.

[Maximum Spin]

I think there are plenty of diagnoses that do not require medication. That's absurd to think that a person cannot manage a condition without medication. Just to confirm, is that really what you are saying? That it's not worth knowing what condition you or your child has sans-meds, and therefore what symptoms are indicative or caused or can be managed without meds?

Because I am severely ADHD, have retained the symptoms well into adulthood, and have found plenty of ways to function without meds throughout my life. I did resort to taking meds occasionally, but they are hardly necessary. I found the diagnosis without prescribed meds empowering, like putting a name to a faceless enemy.

It sounds like your symptoms are probably "serious enough to medicate", you're just choosing to manage them as far as possible without it. I do the same thing with the same diagnosis, so no, I'm not saying it's impossible. "Serious enough to medicate" just means that medication would be a reasonable strategy, not the only strategy. That said, the way psychological diagnoses are defined also means that just trying to find out "what symptoms are indicative or caused" is useless, because the conditions don't actually exist outside of a set of vaguely correlated but independent symptoms. You won't actually find out any new information from a diagnosis, other than possibly the fact that someone has had it before - the diagnosis is literally just a concise way of saying "has at least a certain number of these symptoms".

[Maximum Spin]

DSM is such a silly, silly book. It's with good reason that those in the healthcare professional field who actually work with patients on a day to day basis hate it with a passion. I have yet to meet a social worker / elderly care nurse / field psychologist who does not want the DSM thrown down a paper shredder, because it's only purpose is to appease health insurance companies, and make it near impossible to approach a patient with a personalised and holistic viewpoint.

Funny, I know a certain number of actual psychiatrists, the medically trained professionals who are taught about science and not basing your practice in emotion, and they don't think that at all.

[Dunamisdeos]

I think there are plenty of diagnoses that do not require medication. That's absurd to think that a person cannot manage a condition without medication. Just to confirm, is that really what you are saying? That it's not worth knowing what condition you or your child has sans-meds, and therefore what symptoms are indicative or caused or can be managed without meds?

Because I am severely ADHD, have retained the symptoms well into adulthood, and have found plenty of ways to function without meds throughout my life. I did resort to taking meds occasionally, but they are hardly necessary. I found the diagnosis without prescribed meds empowering, like putting a name to a faceless enemy.

It sounds like your symptoms are probably "serious enough to medicate", you're just choosing to manage them as far as possible without it. I do the same thing with the same diagnosis, so no, I'm not saying it's impossible. "Serious enough to medicate" just means that medication would be a reasonable strategy, not the only strategy. That said, the way psychological diagnoses are defined also means that just trying to find out "what symptoms are indicative or caused" is useless, because the conditions don't actually exist outside of a set of vaguely correlated but independent symptoms. You won't actually find out any new information from a diagnosis, other than possibly the fact that someone has had it before - the diagnosis is literally just a concise way of saying "has at least a certain number of these symptoms".

Yes. That diagnosis is inherently good and helpful, barring misdiagnosis. I can look at what is known about a condition and make further decisions about medication or management. I had the medication available, but used it at my own discretion. To be clear, I went from primary care->specialist->behavioral specialist, and was properly diagnosed. Whole lot of misdiagnosis during that time. And I have absolutely known others who felt they needed the meds to cope, so I'm not saying there's no place for the meds.

For reals, are you really saying a diagnosis has no benefit outside of medication? Because you've said that a few times, and it seems super important to clarify. Only point I'm going for here is that a diagnosis without medication can still be super helpful.

Well, there are other treatment methods than medication, which I think is key here. The best treatment is the one that best balances symptom reduction and impact on one's life.

Yeah pretty much this. I feel like a lot of people are saying the same thing in a different way here and being misconstrued.

[Rolan7]

Eerily similar to what happened to me. I was acting up out of boredom, nothing really that bad, and the teacher insisted I get tested. It was extremely common at the time. I don't remember my diagnosis, just that I started reading in class instead of taking pills. Usually relevant textbooks, still much less boring than the lectures.

[martinuzz]

DSM is such a silly, silly book. It's with good reason that those in the healthcare professional field who actually work with patients on a day to day basis hate it with a passion. I have yet to meet a social worker / elderly care nurse / field psychologist who does not want the DSM thrown down a paper shredder, because it's only purpose is to appease health insurance companies, and make it near impossible to approach a patient with a personalised and holistic viewpoint.

Funny, I know a certain number of actual psychiatrists, the medically trained professionals who are taught about science and not basing your practice in emotion, and they don't think that at all.

What makes you think that social workers / nurses, and psychologists are not professionally trained scientists? Okay maybe they did not study medicine AND psychology, but they did at least one of those, or a pedagogic studies. Well, maybe the nurse is one gradation below university.

Besides, psychiatry inherently isn't an exact science, it deals with the mind, which none of us fully understand.
Psychiatry does indeed try to bring exact sciences like medicine, neurobiology, biochemistry together with the soft science of psychology, but to be fair, a psychiatrist just as versed in the exact workings of the human psyche as a field psychologist, a social pedagogue, or a professor in sociology.
Your emphasis on actual does look a bit like a symptom of ivory tower syndrome.