ADHD -- Overdiagnosed in USA or what?


Fiannan
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Interesting article:

ADHD among American Schoolchildren

And...

CNN - ADHD may be overdiagnosed, study says - September 1, 1999

There seems to be quite an emotional debate in education and psychology over issues like proper diagnosis of ADHD, treatments, etc. The rate of use of drugs like ritalin has grown geometrically in the last decade and a half and is causing concern as to long-term consequences.

Personally, I find it troubling that some areas of the country have huge numbers of young boys being diagnosed with this "disorder" and being put on stimulants that may have adverse side-effects (and which many of these kids now have parents swiping the ritalin and becoming addicted to it). I am also troubled that if you go to Asian nations or places like Sweden or Russia you don't find very many kids diagnosed with this and yet their schoolkids out-perform our's quite easily (maybe in Asia and Russia kids don't dare act up in school or else the penalties are quite severe -- and one wonders if that's a bad thing). Then again, in Sweden which is very non-punishment oriented there too one finds few kids diagnosed with "DAMP" and strict guidlines on how extreme cases should be treated.

Personally, if a kid needs a stimulant to be focused why not pack a Mountain Dew in his lunch? How about classrooms that don't bore someone to tears? And for once why don't we recognize that small children naturally need to burn energy off and it's not natural for them to sit quietly? Brigham Young condemned mothers who gave their little ones alcohol to quiet them down in church meetings. Wonder how he'd feel today with the drugs being prescribed for kids.

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I think there are some kids who are so off the scale that intervention is needed but this guy seems to be more correct than not:

U.S. psychologist Dr. Bob Jacobs told the Youth Affairs Network Queensland conference that doctors and pharmaceutical companies had turned behavioral problems in children into a disorder.

He voiced concern that misdiagnoses resulted in youngsters being prescribed powerful drugs like Ritalin, which may affect their long-term mental and physical development.

In a radio interview afterwards, Jacobs - who is on the advisory board of the International Center for the Study of Psychiatry and Psychology - said his conclusions had been made as a result of his own observations during many years in practice, working with children and families.

He cited cases where parents reported that their ADHD-diagnosed children could not pay attention - but then those same children could play video games for hours without being distracted.

Sometimes where parents made changes in the way they were doing things, the symptoms would go away.

"A real disease doesn't go away when somebody else does something," he argued.

Jacobs said experts had put labels on different behaviors and called them a disease.

"There's no proof. Nobody has ever presented any evidence of a condition called ADHD, except to say all these children are hyperactive; all these children are inattentive, and therefore they all have the disease. It's the 'and therefore' that I'm concerned about."

Jacobs acknowledged that many parents would disagree with him. Parents tend to believe what has become the mainstream view, in part because the drugs prescribed for ADHD do work in that they make the child more docile and more compliant.

Ritalin Debate: Some Experts Doubt Existence of ADHD -- 04/18/2003

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I think most people would agree that it's overdiagnosed in schools.

However, I strongly disagree with the notion that ADD/ADHD doesn't really exist.

LM

I would agree. It seems that every time a child acts up in class or doesn't pay attention, they are diagnosed as ADD or ADHD. It's a hard call to make. My wife is a teacher and she sees kids that are ADD/ADHD and others that are diagnosed ADD/ADHD but really aren't. She thinks the next big "thing" for kids will be "slow processing speed". She has a few kids in her class that have psychologists notes stating this, but they do just fine when it's something that interests them (cartoons, video games, etc).
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I do agree that it is overdiagnosed/overtreated, but I do NOT agree that it isn't a real problem. It is a physical deformation of the frontal lobe of the brain.

Just because a kid acts up does not mean that he/she is ADHD. For a REAL diagnosis, it has to affect more than one part of your life. A common mistake with ADHD is that everyone thinks that it means the person can't focus at all and runs and jumps all over the place. Yes, that CAN happen, but one thing that is not associated with any other disorder is hyperfocus. With ADHD, you either can't focus at all, or you focus too much (like the other night when I sat down to do a sudoku puzzle and the next time I looked up it was 3 a.m.) and the hyperactivity can range from jumping around to a constant, involuntary shaking of legs or arms, twiddling pencils or rubber bands without realizing it, etc.

In response to the video game quote- That's hyperfocus. I couldn't carry on a conversation, do simple tasks like empty the dishwasher, or remember to put shoes on (or the days when I can't remember if I put socks on, so I put some on and later realize that I'm wearing two pairs) but I could sit for HOURS taking electronics apart, play music, or clean cages. It's an uncontrollable thing and you don't get to choose what you hyperfocus on... I once hyperfocused on brushing my teeth and half an hour later my gums were raw. That hyperfocus gets us in a lot of trouble because, logically, if we can focus on THAT thing and dont focus on other things, we're obviously just lazy.

Anyone who says ADHD doesn't exist needs to come meet me. The most common things I hear about it are: "You just choose to be that way." "You're just being immature." "You're just lazy." and my personal favorite: "You're just being rebellious." There are some people (like me... and I swear this has happened on more than one occasion) that it is so severe that they forget to go to the bathroom. I mean, not really "forget" but on the way to the bathroom get distracted with anything and everything so that an hour later you realize "WOW I really have to pee! THAT'S what I was going to do!" That sort of thing is not a choice, that's not immaturity, it's not laziness, and it's not rebellious behavior. It's a DISEASE.

I DO think that a lot of people use ADHD to rationalize their ill-behaved kids, but it is a real disease that causes a lot of problems for those of us who have it.

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Personally, if a kid needs a stimulant to be focused why not pack a Mountain Dew in his lunch? How about classrooms that don't bore someone to tears? And for once why don't we recognize that small children naturally need to burn energy off and it's not natural for them to sit quietly? Brigham Young condemned mothers who gave their little ones alcohol to quiet them down in church meetings. Wonder how he'd feel today with the drugs being prescribed for kids.

I have a couple responses here... Soda + ADHD = Most irritating child you've ever met. First of all, the stimulant doesn't actually stop the hyperactivity part-it helps with the inattentiveness. Once you can focus on things, you actually NOTICE when you're twitching, fiddling with things, etc. so you can stop. So, yeah, the hyperactivity might be lessened a tiny bit, but all that sugar is going to make them go haywire. Diet has a LOT to do with the ability to focus so when you drink a soda, the sugar evens out the caffeine and you don't get any benefit (though your dentist likes those checks he gets for filling the rotting teeth!) PLUS if it's a small child, they think that drinking soda causes you to get hyper and this thought alone is enough to make them bounce off the walls. Also, a soda isn't enough for a lot of people. There are different degrees of ADHD. My sister just needs exercise and she's good to go... I on the other hand need LOTS of different kinds of therapy.

Classrooms are boring, BUT you don't get a choice on what you focus on. Even if it's interesting, I may not be able to pay attention, and the same goes with lessons. Also, any class that requires reading is out of the question. I couldn't read an entire book before medication because I would read a sentence, forget what that sentence said so I'd read it again...and again...and again... until I gave up and just went on.

Parents shouldn't give their kids medication because they are annoying... This is nothing like giving babies alcohol to quiet them down. Yes, I do take my meds partially because I annoy everyone around me (I can't help it) but it's also for ME. Part of treating ADHD with medication is to make the person with the disorder feel better. Imagine being frustrated every single second of every single day for your entire life because you know that you can't do even the most basic tasks a two-year-old could do. That's why depression and anger disorders usually come along with ADHD. That baby isn't bothered by the fact that he/she's annoying someone, someone with ADHD is very bothered by the fact that they KNOW everyone is annoyed by them and that they can't do anything about it.

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Thanks for the insight on ADHD in these posts...I must admit to having been a little confused about the use of caffeine in the treatment of the condition, as I'd always just thought that ADHD meant a child was hyperactive and therefore caffeine would just increase the hyperactivity, thanks for proving me wrong :)

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THANK YOU Cliffie, and fent.

Having ADD is so much more than being hyperactive or messy.

My husband has ADD but he is not hyperactive, but he sure can do that overfocus thing, and forget about time, or what he does with his things, or whether or not he ate that day (unless he's at work, because they feed them free meals), when he organizes everything is still messy. I could go on.

I do agree Fiannan that we have a problem with teh school system. Children are NOT meant to sit at desks all day. So there are doctors and teachers who assume that disruption = ADD.

Depression and Asperger's Syndrome, OCD, and such things are often misdiagnosed as ADD (and even the other way around sometimes).

Ritalin is not the best drug out there for ADD. Adderall and others are better, and it also depends on the type of ADD you have. Many people with ADD can focus on things if they are interested in it, but the moment it stops stimulating them (basically not giving them the adrenaline they need to keep their brain going) nope it's out the window.

Another problem with caffeine is that it is quick release. There's no time delay, and no regulation. Thusly, over the long run caffeine makes ADD worse.

Cliffie is correct about the prefrontal cortex being the issue. The deformity lies in the fact that when someone with ADD tries to focus on something instead of the activity in the prefrontal cortex increasing it decreases. This is why stimulant medication makes it better, and why in the short term caffeine makes ADD patients feel better.

For more information on ADD: Clicky

Chapter 12 deals with ADD (they're mini chapters).

On the same site they have a test you can take to see if you have ADD and what type you have. My husband is Type 2. There's a link to the tests on this page: Clicky

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You had to pay to take the online test in the link provided so I googled and found this site

Free Online ADD Test, Free ADHD Test Online

Don't know if it's reputable or not, I scored 35/90 which I thought was low, but it said many of my answers indicated possible ADHD symptoms and advised that I seek further advice from a doctor...(Don't know what the results are for others, would be good to compare perhaps?)

Btw, I don't think that I have ADD or ADHD and it was difficult to answer some of the questions in a simple 'yes' or 'no' format, for me anyway, lol!

Just thought I'd add another free online test for comparison...the site seems genuine (apart from the blatant plug for medications), and the list of possible symptoms of ADD/ADHD is exhaustive...

Attention Deficit Disorder Test / ADHD Test

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Haha, 90/90... would have never guessed :)

That is the exact preliminary test they have you fill out. What they did for me for diagnosis was they had ME fill out a form kind of like that for school activities, chores, leisure time, time with friends, and time with family so that it could show that these symptoms were in ALL areas of my life. I also had to provide at least 3 examples for each. Then, they gave the same forms to my parents for them to fill out, and then to each of my past and present teachers. Then, they had me see a few different psychs who all observed my speech, my restlessness, etc. Then they compared the results (which all showed a high probability of ADHD) and, because of the high level of consistency (they knew I wasn't just making it all up) they decided that I really did have it. The problem with the online test is that you're going to think of things in different areas of your life- like you may forget to do or become distracted during tasks at home, but not at work/school. That's NOT ADHD. It should be present in all areas of your life.

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The medication is a window of opportunity sometimes. They're not learning. They frequently don't have friends. Social skills are difficult. They can't read situations when distracted. Adults and kids are exhausted just being around them. They can hyperfocus on problems, particularly social ones with no resolution, just a looping of confusion and emotional overdrive. ADHD may go hand in hand with something else: behavioural disorders, psychological, autism spectrum etc. This can make things fairly complex. Intensive early intervention programs and strategies in place can help.

An interesting and stimulating learning environment can be more than they can tolerate and very distracting or without effect. Hands on learning activities do not necessarily lead to learning. The learning that is taking place by others can be affected: the class falls behind and significnant time is lost. Some days are better than others. Various strategies can assist.

THe medication has side effects: sickness, sleeplessness and sometimes worse etc. Medication is not always effective. Sometimes I am surprised by children being diagnosed. But since overdiagnosis is a current theme getting a diagnosis of ADHD isn't all that easy. I don't pretend to be a doctor. I just work with what I have.

It's just one of those things. Teachers are fine with it: medicate or don't medicate...the learning environment is adjusted to meet needs and that's what you do. It's out of your control. Going home and sleeping in a state of exhaustion after intensive days goes with the job. Sometimes it reduces what you can physically do as a teacher. There is no doubt that you will need a vitamin tablet LOL. You will be tired BUT

On the upside they have that extra battery. They can hyperfocus on things with great persistance. They enrich things...but other people may not necessarily be able to maintain energy levels to join in with them. Since it's the great plus of having adhd, sometimes this part is a sad loss with medication.

On the other hand, the attention deficit can lead to safety issues. My friends nephew and a family relative both had adhd and were injured before they hit 15 and will be brain damaged for life. One playing on a railway line and another crossing a road. Both parents decided against medication and were using natural alternatives and parenting strategies. It breaks my heart. I cannot judge parents who do medicate and I cannot judge those that don't.

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Guest migu

that guy... Dr. Bob Jacobs in the article. The psychologist. That sort of reasoning he used is found quite a bit in the anti-adhd camp. I wanted to point out a thing or two.

In a radio interview afterwards, Jacobs - who is on the advisory board of the International Center for the Study of Psychiatry and Psychology - said his conclusions had been made as a result of his own observations during many years in practice, working with children and families.

He cited cases where parents reported that their ADHD-diagnosed children could not pay attention - but then those same children could play video games for hours without being distracted.

The fact that he uses this as evidence shows me his lack of depth in understanding the nature of ADD. All

those years and he still doesn't get it? Having ADD does not denote an inability to focus so much as it

denotes an inconsistency. Being able to play video games for hours is possible, because games provide

instant excitement which stimulate dopamine centers in the brain and thus facilitate focus. Moreover,

sometimes people with ADD can overfocus on tasks in ways that ordinary people do not. Its not so

much an issue of ability as it is one of consistency and control.

Sometimes where parents made changes in the way they were doing things, the symptoms would go away.

Thats a very generalized statement now, isn't it? How is it this guy keeps his job with reasoning like that? It again shows the nature of ADD, and how changes in life stimulate the brain, making things easier to focus on. One might reply, well doesn't that then just mean people with ADD thrive with change and excitement? Well sure! But when it gets to the point it begins to have serious effects on their ability to exercise control over their life, as many people with ADD could tell you, well, there's a problem.

"A real disease doesn't go away when somebody else does something," he argued.

Again stemming from a fundamental lack of understanding concerning the condition. Wrong on so many levels,

but let me mention just one: the disease didn't "go away." The symptoms decreased.

Jacobs said experts had put labels on different behaviors and called them a disease.

Next they should put a label on him and call him "incompetent."

Money trail

In the United States in 2001, pharmaceutical companies made more than $600 million in profits just on stimulant drugs used for attention deficit disorders.

"If ADHD doesn't exist, those hundreds of millions of dollars in profits go away."

"You have to follow the money," agreed Peyton Knight, legislative director at the American Policy Center, a Virginia-based think tank.

"It's big money," he said by phone late Thursday. "The more diagnoses there are every year the more Ritalin and other mind-altering drugs they are going to be able to market and sell."

How common. If you ever want to make something appear evil and have the wrong intentions, be sure to point out how much money they're making. Although it says little about the nature of the industry other than it is active and successful, does being active and successful really make it bad? No, but it sure reminds you about how poor you are.

Ugh. I just noticed the guy they're quoting on this part is from a think tank, of all things. I hope for their sake they were just being lazy and not stupid. Find a random "smart guy" with no demonstrated authority on the subject. He's apparently "Right Wing" and so am I, but being "right wing" doesn't necessarily make you "right" about any random topic.

Welcome to American Policy Center. Their website. Is this really someone that can comment on how legitimate a medical treatment is? No, but I see a lot of potential for bias.

Here's a short pdf declaration from the mainstream on the subject. A good read.

http://www.russellbarkley.org/images/Consensus%202002.pdf

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Guest migu

I do agree that it is overdiagnosed/overtreated, but I do NOT agree that it isn't a real problem. It is a physical deformation of the frontal lobe of the brain.

In response to the video game quote- That's hyperfocus.

you know what, i was just reading that post for the first time, and heck maybe i should have read the whole thread before getting too excited about ripping apart this article (these kinds of articles are generally pretty fun

to point out all of the flaws.)

Anyways, we noticed the same thing. I giggled when I saw that. Its so true.

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Guest migu

Or reading about things like how they process garbage in Antarctica!

but my room is usually messy to the point of having to jump from spot to spot to get around in it.

you seem like a kindred soul. :lol:

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Pushka, interesting test you shared. Since answering 20 "yes" indicated ADHD I just stopped answering once I hit 20.

I enrolled two of my sons in a special high school program which strongly emphasized creativity and advanced learning concepts. The school had won several major awards and was recognized as one of the best in the region. One of the teachers (for fun) sent out one of these tests to the staff and asked them to take it. Every teacher except one "passed" as having ADHD.

The common characteristic of the teachers? Independent, creative, unconventional and highly intelligent. No wonder they tested positive!!!!

One thing I learnt in grad school was that intellect, to be properly used, has to be highly focused and the most successful high-intellect people had to be able to apply extreme focus to the things they were interested in. Opps, another characteristic of ADHD.

Now let's take a look at evolution (I am going to leave God out of this since if we assume God is there then He gave us the traits we have and expects us to use them, not dope them out of existence). The human brain evolved to solve problems and multi-task in order to overcome the disadvantage of having one of the weakest mammal bodies in the woods. Our young have to play to learn -- just as all mammal do...as they mature they use the skills they learn to apply them to survival (gathering food, eventually raising food, acquiring mates and killing beasts for food). The brain then is designed to survive in a state of nature. Now if the school environment is contrary to nature then the brain cannot be faulted for being uneasy in this situation. So drugging that brain is an effort to change the course of nature into something unnatural.

Now it could be argued that so is a nun slapping you with a ruler if you act up and that is true -- however, what has the least physiological damage Sister O'Brian smacking you in class or dopping you with drugs that people here admit are more powerful than having expresso hooked up into your veins 24/7? Then again, we could apply advanced learning techniques into the factory system we call public education (high conformity expected, mediocracy accepted as the norm) but that might cost more than dopping kids.

Migu commented:

How common. If you ever want to make something appear evil and have the wrong intentions, be sure to point out how much money they're making. Although it says little about the nature of the industry other than it is active and successful, does being active and successful really make it bad? No, but it sure reminds you about how poor you are.

Ugh. I just noticed the guy they're quoting on this part is from a think tank, of all things. I hope for their sake they were just being lazy and not stupid. Find a random "smart guy" with no demonstrated authority on the subject. He's apparently "Right Wing" and so am I, but being "right wing" doesn't necessarily make you "right" about any random topic.

Welcome to American Policy Center. Their website. Is this really someone that can comment on how legitimate a medical treatment is? No, but I see a lot of potential for bias.

Now this is really ironic. Major drug companies finance tons of websites and groups to promote the idea of ADHD being real and drugs being good yet most people just accept what they say. Yet if you question the profit-motivation of drug companies it's as if you question God Himself. Now since you attack the "right wing" do you not see the irony???The right is generally promoted as "pro-business" yet here you have an expert being subjected to questioning of his credentials even though he questions business.

Edward Bernays would be proud.

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Guest migu

The problem Fiannan is not so much that he has "business credential" or some "credential to criticize business." An idiot could give you his answer looking at the amount of money flowing through drug companies. Don't think you need a think tank for that. The real problem is that since they are fundamentally wrong on the premise that ADD is wrong to begin with, his thoughts on the subject become irrelevant. So WHAT? if money is a big motivator to people. I would hope it did help them to do their job better! They have not earned any right to use those words as relevant to the matter, and his further incompetence in medical matters makes him further insufficient to comment on what their motives might be. He is not "in the know" on some big scheme as is being portrayed. He is an irrelevant character thinking he's smart for ever thinking money could ever motivate anyone. Thats not a valid credential for their purposes, think tank or no. To reach conclusion B, which is that they are solely doing this for the purpose of money, even in deceit of ADD existing, he or they need to first validate the first conclusion they made which is that ADD does not exist at all, and they have sorely failed to do that. We are all laughing here at their "medical expertise" buddy.

In answer to your other statement, it is not impossible, and in my opinion highly probable, that a teacher somewhere would have ADD. ADD is not uncommon. To some extent everybody probably has some level of it, however the point where it becomes a disease is when it is debilitating so much that it impedes the person's ability to control and manage their own life to a marked extent. And I'd even guess there are plenty of teachers with that level too.

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Guest migu

Pushka, interesting test you shared.

One thing I learnt in grad school was that intellect, to be properly used, has to be highly focused and the most successful high-intellect people had to be able to apply extreme focus to the things they were interested in. Opps, another characteristic of ADHD.

Being of high intellect and applying extreme focus are both abilities that people with ADD have. ADD and sometimes more serious mental problems often accompany those with great intellect. The extra item that makes those highly brilliant people with ADD able to succeed is that somewhere, for some reason, they were able to understand their weakness, and were able to come up with a coping mechanism that worked for them.

Now I am not an advocate of illicit drugs. They pose a high risk, and any of their benefits are far outweighed by their risks. But why don't you check something out for a moment?

Thomas Edison, ADD Poster Child . See that? Edison is especially thought to have ADD. Now I dare you to try this... Go to google, type in these three words. Thomas Edison cocaine. Read what comes up.

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Guest migu

attack the "right wing"

I actually said I was right wing. My statement, being read correctly should have been as a nod to fellow right wingers (prevelant on this forum) but also a call to being humble. Being right wing has nothing to do with being right on a medical topic you have not adequately studied, Thats not attacking the right wing. Thats just pointing out reality.
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Guest migu

One more thing Fiannan. I don't know you personally. I don't mean to attack you. It is my hope that even though I like to use strong statements, and sometimes silliness to make a point, well I'd hope that when all is said and done we could be brothers even if we have differing points of view. Unity in spirit is far more important than unity in cold method. Being able to see past our differences and not be enemies is my strongest hope.

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Being of high intellect and applying extreme focus are both abilities that people with ADD have. ADD and sometimes more serious mental problems often accompany those with great intellect. The extra item that makes those highly brilliant people with ADD able to succeed is that somewhere, for some reason, they were able to understand their weakness, and were able to come up with a coping mechanism that worked for them.

Now I am not an advocate of illicit drugs. They pose a high risk, and any of their benefits are far outweighed by their risks. But why don't you check something out for a moment?

Thomas Edison, ADD Poster Child . See that? Edison is especially thought to have ADD. Now I dare you to try this... Go to google, type in these three words. Thomas Edison cocaine. Read what comes up.

No need, many prominant people used cocaine in the 19th. Century and early 20th. Century -- it was legal...it was even in some soft drinks. Narcotics of all types were legal as well. Didn't mean they were good to use, just that they were legal.

Now here's the catch on Edison...would he have invented and modified so many things if he'd been drugged? Jung and Einstein hated school and didn't perform well -- were they suffering from ADHD?

Perhaps high intellect is not associated with true mental illness -- that's a myth like weak, nerdy-looking people are smarter than average. ANd if lots of people with "ADHD" are smart then maybe the symptoms of ADHD need to be questioned.

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Call to Action - Sophia's Market - View All Items - CTA Shirt: Question Authority - Jesus Did.

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Guest migu

Wow, that's what evolutionists say about scientists who question evolution.

unfortunate when someone uses good logic to such a wasteful means isn't it? They unfortunately are in the wrong on their foundational argument and do not have the whole picture, so good logic cannot back them up. Rather than worrying about what methods of logic people use in their argument, its a lot more helpful to look at the foundation of the argument and see if it holds water.

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Guest migu

No need, many prominant people used cocaine in the 19th. Century and early 20th. Century -- it was legal...it was even in some soft drinks. Narcotics of all types were legal as well. Didn't mean they were good to use, just that they were legal.

Now here's the catch on Edison...would he have invented and modified so many things if he'd been drugged? Jung and Einstein hated school and didn't perform well -- were they suffering from ADHD?

Its actually often thought Einstein had ADHD. I don't know about Jung. I can't honestly make points about whether Thomas Edison would have done something had A or B not occured, because that is obviously information impossible to know. My point was more that he realized he had a weakness and found a method to deal with it. Granted he was one of the few who could make cocaine work, but that is actually much of the work the patent drug industry is doing for us. It is bringing us out of the dark ages so that we don't have to use such rough methods as he did. I for one, am certainly grateful to them for that. If they make huge amounts of money every year or whatnot, more power to them for that. I am happy when I see others doing well. Remember, that running an industry like that also costs a lot of money.

Perhaps high intellect is not associated with true mental illness -- that's a myth like weak, nerdy-looking people are smarter than average. And if lots of people with "ADHD" are smart then maybe the symptoms of ADHD need to be questioned.

Its not an absolute by any means. Also, being smart=IQ. Being able to cope with challenges of life is not the same thing as IQ.

I'd call you back to the foundation. Your first premise. ADD is wrong. That is what we were discussing, and outside of that we could run around in useless circles of meaningless rhetoric for years and never address the topic.

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