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To have a disorder it has to interfere with your activities of daily living. If it doesn't you don't have one.
The equivalence of what you're saying is that if everything contained lactose and just because Phil, with his lactose-intolerance, is always able to make it to the toilet in time, he shouldn't need lactase supplements or a special diet.
Lactose intolerance is actually a very good example. The level of lactase production varies significantly among the population. Different people will find different amounts of lactose as interfering with their ADLs. There's generally a point where too much milk or cheese will cause you to have gas and visit the bathroom within an hour. This is called clinical significance. If they don't have enough clinical significance, it's pointless to diagnose them with lactose intolerance.
Although I agree with the facts, binary „diagnosing“ isnt the only way to go about your life. You, your parents and your doctor can make decisions without a piece of paper. The problem here to me seems to be that „you‘re not diagnosed so you dont have it“ has been a valid strategy for too long and needs to go already. Seeing that your child (eg) shows signs of autism doesnt mean you need to put them in special everything but people are rightly pissed that they have suffered irreperable damage to their bodies for self medicating an issue that could have been mitigated if not soved, were our society able to accept imperfection and not reinforce stereotypes at every turn.
You can and should use nonmedicalized strategies for something that's subclinical. That was my point. A disorder is a medical diagnosis.
A disorder is a medical diagnosis.
As is the absence of one.
That's literally correct for ADHD, yeah - the diagnostic criteria for it is all stuff like "patient says they have difficulty organizing tasks", which, naturally, depends a lot on what kind of tasks they're doing.
That's why ADHD is very common in concentration-requiring professions like software engineering (naively you'd expect the opposite) - there's people with "undiagnosed ADHD" (low concentration) everywhere, but if you're in a profession like that you are much more likely to have it impact your job, and go to a doctor, and get a diagnosis and a prescription of Adderall or some other kind of amphetamine.
You can pretend that clinical significance is the gold standard measure of disability if you like, but you should recognize that you leave a MASSIVE gap in your effectiveness both as a diagnostician and a practitioner if you neglect all the masking your client has been doing to deal with everybody's demands their whole life. Seeing that bias in someone pretending to treat me would be enough reason for me to walk out of the appointment and schedule with someone more capable and knowledgeable.
Sounds like you just want someone to "fix" the things you don't like then. Not that they are truly disabilities nor not disappointing issues but it seems you more want someone to "fix" everyone else, or pretend it's possible to fix you because of a lack of easiness.
You want someone to already agree with you so you can feel better. That's not professional help that's just a sweet lie to tell yourself.
I'm neither a diagnostician nor a provider and I don't pretend to be one. I'm just a nurse. That's one of many things people seem to ascribe to me. I will say however, something needs to be disabling for it to be a disability.
Yeah, my guess is that this post is implying the typical case - it wasn't disrupting grades specifically, so it wasn't diagnosed. You may have gotten those grades by staying up until 3am as a child, lying to get out of forgotten homework, had more injuries, pushed through work by building up a healthy reserve of depression and anxiety, struggled socially because you couldn't prioritize both school and socials or because you couldn't connect with most other people because of your way of talking, been horribly forgetful, etc. but because grades number stays high, nothing is wrong. It's easy for people to see grades as the metric for mental wellness which is wild
Yeah nobody else is mentally well either and we all have our coping mechanisms for this world.
This is basically keeping up with the Jones's but using "happiness" as a grading curve for your life.
People are not superheroes or magical beings above all the downs we share. Hell most of the upper class are busy abusing drugs just as much from their burnout and depression. But someone might have been more social and smart and thus you are somehow less than them? Meh. And Nah.
Can you please define "interfere" Dr. Roguetrick?
Difficulty or inability. I'm not claiming to be a doctor and I'm not making an outlandish statement. People are acting like I'm making a value judgement on them or their lived experiences when I'm not. They sure are making wild assumptions about what I mean though.
"Difficulty or inability"
So some degree of difficulty and/or some degree of inability. Assessed by someone. Subjectively. Which means that there is absolutely no point in trying to infer that somehow those who say they feel they have some degree of difficulty or inability may not, in your opinion as not a medical professional, over the internet, actually have the disorder they and/or their doctor feel they have.
tl;dr your statement is completely meaningless
What a long winded way to rephrase what I just said I wasn't doing. I was making the point that if you don't have clinically significant symptoms you don't have a disorder. That's it. Every other point you've made us a wild supposition.
Nice gaslight Herr Doktor.
Your statement is meaningless. It's just as meaningless as saying you didn't diagnose the absence of a disorder.
I honestly don't even know what you're trying argue with me about at this point. Do you hold the position that a subclinical set of symptoms is a disorder? Because that's what I disagree with. If not, then what exactly is at issue beyond your imagination of my position?
You are trying to claim that you are making a simple factual statement when in fact the subtext - which is probably obvious to all - is that in your opinion you don't think people's claims of impairment or dysfunction are valid unless they have a specific medical diagnosis that YOU feel is valid. And the proof of this is that your statement can be as true reversed. IOW, you have NO idea if they've been medically diagnosed or if any diagnosis or absence thereof is valid or not. It really negates your point.
And why does this all matter to me, personally? Because my own personal experience with the medical establishment is that they pretty much throw shit out there that may be valid or may not and relies heavily on both the doctor's and the patient's own subjective assessment. A sibling was for decades diagnosed as intellectually disabled when in fact he has ASD because they were unable to communicate effectively. I was diagnosed with a common mental disorder by one doctor and told there was no way I could have that by another. It goes on... And so I tend to be pretty sympathetic when someone says "I feel impaired by <condition X>" and I don't feel a need to question whether or not they have <condition X> or if there was a formal diagnosis or not. Again, because many of those diagnoses are about as valid one way or the other has throwing darts. Could be good, could have missed something completely, could have misinterpreted what the patient said because they weren't able to communicate it in that moment.
What is important is what the person says about themselves. If they want to say they have ADHD or ASD or whatever, it's not my place to gate keep or question that. Nor yours.
Edit: To put it another way... your statement is about as useful as, when someone says "I just love this blue dress I'm wearing" pointing out that "well akshually that's turquoise". The point is THEY like the color.
Yeah, but see, that's not at all what I was doing. And that's why what you're saying is completely off base. The core of my position is that medicalizing subclinical symptoms is dangerous and harmful. I believe an individualized holistic approach should be made instead of trying to force a medical diagnosis that cannot fit. Your objections are actually my objections believe it or not! We both want a holistic approach! You just are jumping wild conclusions and what I mean.
The core of my position is that medicalizing subclinical symptoms is dangerous and harmful.
Ok, let's assume you really meant that.
I have three issues with this: 1. what is deemed subclinical in this context is a lot more variable than one might think. It's not like diagnosing cancer. 2. How is it dangerous and harmful? 3. Is it more dangerous to invalidate claims that medical professionals consider subclinical because they just don't know, aren't getting complete information or had too many patients that day?
I believe an individualized holistic approach should be made instead of trying to force a medical diagnosis that cannot fit.
That doesn't make any sense.
Its dangerous and harmful because it leads to inappropriate interventions. Every intervention has a different profile of what harm it could cause. And sure it's a problem if medical professionals don't listen to people. But it's equally a problem to attempt to pathologize something that coping mechanisms and therapy could alleviate. I'm specifically using subjective language here because it IS subjective. Every individual case is different and I don't have a particular opinion on yours or the author of this tweet. This tweet just reminded me (as it did with many other posters that didn't quite get the response I did) that pathologizing everything is also a challenge. You don't need to treat things that don't cause problems, essentially. It seemed to me to be a pretty uncontroversial position.