I think one thing that's kind of goes under the radar a lot of times about the rise of ADHD is that our environment has developed in ways that makes sustained attention and regulation really critical.
I think about this a lot because I have a ADHD and I've had it I was diagnosed as a woman in 2005 when it wasn't that popular. It's something that I've struggled with my whole life (ask my first grade teacher). The demands in an information heavy society has made everyday functioning more difficult for people with the set of regulation issues that is related to adhd.
The second part of it is that I am a big fan of focusing more on function than on symptoms when diagnosing people. I teach diagnosis at a university and this is why I focus on people's ability to function because we all have symptoms of a bunch of different disorders, but it doesn't usually rise to the point where interferes with people's daily functioning and that's the important difference. I think the social contagion in a lot of ways as accompanied by a lack of understanding about what a disorder is. If somebody says that ADHD is a superpower, then they don't have ADHD because obviously it's not interfering with her daily functioning and so they don't meet the criteria.
Is social contagion a big part of this problem? Absolutely. But so are pocket phones and social media. "[O]ur environment has developed in ways that make sustained attention and regulation really critical" --an excellent point, but may I change the last word to "difficult"?
With respect to your first observation on environment, I've really started to wonder if a significant portion of ADHD diagnoses for elementary-school boys isn't caused by contemporary parenting and education culture demanding that those boys sit still and work quietly for many more hours a day than was expected of prior generations.
You've started to wonder? Seriously? That's been the accusation for easily 30 years or more. Parents were being reassured that "hyperactive boys" often had no trouble in adulthood back in the 80s. And it was probably the 90s when people first started noticing that kids stopped their meds in the summer during the 90s.
It's not even remotely new that boys were diagnosed with this since the 70s. What's trendy is this phase of selfdiagnosis.
This isn’t as relevant to kids (I hope) but when it comes to adult ADHD, we also need to look at the increase in marijuana potency and legalization.
My spouse is a psychiatrist, and she sees a lot of patients who developed concentration issues after using marijuana. They’re not happy when she tells them they need to quit weed rather than start taking Adderall, but for the few patients willing to comply it has made a difference.
Both of my younger sons had serious problems with pot.
One has had disabling anxiety, depression since he was 10. He's was medicated successfully for years then I noticed his anxiety had gotten out of control again. I suggested he look into new meds. He had to do drug testing for a job, failed and it took 3 months for it to clear. Now he feels much better. It had gotten to the point where he was sick to his stomach in the morning.
The youngest son had gotten erratic and reactive. I thought he was either on meth or was bi-polar. He went off on me and his dad like a crazy person, then a few weeks later did the same thing with his girlfriend. He quit using pot and is fine. Total change.
I'd take a step back and re-think your ideas about this. Does it really sound like a good idea to put people through the criminal justice system instead of sending them to a psychiatrist? Because that's where "looking at marijuana legalization" leads.
It's a reasonable argument that legalization is what allows these people to admit they use marijuana at all. Prior to legalization most people would be afraid to, lest they either be dismissed outright as "chemically dependent" for any use of marijuana if not potentially subject to criminal penalty.
It's largely beyond speculation that regularly consuming large volumes of marijuana is bad for most people and that for a some people any amount has negative consequences. It's still somewhat fraught to come up with objective figures for what constitutes "large volumes", since biased people will pick low numbers and rapid tolerance acquisition to its effects results in wide variances in individual responses to the same quantities of THC.
The potency argument is largely bunk. In the 1970s when low-quality marijuana was $25 an ounce, people smoked much more volume to get the same effects that a single $10 joint from a dispensary can produce. I remember in the mid-80s smoking 3-4 joints with a group of friends. Now it takes 3-4+ people to finish one joint, and two people seldom want to finish one joint on their own. THC itself didn't get more potent, and people without compulsive use habits largely self-regulate their consumption relative to the effects. Too much marijuana consumption in a single session is dysphoric, an experience most users have had, just like too much alcohol, and most people choose self-regulation.
I never said I want to criminalize users. I’d be in prison too. But there’s a lot of room between criminal penalties and what we have now, selling it at the store, where it’s normalized and we downplay the risks.
We’ve replaced the old set of harms with new ones, and I think the current approach is very misguided. It has led to an increase in psychosis in the population, which is a big deal. Casual users exist, but everyone I know who buys weed uses it too much and is also in denial about the risks. Including how it’s impacting their mental health overall.
At one point I would have agreed with you that there was some third way between conventional legalization and criminalization. The problem is that there isn't much room between criminal penalties and what legalization looks like in most states. Either you make it legally available and sell a regulated product at regulated stores, or people will buy and sell it illicitly and we're back to the black market again with criminal enforcement and losing other positive changes, such as regulations on purity and contaminants and the ability to collect significant taxes. It also opens the door back up to widespread harassment and abuse through selective law enforcement.
And I'd argue there are no new harms. Whatever harms cannabis and THC caused now, they also caused those harms before, whether its excessive use (the 'stoner' is a stereotype which existed before legalization) or driving under the influence. The NY Times even reports in states where cannabis is legalized, adolescent use had actually declined or at worst stayed the same.
I don't know the people you know so I can't judge what their cannabis use patterns are, but blanket statements that everyone uses it too much (what's too much? what's just right?) seems to be more of a lifestyle judgement than any kind of quantifiable standard. I know some people around me who don't use cannabis seem to complain more about it and it always strikes me as something of a reactive social judgement, possibly to being "off trend" given the large spike in general cannabis interest and growing acceptance.
I used to work in the gaming (gambling) industry and there is definitely a difference between having some casinos in out of the way places and ads for sports betting plastered everywhere. There is a London Review Of Books article I found that hit just the right note on slots: Legal, but don’t advertise. It’s really OK to have some things be legal but still sketchy!
The "restricted zoning" concept has two problems. The most immediate one is political actors using zoning restrictions to basically eliminate a legal business. They play all kinds of games which reduce the only zoned space where the business is allowed to operate to places where it's fundamentally unable to operate. Not just remote, but no available real estate at all.
This "one weird trick" has been used for pornography, strip clubs, and firearms pretty brazenly and more subtly for drug treatment, homeless shelters and redlining minority groups.
The larger problem is that greatly limiting legal sales outlets for cannabis means people continue to patronize black markets. This was (and might still be) a problem for California when it legalized -- a number of cities simply refused to zone for dispensaries. Part of the longer-term goal of legalization is eliminating black market cannabis and that won't happen with significant geographical barriers to access.
Eliminating black market cannabis probably won’t happen until states stop sin taxing it and they allow sales to minors, the first of which is unlikely and the second of which will never happen. There was already a huge illegal supply chain for it when we legalized it, all it takes is a slight price differential to keep it going, at least for flower.
I’m glad my state has medical too, I pay like half the price because medical doesn’t have to pay the sin or sales taxes.
I'm pretty convinced (for a half-baked notional theory, at least) that modern society has evolved to demand levels of executive functioning and cognition which exceed baseline human ability. We're also stuck in an economic system that won't reward (and we could even argue punishes) people who don't meet those executive function demands.
I'd argue this is a potential explanation for a lot of things, especially things which appear to be related to lack of economic success.
I'm lucky to be able to perform at a higher than baseline level for these things, more or less successfully managing a diverse set of technologies for a large hospitality group.
By chance, I flipped through the training materials for the wait staff in our restaurants and I was kind of blown away by the large amount of information and processes they're expected to know. To take orders for food and and drinks. I'm not being dismissive of the job, putting up with the public is hard enough, but the function and knowledge base for a job that pays $15/hr plus tips seems excessive.
Yeah, I think most people have a mild form of ADHD in modern-day America just because humans didn’t evolve for the kind of information overload or smartphone dopamine hits that are the air we breathe today. It would be more weird not to, and it’s certainly no superpower (though stimulants may make you feel like Superman!)
It’s a double-edged sword to be sure, but I don’t begrudge anyone who needs adderall to get through school or work, nor anyone who honestly needs additional time to take a test.
Good piece, but in bringing up cases and examples I find it curious that you left out that one stinking dung heap left by the proverbial elephant in the living room: the bourgeois social contagion fueled trans phenomenon. Are there matters that you won’t even go near?
We don't discuss that issue here because the people who are interested in discussing it, generally, are not content with merely espousing their belief that there is a social contagion component to its increased incidence.
They also want to impute disreputable motivations and behaviors upon all sufferers, as well as offering prescriptions for how society should or should not accommodate them, often settling on no accommodations for `scientific' reasons.
Only this issue? Are there other issues that are verboten? If this is the only issue that is verboten, then that's a massive tell. Of what? I don't know, but it would be easy to figure out.
Did you lose your job for being obnoxious and insufferable? There are a 1,000 places to obsess over trans topics online if that's the discussion you want to have. The amount of space trans discussions takes up is quite obviously totally out of proportion to the actual salience of the issue.
I'm not obsessing over anything. Ignorant of the prior history of the matter on this blog I made a comment, others attacked me for my alleged faux pas, but assumed that I would backoff, assume an apologetic stance. I did neither. And neither do I wish to continue the discussion, but if you keep piling on, I will pile back Up to you.
FdB has said that he has no interest in commenting on the issue (mainly due to expertise and, well, lack of interest in the topic), and experience has taught us that any of his posts tangentially related to the subject would cause the comments section to devolve into acrimony. People aren't merely interested in the topic but obsessive about it.
>> FdB has said that he has no interest in commenting on the issue (mainly due to expertise),
Does he have expertise on everything he comments on?
>> that any of his posts tangentially related to the subject would cause the comments section to devolve into acrimony
So, trans is the Islam of sociology. Can't go near it do to it's votaries going violently insane over the matter. I just wonder though, where were all the trans when we were all growing up? Where are the testimonials of adults/elderly now lamenting how their lives would have been so different, so much more fulfilling if they had been sllowed to trans 30,40,50 years ago?
Leftists will excuse any moral abomination. Just yesterday it was reported that archeologists have finally confirmed that one of the Maya sites in Tikal, Guatemal, was indeed used for child sacrifice to the infernal gods of the Maya. Of course the report had akshully quote from a dutiful archeologist claiming that such sacrifices weren't inherently bad, just a way for the Maya to get in touch with their feelings. Lefitists will excuse and make allowances for any abomination.
Loudly speculating about "why is this thing off-topic" is not a loophole to get around discussing the off-topic thing.
I can't find the article where he declared it off-topic, but he had at one point asked it not to be discussed, and that was obeyed for a while. Then he wrote an article for another publication that briefly mentioned the topic as an aside, linked from it here, and then the comment section became 90% that topic. And he turned off comments, completely, for everything, for a week or two while figuring out what to do.
I ain't a mod or anything. But he has stated it's off-topic and will take extreme steps to enforce that.
He's not joking, not even a little bit.
(I'm not even using the word because I anticipate, once he gets back, for bans to get handed out indiscriminately to make sure the message gets received this time.)
There are plenty of places here on substack you can talk about the topic if you want.
You and I and maybe others agree about the trans phenomenon, but I think it's fine if FDB doesn't care to have it commented about here. There are (as others note) tons of places to comment about it, and I've done my part in those forums. There are other sociological phenomena of interest, such as the ones talked about in this piece.
Wow, you've really got your finger on the pulse of leftists. My buddies and I like to spend Sunday mornings seated around a steaming cauldron, rubbing our hands together as we make plans to steal your son's penis. *laughs maniacally*
Yes, one other that I know of, communism/socialism. I am gay and very familiar with the vicissitudes of trans issues. It's astounding how much of this article reads like the exact issues relevant to that.
Is there anywhere where we can discuss transgenderism in a productive manner? I've filed it next to religion on the "more heat than light" subject list.
Yes, Ben Appels substack as well as that of Benjamin Ryan. Ryan is a journalist and his X account is much worth following. There are several others, but those two should be of help.
Lisa Selin Davis is the gold standard, as far as I’m concerned. She was sadly away during the last Informed Dissent podcast (covering the John Oliver piece), and it showed. Even Appel was more militant than I’d expected.
And Cori is just way too guileless about the fundamentalist waters she’s swimming in.
That is probably one reason the social contagion hypothesis is avoided. Might lead to some questions about other popular themes.
What I would like to know is how many people deeply concerned about adhd-medication, and psychiatric medication in general, are perfect fine with other drastic interventions.
If you’re saying why the NYT doesn’t bring it up, I think this is exactly correct. Again, though, the outward behaviors have *very* different social valances depending on your group.
Thank you for writing about this issue Freddie. I am a therapist in California and I can say that this is a major issue and that it also creates barriers in treatment, as people who have told themselves (or been told by an online community) that they have an unchangeable neurological problem/disability are less likely to engage in techniques that could potentially help them. I have been considering writing a piece on my clinical experience with self-diagnosis and social contagion, perhaps I will follow your lead.
That's the nature of communities. They have to protect what makes them Different. When someone struggling with a problem finds sympathy and community, they want to continue that. And continuing requires a certain amount of reinforcing the community.
I first became aware of the phrase "social contagion" in the context of teen girls coalescing around the idea that they were really boys and then grouping themselves as gender dysphoric. The astounding rise in the number of them (compared to their extremely small numbers compared to boys who felt they were gender dysphoric) left health care professionals here and in Europe flabbergasted.
Pretty much all of your arguments here tracked the arguments of those of us who are concerned about separating out the social contagion -- and consequent media attention and deference to young people -- from the real cases of gender dysphoria.
Thanks for harping on an important issue that transcends individual manifestations. I keep reading you because you're annoying in all the right ways.
What is it about teenagers' genitals that so fascinates a middle-aged man of your type? Serious question. You'll be asked it at trial someday, so you might as well get the early practice answering.
Some of us are not middle aged men and work in the medical field and very much agree with David Link's comments. And being sexually aggressive in this and your other comments does not help a healthy discussion about what is the best path forward for these distressed teenagers he refers to.
Do not accuse me of aggression sexual or otherwise. Better you don't interact with me at all in future, if this is your idea of reasonable discourse. Such claims are actionable as defamation and should you persist I will pursue redress through my representative.
The first social contagion I read about was the Salem witch trials. I think it's a pretty common phenomenon. People get swept up into things and quit thinking rationally.
I was going to point out how much Freddie’s bullet points track with ROGD, but he tends to tap the sign about this topic being off-limits.
The main difference between it and ADHD/Autism is that there’s still a huge social stigma in many corners that reaches out into actual policy (and policing), which takes the hysteria on both sides to a whole other level.
But yeah, lots of people are self-diagnosing, and professionals risk reputations ruin if they don’t give the diagnosis their patients want. In fact, I wouldn’t be surprised if the term “gatekeeping” gets thrown around in ADHD/Autism circles.
The concept of "social contagion" was definitely around for the anorexia craze. I'm not sure I ever saw those two words put together back then, but it would have been instantly understood.
I'm with you on this Freddie. EVERYONE is on a spectrum - ALL kinds of spectrums. It's all shades of gray. I have attributes that may well qualify as ADHD or ADD, others that may well qualify as OCD, and yet others as Depression with a capital "D". (Not to mention something called "Pre-verbal PTSD" whatever the hell that is.)
Yet none of these are disabling or even more than occasionally annoying to myself or others at worst. I can pick literally any person I know who exhibit characteristics of those or other conditions. Are they disabling or even limiting in terms of living life in our culture? If the answer to that is yes, then that is one thing. Self-identification as being disabled is another thing entirely. Having a "disease" for social reasons - whether they be to gain advantage, sympathy or even just minor accommodation is understandable in our culture, but it doesn't make it right.
Now, my main point is that perhaps the culture is the cause. Rampant hyper-capitalism, competitive advantage by any means necessary is the unfortunate main characteristic of our modern US culture. THAT certainly causes all sorts of mental and emotional issues for people and is largely unrecognized as the source of so many of our ills. Yet it goes unquestioned like the force of gravity.
I ask you this - not in a flippant way - What comes after Capitalism? What comes next.... because surely this can't continue - a society that operates as a cancer on the planet and the people who live on it. I think so many of the real "ills" we attribute to mental/emotional issues are just people who can't cope under the stresses of the system we live within. Coping mechanisms, however poor or disabling, are still coping mechanisms.
The best ways to deal with the stresses of modern life is family, community and enjoying things in real life. On a personal level you can choose to not buy into it.
Adult diagnoses of ADHD spiking has always just been transparently obvious to me in its roots: stimulants work regardless of whether or not you "really" have ADHD (a fact that makes many activists very angry, but is quickly proven by a talk with literally any undergraduate student in the country), and are professionally advantageous in most mentally intensive work. They're widely used and abused in my industry (tech) along with caffeine and nicotine and it's well known how to quickly get a diagnoses.
When the stakes are your performance in a several-hundred-thousands-of-dollars-a-year job and the hoops to jump through consist of a couple of lies to a doctor, why wouldn't we expect that to be a major factor?
Unless you have a particularly good psychiatrist, I think there's so much confirmation bias involved in handing out amphetamines and then saying the diagnosis must be correct because the diagnosed is now more productive.
And its usually some metric of productivity (grades, vocational achievements, etc) that serves as the signal regarding ADHD affliction and the success of its pharmaceutical therapy.
I'd be kind of curious to see some kind of numerical analysis of employment healthcare benefits that include ADHD diagnosis and therapy and wages. My speculation is that jobs where consumption of ADHD medications is a productivity enhancement are more inclined to provide such benefits. The questions would revolve around what's a cause and what's an effect and whether increased productivity demands lead to benefits which include such coverage, and whether the increased cost of such coverage ends up being subsidized by the increased performance. Edge cases where productivity is demanded but coverage not provided and correlations with methamphetamine use would also be interesting.
All health insurance is going to cover a network of mental health professionals as well as ADHD drugs; generic adderall is very cheap. Some basic mental health care and rx drugs are required to be covered by all qualifying health insurance plans and this is sufficient to get ADHD treated.
Didn't part of the onboarding at FTX involve an off-the-record discussion of what the best stimulants and comedowns were and how one could go about getting prescriptions for same?
My experience with amphetamines is that they keep me awake and alert, but do not actually improve my duration of focus. I'm pretty sure this means I don't have ADHD, but I didn't have to lie to the doc to get the prescription.
If I understood you that in fact the existence of ADHD MAY be a result of what, where and who we are paying attention to as a society, wow do I get it.. I am OLD and grew up with cursive and memorizing spelling words and grammar and learning to write using same. In addition, I read and do read BOOKS which require time and space away from online sources whether computer, phone or TV. AND in another part of my life I am an IT computer solutions professional too BUT I had to concentrate and learn new ideas and about new spaces that were not there as I grew up iinto my years long career too. Without the ability to motivate myself and concentrate I would never have made it. Yes I do think it is more a societal disease for some, a means to ask for attention and time while being unable to manage one's own time in a productive way. I don't think of it as Attention Deficit so much as ATTENTION OVERLOAD all day every day...and an inability to withdraw to be more careful of one's own mental abillities to deal with this constant attentioon NOISE. Thank you.
The broad thrust of what you are trying to explore here is entirely legitimate, and many of your points made here are well argued. The problem is Freddie, you have a habit of coming across like a humongous bellend when you make them. A couple of suggestions coming from a primarily autistic perspective:
> Speak to more autistic people. Sounds like you have done an excellent job of speaking to families of Level 3 Autistic people, but you seem to have the strange notion that people with Level 1 Autism simply have a quirky personality trait with no effects on their life, and seem unaware that Level 2 Autism even exists. If you speak more to these communities you’ll understand why there is such a desire to organise around their disability and some of the motivations behind language choices.
> Distinguish more between those faking the disorders and those who actually have it. For all your talk of bravery, you are still remarkably coy when it comes to explicitly making a distinction and the net effect is that you end up painting the entire community of neurodivergent identifying people as being fake trend followers, which naturally pisses off the people who actually have it. Be explicit in distinguishing between the two and make it clearer your criticisms only apply to the latter.
> Acknowledge some of the difficulties faced by people without the most severe symptoms. Right now it comes across like you are saying either a disability has to be so severe that one is basically incapable of functioning without assistance, or that it’s basically nothing and people should stop claiming to be victims. There is a middle ground here, and telling legions of horrifically bullied but otherwise functional autistic people that actually they’re just faking it and are fine is a bit like lecturing a white working class boy born into poverty on how privileged he is.
Otherwise, some other thoughts:
> One’s answer to whether neurodivergence should have merch is the same one as to whether Pride should have it
> Obtaining an autism diagnosis in many places (the U.K. for example) is extremely difficult and so self diagnosis is frequently the only option
> At some point, most autistic people have someone tell them “you can’t really be autistic because you aren’t like Sheldon Cooper/Rain Man/insert other stereotype here”. As such, they tend to get very pissed off when someone who clearly has no idea what they are talking about doubts them
> If someone has spent their whole life being made to feel stupid, they are likely to simultaneously want to have their natural deficiencies to be fairly taken into account, and also have the things they are particularly good at be acknowledged. One way to do this is to simultaneously point out that something can be both a disability and a superpower at the same time.
> Most people really have no f***ing clue when it comes to autism. When you know what you are looking for, the sheer number of undiagnosed people operating in society becomes very obvious, and it’s clear most people don’t know it when they see it. It also becomes very obvious that many people have no idea how to handle autism, and this swiftly results in the harmful dynamics that make these communities so defensive in the first place.
> When you know what you are looking for, the sheer number of undiagnosed people operating in society becomes very obvious
If you reread your own sentence very carefully here, you may discover the reason Freddie has limited sympathy for "level 1" autistic people like you and I asking for more attention and resources.
Worth noting that under the auspices of social contagion, there is a perverse incentive to adopt identities as a form of commodification of the self. It’s not just about the money injected into the market surrounding identity exploitation, but the sublimation of subject into object. The mind-and-body becomes deracinated from itself.
I feel very conflicted honestly about the rising diagnoses.
ADHD and autism are real neurodevelopmental disorders, and deserve a lot of treatment and support. They’re not supposed to be trendy personality traits to lean back on. Even in the best case scenarios where people can harness their ADHD/autism for good, they struggle with the simple things that everyone else wouldn’t as much.
At least for ADHD, I wonder if its simultaneously over diagnosed for people who most likely don’t have it and under diagnosed for the people that DO have it because quite frankly, they won’t take the steps to be diagnosed. Whether it’s because their ability to retain attention, stick to tasks is far lower and other traits are much weaker than the general population.
I do want the field of psychology to be more strict in diagnosing who actually has it, but I don’t want to throw the baby out of the bathwater and let people think these diagnoses are just “excuses”.
I'm more likely to be forgiving of that because I can see how it would help them recover and del with it to look on the few positive aspects of their condition that help them compete better with normies, and say "well I'm glad I have that it's kinda cool in a way"...but I'm not having this "and that makes me a more evolved human better than you normies" shit...no...
I think very few in the offline world would consider it a 'superpower'. That phrase came up to destigmatize the labels because there are genuine benefits that come from actually having them.
I can speak more for the ADHD aspect in that I have noticed the difference between people who actually have it (properly diagnosed and don't make it their identity) and people who talk about it because they struggle with some aspects of time management and organization. It has always been much more than purely that.
They are more creative, out-of-the-box thinkers, spontaneous (as long as you have the money and support to tamper the worst of the traits but that's another discussion) and are ultimately are more 'real' people than the general population. Not as a 'superpower' to be 'authentic' (the most overused term ever) but more that its harder to mask certain personality traits that everyone else could.
People making one aspect of themselves their entire identity is something I've noticed in other fields than mental health. You can see it in sexuality too. Most people with same sex attractions (inc people who also have opposite sex ones) don't use labels or flags or constantly refer to themselves as a member of a category.
Those who wish to do so are free to do it their own way (though I would argue it's detrimental and even dangerous to others to choose this path but that's a different discussion) however most don't want to and often people who don't want to are accused of 'hiding' or being ashamed by those who do make it their identity. Understand I'm not talking about people being in some kind of metaphorical closet, I mean they just don't want to make their whole life about it.
It's a tendency (to make 1 thing your whole identity) I've never understood. Maybe most people are just not particularly complicated, don't give much thought to their life or what they wish to do with it etc who they are what their role in the world is, but for me personally I don't ever want any one aspect of myself to define me, I'm a complex person and I don't want to be shoved into a neat little box. It's even more dangerous to make an illness or disability your whole identity...don't you want to be more than that? I'd ask these people.
The rise of labeling someone's sexuality as 'queer' is odd for me, because its just so vague. It's fine (and nothing wrong) to say you're gay/lesbian/bi/trans.
Queer automatically in my mind is someone who spends too much time online and is cares more about trying to be interesting than actually be interesting.
Part of life is realizing how utterly boring it can be, even with success and support. I think some people simply can't handle those boring moments. It's not really fun to go to a job 5 days a week like everyone else. The internet really is the only accessible fun for everyone. Everything else costs more money! It's not a shock to see some people go down the rabbit hole of some communities (looking at you reddit and TikTok) and take on a completely new personality and mindset.
I don't want to be shoved into a box either, I acknowledge that everyone, including me, is complicated and nothing can truly describe my life.
I think you got it right there. Not everyone is going to be a politician or a cop or doc/nurse or fireman or some job where their day work is interesting and has a lot of variety in it.
Most of them will have boring, predictable days and a label makes them feel different/special.
My youngest daughter was diagnosed with Aspergers almost 20 years ago, when she was in 2d grade. The teacher thought there was something wrong with her. My wife said 'she is just like you, you should be tested." Yes, I also got the Apergers diagnosis - and I said "This is normal. I am an engineer/physcist/programmer and most of my peers are like me, many are worse.'
The idiots have medicalized a normal human variation. I have aspies up, down, and across my extended family - and not a single case of classic autism.
In my view, the psychologists who grouped autism and Aspergers together were clearly wrong - while they might have shared an aspect or two, they are probably fundamentally different phenomena. The aspies tend to find productive roles where they can function happily and productively, and that is what is important.
Psychology ranges on a lot of independent variables. Anybody who is at an extreme is going to have more difficulties dealing with the social world and finding friends and compatible people. It has always been so. If I remember correctly, the big 5 factors account for ~ 80 percent of variation in personality - and intelligence is an independent variable as well. That allows for a lot of variation from the median in widely different patterns.
Where do you draw the medicalization line? I would do it at the functional / non-functional line. I couldn't make it in the marketing / socialization sphere, I don't think that way. But engineering and the like is just natural for me. Others are the reverse.
Take a software developer who is good but not great and manages to stay employed more or less but is held back by hygiene and personality issues that could be remedied if addressed in a constructive manner. Now you could say he’s functional because he is housed and for the most part employed. But he is operating at a marginal level due to the issues noted.
If some modest early childhood interventions could have helped him live a happier and more productive life - wouldn’t that be a good use of resources?
The OT and child psychologist made a huge difference for my Aspie eldest child, and helped us anticipate problems to come. He has done exceptionally well with these modest supports early on and helped us be better and more supportive parents. I'm not sure what your aggressive agenda in this forum is. Most people want to help their child be the best they can be. Would it be better to ignore issues and let a child or adolescent flounder unsupported through their life?
I hear a constant refrain from the predominantly 20-somethings I work with about the challenges of finding friends and romantic partners. How much of this is today's social media smartphone environment vs. something else? It's not that people with Asperger's don't suffer more, but its not like they're the only ones suffering from what may actually be just the nature of modern social culture.
I'm pushing 60, and I had very similar issues in my 20s. I'm in a much better place now, having learned some social skills by my early 30s, but I still don't navigate the social world very well.
I have never bothered to get a diagnosis but I am sure that if I shopped around that I could find something that puts me "on the spectrum".
But why would I? Like you I work in tech after majoring in physics in college. The professional world has been pretty kind to me as a consequence--I am well compensated, I go on vacation to nice places, I drive a nice car, I buy my dogs gourmet dog food.
Contrast that to somebody who is completely non-verbal, who relies on other people to be fed and bathed, who will spend the rest of their lives in an institution after their parents die or get too old to care for them. I have been successful in life--what's the point of categorizing myself with somebody who needs 24/7 medical care? So I can pat myself on the back for "overcoming" some ill defined "handicap"?
I cannot help but agree with DeBoer that a lot of the people who seem so eager to broadcast their supposed disorders are chasing clout. And in a world where people are in genuine need of real assistance that's shameful.
My brother has Asperger's and Bipolar 1 disorder and that combination has been crippling for him in a way having one or the other like the rest of the family isn't.
He's sufficiently off interpersonally and unable to read social cues enough to BS properly in behavioral interviews, but he's also got significant resume gaps from manic or depressive episodes and their fallout.
The other aspies in the family are able to make up for their interpersonal shortcomings by being extremely reliable employees, and the other manic depressives in the family are sufficiently congenial that we get away with being unreliable employees with intermittent phases of extreme productivity.
Still, I don't believe that my brother's Asperger's is on a spectrum with nonverbal autism. It seems more like the natural result of engineers having kids together for one generation too many.
I'm not sure that Asperger's and severe autism are fundamentally different. My sister-in-law is somewhere in-between. She's very definitely verbal, but she does have tactile sensitivity worse than most people I know, and she's had to be taught social functioning skills that come naturally even to most "aspies". She's probably not capable of being self-sufficient above a really basic level.
Take her symptoms and turn them up, you get classical autism. Turn them down, and you get a typical Asperger's case.
Perhaps, but that doesn’t mean that the mainstreaming of autism by people who are fundamentally not disabled and their handwaving away of the more severe cases isn’t cheapening or stigmatizing her struggle, either.
My nephew is a very smart kid and he seems to have whatever the opposite of ADHD is. He comes home from school and completely unprompted says, “I’m just going to do all my homework now to get it out of the way so I can relax.” He’s probably at least in the 95th percentile for conscientiousness.
But the parents of 50th percentile kids are stressing because little Noah isn’t going to get into Duke if he doesn’t start acting like a kid in the 95th percentile for conscientiousness.
To the degree it’s a contagion it’s the pathologising of the 50th percentile kid and the assumption that 95th percentile is normal and everything else is abnormal.
“the NYT is simply not going to consider the notion that different individual people have fundamentally different levels of academic potential in its pages”
Isn’t this the ubiquitous hypocrisy of the left… to demand complete individualism while lumping people into a narrow band of superficial categories?
It seems a worldview problem connected to gendered evolutionary traits. Specifically females dominate the top-level control of public grade school education and much of higher learning, and females are wired more collectivist. A collectivist worldview is one that tends to reject individual merit as it results in different outcomes based on individual capability. So, people are lumped into categories/groups so care can be metered “fairly”. High differentiation, ideally at the individual level based on the individual’s unique learning needs, runs counter to the impulses of a person holding a collectivist worldview. However, since all people pursue their own self-interest as a primary motivation, there is a darker explanation for this collectivist low-granularity categorization of people into categories to meter out care… it stifles competition. If students are developed based on individual need, more would achieve academic success. This would then lead to more people representing a competitive risk.
Collectivists are also authoritarians. Their worldview is one where a few “elites” are put in positions of power and control over the rest, so that the elites can fairly meter out care to the rest. They do care for others, but only if they can do so in a position of authority and control. That is why they do not support high differentiation… because it leads to people becoming more self-sufficient and not needing the care that the collectivists leverage to retain authority and control.
"Specifically females dominate the top-level control of public grade school education and much of higher learning, and females are wired more collectivist"
This weird and delusional insistence that the world got ruined when women showed up in the workplace is unhealthy, dude. Take it to Arnold's Klings substack. Women do not dominate top level control of grade school, to name just one fly in your scabrous ointment.
Ah, I see. You have some delusion about teachers and principals having "control".
So let's start there: "top level control of public education" is not held by either teachers or principals. Some of it is held by superintendents, but most public education control is held by politicians and judges. That was what I was referring to, not public school employment.
But to deal with your rather provincial notion of "dominance":
Women have "dominated teaching" since the 1950s at least. This dominance is not new, so any excellence you want to claim for public schools was true when women dominated teaching.
One reason women seem so much more numerous than men in your provincial understanding. is because there are far, far more elementary school teachers and schools than there are high school teachers and schools. If you'd said something like "women dominate elementary school employment" you would have at least been correct.
Just over 50% of all public school principals are female and that's only been true for the past few years. And this metric is true only because women are 60% of elementary school principals, and while principal control is overstated to begin with, it's ludicrous in the extreme to think that an elementary school principal of either gender has any sort of "dominance" over their schools.
Less than half of middle school principals and only 35% of high school principals--where a tiny bit of power does accrue--are women. Women make up fewer than 30% of superintendents, where a lot of power accrues.
Women are a *higher* percentage of private school principals than public school. They hold 63% of the positions overall, as opposed to merely half.
Pick your date of decline for public schools and unless it's somewhere around 1945, whatever "dominance" women had was roughly as true then as it was now. Women were first a majority of elementary school principals, then a minority, then a majority again,. Whatever deluded notion you have of decline would not track to their employment percentage. Whatever idiotic thing you want schools to stop doing, male principals are as likely to be enforcing it as women are.
You're simply wrong, and stupid with it. Everything you think is terrible about public schools came from political action and court mandates, both of which are dominated by men.
You work very hard to ignore reality. The education system is a mess because of the dominance of radical 3rd wave postmodernist feminists that have pushed the fake scholarship toxic parasitic mind virus of Critical Theory into the muffin heads of students to indoctrinate them and send them out to the world to spread the virus and infect everything else. It infects all students but primarily females who are more susceptible to this type of brainwashing.
The curriculum and instruction methods have been corrupted to this end, and the system is failing to teach any fundamentals or life skills that students need. Yes, there are weak low-T males also in the education system attempting to appease these radical females for some pets.
Read a few books will ya. Cynical Theories and Woke Racism are two I recommend.
I live in a CA college town that has the highest percentage of female grade school student in the nation, 95% female, going through gender transition and these students are clearly being influenced by the employees of the grade schoolteachers and administrators. I work with a group working to stop it. The opposition to us trying to stop it are all radical feminists that work for the school system, or that have retired after working for the school system.
"Why Can't We Be Honest About the Rise of Mental Disorders as Consumer Products? / this is an undeniable and widespread phenomenon with obvious negative consequences for society that mainstream media simply will not cover"
... And it goes back at least 35 years, in my experience.
Back about 45-50 years ago, as a young adult, I became convinced (justifiably, I believed then and now), that one of the causes of my depression was biological. Now, back in the late '70s, the Zeitgeist reflected the conviction (for lay people, at least) that it was not even possible for anything other than things like schizophrenia or full-blown psychoses to have any biological causes. Accordingly, I was ridiculed by psychotherapists whenever I tried to bring it up, compounding my mental difficulties. Even though we've known since *prehistory* that alcohol (and many other substances) affect conscious states -- Hello?! (I should add that I was not upper or upper-middle class, and could not easily find someone, professional or not, to have a decent conversation about it.)
About ten years (mid-late '80s) after I started pursuing this idea, I finally "arm-wrestled" a doctor at Man's Best Hospital (who demanded cash for the session) and walked out with and Rx for now-"obsolete" MAOI Nardil. After carefully following the risky protocol, about 3-5 months later, I discovered that it *worked*. Significantly. My first thought was not relief - it was anger. Nevertheless, I suppressed that reaction, as my suspicion now had been validated.
However, and the point of my story, is that three or so years later c.1990 -- after Prozac appeared -- is that the floodgates were opened. It was literally from night to day regarding respect for biological causes. At that point, I tried several different drugs -- but curiously, each was less effective than the past, yet every one had weird new side effects. I finally realized, after about fifteen years, that both medical professionals and drug developers really didn't yet understand all that much at this early point in history understanding how the brain works -- certainly not mine -- so that whatever they were doing was more like throwing spaghetti at the wall to see what sticks. (Nardil, in fact, was an early accidental discovery.) The obvious real purpose for the incessant trotting out of new drugs: Money. (Oh, and Marcia Angell spoke up. I'll just leave that there on the table.)
For these reasons (and many more), I now have less than zero respect for psychopharmacology. I'll go to my grave before I'll willingly put another new thing (psychoactive or not) into my bloodstream from the monsters steering the pharm industry. I'm confident they'll find a way around that little annoyance, however, for me and hundreds of million others, as we had an Exhibit A of their power just five years ago that survives to this day.
Thank you for the pointer to current info. However, it was not merely the inadequate state-of-the-science of the 1990s, but the uncontrolled dishonesty/corruption that had occurred, which dovetails with Freddie's theme here.
Whatever advances are actually occurring, it is next to impossible for me to trust what is now being claimed, and I'm too old to fool around wasting time any more. If mine is a widespread consumer attitude in medicine, that doesn't bode well for today's medical "industries". For overall welfare of society, in aggregate they are well-arguably vastly inferior to the doctor-run insurance monopoly that once existed with BC/BS, no matter what dazzling advances on the edge of science they continue to distract us with.
I too remember the 1970s, and the tendency to tell adolescents with depression and anxiety to just snap out of it. One of my friends had chronic stomach pain from anxiety and her doctor told her to take Tums and snap out of it. It was a bad era.
With current food production standards and updated testing of levels of tyramine in foods, the dietary restrictions are not nearly as strict anymore (personally, I don't find it strict *at all* - for most of the "dangerous" foods, you'd have to go out of your way to consume enough in one sitting to get a reaction). Drug-drug interactions leading to SS are still a concern, though of course that's avoidable if informed. Ken Gillman has thorough updated information on his website. Just putting this out in case you ever find yourself in a situation where you need it again.
(I have not tried Nardil; I've been on Parnate for 1.5 years. Also the only thing that worked for me. I hardly think about the food stuff anymore, aside from avoiding large quantities of pickles or food of questionable freshness)
I think one thing that's kind of goes under the radar a lot of times about the rise of ADHD is that our environment has developed in ways that makes sustained attention and regulation really critical.
I think about this a lot because I have a ADHD and I've had it I was diagnosed as a woman in 2005 when it wasn't that popular. It's something that I've struggled with my whole life (ask my first grade teacher). The demands in an information heavy society has made everyday functioning more difficult for people with the set of regulation issues that is related to adhd.
The second part of it is that I am a big fan of focusing more on function than on symptoms when diagnosing people. I teach diagnosis at a university and this is why I focus on people's ability to function because we all have symptoms of a bunch of different disorders, but it doesn't usually rise to the point where interferes with people's daily functioning and that's the important difference. I think the social contagion in a lot of ways as accompanied by a lack of understanding about what a disorder is. If somebody says that ADHD is a superpower, then they don't have ADHD because obviously it's not interfering with her daily functioning and so they don't meet the criteria.
Is social contagion a big part of this problem? Absolutely. But so are pocket phones and social media. "[O]ur environment has developed in ways that make sustained attention and regulation really critical" --an excellent point, but may I change the last word to "difficult"?
agreed
With respect to your first observation on environment, I've really started to wonder if a significant portion of ADHD diagnoses for elementary-school boys isn't caused by contemporary parenting and education culture demanding that those boys sit still and work quietly for many more hours a day than was expected of prior generations.
Yes and there are a fewer pathways for people who can't sit for hours to be successful.
You've started to wonder? Seriously? That's been the accusation for easily 30 years or more. Parents were being reassured that "hyperactive boys" often had no trouble in adulthood back in the 80s. And it was probably the 90s when people first started noticing that kids stopped their meds in the summer during the 90s.
It's not even remotely new that boys were diagnosed with this since the 70s. What's trendy is this phase of selfdiagnosis.
I recall the response of a former schoolteacher, a feminist, to Carol Gilligan's A Diiferent Voice". It went something like this:
"Well, duh! Of course boys are going to get more attention from teachers, as boys are less eager to please authority and harder to keep on task!"
This isn’t as relevant to kids (I hope) but when it comes to adult ADHD, we also need to look at the increase in marijuana potency and legalization.
My spouse is a psychiatrist, and she sees a lot of patients who developed concentration issues after using marijuana. They’re not happy when she tells them they need to quit weed rather than start taking Adderall, but for the few patients willing to comply it has made a difference.
Both of my younger sons had serious problems with pot.
One has had disabling anxiety, depression since he was 10. He's was medicated successfully for years then I noticed his anxiety had gotten out of control again. I suggested he look into new meds. He had to do drug testing for a job, failed and it took 3 months for it to clear. Now he feels much better. It had gotten to the point where he was sick to his stomach in the morning.
The youngest son had gotten erratic and reactive. I thought he was either on meth or was bi-polar. He went off on me and his dad like a crazy person, then a few weeks later did the same thing with his girlfriend. He quit using pot and is fine. Total change.
I'd take a step back and re-think your ideas about this. Does it really sound like a good idea to put people through the criminal justice system instead of sending them to a psychiatrist? Because that's where "looking at marijuana legalization" leads.
It's a reasonable argument that legalization is what allows these people to admit they use marijuana at all. Prior to legalization most people would be afraid to, lest they either be dismissed outright as "chemically dependent" for any use of marijuana if not potentially subject to criminal penalty.
It's largely beyond speculation that regularly consuming large volumes of marijuana is bad for most people and that for a some people any amount has negative consequences. It's still somewhat fraught to come up with objective figures for what constitutes "large volumes", since biased people will pick low numbers and rapid tolerance acquisition to its effects results in wide variances in individual responses to the same quantities of THC.
The potency argument is largely bunk. In the 1970s when low-quality marijuana was $25 an ounce, people smoked much more volume to get the same effects that a single $10 joint from a dispensary can produce. I remember in the mid-80s smoking 3-4 joints with a group of friends. Now it takes 3-4+ people to finish one joint, and two people seldom want to finish one joint on their own. THC itself didn't get more potent, and people without compulsive use habits largely self-regulate their consumption relative to the effects. Too much marijuana consumption in a single session is dysphoric, an experience most users have had, just like too much alcohol, and most people choose self-regulation.
I never said I want to criminalize users. I’d be in prison too. But there’s a lot of room between criminal penalties and what we have now, selling it at the store, where it’s normalized and we downplay the risks.
We’ve replaced the old set of harms with new ones, and I think the current approach is very misguided. It has led to an increase in psychosis in the population, which is a big deal. Casual users exist, but everyone I know who buys weed uses it too much and is also in denial about the risks. Including how it’s impacting their mental health overall.
At one point I would have agreed with you that there was some third way between conventional legalization and criminalization. The problem is that there isn't much room between criminal penalties and what legalization looks like in most states. Either you make it legally available and sell a regulated product at regulated stores, or people will buy and sell it illicitly and we're back to the black market again with criminal enforcement and losing other positive changes, such as regulations on purity and contaminants and the ability to collect significant taxes. It also opens the door back up to widespread harassment and abuse through selective law enforcement.
And I'd argue there are no new harms. Whatever harms cannabis and THC caused now, they also caused those harms before, whether its excessive use (the 'stoner' is a stereotype which existed before legalization) or driving under the influence. The NY Times even reports in states where cannabis is legalized, adolescent use had actually declined or at worst stayed the same.
I don't know the people you know so I can't judge what their cannabis use patterns are, but blanket statements that everyone uses it too much (what's too much? what's just right?) seems to be more of a lifestyle judgement than any kind of quantifiable standard. I know some people around me who don't use cannabis seem to complain more about it and it always strikes me as something of a reactive social judgement, possibly to being "off trend" given the large spike in general cannabis interest and growing acceptance.
I used to work in the gaming (gambling) industry and there is definitely a difference between having some casinos in out of the way places and ads for sports betting plastered everywhere. There is a London Review Of Books article I found that hit just the right note on slots: Legal, but don’t advertise. It’s really OK to have some things be legal but still sketchy!
The "restricted zoning" concept has two problems. The most immediate one is political actors using zoning restrictions to basically eliminate a legal business. They play all kinds of games which reduce the only zoned space where the business is allowed to operate to places where it's fundamentally unable to operate. Not just remote, but no available real estate at all.
This "one weird trick" has been used for pornography, strip clubs, and firearms pretty brazenly and more subtly for drug treatment, homeless shelters and redlining minority groups.
The larger problem is that greatly limiting legal sales outlets for cannabis means people continue to patronize black markets. This was (and might still be) a problem for California when it legalized -- a number of cities simply refused to zone for dispensaries. Part of the longer-term goal of legalization is eliminating black market cannabis and that won't happen with significant geographical barriers to access.
Eliminating black market cannabis probably won’t happen until states stop sin taxing it and they allow sales to minors, the first of which is unlikely and the second of which will never happen. There was already a huge illegal supply chain for it when we legalized it, all it takes is a slight price differential to keep it going, at least for flower.
I’m glad my state has medical too, I pay like half the price because medical doesn’t have to pay the sin or sales taxes.
Nonsense. Buying weed at the store is the ONLY good thing left about America
I'm pretty convinced (for a half-baked notional theory, at least) that modern society has evolved to demand levels of executive functioning and cognition which exceed baseline human ability. We're also stuck in an economic system that won't reward (and we could even argue punishes) people who don't meet those executive function demands.
I'd argue this is a potential explanation for a lot of things, especially things which appear to be related to lack of economic success.
I'm lucky to be able to perform at a higher than baseline level for these things, more or less successfully managing a diverse set of technologies for a large hospitality group.
By chance, I flipped through the training materials for the wait staff in our restaurants and I was kind of blown away by the large amount of information and processes they're expected to know. To take orders for food and and drinks. I'm not being dismissive of the job, putting up with the public is hard enough, but the function and knowledge base for a job that pays $15/hr plus tips seems excessive.
Yeah, I think most people have a mild form of ADHD in modern-day America just because humans didn’t evolve for the kind of information overload or smartphone dopamine hits that are the air we breathe today. It would be more weird not to, and it’s certainly no superpower (though stimulants may make you feel like Superman!)
It’s a double-edged sword to be sure, but I don’t begrudge anyone who needs adderall to get through school or work, nor anyone who honestly needs additional time to take a test.
Good piece, but in bringing up cases and examples I find it curious that you left out that one stinking dung heap left by the proverbial elephant in the living room: the bourgeois social contagion fueled trans phenomenon. Are there matters that you won’t even go near?
You know that relative who, when you say you don't talk about politics, or religion, or abortion, or whatever, insists you do it anyway?
New guy.
We don't discuss that issue here because the people who are interested in discussing it, generally, are not content with merely espousing their belief that there is a social contagion component to its increased incidence.
They also want to impute disreputable motivations and behaviors upon all sufferers, as well as offering prescriptions for how society should or should not accommodate them, often settling on no accommodations for `scientific' reasons.
Only this issue? Are there other issues that are verboten? If this is the only issue that is verboten, then that's a massive tell. Of what? I don't know, but it would be easy to figure out.
The real reason that nobody talks about that here is because DeBoer has declared it off limits and bans people for it. His house, his rules.
It's pretty much the only issue that's off limits.
>> The real reason that nobody talks about that here is because DeBoer has declared it off limits and bans people for it. His house, his rules.
I would be perfectly OK with Deboer banning me right now. I have lost my job and need to cut unnecessary expenses.
Did you lose your job for being obnoxious and insufferable? There are a 1,000 places to obsess over trans topics online if that's the discussion you want to have. The amount of space trans discussions takes up is quite obviously totally out of proportion to the actual salience of the issue.
I'm not obsessing over anything. Ignorant of the prior history of the matter on this blog I made a comment, others attacked me for my alleged faux pas, but assumed that I would backoff, assume an apologetic stance. I did neither. And neither do I wish to continue the discussion, but if you keep piling on, I will pile back Up to you.
FdB has said that he has no interest in commenting on the issue (mainly due to expertise and, well, lack of interest in the topic), and experience has taught us that any of his posts tangentially related to the subject would cause the comments section to devolve into acrimony. People aren't merely interested in the topic but obsessive about it.
>> FdB has said that he has no interest in commenting on the issue (mainly due to expertise),
Does he have expertise on everything he comments on?
>> that any of his posts tangentially related to the subject would cause the comments section to devolve into acrimony
So, trans is the Islam of sociology. Can't go near it do to it's votaries going violently insane over the matter. I just wonder though, where were all the trans when we were all growing up? Where are the testimonials of adults/elderly now lamenting how their lives would have been so different, so much more fulfilling if they had been sllowed to trans 30,40,50 years ago?
Leftists will excuse any moral abomination. Just yesterday it was reported that archeologists have finally confirmed that one of the Maya sites in Tikal, Guatemal, was indeed used for child sacrifice to the infernal gods of the Maya. Of course the report had akshully quote from a dutiful archeologist claiming that such sacrifices weren't inherently bad, just a way for the Maya to get in touch with their feelings. Lefitists will excuse and make allowances for any abomination.
Loudly speculating about "why is this thing off-topic" is not a loophole to get around discussing the off-topic thing.
I can't find the article where he declared it off-topic, but he had at one point asked it not to be discussed, and that was obeyed for a while. Then he wrote an article for another publication that briefly mentioned the topic as an aside, linked from it here, and then the comment section became 90% that topic. And he turned off comments, completely, for everything, for a week or two while figuring out what to do.
I ain't a mod or anything. But he has stated it's off-topic and will take extreme steps to enforce that.
He's not joking, not even a little bit.
(I'm not even using the word because I anticipate, once he gets back, for bans to get handed out indiscriminately to make sure the message gets received this time.)
There are plenty of places here on substack you can talk about the topic if you want.
>> He's not joking, not even a little bit
Now you got me scared.
Yeah, we don't discuss this topic here.
You and I and maybe others agree about the trans phenomenon, but I think it's fine if FDB doesn't care to have it commented about here. There are (as others note) tons of places to comment about it, and I've done my part in those forums. There are other sociological phenomena of interest, such as the ones talked about in this piece.
"Leftists will excuse any moral abomination."
Wow, you've really got your finger on the pulse of leftists. My buddies and I like to spend Sunday mornings seated around a steaming cauldron, rubbing our hands together as we make plans to steal your son's penis. *laughs maniacally*
His previous blog post was about this exact issue, wasn’t it?
Yes, one other that I know of, communism/socialism. I am gay and very familiar with the vicissitudes of trans issues. It's astounding how much of this article reads like the exact issues relevant to that.
It's a sociological debate that's been poisoned by religion.
The failure of honest progressives like Freddie to grapple with the issue is a large part of why it’s been ceded to extremists on the other side.
Keep your fetishes private, freak. I don't kinkshame, but nonconsensual exhibitionism like this constitutes sexual assault.
Is there anywhere where we can discuss transgenderism in a productive manner? I've filed it next to religion on the "more heat than light" subject list.
Yes, Ben Appels substack as well as that of Benjamin Ryan. Ryan is a journalist and his X account is much worth following. There are several others, but those two should be of help.
Benjamin Ryan
@benryanwriter
Lisa Selin Davis is the gold standard, as far as I’m concerned. She was sadly away during the last Informed Dissent podcast (covering the John Oliver piece), and it showed. Even Appel was more militant than I’d expected.
And Cori is just way too guileless about the fundamentalist waters she’s swimming in.
Trans-ness is not actually remotely similar.
oh, ok then. that settles it.
That is probably one reason the social contagion hypothesis is avoided. Might lead to some questions about other popular themes.
What I would like to know is how many people deeply concerned about adhd-medication, and psychiatric medication in general, are perfect fine with other drastic interventions.
If you’re saying why the NYT doesn’t bring it up, I think this is exactly correct. Again, though, the outward behaviors have *very* different social valances depending on your group.
Thank you for writing about this issue Freddie. I am a therapist in California and I can say that this is a major issue and that it also creates barriers in treatment, as people who have told themselves (or been told by an online community) that they have an unchangeable neurological problem/disability are less likely to engage in techniques that could potentially help them. I have been considering writing a piece on my clinical experience with self-diagnosis and social contagion, perhaps I will follow your lead.
That's the nature of communities. They have to protect what makes them Different. When someone struggling with a problem finds sympathy and community, they want to continue that. And continuing requires a certain amount of reinforcing the community.
Paradoxes - not just for 12 step programs and time travel stories anymore!
I first became aware of the phrase "social contagion" in the context of teen girls coalescing around the idea that they were really boys and then grouping themselves as gender dysphoric. The astounding rise in the number of them (compared to their extremely small numbers compared to boys who felt they were gender dysphoric) left health care professionals here and in Europe flabbergasted.
Pretty much all of your arguments here tracked the arguments of those of us who are concerned about separating out the social contagion -- and consequent media attention and deference to young people -- from the real cases of gender dysphoria.
Thanks for harping on an important issue that transcends individual manifestations. I keep reading you because you're annoying in all the right ways.
Thanks for this line..."I keep reading you because you're annoying in all the right ways.".
What is it about teenagers' genitals that so fascinates a middle-aged man of your type? Serious question. You'll be asked it at trial someday, so you might as well get the early practice answering.
Some of us are not middle aged men and work in the medical field and very much agree with David Link's comments. And being sexually aggressive in this and your other comments does not help a healthy discussion about what is the best path forward for these distressed teenagers he refers to.
Do not accuse me of aggression sexual or otherwise. Better you don't interact with me at all in future, if this is your idea of reasonable discourse. Such claims are actionable as defamation and should you persist I will pursue redress through my representative.
Social contagion is real, but stochastic. A million people may get exposed to an idea, but how many will internalize it?
The first social contagion I read about was the Salem witch trials. I think it's a pretty common phenomenon. People get swept up into things and quit thinking rationally.
> People get swept up into things and quit thinking rationally.
People get swept up into things and think even more reactively than they usually do. I'm not sure how much rationality there was to begin with.
I was going to point out how much Freddie’s bullet points track with ROGD, but he tends to tap the sign about this topic being off-limits.
The main difference between it and ADHD/Autism is that there’s still a huge social stigma in many corners that reaches out into actual policy (and policing), which takes the hysteria on both sides to a whole other level.
But yeah, lots of people are self-diagnosing, and professionals risk reputations ruin if they don’t give the diagnosis their patients want. In fact, I wouldn’t be surprised if the term “gatekeeping” gets thrown around in ADHD/Autism circles.
It turns out gatekeeping was always a great thing
The concept of "social contagion" was definitely around for the anorexia craze. I'm not sure I ever saw those two words put together back then, but it would have been instantly understood.
It was a known scourge of girls schools in the 1980's and '90's.
I'm with you on this Freddie. EVERYONE is on a spectrum - ALL kinds of spectrums. It's all shades of gray. I have attributes that may well qualify as ADHD or ADD, others that may well qualify as OCD, and yet others as Depression with a capital "D". (Not to mention something called "Pre-verbal PTSD" whatever the hell that is.)
Yet none of these are disabling or even more than occasionally annoying to myself or others at worst. I can pick literally any person I know who exhibit characteristics of those or other conditions. Are they disabling or even limiting in terms of living life in our culture? If the answer to that is yes, then that is one thing. Self-identification as being disabled is another thing entirely. Having a "disease" for social reasons - whether they be to gain advantage, sympathy or even just minor accommodation is understandable in our culture, but it doesn't make it right.
Now, my main point is that perhaps the culture is the cause. Rampant hyper-capitalism, competitive advantage by any means necessary is the unfortunate main characteristic of our modern US culture. THAT certainly causes all sorts of mental and emotional issues for people and is largely unrecognized as the source of so many of our ills. Yet it goes unquestioned like the force of gravity.
I ask you this - not in a flippant way - What comes after Capitalism? What comes next.... because surely this can't continue - a society that operates as a cancer on the planet and the people who live on it. I think so many of the real "ills" we attribute to mental/emotional issues are just people who can't cope under the stresses of the system we live within. Coping mechanisms, however poor or disabling, are still coping mechanisms.
The best ways to deal with the stresses of modern life is family, community and enjoying things in real life. On a personal level you can choose to not buy into it.
"Capitalism and Its Discontents."
I mean so much would be improved by just making adderall a regular non-controlled prescription drug and giving more time on tests to everyone
"offensive bit of minstrelsy"... worth the whole piece.
Adult diagnoses of ADHD spiking has always just been transparently obvious to me in its roots: stimulants work regardless of whether or not you "really" have ADHD (a fact that makes many activists very angry, but is quickly proven by a talk with literally any undergraduate student in the country), and are professionally advantageous in most mentally intensive work. They're widely used and abused in my industry (tech) along with caffeine and nicotine and it's well known how to quickly get a diagnoses.
When the stakes are your performance in a several-hundred-thousands-of-dollars-a-year job and the hoops to jump through consist of a couple of lies to a doctor, why wouldn't we expect that to be a major factor?
Unless you have a particularly good psychiatrist, I think there's so much confirmation bias involved in handing out amphetamines and then saying the diagnosis must be correct because the diagnosed is now more productive.
And its usually some metric of productivity (grades, vocational achievements, etc) that serves as the signal regarding ADHD affliction and the success of its pharmaceutical therapy.
I'd be kind of curious to see some kind of numerical analysis of employment healthcare benefits that include ADHD diagnosis and therapy and wages. My speculation is that jobs where consumption of ADHD medications is a productivity enhancement are more inclined to provide such benefits. The questions would revolve around what's a cause and what's an effect and whether increased productivity demands lead to benefits which include such coverage, and whether the increased cost of such coverage ends up being subsidized by the increased performance. Edge cases where productivity is demanded but coverage not provided and correlations with methamphetamine use would also be interesting.
All health insurance is going to cover a network of mental health professionals as well as ADHD drugs; generic adderall is very cheap. Some basic mental health care and rx drugs are required to be covered by all qualifying health insurance plans and this is sufficient to get ADHD treated.
Didn't part of the onboarding at FTX involve an off-the-record discussion of what the best stimulants and comedowns were and how one could go about getting prescriptions for same?
My experience with amphetamines is that they keep me awake and alert, but do not actually improve my duration of focus. I'm pretty sure this means I don't have ADHD, but I didn't have to lie to the doc to get the prescription.
"and I’ve read the comments at LessWrong"! lol
I find my favorite thinkers are people who've read SSC/ACX and LessWrong comment sections but are not and never have been capital R Rationalists.
If I understood you that in fact the existence of ADHD MAY be a result of what, where and who we are paying attention to as a society, wow do I get it.. I am OLD and grew up with cursive and memorizing spelling words and grammar and learning to write using same. In addition, I read and do read BOOKS which require time and space away from online sources whether computer, phone or TV. AND in another part of my life I am an IT computer solutions professional too BUT I had to concentrate and learn new ideas and about new spaces that were not there as I grew up iinto my years long career too. Without the ability to motivate myself and concentrate I would never have made it. Yes I do think it is more a societal disease for some, a means to ask for attention and time while being unable to manage one's own time in a productive way. I don't think of it as Attention Deficit so much as ATTENTION OVERLOAD all day every day...and an inability to withdraw to be more careful of one's own mental abillities to deal with this constant attentioon NOISE. Thank you.
The broad thrust of what you are trying to explore here is entirely legitimate, and many of your points made here are well argued. The problem is Freddie, you have a habit of coming across like a humongous bellend when you make them. A couple of suggestions coming from a primarily autistic perspective:
> Speak to more autistic people. Sounds like you have done an excellent job of speaking to families of Level 3 Autistic people, but you seem to have the strange notion that people with Level 1 Autism simply have a quirky personality trait with no effects on their life, and seem unaware that Level 2 Autism even exists. If you speak more to these communities you’ll understand why there is such a desire to organise around their disability and some of the motivations behind language choices.
> Distinguish more between those faking the disorders and those who actually have it. For all your talk of bravery, you are still remarkably coy when it comes to explicitly making a distinction and the net effect is that you end up painting the entire community of neurodivergent identifying people as being fake trend followers, which naturally pisses off the people who actually have it. Be explicit in distinguishing between the two and make it clearer your criticisms only apply to the latter.
> Acknowledge some of the difficulties faced by people without the most severe symptoms. Right now it comes across like you are saying either a disability has to be so severe that one is basically incapable of functioning without assistance, or that it’s basically nothing and people should stop claiming to be victims. There is a middle ground here, and telling legions of horrifically bullied but otherwise functional autistic people that actually they’re just faking it and are fine is a bit like lecturing a white working class boy born into poverty on how privileged he is.
Otherwise, some other thoughts:
> One’s answer to whether neurodivergence should have merch is the same one as to whether Pride should have it
> Obtaining an autism diagnosis in many places (the U.K. for example) is extremely difficult and so self diagnosis is frequently the only option
> At some point, most autistic people have someone tell them “you can’t really be autistic because you aren’t like Sheldon Cooper/Rain Man/insert other stereotype here”. As such, they tend to get very pissed off when someone who clearly has no idea what they are talking about doubts them
> If someone has spent their whole life being made to feel stupid, they are likely to simultaneously want to have their natural deficiencies to be fairly taken into account, and also have the things they are particularly good at be acknowledged. One way to do this is to simultaneously point out that something can be both a disability and a superpower at the same time.
> Most people really have no f***ing clue when it comes to autism. When you know what you are looking for, the sheer number of undiagnosed people operating in society becomes very obvious, and it’s clear most people don’t know it when they see it. It also becomes very obvious that many people have no idea how to handle autism, and this swiftly results in the harmful dynamics that make these communities so defensive in the first place.
> When you know what you are looking for, the sheer number of undiagnosed people operating in society becomes very obvious
If you reread your own sentence very carefully here, you may discover the reason Freddie has limited sympathy for "level 1" autistic people like you and I asking for more attention and resources.
Everyone deserves more attention and resources
Worth noting that under the auspices of social contagion, there is a perverse incentive to adopt identities as a form of commodification of the self. It’s not just about the money injected into the market surrounding identity exploitation, but the sublimation of subject into object. The mind-and-body becomes deracinated from itself.
Don’t make me tap the sign, you know how it goes.
I feel very conflicted honestly about the rising diagnoses.
ADHD and autism are real neurodevelopmental disorders, and deserve a lot of treatment and support. They’re not supposed to be trendy personality traits to lean back on. Even in the best case scenarios where people can harness their ADHD/autism for good, they struggle with the simple things that everyone else wouldn’t as much.
At least for ADHD, I wonder if its simultaneously over diagnosed for people who most likely don’t have it and under diagnosed for the people that DO have it because quite frankly, they won’t take the steps to be diagnosed. Whether it’s because their ability to retain attention, stick to tasks is far lower and other traits are much weaker than the general population.
I do want the field of psychology to be more strict in diagnosing who actually has it, but I don’t want to throw the baby out of the bathwater and let people think these diagnoses are just “excuses”.
I do wonder about the 'superpowers ' aspect.
I'm more likely to be forgiving of that because I can see how it would help them recover and del with it to look on the few positive aspects of their condition that help them compete better with normies, and say "well I'm glad I have that it's kinda cool in a way"...but I'm not having this "and that makes me a more evolved human better than you normies" shit...no...
I think very few in the offline world would consider it a 'superpower'. That phrase came up to destigmatize the labels because there are genuine benefits that come from actually having them.
I can speak more for the ADHD aspect in that I have noticed the difference between people who actually have it (properly diagnosed and don't make it their identity) and people who talk about it because they struggle with some aspects of time management and organization. It has always been much more than purely that.
They are more creative, out-of-the-box thinkers, spontaneous (as long as you have the money and support to tamper the worst of the traits but that's another discussion) and are ultimately are more 'real' people than the general population. Not as a 'superpower' to be 'authentic' (the most overused term ever) but more that its harder to mask certain personality traits that everyone else could.
People making one aspect of themselves their entire identity is something I've noticed in other fields than mental health. You can see it in sexuality too. Most people with same sex attractions (inc people who also have opposite sex ones) don't use labels or flags or constantly refer to themselves as a member of a category.
Those who wish to do so are free to do it their own way (though I would argue it's detrimental and even dangerous to others to choose this path but that's a different discussion) however most don't want to and often people who don't want to are accused of 'hiding' or being ashamed by those who do make it their identity. Understand I'm not talking about people being in some kind of metaphorical closet, I mean they just don't want to make their whole life about it.
It's a tendency (to make 1 thing your whole identity) I've never understood. Maybe most people are just not particularly complicated, don't give much thought to their life or what they wish to do with it etc who they are what their role in the world is, but for me personally I don't ever want any one aspect of myself to define me, I'm a complex person and I don't want to be shoved into a neat little box. It's even more dangerous to make an illness or disability your whole identity...don't you want to be more than that? I'd ask these people.
The rise of labeling someone's sexuality as 'queer' is odd for me, because its just so vague. It's fine (and nothing wrong) to say you're gay/lesbian/bi/trans.
Queer automatically in my mind is someone who spends too much time online and is cares more about trying to be interesting than actually be interesting.
Part of life is realizing how utterly boring it can be, even with success and support. I think some people simply can't handle those boring moments. It's not really fun to go to a job 5 days a week like everyone else. The internet really is the only accessible fun for everyone. Everything else costs more money! It's not a shock to see some people go down the rabbit hole of some communities (looking at you reddit and TikTok) and take on a completely new personality and mindset.
I don't want to be shoved into a box either, I acknowledge that everyone, including me, is complicated and nothing can truly describe my life.
I think you got it right there. Not everyone is going to be a politician or a cop or doc/nurse or fireman or some job where their day work is interesting and has a lot of variety in it.
Most of them will have boring, predictable days and a label makes them feel different/special.
My youngest daughter was diagnosed with Aspergers almost 20 years ago, when she was in 2d grade. The teacher thought there was something wrong with her. My wife said 'she is just like you, you should be tested." Yes, I also got the Apergers diagnosis - and I said "This is normal. I am an engineer/physcist/programmer and most of my peers are like me, many are worse.'
The idiots have medicalized a normal human variation. I have aspies up, down, and across my extended family - and not a single case of classic autism.
In my view, the psychologists who grouped autism and Aspergers together were clearly wrong - while they might have shared an aspect or two, they are probably fundamentally different phenomena. The aspies tend to find productive roles where they can function happily and productively, and that is what is important.
If you’re happy then that’s great.
But a lot of aspies aren’t - they are lonely and struggle to make friends and find romantic partners, they struggle in school and work, etc.
Psychology ranges on a lot of independent variables. Anybody who is at an extreme is going to have more difficulties dealing with the social world and finding friends and compatible people. It has always been so. If I remember correctly, the big 5 factors account for ~ 80 percent of variation in personality - and intelligence is an independent variable as well. That allows for a lot of variation from the median in widely different patterns.
Where do you draw the medicalization line? I would do it at the functional / non-functional line. I couldn't make it in the marketing / socialization sphere, I don't think that way. But engineering and the like is just natural for me. Others are the reverse.
Functional is doing a lot of the work there…
Take a software developer who is good but not great and manages to stay employed more or less but is held back by hygiene and personality issues that could be remedied if addressed in a constructive manner. Now you could say he’s functional because he is housed and for the most part employed. But he is operating at a marginal level due to the issues noted.
If some modest early childhood interventions could have helped him live a happier and more productive life - wouldn’t that be a good use of resources?
"Modest early childhood interventions." What an innocent-sounding phrase.
The OT and child psychologist made a huge difference for my Aspie eldest child, and helped us anticipate problems to come. He has done exceptionally well with these modest supports early on and helped us be better and more supportive parents. I'm not sure what your aggressive agenda in this forum is. Most people want to help their child be the best they can be. Would it be better to ignore issues and let a child or adolescent flounder unsupported through their life?
I hear a constant refrain from the predominantly 20-somethings I work with about the challenges of finding friends and romantic partners. How much of this is today's social media smartphone environment vs. something else? It's not that people with Asperger's don't suffer more, but its not like they're the only ones suffering from what may actually be just the nature of modern social culture.
I'm pushing 60, and I had very similar issues in my 20s. I'm in a much better place now, having learned some social skills by my early 30s, but I still don't navigate the social world very well.
I have never bothered to get a diagnosis but I am sure that if I shopped around that I could find something that puts me "on the spectrum".
But why would I? Like you I work in tech after majoring in physics in college. The professional world has been pretty kind to me as a consequence--I am well compensated, I go on vacation to nice places, I drive a nice car, I buy my dogs gourmet dog food.
Contrast that to somebody who is completely non-verbal, who relies on other people to be fed and bathed, who will spend the rest of their lives in an institution after their parents die or get too old to care for them. I have been successful in life--what's the point of categorizing myself with somebody who needs 24/7 medical care? So I can pat myself on the back for "overcoming" some ill defined "handicap"?
I cannot help but agree with DeBoer that a lot of the people who seem so eager to broadcast their supposed disorders are chasing clout. And in a world where people are in genuine need of real assistance that's shameful.
My brother has Asperger's and Bipolar 1 disorder and that combination has been crippling for him in a way having one or the other like the rest of the family isn't.
He's sufficiently off interpersonally and unable to read social cues enough to BS properly in behavioral interviews, but he's also got significant resume gaps from manic or depressive episodes and their fallout.
The other aspies in the family are able to make up for their interpersonal shortcomings by being extremely reliable employees, and the other manic depressives in the family are sufficiently congenial that we get away with being unreliable employees with intermittent phases of extreme productivity.
Still, I don't believe that my brother's Asperger's is on a spectrum with nonverbal autism. It seems more like the natural result of engineers having kids together for one generation too many.
I'm not sure that Asperger's and severe autism are fundamentally different. My sister-in-law is somewhere in-between. She's very definitely verbal, but she does have tactile sensitivity worse than most people I know, and she's had to be taught social functioning skills that come naturally even to most "aspies". She's probably not capable of being self-sufficient above a really basic level.
Take her symptoms and turn them up, you get classical autism. Turn them down, and you get a typical Asperger's case.
Perhaps, but that doesn’t mean that the mainstreaming of autism by people who are fundamentally not disabled and their handwaving away of the more severe cases isn’t cheapening or stigmatizing her struggle, either.
I certainly prefer having a different word for Asperger’s and autism
I’m not sure about social contagion.
My nephew is a very smart kid and he seems to have whatever the opposite of ADHD is. He comes home from school and completely unprompted says, “I’m just going to do all my homework now to get it out of the way so I can relax.” He’s probably at least in the 95th percentile for conscientiousness.
But the parents of 50th percentile kids are stressing because little Noah isn’t going to get into Duke if he doesn’t start acting like a kid in the 95th percentile for conscientiousness.
To the degree it’s a contagion it’s the pathologising of the 50th percentile kid and the assumption that 95th percentile is normal and everything else is abnormal.
“the NYT is simply not going to consider the notion that different individual people have fundamentally different levels of academic potential in its pages”
Isn’t this the ubiquitous hypocrisy of the left… to demand complete individualism while lumping people into a narrow band of superficial categories?
It seems a worldview problem connected to gendered evolutionary traits. Specifically females dominate the top-level control of public grade school education and much of higher learning, and females are wired more collectivist. A collectivist worldview is one that tends to reject individual merit as it results in different outcomes based on individual capability. So, people are lumped into categories/groups so care can be metered “fairly”. High differentiation, ideally at the individual level based on the individual’s unique learning needs, runs counter to the impulses of a person holding a collectivist worldview. However, since all people pursue their own self-interest as a primary motivation, there is a darker explanation for this collectivist low-granularity categorization of people into categories to meter out care… it stifles competition. If students are developed based on individual need, more would achieve academic success. This would then lead to more people representing a competitive risk.
Collectivists are also authoritarians. Their worldview is one where a few “elites” are put in positions of power and control over the rest, so that the elites can fairly meter out care to the rest. They do care for others, but only if they can do so in a position of authority and control. That is why they do not support high differentiation… because it leads to people becoming more self-sufficient and not needing the care that the collectivists leverage to retain authority and control.
"Specifically females dominate the top-level control of public grade school education and much of higher learning, and females are wired more collectivist"
This weird and delusional insistence that the world got ruined when women showed up in the workplace is unhealthy, dude. Take it to Arnold's Klings substack. Women do not dominate top level control of grade school, to name just one fly in your scabrous ointment.
80% of public school teachers are female. 60% of public school principles are female. 70% of public school administrators are female.
It did not used to be this heavily biased with female employees. But that is what happened and so you are wrong and I am correct.
Ah, I see. You have some delusion about teachers and principals having "control".
So let's start there: "top level control of public education" is not held by either teachers or principals. Some of it is held by superintendents, but most public education control is held by politicians and judges. That was what I was referring to, not public school employment.
But to deal with your rather provincial notion of "dominance":
Women have "dominated teaching" since the 1950s at least. This dominance is not new, so any excellence you want to claim for public schools was true when women dominated teaching.
One reason women seem so much more numerous than men in your provincial understanding. is because there are far, far more elementary school teachers and schools than there are high school teachers and schools. If you'd said something like "women dominate elementary school employment" you would have at least been correct.
Just over 50% of all public school principals are female and that's only been true for the past few years. And this metric is true only because women are 60% of elementary school principals, and while principal control is overstated to begin with, it's ludicrous in the extreme to think that an elementary school principal of either gender has any sort of "dominance" over their schools.
Less than half of middle school principals and only 35% of high school principals--where a tiny bit of power does accrue--are women. Women make up fewer than 30% of superintendents, where a lot of power accrues.
Women are a *higher* percentage of private school principals than public school. They hold 63% of the positions overall, as opposed to merely half.
Pick your date of decline for public schools and unless it's somewhere around 1945, whatever "dominance" women had was roughly as true then as it was now. Women were first a majority of elementary school principals, then a minority, then a majority again,. Whatever deluded notion you have of decline would not track to their employment percentage. Whatever idiotic thing you want schools to stop doing, male principals are as likely to be enforcing it as women are.
You're simply wrong, and stupid with it. Everything you think is terrible about public schools came from political action and court mandates, both of which are dominated by men.
You work very hard to ignore reality. The education system is a mess because of the dominance of radical 3rd wave postmodernist feminists that have pushed the fake scholarship toxic parasitic mind virus of Critical Theory into the muffin heads of students to indoctrinate them and send them out to the world to spread the virus and infect everything else. It infects all students but primarily females who are more susceptible to this type of brainwashing.
The curriculum and instruction methods have been corrupted to this end, and the system is failing to teach any fundamentals or life skills that students need. Yes, there are weak low-T males also in the education system attempting to appease these radical females for some pets.
hahahahaha. Ooooookay.
Read a few books will ya. Cynical Theories and Woke Racism are two I recommend.
I live in a CA college town that has the highest percentage of female grade school student in the nation, 95% female, going through gender transition and these students are clearly being influenced by the employees of the grade schoolteachers and administrators. I work with a group working to stop it. The opposition to us trying to stop it are all radical feminists that work for the school system, or that have retired after working for the school system.
"Why Can't We Be Honest About the Rise of Mental Disorders as Consumer Products? / this is an undeniable and widespread phenomenon with obvious negative consequences for society that mainstream media simply will not cover"
... And it goes back at least 35 years, in my experience.
Back about 45-50 years ago, as a young adult, I became convinced (justifiably, I believed then and now), that one of the causes of my depression was biological. Now, back in the late '70s, the Zeitgeist reflected the conviction (for lay people, at least) that it was not even possible for anything other than things like schizophrenia or full-blown psychoses to have any biological causes. Accordingly, I was ridiculed by psychotherapists whenever I tried to bring it up, compounding my mental difficulties. Even though we've known since *prehistory* that alcohol (and many other substances) affect conscious states -- Hello?! (I should add that I was not upper or upper-middle class, and could not easily find someone, professional or not, to have a decent conversation about it.)
About ten years (mid-late '80s) after I started pursuing this idea, I finally "arm-wrestled" a doctor at Man's Best Hospital (who demanded cash for the session) and walked out with and Rx for now-"obsolete" MAOI Nardil. After carefully following the risky protocol, about 3-5 months later, I discovered that it *worked*. Significantly. My first thought was not relief - it was anger. Nevertheless, I suppressed that reaction, as my suspicion now had been validated.
However, and the point of my story, is that three or so years later c.1990 -- after Prozac appeared -- is that the floodgates were opened. It was literally from night to day regarding respect for biological causes. At that point, I tried several different drugs -- but curiously, each was less effective than the past, yet every one had weird new side effects. I finally realized, after about fifteen years, that both medical professionals and drug developers really didn't yet understand all that much at this early point in history understanding how the brain works -- certainly not mine -- so that whatever they were doing was more like throwing spaghetti at the wall to see what sticks. (Nardil, in fact, was an early accidental discovery.) The obvious real purpose for the incessant trotting out of new drugs: Money. (Oh, and Marcia Angell spoke up. I'll just leave that there on the table.)
For these reasons (and many more), I now have less than zero respect for psychopharmacology. I'll go to my grave before I'll willingly put another new thing (psychoactive or not) into my bloodstream from the monsters steering the pharm industry. I'm confident they'll find a way around that little annoyance, however, for me and hundreds of million others, as we had an Exhibit A of their power just five years ago that survives to this day.
https://www.amazon.com/Brain-Energy-Revolutionary-Understanding-Health/dp/1637741588/ref=sr_1_1?crid=3OGWYQ7JOVR0G&dib=eyJ2IjoiMSJ9.Mz9DPpv5doAYCaJSEjzv8KHf_seWqAHSGo91_vvJy1hr0KGkUqEdvyoyyv4gTgNe2ILNkGgsoYxAxAbIHzazu11G27QLH6uiinreOLkk9w4kecS-OmMObTJb3k546GvbEkZRNlFVI8XsSnktMO74In38Rlw9vERvjzLN-TpiX0-YZtGRt4rLCJ4a22rTelo8ufh_yD0DUPMq9gbJD-NVkLm6U4TOlCE0OQXZpcJtitA.Mp6AUbRscL3ia_R8F8CcYHlbFo7sAJ4DsiYN5g-pcSc&dib_tag=se&keywords=brain+energy&qid=1744740610&sprefix=brain+energy%2Caps%2C193&sr=8-1
Thank you for the pointer to current info. However, it was not merely the inadequate state-of-the-science of the 1990s, but the uncontrolled dishonesty/corruption that had occurred, which dovetails with Freddie's theme here.
Whatever advances are actually occurring, it is next to impossible for me to trust what is now being claimed, and I'm too old to fool around wasting time any more. If mine is a widespread consumer attitude in medicine, that doesn't bode well for today's medical "industries". For overall welfare of society, in aggregate they are well-arguably vastly inferior to the doctor-run insurance monopoly that once existed with BC/BS, no matter what dazzling advances on the edge of science they continue to distract us with.
Are you still on the Nardil? Just curious. I know SSRIs and SSNIs don't work for everyone.
No, I decided the lifelong dietary restrictions and side effects weren't worth the trouble. But I never found anything that worked better.
I too remember the 1970s, and the tendency to tell adolescents with depression and anxiety to just snap out of it. One of my friends had chronic stomach pain from anxiety and her doctor told her to take Tums and snap out of it. It was a bad era.
With current food production standards and updated testing of levels of tyramine in foods, the dietary restrictions are not nearly as strict anymore (personally, I don't find it strict *at all* - for most of the "dangerous" foods, you'd have to go out of your way to consume enough in one sitting to get a reaction). Drug-drug interactions leading to SS are still a concern, though of course that's avoidable if informed. Ken Gillman has thorough updated information on his website. Just putting this out in case you ever find yourself in a situation where you need it again.
(I have not tried Nardil; I've been on Parnate for 1.5 years. Also the only thing that worked for me. I hardly think about the food stuff anymore, aside from avoiding large quantities of pickles or food of questionable freshness)
+1 for the Marcia Angell reference. Her reviews on SSRIs for the NY Review of Books are illuminating