Sunday, February 26, 2017

Facebook Discussion About Whether ADD/ADHD is a Fraud


This is a transcript of a Facebook conversation I had with Robit Hairman about ADD/ADHD in response to an article he posted about how ADD/ADHD is a fraud. My response was treated with contempt by Robit, so I let loose with a full dose in response. I have retained some of the FB formatting to try and keep some of the flavor of my response. I believe that ADHD denial is another form of science denial on the part of Americans. At the same time I have no doubt that the disorder may be over-diagnosed.

But it is not a fraud.

Michael Wahrman
Michael Wahrman So every five years or so, some asshole comes out with an article about how ADHD is not real. But it is real. And the medication works. But the medication is nearly impossible to get because of stupid laws put in place by the Nixon administration. You may not like that, but that is just too bad. Oh by the way, thousands of doctors think that ADHD is real. I suppose you deny Climate Change is manmade as well?
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Michael Wahrman
Michael Wahrman Since I have been publicly humiliated for daring to discuss some experiences with ADHD and medication here on this forum, let me go further and share with you a little bit of what I think I have learned after living with this disease all my life and studying it for 20 + years after being diagnosed. I should mention that I am not a Dr. of Medicine, although I hope to be a Dr. of Philosophy in a few years if that matters. First, the track record of psychiatry in diagnosing this and other "mental" disorders (that is, for the most part I am referring to physical disorders that affect cognition) is not great. They have to rely on a lot of patient-reported states of mind in many cases, and there is no definitive blood test for depression or ADHD. Second, various classes of psychiatrists do not talk to each other, or maybe do not respect each other, and in the case of adult ADHD this affected people getting diagnosed and treated for decades. Third, there are excellent tests in child psychiatry for ADHD and if you have a child you suspect may have ADD/ADHD, I hope that these tests are used before a diagnosis is made. I have only been through these tests once, and they were hilarious and very convincing. Ask for more details if you like. Fourth, it was only my first doctor, the highly recommended Dr. Koch of Greenwich Ct who ever used these tests, none of the others have. It is not a coincidence that the others are adult ADD/ADHD doctors but Dr. Koch treats both types of patients. Fifth, I can tell you from personal experience that not all ADHD doctors are drug mad who prescribe at the first sign of anything wrong, on the contrary, the doctors I have used are anti-stimulant and prescribe them as a last resort. As someone who has tried all on-label medications for this disease and most of the off-label ones, I can tell you that for those with my class of the disorder, it is only the stimulants that reliably and significantly work. (The others may indeed be sufficient for those with a minor case of this disease). Sixth, which leads us to the next problem .... (end of part 1)
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Michael Wahrman
Michael Wahrman (beginning of part 2), Sixth, there is no objective way to judge in advance which medication is sufficient or effective or in what dose for the patient, at least not to my knowledge. If you are like me, you will find the hit and miss approach used by doctors to be both annoying and time consuming. In fact, I only found the best medication for my particular version of this problem more or less by accident (in the same way I was diagnosed by a friend not a doctor, originally). Seventh, once you do find the appropriate medication, if you are lucky enough to do so, good luck in getting the Dr to prescribe what you need in a reliable and cost effective manner. I repeat, Drs do not like to prescribe stimulants as it puts them at risk of losing their license. And why on earth would they want to lose their license merely because it helps the patient? Eighth, I have no doubt that this as well as many other "psychiatric" diseases are or may be overdiagnosed, and powerful medications prescribed. Sadly it is up to the parent to figure out if this medication is appropriate or not, as the patient, if a child, may not be able to. Now in the case of adult ADD/ADHD, this is quite straightforward believe it or else. Particularly in the case of ADHD but also with ADD to a lesser extent, the effects of medication in the appropriate dose are not subtle, not in the least. And in the case of the adult, it is extremely likely that the patient has self-medicated all their life to try and get relief in the absence of diagnosis and treatment. (end of part 2)
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Michael Wahrman
Michael Wahrman (beginning of part 3) Ninth, I can tell you, and Robits contemptuous response to my comment above demonstrates, that many people, perhaps most people, do not take this disease seriously. They either do not believe it exists, or that it is serious, or that the medication is required, or some other version of contempt. The fact that millions of Americans will tell them differently has no effect on their preconceptions. But let me tell you, for people like me, and I can not tell you how many there are, the disease is non trivial and the medication is non optional. If you do not believe that, then you are not going to care about the rest of this testimony. It will be dismissed by you with some off hand gesture or ("aww"). And so, tenth, you would not believe how difficult it is to get this medication legally. And we are only talking about legal medication here, not illegal self-medication. I could go on for pages about the hurdles you have to go through and not be exhaustive and you would probably not believe me anyway (most people dont). So if I have any credibility here, let me say that anyone with a serious version of this disease will spend an unknown amount of time per month getting the medication and in many, many cases not get sufficient or reliable medication for years on end. But you probably dont care because you do not believe that this is a real and serious disease, now do you? (end of part 3)
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Michael Wahrman
Michael Wahrman (part 4) Tenth, do I believe that this disease is probably overdiagnosed? Yes, I do. Psychiatry is a screwy business, subject to fads and other influences (including a very corrupt Pharma business) and the free market (what a stupid concept to apply to medicine). To all parents, I would tell you to insist on the tests I went through when I first formally diagnosed. Believe me, they are not subtle. And if your child is only ambiguously diagnosed, then dont worry about it. Its not severe. If it is a clear diagnosis, then trying a low dose of stimulant (or if you prefer the more ambiguous non-stimulants) is not going to kill anyone, and if it works or sortof works, then it will be obvious within hours. This is less true for ADD than ADHD, in the former case, one must rely more on personal testimony of the patient, but even then there are informal tests one can apply. In the latter case, the symptoms of ADHD respond very well to low dose stimulants and one can see results within hours (or even minutes in some cases). Eleventh, the good news is that the primary stimulants prescribed for ADD/ADHD are trivial to get off of. They are no where near as addictive as say, coffee or cocaine. There is the problem that people can get dependent on them for psychological reasons as these are human performance drugs, which is why Dextroamphetamine has been used by our armed forces in WW2 and afterwards. (The Germans used methamphatamine btw, a drug I have no experience with). Twelth, I do not write about my personal experiences because it does me any good. It has been used against me whenever I have, or I have been subjected to abuse or contempt. I do it to help my friends and others who may have this disease and do not know what is going on and may not realize that there is a solution. Therefore you should say thank you for the time I have taken to give you the benefit of my experience and research. You are very welcome.
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Saturday, February 25, 2017

Spending a Lot More Time on FB


I am spending a lot more time on Facebook because at least there I get some response to my outrage about the Trump disaster. My other friends, assuming I have friends, are silent on email. They are silent on the blog. Since I live like a total hermit here in exile, and I do enjoy that human contact now and then, it is more efficient to use FB.

There are other things happening in life that are both good and bad. On the one hand, I have received a contribution from a long-lost relative that will allow me to apply to grad school and keep the power and water on for six months or so. Ideally I could be on my feet again at the end of this time. I do appreciate this contribution, it has totally turned around my life in the short run.

But in the long run, or in six months, what is the liklihood that things will be better? Ultimately, I have to leave this house, what is the liklihood that I will ever be able to afford rent again? Be employed again? Work on something I love again?

Now that China takes its place as the world leader, and the United States self destructs with a right wing faction in charge of the state apparatus, I think it is foolish and unrealistic to have any hope for the future.

Nevertheless, I will press forward with grad school and with my book project and a few other things. Its better than a stick in the eye. I have enjoyed writing this blog and no doubt will enjoy writing more, from time to time, going forward. I appreciate those of you who read this, whoever you may be.

Wednesday, February 8, 2017

Feminism and Sex with Mary Tyler Moore and Joan Jett


Most people of the Boomer generation remember Mary Tyler Moore (MTM) for her TV show which aired on CBS from 1970 to 1977. This show supposedly redefined the concept of the American woman on her own, outside of marriage, having a career. That might be true, and if so it is certainly a good thing. I never watched this show.

But for men and some women of my generation, there is an earlier incarnation of Ms. Moore which we remember with great fondness. This show I most certainly watched, particularly as a daytime rerun in syndication after school. This was the very funny Dick Van Dyke Show and on this show, Mary Tyler Moore played the character of the loving and long suffering wife of Mr. van Dyke, Laura Petrie. For those of us discovering that we liked women, Laura Petrie was a revelation no less than Ms. Emma Peel played by Diana Rigg on The Avengers.

Mary Tyler Moore and Dick van Dyke from the earlier period

What we have for you today is a cover of the MTM Show Theme Song by Joan Jett and the Blackhearts. I think this version captures both the nascent feminism of the MTM Show with Ms. Moore's (no doubt exploited by the patriarchy) sex appeal.

I never doubted that she would “make it”, whatever it is that she was trying to make.

Love is All Around performed by Joan Jett and the Blackhearts

Love is All Around written and performed by Sonny Curtis

Who can turn the world on with her smile?
Who can take a nothing day, and suddenly make it all seem worthwhile?
Well it's you girl, and you should know it
With each glance and every little movement you show it
Love is all around, no need to waste it
You can have a town, why don't you take it
You're gonna make it after all
You're gonna make it after all
How will you make it on your own?
This world is awfully big, girl this time you're all alone
But it's time you started living
It's time you let someone else do some giving
Love is all around, no need to waste it
You can have a town, why don't you take it
You're gonna make it after all
You're gonna make it after all



The Mary Tyler Moore Show on IMDB

The Dick van Dyke Show on IMDB

The Avengers (TV Series 1961 - 1969) on IMDB

Saturday, February 4, 2017

"The Grinnell Method" by Molly Gloss


All I know about this story is that Molly Gloss wrote it, that it was published on Strange Horizons, and that Jeff VanderMeer recommends it. It has a feel of The Southern Reach to it.

This is one of those essentially perfect short stories that we all wish that we could or would write.

An excerpt from The Grinnell Method

From the edge of the marsh, she could hear a dog howling, a terrible prolonged wailing of pain or fear, and when she came out on the mud flats a wet black dog was pacing back and forth, lifting its muzzle every little while in a long, loud, doleful cry of anguish. She called to it without coming very near—she knew nothing of dogs, and thought this one might be rabid. The dog went on pacing and crying, looking out across the bay where an oyster boat rolled and heaved on the swell. Several men on the deck of the boat appeared to be casting and retrieving a drag net without recovering anything. The water was too choppy to see what it was they cast for—a man overboard, she feared, and then realized he must already have drowned—that they were casting for a body—or their efforts would have had more urgency. This was not something she could think about for long.
While she stood watching they brought up something heavy and dark, something like a waterlogged stump. The oystermen had seen her watching from the bay shore, and when they had the thing aboard they hoisted it up and displayed it for her, lifting and spreading the arms wide, lifting up the heavy head until the mouth fell open to white teeth, a red tongue. The bear's thick, sodden pelt streamed with salt water. The dog pointed his nose at the sky and suddenly raised a new wail—it seemed to her a sound of terrible bereavement. One of the men on the boat shouted something, but she could not make it out against the chop of waves on the muddy shore.

The "Oyster Catcher" plays a supporting role in this story

The Grinnell Method by Molly Gloss

Part 1
Part 2
Molly Gloss signing a book