Facebook Discussion About Whether ADD/ADHD is a Fraud

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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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Spending a Lot More Time on FB

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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.

Feminism and Sex with Mary Tyler Moore and Joan Jett

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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

https://www.facebook.com/silvereagleaudio/videos/686567971544898/

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

____________________________________________________

Notes

The Mary Tyler Moore Show on IMDB

https://en.wikipedia.org/wiki/The_Mary_Tyler_Moore_Show

The Dick van Dyke Show on IMDB

http://www.imdb.com/title/tt0054533/

The Avengers (TV Series 1961 - 1969) on IMDB

http://www.imdb.com/title/tt0054518/

"The Grinnell Method" by Molly Gloss

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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

http://strangehorizons.com/fiction/the-grinnell-method-part-1-of-2/

Part 2

http://strangehorizons.com/fiction/the-grinnell-method-part-2-of-2/


The web site of Molly Gloss can be found at http://mollygloss.com/

Molly Gloss signing a book

How to Start A Nuclear War Without Nuking First

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Many people are concerned that Trump might start a nuclear war by launching missiles. They are afraid of this because they believe that Trump is a nut. But there are many ways to start a nuclear war without launching nuclear missiles.

For example, let us say that Trump decides to get rid of Kim Jung-Un. He orders the CIA to set up a predator base in S. Korea and when they have a clear shot at him, launch a few Hellfire missiles at him. But miss. Trump denies it and Kim loses his mind and nukes Seoul. We nuke him back. See? Nuclear war without us having used nuclear weapons first.

Easy.

Marching in San Marcos, California

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I attended the “Women's March” today at San Marcos, California and it was a blast. As always I do not care for the speakers, they embarrass me a little. But there was a whole lot of people, easily a thousand, of all ages, from 3 or so to 70 at least.

Will it do any good? I have no idea, but it was certainly a real morale builder.

San Diego Free Press March Announcement

Also, for what it is worth, the organizers picked a good day for the march.  The day before was rain and today, the day after, there is so much rain we are having flash flood warnings.  Good job!

The Day After Disaster

As I madly dress for the San Marcos Women's March, I want to review for you another inaugural address, none other than that most hated liberal elitist of them all, John Fitzgerald Kennedy. Oh the flames of protest! Not that horrible person. Yes, that very same horrible person. Rich kid, swore like a sailor, abandoned his men on an island to swim for help (some say). Here is what he said on his inauguration:

Now the trumpet summons us again – not as a call to bear arms, though arms we need; not as a call to battle, though embattled we are – but a call to bear the burden of a long twilight struggle, year in and year out, ‘rejoicing in hope, patient in tribulation’ – a struggle against the common enemies of man: tyranny, poverty, disease, and war itself.

Clearly this is inadequate. What would that master of all that is right and decent, Donald Trump, tell us? Well, of course, he would attack his enemies. And he would play to his base.

For too long a small group in our nation’s capital has reaped the rewards of government while the people have borne the cost. Washington flourished but the people did not share in its wealth. Politicians prospered but the jobs left and the factories closed. The establishment protected itself but not the citizens of our country. Their victories have not been your victories. Their triumphs have not been your triumphs. While they have celebrated there has been little to celebrate for struggling families all across our land.

What is funny about this, from my point of view, is that even when I agree with Donald, I disagree with him. I generally think that some of this is correct.  That Washington did pursue a neoliberal economic policy that hurt millions and millions of Americans whose struggle and complaints were ignored. But that is not what I would put in my inauguration speech. There is a way to say this, even (some of) these exact words, and spin it in a new way forward. This is not a campaign speech, you idiot, I want to say, this is your inauguration speech. You won (well, sortof). Its a speech that is supposed to show us the way forward, the way for all of us forward.

And one more time, Donald, you failed. This is just the beginning of your failures, I think.

________

An afterthought. I want to thank all the idiots who disgraced America with this narcissistic swine. Just to let you know how much you are hated. And you are truly hated.

Why I Doubt Trump Will Be Impeached

Many of my friends on Facebook and otherwise are convinced that Trump will be impeached within 18 months or so. Well I hate to pour cold water on my friends hopes, but I am not of that opinion and I want to explain why.

Let me say before I begin that I have been very wrong about many things this election season (I thought Hillary would win easily), so take all this with even extra salt.

The argument goes like this. What people think of as “impeachment” is really a two step process. The first step is that the House of Representatives has to have a majority vote for impeachment, and then the Senate has to vote to convict by a 2/3rds margin.

But what is an impeachable offense? Well, practically it is what the House of Representatives says it is. But the Republicans control the House of Representatives, so why would they vote to impeach Trump? Well, they might if their base insisted that they impeach him, presumably because Trump's behavior was so egregious.

Although the Republican base does not exactly equal Trump's voter base, they are pretty close, and Trump's base seems to be immune to pretty much everything that the Democrats and my friends find so offensive. Even worse, this base seems to even be delighted at anything that annoys (I almost said “pisses off” but I restrained myself) my so-called “liberal” friends.

So one of three things has to happen. Any of the three is sufficient, but how likely are they?

First, the Democrats could win a majority of the House, that would do for impeachment. Then to convict, they would have to have 2/3rds of the Senate or, of course, get a number of Republicans to vote with them in either case. Well, I think it is unlikely that the Democrats will win either house, and if they do, by definition that will not be for at least two years (the next mid-term election).

Second, Trump could do something so egregious that the Republican congressman and/or their base are do disgusted that they *have* to impeach him. What you and I think is egregious does not matter, it is what they think is egregious. I dont know what this would be, maybe a few “bunga bunga” parties?

Third, Trump could do something so dangerous or show such psychotic behavior that they have to remove him from the presidency and commit him. This would probably not use the impeachment process but would probably use the 25 th Amendment:

Section 4 of the XXV Amendment:

Whenever the Vice President and a majority of either the principal officers of the executive departments or of such other body as Congress may by law provide, transmit to the President pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the President is unable to discharge the powers and duties of his office, the Vice President shall immediately assume the powers and duties of the office as Acting President.Thereafter, when the President transmits to the President pro tempore of the Senate and the Speaker of the House of Representatives his written declaration that no inability exists, he shall resume the powers and duties of his office unless the Vice President and a majority of either the principal officers of the executive department or of such other body as Congress may by law provide, transmit within four days to the President pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the President is unable to discharge the powers and duties of his office. Thereupon Congress shall decide the issue, assembling within forty-eight hours for that purpose if not in session. If the Congress, within twenty-one days after receipt of the latter written declaration, or, if Congress is not in session, within twenty-one days after Congress is required to assemble, determines by two-thirds vote of both Houses that the President is unable to discharge the powers and duties of his office, the Vice President shall continue to discharge the same as Acting President; otherwise, the President shall resume the powers and duties of his office.

See the Wikipedia Page on the 25th Amendment

Now, while this is possible, it is not something to count on.

In short, while my friends may wish Trump to go away, I don't believe that he will. So, it seems to me that my friends must redouble their efforts to win back Congress if they want to turn this country around. And that is a totally different problem.

Why I Think Obama Was Adequate At Best

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Being POTUS is a nearly impossible job. Those who were great at it in our history have had a number of things going for them that were extraordinary, had accidents of history on their side in some sense, and still made enemies who were bitter thirty years later. Like the Pope of the Roman Catholic Church, a great Pope or a great President is very hard to predict in advance, and even they make enemies.

I do not think Obama was a great president; I think he was an adequate president. He and his administration was certainly better than any Republican administration since Eisenhower, and possibly better than any Democratic one since LBJ, but that is faint praise. LBJ, as flawed as he was, had elements of greatness in him.

In the following, I admit that there are many issues below that quite possibly could never have gone “our” way, or at least the way I would have liked. But I felt that he could have tried harder, made more of a stink, rallied the troops, and generally raised hell. This is the POTUS after all, it is an impossible job and judged by impossible standards.

The following is in no particular order.

1. He needed to fight harder for our supreme court position. He should have raised bloody hell in the morning, and then complained about it at night. He should have shut the government down, pulled our troops home, and stopped spending money until the Congress did its constitutional duty. The damage to our republic will last for decades and may never be repaired.

2. Someone needed to lead the Democratic party to deal with redistricting in the states. That is only part of the problem that the Democrats need to face to regain control of Congress but it is an important part. He needed to lead the Democrats to at least formulate a plan.

3. He continued the bipartisan neoliberal economic policies that have destroyed manufacturing, destroyed employment for whole sections of our people, and destroyed the unions. He tried to pass the TPP which represented everything bad about the discredited neoliberal policies. The Democrats abandoned the working man and woman. Some say this was inevitable and nothing could be done. Fine, then enjoy your time with Trump because that is what you get.

4. He squashed criminal indictments against Wall Street for the economic meltdown. No new laws were passed to see that corporate malfeasance was punished.

5. The decision not to prosecute the Bush administration for their use of torture disgraced this country and set a bad precedent.

6. He did nothing to address inequality in this country.

7. He did nothing to address the way the tax code, exemptions and loopholes favor the rich.

8. He did nothing to address economic inequality in this country.

9. He did nothing to improve support for the poor.

10. He did nothing to improve how we finance education for the poor and middle class.

11. He did nothing to stop the civil asset forfeiture insanity that is being perpetrated by our local police forces. The Justice Dept briefly halted it, but then allowed it to continue.

12. The Affordable Care Act was adequate at best but did not address the issues of greed in the medical and pharmeceutical industries. These industires need to be nationalized or become not-for-profits. Doctors should be paid what teachers are paid.

13. The policies towards Russia were, in my opinion, unrealistic and certain to cause more conflict.

14. His response to China's cyberattack on this country was inadequate.

15. His response to Russia's cyberattack on this country was too little, too late. 

16. Finally, he was behind that UN resolution that is causing so much glee for those who would destroy Israel. He did so against objections in his own party and as a deliberate f*ck you to some of his strongest supporters.

I have a problem with these things.

I liked his style and manner. I thought he was a first class communicator. And compared to what comes after him, I thought he was a bloody genius and a saint. As our first African-American president, I think he is a credit to his nation.

But he was not the advocate of change that I feel we needed then and now.

Comments on the Visual Effects Bake Off 2017

This post collects a review from Joseph Goldstone of the Bakeoff Screening and my response from Facebook. Neither Joseph nor myself are members of the Academy Visual Effects branch, although Joseph does a lot of work for the Academy and will no doubt be a member one day in my estimation.

Joseph knows Rob Legato from Digital Domain and I know him from Robert Abel and Associates. Thus Rob represents a homeboy and local favorite to us.  Rob is visual effects supervisor on Jungle Book.

Joseph Goldstone writes:

I was unprepared for how good Jungle Book was; the creation of a virtual environment and the interactive lighting was just extraordinary. Rob Legato consistently pushes the state of the art, about once every half-dozen years.

Passengers was another surprise; it's one of the few features I would actually WANT to see in 3D, given the design of that colony ship.

But the big surprise was how convincing the effects were for Deepwater Horizon. I was completely gripped.

If I were looking for another high point I might pick Peter Cushing's synthesized performance in Rogue One, which I found much more impressive than their one-shot of a young Carrie Fisher.

The BFG just left me cold. As for Captain America: Civil War, Fantastic Beasts and Where to Find Them, Doctor Strange, and Arrival, the execution was superb, but (except perhaps for the astonishing visual weirdness of Dr. Strange, as if Escher was a moviemaker) the content was not novel. Kubo and the Two Strings is beautiful, and might make the final four just because there's something about the level of investment that stop-motion animators make over two solid years of knocking out 3 seconds a week that just shows tremendous heart. It showed last, which is the best place to be when you're asking for a sympathy vote.

Talking and singing animals are really not my thing, but damned if I wouldn't give my top-rank vote to Jungle Book, based on it having pushed the envelope harder than anything else.

As always, the VFX branch acts as a filter for quality and novelty of the work itself, and then the general membership undoes that by voting for cuteness. Sorry, I will never forgive the general membership giving the award to Babe and passing up Apollo 13. Never.

Global Wahrman replies:

Regarding Apollo 13 and Babe, I remember being struck by that award as well. When I saw Apollo 13 I was amazed at how seamless it was and that it might present a problem when the awards came because the general membership might not realize they were seeing visual effects. I was approached for Babe but could not take it at the time (big mistake I suppose, although I think Scott definitely did a better job than I would have).

I think that the issue with Dr. Strange was that neither you nor I are fans of the comic and that if we were we might be more impressed with the imagery. I loved the Cloak of Levitation, best part of the movie for me.

As for Arrival, I could not get beyond the fact that an alien invasion movie *must* contain more gunfights, car chases and Jeff Goldblum. I am joking.

Generally stop motion does not do well at this level because there are so few stop motion people in the visual effects subsection.

I did not understand why Capt America Civil War was even on the list, unless they felt they had to pad it. Yes, there was a lot of it. Yawn.

It is odd how movies show at this screening. The year of Cast Away I was shocked at how good that showed at the screening. And how badly, for example, Gladiator did, even though Gladiator was obviously a really interesting film. If you get the chance, read the NY Times Magazine article on Deepwater Horizon, it is a great, great story. I would not be surprised if the movie was not based on that article.

As for Rob Legato, I know him from Abel's and one night he was working on an Eastern Airlines commercial on camera 2 all by himself in the middle of the night. The man deserves the best just for enduring that. Ive only seen bits and pieces of Jungle Book, but it looked great. It should be the winner.

Cushing vs Leia, in terms of impact, I am told that Leia wins hand down. This is perhaps because that movie is so grim that it needed an upbeat moment. We can not separate the visual effects from the emotion and content of the film, much as some would like.

At the end of the day (or in this case, a very long night), the problem with the visual effects bakeoff is that they only show visual effects films. (sarcasm alert) I was disappointed that Independence Day Resurgence was not there. Was there another movie this year as stupid as that? How about a fight between giant robots? Is visual effects losing its touch with the common filmgoer?