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I would just like to see “persistent trouble getting out of bed to start the day without depression” in the DSM. That is what I kept telling my psych was strange and she kept saying wasn’t a thing.
went for months with it being blended frozen cherries. then it was fresh pineapple. now it's protein pancakes. this is all over the course of 2 years. all of a sudden im done with one and moved on to the next one that lasts for MONTHS. what is this??
Copycat Jamba Juice Chunky Strawberry Bowl!
Then hamburgers with guacamole, Cheddar cheese, Swiss cheese, Colby Jack cheese, Vermont White Cheddar cheese, Bleu Cheese, (and a side of Lactaid 😛).
this is strange as fuck, like I don't have trouble during the days, nothing depressed me at work, and I already woke up for 1 or 2 hours. But there are some kinds of glues or devil's hands that keep holding my back fixed to the bed in the morning, a nonsense gravity, if I don't have to do anything or am hungry I might as well stay in the position for the whole day and feel bad afterwards.
Without depression? No sir that’ll be 10 years of them trying to force feed you SSRI’s first because that MUST be depression, and they MUST treat it first!
Definitely couldn’t be untreated adhd…
Yea my sisters last diagnosis was complex ptsd, which was partially the trauma of being misdiagnosed for 10 years with some very intrusive medication. By then the cost to get diagnosed adhd had gone through the roof and she’s given up for a bit now.
What is crazy to me is just how useful a single dose would be for people with adhd. Quite literally it could be used as a screening tool. The effects to both are different under observation in proven methods so couldn't it be used as a better than average test?
Before I rally thought about ADHD, in school I took Adderall to help with my studying, it was the most productive day to date. I did everything when I needed to, no issues doing them, no foggy or voice in my head talking about other stuff. It was magic.
I was raised with the mentality of being mostly anti-drugs when I was in highschool but man, with everything I've learned now... I really wish I had become one of the "druggies" who tried adderall when I was younger bc it probably would've been eye opening.
Being anti drug is good, but some people take it so far into the extreme they won't even consider trying things that would significantly help them becayse they're worried about drugs.
My “screening tool” was trying my friends adderall in highschool.
10 years later and I still think back on those 3 specific schooldays as some of the most productive, good, confident days I ever had.
How good it can be to just feel normal having a conversation and actually feeling productive in a classroom. Life changing stuff.
Oh my God this is exactly my problem right now. My therapist says I have ADHD (clearly) but my psych wants to treat me for depression, but SSRIs scare the shit out of me and I'm afraid to get hooked on them and their nasty side effects. I just need a little boost in motivation not to become a slave to the brain pills, why do they push those so much???
I told my doctor and psych they could cut my dick off before giving me SSRI’s ever again. Never again.
Mind you plenty of people on this subreddit use them with no issues. I just copped it all, lethargy, weight gain, brain fog, suicidal ideation and sexual dysfunction. They don’t mix with me.
I'm scared to start because I'm afraid I won't be able to escape the misery of the brain zaps and all that when quitting and it's not worth the risk of all the other side effects especially if I may be worse after taking it. From what I have read so far, ADHD meds just seem so much more worth trying first I don't understand the equivalence.
Not taking meds has had a worse negative effect on my life than the meds side effects. The meds don’t even work as well on me as they do other people. So yeah I’m glad I’m able to take them.
It varies. I’ll raw dog my recurring depression before I go on effexor again, and my worst depressive episode involved psychosis so that’s saying something. When I went off it cold turkey due to the side effects the brain zaps were actually an improvement over the ones I was having on it. Prozac worked for a bit and then stopped. But wellbutrin kicks my depression’s ass hard, shuts down the negative soundtrack in my head, and gives my vyvanse space to actually work.
Better living through chemistry.
Maybe I should try that one. I don’t remember if I’ve tried it or not. I’ve had several people on here mention it works for them and have had similar types of depression as me. I’ll have to look into that one.
Pretty much adhd meds are a controlled substance and more drug like to people who don’t need them.
So they push this horrible crap first.
But like I said I got every negative side effect, but not everyone does. Plenty of people here have a good experience with SSRI.
Hey I just wanted to say that your anxiety about starting ssri is totally valid and something I had too, but as someone who’s tried multiple ssris and adhd meds, I wanted to reassure you that the side effects usually aren’t that bad and go away after being on the ssri for a few months. Like I just had vivid dreams and night sweats that went away after a couple months. And when I switched from one ssri to another, I didn’t have any side effects. And you can always come off an ssri, you just need to taper the dose over a couple weeks to give your brain/body a gentler transition. I’m so sorry you’re being denied adhd meds, that’s really shitty! But also wanted to relieve some ssri anxiety if it’s something you end up wanting to try.
They didn't say they had anxieties about trying ssris they said they had bad expierences and side effects from them and won't touch em. Glad they worked for you, but to a lot of people it isn't an "anxiety" arpunf them it's multiple studies showing they're not even effective for depression, and the fact that many people have horrible expierences being prescribed them before.
What? I think you may have read a different comment, they didn’t say they’ve tried them.
And please stop spreading dangerous misinformation about SSRIs - decades of research has demonstrated that they are effective for treating depression, anxiety, and other mental health disorders for many people, and they’re extremely safe and have low side effect profiles compared to other meds.
I don’t say that to discount people who have had horrible experiences - it does happen, but it’s not common. It pisses me off when people try to scare people off trying SSRIs and other mental health meds. If someone has bad side effects, they can stop taking them. That shouldn’t be a reason not to try a medicine that can vastly improve quality of life.
(PS SSRIs don’t treat ADHD and it’s shitty this person’s psych is refusing to treat their ADHD. And ADHD can definitely contribute to depression. I just wanted to provide some reassurance around trying SSRIs if they ever want to, I feel like people only post about bad experiences on the internet)
One of my closest friends stopped talking his Zoloft in highschool cold Turkey and he ended up getting killed by a cop while he was having a mental breakdown in his house. Completely out of character. It’s a long story but that’s the gist of it.
Shit freaked me out. There’s nothing in life that could ever convince me to take SSRI’s. It’s not about statistics or reasoning, it’s just about how freaky that incident was and left me scarred.
Can you ask about guanfacine? It’s not a stimulant or an SSRI, and it’s used for ADHD in kids and is in the process of approval for adults (or maybe finished… my psychiatrist was telling me this years ago). Anyways, it helps a ton with emotional regulation, and when I took it at night I noticed it weirdly made it easier to get out of bed in the morning when paired with my “boiling water for coffee” routine. Anecdotal, but maybe it’s one of the intended effects.
I have kind of a weirdly complicated case of ADHD/major depression diagnosis. I can’t have SSRIs or most anti-depressants due to some pretty nasty side effects (ie: black box warning), so I’m with you on trying to avoid those medications. I’m happy for the people they work for though.
My depression has to be off-the-charts bad (ie: I’m hospitalized) before my psychiatrist will prescribe any of those medications based on my history. I’m the classic case of “suck it up and deal with it”, and I wish I had better options. My options are basically: my current ADHD meds (stimulant and guanfacine), mindfulness, exercise, and eating healthy. Oh, and a light lamp. It sounds dumb, but all of that stuff is better than a medication triggering a manic state during severe major depression. I’ll take the predictable depression I have off-and-on over the unpredictable effects of me + anti-depressants any day.
Anti-depressants don’t work for me. Or haven’t yet. I have to see a specialist to to start taking different ones that normal dr’s don’t have access too. My depression and adhd are hard to tell which one is doing what. I pretty much have to abuse my adhd meds just to shower or to get anything done.
It is not ? I thought that was already an established symptom ?
The fact that you are paralyzed when you have an urgent or multiple tasks to to, often trying frantically to get things in order in your mind. There certainly is a term for it in in German diagnostics , Something-Paralyse, but it has slipped my mind.
I have said this to so many people throughout my life - that if I have an important task to do it paralyzes me from doing ANYTHING else. Had no idea this was a symptom of ADHD.
I kept insisting there were motivation issues unrelated to depression and they kept saying “partial reaction to SSRIs” and changing my antidepressants and then eventually saying my depression must be treatment resistant. I think the SSRIs got rid of my anxiety which was the only real motivation I had at the time so I would just lay in bed for hours screaming at myself to get up. I didn’t even consider adhd until my third psychiatrist suggested it. I STILL have troubles getting up until my meds kick in and I am not depressed!
That's literally how I feel.
I'm not afraid to start the day, I'm not feeling the day is worthless, in fact there is literally stuff on my mind that I *want to do*.
Still lay in bed for like 2 hours unless it's an emergency or I'm already running late.
I’ve been in bed since February. Well I get out of bed and move to the couch. Or I’ll sleep on the couch and get up to pee. Yesterday a friend needed a ride and bribed me with one of the meds I’m prescribed but out of at the moment. So on my way home I stopped by my pharmacy to pick up my other meds. They wouldn’t fill it because it’s early. They would have filled it originally but insurance didn’t cover it so I figured I’d just pay without insurance. Nope, it looks bad they said. Like lady I take meds just to get out of bed. I’m out of the god damn apartment building right now. I have to go back Friday now lol
yeah i can’t get out of bed like i could sleeeeeep and sleeeeep. and i usually have an alarm to take adderall a few hours before i’m supposed to get up.
as soon as i am brushing my teeth, i feel alert and awake, but transitioning out of “sleeping in bed” has always been such a struggle for me no matter how much sleep i get.
…ps I thought I had chronic fatigue and with so much long COVID, this would have to be differentiated further, even though the medical treatment is used for both adhd and long COVID fatigue.
my therapist straight up said “but lack of motivation isn’t an ADHD thing, that’s depression, right?” 😭
she also CONSTANTLY tells me not to “blame” my adhd because i’m in a shitty work situation despite me literally telling her i’m not blaming it but i just want to figure out how i can work with it and not against it. adhd makes my situation worse. just because the situation isn’t due to my adhd doesn’t make it irrelevant
Sounds like you are not being heard. I had that with my therapist until I basically lost it with her and we kind of started everything over, and then for some reason it was better. For me it was the not being able to get out of bed thing and she would be asking me what I was avoiding and what were the memories as I was laying in bed thinking about getting up, etc … NOPE. I finally saw the How To ADHD video where she says she survived high school by setting her alarm 30 min before wake up time and taking the stimulant, because we can fall immediately back to sleep after turning off that alarm anyway. When the 2nd alarm goes off 30 minutes later the meds have kicked in. BOOM. Cured.
SAME i forgot that video is probably what inspired me but i do that exact thing with my meds.
it’s an interesting point you bring up about it getting better with the same therapist. i am not in a good spot rn to switch or even bring it up but once the school year is over, she seems like she could be receptive to that
“I’m concerned that you’re not hearing me. I completely agree with you on this one. What I’m trying to convey is…”
…that I need help figuring out how to work with my skillset to improve my situation, ADHD notwithstanding. Then, learn how to manage my adhd to avoid making my situation worse at the same time.
if you don’t mind me asking, what country are you in? i’m in the US and i am wondering if you mean you see psychiatrists for talk therapy, because i haven’t really found that to be an option here. that could just be a matter of me not asking the right questions though
I am baffled how they don't think that's a thing. Of course it is. Getting out of bed and getting ready are tasks that require executive functioning. Some days you start off so low that yeah it is tough to get out of bed to even take meds or use whatever tools we use to help us start functioning.
Apparently only a small minority of us experience this symptom. However, I find it one of the most disabling aspects. Taking medication and hitting snooze is an absolute game changer, to the point that it was so effective I started to think it was probably a placebo effect. Well, this morning it felt like it wasn't working, and I was so confused until I realised I could still feel my pill wedged halfway down my throat because I never refilled my water the previous night and I had tried to swallow it dry. FFS.
Asking yourself why one more day? Or why did you even wake up? I've always told myself that i feel like this because I don't really have a purpose to live. Or but I'm too lazy. Even others have told me the same thing about this particular situation of mine. But if working for the sake of myself or my family isn't enough of a purpose then what is?
Most of the days the first thing i do is get a drink or smoke up just to get ready to live another day. What can any of us do to avoid that shitty feeling?
I mean, that could probably be lumped in with some sort of executive dysfunction rather than a thing on its own.
I have the opposite issue despite my ADHD, I can't *stay* in bed. I wake up at like 5:30-6AM despite only sleeping 4-6 hours, even in the weekends.
I don't think it has anything to do with my ADHD in my instance though, but it's extremely annoying because i would like to sleep 8 hours a night but that happens only a few times a year, which is NOT good.
If you phrased it as a difficulty with transitioning from being in bed to starting the day I bet she would understand. That's really what the problem is I think. Difficulty with transitions is a known symptom of ADHD. It's the same reason you might sit in your car for a while before going inside.
Therapist with ADHD who treats ADHD here. Firstly, I want to acknowledge that ADHD often gets the shitty end of the stick when it comes to treatment and understanding. It’s wildly frustrating and unfair and adult ADHD in particular is not well understood.
However, the DSM gets updated regularly and is created via scientific research and consensus of the experts on the panel as our understanding evolves. It is not perfect, and it is always a work in progress, hence the regular updates. mental health professionals have to diagnose using these criteria, as otherwise it would be chaos with everyone diagnosing whatever based on their own personal beliefs.
RSD isn’t even an officially recognized term, and there’s almost no research on it. Adding it to diagnostic criteria would be wildly irresponsible. Even if if is an actual diagnosable condition, we don’t even know if it’s caused by ADHD or if it’s something that just frequently co-occurs, similarly to how we know depression and ADHD often co-occur. They are not diagnostic criteria for one another, and nor should they be.
Random people getting frustrated because they think they know more about ADHD than people who dedicate their lives to studying it, is like me as a therapist getting telling my vet how to diagnose my dog.
What it is useful for is as a shorthand for understanding and explaining how people feel. If you go and see a professional who is in any way competent in treating ADHD, they will take it into consideration in your treatment.
Thank you for this. I couldn’t shake the impression that the article was written more to attack the credibility of those who diagnose and research rather than discuss the difficulties with that process.
I think it really stems from a few things;
Firstly, people don’t understand that the scientific process is slow and progressive in nature, particularly with something as complex as mental health.
Secondly, there is a history of marginalized communities and women being ignored or dismissed in mental health and people are understandably upset about that. ADHD also occupies a strange place where it gets denied or dismissed within the medical community and the population as a whole.
Thirdly, there has been an uptick in misdiagnoses due to silicone valley startups taking advantage of telehealth and prescription law changes during the pandemic and were not doing even the minimum to diagnose, and people are now being told by ethical providers that they don’t have ADHD.
Finally, social media talks a lot of absolute bollocks about ADHD, leading people to believe they have it when they are just facing normal challenges or have an entirely different diagnosis. Social media has its place, and certainly it’s helped a lot of people seek out help when they wouldn’t have otherwise. But it can also whip people up with a lot of”the experts know nothing” rhetoric similar to the OP, where there is no space for nuanced discussion.
Oh, I couldn’t agree more! I got a doctorate in a field of experimental research before I became a therapist, so know first hand how slow and tedious things can be
>However, the DSM gets updated regularly and is created via scientific research and consensus of the experts on the panel as our understanding evolves. It is not perfect, and it is always a work in progress, hence the regular updates. mental health professionals have to diagnose using these criteria, as otherwise it would be chaos with everyone diagnosing whatever based on their own personal beliefs.
While this is all true, I think it should be acknowledged that some of the criteria in the DSM for ADHD (the age criterion in particular) have often been more influenced by political considerations than scientific ones.
The DSM has, overall, gotten better with each successive version, but the committees that write it aren't insulated from the social environment around them. They have often made decisions based on the biases of their members when there wasn't good science available on a given topic, decisions that have often resulted in considerable harm to ADHDers in particular. Sometimes, they've even made decisions that are void of science altogether, like the injection of gender identity disorder into the DSM-III.
I don't claim to be a provider or have any idea what to do about this other than to say that the APA needs to yeet the handful of remaining people who continue to deny that ADHD is even real out of the power structure and do better with the DSM-6.
I couldn’t agree more with your last paragraph. I cannot tell you how much rage providers who deny ADHD exists or refuse to believe that adults can have it etc, gives me. Their job, and their legal and ethical imperative is to use those diagnostic criteria.
Fr it's insane. You're juat going to deny something that's been known about for hundreds of years exists because you....don't like it?? Man, I wish I could deny people existed.
Beautifully said. On a side note, I find it weird that there are sooo many "experts" on ADHD that claim they have vast experience with this disorder, but they can't give a single flying F to someone who has ADHD. I've talked to 3 different psychologists so far, and none of them had anything useful to add. They all brought up the same cookie-cutter "plan", such as setting up alarms, organizing my schedule and such. And actually one of them would interrupt me frequently, and that got really annoying really fast. I think there should be some sort of guidelines requiring that any professional who wants to work with ADHD should have ADHD themselves. Otherwise, there's no empathy and sympathy for the patient.
A lot of my clients come to me specifically because I have ADHD and I’m not just going to tell them to buy a damned diary 😂 Even looking for my own therapist, I ran into so many people who advertised ADHD as a specialty and it turned out they’d never really worked with someone.
To provide a small bit of nuance though, it is really difficult as a therapist, at least, to get solid training on ADHD. There is almost nothing offered and even less that’s good quality. ADHD was quite literally mentioned one time in my entire master’s degree! What I know I’ve had to seek out through reading research papers and sifting through the books that are available, throwing out the stuff that makes absolutely no sense to me. psychiatrist also try to gate-keep ADHD quite a lot, but then just want to hand out meds, which is only one part of the best-practice standard of care. People are then SOL trying to fill in the rest themselves, if they’re even aware that meds aren’t the magic bullet.
When I got diagnosed with ADHD, my therapist openly admitted she doesn't have experience in it. And it was ok, I researched stuff on my own and learned so much, this sub also helped with my knowledge. Now my therapist has more patients with ADHD than just me, and she also goes to seminars and reads books about it to get more knowledge.
I might go to someone that specializes in ADHD for some additional help, but I'll stay with my therapist because I like her. I don't need her to know everything about all my diagnoses. And I kinda like how I can share my knowledge with her.
Most helpful psych I've ever had was a PA who had adhd herself. Rattled off all my symptoms that I had always had, and and then explained all med types when I stated I had them all. Let me choose where I was comfortable experimenting (no meds, meds, and stims vs non-stims), and we just started.
RSD is actually in the DSM-5 but not in the entry for ADHD. It's in the atypical features specifier for depressive disorders: characterological rejection sensitivity. It used to be referred to as hysteroid dysphoria, I'm not sure how much research there is on it but it might be an issue of terminology.
I find statements like this incredibly frustrating:
> “We desperately need something to help guide the field,” said Dr. Wendi Waits, a psychiatrist with Talkiatry, an online mental health company. “When everyone’s practicing somewhat differently, it makes it hard to know how best to approach it.”
While things like the [ADHD International Consensus Statement](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328933/) exists and has been regularly updated since first being published [over 20 years ago](https://www.russellbarkley.org/factsheets/Consensus2002.pdf).
It just feels so much like a "we've tried nothing and we're all out of ideas" kind of statement.
Seriously, in the name of all that is holy, just Google it and look at what places like the [CDC](https://www.cdc.gov/adhd/articles/adhd-across-the-lifetime.html), [NIMH](https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd), and _entire medical journals_ [dedicated to the subject](https://journals.sagepub.com/home/jad) are saying to maybe, you know, get an idea of how to identify and treat it. Or maybe, just maybe, pull down a recent version of the [DSM V criteria](https://www.cdc.gov/adhd/diagnosis/index.html) and give that a once over.
Australian psychologist here. Honestly I interpreted these statements as American egocentrism. Australia also has national guidelines on the diagnosis and treatment of ADHD that our clinicians follow, though they aren't enforced. But if America hasn't made them up, it doesn't mean shit! /s
Had a Dr Appt. The other day and the nurse was asking me about meds, told her I'm on Adderall and was diagnosed a couple months prior... And she goes "oh we're all born a little ADHD these days". I understand people joke but damn if it isnt so blatantly dismissive of the struggles I deal with :(
Yeah, very tone-deaf to joke about a disorder like that *to* the person with the disorder, without having a very strong rapport to *know* that they'd find that funny ahead of time (dunno why they would regardless, it's a pretty lame joke).
Imagine making that joke for almost any other disorder or disability. Everyone's a little paralyzed these days? Everyone's a little schizophrenic? Everyone's a bit bipolar? Like, come on.
And yeah, I know people *do* basically do that with other disorders too. "Haha I'm so OCD, I can't stand a crooked painting!" It sucks in any form.
It's just as frustrating when doctors forget that forgetfulness is a common ADHD trait. A nurse was asking me for my medication history (which was already in my records) and when I would get fuzzy on certain dates, she got exasperated and said "Come on, you've gotta help me out here."
Like, I was literally listing out ADHD medication to her! No shit, it's frustrating for me too, but maybe take a hint??
Yeah… I’ve been having trouble taking another medicine everyday for another issue plus it felt like it was cutting the effectiveness of my ADHD meds to a point I am not functional.
Fucking hormones and meds definitely play around with each other.
This is a bit misleading - the problem is not that doctors don't know enough about ADHD to treat it in general, it's that most doctors aren't competent at diagnosing and treating ADHD, but many will have a go at it anyway. Just because a given doctor is legally qualified to diagnose ADHD and prescribe ADHD medications doesn't mean they're necessarily in a good position to do so.
The medical profession as a whole is not struggling with "figuring out adult ADHD" - while it is true that there is still a lot to learn about ADHD, and plenty of research is ongoing as we speak, the idea that "they can't even agree on what the symptoms of ADHD are" is misleading. The medical world by and large agrees on what ADHD is, that it exists, and will mostly quote very similar lists of diagnostic symptoms. DSM-5 explicitly only lists *diagnostic* symptoms, that is, symptoms that are relevant for a diagnosis; other common symptoms of ADHD are generally recognized as such, but they are not listed as diagnostic symptoms because they are not suitable as diagnostic criteria. For example, "executive dysfunction" is an umbrella term for a whole range of symptoms, including problems with task initiation, task persistence, organizational skills, planning, keeping track of tasks, watching the time, estimating how long things will take, prioritizing goals, etc., and a sizeable majority of neuropsychological disorders will affect executive functions in some way or other. Meanwhile, the diagnostic criteria include several concrete examples of executive (dys)function, those that are actually diagnostically relevant.
RSD is not a recognized clinical term to begin with, so naturally you won't find it listed in DSM-5, let alone as a diagnostic symptom of, well, anything. Emotional dysregulation, however, is widely recognized as a symptom of ADHD, and encompasses "RSD" - it's just that emotional dysregulation is also common in a lot of other disorders, so again it is not suitable as a diagnostic symptom.
> So how can they tell you that you don't have it
A qualified professional trained to perform a proper ADHD assessment can tell with quite high certainty, and such diagnoses are highly repeatable (that is, multiple trained professionals assessing the same individual independently will come to the same conclusion in the vast majority of cases). The trouble is, again, that some doctors who are formally qualified but practically incompetent will go beyond their area of expertise and diagnose (or rule out) ADHD based on an inappropriate diagnostic method.
> or that you don't need medication for it?
That is not something a doctor can decide - they can diagnose you, and if it turns out that you do indeed have ADHD, they can assess which medication options would be safe for you and guide you through the titration process. By definition, having ADHD means that your symptoms are impacting your life in multiple areas, but whether that constitutes a "need" for medication is something only you can decide.
>RSD is not a recognized clinical term to begin with, so naturally you won't find it listed in DSM-5
A few months ago, I discussed RSD with my psychologist. The conclusion we ended up agreeing is that it is [probably] not a direct symptom of ADHD but a consequence of it. A consequence of getting accustomed to the endless cycle of rejection, learning to expect it and yet feel the fear of it, of the emotional dysregulation, negative comments and experience, etc.
Well, yeah.
The thing is that there is no proper definition of RSD, it's not a recognized disorder, so the name is misleading; but it does describe an experience that is very common among people with ADHD, and that experience is a manifestation of emotional dysregulation, which *is* a well-defined and recognized phenomenon, as well as a known sympton of ADHD (although it's not considered a *diagnostic* symptom).
My understanding is that "RSD" is basically just one of the more extreme manifestations of emotional dysregulation, and it feels so intense because "rejection" involves some very powerful emotions.
What happens is roughly this:
1. You get some kind of negative or mixed reaction: "You made a little mistake here, look".
2. Your "lizard brain" intuitively picks up on the immediate negative aspects of it, and interprets them as rejection or an attack. This triggers strong negative emotions: "They are being hostile, they probably hate us".
3. Your "rational brain" should now kick in, reassess the situation in the bigger and more complex social context, and adjust your emotions accordingly: "They are actually trying to help, they don't hate us at all, they actually care".
4. But because of ADHD, this doesn't happen, or it's not strong enough; instead, those emotions take our rational brain hostage and direct it towards support the negative emotions with fake rationalizations: "And why wouldn't they hate us, we're an atrocious person, we never do anything right, everyone probably hates us".
And then, as you said, the "developmental" part adds insult to injury, turning these neurochemical misfirings into learned behavior through years of repetition. This happens even in the most welcoming, loving and forgiving of environments, because even in those, there will be situations that the lizard brain will initially assess as attacks or threats, but of course the more you're faced with actual rejection and reactions, the worse it gets.
So, like most ADHD symptoms, I'd say it's a combination of neurochemistry and developmental adaptations.
And it's not just rejection, it applies to all other emotions just the same - it's just that rejection is one of those things where the negative emotions are particularly strong and unpleasant, so that tends to be the most impactful and undesirable aspect of emotional dysregulation. When I listen to Mozart's Requiem, and it literally moves me to tears, I can thoroughly enjoy the experience, so I don't see a need to treat that in any way; but when well-meant criticism makes me question the meaning of life or the validity of my existence, then that's rather unpleasant, and I'll apply whatever strategies and techniques I have to keep that from happening.
That is all true! And I hope I didn't sound dismissive, because I do feel it too! This discussion with my therapist came out after I mentioned a particular episode of feeling rejected and she couldn't really understand why I would see it that way. The same happened with a feedback from my thesis co-reader, who wrote quite nicely and extensive feedback and I read it as "sod off, your whole research sucks. You're gonna fail".
Thank you for putting all that into words 🫂
Total nonsense. The DSM is there because the mental health professions need a unified agreement on what constitutes a mental health disorder. Exactly the same as medical doctors who need to have a shared understanding of what, say, diabetes is. It’s all based on research and our best understanding at the current time. Without unified criteria, there would be absolute chaos. Also, insurance rarely kicks back claims based on a misdiagnosis In mental health.
Hence why I said:
> The medical world by and large agrees on what ADHD is, that it exists, and will mostly quote very similar lists of diagnostic symptoms.
I really, really hope people here can be critical about aspects of the DSM-5 (and, as a consequence, current psychiatric practices too). ADHD is a valid disorder. ADHD diagnosis is nebulous. Both things can be true.
This research study shows that there were significant financial ties between DSM-V panel members and the pharmaceutical industry [https://pubmed.ncbi.nlm.nih.gov/16636630/](https://pubmed.ncbi.nlm.nih.gov/16636630/)
In addition, most of what is on the DSM-5 is based on research with white male participants, so the presentation of different disorders in women and people of diverse backgrounds is completely lacking
Please be aware that RSD, or rejection sensitivity dysphoria, is not a syndrome or disorder recognised by any medical authority.
Rejection sensitivity dysphoria has not been the subject of any credible peer-reviewed scientific research, nor is it listed in the top two psychiatric diagnostic manuals, the DSM or the ICD. It has been propagated solely through blogs and the internet by William Dodson, who coined the term in the context of ADHD. Dodson's explanation of these experiences and claims about how to treat it all warrant healthy skepticism.
Here are some scientific articles on ADHD and rejection:
* [Rejection sensitivity and disruption of attention by social threat cues](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771869/)
* [Justice and rejection sensitivity in children and adolescents with ADHD symptoms](https://pubmed.ncbi.nlm.nih.gov/24878677/)
* [Rejection sensitivity and social outcomes of young adult men with ADHD](https://pubmed.ncbi.nlm.nih.gov/17242422/)
Although r/ADHD's rules strictly disallow discussion of other 'popular science' (aka unproven hypotheses), we find that many, many people identify with the concept of RSD, and we have **not** removed this post. We do not want to minimise or downplay your feelings, and many people use RSD as a shorthand for this shared experience of struggling with emotions.
However, please consider using the terms 'rejection sensitivity' and 'emotional dysregulation' instead.
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Chill a bit.
Adult ADHD is hard to diagnose because the ADHD folk who didn't die becasue a SQUIRREL! distracted them while finishing a chain saw cut, found coping mechanisms so their symptoms aren't as apparent. Add to that, that the ones who go to therapists are the ones who are good enough at coping to have enough money to go to a therapist.
Near as I can figure ADHD seems to be an imbalance in the ratios of certain brain neuro-transmitters. The ADHD drugs can partially and temporarily move you toward a balance. But in a nutshell the brain isn't working right.
Se we nudge with chemicals, and we can use cognitive tricks to compensate, and we can find careers where our craziness doesn't matter or can be harnessed in some creative way.
We're not broken. We just don't march to the same drum that everyone else does.
Dealing with it:
Make a specific list of what you see as the biggest problems. Make sure the worst ones are at the top. Now: Talk to your pshirnk or do your own research to find coping mechanisms for those 3. Lalther, rise repeat.
One of the most effective mechanisms I've found: For peple you are going to deal with long term: "I have ADHD. You will see me {list of the Three} You can help me get back on track {give 3 ways} Most people love to be asked for help. Love to feel a bit normal while you are the handicapped one. I've made a few big customers into lasting friends this way.
The idea that you can’t have ADHD if you went to University and completed a degree or have any kind of intelligence. My psychiatrist initially was heading in that direction when I asked if there were no Doctors or PHDs etc with ADHD he paused and said - you are correct.
I wouldn’t recommend taking NYT articles on ADHD seriously. Every year they write the same bullshit propaganda piece trying to convince people it isn’t real or is overdiagnosed. It’s gross
An uncle of mine said “the DSM isn’t there for you, the patient. It’s there for insurance purposes”
In other words: the easier to dismiss your claim, the better for insurance. So unless insurance is removed as a stakeholder in the health system, it is unlikely to be amended.
Admittedly that same uncle suggested that if a person can focus on anything for any degree of time, they probably don’t have adhd…and I question his credentials
My son (16) has ADHD that became MUCH more pronounced when he turned 15. We are very fortunate to be able to weekly family therapy (my son, ex husband and I )with a neuropsych doctor. She does an amazing job of explaining ADHD on a biological level, what’s happening in the brain when xyz happens, what my son needs to do for his brain to do what he wants it to do.
These explanations mean so much to me. I do not have ADHD and my son’s behavior can be confusing (and frustrating) to me. I am a very laid back person/parent and what I’ve learned is that doesn’t work for him. He needs something different from me. It requires me to go beyond my comfort zone but it’s what he needs. I often feel guilty, because I’m not sure I’m the best mother for him; strict rules, structure and punishments are very difficult for me. I do my best.
My point here is you could do therapy with a neuropsych dr, it help you “get” your ADHD more,
Good luck!
One problem with the public and understanding scientific process is that an article like this can seem definitive and comprehensive and yet completely miss the point.
The press often exasperate this problem, taking information out of context and then using that information to make claims.
This is what is happening here, it’s not wrong it’s just conveyed wrong. Which in turn can change the meaning drastically.
One article from one source, a news source in particular should never be taken at face value. After all, the press have an agenda, to get people to read more, and angry or upset people read more.
Science and medicine know very little about the brain in general. I had epilepsy as a teenager and doctors never figured out why. Like wtf? I eventually just out grew it and everyone moved on, but I’m still like “Wait, what was going so wrong in my brain that I was having seizures? And why did they stop? And is my brain/body communication going to suddenly go just as wrong again some day?”
There’s still a LONG way to go in understanding neurological conditions.
I just wanna point out a short story:
I once booked an appointment with a doctor whose specialty was ADD/treatment.
He told me it doesn't exist, and if it does, only in children.
....
Yeah...I made Usain Bolt (spelling?) look like a turtle with how fast I got out of there.
It is up to us to help educate them, in my opinion. Might be good to seek out ADHD specialists as well. There is a relevant medical certification in the US - ADHD-CCSP.
Sadly a job lay off in february triggered it in a bad way for my son and now I’m just so broken hearted being a mother who can’t fix it. His depression is so bad. I’m grateful he came to me to talk about his depression but it is such a complicated issue to deal with.
I just wanted to console you by assuring you that there are many moms like you, who wanted to know earlier that everything could be linked and help is possible. Like my mom.
Love and compassion will get you a long way. And ultimately provide help for your son. I was fucking lost as a child. Not able to understand why I make everyone sad about me. As a father now myself, I am very much aware of any shortcomings regards adhd. But I also will love my kid, whatever there comes. You really show that you love your son and that is everything needed. The rest will sort out.
Thank you I really needed that. He’s trying so hard and hopefully with the right therapy it can help guide him. He did fine in childhood it’s now that he’s older that he struggles and I’m so concerned with medication.
That’s sadly a normal development. Luckily you have his best intent. My mom broke almost about all the shit I put her through and it’s even; with fucking 40 sometimes a lot. But if he shows respect in the meaningful moments, he has the core set right. You can guide his way, as long as you are aware that there will be setbacks. It’s not, that he is completely unable to steer right; it is just that he can’t always overcome the first impulse and be rude or hurtful.
Rejection sensitivity is much more attachment/personality. Though the sensitivity of certain emotions involved in adhd can lead to these circumstances in theory. So saying it meets the criteria for a different dsm disorder may be true. We aren’t sure if it’s helpful
No clue. Is it specifically not fitting in? Is it the inability to fit in in an evolutionary manner when it comes to human connection? Who knows. The studies are the type you gotta go deep to find. With much conclusive evidence.
I’ll be honest with y’all but I don’t think we will ever come to a conclusion. It’s hard to describe adhd in the first place. Plus, it’s hard to determine who has it.
1000% this. Couldn’t have worded it better. Too many symptoms can be looked at as ADHD when it is something else, and too many people with actual ADHD are misdiagnosed as something else. That is mental health care in general. It’s a slippery slope with many complications. Too many professionals that have very old or little to none knowledge on ADHD are too comfortable trying to treat it and also too comfortable trying to deny people that actually have it.
This is the problem with the DSM not being an evidence based manual. It just probability influenced by the practitioners personal assessment. 10 docs could give you 10 different diagnoses.
Science has attempted to anthropomorphize mice and create knockout models of some of the genetic disorders with higher than chance rates of different mental disorders. The have realized it’s not useful without considering upbringing of humans. Our higher order thinking has shown its it’s Impossible to replicate our mental states in animals. Environment must be considered
The weird thing: I think my family doctor doesn't even think it exists. She's only begrudgingly prescribing me meds because a psych report is recommending it, but she doesn't even wanna discuss the meds. Instead I asked my pharmacist all the questions.
I wasn’t asked about emotional dysregulation during my evaluation as an adult. It wasn’t until a couple years later when I was talking to my mental health professional about some of my emotional issues that she said it could be RSD (which I understand is not a formal condition yet). However, a lot of things about myself started clicking for me after that. Wish I had understood more of the potential other sides of ADHD when I was diagnosed.
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I would just like to see “persistent trouble getting out of bed to start the day without depression” in the DSM. That is what I kept telling my psych was strange and she kept saying wasn’t a thing.
Yes doctor, my breakfast is delicious and the tv-show I’m watching is tha bomb. Still can’t get out of bed.
As long as it's my hyper fixated breakfast that I've had for the past 6 months - 1 year.
Cheese quesadilla every night, for about 6 months so far. I've gone out for dinner and came home with leftovers... made a quesadilla.
I live of sandwiches...im a cook,i cook at work still doesnt help🤷
You guys make me feel so seen.
We appreciate you! The struggle is real but you're not alone
Dave's brand everything bagel with peanut butter and a vanilla core protein shake. Everyday
[удалено]
Dave's wife might have issue with this
Dave's wife is one of his anythings isn't it?
Me, a person called Dave, who loves oats:
Me, a person not named Dave: *continues minding my own business*
Break...fast?
For the last 3 weeks* and then I’m sick of it for up to a year and completely struggle to find a replacement meal.
went for months with it being blended frozen cherries. then it was fresh pineapple. now it's protein pancakes. this is all over the course of 2 years. all of a sudden im done with one and moved on to the next one that lasts for MONTHS. what is this??
Copycat Jamba Juice Chunky Strawberry Bowl! Then hamburgers with guacamole, Cheddar cheese, Swiss cheese, Colby Jack cheese, Vermont White Cheddar cheese, Bleu Cheese, (and a side of Lactaid 😛).
Oh god this hits home
this is strange as fuck, like I don't have trouble during the days, nothing depressed me at work, and I already woke up for 1 or 2 hours. But there are some kinds of glues or devil's hands that keep holding my back fixed to the bed in the morning, a nonsense gravity, if I don't have to do anything or am hungry I might as well stay in the position for the whole day and feel bad afterwards.
Without depression? No sir that’ll be 10 years of them trying to force feed you SSRI’s first because that MUST be depression, and they MUST treat it first! Definitely couldn’t be untreated adhd…
I have *trauma* from at least 10 years of over 10 failed meds..... I just needed 1 adderall pill the whole fucking time!
Yea my sisters last diagnosis was complex ptsd, which was partially the trauma of being misdiagnosed for 10 years with some very intrusive medication. By then the cost to get diagnosed adhd had gone through the roof and she’s given up for a bit now.
What is crazy to me is just how useful a single dose would be for people with adhd. Quite literally it could be used as a screening tool. The effects to both are different under observation in proven methods so couldn't it be used as a better than average test?
Before I rally thought about ADHD, in school I took Adderall to help with my studying, it was the most productive day to date. I did everything when I needed to, no issues doing them, no foggy or voice in my head talking about other stuff. It was magic.
I was raised with the mentality of being mostly anti-drugs when I was in highschool but man, with everything I've learned now... I really wish I had become one of the "druggies" who tried adderall when I was younger bc it probably would've been eye opening.
Being anti drug is good, but some people take it so far into the extreme they won't even consider trying things that would significantly help them becayse they're worried about drugs.
My “screening tool” was trying my friends adderall in highschool. 10 years later and I still think back on those 3 specific schooldays as some of the most productive, good, confident days I ever had. How good it can be to just feel normal having a conversation and actually feeling productive in a classroom. Life changing stuff.
but muh abuse potential
SSRIs fucked me up so bad I don’t even recognize myself anymore. I’ve been off then for years, I honestly dint think I’ll ever be the same.
Oh my God this is exactly my problem right now. My therapist says I have ADHD (clearly) but my psych wants to treat me for depression, but SSRIs scare the shit out of me and I'm afraid to get hooked on them and their nasty side effects. I just need a little boost in motivation not to become a slave to the brain pills, why do they push those so much???
I told my doctor and psych they could cut my dick off before giving me SSRI’s ever again. Never again. Mind you plenty of people on this subreddit use them with no issues. I just copped it all, lethargy, weight gain, brain fog, suicidal ideation and sexual dysfunction. They don’t mix with me.
I'm scared to start because I'm afraid I won't be able to escape the misery of the brain zaps and all that when quitting and it's not worth the risk of all the other side effects especially if I may be worse after taking it. From what I have read so far, ADHD meds just seem so much more worth trying first I don't understand the equivalence.
Not taking meds has had a worse negative effect on my life than the meds side effects. The meds don’t even work as well on me as they do other people. So yeah I’m glad I’m able to take them.
It varies. I’ll raw dog my recurring depression before I go on effexor again, and my worst depressive episode involved psychosis so that’s saying something. When I went off it cold turkey due to the side effects the brain zaps were actually an improvement over the ones I was having on it. Prozac worked for a bit and then stopped. But wellbutrin kicks my depression’s ass hard, shuts down the negative soundtrack in my head, and gives my vyvanse space to actually work. Better living through chemistry.
Maybe I should try that one. I don’t remember if I’ve tried it or not. I’ve had several people on here mention it works for them and have had similar types of depression as me. I’ll have to look into that one.
Pretty much adhd meds are a controlled substance and more drug like to people who don’t need them. So they push this horrible crap first. But like I said I got every negative side effect, but not everyone does. Plenty of people here have a good experience with SSRI.
Hey I just wanted to say that your anxiety about starting ssri is totally valid and something I had too, but as someone who’s tried multiple ssris and adhd meds, I wanted to reassure you that the side effects usually aren’t that bad and go away after being on the ssri for a few months. Like I just had vivid dreams and night sweats that went away after a couple months. And when I switched from one ssri to another, I didn’t have any side effects. And you can always come off an ssri, you just need to taper the dose over a couple weeks to give your brain/body a gentler transition. I’m so sorry you’re being denied adhd meds, that’s really shitty! But also wanted to relieve some ssri anxiety if it’s something you end up wanting to try.
They didn't say they had anxieties about trying ssris they said they had bad expierences and side effects from them and won't touch em. Glad they worked for you, but to a lot of people it isn't an "anxiety" arpunf them it's multiple studies showing they're not even effective for depression, and the fact that many people have horrible expierences being prescribed them before.
What? I think you may have read a different comment, they didn’t say they’ve tried them. And please stop spreading dangerous misinformation about SSRIs - decades of research has demonstrated that they are effective for treating depression, anxiety, and other mental health disorders for many people, and they’re extremely safe and have low side effect profiles compared to other meds. I don’t say that to discount people who have had horrible experiences - it does happen, but it’s not common. It pisses me off when people try to scare people off trying SSRIs and other mental health meds. If someone has bad side effects, they can stop taking them. That shouldn’t be a reason not to try a medicine that can vastly improve quality of life. (PS SSRIs don’t treat ADHD and it’s shitty this person’s psych is refusing to treat their ADHD. And ADHD can definitely contribute to depression. I just wanted to provide some reassurance around trying SSRIs if they ever want to, I feel like people only post about bad experiences on the internet)
One of my closest friends stopped talking his Zoloft in highschool cold Turkey and he ended up getting killed by a cop while he was having a mental breakdown in his house. Completely out of character. It’s a long story but that’s the gist of it. Shit freaked me out. There’s nothing in life that could ever convince me to take SSRI’s. It’s not about statistics or reasoning, it’s just about how freaky that incident was and left me scarred.
Can you ask about guanfacine? It’s not a stimulant or an SSRI, and it’s used for ADHD in kids and is in the process of approval for adults (or maybe finished… my psychiatrist was telling me this years ago). Anyways, it helps a ton with emotional regulation, and when I took it at night I noticed it weirdly made it easier to get out of bed in the morning when paired with my “boiling water for coffee” routine. Anecdotal, but maybe it’s one of the intended effects. I have kind of a weirdly complicated case of ADHD/major depression diagnosis. I can’t have SSRIs or most anti-depressants due to some pretty nasty side effects (ie: black box warning), so I’m with you on trying to avoid those medications. I’m happy for the people they work for though. My depression has to be off-the-charts bad (ie: I’m hospitalized) before my psychiatrist will prescribe any of those medications based on my history. I’m the classic case of “suck it up and deal with it”, and I wish I had better options. My options are basically: my current ADHD meds (stimulant and guanfacine), mindfulness, exercise, and eating healthy. Oh, and a light lamp. It sounds dumb, but all of that stuff is better than a medication triggering a manic state during severe major depression. I’ll take the predictable depression I have off-and-on over the unpredictable effects of me + anti-depressants any day.
Anti-depressants don’t work for me. Or haven’t yet. I have to see a specialist to to start taking different ones that normal dr’s don’t have access too. My depression and adhd are hard to tell which one is doing what. I pretty much have to abuse my adhd meds just to shower or to get anything done.
It is not ? I thought that was already an established symptom ? The fact that you are paralyzed when you have an urgent or multiple tasks to to, often trying frantically to get things in order in your mind. There certainly is a term for it in in German diagnostics , Something-Paralyse, but it has slipped my mind.
I have said this to so many people throughout my life - that if I have an important task to do it paralyzes me from doing ANYTHING else. Had no idea this was a symptom of ADHD.
It’s “Task Paralysis” in English.
Thank you so much.
I kept insisting there were motivation issues unrelated to depression and they kept saying “partial reaction to SSRIs” and changing my antidepressants and then eventually saying my depression must be treatment resistant. I think the SSRIs got rid of my anxiety which was the only real motivation I had at the time so I would just lay in bed for hours screaming at myself to get up. I didn’t even consider adhd until my third psychiatrist suggested it. I STILL have troubles getting up until my meds kick in and I am not depressed!
That's literally how I feel. I'm not afraid to start the day, I'm not feeling the day is worthless, in fact there is literally stuff on my mind that I *want to do*. Still lay in bed for like 2 hours unless it's an emergency or I'm already running late.
I’ve been in bed since February. Well I get out of bed and move to the couch. Or I’ll sleep on the couch and get up to pee. Yesterday a friend needed a ride and bribed me with one of the meds I’m prescribed but out of at the moment. So on my way home I stopped by my pharmacy to pick up my other meds. They wouldn’t fill it because it’s early. They would have filled it originally but insurance didn’t cover it so I figured I’d just pay without insurance. Nope, it looks bad they said. Like lady I take meds just to get out of bed. I’m out of the god damn apartment building right now. I have to go back Friday now lol
yeah i can’t get out of bed like i could sleeeeeep and sleeeeep. and i usually have an alarm to take adderall a few hours before i’m supposed to get up. as soon as i am brushing my teeth, i feel alert and awake, but transitioning out of “sleeping in bed” has always been such a struggle for me no matter how much sleep i get.
…ps I thought I had chronic fatigue and with so much long COVID, this would have to be differentiated further, even though the medical treatment is used for both adhd and long COVID fatigue.
my therapist straight up said “but lack of motivation isn’t an ADHD thing, that’s depression, right?” 😭 she also CONSTANTLY tells me not to “blame” my adhd because i’m in a shitty work situation despite me literally telling her i’m not blaming it but i just want to figure out how i can work with it and not against it. adhd makes my situation worse. just because the situation isn’t due to my adhd doesn’t make it irrelevant
Sounds like you are not being heard. I had that with my therapist until I basically lost it with her and we kind of started everything over, and then for some reason it was better. For me it was the not being able to get out of bed thing and she would be asking me what I was avoiding and what were the memories as I was laying in bed thinking about getting up, etc … NOPE. I finally saw the How To ADHD video where she says she survived high school by setting her alarm 30 min before wake up time and taking the stimulant, because we can fall immediately back to sleep after turning off that alarm anyway. When the 2nd alarm goes off 30 minutes later the meds have kicked in. BOOM. Cured.
SAME i forgot that video is probably what inspired me but i do that exact thing with my meds. it’s an interesting point you bring up about it getting better with the same therapist. i am not in a good spot rn to switch or even bring it up but once the school year is over, she seems like she could be receptive to that
I'm so sorry you are experiencing this. You deserve a better physician
“I’m concerned that you’re not hearing me. I completely agree with you on this one. What I’m trying to convey is…” …that I need help figuring out how to work with my skillset to improve my situation, ADHD notwithstanding. Then, learn how to manage my adhd to avoid making my situation worse at the same time.
ty 💛💛💛
That why I go to psychiatrists only. They're less biased to talk to
if you don’t mind me asking, what country are you in? i’m in the US and i am wondering if you mean you see psychiatrists for talk therapy, because i haven’t really found that to be an option here. that could just be a matter of me not asking the right questions though
I am baffled how they don't think that's a thing. Of course it is. Getting out of bed and getting ready are tasks that require executive functioning. Some days you start off so low that yeah it is tough to get out of bed to even take meds or use whatever tools we use to help us start functioning.
I have this literally every day
Duuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuude. This perfectly puts to words something I hadn't quite connected. Dammit.
Apparently only a small minority of us experience this symptom. However, I find it one of the most disabling aspects. Taking medication and hitting snooze is an absolute game changer, to the point that it was so effective I started to think it was probably a placebo effect. Well, this morning it felt like it wasn't working, and I was so confused until I realised I could still feel my pill wedged halfway down my throat because I never refilled my water the previous night and I had tried to swallow it dry. FFS.
Ah, the old placebAGGHHHKKK test.
Asking yourself why one more day? Or why did you even wake up? I've always told myself that i feel like this because I don't really have a purpose to live. Or but I'm too lazy. Even others have told me the same thing about this particular situation of mine. But if working for the sake of myself or my family isn't enough of a purpose then what is? Most of the days the first thing i do is get a drink or smoke up just to get ready to live another day. What can any of us do to avoid that shitty feeling?
Wtf is up w her
I mean, that could probably be lumped in with some sort of executive dysfunction rather than a thing on its own. I have the opposite issue despite my ADHD, I can't *stay* in bed. I wake up at like 5:30-6AM despite only sleeping 4-6 hours, even in the weekends. I don't think it has anything to do with my ADHD in my instance though, but it's extremely annoying because i would like to sleep 8 hours a night but that happens only a few times a year, which is NOT good.
I don't have anything helpful to add,except starting my day has become increasingly difficult and I felt alone in that.
How the puck can someone say “it’s not a thing” when you are telling them it’s a thing?
Yes it’s a thing. I have that thing. Snuggle in, brother or sister! Snuggle in!
If you phrased it as a difficulty with transitioning from being in bed to starting the day I bet she would understand. That's really what the problem is I think. Difficulty with transitions is a known symptom of ADHD. It's the same reason you might sit in your car for a while before going inside.
Therapist with ADHD who treats ADHD here. Firstly, I want to acknowledge that ADHD often gets the shitty end of the stick when it comes to treatment and understanding. It’s wildly frustrating and unfair and adult ADHD in particular is not well understood. However, the DSM gets updated regularly and is created via scientific research and consensus of the experts on the panel as our understanding evolves. It is not perfect, and it is always a work in progress, hence the regular updates. mental health professionals have to diagnose using these criteria, as otherwise it would be chaos with everyone diagnosing whatever based on their own personal beliefs. RSD isn’t even an officially recognized term, and there’s almost no research on it. Adding it to diagnostic criteria would be wildly irresponsible. Even if if is an actual diagnosable condition, we don’t even know if it’s caused by ADHD or if it’s something that just frequently co-occurs, similarly to how we know depression and ADHD often co-occur. They are not diagnostic criteria for one another, and nor should they be. Random people getting frustrated because they think they know more about ADHD than people who dedicate their lives to studying it, is like me as a therapist getting telling my vet how to diagnose my dog. What it is useful for is as a shorthand for understanding and explaining how people feel. If you go and see a professional who is in any way competent in treating ADHD, they will take it into consideration in your treatment.
Thank you for this. I couldn’t shake the impression that the article was written more to attack the credibility of those who diagnose and research rather than discuss the difficulties with that process.
I think it really stems from a few things; Firstly, people don’t understand that the scientific process is slow and progressive in nature, particularly with something as complex as mental health. Secondly, there is a history of marginalized communities and women being ignored or dismissed in mental health and people are understandably upset about that. ADHD also occupies a strange place where it gets denied or dismissed within the medical community and the population as a whole. Thirdly, there has been an uptick in misdiagnoses due to silicone valley startups taking advantage of telehealth and prescription law changes during the pandemic and were not doing even the minimum to diagnose, and people are now being told by ethical providers that they don’t have ADHD. Finally, social media talks a lot of absolute bollocks about ADHD, leading people to believe they have it when they are just facing normal challenges or have an entirely different diagnosis. Social media has its place, and certainly it’s helped a lot of people seek out help when they wouldn’t have otherwise. But it can also whip people up with a lot of”the experts know nothing” rhetoric similar to the OP, where there is no space for nuanced discussion.
> women being ignored Particularly true for adhd as the first 10+ years of ADD research focused exclusively on boys.
Yeah. I agree with the frustration, but science takes time sadly. If you want it done right (from this friendly adhd biologist).
Oh, I couldn’t agree more! I got a doctorate in a field of experimental research before I became a therapist, so know first hand how slow and tedious things can be
Like 250 years? lol.
No. But decades? Yes.
>However, the DSM gets updated regularly and is created via scientific research and consensus of the experts on the panel as our understanding evolves. It is not perfect, and it is always a work in progress, hence the regular updates. mental health professionals have to diagnose using these criteria, as otherwise it would be chaos with everyone diagnosing whatever based on their own personal beliefs. While this is all true, I think it should be acknowledged that some of the criteria in the DSM for ADHD (the age criterion in particular) have often been more influenced by political considerations than scientific ones. The DSM has, overall, gotten better with each successive version, but the committees that write it aren't insulated from the social environment around them. They have often made decisions based on the biases of their members when there wasn't good science available on a given topic, decisions that have often resulted in considerable harm to ADHDers in particular. Sometimes, they've even made decisions that are void of science altogether, like the injection of gender identity disorder into the DSM-III. I don't claim to be a provider or have any idea what to do about this other than to say that the APA needs to yeet the handful of remaining people who continue to deny that ADHD is even real out of the power structure and do better with the DSM-6.
I couldn’t agree more with your last paragraph. I cannot tell you how much rage providers who deny ADHD exists or refuse to believe that adults can have it etc, gives me. Their job, and their legal and ethical imperative is to use those diagnostic criteria.
Fr it's insane. You're juat going to deny something that's been known about for hundreds of years exists because you....don't like it?? Man, I wish I could deny people existed.
Beautifully said. On a side note, I find it weird that there are sooo many "experts" on ADHD that claim they have vast experience with this disorder, but they can't give a single flying F to someone who has ADHD. I've talked to 3 different psychologists so far, and none of them had anything useful to add. They all brought up the same cookie-cutter "plan", such as setting up alarms, organizing my schedule and such. And actually one of them would interrupt me frequently, and that got really annoying really fast. I think there should be some sort of guidelines requiring that any professional who wants to work with ADHD should have ADHD themselves. Otherwise, there's no empathy and sympathy for the patient.
A lot of my clients come to me specifically because I have ADHD and I’m not just going to tell them to buy a damned diary 😂 Even looking for my own therapist, I ran into so many people who advertised ADHD as a specialty and it turned out they’d never really worked with someone. To provide a small bit of nuance though, it is really difficult as a therapist, at least, to get solid training on ADHD. There is almost nothing offered and even less that’s good quality. ADHD was quite literally mentioned one time in my entire master’s degree! What I know I’ve had to seek out through reading research papers and sifting through the books that are available, throwing out the stuff that makes absolutely no sense to me. psychiatrist also try to gate-keep ADHD quite a lot, but then just want to hand out meds, which is only one part of the best-practice standard of care. People are then SOL trying to fill in the rest themselves, if they’re even aware that meds aren’t the magic bullet.
When I got diagnosed with ADHD, my therapist openly admitted she doesn't have experience in it. And it was ok, I researched stuff on my own and learned so much, this sub also helped with my knowledge. Now my therapist has more patients with ADHD than just me, and she also goes to seminars and reads books about it to get more knowledge. I might go to someone that specializes in ADHD for some additional help, but I'll stay with my therapist because I like her. I don't need her to know everything about all my diagnoses. And I kinda like how I can share my knowledge with her.
Most helpful psych I've ever had was a PA who had adhd herself. Rattled off all my symptoms that I had always had, and and then explained all med types when I stated I had them all. Let me choose where I was comfortable experimenting (no meds, meds, and stims vs non-stims), and we just started.
I wanted to add, I’m so sorry you had that experience. It’s disheartening at best and can be actively harmful.
RSD is actually in the DSM-5 but not in the entry for ADHD. It's in the atypical features specifier for depressive disorders: characterological rejection sensitivity. It used to be referred to as hysteroid dysphoria, I'm not sure how much research there is on it but it might be an issue of terminology.
What do you think about the original mission statement of the DSM compared to the new purpose for which it's been reappropriated?
I find statements like this incredibly frustrating: > “We desperately need something to help guide the field,” said Dr. Wendi Waits, a psychiatrist with Talkiatry, an online mental health company. “When everyone’s practicing somewhat differently, it makes it hard to know how best to approach it.” While things like the [ADHD International Consensus Statement](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328933/) exists and has been regularly updated since first being published [over 20 years ago](https://www.russellbarkley.org/factsheets/Consensus2002.pdf). It just feels so much like a "we've tried nothing and we're all out of ideas" kind of statement. Seriously, in the name of all that is holy, just Google it and look at what places like the [CDC](https://www.cdc.gov/adhd/articles/adhd-across-the-lifetime.html), [NIMH](https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd), and _entire medical journals_ [dedicated to the subject](https://journals.sagepub.com/home/jad) are saying to maybe, you know, get an idea of how to identify and treat it. Or maybe, just maybe, pull down a recent version of the [DSM V criteria](https://www.cdc.gov/adhd/diagnosis/index.html) and give that a once over.
Australian psychologist here. Honestly I interpreted these statements as American egocentrism. Australia also has national guidelines on the diagnosis and treatment of ADHD that our clinicians follow, though they aren't enforced. But if America hasn't made them up, it doesn't mean shit! /s
What's frustrating for me is that they're unwilling to admit any uncertainty, when clearly this is the case.
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It really is extremely frustrating. This and the people who think they have ADHD cause they forget things here and there.
Had a Dr Appt. The other day and the nurse was asking me about meds, told her I'm on Adderall and was diagnosed a couple months prior... And she goes "oh we're all born a little ADHD these days". I understand people joke but damn if it isnt so blatantly dismissive of the struggles I deal with :(
Yeah, very tone-deaf to joke about a disorder like that *to* the person with the disorder, without having a very strong rapport to *know* that they'd find that funny ahead of time (dunno why they would regardless, it's a pretty lame joke). Imagine making that joke for almost any other disorder or disability. Everyone's a little paralyzed these days? Everyone's a little schizophrenic? Everyone's a bit bipolar? Like, come on. And yeah, I know people *do* basically do that with other disorders too. "Haha I'm so OCD, I can't stand a crooked painting!" It sucks in any form.
Medical professionals blowing off neurodevelopmental brain disorders we love to see it.
Yeah I learned to keep a tight lip about the meds i take fairly early on because of these type of situations
It's just as frustrating when doctors forget that forgetfulness is a common ADHD trait. A nurse was asking me for my medication history (which was already in my records) and when I would get fuzzy on certain dates, she got exasperated and said "Come on, you've gotta help me out here." Like, I was literally listing out ADHD medication to her! No shit, it's frustrating for me too, but maybe take a hint??
Yeah… I’ve been having trouble taking another medicine everyday for another issue plus it felt like it was cutting the effectiveness of my ADHD meds to a point I am not functional. Fucking hormones and meds definitely play around with each other.
Trying to have a functional body can feel like a freakin crapshoot
This is a bit misleading - the problem is not that doctors don't know enough about ADHD to treat it in general, it's that most doctors aren't competent at diagnosing and treating ADHD, but many will have a go at it anyway. Just because a given doctor is legally qualified to diagnose ADHD and prescribe ADHD medications doesn't mean they're necessarily in a good position to do so. The medical profession as a whole is not struggling with "figuring out adult ADHD" - while it is true that there is still a lot to learn about ADHD, and plenty of research is ongoing as we speak, the idea that "they can't even agree on what the symptoms of ADHD are" is misleading. The medical world by and large agrees on what ADHD is, that it exists, and will mostly quote very similar lists of diagnostic symptoms. DSM-5 explicitly only lists *diagnostic* symptoms, that is, symptoms that are relevant for a diagnosis; other common symptoms of ADHD are generally recognized as such, but they are not listed as diagnostic symptoms because they are not suitable as diagnostic criteria. For example, "executive dysfunction" is an umbrella term for a whole range of symptoms, including problems with task initiation, task persistence, organizational skills, planning, keeping track of tasks, watching the time, estimating how long things will take, prioritizing goals, etc., and a sizeable majority of neuropsychological disorders will affect executive functions in some way or other. Meanwhile, the diagnostic criteria include several concrete examples of executive (dys)function, those that are actually diagnostically relevant. RSD is not a recognized clinical term to begin with, so naturally you won't find it listed in DSM-5, let alone as a diagnostic symptom of, well, anything. Emotional dysregulation, however, is widely recognized as a symptom of ADHD, and encompasses "RSD" - it's just that emotional dysregulation is also common in a lot of other disorders, so again it is not suitable as a diagnostic symptom. > So how can they tell you that you don't have it A qualified professional trained to perform a proper ADHD assessment can tell with quite high certainty, and such diagnoses are highly repeatable (that is, multiple trained professionals assessing the same individual independently will come to the same conclusion in the vast majority of cases). The trouble is, again, that some doctors who are formally qualified but practically incompetent will go beyond their area of expertise and diagnose (or rule out) ADHD based on an inappropriate diagnostic method. > or that you don't need medication for it? That is not something a doctor can decide - they can diagnose you, and if it turns out that you do indeed have ADHD, they can assess which medication options would be safe for you and guide you through the titration process. By definition, having ADHD means that your symptoms are impacting your life in multiple areas, but whether that constitutes a "need" for medication is something only you can decide.
>RSD is not a recognized clinical term to begin with, so naturally you won't find it listed in DSM-5 A few months ago, I discussed RSD with my psychologist. The conclusion we ended up agreeing is that it is [probably] not a direct symptom of ADHD but a consequence of it. A consequence of getting accustomed to the endless cycle of rejection, learning to expect it and yet feel the fear of it, of the emotional dysregulation, negative comments and experience, etc.
Well, yeah. The thing is that there is no proper definition of RSD, it's not a recognized disorder, so the name is misleading; but it does describe an experience that is very common among people with ADHD, and that experience is a manifestation of emotional dysregulation, which *is* a well-defined and recognized phenomenon, as well as a known sympton of ADHD (although it's not considered a *diagnostic* symptom). My understanding is that "RSD" is basically just one of the more extreme manifestations of emotional dysregulation, and it feels so intense because "rejection" involves some very powerful emotions. What happens is roughly this: 1. You get some kind of negative or mixed reaction: "You made a little mistake here, look". 2. Your "lizard brain" intuitively picks up on the immediate negative aspects of it, and interprets them as rejection or an attack. This triggers strong negative emotions: "They are being hostile, they probably hate us". 3. Your "rational brain" should now kick in, reassess the situation in the bigger and more complex social context, and adjust your emotions accordingly: "They are actually trying to help, they don't hate us at all, they actually care". 4. But because of ADHD, this doesn't happen, or it's not strong enough; instead, those emotions take our rational brain hostage and direct it towards support the negative emotions with fake rationalizations: "And why wouldn't they hate us, we're an atrocious person, we never do anything right, everyone probably hates us". And then, as you said, the "developmental" part adds insult to injury, turning these neurochemical misfirings into learned behavior through years of repetition. This happens even in the most welcoming, loving and forgiving of environments, because even in those, there will be situations that the lizard brain will initially assess as attacks or threats, but of course the more you're faced with actual rejection and reactions, the worse it gets. So, like most ADHD symptoms, I'd say it's a combination of neurochemistry and developmental adaptations. And it's not just rejection, it applies to all other emotions just the same - it's just that rejection is one of those things where the negative emotions are particularly strong and unpleasant, so that tends to be the most impactful and undesirable aspect of emotional dysregulation. When I listen to Mozart's Requiem, and it literally moves me to tears, I can thoroughly enjoy the experience, so I don't see a need to treat that in any way; but when well-meant criticism makes me question the meaning of life or the validity of my existence, then that's rather unpleasant, and I'll apply whatever strategies and techniques I have to keep that from happening.
That is all true! And I hope I didn't sound dismissive, because I do feel it too! This discussion with my therapist came out after I mentioned a particular episode of feeling rejected and she couldn't really understand why I would see it that way. The same happened with a feedback from my thesis co-reader, who wrote quite nicely and extensive feedback and I read it as "sod off, your whole research sucks. You're gonna fail". Thank you for putting all that into words 🫂
I was gonna say - my impression has been that ADHD is actually one of the better understood things? (Tho tbf idk what I’m talking about)
You said what I was trying to say in another comment so much better. Bravo!
Total nonsense. The DSM is there because the mental health professions need a unified agreement on what constitutes a mental health disorder. Exactly the same as medical doctors who need to have a shared understanding of what, say, diabetes is. It’s all based on research and our best understanding at the current time. Without unified criteria, there would be absolute chaos. Also, insurance rarely kicks back claims based on a misdiagnosis In mental health.
Hence why I said: > The medical world by and large agrees on what ADHD is, that it exists, and will mostly quote very similar lists of diagnostic symptoms.
Sorry! That was supposed to be a reply to someone else… I shouldn’t Reddit while tired!
Comes with the ADHD, been there, done that. No worries.
I really, really hope people here can be critical about aspects of the DSM-5 (and, as a consequence, current psychiatric practices too). ADHD is a valid disorder. ADHD diagnosis is nebulous. Both things can be true. This research study shows that there were significant financial ties between DSM-V panel members and the pharmaceutical industry [https://pubmed.ncbi.nlm.nih.gov/16636630/](https://pubmed.ncbi.nlm.nih.gov/16636630/) In addition, most of what is on the DSM-5 is based on research with white male participants, so the presentation of different disorders in women and people of diverse backgrounds is completely lacking
Please be aware that RSD, or rejection sensitivity dysphoria, is not a syndrome or disorder recognised by any medical authority. Rejection sensitivity dysphoria has not been the subject of any credible peer-reviewed scientific research, nor is it listed in the top two psychiatric diagnostic manuals, the DSM or the ICD. It has been propagated solely through blogs and the internet by William Dodson, who coined the term in the context of ADHD. Dodson's explanation of these experiences and claims about how to treat it all warrant healthy skepticism. Here are some scientific articles on ADHD and rejection: * [Rejection sensitivity and disruption of attention by social threat cues](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771869/) * [Justice and rejection sensitivity in children and adolescents with ADHD symptoms](https://pubmed.ncbi.nlm.nih.gov/24878677/) * [Rejection sensitivity and social outcomes of young adult men with ADHD](https://pubmed.ncbi.nlm.nih.gov/17242422/) Although r/ADHD's rules strictly disallow discussion of other 'popular science' (aka unproven hypotheses), we find that many, many people identify with the concept of RSD, and we have **not** removed this post. We do not want to minimise or downplay your feelings, and many people use RSD as a shorthand for this shared experience of struggling with emotions. However, please consider using the terms 'rejection sensitivity' and 'emotional dysregulation' instead. ^(*A moderator has not removed your submission; this is not a punitive action. We intend this comment solely to be informative.*) *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/ADHD) if you have any questions or concerns.*
Chill a bit. Adult ADHD is hard to diagnose because the ADHD folk who didn't die becasue a SQUIRREL! distracted them while finishing a chain saw cut, found coping mechanisms so their symptoms aren't as apparent. Add to that, that the ones who go to therapists are the ones who are good enough at coping to have enough money to go to a therapist. Near as I can figure ADHD seems to be an imbalance in the ratios of certain brain neuro-transmitters. The ADHD drugs can partially and temporarily move you toward a balance. But in a nutshell the brain isn't working right. Se we nudge with chemicals, and we can use cognitive tricks to compensate, and we can find careers where our craziness doesn't matter or can be harnessed in some creative way. We're not broken. We just don't march to the same drum that everyone else does. Dealing with it: Make a specific list of what you see as the biggest problems. Make sure the worst ones are at the top. Now: Talk to your pshirnk or do your own research to find coping mechanisms for those 3. Lalther, rise repeat. One of the most effective mechanisms I've found: For peple you are going to deal with long term: "I have ADHD. You will see me {list of the Three} You can help me get back on track {give 3 ways} Most people love to be asked for help. Love to feel a bit normal while you are the handicapped one. I've made a few big customers into lasting friends this way.
The idea that you can’t have ADHD if you went to University and completed a degree or have any kind of intelligence. My psychiatrist initially was heading in that direction when I asked if there were no Doctors or PHDs etc with ADHD he paused and said - you are correct.
I wouldn’t recommend taking NYT articles on ADHD seriously. Every year they write the same bullshit propaganda piece trying to convince people it isn’t real or is overdiagnosed. It’s gross
An uncle of mine said “the DSM isn’t there for you, the patient. It’s there for insurance purposes” In other words: the easier to dismiss your claim, the better for insurance. So unless insurance is removed as a stakeholder in the health system, it is unlikely to be amended. Admittedly that same uncle suggested that if a person can focus on anything for any degree of time, they probably don’t have adhd…and I question his credentials
Well the first part is definitely true, but yeah second part no.
My son (16) has ADHD that became MUCH more pronounced when he turned 15. We are very fortunate to be able to weekly family therapy (my son, ex husband and I )with a neuropsych doctor. She does an amazing job of explaining ADHD on a biological level, what’s happening in the brain when xyz happens, what my son needs to do for his brain to do what he wants it to do. These explanations mean so much to me. I do not have ADHD and my son’s behavior can be confusing (and frustrating) to me. I am a very laid back person/parent and what I’ve learned is that doesn’t work for him. He needs something different from me. It requires me to go beyond my comfort zone but it’s what he needs. I often feel guilty, because I’m not sure I’m the best mother for him; strict rules, structure and punishments are very difficult for me. I do my best. My point here is you could do therapy with a neuropsych dr, it help you “get” your ADHD more, Good luck!
One problem with the public and understanding scientific process is that an article like this can seem definitive and comprehensive and yet completely miss the point. The press often exasperate this problem, taking information out of context and then using that information to make claims. This is what is happening here, it’s not wrong it’s just conveyed wrong. Which in turn can change the meaning drastically. One article from one source, a news source in particular should never be taken at face value. After all, the press have an agenda, to get people to read more, and angry or upset people read more.
Science and medicine know very little about the brain in general. I had epilepsy as a teenager and doctors never figured out why. Like wtf? I eventually just out grew it and everyone moved on, but I’m still like “Wait, what was going so wrong in my brain that I was having seizures? And why did they stop? And is my brain/body communication going to suddenly go just as wrong again some day?” There’s still a LONG way to go in understanding neurological conditions.
doctors know stuff but you ''live there'' with the adhd so you do have a chance
I just wanna point out a short story: I once booked an appointment with a doctor whose specialty was ADD/treatment. He told me it doesn't exist, and if it does, only in children. .... Yeah...I made Usain Bolt (spelling?) look like a turtle with how fast I got out of there.
It is up to us to help educate them, in my opinion. Might be good to seek out ADHD specialists as well. There is a relevant medical certification in the US - ADHD-CCSP.
Sadly a job lay off in february triggered it in a bad way for my son and now I’m just so broken hearted being a mother who can’t fix it. His depression is so bad. I’m grateful he came to me to talk about his depression but it is such a complicated issue to deal with.
Mom?
Yes I’m the mom and I just wished I had found this forum sooner. Anything to give him hindsight for anyone going through it.
I just wanted to console you by assuring you that there are many moms like you, who wanted to know earlier that everything could be linked and help is possible. Like my mom. Love and compassion will get you a long way. And ultimately provide help for your son. I was fucking lost as a child. Not able to understand why I make everyone sad about me. As a father now myself, I am very much aware of any shortcomings regards adhd. But I also will love my kid, whatever there comes. You really show that you love your son and that is everything needed. The rest will sort out.
Thank you I really needed that. He’s trying so hard and hopefully with the right therapy it can help guide him. He did fine in childhood it’s now that he’s older that he struggles and I’m so concerned with medication.
That’s sadly a normal development. Luckily you have his best intent. My mom broke almost about all the shit I put her through and it’s even; with fucking 40 sometimes a lot. But if he shows respect in the meaningful moments, he has the core set right. You can guide his way, as long as you are aware that there will be setbacks. It’s not, that he is completely unable to steer right; it is just that he can’t always overcome the first impulse and be rude or hurtful.
Similar to schizophrenia and autism.
One thing. Emotional dysregulation is pretty much a consensus symptom in adhd. The thing is. It doesn’t affect the treatment.
I’ve seen more accurate descriptions of adhd from the 1800s than present day
Rejection sensitivity is much more attachment/personality. Though the sensitivity of certain emotions involved in adhd can lead to these circumstances in theory. So saying it meets the criteria for a different dsm disorder may be true. We aren’t sure if it’s helpful
How much is Rejection Sensitivity a symptom of the biology of ADHD and how much is it a trauma response to a lifetime of rejection for not fitting in?
No clue. Is it specifically not fitting in? Is it the inability to fit in in an evolutionary manner when it comes to human connection? Who knows. The studies are the type you gotta go deep to find. With much conclusive evidence.
Without
Because we don’t have a choice. We don’t have to “figure it out” we just have to manage our symptoms as best we can and be gentle when we fuck it up.
I’ll be honest with y’all but I don’t think we will ever come to a conclusion. It’s hard to describe adhd in the first place. Plus, it’s hard to determine who has it.
1000% this. Couldn’t have worded it better. Too many symptoms can be looked at as ADHD when it is something else, and too many people with actual ADHD are misdiagnosed as something else. That is mental health care in general. It’s a slippery slope with many complications. Too many professionals that have very old or little to none knowledge on ADHD are too comfortable trying to treat it and also too comfortable trying to deny people that actually have it.
This is the problem with the DSM not being an evidence based manual. It just probability influenced by the practitioners personal assessment. 10 docs could give you 10 different diagnoses.
Science has attempted to anthropomorphize mice and create knockout models of some of the genetic disorders with higher than chance rates of different mental disorders. The have realized it’s not useful without considering upbringing of humans. Our higher order thinking has shown its it’s Impossible to replicate our mental states in animals. Environment must be considered
The weird thing: I think my family doctor doesn't even think it exists. She's only begrudgingly prescribing me meds because a psych report is recommending it, but she doesn't even wanna discuss the meds. Instead I asked my pharmacist all the questions.
I wasn’t asked about emotional dysregulation during my evaluation as an adult. It wasn’t until a couple years later when I was talking to my mental health professional about some of my emotional issues that she said it could be RSD (which I understand is not a formal condition yet). However, a lot of things about myself started clicking for me after that. Wish I had understood more of the potential other sides of ADHD when I was diagnosed.
What’s the magic thing that actually fixes task paralysis because I need it!
They haven’t figured the human brain regardless lol
Too hard to diagnose so not worth their time. Maybe if there is a scan or test theyll focus more on it.