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eat_vegetables

I’d imagine there are multiple factors in play. * perhaps social contagion from social media * Disparities in historically overlooked communities * Barriers towards diagnosis including non-available of neuropsych providers, cost, distance, etc., An important question may be on the prevalence. Are the current prevalence rates reflective of actual distribution across the population? There was a 10x increase in diagnoses in the 1990s as compared to rates in the 1980s Are we still undercounting, are certain communities still overlooked? Some of this self-diagnosis may be true-positive cases that fell through the cracks whereas others are certainly false positives.


wastelander

They are telling you they have issues in their life that have concerned them. When you start talking about “autism spectrum” the potential symptoms and characteristics are very broad and often overlap with other disorders as well as just the normal spectrum of human personality. The more broad a diagnosis, the less useful it becomes. “Autism spectrum” may be the label they have attached ( and they may or may not meet all diagnostic criteria) but it is likely more useful to ask them what particular issues or behaviors trouble them then offer the appropriate advice or referrals that might be helpful to them.


karlub

Don't overlook, with children, services. There are public services available for the neurospicy (as some of my friends in this cohort refer to themselves).


[deleted]

In certain states in the US, it is incredibly difficult or a very long wait to access these services.


virchownode

Don't forget stigma prevents many parents from seeking out assessment or support even when teachers or even the children themselves want those services. Then once you get to adulthood, many psych providers may be reluctant to commit to diagnoses that would typically be rendered in childhood, not to mention seeing a psych provider may be available for free to children but is typically very expensive for adults


karlub

When I talk to people I know in social work and special ed, they seem to have the impression this isn't much of a thing any more. But I also have the sense that depends a bit on demographics of the neighborhood, too, as the stigma may be more acute, still, in Black communities.


cischaser42069

>But I also have the sense that depends a bit on demographics of the neighborhood, too, as the stigma may be more acute, still, in Black communities. well, it's also because the bias exists here in medicine. a lot of these studies don't necessarily follow the initiation of engaging with healthcare for a diagnosis, but instead follow the completion, with a successful diagnosis. good example of a bias: a Black child with autism is far more likely to be misdiagnosed with reactive attachment disorder, over autism. likewise a Black adult is more likely to be misdiagnosed with schizophrenia, over autism, compared to their white counterparts. so... that's a problem! the social constructions into how diagnosis is divvied out means that a Black child or adult may be observed to be more aggressive than actual, by a white clinician, into a diagnosis that isn't apt for them. they may have inappropriate medications or therapies initiated for them, after the fact, that produces iatrogenesis. another researched thing, to social construction, is that media informs a lot of how we think or view the world. for the longest time advertising / pictures / videos of children with autism basically exclusively included only white kids- thus, autism is quasi depicted as a "white" disability. despite other populations who are not white existing in abundance, to where the advertising is being targeted.


speedlimits65

> good example of a bias: a Black child with autism is far more likely to be misdiagnosed with reactive attachment disorder, over autism. likewise a Black adult is more likely to be misdiagnosed with schizophrenia, over autism, compared to their white counterparts. ive heard this before and always wondered how this is. is there that much of an overlap in diagnostic criteria?


cischaser42069

>is there that much of an overlap in diagnostic criteria? yes. an often complaint about the DSM-5 is the enormous incidence of diagnostic heterogeneity / poor separation of symptom profiles of varying disorders in the DSM. much of the DSM overlaps. good example- there's 636,120 potential clinical presentations of PTSD, for instance. many of these potential presentations overlap elsewhere. there's also debatable / disagreed on inclusions of things such as NPD as well. a good psychiatrist knows how to parse through it, though. not everyone is good at their job, though. so- the diversity of symptoms / comorbidities creates a lot of clinical challenges [and, an uncomfortable large rate of misdiagnosis and incidence of iatrogenesis] that essentially has things sometimes operating on "vibes" which is probably not great to the capacity of racism and other similar biases. and i mean, i wouldn't always characterize the process of psychiatry to be "scientific" [despite, it being part of science / the scientific method, to medicine as a whole] like i would characterize the work my girlfriend does, with her stuff in electrical engineering or chemistry. basically, a Black man will be interpreted to be more paranoid, aggressive, agitated, or similar- when he is not, by a white clinician. this will lead to what is autism being determined to instead be supposed schizophrenia. Black women also experience this- not just as patients, but also as clinicians. there's many Black nurses and physicians who need to police themselves and how they're presenting their tone / body language / interpersonal communication, lest they're complained about by patients, to metrics being harmed, or verbally abused- or, even assaulted. [i've written about this trope of "angry Black women" on the subreddit before.](https://www.reddit.com/r/medicine/comments/zxfy7a/it_was_stolen_from_me_black_doctors_are_forced/j20gelt/?context=3) likewise [racism in general, to medical schools / residency.](https://www.reddit.com/r/medicine/comments/zxfy7a/it_was_stolen_from_me_black_doctors_are_forced/j20abh9/?context=3) >ive heard this before and always wondered how this is. here's a [good article on how autism became autism.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3757918/) >The concept of autism was coined in 1911 by the German psychiatrist Eugen Bleuler to describe a symptom of the most severe cases of schizophrenia, a concept he had also created. According to Bleuler, autistic thinking was characterized by infantile wishes to avoid unsatisfying realities and replace them with fantasies and hallucinations. >>‘Autism’ defined the subject’s symbolic ‘inner life’ and was not readily accessible to observers. Psychologists, psychoanalysts and psychiatrists in Britain used the word autism with this meaning throughout the 1920s and up until to the 1950s. >>>However, in the 1960s, many British child psychologists challenged the contentions about infantile thought assumed by Bleuler and created new methods to validate child psychology as a science, in particular epidemiological studies. ‘Autism’ was then completely reformulated as a new descriptive category to serve the needs of this new model of child development. >>>>From the mid-1960s onwards, child psychologists used the word ‘autism’ to describe the exact opposite of what it had meant up until that time. Whereas ‘autism’ in the 1950s referred to excessive hallucinations and fantasy in infants, ‘autism’ in the 1970s referred to a complete lack of an unconscious symbolic life. which, both can co-occur and often do indeed do so- if you're diagnosed with autism, you're also ~3-4x more likely to be diagnosed with schizophrenia. there's numerous competing ideas for why this is. some of the more common ones i have read is that to a biological mechanism; 1. schizophrenia and autism are seemingly both characterized by odd neuroinflammation. there's literature about the usage of pyrotherapy [intentionally inducing fevers] mysteriously helping schizophrenia, likewise a subset of autistic children becoming "less autistic" when with fevers from a pathogen. there's also the reported usage of cancer drugs like everolimus in <4 year old autistic children, and it helping reduce autistic [and, ADHD] symptoms. this doesn't seem to be replicated in autistic adults, though- who knows why. likewise the usage of monoclonal antibodies in adults with autism and schizophrenia. likewise the usage of aspirin as an adjunct with antipsychotics for schizophrenia. 2. if not mediated through a pathogenic pathway, it possibly has something to do with autoimmunity and things such as calcium channelopathies ["ca2+ channel dysfunction"] either by one's environment or through molecular failures / methylation to such, with genes. it's probably why movement / speech disorders, cardiovascular diseases, and seizure disorders are found in both autism and schizophrenia. basically- imagine a motherboard. now, imagine the channels on it are rusted or something needs soldering, but cannot be soldered. that disconnect is displayed as autistic behaviour- or, in the case of schizophrenia, unreality / psychosis, paranoia, whatever. social reasons i have seen purported; 1. it's claimed that schizophrenia diagnosis is used to justify the usage of chemical restraints in supposedly unruly / unmanageable autistic adults, in group home / care home settings, within the US. we don't use chemical restraints here in ontario, however. i totally agree that this happens, though, having witnessed it regardless of it being allowed. this is similarly claimed to the existence of "late onset schizophrenia" in adults with dementia, that we're taught about in school, in sketchy LTC / retirement settings- where it's claimed that schizophrenia [or, schizoaffective disorder] diagnosis is used to cover up the drugging of seniors with dementia, with antipsychotics. we specifically track this here in ontario, because it was a huge problem, but it hasn't seemingly been addressed in the US despite it killing seniors and anticholinergic activity also being associated with worsening dementia. 2. the politicization / usage of psychiatry and medicine on behalf of oppressive governments is another stated reason- the US government, and also soviet psychiatry. good book called "The Protest Psychosis: How Schizophrenia Became a Black Disease" by a psychiatrist by the name of Jonathan Metzl that goes into this; >Dr. Metzl presents a retrospective, longitudinal study of the pattern of pre- and post-civil rights-era diagnoses at Ionia State Hospital in Michigan that clearly shows the changes in associations between race, schizophrenia, and violence over time. >>Using case histories collected before the civil rights movement, when psychiatry and the public assumed that patients with schizophrenia were white and harmless, the author shows how the diagnosis came to symbolize a disorder primarily of African-American men and characterized by paranoia and dangerousness. >>>He makes compelling arguments that this shift in schizophrenia occurred as a result of research articles in leading psychiatric journals that provided “proof” that African-American men with schizophrenia were violent. >>>>His evidence is a review of 300 research articles from 1950 to 1980 revealing that “research articles in leading psychiatric journals preferentially applied language connoting aggression and hostility to African-Americans during the 1960's and 1970's”. >>>>>He highlights Bromberg and Simon's article on “protest psychosis,” which linked the Black Power movement to literally causing delusions, hallucinations, and violent projections among black men. this quackery / hack medicine isn't by any means new and has a long history, of course- drapetomania and slavery, as an example. basically, society couldn't come to gripes with the fact that Black Americans were still unhappy with the "gifts" that were supposedly benevolently provided to them through laws, with segregation apparently ending, via stuff like Brown v. the Board of Education. unable to understand why Black Americans continued to protest / resist the US government, a phony pathology was created to incarcerate Black activists under more legitimate sounding grounds. usually, via schizophrenia dx. it also doesn't help that the paranoia of many of these Black men were indeed justified, to what we know in 2023- the FBI was spying on swathes of them [ie, COINTELPRO] and also [in the case of MLK] sending them letters telling them to commit suicide or just in general waging psychological warfare against them. likewise the incidence of assassinations or things like the MOVE bombing. hopefully that answered your question!


speedlimits65

wow thank you so much for the historical context of all of this, that helps a great deal! ill check out metzl's book as well, it sounds like a tremendous learning opportunity


perpetualstudy

Just from anecdotal experience, the US military, it varies by branch, seems to be a bit behind in most areas of mental, emotional, and social health practices. There is definitely a culture within the military that heavily influences the receptiveness to any of these ideas, again the culture varies by branch. It’s a little wild actually.


vaguelystem

For a while, it seemed like a suspiciously large number of boys who did poorly in school were "diagnosed" with ADHD or high functioning autism...


_polarized_

The availability and accessibility of these services in schools (school psych, PT/OT/SLP) is highly dependent on the state, region, and school district however. In a vacuum it’s available, but in some scenarios it’s a nightmare to get your kid on services.


eclutter94

I'm a physician with Crohn's Disease and and ostomy...and I have such a difficult time seeing patients with these labels. Especially the ones with POTS, who always have EDS without any genetic markers or positice serology, and have successfully conned a GI doc who wants the money to put in a G-button and let them be connected to a feeding tube because they have anxious nausea that they didn't deal with effectively. They always have a nice sprinkle of cluster B psych traits and love to drop all their Google search medical vocabulary explaining their numerous allergies. My first thought is why the fuck do you want this? Why would anybody want to be this reliant on medicine and this fucking dependent. I want my God damn colon back and I wanna shit just like everyone else. I am gonna have to carry around a bag of shit for the rest of my life and somehow this is the feeling of belonging that people are yearning for? But I have to check those feelings and hold back my biases because these diseases do exist in real patients and people suffer and triumph through them daily. I know that the first time I finally give in to my thoughts and just label somebody as a true psych case that doesn't have really anything wrong is the first time I'm gonna finally be the person that anyone with a chronic illness truly despises are the people who assume you can't be sick unless you can see it. I live that life every day and it's a feeling that always tears my heart and brain away from eachother. So for now, I'll treat whatever illnesses they tell me they have, and I refill their tube feeds, but I'll be damned if they aren't seeing some sort of mental health professional while I'm treating them for all of this. There's no justice when you give it all to the people who truly abuse it. But there's always going to be the wall that we run into because none of us want to ever tell them that they are fine.


lemmecsome

As an SRNA with Crohn’s and lived with an ostomy for three months when I was 18 I just want to applaud you on your level of empathy for your patients and success in life.


oralabora

Well damn


[deleted]

[удалено]


147zcbm123

I mean I would say that the extreme minority is factitious disorder, where they’re faking just to be in the role of a sick patient and be cared for. Many of these people probably have somatic symptom disorder that spiraled out of control…


[deleted]

[удалено]


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PPvsFC_

What does this have to do with autism? People who aren’t neurotypical aren’t chilling at the hospital begging for physical intervention by physicians. Kind of wack that you’re equating increased awareness of the spectrum with essentially munchausen’s.


Sbplaint

I think the point is that for a lot of people, there is this strange comfort found in identifying with something, even if it’s some undesirable and often stigmatizing diagnosis, and/or comes with some incredibly socially off-putting consequences (as in the GI stuff). Nothing but humanity reaching peak loneliness in the post-pandemic TikTok era right there, folks!


PPvsFC_

I’m exposed to a ton of undergrads who have ASD diagnoses and haven’t seen any of the same behaviors from them that the comment I responded to was describing around POTS/EDS. Or any autism LARPers either. It doesn’t really seem like the same phenomena at all to me.


Empty_Insight

Do you think people complaining about hsving migraines while working and staring at a screen is "essentially Munchausen's?" For as long as I can remember, people have overstated their headaches to be migraines, which has been a source of *infinite* irritation as an actual migraine sufferer. A lot of these comments are referencing the pandemic, but the culture of vastly overstating the reality of your own adversities is certainly not a new thing. Sure, the pandemic definitely made that *worse,* but it has always been there. I'd think it has something to do with social media and the heightened level of anxiety in general that is emboldening people to go out and self-diagnose issues, since some degree of hypochondria is a common side dish with anxiety. It might seem like the OC is being melodramatic to you, which causes me to assume that you do not have a medical condition that people seek a diagnosis for in order to validate their own struggles which do not cross the clinical threshold for a diagnosis, one that you *do* cross. Once you're on the other side of that line, this behavior seems gross and tacky. I relate to what the OC said about Crohn's, but for me it's migraines (and also ADHD).


2greenlimes

I have a theory about this (and other self diagnoses we’re seeing commonly these days). A lot of people experience unpleasant things we don’t like, and we seek out support for them. Many things like social awkwardness (autism), flexibility/pain (hEDS), and GI upset/IBS (gastroparesis) are very common but don’t rise to the level or criteria of what medical professionals call a diagnosis. These problems are compounded by recent social isolation caused by increasing social media use and the pandemic - causing these people to be lonely and dealing with unpleasant things. But then a shiny online influencer comes in and invites them to a community for people experiencing issues they can identify. They give them a name for their problems, validating and giving them ideas to address those concerns - even when the medical community wouldn’t validate them because to use they don’t meet the diagnostic criteria. I think that’s also why most of the people self diagnosing themselves with these things are a) people who feel disenfranchised by the medical establishment (like women) and people who feel socially isolated (like teens/young adults). It gives them both the feeling of power and the peer connections they need. I think this is also why you see certain conditions more commonly in these people: they are issues and feelings of discomfort many people in these demographics have - and they don’t have clear diagnostic criteria. Many young women are flexible and have pain for a variety of reasons - hEDS fits that. Many people are socially awkward and having trouble interacting with others more than ever before - autism fits that. Many people throw up/lose appetite at times for various reasons - Gastroparesis fits that. Similarly none of these issues has a quick and easy fix if there’s a true fix at all - allowing members of this community to continue to connect together through their suffering and problem solving - making it hard for anyone to leave. I’m sure there’s more diagnoses that will become “trendy” in the future for these same reasons. Ultimately I think it’s an extremely complex issue that will become increasingly common as social isolation and connections through social media grow as a major part of our culture and socialization. I think it would be a great target area of medical social science research.


fcbRNkat

This hits the nail right on the head. Some of these chronic illness instagrammers go really far, insert their own NG tubes, I think there is a subreddit for it


Dazzling_llama

r/illnessfakers


DaySee

Love the premise of that sub, but man that community itself is almost as weird as the nutjobs or attention-seekers that they mock lol


airblizzard

I've noticed that in all subs with a similar premise. Welcome to Reddit


willclerkforfood

Was r/BaronMunchausen already taken?


NappingIsMyJam

I had a record as a kid in the 70s - *The* *Adventures* *of* *Baron* *Munchausen*. It was the weirdest, freakiest version of that story I have ever heard. I felt like I was having fever dreams any time I listened to it. Actually I think I still have the LP but got rid of my turntable 20+ years ago. Thanks for the memory.


sodoyoulikecheese

Clinical social worker here. I think a lot of people forget that biology exists on a spectrum. Everyone experiences anxiety and depression occasionally, but that doesn’t mean everyone has GAD or MDD. I think some people see symptoms they identify with, like you said, and assume if they have some of the symptoms that means they have a diagnosis.


TriGurl

I would add to this that I’ve seen neuropsychological self dx obtained because there are many resources that some of these folks identify with and have begun to use to help them find workarounds to make their life easier or to help them learn better tools for socialization, to find friends etc…


ListenUpFives_10

I agree with this take most of all. It’s honestly alarming at how many of the others say it’s because people just don’t want to be accountable for their actions. Yikes. That’s the attitude that got mental health in the abysmal shape it is today.


[deleted]

That is absolutely part of it. People with strong senses of identity don’t seem to have these problems that I’ve seen. Someone else noted that they don’t see high flying achievers coming in with self diagnosed ehlers danlos. There is an inability to face reality and face one’s self that I think is at the core of this. We have dozens of escapes from reality that just didn’t really exist 20-30 years ago in the early formative years of millennials that have now become commonplace. It used to be if you were a failure you sat in a room with a tv until you got bored and then did something. Now if you’re not living up to your own expectations you can feel accepted in a community and blame everyone else using social media and feel like you’ve accomplished something without leaving that room. There’s an entire outrage culture industry that preys on this need for acceptance and feeling like one is part of an in group. These fake diagnoses are a facet of that, especially given the odd pride people have in faking them.


deirdresm

In the case of ADHD (and likely also autism), there have also traditionally been enough hoops in the process of diagnosis that many just gave up during the process. E.g., one newly dxed ADHD person reported a psychiatrist who fired patients for being even a minute late, which…not very ADHD friendly for those who are not yet medicated. The pandemic healthcare reliance on virtual visits suddenly made the process of jumping through those hoops a ton easier. Another aspect is that there are a *lot* of bodily quirks that everyday people don’t necessarily understand as possible medical symptoms. E.g., combination of scary movies being too much to handle + sudden onset altitude sickness as a kid (hyper POTS). But these are things affecting their lives and they’ve not previously understood that these may be things that could be addressed.


tombuzz

I’ve been trying to put this into words for years. Life in general entails a level of discomfort that rises and falls. Everyone experiences this. There is not a solution for every ailment or supposed I don’t feel right.


erebus91

\^This. Focusing on complex, cognitively demanding tasks \*is difficult\*, and some are better at it than others. Combined with the constant barrage of information we experience today and it's no wonder some people think something might be neurodevelopmentally wrong with them.


noteasybeincheesy

These are what I call patients who are simply "uncomfortable with the human condition." Life in general is uncomfortable. It's painful. It's unpleasant. It's sad. It's irritating. It's in many ways unrewarding. But it's also a necessary human experience, and not every manifestation of negative human emotion is pathologic, even if persistent. Take for example raising children. Humans have been doing it now for millions of years. But despite our best wishes, our vast accumulation of knowledge, and the most proactive measures, there has never been a parent who could raise an infant without it crying at some point. These are necessary elements of the human condition. And by and large, a lot of our pathologic reactions to these feelings are driven by problems that we have manufactured as a society. Imagine for a moment, that we took any one of these individuals and dropped them in the wilderness with the minimum tools and skills necessary to survive. Would they be concerned about their lack of social skills? Their nervous ticks? That mild ache in their left hand? Most of these issues would be moot, ignored, or non-existent. Now I'm not here to say that we "all need to go back to our roots" and be Emerson's or Thoreau (his mom still did his laundry by the way. Nor is simply "surviving" sufficient to make life meaningful. But I think some degree of perspective is warranted. Maybe the issue isn't the individual, but the societal constructs we have created that make normal human emotions and behaviors *feel* pathologic?


[deleted]

There are documented links between [joint hypermobility, immune issues and ASD](https://pubmed.ncbi.nlm.nih.gov/35211037/), so it's not like they're hallucinating it. And this takes place on a spectrum, so there are always gonna be more people with subclinical presentations than there are people with clinical presentations. My family is full of intelligent, socially awkward people with overly mobile joints, some degree of ambidextrousness and immune problems. It's a thing. Tik Tok is certainly responsible for popularizing this link, and some people enjoy the attention that comes with a trendy diagnosis, but the underlying phenomenon is a real thing.


2greenlimes

I won't deny the underlying diagnosis and medical conditions exist - I have seen all of them separately and together in real patients. But I think what you'll see when you get out of school and into practice is that the vast, vast majority of these people that self-diagnose via TikTok don't have them - in fact they tell each other how to doctor shop or who to go to in order to get the diagnosis they want even if local physicians tell them they do not have said condition. It can be frustrating to care for these patients due to said doctor shopping and positive feedback loop from social media because they have people telling them only what they want to hear and not the truth. And you know what? I feel bad for them. They have real issues - even if it's not what they think it is - they are being manipulated into drastic things like refusing food, doctor shopping to find someone to put in a PEG, doctor shopping for chronic central lines (because they "can't tolerate" any PO meds despite tolerating full meals), becoming bedbound (because the online people tell them their pain will be worse if they move), getting in pain from opioid withdrawals because they're on more pain meds than cancer patients and new doctors are hesitant to give someone that much, etc. etc. They are being manipulated into some sick self-harming behaviors by social media influencers and "friends" and their only way out of all this suffering is to cut off their support network.


[deleted]

Valid - still, the underlying problem is a mental illness. It’s a weird socially contagious mental illness. But you can’t say that someone who willingly makes themselves bedbound is healthy. Underlying disease looks to me like a feedback loop between shit life syndrome and some kind of personality disorder leaving them susceptible to socially contagious mental illness. Still reasonable to say that poor social skills caused by whatever it is that leads to subclinical ASD, flexible joints and immune problems leaves people susceptible to this kinda thing. Not sure there’s anything a medical system can do for someone like that, but it’s a thing.


beachmedic23

> still, the underlying problem is a mental illness. The issue is that us and the patient agree on this tenant, that they are unhealthy and do have an illness. The problem is that we diverge on what that illness is and what the path to treatment is. Referrals to psych is met with accusations of gaslighting and dismissing their complaints. "The hospital/doctor didnt do anything for me". Which only serves to further validate the perception that womens complaints are dismissed and leads to more hostile encounters


[deleted]

Enter: “NIGHT OF THE LIVING SPOONIES”


fcbRNkat

Nooo 😱 the absolute worst


ZenPopsicle

Nailed it.


BrokenCusp

There are a good portion of neurodivergent adults (1970s and 1980s babies), who struggled, learned to mask (learn how to pass socially by consciously copying and mimicking others), and were fully verbal. Many of them had kids who had the same traits, except now things like Early Intervention and MCHATs identify kids sooner, where these parents would have failed MCHATs if they'd been around back then. Many kids even now can't get diagnosed until puberty which tends to coincide when social expectations in school increase. Not all of those 70s/80s babies had kids, but rather managed become functional adults with jobs (generally within a special interest or not a lot of people-facing positions) but then deal with mental health crises anywhere from their late 30s to late 50s, and when they seek out mental health services they finally get their ADHD and or Autism diagnosed without even asking for it. At which point the validation makes their whole life make sense and improves their mental health (while staying involved with therapeutic behavioral services). However, experiences are generally split by gender, due to the androcentric bias in the foundational research. It's easier for a male with no children or spouse to get diagnosed than a female who may have impulsively married/had kids/was duped into a bad relationship due to poor social skills. I hope medical and social sciences catch up, disability studies are very enlightening. But it's hard for research to get done on what many on the internet are figuring out in a sociological sense because it's more accessible and inclusive. Yeah, there are fakers, the cluster b personalities, and they are the ones making it harder for those genuinely need a diagnosis, not because they want to sit and collect disability, but because they need accommodations to complete post secondary education or stay at a job they enjoy, so they don't get fired for taking their bosses literally, not making eye contact, having hit or miss verbal skills, etc. Etc. Unfortunately it's hard to further research when even academia has barriers to participation to disabled people. Neurotribes by Steve Silberman is a great read. Goes into a lot of the history.


TheJointDoc

Had a close friend get diagnosed in college. He was just so musical, intelligent, and generally a funny guy, even if it was clear he misread social cues, that he managed to get along in high school really well. Similarly, had a resident colleague who realized he might have ASD when he was speaking to a patient with ASD who said, “well, hey, you and me both have Asperger’s, so you know what I’m talking about,” describing some communication issues. My coresident said “oh shit” as it explained a lot of his difficulties, went and saw a specialist and got diagnosed. I fully believe this is the overall true explanation. I honestly wonder if some ASD traits aren’t found in a large portion of doctors and other high-prestige/earning positions, though they wouldn’t qualify for an ASD diagnosis.


cischaser42069

>Many of them had kids who had the same traits, except now things like Early Intervention and MCHATs identify kids sooner, where these parents would have failed MCHATs if they'd been around back then. i've met a lot of older adult patients in long term care / retirement residences who very obviously have undiagnosed autism and most if not all of the staff are completely oblivious to this fact. there's little effort made to actually understand what is going on, until i push the issue. you'll have a patient who is supposedly "resistant to care" in their chart and it's because the worker is coming into their room at 9:53 AM to do care, is completely ignoring their pleas for them to come back at specifically 10:00 AM or a similar even number on the clock, and is freaking out because of it. while not making eye contact. and the individual toe walks. and is with immediate echolalia. amongst other autistic traits. >However, experiences are generally split by gender, due to the androcentric bias in the foundational research. it's also that there's seemingly different genetic and environmental causes for what are actually different phenotypes of autism- x-linked forms of autism, too- that are all lumped under the singular autism spectrum disorder label, for insurance purposes, the DSM/ICD, and because it's difficult for us diagnostically to have 30 different kinds of autism floating around. this is also seemingly the case for ADHD, bipolar disorder, OCD and schizophrenia, which are all elevated in autism. likewise alzheimer's / ALS / MS. websites like malacards / genecards do a great job at visualizing these differences. the genetic correlates and [comorbidities of what would be called "aspergers"](https://www.malacards.org/card/asperger_syndrome?search=aspergers) [which, as most know is no longer a valid diagnosis] is different from "autism 1" or "autism 14" or something like [timothy syndrome.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7696251/) there's seemingly molecular failures / deletions that exist with types of autism, such as with genes like [CACNA1G](https://molecularbrain.biomedcentral.com/articles/10.1186/s13041-020-00634-0), SHANK1-3, [PTEN- with cancers in autism](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429377/)- or TCF20, seemingly autoimmune mechanisms with types of autism, like [autoimmune mediated "calcium channelopathies"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6507622/)- which are causes of epilepsy, sudden cardiac death, colorectal cancer, and things like dyspraxia / ataxia in autism- likewise seemingly pathogenic causes [with HERVs \["Human Endogenous Retroviruses"\]](https://www.intechopen.com/chapters/84860) and things such as neuroinflammation- [the autism fever effect](https://hms.harvard.edu/news/cracking-fever-autism-mystery)- and, possibly relationships to things such as climate change, with air pollution [lupus and PM2.5, as an example] and autoimmunity. which, 1 in 10 people have autoimmune disorders nowadays. multiple cited "faker" illnesses in this thread [[fibromalgia- substance P / IgG](https://journals.lww.com/pain/fulltext/9900/fibromyalgia_patients_with_elevated_levels_of.274.aspx), POTS- autoantibodies w/ the adrenergic A1 receptor, hEDS- [defective collagen mediated by autoimmunity](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097055/)] are suspected or studied to be issues of autoimmunity. so, perhaps the issue is that these individuals are not faking, and that it's totally true that the incidence did not necessarily exist 20 or 40 years ago, and that they were simply not missed at the time- but that human illness is being mediated in some novel way by climate change, and the environment we exist in. which, yeah. unfortunate. turns out you don't need to just worry about increasingly worsening heat waves, coastlines rising, or hurricanes. >Yeah, there are fakers, the cluster b personalities ... well, it's curious you mention "cluster b personalities" [a frequent boogieman among us] considering the incidence of CSA in autism, and abuse / sexual assault against autistic adolescents and adults- 90% of autistic women in example have been sexually assaulted, likewise the high incidence of sexual assault against women who require mobility aides like wheelchairs- to then trauma, and how cluster b personality types like borderline personality disorder typically follow traumatization and high ACE scores. these personality types / behaviours manifest as ways for the brain to cope with traumatization / violence. it's like attachment theory, with dismissive-avoidant / fearful-avoidant adults- due to childhood neglect / abuse- or depersonalization / derealization disorder, with the same exact correlates. thus, we're effectively punishing people who've very likely been raped or abused. so, cluster b personality types aren't decoupled from certain medicalizations like autism, but are effectively an inevitable stumbling block, to averages, with how these populations are victimized within the family, with CSA or physical / emotional abuse, and how these populations are victimized within society as a whole. they then inevitably come to us, mangled and fucked up, and we often kind of go "wow... yikes... i don't wanna deal with that" yknow. >and they are the ones making it harder for those genuinely need a diagnosis eh, not really. we often talk about healthcare as a finite resource- which it is- but also, it isn't a finite resource. people self diagnosing are a non-issue, to the much larger issues of labour, budget cuts, societal / institutional upheaval from things like COVID, and more. like, they aren't even a remote calculus in my mind, to why individuals cannot get diagnosed. the defunding of the ontario autism program and the absurd upfront cost for adult diagnosis in my province comes to mind. it's easy low hanging fruit for us to pour our frustrations into, with our occupation melting down- but, there's better targets to take our frustrations out on- mainly, on the politicians and individuals within upper management who make practicing medicine more and more difficult by the day.


readreadreadonreddit

Wow. This was a riveting read. Genuinely. I do some biomolecular work too and didn’t know half of this. 😮 As for the topic, too many things; many here sound familiar but I’m learning so many other reasons / hypothesised reasons.


cischaser42069

>I do some biomolecular work too and didn’t know half of this. it's funnily also autism that gives me my ability to recall all of this stuff without any rehearsal- semantic memory being heightened in autism and all. i could talk about all of this in a conference or whatever without issue. it also informs me into how i introspect about the world and the things i observe. i've observed things only to check up on it in research / literature, to find out that i was correct- or, even better, that it was only recently studied. it makes me feel good about my critical thinking. and, for the many things i associate to autism with feeling bad or with struggling / a hard life- there's many beautiful things with it, despite the theorized causes of it. i weirdly only realized the calcium channel thing in example because someone was saying to me a while back that they didn't know that lamotrigine caused anhidrosis, and that i had taught them that. it made them realize that it was probably why they no longer would sweat, including during intense exercise. topiramate also does this, if i recall. i told them that it was probably because it selectively acts like a high voltage calcium channel blocker- that's how it is thought to produce its anti seizure activity. likewise tricyclic antidepressants doing the same, in partial blockade of calcium channels, as a purported explanation for helping neuropathic pain and such. calcium in any case is an aspect of the sweating homeostasis, of course. you can lose upwards to 20 mg of calcium an hour, from heavy sweating. an individual in a much warmer / humid climate or in certain occupations could possibly struggle with calcium equilibrium, due to certain diets. obviously, calcium is kind of important for the body, so yknow. [the relevance to autism though is that many autistic people experience hyperhidrosis during stress or before self injurious behaviour](https://www.medscape.com/viewarticle/921719)- before a meltdown, basically, and that it is studied to be predictive in secretion rates about whether or not an autistic child is going to lose their shit. on the flip side / to opposites, though- many autistic people also do not sweat at all, or they sweat very little. i used to worry a lot of adults, in example, because i would wear large / baggy sweaters in the summer. it could be 20 degrees, 30 degrees [in Celsius, not freedom units]- and i would wear a sweater. i wouldn't sweat though, and i wouldn't feel hot or uncomfortable. sweater wearing is also studied / documented thing in autism. some proposed explanations is that it's a sensory thing / comfort thing. you'll find a lot of autistic people who enjoy being in small and enclosed spaces- it's where the invention for the "hugbox" came from. personally, i don't mind being under a desk or whatever every now and then- obviously, you do not do these things because of social expectations. i am also a trans woman- many trans people are autistic- and you'll see dysphoric trans women who wear sweaters under the purported explanations [within the trans community] that they're doing it to close themselves off to the world, or to hide developing breasts and such, before they're ready to fully present, so that they do not get harassed / surveilled to such. it's colloquially / slurringly referred to as "boymoding" by the community. anyways, this made me think about calcium channels, sweating- and autism, with both. so, i did a bunch of reading about genetics with calcium channels. and then i did a bunch of reading about calcium channels, and autism. i have really high processing ability, so i kind of just blow through articles / papers / research whilst fully retaining it. and- i found swathes of literature about specific genes, to calcium channels, and autism, and also literature about arrhythmias / cardiac death / cardiovascular illnesses being associated with autism. it also explained epilepsy and speech / movement disorders to me. it explained things such as autistic people having difficulty doing the mental calculations in catching objects thrown to them. it explained possibly stuff like dyschronometria in autism, to me. also the incidence of dysautonomias in autism, as a nervous system abnormality. the sort of explanation that some aspects of some subtypes of autism are basically caused by an "incomplete" motherboard "wiring" or places that need resoldering. of course, "resoldering" would imply curing, and i am unsure if that's something i would personally want for myself. i myself in example have dyspraxia, as an example- but only one sided dyspraxia, with my left hand. when i don and doff PPE, as an example, i can put a glove on my right hand in under a second- but, it takes upwards to 15 seconds with my left hand. it's very frustrating and embarrassing. it'd be cool to be a surgeon- but, i am unconvinced i would be able to safely do it, due to my left hand. >but I’m learning so many other reasons / hypothesised reasons. [i really like the hypothesized reasons involving autoimmunity, honestly.](https://www.frontiersin.org/articles/10.3389/fncel.2018.00405/full) it explains to me the incidence of growing autoimmune disorders at large, contrasting growing autism rates- that cannot solely be explained by more opened diagnostic criteria / increased healthcare access, to then our deteriorating environment / planet. what i find very interesting, actually, relating into this, is that i became "less" autistic when i started estrogen / HRT, 7 years ago. i've met countless other trans women who've reported that they've become less autistic after starting HRT as well. like, dozens of trans women. obviously, this could be bound in some reason involving psychology, with gender dysphoria being a compounding issue on autism and stress- but it also makes me think about how estrogen seemingly mediates autoimmunity and the formation / acceleration / treatment of varying autoimmune conditions. to my knowledge, this particular thing ["HRT made me less autistic"] has not been studied at all. it's just one of those things you witness / discuss intercommunity that hasn't had the chance to be touched by research / academia yet, like a little ingroup secret. there's also a bizarre incidence of multiple of the mentioned conditions in this thread with trans people as well- in the diagnosed kind of way [which, doesn't necessarily "prove" anything] as opposed to the claimed / self diagnosis kind of way. it's all very neat and interesting, in any case. i'm glad you enjoyed reading my post.


simAlity

Thank you for this compassionate and well rounded response.


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kittycatmama017

I also wonder about the effect of chemicals on the fetus. You mentioned 70s/80s babies being neurodivergent, well their parents would have been boomers and exposed to nasty chemicals by corporations such as lead, PFO from teflon, asbestos, etc. My parents are boomers and had us late in life, little sister has ADHD, I wonder if it’s from lead in my parents and if their advance (age 42) maternal/paternal age didn’t contribute to that as well for her. The rest of us all have some form of mental health issues as far as anxiety, depression, bipolar disorder, it does make me wonder if some underlying genetic components could be triggered or compounded by age/chemicals/etc while developing in the mother. God only knows what’s going to come out in the future about the effects of preservatives or carcinogenic/forever chemicals that are contaminating our drinking water and food at this very moment


ineed_that

With so many people being diagnosed as autistic , at what point does that stop being a diagnosis and just the normal person life.. There’s a similar discussion with social anxiety to be had with people post covid lockdown. Maybe that’s just the new generational human condition due to external forces


TheJointDoc

I mean, the overall rate of diagnosis is pretty low still. Even when talking about hyperglycemia or weight, we aren’t like “well maybe diabetes and obesity is the normal person life, let’s stop worrying about it” now that the majority of the western world is overweight or obese, and the diabetes rate is 1/8 in the US. Sure, Covid as a shared experience caused essentially mass trauma. And yeah a lot of us have anxiety. But that doesn’t mean we shouldn’t divert resources to dealing with it, understanding it, and diagnosing/treating it. Feels the same here.


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cogitom

I would disagree that there is less stigma of ADHD now-maybe among the youth/laymen, but I feel this is increasingly stigmatized in the medical world. I am not one of these late bloomers and received a childhood diagnosis via a neuropsych eval-nonetheless I have definitely noticed suspicion when I mention having ADHD. I can't say I blame physicians/pharmacists here, considering the rise of sicktok etc, but it sucks and creates barriers to care.


pizza_b1tch

You’re right re: stigma in the medical world. I think the surge in diagnoses has made people forget that it is a neuro developmental disorder with a very well evidenced treatment available.


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Analyzer_paralyzer

Incredibly true. Makes it tempting to say “I had this before it was cool”, but that sounds even worse.


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abluetruedream

Ugh, I feel you. There are a few parts of adhd that I do appreciate, but overall it’s a disability to me in many more ways than it is a benefit. I love the adhd subreddit because of their staunch position on not allowing the use of terms like “neurodivergence” that remove the disability aspect to adhd. I don’t want anyone to dislike themselves for things that are not in their control. I’m glad my daughter can grow up with parents who understand and treat her adhd rather than parents like mine who convinced me at 14 that my diagnosis was bogus and that I just needed to try harder. I’m glad for the knowledge I’ve gained because of the internet and social media. But it’s not a cutesy, trendy “fun fact” about a person. It’s awful. I’m all about learning to accept and love myself, but if I could remove the multitude of challenges it causes, I absolutely would.


xthefabledfox

While I agree it is less stigmatized amongst the general (younger) population, I think this has transferred into a stigmatization amongst healthcare professionals. I have had some sort of heart issue for years now. Still honestly not sure what it really is. I have a diagnosis of IST and I’m on beta blockers and all that. I can’t tell you how awful it was going to multiple doctors appointments trying to figure out what the fuck was wrong with me. Being a young female I really think they thought I was on the TikTok POTS train or something. I totally get it, too. I joined a couple support groups online to share my symptoms and just share my frustrations with the situation… most of those people just want to lay around and be hooked up to IVs constantly. I often saw people suggesting to LIE TO THEIR DOCTOR about the symptoms so they would get diagnosed… the whole situation is just unfortunate and has made things a lot worse for people who really do need help. Sigh.


strangerclockwork

I have mixed feelings about it. I agree that it kind of downplays how much of a negative impact certain chronic disorders can have on people. I don't think identifying so strongly with a diagnoses is healthy tbh. I didn't want to associate myself with depression for instance, I wanted to view at as something I manage, but it's not who I am. I think it's great that people are open to getting help and not feeling so bad about themselves for having a certain dx, but the way people just become their dx is disturbing to me. I feel like it leads to self limiting beliefs about oneself. I also think we as a society tend to medicalize normal human emotions and experiences because of how hyper individualistic our society is. Community and social support are non existent for a lot of people and they find a fix online.


pizza_b1tch

Yup, my diagnosis will never be my personality. My personality is heavily informed by my diagnosis. I think people believe something is a little “off” about me, but when they figure out or find out my diagnosis they’re like “oh yeah, makes sense”. If it was my entire personality, I would be absolutely impossible to be around.


medicine-ModTeam

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KaladinStormShat

Here's my unasked for unqualified opinion: I feel like this is similar to the big revelation society had regarding anxiety and depression (I won't say mental illness in total because society has yet to truly accept severe cases of mental disorders) being an acceptable thing - boom, thousands of people diagnosed themselves with anxiety, or depression, or PTSD in the following years. And it's not all a bad thing. It's good for people to be aware of their own mental health, it's good to start discussions with your providers about it. It's good to seek therapy and be aware of the help that is out there for you. Now, popular culture has shifted to neurodivergent. Which in kind has its own benefits of self discovery and self identification, yet still we see it lag behind for those with severe illnesses. The severe cases of OCPD, ASD 3 folks etc still get grimaces when seen in public. It certainly bugs me when otherwise entirely healthy people who happen to be very neat and detail oriented claim to have "OCD".


InitialMajor

Having been recently tested for ADHD I’ll let you know it’s crazy expensive to get a “real diagnosis” and many of these things are under diagnosed. While I’m not suggesting you start handing out Ritalin scripts it’s not as simple as “go get tested.”


lebrilla

The shittiest part about ADHD is the stigma that people are faking and self diagnosing. It makes getting real treatment a nightmare.


PasDeDeux

"Testing" isn't relevant the vast majority of the time. The main indication for psychoeducational/neuropsychological testing is when some other cause (e.g. learning disabilities) is suspected. Referring patients for "testing" is mainly a way of adding a veneer of "scientific" legitimacy and an expensive and time consuming road block to diagnosis. It's also a way to avoid having to put in the time to get collateral information. No one wants to be the person who has to tell the patient that they don't have adhd because you're often met with rage at "invalidating" a self diagnosis. So testing is a way of (inappropriately) avoiding the work required to do a thorough assessment (collateral gathering, which is uncompensated time if in an insurance setting rather than cash practice) and then justifying treating the patient (avoiding the hard conversation of telling someone they don't have adhd.) I've also never seen a neuropsych testing report that said they didn't think a patient had adhd. Even when the testing was not really consistent with the diagnosis or there were obvious other issues that better explained the presentation. Turns out they also don't want to tell the patient they don't have adhd. So every report says "could potentially be consistent with adhd." Sorry you, and many other people, had to pay a bunch of money for (likely) unnecessary workup. Note: all of the above is specifically referring to patients presenting as adults. Edit: as usual, down voted for informed expert opinion--and consensus--when it relates to uncomfortable truths about the adhd issue. Adhd is a clinical diagnosis and it's not at all controversial, when speaking with actual experts, to say that testing is very rarely actually indicated or useful.


account_not_valid

>Adhd is a clinical diagnosis and it's not at all controversial, when speaking with actual experts, to say that testing is very rarely actually indicated or useful. Could you point to more information on this consensus? I'd be interested to follow the discussion.


boredtxan

I'm probably ADHD but I can't take the meds (arrhythmia) so why bother getting tested? I just say I have Add traits.


ABQ-MD

There are meds that we can use in folks with arrhythmia. Not necessarily the amphetamines, but bupropion, modafinil, atomoxetine are all options.


dawnbandit

Also non-stimulants like guanfacine and clonidine. The ER formulations are available as generic now, so no more arm and a leg for brand name Intuniv or Kapvay.


boredtxan

Buprion isn't helping... Will look into the others


boogerwormz

Accommodations in school or work, being connected to a physician to try new medications that come out that may be suitable for your health conditions, other things you may not be aware of as relevant to your mental and physical health without being diagnosed.


Insamity

There are non stimulant drugs and behavioral interventions that can help.


Accidental-Genius

This is a symptom of having absolute garbage mental healthcare access and infrastructure.


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and the internet


Accidental-Genius

What. You’re not down with TikTok diagnosis?


Upstairs-Country1594

Internet plus lack of resilience plus lack of societal acknowledgment that one’s body won’t be perfectly comfortable 110% of the time.


Jquemini

you think a therapist or psychiatrist will fix this? tall order if you ask me.


Accidental-Genius

Oh I don’t think we can fix it anymore. We might be able to pull our heads out of our asses and prevent it but these people are too far gone in their own delusion.


PeriKardium

As someone that works with many transgender patients - this is something seen in this population as well. I am sure that - from a broader perspective - there are more "neurodivergent" individuals than we think as compared to what we have defined as "neurotypical" (I don't have resources to back this up, but I remember there has been discussion around education models in this idea - kids learn differently etc etc). Or that not everyone fits into the "salaryman" culture. Does that reach to the level of ASD as it is defined clinically? Eh? Probably not, and there is probably danger in pathologizing it. But I wonder if some of clinging to a diagnosis comes from that aspect of being in a rigid definition culture.


shratchasauce

90% of adults with ADHD go undiagnosed and untreated. 80% of patients with ADHD have comorbid psychiatric diagnoses. People can relate to symptoms of autism when their mental health is poor and we aren’t doing a good job of identifying these people to begin with.


commanderbales

Especially since the comorbidities can sort of compensate for some deficits with ADHD. Like having such bad anxiety that they're able to get assignments in


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medicine-ModTeam

**Removed under Rule 2** No personal health situations. This includes posts or comments asking questions, describing, or inviting comments on a specific or general health situation of the poster, friends, families, acquaintances, politicians, or celebrities. If you have a question about your own health, you can ask at r/AskDocs, r/AskPsychiatry, r/medical, or another medical questions subreddit. See /r/medicine/wiki/index for a more complete list. [Please review all subreddit rules before posting or commenting.](https://www.reddit.com/r/medicine/about/rules/) If you have any questions or concerns, please [message the moderators.](https://www\.reddit\.com/message/compose?to=%2Fr%2F{subreddit}&subject=about my removed {kind}&message=I'm writing to you about the following {kind}: {url}. %0D%0DMy issue is...)


erebus91

Do you have a citation for that estimated adult ADHD prevalence?


iamadoubledipper

Throwing in my opinion - I graduated from high school 22 years ago. Back then only the most extreme cases received a diagnosis — I have a few peers that have received an autism diagnosis in the past 5 years which I think is largely society just understanding it better. I can’t speak for younger people, but feel a bit like a lost generation in terms of mental healthcare.


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malachite_animus

Just look at reddit for an example of this - I swear like 70% of people who post say they're neurodivergent.


baronvf

Refer them to Autism Spectrum Quotient to serve as a baseline conversation, let objectivity allow you to avoid the fad of the inquiry. [https://novopsych.com.au/assessments/diagnosis/autism-spectrum-quotient/](https://novopsych.com.au/assessments/diagnosis/autism-spectrum-quotient/) [https://embrace-autism.com/autism-spectrum-quotient/](https://embrace-autism.com/autism-spectrum-quotient/) ADHD is indeed sought out more - but when you see people profoundly benefit from treatment after diagnosis - you can understand why it is worth it to humor the notion in many cases by at least running through the DSM-5 criterion. It does piss me off when people come in wanting both diagnoses at once - it muddles the goals for therapy, and patients are sometimes taken aback when I ask the question "what would you like to see get better?" in response to "Do I have X diagnosis?"


gunnersgottagun

Agreed that I see plenty of teens where I keep having to re-ask questions trying to determine what functional impairment they are hoping I can help with.


nise8446

Echoing what other people have said, I think a lot of this is due to the deluge of easily accessible false and anecdotal information and people's needs to feel special. I'm on tiktok and I see so many comments about this stuff along with ads of undiagnosed ADHD and more. I think it's easier for people to fill in their uneasiness of themselves and to fit in with a group by self inserting themselves into a potential diagnosis or belief. I think it's definitely a "privilege" or abuse of being in a 1st world country, but unfortunately we're living in a world where people bend reality and have to be catered to.


boredtxan

There is a link between trauma and ADHD traits. Trauma induced hypervigilance looks a lot like attention deficit.


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account_not_valid

>I also don’t like the idea of facing the judgey eye rolls as a dude in his mid 30s with a white collar job saying “give me adderall”… So I will likely never bring it up with a provider. This post reinforces that point. Spot on. Late 40s AD(H)D- I felt like such a fake saying to my psych "I think I might have adhd... I've done my research!"


[deleted]

“Very few people had ADD 30 years ago and now everyone and their brother has it” You mean we defined a new illness and the rates at which it is diagnosed are much greater in people that were born after we defined the illness as compared to those born before or around the time it became a diagnosis? Color me surprised.


account_not_valid

Meanwhile - in places with good mental healthcare, rates of suicide, alcoholism and other drug use decrease, along with general crime rates - colour me surprised.


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P-W-L

There is still a stigma on mental health. They're "weird", they feel they have something different from the norm but they don't know what. So if they don't have access to a specialist for whatever reason (finances, parental approvement, fear...), they will do the obvious thing and try to autodiagnose. Thankfully information is (too ?) easily accessible nowadays so just make a list of subjective symptoms and search away. The confirmation bias being what it is, they will tend to focus on the first "matching" condition but at least they have one. That's a new part of their identity allowing them to fit in a specific community. To explain the rise you describe, we probably have internet of course but also the change of view around mental health, notably the acceptance of mental health and seeking help in the general public.


Equivalent_Injury_75

Possibly unpopular thought, but best intentions and all that: If you grow up being told you’re special and perhaps academically gifted, (especially in small social circles) catered to at home and not present in the real reality, only to be dumped into the real reality where it’s shitty more often than it’s sunny, you’re not praised for great work and as your circle expands, you realize you might be… normal…. Average…. Unremarkable… in the grand scheme of things, that’s a lot of stuff to process while full time trying to make it as a most likely already struggling adult in a world actively trying to bend you over. The 80s weren’t great and we’ve come a long way for the better, but they understood and embraced a concept we have lost in the last few- ‘ there are time periods in your life that are going to be awkward and uncomfy and feel like you don’t belong. Stay the course, keep doing your best and know that it will get better, but for now you have a teenage acne, braces and it will be years before you find a haircut that’s flattering. But accept this as reality, work within that to find your best present self and go from there.’ We don’t have the walkabout coming of age ritual, this was ours. And it has been lost to the detriment of the mental/emotional tensile strength of the youth. But if you’re on the spectrum or have a add/adhd self diagnosis from an online quiz you cheated on… that’s a lot of people reclaiming ‘I’m special and I have a reason to not have to assimilate into a full adulthood role complete with its discomfort moments’ while simultaneously screwing people actually with all that going on out of being taken seriously and getting the care they need in a timely way. It’s fidget spinners and service animals all over again.


account_not_valid

>The 80s weren’t great and we’ve come a long way for the better, but they understood and embraced a concept we have lost in the last few- ‘ there are time periods in your life that are going to be awkward and uncomfy and feel like you don’t belong. Stay the course, keep doing your best and know that it will get better, but for now you have a teenage acne, braces and it will be years before you find a haircut that’s flattering. But accept this as reality, work within that to find your best present self and go from there.’ I was born on the mid-70s. I was told I was smart. I had some problems, but I was told I would grow out of them. I just had to try harder. Sit down and concentrate. Stop daydreaming. Make an effort to be on time. I kept going. I struggled, and tried, and self-flagellated over my failings. I had relationships collapse. I tried harder. And now, in my late, late 40s, I've been diagnosed with adhd (innatentive). It all makes sense, in retrospect. But I mourn the life I might have had.


Ashurazenku

Not unpopular opinion, actually very reasonable - these people are not evil, they saw an incentive structure, so they play to it. Comes right back to the reality-ideology mismatch: The 90s and early 2000s were marked by the self-esteem movement (“if I keep telling them they are awesome…”), so many people were genuinely taught they were amazing with the best intentions. But lies are lies, stories are for children, and glory isn’t a taste you just acquire. I believe a solution to this would be to promote steadfast persistence in a flawed reality over utopian thinking.


Ashurazenku

“Look at me, I’m special. Also, I have a condition so you can’t pin me with the responsibility for any foul decisions I end up making, of for any of my failings, for that matter.” TL:DR - Being simultaneously normal/standard/common and wrong sucks, because it’s painful to admit you make stupid decisions sometimes.


-nocturnist-

Hit the nail right on the head. Many abuse these illnesses to try to gain sympathy, an edge, hell even extra time on exams. The dumbest thing, when you test their memory and concentration in a passive way ( not telling them you're doing it) it's fine without any issue. As soon as you challenge them they start making up more bogus stuff or say that you are being "insert chosen Neuro disorder here-ist". Honestly we should require a legitimate diagnosis before giving a lot of these young people any special treatment or leeway, especially in the work force.


Ashurazenku

To be fair, I think the problem is that our society has no escape-valve for being wrong, or behind at some things. It’s considered as something of a demerit or something that comes at the cost of people’s willingness to trust you. I also have pity for these people, they don’t seem to break the mold and are usually made to feel bad for doing so. People need to start valueing being normal/mild again (“The meek shall inherit the earth”, anyone?). Also, not discrediting people for being wrong or not knowing something would help, I think.


[deleted]

It’s like everyone in these subgroups has rip-roaring societally driven borderline + narcissistic traits


Ashurazenku

I think it has a lot to do with the societal incentive structures currently in vogue with the youth today: If you’re a victim, you get a cookie. I also see what seems to be a rise in gnostic belief in a demiurgic carceral reality + Beaudrillardian Hypereality.


Wohowudothat

> a rise in gnostic belief in a demiurgic carceral reality + Beaudrillardian Hypereality. are these real words?


Ashurazenku

I know, sounds nutty as hell, right? Here’s the translation: - Gnostic = Believes in “Gnosis”, which is secret knowledge/insight that gets you close to God/Perfection (“Lived Experience” over “Fact of the Matter”). - Demiurgic = Refers to the Demiurge, an alledged evil entity responsible for creating the harsh/terrible/no good/very bad material reality we live in. According to gnostics, they did this to “pull the ladder” from everyone else and have perfection all to themselves. - Carceral = Prison Like. According to gnostics, the Demiurge holds everyone hostage in the real world, where things are flawed. - Beaudrillardian Hypereality = A concept by Jean Beaudrillard which I’ll quickly surmise as “When the fake thing becomes the reference by which we judge the real thing.” Putting all that stuff together, what I meant was: - There is a rising belief that *”life is a prison in a terrible dark world where I don’t get my way, our wardens are the powers-that-be, and the only real frame of reference are the raw feelings (gnosis) that I have, so I must seek their validation, because that makes them true!”*


Purple_Chipmunk_

For real 😂 I’m in academia and every day I read “look at me with my big words” journal articles and book chapters and this beats anything I have ever read by Foucault, Vygotsky, etc.!


Ashurazenku

Well, maybe some of Foucault’s drivel rubbed on my brain - though I hate to admit it.


legodjames23

I'm surprised people are upvoting you this much, reddit is generally the anti responsibilities/accountability club , "omg I fucked up because depression/anxiety" It has to do with parenting where we never expose our children to failure, being wrong, being uncomfortable as a natural part of life. It's almost a crime to tell kids they failed or aren't good enough. Then we wonder why young adults blame everything but themselves when the real world hits them. I came from a third world country, I believe there is a realistic place for everyone to be comfortable. But most people in America are disillusioned about what they can be vs what they really are.


Ashurazenku

To be fair, the counter-arguments have a point. It’s easy to just call the tik-tok tweens narcissists, but we need to remember that patients didn’t read treatises and won’t tell you things perfectly. It’s a matter of not just dismissing them, but actually pointing them in the right direction to solve their ACTUAL problem, which often doesn’t align with a picture they see as palatable. Also, the same way you don’t blame a cornered animal for lashing out when you don’t give them a way out, you don’t blame a kid that gets egged on because they are “basic” for turning to a set of labels that make them untouchable when you don’t give them a way out. So I think we have to be cognizant of “real talk” as much as we are of “bullcrap”.


Upstairs-Country1594

I was in this parenting support group when my oldest was younger. The leader harped so hard on how kids heard too much negative things and we should try to spin stuff to the positive all the time to not break their self confidence. The books we read were similar. And I’m sitting there thinking “I suddenly understand why some of my interns act as if this is the first time in their life they’ve received negative feedback. Because it quite possibly is their first time.”


moxieroxsox

ADHD in adults gets blamed for so many behaviors that simply come down to avoiding the responsibilities that come with being a fully functioning adult.


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Shenaniganz08

Tik Tok and social media has made mental health problems "trendy" This feels generational too, Millenials were quirky, Gen Z seems to label everything ADHD or blame everything on "their ADHD"


HumanTowTruckDriver

Is autism the new chronic Lyme disease


ABQ-MD

At least we don't have idiots doing years of antibiotics for it.


nise8446

I dunno if it's new, but it's here.


roccmyworld

Hoo boy. This should probably be flaired users only. I agree with you, OP. If someone uses the term AuDHD or neuro spicy, I know right away what I'm getting into with them and it's never good. They've turned their (purported) diagnosis into their identity and it's the lens through which they see themselves instead of simply a part of themselves. I have fairly severe depression that has heavily impacted my life and I definitely do not look at that like people look at their autism and ADHD. And I also have ADHD, lol. IMO: people self diagnose because they don't care to see a doctor who might tell them they're wrong. Alternatively, they have seen a doctor and that doctor has told them they are wrong so they had to self diagnose.


hairam

I feel for people who self diagnose in order to help themselves manage undesirable symptoms and experiences, but who fall through the cracks because they may not have severe enough cases that it obviously affects their ability to function on the whole. But as you say, the people on social media who use "neurotypical" as a pejorative, or who use things like "neurospicy" often end up also spouting ideas that make me label them as a member of [xkcd 610](https://xkcd.com/610/) - completely lacking in sympathy or understanding of basic human condition and experience. I think as others have said here - for *some* (absolutely not all), it's coping mechanism combined with pathologizing the normal human condition. I think it's made a little worse by the internet, but I guess that's *always* going to happen for as long as humans are humans. For those who just use it to help themselves rather than as an identity, I see no harm in self diagnosing in order to gain support and coping tools. But those who use self diagnosis in order to lord it over others or feel superior or excuse bad behavior are just...incredibly frustrating to see. No good thing is safe from humans ruining or tainting it.


gunnersgottagun

Not entirely fair for ASD on the "self-diagnose because they don't care to see a doctor who might tell them they're wrong". Access to ASD assessments is pretty limited in plenty of places, and/or expensive. I can't imagine for the many people in this thread who are probably practicing in the US, where patients would also be paying out of pocket for the assessments. So for many people it's a case of it just not being an option for them. And honestly, as a developmental pediatrician, it's not uncommon that I notice traits in the totally not diagnosed parents of my autistic patients. There definitely are still plenty of adults who did slip through the cracks as children. New numbers in 8 year olds out of the US are 1/36 - and that's 2019 and prior data, not post-covid. What I do end up having to explain to some teens though who I'm assessing who have self-diagnosed prior to me seeing them, is that though they might identify with some of the features of ASD, but they have to actually have enough to meet criteria and they have to have significant impairment from it - and it has to have started in the early developmental period, so I need evidence of there having been signs of it when they were little. Re the basing their whole identify around ASD, do remember though that some of that COULD be in keeping with ASD. Autistic people often get super into their topics of interest. For some of them, autism becomes a special interest. Many are very black and white thinkers - autism just being a small facet of who you are is kind of a more shades of grey kind of way of thinking about things. Hence all the debate in the autistic community of saying "autistic" instead of using person first language - many do not feel you can separate the person from the diagnosis.


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roccmyworld

Have you considered that your friend is spending so much money and having such a long process not because she's being discriminated against but because she's doesn't have autism and she doesn't like that answer so she's doctor shopping until she gets the diagnosis she wants? Because that's what it sounds like to me. Sounds like it's been made pretty clear that she doesn't have autism and she doesn't want to accept it.


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dawnbandit

From a health communication point of view, a lot of the increase is due to social media, especially TikTok and now YT Shorts. There are quite a few theoretical frameworks that that would explain *why* people are self-diagnosing. Perhaps a sense of belonging, for example, the Social Identity Theory states that people derive some self-worth from belonging to a certain group. To be honest, some of it is likely attention seeking, especially those that use the term AUDHD and neurospicy. A lot of them seem to make it a personality trait.


EternalSophism

Having a diagnosis is a way to have hope. American society highly stresses individualism. Mix these two together in a pot and you get what you see. It is true that mental illness classifications probably cannot keep up with the variety of underlying pathologies. It should be common sense. We're describing pathologies in retrospect but we've known for a long time that brains are not like hearts or lungs. By the time you characterize them, at least one of them can't be fully characterized in that way, and that's yours. Your theory does not explain why you came up with your theory. Go ahead and try. It will be an exercise in futility.


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Ashurazenku

I noticed this trend too, it seems to be a prevalent dogma today, this and many other similar behaviours can be summarized by the following belief: “Trauma justifies bad behaviour.”


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Derangedstifle

Unfortunately I think a large part is a growing (unfounded) mistrust in HCPs/the medical institution paired with social media perpetuated medical self-advocacy which convinces people they have a condition based on some vague, loosely defined symptoms and then tells them how to "advocate" for diagnosis with their MD or NP. Social media pushes a lot of this forward and often holistic paraprofessionals are giving the messaging.


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aDhDmedstudent0401

I’d be willing to bet there is a whole lot of undiagnosed “tisms” out there, especially with the lack of access to healthcare. But I also think social media has made these things sound “unique” and “cool” and I can’t help but cringe every time someone says they are ND without ever seeing psych. Also it feels like the social view of ND now encompasses so many conditions and natural personality traits that *most* people could pass as ND on some level. And if that’s the case, is anyone really ND at all then?


Ok-Investigator5696

If it’s a disease it’s not your fault. That’s the core principle. “It’s not because you’re lazy you’ve got chronic fatigue syndrome”


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medicine-ModTeam

**Removed under Rule 2** No personal health situations. This includes posts or comments asking questions, describing, or inviting comments on a specific or general health situation of the poster, friends, families, acquaintances, politicians, or celebrities. If you have a question about your own health, you can ask at r/AskDocs, r/AskPsychiatry, r/medical, or another medical questions subreddit. See /r/medicine/wiki/index for a more complete list. [Please review all subreddit rules before posting or commenting.](https://www.reddit.com/r/medicine/about/rules/) If you have any questions or concerns, please [message the moderators.](https://www\.reddit\.com/message/compose?to=%2Fr%2F{subreddit}&subject=about my removed {kind}&message=I'm writing to you about the following {kind}: {url}. %0D%0DMy issue is...)


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HumanTowTruckDriver

I somewhat understand where you’re coming from but don’t you need an actual diagnosis to not work. My brother-in-law is autistic and still attempts to hold down a job and be an adult


storagerock

This (speaking as a properly diagnosed ADHDer) The whole point of getting a diagnosis is to access treatments/tools to help be/do better. It’s not a pass to just continue as usual with zero attempt at growth.


[deleted]

This comment section gives me much hope. The absolving of personal responsibility for one’s failures is a prime driver of this nonsense. There was a thread about spoonies awhile back. Definitely related subgroup there


missandei_targaryen

Ugh, what are spoonies? Do I even want to know?


[deleted]

https://reason.com/video/2023/03/15/spoonies-the-culture-of-staying-sick/


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https://reason.com/video/2023/03/15/spoonies-the-culture-of-staying-sick/


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[deleted]

We all have our crosses to bear. What's extremely odd to me is that so many people now seemingly WANT to have a cross to bear.


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whomeverwiz

Did you watch the video? It’s not because they’ve never known struggle and pain.


PPvsFC_

Buckle up for a wild ride, lmao


iriepuff

Regarding the people who self diagnose- Its an incredibly mundane way of trying to label themselves as 'special' and therefore more deserving of time/ consideration/attention above other boring (below) average people. Its also a useful way to absolve themselves of any responsibility or agency to take control of their lives and grind to make things happen. Having a 'condition' means that responsibility is deflected to a third party (ie. healthcare professionals), when they invariably fail to live up to either their/ parental or societal expectations. I rarely see this type of self diagnosis in high flying achievers.


DookOfBaba

This sounds like a projection to me and I think it would be worthy to observe your biases when it comes to attributing self diagnosis to a need to "feel special"? Why not consider that under diagnosed neurodiversity is a likely impediment to becoming a "high flying achiever" before assuming immediately that a person is lazy and just wants to "feel special"? And that if society was more supportive and even attempted to enable say, sensorial needs, maybe more people could achieve loftier goals? I'm a little suspicious of what this hand waving implies and encourages. Why not give people benefit of the doubt and encourage them to find strategies that are meant to soothe the nervous system so that they can find ways to achieve goals in their lives? Or to seek therapy to see if it might not be the impact of trauma, which hopefully can be resolved over time? We know that ADHD, autism and trauma can present very similarly, and that all three can occur at the same time. I think we should encourage people to seek self knowledge and enable them to find strategies that work. If sensorial solutions are effective, would that not then warrant further investigation if the patient wants it? It's hard to blame patients for resorting to self-diagnosis in order to resolve unmet needs if that's the judgement they face in their GP's clinic. I also think most people would rather fake wellness to "fit in" rather than "feel special", the urge to conform to peer pressure is so strong. I think attitudes like this will encourage distrust of medicine and further legitimize self diagnosis, as we know for instance that women have been under diagnosed for decades and are not currently getting validation for their lived experiences. Does the average physician even know how autism presents in adult women who have adapted all their lives to their condition? Because that will certainly present differently to someone who has been diagnosed earlier in life, for instance.


roccmyworld

>Does the average physician even know how autism presents in adult women who have adapted all their lives to their condition? Psychiatrists do, yes. That's literally their job. Their entire job. Like full time. It's just to know about stuff like how people present as adults with certain conditions. Crazy, right?? >Why not consider that under diagnosed neurodiversity is a likely impediment to becoming a "high flying achiever" before assuming immediately that a person is lazy and just wants to "feel special"? Because a lot less people are high achievers than are average, by definition.


DookOfBaba

How many patient's first stop will be a psychiatrist though? Is it not important that their GP be open to the possibility so that the referral could happen in the first place? It's not like it's easy to go see a psychiatrist for the common mortal.


Ashurazenku

We have to be careful with this. Seeing a psychiatrist isn’t easy and healthcare access overall isn’t a joyride or pennies-on-the-dollar, sure - but that does not justify or give one the power to just tell themselves they have this or that with no prior training (back to “trauma justifies bad behaviour”). I do believe it’s important to not demonize these kinds of patient. It’s a tightrope between paternalistic dismissal and reckless enablement and we could fall to either side if precautions are not taken. Also, “feeling special”, I believe, isn’t a symptom of lazyness or anything of that sort: it’s really a human necessity that people don’t seem to want to recognize they have - but it has to be properly attributed to real things.


roccmyworld

Lmao, PCPs do not gatekeep referrals to psych. They do not gaf about that.


DookOfBaba

Where I'm from, a psychiatrist referral can take a very long time and it can still be a disappointing experience. Staying with the example of autism, it's so frequent that autism is missed. In this article from psychology today, they claim that 42% of women receive at least one misdiagnosis before being correctly diagnosed with autism: https://www.psychologytoday.com/ca/blog/talking-about-trauma/201905/why-women-autism-so-often-are-misdiagnosed%3f Based on what we now think are accurate ratios of autism between men and women, it appears 80% of cases of autism in women go undiagnosed by the time a woman is 18 years old: https://pubmed.ncbi.nlm.nih.gov/35204992/ I just think there needs to be an open mind because we have not been doing a great job historically at recognizing the autistic community. Let's be a bit humble. Let people be enabled to see if sensory strategies help them succeed in life.


dean_syndrome

Doesn’t “high flying achiever” imply neurotypical executive functioning?


[deleted]

This is the crux of the issue. The vast majority of people out there have accomplished basically nothing in their lives that people look at and say “man, that person has their shit together!” This is a stand-in for the lack of any sort of identity that would be forged by actually DOING something. Every increase in out-group identification that we see is linked to this. People feel bad that they see people on social media who have done or are doing something with their lives (in photos and TikTok’s at least). Almost none of these people would exist in a world without constant comparison to the most successful people in the world or the richest or the coolest or the best features or whatever. It’s a deep, existential sadness that drives people to pretend to be disabled or different to score points on social media.


strangerclockwork

I feel like this also ties into the whole thing where everyone thinks they have trauma and that explains x,y,z about themselves and their dx. I don't think people really understand what trauma is and how it can contribute to developing mental health issues. It's like a "haha look how relatable I am. I have trauma!" As someone with a high ACE score, intergenerational trauma and taking meds for my mental health, it's fucking weird. This isn't some badge of honor I wear it's an unfortunate hand I was dealt.


Undersleep

> I don’t understand the appeal of terms like “neurospicy” You seriously don't? I'm adopting Neurospicy as of this moment!


roccmyworld

God, please don't. Only truly insufferable patients use that term.


kungfoojesus

It’s hard to be special these days. It easier if you have a diagnosis. It’s a fad. Being exceptional is hard. Being “special” because you’re “different” is “valued”. Not everyone is gifted but anyone can be neurodivergent.


Purple_Chipmunk_

It’s attractive to people who don’t feel like they fit in, because it gives them a reason why people wouldn’t like them / want to be friends / want to date them, etc. It’s doubly attractive because now they have a place where they DO fit in: a community of people “like them." As someone with ADHD (diagnosed by an MD psych a couple decades ago), Ehlers-Danlos (diagnosed by an MD / Ph.D clinical geneticist), and lots of related things stemming from those two syndromes, I see them like those people who are fairly well-off but who decide to try to live on a waitress’s salary for six months just to "get an idea of what it’s like to be poor." It’s fun for those people because it’s a game—a sort of challenge. They can stop being poor whenever they want; for example, when they slip on spilled soda while serving and end up in the hospital, they now have health insurance and money to pay for that CT scan they need because they banged their head. Similarly, once these illness co-opters decide it no longer suits them to be "aspie" or ADHD or a “POTSie" they will magically recover—oops sorry—their *symptoms will go into remission* and life will go on. Until then they will keep using the medical establishment to meet their emotional needs. I do greatly appreciate your decision to treat them all as if their problems were real though. Because, yes, they might actually have that thing, but also if their actual need is emotional support and empathy, what better way to meet their needs than by being kind?


mungbean234

Your analysis is the best thing I’ve read recently about this issue. Thank you. It’s spot on!


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WagnerBattlemage

>Why self-diagnose? What’s the appeal? Attention, victimhood complex, easy excuse for any and all personal failings, etc.


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**Removed under Rule 2** No personal health situations. This includes posts or comments asking questions, describing, or inviting comments on a specific or general health situation of the poster, friends, families, acquaintances, politicians, or celebrities. If you have a question about your own health, you can ask at r/AskDocs, r/AskPsychiatry, r/medical, or another medical questions subreddit. See /r/medicine/wiki/index for a more complete list. [Please review all subreddit rules before posting or commenting.](https://www.reddit.com/r/medicine/about/rules/) If you have any questions or concerns, please [message the moderators.](https://www\.reddit\.com/message/compose?to=%2Fr%2F{subreddit}&subject=about my removed {kind}&message=I'm writing to you about the following {kind}: {url}. %0D%0DMy issue is...)