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Comment by djaychela | Hacker News Reader

This has been my experience, both professionally (I used to teach children at a school which specialises in those who may have some form of diagnosis), and in my personal life with 4 step children, 3 of whom have ASD diagnoses.

For the vast majority who I taught, the diagnosis became their identity, rather than a way to understand their behaviour. Any disagreement with them was answered with "that's because I'm X". I can only recall one who approached it as a way to identify and understand their behaviour and experience of the world, and as a way to deeper understanding.

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When my daughter was young, my wife and I were concerned, and we took her to a place that specializes in identifying and working with autistic children. In about thirty minutes of observation, they said she's obviously autistic, and recommended that we begin bringing her for ~20 hours of intervention a week. We decided against it, because we thought it was excessive, and decided we didn't really want autism to be her entire life. Several years later, she's doing very well: good skills for life, good progress in her schoolwork, and good ability to deal with social situations. Yes, she's a little socially awkward, but she puts herself out there anyway, and makes no excuses. (She's aware of the evaluation and after reading a couple books about autism, thinks, yeah, that's probably what's up.)

I know that's an anecdote, but can anyone imagine that she would have gained more from 20 hours per week of being told she has special problems with a special name, and needs professional help to overcome her many, many obstacles? I certainly can't.

this is a reflection on you, not your child. i was diagnosed with an ASD issue. my father was devastated, i can’t be “broken” because he clearly isn’t. i was shown by my fathers actions that my “affliction” wasn’t ok. if i was broken, he was, and that didn’t work for him.

i said what my dad wanted to hear WRT if i had had more classes to cope, “a total waste” i agreed.

in the end i spent half a decade in these classes learning how to understand what the other person is trying to say, not what their actions and subtext scream out. i did this as an adult, against my father thinking it was needed.

after five years i can finally manage my emotions well enough and with enough expertise that it no longer causes me to loose friends and ostracize coworkers.

think about the impact that your clear disdain for the “condition” and down playing of the value if the courses. imagine your daughter not “still struggling” and instead “able to deal with emotions in a non familial situation”.

your fear is harming your perspective

That sounds like you are denying their lived reality, perhaps even “projecting” your golden experience, saying that others can’t find different paths through complex human topics. Your opinion is fine, but denying the opinion of others is not.

Here are two things that I have commonly seen: 1: getting labelled often leads to negative outcomes, in particular when others judge by a person’s label and not the person, and 2: psychologists and counsellors can sometimes create victims, trained codependency, and a variety of very negative outcomes. In this case the OP judged the cost of 20 hours per week of professional help to be high cost/risk, and they tentatively said it seems to be a reasonably good outcome (fantastic - given the diagnosis).

Professional “help” can easily be harmful, and I think you should acknowledge that fact. Of course the opposite can happen when people ignore help, or deny problems, and then hurt themselves or others.

The key point is that there is no golden standard where you can predict if professional help will work, or harm.

PS: https://news.ycombinator.com/newsguidelines.html

The parent post wasn't suggesting that she didn't have a problem, but rather that the suggested treatment by an organization whose sole purpose is to identify and treat these cases was not appropriate for her circumstances. They've essentially got a vested interest in over-diagnosing, and parent sniffed that out.

It is entirely possible that, had she not improved, parent would have gone back, or found another source of treatment. I didn't see anything at all in the parent's post to indicate that they have a `disdain for the "condition"`.

You might be projecting your own experiences a little too much.

> classes learning how to understand what the other person is trying to say, not what their actions and subtext scream out

I know this is a total sidebar: Do you mind sharing a little more about these classes?

Not knowing anything about this, my reaction on reading this was the exact opposite.

As a kid, I was always naively trusting of people's words, and I would expend huge amounts of empathy on trying to understand them based on what they were saying. I feel like a large part of growing up and understanding people is being able to look past that — trust what they do, rather than what they say.

You’re saying these people were able to understand one of the major aspects of their make-up and were able, after years of struggle, to at least give a name to the reason for the struggle they still had to deal with.

They must have had some sense of relief when they got diagnosed. Perhaps they thought they would be given a little bit of a break by those who expected them to act like people who are literally not like them.

Perhaps they found, though, that despite finally being able to show others that they weren’t just lazy, or stupid, or that they didn’t care, or they weren’t interested in paying attention, or they were just being weird, they were still expected to somehow ‘snap out of it’ and be like people who weren’t like them.

After not being able to explain your behaviour for so many years, and then being expected to just somehow ‘identify and understand’ and gain some ‘deeper understanding’ would sound to them exactly like ‘you can just try to stop being yourself now you have a label, right?’

It’s exhausting. Even with - and especially with - those you love and who you see every day, including those who are on the spectrum themselves, there is still a lack of understanding and a pressure to just ‘fix’ yourself, and do so consistently.

No wonder some, as soon as they get a diagnosis, default to saying ‘I did that because I am X’ and don’t want to have to bow and promise to work on themselves so that they can be a better - different - person. They are doing this every day because they feel the weight of society. They don’t need to have those closest to them be the nagging voice of that society.

As someone who got an ASD diagnosis later in life, this is absolutely spot on.

And as someone who got an ASD and ADHD diagnosis earlier in life (which doctors are now unable to reproduce), this couldn’t be further from being spot on.

So much unnecessary bullshit I had to go through because shrinks were too eager to label me as a kid. In the end my only fault was a general aversion to authority, only further intensified by this experience.

If you're referring to the 'overdiagnosis' (i.e. misdiagnosis) of ASD/ADHD early in life, I completely agree that this shouldn't be happening.

I also wasn't arguing for early diagnosis, as I understand the dangers of this, not simply because it's difficult to get right, but I am worried that handling the label in a useful way does seem like it could be more difficult at a younger stage of development.

I was commenting on what appeared to be an assumption - by the commenter I replied to - that those they had dealt with were lazily (!) using their diagnosis label as some kind of excuse for their behaviour or to avoid challenge.

The original commenter could, of course, be entirely correct, but some of the most difficult aspects of ADHD to deal with are:

Not being believed - the assumption that you're actually just lazy, or otherwise morally defective

Constant pressure to 'get over' your ADHD, never letting it influence your actions (or inaction)

It's difficult to relate how much these two pressures can cause agony within the family - with _or_ without any knowledge or understanding of ADHD, and with or without any diagnosis.

The intent of my comment was to ask for patience and understanding for those affected, not to advocate for or against any position on diagnosis.

> a pressure to just ‘fix’ yourself, and do so consistently

Now that's just silly, though. "Fixing yourself" is a ridiculously hard problem even for those who don't have the benefit of a formal diagnosis - the ones anyone would simply dismiss as lazy, stupid, uncaring, weird etc. etc. That's basically what wisdom is. It's not clear that the formal choice of getting a diagnosis is changing anything substantial beyond the picking of an arbitrary label for some known cluster of behaviors, perhaps with varying amounts of personal or social adaptiveness.

A formal diagnosis has helped many people significantly in living their lives. It allows them to get medications and/or support that they need.

It might be useful to actually talk to people who receive these diagnoses. In my personal experience I have seen people benefit greatly from formal diagnoses (even if initially it takes time to make sense of it). But even if there are people who are hurt by a formal diagnosis, their numbers are absolutely demolished in comparison to the numbers of people who would benefit by help for mental health issues but never seek it out.

Complaining about people who might not be responding perfectly to a diagnosis seems like a drastically minor issue relative to people who have undiagnosed mental health issues.

Undiagnosed mental health issues such as being lazy and unmotivated? There's lots of people like that out there. For that matter, the formal mental health field can hardly be said to have a monopoly on soulcraft. Seeking wisdom and striving to improve one's core state of being are practices as old as man himself.

"being lazy and unmotivated" can be ADHD, anxiety, depression, a stroke, low key narcolepsy or else wise and how you treat them is very, very different as one example.

"lazy and unmotivated" are mental health symptoms, not causes.

I think we ought to think about these things maybe in a bit of a different perspective.

Why do you think someone would want to be lazy and unmotivated? Wouldn't people prefer to simply be able to accomplish things, being lazy and being unmotivated is very detrimental to one's well-being in today's society.

And from this perspective then maybe you would think: okay, why are these people making everything harder for themselves? Could it be that, maybe, there's something else behind that behavior? Maybe being lazy is a natural trait on some people, in which case, should they be blamed for it?

These are not simple questions. I think dismissing people's struggles is very problematic. I mean, any struggle is worth taking a look at. I think a lot of people don't really understand what it means for someone to be mentally ill because it's not something that is so evident. But I don't think you would ever tell someone that was born without their legs to "stand up and walk like everyone else does, sometimes my legs hurt too, and look at me running a marathon". So why would you do the same for people with mental illness? Why would you assume that laziness and lack of motivation is simply a momentarily ailment?

ADHD and depression are very much real, and we need to take mental illness seriously and a big part of this means not just going "get up and walk like i do" but actually trying to understand another person's struggle.

There is a pervasive theme in this comment that labelling people is an action that helps them. Maybe. In some cases yes.

But it is suspicious generality - there are also a lot of cases where people being labelled is an action that harms them. Especially since all the sciences involving the human mind have long histories of quackery, failure and discrimination to draw on. The results are rarely clear and the goals of the people involved are cloudy.

There is probably some balance between the perspectives here and finding it is the real question here.

This isn’t my field so trying to speak with any authority isn’t possible but amongst my close colleagues we feel that pervasive labelling and the need to name every phase ends up creating in some people ‘tethers’ around which a person’s entire psychological makeup revolves. It’s good to forget sometimes. Ie person goes through bad breakup. Would meet clinical (DSM-V) depression definition. After a year goes and sees a therapist and gets on antidepressants. Begins to feel good. Stays with therapy. The rest of their life is now a pivot point around that breakup. They’re labelled as depressed. Other stuff comes up. In some worlds, maybe that’s necessary. In others, maybe they come good, make lifestyle changes, find happiness again, and don’t have the label or the antidepressants for life.

This is so true. My friend got a ADHD diagnosis very late in life and it became so much of his fucking identity. Thankfully, he was smart enough to know the dangers of abusing adderall so he took it in moderation. But he refused to listen to my assessment that it was not helping him at all.

The worst part of it was that he was convinced that his academic failures in life were due to his ADHD. Now we are both successful people in general. He's a software engineer in a major company. But since he couldn't figure out some simple math shit that was obvious to me, he thought he was being handicapped by his disorder. He refused to listen to my claim that everyone has a lot of stuff in math they just do by the rules they were taught and only realize later in life that there's an underlying concept. It is kinda the point of our education system because our young brains take more time to grasp the basics so we cram the rules and wait for the rest of cognition to catch up before teaching the basics.

He stopped taking the meds a while ago when he realized it wasn't doing him much good and realized that there's a limit to how smart people get and it is ok to not be born as next Terry Tao or something.

> He refused to listen to my claim that everyone has a lot of stuff in math they just do by the rules they were taught and only realize later in life that there's an underlying concept.

You're probably misinterpreting "refusal" as "unable". After a lifetime of being told "if you would just apply yourself...", you start to get a distorted impression on what the average experience is. Obviously, he's just coming to understand something that everyone else had appreciated since they first learned it, because they applied themselves.

Maybe I'm projecting -- I'm in a similar spot, but I've been diagnosed since high school, and it wasn't exactly a shocker then.

What you're describing really sounds like the secondary depression[0] that usually comes with adhd. That is, he's probably is being handicapped by the disorder -- it can be a real slog to read math, and very hard to practice it, even when it's interesting. But it sounds like you were coming face to face with depression caused by a lifetime of not feeling good enough. Frustration that you can't apply yourself harder. Being gaslit into believing that you weren't trying.

I have the same issues with being told to apply myself. It's a common story for people in the 95-99th percentile regardless of whether or not there is an ailment holding them back. I am not trying to reduce what people are going through, but I just think this is not the point of variation. Maybe experiences around not being able to earn money at work due to concentration issues are a bigger differentiator (I don't know).

But I understand why people have an achilles heel about certain aspects of their life that they have been scolded about constantly. I have those issues too but in certain areas I overcame them entirely like in academics.

So what is an identity if not “a way to understand their behaviour and experience of the world”? I think the problem the GP raises is inherent in the whole diagnosis concept, and that it’s generally a bad idea to label large parts of the personality spectrum as some kind of (incurable) illness.

Not the gp, but I think the difference lies in mindset. There’s the “victim” mindset where you know the diagnosis and it becomes a convenient scapegoat for your symptoms. “I can’t do that because I’m X.” You see yourself as unable to escape the diagnosis and enter a state of learned helplessness.

The desired outcome is an enlightenment mindset. “Ah, so that’s why I act that way. Well now that I know that and have x, y and z methods for addressing it, I can overcome/adapt”. As you can imagine it’s a lot more work to achieve this mindset.

I don’t know… I think it’s kind of unfair to lay this on people who are already struggling, when it’s quite clear that most healthy adults are unable to adapt that mindset when it comes to (other’s) psychiatric diagnoses…

I can empathize with your position, and it would be nice if there was a way to help from the “outside”. But the truth is that the only way to make meaningful change is to internalize the change and do it yourself.

I say this not as some sort of holier than thou proclamation. I struggle with this daily myself. Posting on hacker news helps reinforce what I should do to help myself :)

> There’s the “victim” mindset where you know the diagnosis and it becomes a convenient scapegoat for your symptoms.

Spend some time to think about that sentence. The diagnosis is not a "scapegoat", it's literally an explanation for the symptoms.

Why should they have to try to "escape" the diagnosis?

Now combine this with the 21st century "victim industrial complex" and we have a recipe for disaster.

Actually, I do wonder. Are these independant variables, or is the search for victimhood driving the "mental illness" trend?

I fear that exposing teens to self educating on too personal and too complex topics is gonna backfire. They're extremely quick to accept theories and blend in with it to make it an instant reality.

ps: not helped by online groups or bubbles (twitter, discord) where they can all reinforce their own beliefs in a joyful mayhem.

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