Is ADHD Being Over-Diagnosed For Cash?

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Is ADHD Being Systematically Overdiagnosed?

The BBC’s investigative “Panorama” program all so recently did a documentary in which one of their journalists—who does not have ADHD—went to three private clinics and got an ADHD diagnosis from each of them:

So… Is it really a case of show up, pay up, and get a shiny new diagnosis?

The BBC Panorama producers cherry-picked 3 private providers, and during those clinical assessments, their journalist provided answers that would certainly lead to a diagnosis.

This was contrasted against a three-hour assessment with an NHS psychiatrist—something that rarely happens in the NHS. Which prompts the question…

How did he walk into a 3-hour psychiatrist assessment, when most people have to wait in long waiting lists for a much more cursory appointment first with assorted gatekeepers, before going on another long waiting list, for an also-much-shorter appointment with a psychiatrist?

That would be because the NHS psychiatrist was given advance notification that this was part of an investigation and would be filmed (the private clinics were not gifted the same transparency)

So, maybe just a tad unequal treatment!

In case you’re wondering, here’s what that very NHS psychiatrist had to say on the topic:

Is it really too easy to be diagnosed with ADHD?

(we’ll give you a hint—remember Betteridge’s Law!)

❝Since the documentary aired, I have heard from people concerned that GPs could now be more likely to question legitimate diagnoses.

But as an NHS psychiatrist it is clear to me that the root of this issue is not overdiagnosis.

Instead, we are facing the combined challenges of remedying decades of underdiagnosis and NHS services that were set up when there was little awareness of ADHD.❞

~ Dr. Mike Smith, Psychiatrist

The ADHD foundation, meanwhile, has issued its own response, saying:

❝We are disappointed that BBC Panorama has opted to broadcast a poorly researched, sensationalist piece of television journalism.❞

Click here to read their full statement!

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  • How Healthy People Regulate Their Emotions

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    Some people seem quite unflappable, while others are consistently on the edge of a breakdown or outburst. So, how does a person regulate emotions, without suppressing them?

    Eight things mentally healthy people do

    Doing these things is hardest when one is actually in a disrupted emotional state, so they are all good things to get in the habit of doing at all times:

    1. Recognize and label emotions: identify specific emotions like anxiety, excitement, frustration, and so forth. You can track them for better emotional management, but it suffices even to recognize in the moment such things as “ok, I’m feeling anxious” etc.
    2. Embrace self-awareness: acknowledge emotions without judgment, using mindfulness and meditation to enhance emotional awareness and reduce reactivity—view your emotions neutrally, with a detached curiosity.
    3. Reframe negative thoughts: use cognitive reappraisal to change your perspective on situations, viewing setbacks as opportunities for growth.
    4. Express emotions constructively: use outlets like writing, or talking to someone to process emotions, preventing emotional build-up. Creating expressive art can also help many.
    5. Seek social support: cultivate strong relationships that provide emotional support and perspective, helping to manage stress and emotions.
    6. Maintain physical health: exercise, sleep, and a balanced diet support emotional resilience by improving overall well-being and brain function. It’s harder to be in the best mental health if your body is collapsing from exhaustion.
    7. Use stress management techniques: practice deep breathing, meditation, or other (non-chemical) relaxation methods to reduce stress and calm the mind and body.
    8. Seek professional help when needed: when emotions become overwhelming, consider therapy to develop personalized coping mechanisms and emotional regulation strategies.

    For more details on all of these, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • But First, Inner Peace – by Case Kenny

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Thinking positively and vividly imagining a Ferrari parked in your driveway will not, in fact, cause it to manifest there.

    You know what that method does work for, though? Feelings.

    This book is essentially a guided thought-and-feeling modelling system that, consisting of 60 chapters to be taken one-per-day, aims to rewire your mind for inner peace.

    This is not, however, just a matter of “imagine peacefulness”, or nice-sounding platitudes. Rather, at the end of each chapter there is an exercise and journaling prompts; effectively, work to do along the way.

    Weighing in at 438 pages, this is a sizeable book, but part of that is because of the space to write answers to journaling prompts. Still, it’s not exactly a pamphlet, either—there is serious and extensive content here too.

    Like any daily reader, you can zip through it all at once if you like, but a benefit to doing the chapter-a-day approach is that it sets a habit of mindful reflection, and gives you a chance to implement each thing, one per day, building up new habits in that regard, too. In contrast, reading it all in one sitting wouldn’t give that.

    Bottom line: without inner peace, we don’t have much. Treat yourself—you deserve it.

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  • Escape From The Clutches Of Shame

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    We’ve written before about managing various emotions, including “negative” ones. We put that in “scare quotes” because they also all have positive aspects, that are just generally overshadowed by the fact that the emotions themselves are not pleasant. But for example…

    We evolved our emotions, including the “negative” ones, for our own benefit as a species:

    • Stress keeps us safe by making sure we take important situations seriously
    • Anger keeps us safe by protecting us from threats
    • Disgust keeps us safe by helping us to avoid things that might cause disease
    • Anxiety keeps us safe by ensuring we don’t get complacent
    • Guilt keeps us safe by ensuring we can function as a community
    • Sadness keeps us safe by ensuring we value things that are important to us, and learn to become averse to losing them
    • …and so on

    You can read more about how to turn these off (or rather, at least pause them) when they’re misfiring and/or just plain not convenient, here:

    The Off-Button For Your Brain

    While it’s generally considered good to process feelings instead of putting them aside, the fact is that sometimes we have to hold it together while we do something, such that we can later have an emotional breakdown at a convenient time and place, instead of the supermarket or bank or office or airport or while entertaining houseguests or… etc.

    Today, though, we’re not putting things aside, for the most part (though we will get to that too).

    We’ll be dealing with shame, which is closely linked to the guilt we mentioned in that list there.

    See also: Reconsidering the Differences Between Shame and Guilt

    Shame’s purpose

    Shame’s purpose is to help us (as a community) avoid anti-social behavior for which we might be shamed, and thus exiled from the in-group. It helps us all function better together, which is how we thrive as a species.

    Shame, therefore, is often assumed to be something we can (and possibly should) use to ensure that we (ourselves and/or others) “do the right thing”.

    But there’s a catch…

    Shame only works negatively

    You may be thinking “well duh, it’s a negative emotion”, but this isn’t about negativity in the subjective sense, but rather, positive vs negative motivation:

    • Positive motivation: motivation that encourages us to do a given thing
    • Negative motivation: motivation that encourages us to specifically not do a given thing

    Shame is only useful as a negative motivation, i.e., encouraging us to specifically not do a given thing.

    Examples:

    • You cannot (in any way that sticks, at least) shame somebody into doing more housework.
    • You can, however, shame somebody out of drinking and driving.

    This distinction matters a lot when it comes to how we are with our children, or with our employees (or those placed under us in a management structure), or with people who otherwise look to us as leaders.

    It also matters when it comes to how we are with ourselves.

    Here’s a paper about this, by the way, with assorted real-world examples:

    The negative side of motivation: the role of shame

    From those examples, we can see that attempts to shame someone (including oneself) into doing something positive will generally not only fail, they will actively backfire, and people (including oneself) will often perform worse than pre-shaming.

    Looking inwards: healthy vs unhealthy shame

    Alcoholics Anonymous and similar programs use a degree of pro-social shame to help members abstain from the the act being shamed.

    Rather than the unhelpful shame of exiling a person from a group for doing a shameful thing, however, they take an approach of laying out the shame for all to see, feeling the worst of it and moving past it, which many report as being quite freeing emotionally while still [negatively] motivational to not use the substance in question in the future (and similar for activity-based addictions/compulsions, such as gambling, for example).

    As such, if you are trying to avoid doing a thing, shame can be a useful motivator. So by all means, if it’s appropriate to your goals, tell your friends/family about how you are now quitting this or that (be it an addiction, or just something generally unhealthy that you’d like to strike off your regular consumption/activity list).

    You will still be tempted! But the knowledge of the shame you would feel as a result will help keep you from straying into that temptation.

    If you are trying to do a thing, however, (even something thought of in a negative frame, such as “lose weight”), then shame is not helpful and you will do best to set it aside.

    You can shame yourself out of drinking sodas (if that’s your plan), but you can’t shame yourself into eating healthy meals. And even if your plan is just shaming yourself out of eating unhealthy food… Without a clear active positive replacement to focus on instead, all you’ll do there is give yourself an eating disorder. You’ll eat nothing when people are looking, and then either a) also eat next to nothing in private or else b) binge in secret, and feel terrible about yourself, neither of which are any good for you whatsoever.

    Similarly, you can shame yourself out of bed, but you can’t shame yourself into the gym:

    Is there positive in the negative? Understanding the role of guilt and shame in physical activity self-regulation

    Let it go

    There are some cases, especially those where shame has a large crossover with guilt, that it serves no purpose whatsoever, and is best processed and then put aside.

    For example, if you did something that you are ashamed of many years ago, and/or feel guilty about something that you did many years ago, but this is not an ongoing thing for you (i.e., it was a one-off bad decision, or a bad habit that have now long since dropped), then feeling shame and/or guilt about that does not benefit you or anyone else.

    As to how to process it and put it aside, if your thing harmed someone else, you could see if there’s a way to try to make amends (even if without confessing ill, such as by acting anonymously to benefit the person/group you harmed).

    And then, forgive yourself. Regardless of whether you feel like you deserve it. Make the useful choice, that better benefits you, and by extension those around you.

    If you are religious, you may find that of help here too. We’re a health science publication not a theological one, but for example: Buddhism preaches compassion including for oneself. Judaism preaches atonement. Christianity, absolution. For Islam, mercy is one of the holiest ideals of the religion, along with forgiveness. So while religion isn’t everyone’s thing, for those for whom it is, it can be an asset in this regard.

    For a more worldly approach:

    To Err Is Human; To Forgive, Healthy (Here’s How To Do It) ← this goes for when the forgiveness in question is for yourself, too—and we do write about that there (and how)!

    Take care!

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    This one’s not a clinical book, and the author is not a clinician. However, it’s not just a personal account, either. Kat Brown is an award-winning journalist (with ADHD) and has approached this journalistically.

    Not just in terms of investigative journalism, either. Rather, also with her knowledge and understanding of the industry, doing for us some meta-journalism and explaining why the press have gone for many misleading headlines.

    Which in this case means for example it’s not newsworthy to say that people have gone undiagnosed and untreated for years and that many continue to go unseen; we know this also about such things as endometriosis, adenomyosis, and PCOS. But some more reactionary headlines will always get attention, e.g. “look at these malingering attention-seekers”.

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  • Hemp Seeds vs Flax Seeds – Which is Healthier?

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  • Eat Real Food and Love It – by Kari McCloskey

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    Half the battle of healthy eating is enjoying it—because once you do, it’s no longer a battle!

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