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Dr Kirk Honda and Bob rant about the DSM and answer patron emails.


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The Psychology In Seattle Podcast ®


Trigger Warning: This episode may include topics such as assault, trauma, and discrimination. If necessary, listeners are encouraged to refrain from listening and care for their safety and well-being.


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Anonymous

The dsm rant starts at 40:15 fyi.

Anonymous

I am B E G G I N G you, Kirk, to please stop saying "autism/adhd is thrown around too much." It absolutely is not. It is tragically underdiagnosed, particularly in women and femme presenting people and among people of color. All you are doing by saying this is vindicating the ableist shit heels who claim that people who identify as autistic but haven't yet received a formal diagnosis, or cannot because of accessibility issues that come with the process of formal diagnosis, are just "trying to be unique/special" and are "fakers" and that autism is this super rare, unicorn thing. It. Is. Not. And your chronic insistence that it's "thrown around too much", particularly while refusing to say anything further on the matter because you paradoxically say you "know enough about it to know you know nothing about it" (??? So you know enough about it to routinely dismiss the people who diagnose us, but not enough to talk about it on the podcast in any other way??? Nice), is actively harmful to us. Please, I am begging you, PLEASE stop this.

SeattleTransAndNonbinary ChoralEnsemble

I agree that autism in particular is not overdiagnosed or frequently misdiagnosed, if anything it’s underdiagnosed especially in AFAB individuals as you noted. and I wouldn’t say adhd is over diagnosed either nor that more than a fraction of people are misdiagnosed with it. However ADHD is for sure overmedicated, and is often treated (at least in the USA and Canada) by general practice physicians who throw Ritalin and adderall at the problem without even informing the patient that there are options involving cognitive behavioral therapy. Sometimes these kids or their parents don’t really want to take meds but acquiesce and realize they can finally do enough homework to pass classes and stay a little more organized. Many eventually find themselves college aged, starting to have major side effects and dependencies on these medications, which compensate for some of the symptoms but not others and are not safe for lifelong daily use, and find themselves without having developed any therapeutic strategies to deter behaviors associated with inattention or disruption, or that help them improve their executive function or time management, when they try to go off the meds. I was in this situation and it was pretty rough. That’s what I think most people who talk about ADHD being ‘overdiagnosed’ actually mean, and should be saying ‘overmedicated’, or better yet ‘undertherapized’ as an ideal plan for those without contraindications would usually involve medication - in modest doses no more than 5 days per week to avoid developing tolerance - as an adjunct to therapy’. As autism typically is treated in a psychosocial manner working with providers, school paraprofessionals, student and parents utilizing individualized learning plans and therapy (of a wide variety of styles) rather than medication or CBT, and more and more patients are realizing they have it and seeing a doctor rather than the other way around and feeling coerced into taking meds for a diagnosis they don’t identify with, it does not have this same problem.