ADHD meds and diving

[DocVikingo]

Perhaps I'm not seeing the trees through the forest, but I'm having trouble finding direct or meaningful responses to most of the rather specific comments & questions that I posed.

When you get a chance could you please sift through, condense & then array your replies to my comments and questions according to the 1-5 item format in which I posed them?

Thanks,

DocVikingo

PS: Your bashing of the APA based on very incomplete knowledge does no more to advance this discussion than would my bashing the ABA or telling lawyer jokes. Can we please conduct the discussion with focus, respect & professionalism?

 

[DocVikingo]

Please excuse my apparent denseness this morning. Perhaps I'm short on caffeine or something.

The initial inquiry in this thread by Ber Rabbit concerned "... the consensus on someone with ADHD (don't know what type) taking Dexadrine (spelling error possible here) and diving? Person also takes Zoloft for anti-social behavior (extreme shyness)."

In your response, you indicate that you have a diagnosis(es) other than either of these, and are not taking an amphetamine-like drug, but rather one used to treat depression.

What is it that you would like to have Ber Babbit & the rest of us learn from your post?

Thanks,

DocVikingo

 

[diverbrian]

Please excuse my apparent denseness this morning. Perhaps I'm short on caffeine or something.

The initial inquiry in this thread by Ber Rabbit concerned "... the consensus on someone with ADHD (don't know what type) taking Dexadrine (spelling error possible here) and diving? Person also takes Zoloft for anti-social behavior (extreme shyness)."

In your response, you indicate that you have a diagnosis(es) other than either of these, and are not taking an amphetamine-like drug, but rather one used to treat depression.

What is it that you would like to have Ber Babbit & the rest of us learn from your post?

Thanks,

DocVikingo

I will PM you with more details. I just wanted to say that having read the information that you listed on Attention Deficit Disorder, that sometimes it can be misdiagnosed. I have a brother with Autism. It took God knows how many diagnoses to get it right and I think that the psychologists went though all of the non-drug related ones to finally get it right as he is very high-functioning and that is a strange disorder to begin with.

I just find it odd that all of these behaviors can be classified just like that. There is more to it and many of the questions that should be asked are environmental.

I believe that considering that meds that this student was taking, that Ber made the correct decision, and that she was advised accordingly. I was just trying to say that there is more than one side (or two) to most things that "easy" classifications often fail us.

 

[Genesis]

The truth is what it is Greg.

Witness the laws now on the books in several states that explicitly prohibit school personnel from attempting to pressure parents into having their kids put on psychotropic medication for this claimed "disorder".

The truth is that was exactly what was going on - teachers were effectively forcing parents to find a "complient" physician to write the script, which was often done on nothing more than the teacher's recommendation. It got bad enough that in many school districts 30% or more of all boys in certain classrooms were on Ritalin or similar drugs. These teachers were basically acting as medical doctors and, for all intents and purposes, writing scripts for powerful, mind-altering pharmaceuticals.

Think about it - 30%. Three in 10 kids have a biochemical imbalance serious enough that we need to tamper with their brain chemistry? Really?

Where's the evidence for that?

Its non-existant - that's where.

Never mind that there is strong evidence that amphetamine-derivitives create permanent biochemical changes that make it extremely difficult to come "clean" from them in the future. This is one of the reasons that methamphetamine addictions are so damnedly difficult to break - the craving never goes away, because the brain chemistry changes are permanent. That these changes are caused in animals we know conclusively. The evidence for this in humans, at least among former amphetamine abusers, is extremely strong. From a simple analysis of the similaries of the compounds, it is perfectly reasonable to assume that this will show up in Ritalin-prescribed youths down the road. We do not know - yet - whether this overprescription of these drugs is going to cause a lot of little Johnny's to be predisposed to abuse methamphetamines and their cousins later in life - but I wouldn't bet against it. (Never mind that Ritalin and its cousins are already favored black-market drugs of abuse in our schools - yes, Johnny does sometimes sell his pills instead of taking them, and yes, they can be bought in most schools nowdays! It seems they provide quite a nice "buzz", if word on the street is to be believed.)

As for Doc's request, its a bit late right now. I think I've already laid it all out, but will go back through it in the AM and see if I can clarify any of it.

I have little respect for a lot of this area of so-called "medicine", if you can't tell. Like I said, if I was a kid now, I'm absolutely certain that I'd be drugged up the wazoo with these substances - and yet the exact psychological components in my personality that would guarantee this are a huge part of why I was able to find the success that I did find in my life. If those parts of me had been destroyed by permanent brain chemistry changes in my youth, IMHO I'd have every reason to consider the people responsible - each and every one of them - felonious child abusers or worse. As others have pointed out in this thread, a huge part of the situation at hand with these kids is environmental and not a chemical imbalance. I can tell you with certainty that my for my nephew this was the case, because I saw it with my own eyes and I am intimately aware of exactly what influences and situations arose in his life. I cannot speak to all, of course, but I can speak to what was done in his case - and it was truly expediency over actually addressing the issues. See, solving home environmental problems is hard (and sometimes impossible, if the adults involved won't do anything about it) while prescribing a pill and turning Johnny into a zombie is easy (and profitable) - for everyone involved.

 

[diverbrian]

The truth is what it is Greg.

Witness the laws now on the books in several states that explicitly prohibit school personnel from attempting to pressure parents into having their kids put on psychotropic medication for this claimed "disorder".

The truth is that was exactly what was going on - teachers were effectively forcing parents to find a "complient" physician to write the script, which was often done on nothing more than the teacher's recommendation. It got bad enough that in many school districts 30% or more of all boys in certain classrooms were on Ritalin or similar drugs.

Think about it - 30%. Three in 10 kids have a biochemical imbalance serious enough that we need to tamper with their brain chemistry? Really?

Where's the evidence for that?

Its non-existant - that's where.

Genesis, I was somewhat guilty of this early on and Doc V. rightly called me on it.

What does your current post have to do with diving and meds? You can PM me about this for my opinion and find me in *some* agreement with you, but it is NOT important to this topic or this thread. Are these young boys diving?

Also, where is your degree in psychology or medicine? I don't have one either! Please, let the doctors in this thread do their jobs. They have given good advice to the situation at hand. If you want to make a political statement about what is the truth or not, it may be appropriate to find another forum for that!

The best way to second guess a doctor is to get a second opinion from another doctor. This is true of most other professions. I am sure that you wouldn't much appreciate it if an MD tried telling you how to set up a computer network. If you want to drag off topic, I would recommend another place besides the medical forums.

 

[Genesis]

Its flat-out irresponsible to condemn someone for diving based on a claim of "ADHD/ADD" without knowing whether they are or are not truly suffering from something that makes them unsafe.

That someone has labelled them does not meet that test - even if the person doing the labelling has a few letters after their name.

THAT is my point.

There is a separate issue related to the safety of the drugs under pressure - and I've already said that I agree with this.

However, this kind of thing is NOT the same deal as someone asking about a heart condition, or emphysema, or any particular physical malady.

The issue here in terms of psychological fitness is really, IMHO, quite simple - is the person focused enough in their life to be able to safely dive.

I understand that perhaps 'Doc may think I'm overboard with some of this, and so may a few others. However, as I've pointed out, this PARTICULAR issue is one that is near and dear to me, both due to the incredible abuse that a nephew of mine suffered as a direct consequence of being so labelled and forcibly drugged through his entire childhood, as well as literally hundreds of others who I have spoken with (most parents, but some who were kids/adolescents at the time, and are now grown) on the issue, and the evolution of thought that I have witnessed on this claimed disorder.

This particular issue has made the mainstream press, it has prompted legislation in many states, and it is by no means a settled matter that this claimed "disorder" is anywhere near as prevalent - nor as "real" - as many have claimed. As an activist in this area who has done a LOT of study of the so-called "statistics" and claims of those who have built an entire industry around prescribing these drugs, I find the science hair-thin and the claims overblown - and that's being polite.

As such to disqualify someone from diving based on a "diagnosis" of ADD/ADHD is breathtakingly suspect.

IMO, of course, and your opinion (and others) may vary.

I've said my peace - those who disagree are free to say theirs; they're welcome to the "last word"

 

[Pharmgirl]

Wow, did I open a can of worms or WHAT? I was replying to a post from Oct. 2002 and this happens! (Sorry, I am brand new and didn't know what to expect.)

Anyway, I appreciate those who contributed to giving me helpful answers (thanks, Jersey!) It definitely gives me a good list of question to discuss with my doc prior to my May dive trip.

One brief, non-SCUBA related comment: I JUST read a book called "Driven to Distraction" by an MD with ADD (Dr. Edward Hallowell). I found it to be extremely informative, and it had loads of outside references. (Even about early ADD studies from 1902. It just hadn't been given a name yet!) It's a great source for learning more on the topic, written in a organized, well-informed manor. I would expect even those who didn't "believe" in this condition would be very interested on what the "other side" has to say. This may be a great place to start. Sometimes being fully informed can be an unbelievable eye-opener!

Thanks everyone! :54:

 

[miguel sanz]

Woauh! what a thread.
I´m a doctor, but not a psychiatrist. I agree with many of Genesis arguments, although probably not as radical. I don´t say this disorder doesn´t exist, but it has probably been overdiagnosed and probably not approached correctly, genesis told some of the reasons: industry need to sell, teacher and parents wanting to calm down the kids the easy way, of course it´s more difficult to change the social enviroment that promotes mental disorders (also anxiety, some depressions...).
Well, i don´t want to get back to all that has been said. My points are: doctors are not gods, nor doctor´s books are bibles. There are many psychiatrist than don´t agree with the mainstream psychiatry. And you don´t kneed to be a doctor to be an expert on some medical topic .
Salud y locura.

 

[fins wake]

Its flat-out irresponsible to condemn someone for diving based on a claim of "ADHD/ADD" without knowing whether they are or are not truly suffering from something that makes them unsafe. That someone has labelled them does not meet that test - even if the person doing the labelling has a few letters after their name. THAT is my point. [snipped] The issue here in terms of psychological fitness is really, IMHO, quite simple - is the person focused enough in their life to be able to safely dive.

This is a contentious subject, and the thread has also swamped beyond the original topic, so I'll try to focus only on the above point.

While not being a physician myself, I have in a previous capacity worked extensively with children diagnosed with ADD/ADHD, and I'm very familiar with the effects of ritalin on these children. (Which incidentally is very different to that of ritalin on non-ADD/ADHD people.)

Although I agree there is some merit to Genesis' argument that ADD/AHDH is a bit of an "encompass-everything" classification (at least for the kids I worked with and depending on whom originally diagnosed them), I would say that my personal tuppence in the main are solidly on ScubaDoc's and DocVikingo's arguments. I would urge people to re-read ScubaDoc's first reply from 2002 (the Quigley memorandum, nice title ) and also DocVikingo's 2nd post in this thread.

In short, although there might well be the odd 'wrongly-diagnosed' individual out there, or plenty of properly-diagnosed individuals who may be able to safely scuba dive, there are certainly plenty of properly-diagnosed individuals who would not!

I think the concensus is pretty clear.

 

[diverbrian]

In short, although there might well be the odd 'wrongly-diagnosed' individual out there, or plenty of properly-diagnosed individuals who may be able to safely scuba dive, there are certainly plenty of properly-diagnosed individuals who would not!

Many people with no medical conditions whatsoever that should not be diving either. That is a separate issue, LOL.

As I said, I have nothing but respect for the psychologists and neurologists who worked with my brother. Knowing what I know now (and even knew then), there are some diagnoses that are just plain difficult to make. Some symptoms hide other symptoms that may be more important to see. It takes time to see these things.

Another example is that you didn't hear about high cancer rates several years ago. Why would that be? Because the average life span wasn't long enough to run into that problem and the internal diagnostic procedures were too primative. Many doctors concluded that it was something else. Many of the mental disorders that we rail about now have most likely been around since the beginning of time. There are rumors that many of our great inventors/teachers/scientists (ie. Albert Einstein) actually had some form of undiagnosed learning disability.

The primary issue in this thread in my mind is still the meds and being able to dive. That is still for a physician to determine and not most of us. There are plenty of people that don't pay careful enough attention to detail to be safe divers. That doesn't mean that they have a mental defect. I still focus far better underwater than I do driving a car. I will freely admit that there are safer drivers than I. But I am safe enough to put thousands of miles on a car in a year.

In that same vein, there a couple of people that I have read about in this thread that have to force themselves to pay attention to what they (or their spouses) are doing. This doesn't make them unable to dive unless the meds preclude it. Again, that is up to a doctor, not me.