[LMB] We've been discussing gene engineering on people...

Beatrice Otter beatrice_otter at zoho.com
Mon Oct 14 08:18:40 BST 2019

---- On Sat, 12 Oct 2019 12:01:54 -0700 Matthew George <mailto:matt.msg at gmail.com> wrote ----

On Fri, Oct 11, 2019 at 8:03 PM Jelbelser <mailto:jelbelser at comcast.net> wrote:
> Properly prescribed ADHD meds don’t change a person’s personality; they
> merely allow a person to achieve more of their goals.

Two points:

First, demonstrate the difference between someone with that diagnosis
achieving more on drugs, and a 'normal' person achieving more on drugs.

Second, they achieve more of their goals because their behavior and
thinking have been altered.  What precisely excludes those things from
'personality' in your mind?

Beatrice Otter:
I don't have ADD/ADHD, but I am autistic, and executive function is a core problem area in autism.  Executive function is the central issue of ADD/ADHD; basically, the part of your brain that's supposed to be the CEO and govern how much/how little attention should be given to any one task or stimuli or memory or whatever.  It's a lot more complicated than that, but that's the layman's version. (here are two more in-depth explanations if you are interested: https://www.understood.org/~/media/images/categorized/ebooks/executivefunction101ebook.pdf and https://musingsofanaspie.com/executive-function-series/)  Basically, ADD/ADHD is when your brain has poor executive function but everything else is neurotypical; autism is when you have poor executive function plus several other areas where your brain differs from standard.  So while I don't have ADD, I can tell you a bit about what executive dysfunction is like and why medication can make such a huge difference (and why ADD meds DON'T work for people who don't have executive function problems).

The thing about executive dysfunction is that it doesn't matter how much you WANT to be able to do something or stop doing it.  The core nature of the problem is that things that other people CAN consciously control, at least to a certain extent, a person with executive dysfunction CAN'T consciously control, or can't control anywhere near as much.  This sometimes manifests as being unable to focus; it sometimes manifests as being hyperfocused.  If you can channel that hyperfocus productively, that's awesome! ... if you can't, that SUCKS.  For example!  I regularly sit down to a task, and then can't SWITCH tasks even when I want to or need to.  I get a lot done ... but can't get up and go make myself lunch when I'm hungry because even though the food is only in the next room, I can't make myself stop what I'm doing.  When I was a teenager, I would regularly be home on Saturday by myself while my parents were at work.  And I would regularly pass out from low blood sugar because I wouldn't eat.  Not because of an eating disorder, but just because I couldn't actually make myself stop what I was doing, get up, go into the kitchen, make food, and eat it.  I could sometimes get myself as far as the kitchen, but then I would become overwhelmed with choices and how complicated it would be to prepare food, and give up.  (Decision making also requires executive function.)  My parents thought that their perfectly competent, straight-A student daughter who regularly cooked dinner for the family would be able to feed herself if left alone for eight hours in a house with a fully stocked kitchen, but that was not, as it turned out, actually the case.  I still struggle with feeding myself when I'm living alone.  If I'm living with someone who shares the food prep duties and will tell me what to make and when to make it and what to get at the grocery store (in other words, to take over much of the executive function duties), it's not a problem.  By myself ... it's hard.

Then there are all the things I can't remember to do no matter how hard I try.  I forget things very easily.  There are times when I can't focus on anything, even things which I love doing and which are vitally important to me.  I have many times broken down in tears because I want to do something that I am capable of doing and would very easily be able to do ... if I could just focus a little bit.

What executive function meds do is stimulate the part of the brain that handles executive function so that it starts working better.  But if the part of your brain that handles executive function is already working correctly, then what happens is that you get OVERstimulated and jittery.  So, basically, if stimulants make you wired, you do not have executive dysfunction.  If stimulants make you able both to concentrate and switch concentration at will, you have executive dysfunction.

Or, to put it another way: someone without executive dysfunction could complete X task without any stimulants.  All a stimulant would do is allow them to do it when they would otherwise be too tired.  For someone WITH executive dysfunction, stimulants/medication are the difference between being able to do it and not being able to do it, period.

Regarding your second point, we have all kinds of tools for people to change their behavior and thinking.  That's what psychiatry and psychology ARE.  They are very powerful tools, and can be used for good or evil.  They can do wonderful things and horrifying things.  I believe the balance of control should be in the people who have a condition figuring out what works for them and is beneficial to them.  This is why I firmly support proper, consensual use of psych meds, but want strict controls on prenatal genetic modifications.  An adult can decide what's right for them, and even a child can give an opinion on a medication or course of treatment.  A fetus can't.

Beatrice Otter

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