is ADHD a mental illness ?

a thread

ADHD is a neurodevelopmental disorder - people with it are born with it and it cannot be altered because it's part of their brain structure and is seen on brain scans. ADHD is also linked to premature births and hypothyroidism during pregnancy, among other things
from the WHO website: "neurodevelopmental disorders are disabilities in the functioning of the brain that can affect behaviour, memory and/or ability to learn."

neurodevelopmental disorders are not caused by external/environmental factors. you cannot *develop* these conditions
mental illness is a general term for a health problem that significantly affects how someone feels/thinks/behaves. mental illnesses cause suffering to those who experience them, as well as often their loved ones. ADHD does not directly cause suffering.
neurodevelopmental disorders are not mental illnesses. ADHD however, does make it more likely for a person to experience mental illness. ADHD can cause dysfunction and stress, but more often than not this comes from lack of accommodation rather than the symptoms themselves.
my ADHD does not cause me distress by itself, misunderstanding and ignorance in the general population is what causes the distress.

my depression does cause distress by itself. there is often no trigger or cause but i can find myself bed bound for days because of my symptoms.
it's very common to be mentally ill *and* have ADHD, and ADHD can be a challenge, but having ADHD alone does not make one mentally unwell.

growing up with ADHD can be traumatising, which again increases the likelihood of mental illness but it is not always the case.
basically, ADHD comes with a bunch of symptoms that can be difficult to manage and can make us vulnerable to low self esteem and increase our chances of becoming unwell - some people take medication to manage their symptoms which in turn helps to prevent us becoming mentally ill
the argument that taking medication means you're unwell is reductive and harmful - people take medication for all kinds of reasons (often to *prevent* them becoming unwell) and it is no one's place to ask about motivations behind taking medication and what medication they're on.
my executive functioning is really bad today so i'm gonna try and wrap this up

ADHD is hard. we often have to work twice as hard for half the work, but it is not a mental illness. not having the right accommodations and management can very quickly cause us to become mentally ill
i hope this makes sense. simply put, to have ADHD is to have a different brain structure. we are only disabled or ill in the sense that our society does not make room for us & we have to adapt accordingly or mask our symptoms & risk burning ourselves out or making ourselves ill
i know this might not be that coherent and if anyone has anything they'd like to add to help it make sense it would be really appreciated :)
forgot to add also that mental illnesses are caused by genetics as well as environmental factors - for example, no one is born depressed. you can be genetically vulnerable to depression but something in your environment must trigger it to develop. this is not the case for ADHD.

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Why do B12 and folate deficiencies lead to HUGE red blood cells?

And, if the issue is DNA synthesis, why are red blood cells (which don't have DNA) the key cell line affected?

For answers, we'll have to go back a few billion years.


2/
RNA came first. Then, ~3-4 billion years ago, DNA emerged.

Among their differences:
🔹RNA contains uracil
🔹DNA contains thymine

But why does DNA contains thymine (T) instead of uracil (U)?

https://t.co/XlxT6cLLXg


3/
🔑Cytosine (C) can undergo spontaneous deamination to uracil (U).

In the RNA world, this meant that U could appear intensionally or unintentionally. This is clearly problematic. How can you repair RNA when you can't tell if something is an error?

https://t.co/bIZGviHBUc


4/
DNA's use of T instead of U means that spontaneous C → U deamination can be corrected without worry that an intentional U is being removed.

DNA requires greater stability than RNA so the transition to a thymine-based structure was beneficial.

https://t.co/bIZGviHBUc


5/
Let's return to megaloblastic anemia secondary to B12 or folate deficiency.

When either is severely deficient deoxythymidine monophosphate (dTMP*) production is hindered. With less dTMP, DNA synthesis is abnormal.

[*Note: thymine is the base in dTMP]

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Why can cefepime cause neurological toxicity?

And why is renal failure the main risk factor for this complication?

The answer requires us to learn about cefepime's structure and why it unexpectedly binds to a certain CNS receptor.

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2/
Let's establish a few facts about cefepime:

🔺4th generation cephalosporin antibiotic
🔺Excretion = exclusively in the urine (mostly as unchanged drug)
🔺Readily crosses the blood-brain barrier (so it easily accesses the brain)

https://t.co/rjYG1BfGPR


3/
The first report of cefepime neurotoxicity was in 1999.

A patient w/ renal failure received high doses of cefepime and then developed encephalopathy, tremors, myoclonic jerks, and tonic-clonic seizures.

✅All symptoms resolved after hemodialysis.

https://t.co/u7JLVitQpp


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Cefepime neurotoxicity is surprisingly common, occurring in up to 15% of treated critically ill patients (w/ symptoms varying from encephalopathy to seizures).

💡The main risk factors = renal failure and lack of dose adjustment for renal function.

https://t.co/nxbnzSq8AR


5/
What about cefepime induces neurotoxicity?

One clue is that it's not the only antibiotic that causes neurotoxicity, particularly seizures.

This actually is a class effect w/ other beta-lactam antibiotics (including penicillins and carbapenems).

https://t.co/Lf4BhON9IY

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