Review: The Age of Diagnosis

 The Age of Diagnosis is written by a neurologist/psychologist.  It starts with a discussion of Huntington's disease, which is a genetic disease with no known cure, and goes through case study after case study as to why even though there's a non invasive definitive test, people don't get diagnosed for it. Apparently, people show up at her office thinking that taking the test is the responsible thing but looking for permission to not test.

Then she launches into discussions of much more controversial topics, especially topics like autism, which has had increasingly broad ranging diagnostic criteria, to the point where almost anyone could self-diagnose as being on the spectrum. The author is british, and when she spells out the criteria for getting a diagnosis (one thing I learned in this book is that self diagnostic tests are not accurate, and as many as 50% of people who self-diganose are mistakenly thinking that they're on the spectrum when they're actually not!), I'm astonished that the rates of autism have been going up so much. And then she reveals that a lot of the increase in diagnostics come from a small number of physician groups who have an incentive to diagnose more people as being autistic! Even worse than that, the highest functioning autistic folks presume to speak for everyone on the autism spectrum, and of course, the ones most afflicted with autism have a hard time even getting dressed, let alone speak up for their positions, which leads to huge amounts of conflict both within and without the medical and patient communities. (She doesn't mention the elephant in the room, which is that by writing the criteria for autism so broadly, the medical community has inadvertently armed the anti-vaccine folks, who're using the increased number of diagnosis to turn public opinion against vaccines!)

There's a bunch of other diseases discussed in the book, including breast and ovarian cancers (certain genetic mutations vastly increase your chance of getting both, and one way to protect yourself against those cancers is to have those organs removed, but then you have to trade that off against when to have the procedure because you want to maintain maximum optionality for having offspring), down syndrome (testing there has sufficient false positives to make the decision a hard one), long covid, lyme disease, and probably one or more items that I've forgotten about because I read this book in paper format and not on the kindle.

The book ends with a discussion of pyschiatric syndromes and psycho somatic disorders (which the author takes pains to note that a psychosomatic disability is just as real and painful to live with as one with physical manifestations). One of her concerns is that the diagnosis of having one of those boxes you in, and if you believe in that diagnosis enough, it becomes an excuse to not work on getting better in those areas. You start to believe in that instead of your own ability to induce positive changes in yourself!

The book left me quite a lot to think about even though it's short and easily finished in a handful of hours. Definitely worth your time.