More on Attention Deficit Disorder, modern society, and neuroscience
Dr. Friedman (New York Times, October 31, 2014, “A Natural Fix for A.D.H.D“) wrote an interesting article about Attention Deficit Hyperactivity Disorder (A.D.H.D) and how it’s neurological basis, as we currently understand it, collides with modern life.
Why is ADHD the most prevalent psychiatric condition diagnosed in youngsters today? Recent studies show that it affects 11% of children. Many wonder whether this is really a disease after all.
In our practice at the Behavioral Health department of The Everett Clinic we see scores of adults who wonder if they suffer from ADHD. Is that why they have so much trouble with planning and organization? Do they have undiagnosed ADHD? Is there a medication that might help them pay better attention? The diagnosis of ADHD in adults has way more gray than black and white.
The ever-developing field of neuroscience suggests that individuals with ADHD are “hard wired for novelty-seeking—a trait that had, until relatively recently, a distinct evolutionary advantage”. To some degree, kids and adults with ADHD have brains that don’t work very well when they have to perform low interest, low satisfaction tasks. Of course everyone has to use more mental energy to do boring stuff. (Is this why all teenage boys hate to bring out the garbage?). But for folks with ADHD, performing these tasks is like swimming through molasses.
Some research has found that individuals with ADHD have fewer dopamine receptors in their brains. Perhaps these individuals have “sluggish reward circuits which makes normally interesting activities seem dull…or painfully boring” suggests Dr. Friedman. Medications like Ritalin or Adderall increase the amount of dopamine in the brain.
As hunter-gatherers, human beings would benefit from genes which would make them able to respond to new situations and find new solutions in a dynamic eco-system. These individuals would probably have more to eat than individuals whose brains were less active and restless. But with the development of agriculture and farming, those with high-octane brains would have more difficulty in this more sedate and predictable environment. This is an interesting idea.
Still, Dr. Friedman wonders why, according to the CDC, that there has been a 41% increase in the diagnosis of ADHD from 2003 to 2011? A whopping 6.1% of kids were taking some kind of ADHD medicine in 2011. And what’s even more alarming, over 10,000 toddlers at ages 2 and 3 are on these drugs.
One explanation may be the contrast between the predictable and disciplined school environment and the highly stimulating digital world that we now live in. Children’s lives are filled with shoot-um-up fast action video games, mile a minute tweets, instant communication, streaming and steaming video and hundreds of text messages a day. It’s a world of instant gratification–highly rewarding and stimulating. Perhaps it makes our work a day world appear boring and dull. How can math homework compete with “World of War Craft” or texts from scores of friends, sitting at their desks at home, also bored stiff with homework?
When I was a kid, all I had was a black and white television with “Dennis the Menace” and a rotary phone. In my day (when dinosaurs roamed), phone calls were actually pricey. So my friends and I shot hoops, played Ping-Pong, and spent hours playing Monopoly. I don’t remember being bored. But then again, I didn’t have ADHD.
One solution, says Dr. Friedman, is to make school more exciting, more stimulating, and more gratifying with smaller classes. Transform education to fit into our emerging culture, with its high-speed technology. Employ a more hands on approach. Perhaps many of these children with high-speed brains will cope better.