Falling Out of Focus: What Science Says About ADHD



So Is It Real?

A lot of people simply dismiss the complications of ADHD as, “These kids today.” Such thinking has us believe that it’s not any disorder that’s the problem, but that it’s our lax moral standards that cause kids to not do their homework, or to talk out of turn. Surprisingly, ADHD isn’t all that new, with psychological literature describing its symptoms dating back to the late 19th century — making the disorder nearly as old as psychology itself. While no cure is known, researchers are somewhat more confident in understanding some of the root causes, with genetics playing a crucial role.

An array of studies among identical twins suggest heredity as a primary cause of ADHD. In one Australian study of nearly 2,000 families with twins and siblings, the concordance rate of ADHD in identical twins was 82 percent, compared with 38 percent in nonidentical twins. Children diagnosed with ADHD also suggest a 5 percent risk that someone in their family will get the disorder in the future, or that a parent or other close relative also suffers from it.

While there is no single cause, the dopamine-active transporter-1 (the primary regulator of dopamine neurotransmission) and dopamine receptor D4 (associated with disorders like Parkinson’s and schizophrenia) are strongly linked to ADHD, perhaps responsible for up to 80 percent of cases. These transmitters are responsible for carrying dopamine — a chemical involved in the brain’s reward circuitry, helping it to recall pleasurable experiences. A failed mutation in the DRD4 replication could cause a number of behavioral changes — among them, are the hyperactivity and impulsiveness associated with ADHD.

There are environmental factors that may play a role in ADHD, too — lead painting can impact a child’s brain in a negative way during the first three years of life, resulting in ADHD among other complications. Smoking during pregnancy can also negatively impact the central nervous system, increasing the risk of ADHD in an unborn child, as does fetal alcohol syndrome. Nearly 30 percent of children who experience traumatic brain injuries, such as seizures, have been known to show signs of ADHD as well.

While food allergies were an early suspect in the cause of ADHD, no link has been established. Nor, for that matter, is there a correlation between ADHD and watching too much television, or electronic media, as a host of studies have roundly refuted. In fact, our more primitive ancestors may have been more responsible for the prevalence of ADHD today than anything else, as natural selection favors a few of its traits.

Where We Go From Here

Our more-impulsive ancestors probably found mates much more easily than the less aggressive hominids, passing down phenotypes that don’t work out so well in a modern-day office. As the earliest humans migrated across the ever-changing landscapes of Africa in search of food, the constant drive associated with ADHD may have helped with endurance and hunting, as would faster reaction times that made our ancestors ideal predators. Because a number of genes have been associated with the disorder, ADHD actually thrives where there’s gene flow in a large population.

In just a short span of human evolution — as we formed tribes, societies, states, and eventually online social networks — our brains have grown considerably. If anything, it’s proven the human brain to be capable of rapid change — neuroplasticity. In addition to the medications available today to treat ADHD, there is also the growing popularity of cognitive behavioral therapy, which has been used historically to treat obsessive-compulsive disorder and depression. Since many adults who also suffer from ADHD show symptoms of depression, cognitive behavioral therapy techniques not designed specifically for ADHD can also work well in these cases, as they require patients to draw out their negative thoughts — thoughts that develop in response to actions and how we see the world around us — and work on refuting them.

While cognitive behavioral therapy does not negate the use of stimulants to treat ADHD, it allows patients who suffer from it to control the environment around them in better ways — such as designing a planner or filing system to better manage their day-to-day lives, allowing them to plan for both the long and short term. While the world around us may have enabled ADHD to thrive and spread, perhaps we can curb it by making the world a better place.

This article is updated from its initial publication in Brain World Magazine.

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