As Dr. Perri Klass points out in her piece in the December 13 New York Times, scientists and physicians now widely recognize Attention Deficit Hyperactivity Disorder (ADHD) as a real brain disease. There is still a great deal of debate about the mechanisms in the brain that cause ADHD, but it's clear that the neurotransmitters, dopamine and noradrenaline are somehow involved. It is these two chemicals that are affected by stimulants like Ritalin that are effective in treating ADHD, and a great deal of research shows that these drugs have positive effects on the ability of children with ADHD to control and focus their behavior. Further, as Dr. Klass points out, there is strong evidence that ADHD has a substantial genetic component.
However, Dr. Klass gets it wrong when she argues against the idea that the modern device culture may be causing "cultural ADHD":
I've lately read a number of articles and essays that use attention (or its lack) as a marker and a metaphor for something larger in society -- for the multitasking, the electronic distractions, the sense that the nature of concentration may be changing, that people feel nibbled at, overscheduled, distracted, irritable. But ADHD is not a metaphor. It is not the restlessness and rambunctiousness that happen when grade schoolers are deprived of recess, or the distraction of socially minded teenagers in the Smartphone era. Nor is it the reason your colleagues check their email in meetings and even (spare me!) conversations.
This claim highlights a common confusion about biological disorders: Just because a disorder is biologically-based or genetically-influenced does not mean that other factors (such as behavior or the environment) cannot also cause the same problem. Take high cholesterol as an example. There are some people with a genetic disorder called familial hypercholesterolemia that causes their cholesterol levels to be very high, even if their dietary cholesterol intake is low. However, someone without this genetic disorder can also have high cholesterol simply by eating too much animal fat. The fact that high cholesterol can be caused either by genetics or behavior doesn't make it any less of a biological disorder, though it does affect how we go about treating it.
What about "cultural ADHD?" It's clear (at least to me) that the inability to focus that is being driven by the speed and richness of our informational environment bears at least some resemblance to the inattention that marks ADHD. For example, some of the diagnostic markers for ADHD in the DSM-IV (which is the guide that psychiatrists use to diagnose the disorder) include "often has trouble keeping attention on tasks," "often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period," and "is often easily distracted." Sound familiar?
In addition, there are reasons to believe that information overload also affects the same neurotransmitter systems that are dysfunctional in children with ADHD. Dopamine and noradrenaline are important for the prefrontal cortex to function properly, and it is this brain system that allows us to keep our behavior under control. Interestingly, there seems to be a "Goldilocks zone" for dopamine and noradrenaline; either too little or too much and our prefrontal cortex function goes south, leaving us disorganized, forgetful and unable to focus. It is thought that ADHD is related to too little of these transmitters in the prefrontal cortex, whereas too much of them can result from stress. This is why stress can leave us feeling frazzled, and why jitters during a public speech can cause one's mind to sometimes go completely blank. Research has not yet identified whether information overload affects dopamine and noradrenaline in the same way that stress does, but I think we will find that it does, given how similar the outcomes can be.
This argument in no way diminishes the importance of understanding and treating ADHD as a biological disorder. By realizing that there are many ways that humans can become inattentive and distractable, we can start to gain a better understanding of how we might change our behavior, our environment and our brains in order to optimize our ability to focus.
Dr. Harold Koplewicz: Why Are People So Divided When It Comes To Children's Mental Health?
Katherine Ellison: Can Nutrition Cure Distraction?
Jay P. Granat, Ph.D.: ADHD Treatment Through Sports
Dr. Harold Koplewicz: Stress: The Unwanted Holiday Gift for Kids
Attention Deficit Hyperactivity Disorder (ADHD): Symptoms & Types
Adult ADD / ADHD: Signs, Symptoms, Effects, and Treatment
Attention-deficit/hyperactivity disorder (ADHD): Symptoms ...
1. Inappropriate stimulation in early years, including, none, emotional neglect, exposure to fear, etc.
2. Lack of established social boundaries in early childhood.
3. Childhood: Lack of impact or control over immediate reality. Power only in mediated reality.
4. Continuous experience of cognitive dissonance: We are equal: do as you are told. Quiet!
Marla Rosner
Author: Digital Manners & House Rules:A Parent Handbook
Best,
Marla
http://beyondnetiquette.com/drawing-the-line-setting-digital-boundaries/
The reference to cultural ADHD is in the second paragraph.
Best,
Marla
Let's say part of my objection is based on this:
http://ritalinsideeffects.net/
We even posted a sign when there was to be quite in the house and there was to be NO argument about it or the quite time extended all week long.
Before long the kids got use to the quite and never ask if the 3 hours of quite was up and they often just read books till they fell asleep. Or actually got all their homework done and checked it over themselves.
We broke their addiction to noise.
Yes, if you make the house completely quiet, he can concentrate better and when he focuses, he can get his homework done - but the reality is, you can't control the rest of the world. Getting organized in school was a disaster. They gave him extra time for tests, but he didn't need the extra time for tests because the environment was quiet and controlled - it was the other 98% of the time. Also, the energy required to focus was huge and exhausting.
He is doing better now (25), but still does his meds to referee college hockey games, which can be very dangerous if you lose focus for even a split second.
Maybe something will help others.
I have seen several of my kids friends who were misdiagnosed, there was a Doctor here that was drugging every kid that came through his door.
Some of the parents wanted the drugs.
Turning off the noise was taught to us by a neurologist so we could regain control of the household.
(Including my 22 year old son)
People that don't have it think they know more about it than people who do?
I don't think so.
That mostly applies to teachers.
That especially applies to doctors.
Another, simple way to reduce hyperactivity... and it works almost every time... is to eleminate dairy products... yes, try it for a week or so, (instead of a drug) and see if it's not a factor.
ADHD is not "losing it." It's a failure of the executive functions of the brain that allows a person to make critical decisions, focus and other similar tasks. Without them, a person becomes impatient, easily distracted, less alert and impulsive.
It's not stimulation or over stimulation but an inability to adequately deal with that input.
1) ADHD is a label put on a wide range of symptoms (behaviours), The experts who apply this label do not agree on the type and range of symptoms that are necessary and sufficient to the disorder. Thus, it is a nonsense to speak of a "cause" before agreeing on what is being caused.
2) Those to whom the label is applied have had a wide range of experiential or environmental precursors: diet of the mother, child abuse, bed wetting, thumb sucking, bad parenting, over-use of social media, listening to hiphop, turning cartwheels in the schoolyard, etc, etc, etc
3) Some of those to whom the label is applied have innate differences from those who are not so labeled (genes, body chemistry, brain configuration, etc, etc, etc.)
4) No experiential or innate difference is both necessary (present in all those labeled) or sufficient (present in none who are label free).
But you are correct that ADHD is unique among other disabilities in that many people seem to think that it's okay to ridicule people afflicted with that disability. How many jokes are out there about diabetics or cancer patients? So on top of the struggle these people have in dealing with a lack of executive functions, they are also compelled to hide their disability.
Future humans may have multiple compound eyes (not unlike those of a fly) to detect all of this massive amount of streaming information
LOL
Who needs Ritalin?
So I put them to work around the farm and even bought a house to remodel.
They got lots of exercise and ways to take out their frustrations working.
All I really needed to do was get them busy and keep them loaded up with things that needed doing when they had free time.
All their friends love to come over and work too it makes them feel good to actually do some real work not just mowing a little yard.
I teach they how to wire a house, redo the plumbing, install flooring, cabinets, doors, sheet rock and all kinds of stuff . Just feed the guys lots of pizza and they can work.