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Monday, September 22, 2008

Switching On to Better Understand ADHD

Stated succinctly, ADHD or Attention Deficit Hyperactivity Disorder refers to problems with attention, with a need for a complicated and complex motor involvement that grabs the attention.

Our Culture

Our culture helps to bring out the disorder due to the type of frantic activity we seem to have more and more of such as television, continual distraction, noise, and our general lifestyle.

Biological Causes

John Ratey, M.D. was recently interviewed on one of the websites I highly recommend called Brain Science Podcast about this very controversial subject. He states that there are biological causes of ADHD and that they are genetically transmitted, that ADHD is a syndrome passed on by families and that if a parent has it, there is a 30% higher likelihood that the child will get it too.

ADHD & Addiction & the Reward Network

There is a strong relationship between ADHD and addiction due to a similarity in what is called the reward network or the addiction network in the brain, where a dopamine track runs from one end of the limbic system to the other. This has a pleasure button or reward center that is highly involved with dopamine.

People with ADHD or addiction problems have trouble - because they don't have enough motivation to sustain their attention in situations which are not highly charged, so they are seeking high intensity activity or situations.

With ADHD that is not treated in adolescence, at least twice as many individuals are seen that are prone to addiction problems as with those who were treated in adolescence.

This reward network is the reason there is such a high addiction rate in kids with ADHD for video games because these games offer a highly charged environment.

Concentrating on Video Games...and French Verbs

Other people tend to say in an almost moralizing fashion that these kids can concentrate (their concentration in video games is proof of the pudding) if they want to enough, and while it is true that they can, it is only true if they have a support structure of awareness of people who understand their brain and know how to help them manage it.

It is very different sitting in front of a creative and stimulating environment such as a video game as opposed to sitting in school learning French verbs. In the stimulating environment their is personal involvement and there tends to be life or death role playing. As Dr. Ratey puts it, when we are in survival mode, we tend to do very well with our attention, and people diagnosed with ADHD generally do very well in crisis situations. And of course, conjugating French verbs can not compete with that.

Our school environment is a sort of anti-evolution, as it is not geared to movement, survival, and so on, unless we make a game of what we need to do for school.

Reward Deficiency Syndrome

Ratey states that it has been suggested that ADHD should be re-named to something that is less judgmental such as the Reward Deficiency Syndrome which is a term that has already been used with some types of addiction that recognize a genedtic difference that codes for less dopamine-2 receptors so these individuals tend to search for high stimulation situations.

Hunter-Gatherers & ADHD

Interestingly, Ratey suggests that in hunting and gathering societies, the individuals with ADHD were probably the hunters. Their craving for survival stimulation probably made them the leaders.

Memory in ADHD

A key fact is that persons with ADHD have problems with their short-term, or working memory, partly because, as Ratey puts it, their frontal cortex is sleepy, it has to be jazzed all the time. That area of the brain is not lit up enough for school type activity, but jazzed when it needs to remember facts about a video game that puts the player into a creative environment or survival mode.

Procrastination

Another key problem is procrastination, mainly because people with ADHD absolutely forget what they are supposed to be doing. Even their motivation may be forgotten.

Structure

Structure is anathema to people with ADHD, they are allergic to it, they rebel against it, and yet they absolutely know that they need it to manage their lives and goals, and to remind them to do whatever is necessary to achieve their goals.

Some of the solutions for this lack of structure have to do with
  • parents helping their children learn how to plan
  • helping them talk it out
  • helping to train them to do things a certain way that is personally useful in order that the child learns to develop these resources (e.g. keeping their keys in the same place every day)

Anger & Impulsivity

Anger and impulsivity are major problems with ADHD as the survival switch is turned on too quickly resulting in uncontrollable rage, causing the individual to see the situation as a survival problem, rather than simply a problem one has to effectively deal with.

Hence, the energy goes into the response of what one sees a a threat as opposed to resolving the problem.

Some Solutions Beyond Medication
  • Exercise
  • Meditation
  • Learning about choices
  • Learning about awareness

To listen to the entire interview, click here

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