Wednesday, June 23, 2010

Dr. Jory Goodman - ADHD Brains: The Quintessential Supercomputer

ADHD diagnoses are disproportionately given to boys over girls - as much as 5 to 1 in some studies. The CDC shows only a 2 to 1 difference, which is still significant. Here are some stats from the CDC page:
  • Diagnosis of ADHD increased an average of 3% per year from 1997 to 2006. [Read article Adobe  PDF file]
  • Boys (9.5%) are more likely than girls (5.9%) to have been diagnosed with ADHD. [Read article Adobe  PDF file]
  • ADHD diagnosis is significantly higher among non-Hispanic, primarily English-speaking, and insured children. [Read article]
  • Prevalence rates are significantly higher for children in families in which the most highly educated adult was a high school graduate (or had completed 12 years of education), compared with children in families in which the most highly educated adult had a higher or lower level of education. [Read article]
  • ADHD diagnosis among males was reported significantly more often in families with incomes below the poverty threshold [Read article]
Monroe A. Gross, M.D., suggests that from his experience, girls are just as likely as boys to have ADHD, but boys are much more likely to be diagnosed because their behavior is seen as disruptive, while girls are more likely to be diagnosed as adults.

In Virginia, in 1998:
Among elementary students, 17% of all students and 33% of white boys had been diagnosed with ADHD and the vast majority had been medicated for this condition at some time during the 1997-98 school year. At the time of the survey, which spanned the summer months (when drug therapy is sometimes temporarily discontinued), 12% of all elementary students were medicated for ADHD (LeFever et al., 2002). Ninety percent of all identified cases had been medicated for the disorder at some point and the majority had been treated for over two years. These findings suggest that as of 1998, school-based studies of ADHD prevalence captured approximately half of the cases treated in the community. Preliminary data from a follow-up study suggest that as of 2002, school records capture as few as 25% of ADHD cases (LeFever, 2002).
This is from an excellent article looking at the over-diagnosis and over-medication of ADHD in children:
LeFever, G.B., Arcon, A.P. & Antonuccio, D.O. (2003). ADHD among American Schoolchildren: Evidence of Overdiagnosis and Overuse of Medication. The Scientific Review of Mental Health Practice; Spring: Volume 2 Number 1.
As someone diagnosed with ADHD as a kid (no treatment) and AADD (adult attention deficit disorder) as an adult (low-dose Adderall), I feel grateful that I was never medicated as a child. The medication is useful now, but when I was younger it may have squashed my exuberance for learning and my fast-paced brain function. Yes, I think quickly and sometimes that costs me on exams, but it also allowed me to excel in ways I may not have otherwise - it made me creative and able to process and synthesize large amounts of information. It also gives me a short attention span and I get bored quickly and easily.

All of that was to set up this new article from Dr. Goodman at the Attention, Please blog at Psychology Today, introduces an idea new to me - that ADHD brains are not simply different (which is how I tend to look at it, rather than dysfunctional), but maybe better.


Cowboys and sodbusters, the ADHD Supercomputer

ADHD is not a disorder. It is a difference. The ADHD brain is a genetic adaptation found in populations that have had to adapt to difficult situations; migrate, survive. There is very little ADHD in sedate, bucolic agrarian populations that have done the same things for eons. There is a lot of ADHD in Jews, Gypsies, American Irish, and so forth. These are groups that have been assailed and attacked. And the survivors are the ones able to think on their feet, adapt, stay ahead of death. America has an unusually high prevalence of ADHD because it is to America that the firebrands, pioneers, resisters, and survivors went. From Europe, Asia, Ireland, England; everywhere. There is a clear and direct correlation between the great creativity, productivity and success of America and the nature of it's immigrant, melting pot society. After WWII it was described as "The Brain Drain" as the best and brightest scientists, artists and so on...came to America. The Jews who made it, the Irish who made it earlier, were the one's who wouldn't take it, saw the writing on the wall and moved on. Notwithstanding the politically motivated Nobel prizes for "peace" and literature exactly how many Nobels have come out of the Europe engulfed by the Holocaust. And how many have come from the Arab world?

The brain is the world's most sophisticated computer. In the parlance of cyberese the regular brain has 20 gigs of RAM, a modest, linear processor (speed of sound), and a methodical, one thing at a time desktop. Attempts to run too many programs at once slows it down until it freezes or crashes. Programs must be put to sleep and then closed on the hard drive, and tediously retrieved when needed.

The ADHD brain has almost a google of RAM, a splendidly fast non-linear processor (speed of light), and a busy, frenetic desktop. Dozens or hundreds of programs are open and running all of the time; the RAM buzzes along with stupendous amounts of data, often to a fault. It is internally as distracting as the continuous attention to all manners of external and extraneous sensory input. It can't "turn off" at night and go to sleep. Neither can it's owner. It can frazzle you into anxiety. It can keep you "obsessively" re-checking things.

It's the distinction between the Cowboys and the Sodbusters. One breaks new ground, explores and discovers. The other moves in and builds fences and makes rules and needs order and struggles for control. It's the difference between the Special Forces and the Regular Military. The former think the latter to be stupid bean counters. The latter think the former crazy! It's very difficult to make it in the Special forces without ADHD. They screen for it. You know; think on your feet, improvise, multitask, intuit, anticipate. You know; the irritating kid/adult who blurts out the solution to a problem before the teacher finishes the question/the committee administrator has explicated the conundrum. Infrastructure? We don't need no stinkin' infrastructure! Oh yeah.

Linear thinkers describe ADHD as an executive function disorder because folks with ADHD don't think as they do. Actually the ADHD brain is a true Executive brain; non-linear, super-fast, creative, decisive. It just doesn't count all of the beans, zips about and can't often tell you how it got there. That's why so many creative, inventive executives are forced out of their own companies when their success takes them to a critical mass (called the chasm by an author I can't recall) and there is a need for the dreaded infrastructure, organization and that most detestable of all, the administrative middle manager.

I'll enlarge upon this in future posts.

1 comment:

Andrew Kinsella said...

I agree that ADHD arises from a superior brain. I was started on treatment for ADHD 2 years ago, and am now off treatment and functioning very well and very happily. I see an attention difference as the underlying natural, "superior" state. I am very happy to have my attention difference brain, now that I know how to cut with the grain not against it. The dysfunction in ADHD was really not at all pleasant though. I do not see it as being integral to the way my brain works- just as a malfunction caused by the delusion that all people have minds that work the same way. I think if we were more responsive to the individual needs of our children and less influenced by one-size-fits-all cookie cutter approaches to education and discipline then maybe no child or adult would eve have to endure the distress that goes hand in hand with ADHD.