Is increase in ADHD an artifact of our modern educational system?

adhd

After lunchtime in elementary school, I remember a handful of my fellow students would discretely visit he nurses office before heading back to homeroom. It was only a few years later when one of those students became my good friend that I learned they took medication for attention defect hyperactivity disorder, known more commonly as ADHD. The condition was just simply not part of mainstream culture.

Twenty years later 11 percent of American children are diagnosed and treated for ADHD at some point in their lives. How has the incidence increased so much? And how is it that so many children simply seem to outgrow it since ten percent of the adult population does not continue to be treated?

But, from what we are learning about neurobiology of ADHD, the condition we treat as a disorder may just be the result of natural variations in our population, writes Richard Friedman in a New York Times opinion piece. The trouble comes because that natural variation doesn’t fit with a formulaic educational or cultural system:

Neuroscience research shows that people with A.D.H.D. are actually hard-wired for novelty-seeking — a trait that had, until relatively recently, a distinct evolutionary advantage. Compared with the rest of us, they have sluggish and underfed brain reward circuits, so much of everyday life feels routine and understimulating.
To compensate, they are drawn to new and exciting experiences and get famously impatient and restless with the regimented structure that characterizes our modern world. In short, people with A.D.H.D. may not have a disease, so much as a set of behavioral traits that don’t match the expectations of our contemporary culture.

Once these kids are out of school and free to make their own work and life choices, like taking jobs that require travel or pursing careers that deeply interest them, they don’t need the medication that helped them focus through their school and college years.

The culprit maybe that people with ADHD have fewer dopamine receptors in their brains, according to research by Nora Volkow. The neurotransmitter dopamine gives us pleasure, and drives our reward system. People with fewer receptors have a reward system with the volume constantly turned down, so they seek new experiences to drive a greater release of the neurotransmitter more than other people.

Many people with ADHD and their relatives also suffer from substance abuse problems. Alcohol and other drugs temporarily raise dopamine levels in the brain, engaging the reward system. Other evidence has shown that exercise can help with some symptoms. Although that was long thought to be the result of ‘burning off extra energy’ it may actually be caused by introducing a new activity to the day, getting a child or adult away from the desk or by a bump in dopamine release associated with physical activity and novelty.

Friedman does not think that all children who are diagnosed with ADHD don’t need medication. But it might be helpful for the 10 percent of students in our educational system if there were options other than the status quo:

Perhaps we can leverage the experience of adults who grew out of their symptoms to help these kids. First, we should do everything we can to help young people with A.D.H.D. select situations — whether schools now or professions later on — that are a better fit for their novelty-seeking behavior, just the way adults seem to self-select jobs in which they are more likely to succeed.

Meredith Knight is editor of the human genetics section for Genetic Literacy Project and a freelance science and health writer in Austin, Texas. Follow her @meremereknight.

Additional Resources:

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