23. Where does ADHD come from?
Photo by Mart Production
We constantly debate about what ADHD is and ways to treat and navigate the neurological difference. This episode is equal parts informative and culturally philosophical. Throughout my research, I've seen that ADHD is a mystery to professionals, and nobody knows where it comes from or how it occurs.
Over time, we have studied the characteristics and traits of ADHD. However, we are still trying to understand the condition's root causes. I'm not a doctor or medical professional, and I'm not educated enough to begin to understand neuroscience. Still, I have been reading and viewing lectures from someone who is, and his theories about the origins of ADHD astound me.
In this two-part episode, I'll talk about the most substantial theory about where ADHD and other conditions come from, the circumstances that cause them, and some heady tangents on the more profound cultural discussions that arise as a byproduct. If that is your Jimmy Jam, then stay tuned.
ADHD Theories
A few posts back, I talked about a gene linked to ADHD by a scientist at the University of Carlina - Irvine. The study found a link between people with ADHD and ancient tribes who migrated a lot. The claim was that ancient tribes who had highly nomadic lifestyles had a mutation to a gene linked to motivation and that people related to these people also carried the gene. As a result, this gene made these ancient nomads more attracted to novelty-seeking behavior.
This makes sense because what is a more helpful trait as a nomadic hunter-gatherer than one that allows you to be hyperaware of multiple subjects in your surroundings at once, have superior pattern recognition, and thrive on thrill-seeking behavior in search of life-saving resources? If our ancient ancestors had ADHD, it would make sense, and it seems like the perfect adaptation to gain if you live a life on the run.
It's an interesting theory, but it caused me conflict. Years prior, I had learned of a Dr. who made compelling claims about ADHD and other mental conditions resulting from trauma. Dr. Gabor Mate has worked in family practice and palliative care for over forty years. He is known for his addiction, stress, and childhood development expertise.
He has written several books, including "Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder," and "When the Body Says No: The Cost of Hidden Stress." He has also appeared in numerous documentaries and given many talks and interviews on addiction, trauma, and mental health topics.
Dr. Mate's approach to addiction and mental health emphasizes the importance of understanding the underlying causes of these issues, such as childhood trauma and social factors. His work has been influential in promoting a more holistic and compassionate approach to addiction and mental health treatment.
Dr. Gabor Mate's ideas about mental health are profound and controversial because he believes that ADHD (and other mental disorders/illnesses) is(are) primarily caused by genetic, environmental, and developmental factors. He has written extensively on the subject in his book "Scattered Minds."
So where do ancient nomads fit into all of this? I used to be unsure at first, but now I have my own theories about how they support one another. I'll talk about that later. First, I must share Dr. Mate's theories, research, and supporting scientific evidence. In the next episode, I'll talk about how to heal ADHD in theory, based on the evidence I'll provide today.
This could be controversial because of the social commentary, and parents may feel jaded about some of today's subjects. Remember, there's no judgment. I don't even have kids, so what do I know?
Let's start by setting this whole thing up with how Dr. Mate came to this conclusion.
Dr. Mate's Ah-ha moment
After living with patients struggling with conditions like ADHD and Addiction, he noticed that every person he worked with had childhood trauma. The extent of the symptoms seemed to correlate with the extent of the trauma in many if not most, cases.
According to Dr. Mate, ADHD (and depression, addiction, etc.) is not just a brain disorder but a whole-body disorder that arises from a complex interaction of genetic vulnerability, environmental toxins, and developmental factors. He argues that ADHD is often related to early childhood experiences of stress, neglect, and trauma, which can affect the developing brain and lead to problems with attention, impulse control, and emotional regulation. He has publicly stated that he has ADHD (Attention Deficit Hyperactivity Disorder) and has written about his personal experiences with the condition.
How did he get ADHD? Remember the baby from the story? In the story of Dr. Dennis Gabor Mate. It is a harrowing tale of triumph in the face of the ultimate adversity and a key indicator in Young Gabor's struggle with ADHD and addiction.
He had a deep insight into how his childhood traumas from growing up in a Nazi-occupied country impacted him. One day he was waiting for his wife to pick him up from the airport but she last time and he became upset with her. He began giving her the silent treatment and having emotional outbursts. He connected this reaction to being separated from his mother before they escaped Budapest during world war II.
The feelings of abandonment that he felt didn't have anything to do with being picked up late, but he was triggered essentially. The experience aroused in the neural pathway likely was part of some defense mechanism.
He argues that the pressures of modern society, such as the demands of school, work, and technology, can exacerbate the symptoms of ADHD and create a culture of over-stimulation and distraction that is particularly challenging for individuals with the condition.
We have this idea of what is expected in our society, about what's normal. Dr. Mate', on the other hand, believes the culture we've created is responsible for worsening mental illnesses.
The kids aren't alright.
Love and value come at a cost in our society. If you behave within the accepted guidelines, life tends to carry certain benefits. Not just better opportunities but acceptance and a sense of belonging.
As a child, you're punished if you don't get good grades, behave yourself, or eat all your veggies; This lack of unconditional love is the root of the problem. That's because the ways we are conditioned from early childhood often result in traumas that lead to specific disorders and diseases.
The Explanation of Trauma and Brain Development
Dr. Mate explains that when we are undergoing our formative years, we are often traumatized by our parents unintentionally or by other environmental factors, and this trauma affects our brain development.
In his case, it was being born in WWII-torn Budapest, Hungary, and what he experienced as a result. Yes, the story from the beginning was about him as a baby. Dr. Gabor has openly spoken about his struggles with ADHD and linked his childhood trauma to those formative experiences.
A brain, during development, is meant to act as a sponge and to take in as much about the world as possible to create a model for survival into our adult years. Psychologists say that humans establish our strongest foundational worldviews at early ages.
This is why kids are so playful and curious. They laugh and then cry. They are hungry and then unwilling to eat. They fall down, and they get back up. They experience various emotions from second to second because they are biological learning machines. They are learning how to tolerate discomfort and correctly manage stress in the future, amongst other things, during this time. Learning isn't conscious; it has almost everything to do with brain development brain.
During early development, while your body is still growing, your brain is also growing. Two parts of the brain are interesting regarding this topic. The amygdala and the prefrontal cortex. They are both interesting because they are both crucial parts that control our emotions. Depending on the conditions of the environment you sou spent your formative years will affect the size, shape, and activeness of these parts.
The Amygdala
The amygdala is a small kidney bean-shaped thing in the center of your brain, and its primary function is to recognize threats. Danger, fear, pain, and in other words, stress. It's constantly on the lookout for stressors. During a stressful experience, it sends a message to your hypothalamus, leading to a bunch of other signals and, inevitably, stress response hormones being released into your body. This biological response evolved as a trait for protection and survival.
An example would be if you're walking through the woods and come across a bear. Your amygdala will see it and say, "Yo, wake up! This is not a drill!" Then you get an adrenaline rush and run from the bear. Or, go beast mode and fight the bear. Not to be crass, but this is why sometimes if people become frightened enough, they'll lose control of motor functions like bladder control and wet their pants. Sometimes people vomit in stressful situations because processes like digestion and holding urine are non-vital mechanisms in the face of a fight or flight situation, according to the body. Losing consciousness is another response to danger. A very unfortunate one. If anyone's ever seen the videos of people on the slingshot ride at a theme park. Usually, two people are strapped into a seat anchored down to the ground with latches. The seats are attached to bungee cables on either side and the cables are stretched to capacity. The cables stretch from two towers, a hundred or so feet in the air. Once the latches are removed, the two seat are flung into the sky. It goes up and down a few times. There are videos all over youtube of people blacking out while riding it.
A guy is passing out on the slingshot. Example of stress responses triggered by the brain
From my understanding, stress responses like the ones I mentioned are first started by the amygdala once it perceives a sense of danger.
The Prefrontal Cortex
Image of Tony (right; Amygdala) and Manolo (left; prefrontal cortex). Still from 1983's "Scarface.
The prefrontal cortex is the other part of the brain involved in this process. It's a big part of our brain and helps us control our thoughts and actions. Imagine your amygdala as Scarface and your prefrontal cortex would be his right-hand man, Manolo. Loyal to the very end. The whole job of the prefrontal cortex is to control our stress and emotional responses and save them for times that are only absolutely necessary.
Say you're walking through the same woods and think you see a bear. Your amygdala is like, "Oh shit, it's a fucking bear!" It is the job of your prefrontal cortex to put its arm out across your chest and say, hold up, that's not a bear, it was just a shadow. And that stops your body from staying flooded with stress hormones. It calms you back down and lets you know everything is okay and you can relax again. This is extremely important!
Stress hormones like adrenaline are perfect for momentary bursts of speed, strength, visual acuity, and energy. Still, they mute other primary body functions to work. Digestion, focus, blood flow to certain organs are all dialed down to deal with fight or flight situations. Chronically stressed people have issues with losing belly fat, experiencing hair loss, and other more severe health problems as fight or flight states persist. That's why we need the prefrontal cortex. It's a temporary boost of superhuman powers that also hurts us as well.
Suppose you haven't seen the movie Scarface. In that case, there's a reason why I chose to use the characters of the movie to explain how the amygdala and PFC work together to keep us safe. In the film, Al Pacino's character "Scarface" is a hot-headed go-getter. He's a shark sniffing for any hint of blood in the water. He's constantly paranoid and overreactive. Manolo, on the other hand, is Tony's level-headed, lighthearted half. When Tony begins to fly off the handle, Manolo always brings him back to reality by putting situations into perspective.
A still from the 1983 movie, Scarface.
Spoiler alert if you have yet to see Scarface. I'm sorry, the movie came out in 1983, and you've had 40 years to watch it. Tony, a.k.a. Scarface, kills Manolo in a fit of anger. We see a broken man afterward. Without his voice of reason to keep him level-headed, he goes total juggernaut and, shortly after, is killed.
Tony and Manolo's story are perfect metaphors for how the brain responds to stress and what happens if we let our environments get the best of us. I'll explain more about this correlation in a moment, but first, I have to explain more of how the brain functions under stress, particularly while undergoing early stages of Brain development.
Children, in particular, who experienced minimal to severe stress before the age of 15 months old, showed an increase in amygdala volume. I take that as it's enlarged. This increase in the amygdala size is linked to a hyperactive amygdala. Meaning you're hyper-vigilant for stressors to come and attack you, and you're always on the lookout. Another word for this is paranoia or anxiety.
The amygdala is also an essential link to emotional learning and memory, attention, perception, emotional and social behavior, inhibition, and self-regulation. It reinforces learned experiences. So if you developed as a child in a crazy environment, you might experience anxiety and have an enlarged amygdala.
That being said, here are some potential behaviors that someone with an enlarged amygdala may exhibit:
Heightened anxiety
Emotional sensitivity
Increased stress response
Impulsivity
Those symptoms run parallel with ADHD symptoms, don't they?
Back to the Scarface reference for a second, The prefrontal cortex (Manolo) is supposed to calm you down. Still, after a certain point, the amygdala seems to overpower the PFC if you have experienced persistent stress in your early childhood years and make it so that you remain in a state of stress-induced hypervigilance. It's like when Tony kills Manolo. As such, a person who now lives in a prolonged state of hyperactivity starts to become ill with no relief.
Stress-induced vigilance sounds like being distracted and not being able to sit still for long periods of time...
When you grow up in an environment that causes you to stress, your brain grows intertwined with stress and its responses. What's proposed by Dr. Mate's ideas are what we have named ADHD, depression, anxiety, PTSD, and more, are, in truth, merely external symptoms used to describe a person whose brain has been imprinted upon by a traumatic experience or some stress; and it probably happened during childhood.
You might think, phew, at least I didn't grow up in a traumatic household; Chances are you weren't born during a bombing raid or had to flee a genocidal dictatorship. You've likely never endured that kind of trauma as a child or even an adult; hold on though.
Have you ever wondered what qualifies as stress to a child? This is the part I talked about upfront. The part where things could get interesting. It takes a lot less to traumatize a child than you think. Let's take a moment to understand stress and trauma better.
I'll Cry if I Want To
Here's where things get very interesting. According to Doctor Mate, due to our culture, people en masse spend their formative years in situations that attack the psyche but don't even know it. But the PFC and amygdala tell the story. He claims that collectively, we have adopted behaviors that harm and traumatize our children.
The prefrontal cortex consists of three major anatomical regions:(A the dorsolateral prefrontal cortex (dlPFC), B the orbitofrontal cortex (OFC), and C the medial prefrontal cortex (mPFC).) Let’s call them parts A, B, and C.
A( The dorsolateral prefrontal cortex) is a multimodal association area that participates in higher cognitive functions (e.g., executive functions). In contrast, the B (OFC) and C (the mPFC) are considered to make up the limbic (or paralimbic) area that participates in emotional and motivational functions (Ichihara-Takeda and Funahashi, 2007).
Volume reduction in part C has been profoundly evident in adults who experience maltreatment as a child. Not even including something as traumatic as sexual abuse. Remember, this is the part of the brain associated with motivation and will. Volume reduction in this area seems to result in depressive behaviors.
Cry it out
If you're not familiar with crying it out, it's basically leaving your baby in a room, in a crib, alone, to sleep. If the baby starts to cry for the parents, you don't pick it up and soothe it. The idea is that it makes the child more independent and less afraid to be on their own as they get older.
Crying is a built-in biological signal meant for the parents to give attention to the baby by picking it up and soothing it. We somehow translate that to spoiling. If the baby persists in crying and nobody comes to get it, it triggers a stress response. This is telling the brain that's still forming: "This is not a safe environment. Access to stress relief (parents) is not coming.
Verbal Abuse
Yelling at your kids again. Same thing. Name-calling, belittling, nagging. It triggers a stress response. Children begin to internalize negative comments as truths. To say, "Stop being stupid. Or you're being a crybaby", is incredibly damaging to a child's self-image.
Grounding, the corner, silent treatment
When children are isolated from people they get comfort from, they feel abandoned. They become subconsciously ingrained with the idea that something is wrong with them or that love is foundationally conditional. That it's a quid pro quo exchange, and if you want to be loved by someone, you are only worthy if you do what they've asked of you.
In childhood, you may try to overachieve because you have low self-esteem because of isolation as punishment. Isolation says, "I don't love you right now because you made a mistake. When you do what I say, you'll be worthy of love again.". It's meant to induce shame as a punishment. Now you grow up to need validation. Later in relationships, you may think that you need to fulfill the desire of a toxic person to keep their love and feeling of being noticed.
Spanking
Again, when you say it out loud, "I should inflict pain upon my child by hitting them with my hand or an object.". It's more evident that this is an absurd statement.
When you hit your kids, you're triggering a response similar to what happens during crying it out. The amygdala immediately says, "I'm unsafe here because something is inflicting pain upon my body against my will.". Your home should feel like a place where things like that don't happen, where you can explore and make mistakes and learn and let your guard down.
This inevitably shortens the child's ability to sort out conflicts. In the long run, they may become easily angered and confrontational when confronted with adversity. The long term still, they may develop a state of hypervigilance and anxiety. Trying to shrink themselves as much as possible so that they reduce the likelihood of confrontations with others. They turn into cowards and yes-men later.
Chronic exposure to harsh corporal punishment, like getting spanked, was associated with a marked reduction in gray matter volume in the right mPFC in young adults (18-25 years).
Changes in gray matter volume are associated not only with trauma-related psychiatric disorders but also with recent adverse life events and perceived stress; these associations suggest that some trauma-related changes in gray matter volume may act as vulnerability markers that precede the presence of trauma-related psychiatric disorders. Corporal punishment is spanking if you didn't know,
So basically, if you experience trauma, the parts of your brain that are responsible for regulating your stress levels, for feeling safe, motivating you to do things, having the willpower to resist engaging in certain activities, and the ability to perceive things with cognitive clarity, that's all potentially diminished. This is a significant contributor to ADHD and many other illnesses. Remember, trauma is dealing with the parts of the brain in charge of cognitive abilities. Your ability to think, solve problems, focus, etc.
Okay, the brain becomes in a hyper state of stress and can't calm down, so what? Well, what do people do when they need to relax. They self-medicate! People become addicted to the rush of feelings acquired from drugs, alcohol, and even certain harmful behaviors like impulsivity.
When looking at the brain, drug use releases the chemicals that we very much desire as children to develop. Dr. Mate describes the drive to seek out drugs as a quest for synthetic, chemical love.
Addictive behavior feels really good. When someone engages in addictive behavior, significant parts of the brain are affected. When an addict takes drugs, the drugs interact with the brain's reward system, which is responsible for generating feelings of pleasure and reinforcing behaviors that are associated with pleasure. Drugs such as opioids, cocaine, and methamphetamine release the neurotransmitter dopamine in the brain's reward center, leading to a surge of pleasurable sensations.
We're all mad here
Evidence suggests that mental illness is becoming more prevalent in many parts of the world. The World Health Organization (WHO) estimates that around 1 in 4 people worldwide will experience a mental health condition at some point. The prevalence of some mental illnesses, such as depression and anxiety, appears to be increasing globally. However, it's difficult to determine if this is due to better diagnosis and reporting or an increase in these disorders' incidence.
What Dr. Mate proposes is the cause of ADHD and other illnesses and disorders. Basically, he says that the diseases that we have named, depression, anxiety, addiction, and PTSD, are all linked. More so, they exist on a spectrum related to how our brains develop and the stress we endure during our formative years and our lifetime.
The deeper implications
This becomes a social discussion because why do we treat our children this way? My guess it has something to do with the economy. The standard we discipline our children is primarily to prepare them for the world.
If we aren't straight-up abusing our kids, our attempts to make them "well-behaved" are often traumatizing. The standard we use to judge their behavior is directly influenced by paradigms children will eventually experience in the real world.
You don't have value in our societies which are hyperfocused on profit and neurotypical behavior to thrive. For this society to thrive, we need people willing to go to work while they are sick, not need breaks, and follow instructions.
If you have difficulty doing this, you'll likely have a life of struggle anyways. But just because you do well in this world and economy that's been entirely made up, it's not the same thing as being "okay." To be well-adjusted to the world as it is now, to be successful, almost requires a certain amount of being broken, doesn't it?
In the next post
That's it for part one of this episode. We've covered pretty much everything, so part two will be a bit shorter. In the next episode, I'll discuss what can be done to help remedy the damaging circumstances we live in. Not just that, but I'll talk about ways to heal such trauma potentially.
Apparently, ADHD can be treated holistically. Dr. Mate claims he struggles very little with ADHD now. He used stimulants to suppress his symptoms and now says he does not need them to accomplish work.
I'm excited to talk about it. See you next week; much love, D.C. out!