A little girl dozing off, staring out of the window at the back of a classroom. A little boy unable to stop chatting with his neighbor while the teacher is trying to give instructions. These are not new or surprising phenomena by any means, yet over the better part of the last century, we have grown to understand that some seemingly ordinary behaviors could be signs of a deeper issue affecting children and their surroundings. Psychologists call the condition Attention-Deficit/Hyperactivity Disorder (ADHD), an increasingly common diagnosis that has attracted much attention, discussion, and controversy. It can be challenging to acknowledge for both parents and students: the line between symptoms and “normal” behavior can seem blurry, and the stigma of being diagnosed (or having one’s children diagnosed) with a disorder can cause people to avoid confronting it. Nonetheless, it is important for everyone involved to understand what ADHD is, how to spot potential symptoms and become familiar with the causes and treatment options.
As someone who was diagnosed with ADHD in my late teens, I initially found the label quite confusing. While many of my teachers would testify that I was a distraction in class, I would not have said I was unable to control my behavior because of a mental “disorder.” From my point of view, I had classes where I struggled and classes where I didn’t. Classes that I found too easy or useless, and especially those where I had my friends around, were too much of a playground for me. Some may argue that this is selfish behavior and that just because I was bored it didn’t give me the right to distract others who wanted to learn. This is certainly true. However, I found that when I switched schools and became a boarding student, I was a completely different person.
My new school had a very flexible approach to learning, and I was allowed to study independently for classes that I excelled in. I used the time to work, exercise, or hang out with other students who had free periods. The extra freedom and opportunity to have control over how I utilized my excessive levels of energy allowed me to be more focused and productive in the classes I did attend. This experience led me to consider the importance of environmental factors, whether they affect how ADHD manifests, and how the condition can be dealt with.
I don’t claim to be a medical professional, and any decisions you make regarding diagnosis and treatment should, of course, be made under the guidance of qualified doctors. The purpose of this blog post is to introduce families to some emerging perspectives on ADHD so that they can better navigate the landscape of potential causes and solutions.
Understanding the Causes: Nature or Nurture?
Traditionally, ADHD has been recognized as a complex interplay of various factors, including genetics, brain structure and function, and environmental influences. Research indicates that ADHD has a strong genetic component, with multiple genes implicated in its development, while brain imaging studies have revealed differences in regions involved in attention and impulse control in affected individuals. Additionally, factors like prenatal exposure to tobacco smoke, low birth weight, and early exposure to lead may increase the risk of developing ADHD.
However, not all researchers are satisfied with the above model, which can be seen to describe a person with ADHD as a passive and helpless victim of their condition. Gabor Mate, a Canadian physician and author of Scattered Minds: The Origins and Healing of Attention Deficit Disorder (1999), has proposed that ADHD could, in fact, be the result of how children adapt to certain kinds of environmental stress. His research questions the interpretation of ADHD as a genetic disorder and investigates whether its occurrence in multiple generations of a family could instead be the result of socialization and exposure to similar emotional stress. Maté observes that certain genes are strongly linked with multiple and often overlapping mental health conditions. ADHD, for example, shares much with depression and anxiety. Maté proposes that the genes involved could contribute to a person’s generally increased sensitivity, rather than any specific disorder. The result is that children with these genes may be less resilient to adverse experiences early in life, and as a result more likely to develop anxiety, depression, or ADHD as a response to these stressors. Maté hypothesizes that the “tuning out” aspect so commonly associated with ADHD is an escape-like response, a way to distract oneself from internal or external struggles. Rather than being something that genetically haunts a child, the condition could be an adaptive response, a superpower that protects them from being emotionally overwhelmed.
As evidence for the psychosocial roots of ADHD, Maté points to the fact that children from lower socioeconomic backgrounds are diagnosed at a higher rate. He argues that financial pressure on struggling parents may be transferred into mental and physiological stress on their children. He also suggests that the modern parenting environment has become increasingly stressful for many reasons, including volatile economic conditions, rising costs of living and income inequality, the need for parents to work more jobs and hours, the shrinking of the welfare state, the expenses and difficulties of securing daycare, an antagonistic and polarized social and political landscape, apocalyptic warnings about climate change, and so on. Children easily pick up on their parents being upset, afraid, angry, and confused by life’s growing challenges. Meanwhile, parents become increasingly limited in their ability to give them the attention and care they need. Maté writes frankly about his own journey: the intergenerational distress of being born into a Jewish family in Hungary during the Holocaust, eventually being diagnosed with ADHD, and realizing the many traumas he had inflicted on his children (who also have ADHD) as a wound-up, workaholic parent. with ADHD, Maté says, are symptoms of our dysfunctional society. As long as we focus on their problems as only their problems, we are fighting a losing battle. Genuine treatment has to address our social contract, our values, the way we collectively agree to take care of each other.
Maté’s position can be boiled down to this: if ADHD is a learned pattern of behavior, then it can also be unlearned, and the associated neuro- and physiological conditions can potentially be improved as well. Change can begin at home with families becoming more mindful of their internal dynamics, seeking to improve the way they as a group deal with pressure and stress. It may be tempting to turn to medication, and in some cases truly necessary, but if many cases of ADHD are indeed psychosocial, then treating the symptoms merely desensitizes children to real problems in their environment. And in doing so, it can desensitize the parents as well, since their children’s behavioral issues no longer function as a warning system.
This is not to say that the traditional understanding of ADHD is a myth created by Big Pharma to market Adderall, Ritalin, and other common medications. Maté’s is a theory and it has its critics within the medical community. However, it is important to consider just how nuanced the ADHD phenomenon can be, and what it can potentially teach us about ourselves as individuals, families, and society at large. Understanding the health implications of social stress can motivate parents to be better caregivers to their children, guide them to develop healthy coping mechanisms - and work on their own coping, too.
My own experience of having ADHD “emerge” at one type of school and “disappear” at another causes Maté’s work to really resonate with me. The lifestyle changes I made at boarding school enabled me to design healthier, more productive habits. Having greater freedom to choose when and how I fit into the social groups around me, I improved the quality of my relationships and reduced the factors that got in the way of academic success. Now, as a university student, I benefit from a similar kind of autonomy: I’m stimulated by the responsibilities of living by myself, managing my schedule, and making my first moves as an entrepreneur. In hindsight, I wonder if what my doctors diagnosed as ADHD was simply one case of poorly adapting to an environment that was insufficiently stimulating for me. And I wonder how many other cases can be resolved with behavioral changes or healing social dynamics.
Navigating Treatment Options
When it comes to treating ADHD, a multi-modal approach is often recommended. The primary treatment options backed by the latest research are as follows:
Behavioral Therapy: Interventions such as parent training and behavioral modification techniques have effectively managed ADHD symptoms. They focus on improving organizational skills, implementing consistent routines, and promoting positive behaviors.
Educational Support: Academic accommodations and support services within the educational setting can play a crucial role in helping students with ADHD succeed. These may include individualized learning plans, extra time on exams, or access to specialized resources. For me, this made a massive impact. My boarding school offered a wide range of activities throughout the day besides studies. We also had daily evening tutoring sessions that we could choose to attend. This allowed for stimulation to be spread out throughout the day and made it easier for students to channel their energy. If I found myself struggling to focus in an economics class during the day, I knew that I would have time to take a break and resume my studies in the guided evening sessions with a tutor.
Lifestyle Strategies: Implementing healthy lifestyle habits can complement other treatment approaches. Adequate sleep, regular exercise, a balanced diet, and minimizing exposure to environmental triggers can contribute to overall well-being and symptom management. Around the age of 15, I was introduced to weightlifting, and I found that it was an excellent outlet for my excess energy. I noticed a significant improvement in my attention span and overall concentration when I exercised before a study session or any general activity where I would have to sit for long periods of time. A sedentary lifestyle, especially coupled with a poor diet, is a recipe for difficulties in concentrating.
Medication: Stimulant medications, such as methylphenidate (Ritalin) and amphetamines (Adderall), are commonly prescribed for ADHD. They work by enhancing neurotransmitter activity in the brain, improving attention and impulse control. Non-stimulant medications, like atomoxetine (Strattera), are also available and may be suitable for certain individuals.
The multi-modal approach is especially critical to avoid jumping directly to drastic treatment options such as stimulant medications, which can merely suppress symptoms and lead to side effects and addiction. But as I reflect on the factors that made it possible for me to cope effectively without medication, I cannot overlook the wealth of resources that were available to me at a private boarding school. Families that are struggling financially are not only more likely to have their children diagnosed with ADHD, but also have fewer resources to cope without pharmaceutical intervention: they are likely to be constrained in their choice of school, access to academic support, housing situation, and other non-medical solutions. Without large-scale help from institutions such as the state or generous private initiatives, it is difficult to see a way out of this vicious cycle.
Families that do have a range of options available have an important role to play in providing the evidentiary base for new or improved treatment. By exploring the full spectrum of solutions, they can help doctors more precisely diagnose what could be varieties of ADHD and recommend increasingly personalized, effective care. Parents and students alike should recognize the importance of collaboration among healthcare professionals, educators, and family members. Open communication channels and a support network can provide valuable guidance, practical strategies, and emotional support throughout the ADHD journey.
About the author: GT is a Master of Arts student at the University of Glasgow Adam Smith Business School. He is the founder of the U of G Private Equity Club as well as several businesses across the EU specializing in logistics and event management.
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