Hello and welcome back to Seeker+! The show where we take one topic and really hyperfocus
on it. I’m your host Julian Huguet and if you’re anything like me you’re very online.
You’re constantly bouncing between YouTube and Twitter or TikTok or Twitch or any number
of sites and apps, and heck I wouldn’t be surprised if you’ve already clicked on something
else while this episode plays in the background. It’s OK, it’s why we made an audio-focused
show, I’m not offended. But on a lot of these other sites you may have noticed, as
I have, that there seems to be a growing conversation about ADHD, or Attention-Deficit/Hyperactivity
Disorder. You may know it better as ADD, although today the hyperactivity component is included
in the name. Suddenly though it seems like people with the condition are coming out of
the woodwork and talking about how it’s affected their lives in some surprising ways.
You may even be starting to wonder, as you flick from one app to the next, that you yourself
may have ADHD. I know I certainly did. So that’s what I’ve chosen to focus on today:
ADHD. What is it? What is it like to have it? And how is it diagnosed and treated? Of
course any talk about ADHD is going to involve a lot of discussion about the brain, which
is a really complex thing. Understatement of the year. Now I’m no expert on brains,
I by no means wrote the book on them. But I do know two people who did. Dr. Alison Caldwell
has a Ph.D in Neuroscience and Micah Caldwell has a masters in Clinical Mental Health Counseling.
Together they run the YouTube channel Neuro Transmissions, and a while ago they sent me
a copy of their book called Brains Explained. This isn’t an endorsement by the way, that’s
what my Amazon review is for. But If anyone was going to explain the brain to me, well
I figured it would be them. So let’s start off with a simple question for Micah. What
is ADHD? It's a complicated question to start off with, but I'll try my best. ADHD can come
in a few different flavors. Typically, when we think of ADHD, we think of someone who's
hyperactive. Someone who's just all over the place, but ADHD is a disorder, a diagnosis
that describes someone who struggles with executive functioning, and with attention,
typically to the degree that it causes pretty significant disruption to daily life. That
last bit is important, the significant disruption to daily life. To someone without ADHD, these
symptoms don’t sound unusual. I mean who doesn’t have trouble focusing from time
to time? What kid doesn’t have too much energy, amiright Alie? I know that a big
part of the conversation on ADHD is that it's not real, that it's like not a real thing.
And it's just an excuse to over-medicate little Jimmy, so he will sit still in class. And
it's a challenge to push against that, because it is a real thing. There are real measurable
differences in people with ADHD, in their brains and in their behavior. So people with
ADHD aren’t just particularly inattentive and/or hyperactive, their brains are empirically
different compared to people without ADHD. So the thing with ADHD and a lot of these
kinds of behavioral conditions is that they tend to be super complicated. So it's really
hard to pinpoint something that can be like, "Oh yeah, there's this one gene that causes
ADHD." We know from genetic studies that look at sort of the overall genome, that people
with ADHD tend to have differences in genes involved in dopaminergic signaling, as well
as in norepinephrine signaling. So these are two major neurotransmitters in the brain.
Dopamine is often thought of as like the reward neurotransmitter, but it's actually involved
in a lot of different processes. In particular, it's involved in things like motivation, and
impulse control, and movement control. So you can see how that would relate to ADHD,
and then norepinephrine is involved in all kinds of things, including attention, focus.
So another one that you can see how that would be involved. To recap, people with ADHD appear
to be low on two important chemicals in their brains, dopamine and norepinephrine. But their
brains might not just fire differently, they could as the kids say it today, be built different.
Particularly there appear to be differences in the circuitry that connects the front of
their brains to other parts of it. The frontal lobe by the way is incredibly important. I
mean what part of the brain isn’t I guess, but the front of your brain handles, among
other things, like voluntary movement, expressive language, and high level executive functions
like the ability to plan, organize, and control impulses. So it has to do with how your executive
processing system is handling and coping with information. They basically saw this decrease
in activation, which indicates that there's a decrease in the circuit that controls movement,
that helps you control your ability to like stop movement. So now, you can understand
the hyperactivity thing a little bit better. Okay, so far so good, I think I’m keeping
up with a neuroscientist, which I’ll admit I’m a bit surprised by that. But what causes
these differences in the brains of people with ADHD? There are some popular views that
it’s a consequence of sugary diets, too much TV, or that the parents are to blame
or something like that. Research though doesn’t back that up and instead it looks like ADHD
is largely inherited. According to Dr. Thomas Brown, a clinical psychologist who runs an
ADHD clinic in Los Angeles, 1 in 4 people with ADHD have a parent who also has it, whether
the parent knows it or not. A 2016 study found that that could actually be a lot more common
with around 40% of mothers and 50% of fathers having it. So… okay yeah technically in
a roundabout way you could say the parents are responsible. Dr. Brown also says the other
3 out of 4 people likely have another relative like a sibling, aunt, uncle, or grandparent
with it. I was reading that, at least one study has been done, where they knocked out
a gene involved in dopaminergic signaling in zebra fish, and it caused hyperactivity
behavior in the zebra fish. So we basically gave zebra fish the zebra fish equivalent
of ADHD, just by knocking out this gene. Ok so they were hyperactive, but how could they
tell if the fish couldn’t pay attention? Obviously they put them in a school. Alright
fish puns aside, this study had me hooked. But of course, like all things brain, it’s
not so simple. ADHD isn’t linked to just one gene that can be flipped like a switch,
and it doesn’t appear to be solely related to the DNA passed down from your relatives.
Researchers are exploring possible environmental factors as well.If your birthing parent experiences
a measles infection during pregnancy, that can lead to ADHD-like symptoms. There's actually
a big study that just came out recently, that freaked out a lot of people of reproductive
age, because it showed that any consumption of caffeine, not even just like one cup of
coffee a day, but any consumption of caffeine during pregnancy is linked to increased risk
of ADHD. Now before you go swearing off coffee, this is one study, and there have been other
studies that have found no link between caffeine consumption and ADHD risk. Like Alie mentioned,
the exact causes and risk factors associated with disorders like ADHD can be very difficult
to point to definitively. What we’ve talked about so far is our best understanding based
on current research. Consider this your regular reminder that science is a process. But now
that we’ve established how we think ADHD works inside the brain, the next step is to
look at how it works outside the brain. That is to say, how do these neurological differences
manifest themselves as symptoms? What makes the symptoms rise to the level where ADHD
is considered a disorder? And how might they be related to or conflated with the symptoms
of other disorders? We’ll get to that in our next episode. Thanks again to Alie and
Micah Caldwell for being our expert guests. What do you all think of these brainy topics?
Do they tickle you right in the amygdala and are there others you’d like to see us cover?
Maybe we can convince Alie and Micah to come back. Of course you can always find them over
on their Neuro Transmissions channel, and you can always find me here! I’ll see you
for our next episode on ADHD here on Seeker+.