
Evidence That ADHD Is a Genetic Disorder - wmat
http://www.sciencedaily.com/releases/2010/09/100929191312.htm
======
rauljara
One thing to note about ADHD research: The bar for getting diagnosed with ADHD
in a clinical trial is much higher than getting diagnosed with it by your
family doctor. All of the symptoms involve a great deal of leeway and personal
interpretation, and in a clinical trial, they are really, really strict about
that stuff. A doctor, who has a financial incentive to prescribe ADHD
medication is much more likely to bend the diagnosis towards positive.

There is no shortage of writings by smart people arguing ADHD is over
diagnosed. I am also of the opinion that it is. But I also think ADHD is a
real disorder. I have no doubt that the findings of this study apply to people
who really have ADHD. I also have very little doubt that this study doesn't
apply to the vast majority of kids who have been diagnosed with it.

------
Rexatron
As a child of 8 years old, I was given 120MG of Ritalin per day. I rarely
slept the first 2 years. If I did it was around 6am for an hour or so. Then I
had to take my morning dose for school. They also wanted me to take a pill to
sleep, which felt so horrible I cannot even explain it. I was a zombie in the
morning if I took it, then onto the morning ritalin dose. I would just do
pushups in my room until 3am some nights just to get the energy out.

Yes, I did well in school while I was on it. Yes, I stayed out of trouble when
I was on it. But I was not myself. I felt as if I were on drugs. I did not
learn "how to learn" or "how to get things done" without being on drugs. When
I finally kicked the habit in college, I was a mess. I couldn't do anything
that took more than 30 seconds of concentration. I had to learn how to live
life without drugs. For a condition I may or may not have had. It took me to
more years to finish my last semester of college because I could not function.
Years later I’ve relearned what I should have learned as a child – how to
discipline myself and get things done.

The DSM IV/V has a very loose definition of this "DISORDER". The genetic basis
I don't doubt, because at one time in our evolution it was a selective
adaptation that made us better at hunting, preventing accidents, and trying
new things. Now, because our society resides in cubicles, desks, and
institutions, it's a "DISORDER" that needs to be medicated.

Just be good parents and give your child an environment where his or her
differences can thrive. Find some open space and let them loose for several
hours a day. Homeschool them with creative and intriguing lessons tailored
just to them. Do whatever you can to allow their abilities become advantages
rather than brand it a disorder and ruin their self-esteem by sending them to
the nurse twice a day to be force-fed a pill they don’t need.

Don't just give them a pill. That's lazy and detrimental to them in the long
run.

The over-prescription of these drugs is epidemic and I can't stand by and
watch comments say :

"Each year a parent doesn't take actions is a year lost for a child" to
convince people to medicate children for what used to be a genetic advantage
(and still is given the right environment).

Each year a parent doesn't take actions to provide the right environment for
their child's natural ability to thrive (rather than be told to have a
disorder) is a year lost for that child.

~~~
roel_v
What are you saying, that people should build corralled pens for children so
that they can 'thrive' on their natural ability to bounce from left to right
and generally moving about a lot but accomplishing nothing?

Your appeal to emotion argument is detrimental to all those who are (through
prejudices like yours) denied treatment for what is an actual, physiological
brain defect. 120 mg is a lot, it may have been too much for you, or you may
not have ADHD, I don't know. But denying that a disorder exists because you
had a bad experience is intellectually dishonest and holding back the
treatment of hundreds of thousands if not millions, and social acceptance of
treating it.

The science is clear on this point: ADHD exists, it is treatable, and the
quality of life of people who have it is improved significantly with
medication and behavioral therapy. That methylphenidate works has been widely
proven scientifically, and its effects have been studied for decades. It's
true that we don't know everything about it, and we will need further studies
for decades, but that doesn't take away from the dramatic improvements in
functioning that many people get from it.

Your 'argument' seems to be based on 'But I was not myself.'. I'm sorry that
you apparently feel that there is some sort of mystical 'true self' that is
somehow different when your neural functioning is chemically improved, and I
hope that until you come to terms with reality you can live a productive life
and be generally happy. But until then, don't be the crab at the bottom of the
bucket.

~~~
Rexatron
Is that so? I don't recall saying those things.

I did say an open space for them to get the energy out, so that when they
return they are more able to focus on 'accomplishing things'. Whatever it is
kids need to accomplish other growing up.

Yes, I'm biased (not prejudiced). Due my experience, which I stated clearly.

Taking a set of traits that don't work in modern society and calling it a
DISORDER is the only intellectual dishonesty here. Prescribing meds for a
behavioral traits that people don't approve of is selfish, controlling, and a
true detriment to those kids.

That ADHD (which I did not deny exists, I stated it did, and that I believed
it's genetic basis) is treatable by Ritalin/Adderall I don't deny.

I just happen to know the long-term effects are detrimental. Studies happen to
back me up.

Studies also show behavioral therapy is as good as medication. It's far better
for kids as they get to learn about life without being on drugs. They learn
real life skills rather than brute force concentration through drugs.

"I was not myself" is true. I was drugged with something that crams neuro-
chemicals into my brain making me into something other than I wanted to be.

There is no true self (especially mystical). There was a natural me and a me
on Ritalin (which was very different). I would have preferred to learn the
life skills I needed and haven't learned until recently. I had the experience
for a reason and often I believe it is to let people know about it and
possibly protect other kids from what I experienced.

Sincerely, -Crabby McGee

~~~
onemoreact
The human brain is arguably the most complex system on the planet. We have a
very poor understanding of how it functions so we fall back to the old, "is
this useful metric" and DISORDER only refers to things that are less than
optimal.

There are plenty of environments where a mild level of ADHD is not an issue;
unfortunately children are expected to be able to sit and concentrate for
several hours a day. In that context the term DISORDER is appropriate which is
not to say it can be compensated for just that there is an issue. There are
plenty of ways to compensate for poor vision and people are starting to think
of mental issues in those terms. Unfortunately it's harder to change the
environment or give extra attention than a cheap external prosthetic. Thus,
drugs are often the first choice, even if they have minimal value or just
trade harming the user to help those around them.

------
tomlin
This is welcome news. I recently got diagnosed and after taking the
medication, I've found a great increase in the quality of life.

There are a few who are very _anti-drug_ when it comes to this condition and
their children. Let me tell you from personal experience, these people are
doing more harm to their children than good. Education is important.

Depending on the severity, each year a parent doesn't take action is a year
lost for their child.

~~~
Alex3917
"Let me tell you from personal experience, these people are doing more harm to
their children than good."

The problem is that the science clearly says the opposite:

"At the end of 14 months, core ADHD symptoms were reduced more in the children
treated with stimulants than with behavioral therapy. However, at the end of
three years, 'medication use was a significant marker not of beneficial
outcome, but of deterioration. That is, participants using medication in the
24-to-36 month period actually showed increased symptomatology during that
interval relative to those not taking medication.'"

[http://www.madinamerica.com/madinamerica.com/Children_files/...](http://www.madinamerica.com/madinamerica.com/Children_files/3-year%20followup%20of%20the%20NIMH%20MTA%20Study.PDF)

"At the end of six years, medication use was 'associated with worse
hyperactivity-impulsivity and oppositional defiant disorder symptoms,' and
with greater 'overall functional impairment.'"

[http://www.madinamerica.com/madinamerica.com/Children_files/...](http://www.madinamerica.com/madinamerica.com/Children_files/Mta%20at%208%20years.PDF)

"Within 21 months, 11 percent of children treated with a stimulant for ADHD
developed 'psychotic symptoms.'"

[http://www.madinamerica.com/madinamerica.com/Children_files/...](http://www.madinamerica.com/madinamerica.com/Children_files/Psychotic%20side%20effects%20of%20stimulants.pdf)

"Two-thirds of the adolescent patients hospitalized for mania at the
University of Cincinnati Medical Center had been on stimulants 'prior to the
onset of an affective episode.' Stimulants, the researchers concluded, may
'precipitate depression and/or mania in children who would not have otherwise
developed bipolar disorder.'"

[http://www.madinamerica.com/madinamerica.com/Children_files/...](http://www.madinamerica.com/madinamerica.com/Children_files/Prior%20stimulant%20treatment%20in%20adolescents%20with%20bipolar%20disorder_%20association%20with%20age%20at%20onset.pdf)

via <http://www.madinamerica.com/madinamerica.com/Children.html>

~~~
tomlin
If we're getting into a debate of whether medications can have other effects
than intended, I cannot argue that.

ADHD and ADD should be treated in completely different ways. People diagnosed
with ADHD have a much higher chance of psychotic symptoms than those who are
only of the inattentive type. Then there is the old saying, "if you've seen
one child with ADHD, you've seen _one_ child with ADHD."

In my experience, and for many others, it has provided a world untold, halted
depression, increased motivation and enjoyment in life. Stimulants aren't
perfect, but we're throwing the baby out with the bath water when we ignore
their usefulness.

~~~
Rexatron
Your experience is yours. How long have you been on medication? What
medication specifically?

I've heard that some new meds are not stimulant. They might be good. But the
old Ritalin/Adderall stimulants have quite possibly caused the psychotic
symptoms you are talking about. That's what they do.

Are you familiar with street meth? Ritlain/Adderall are pharma grade long
duration forms of that. They have made me crazy before. And they don't "Halt
Depression" they get you so busy you that you won't reflect on yourself.

Artificial increases in motivation are silly. If you aren't inspired on your
own to do something, you probably should be doing something else.

Stimulants are much less than perfect and throwing out a pharma grade street
drug with the bath water is fine with me. It's drugs or it's not.

There are ways to handle ADD/ADHD without drugs. Change the environment.
Forcing kids to take meth is just wrong.

~~~
true_religion
If you're willing to throw out a "pharma grade street drug" then wouldn't you
be willing to throw out _any_ pharma-grade drugs that are used directly on the
street such as codeine, morphine, Valium, Vicodin, and any other broad
spectrum pain reliever.

~~~
Rexatron
Not pain meds for legit pain.

But as a ex-addict of benzos I would restrict those to epileptic patients...

The data on benzos for mania, depression, and suicide is scary. Long term use
has terrible effects.

Most docs don't prescribe the heavy ones for psychiatry anymore. Seizures are
a different story.

~~~
Alex3917
"Most docs don't prescribe the heavy ones for psychiatry anymore. Seizures are
a different story."

Benzos have actually made a huge comeback recently, and are quickly catching
up to their peak prescription levels in 1975. In 2009, benzos were 3 of the
top 20 most-prescribed psychiatric drugs prescribed in the US:

1\. Alprazolam (Xanax) 44,029,000

3\. Lorazepam (Ativan) 25,868,00

10\. Diazepam (Valium) 14,009,000

There were 83 million prescriptions for benzos written in 2007, as compared
with 103 million at their peak in 1975. (Granted there are more people today,
but still.)

source:
[http://www.erowid.org/general/newsletter/erowid_newsletter18...](http://www.erowid.org/general/newsletter/erowid_newsletter18.pdf)

(And also Anatomy of an Epidemic, p. 131)

~~~
Rexatron
That is scary.

My experience,when I was addicted, was that I couldn't find a doc to prescribe
them for me. Was it the dead-faced junkie staring back that prevented it?
Probably.

It's sad they are so heavily prescribed again, because I know how it feels to
rely on a pill to stop the pain and get out of my own head/anxiety. I'm lucky
to have found another way.

------
juiceandjuice
I'm one of those people who wishes they were diagnosed as a kid.

I've been diagnosed by two different psychiatrists with ADHD. I've been on
Adderall (XR) at dosages up to 80mg, Strattera, Wellbutrin XL + 10mg Adderall
(actually my favorite, but not so effective), and now I'm on Concerta
(Ritalin) 27mg/54mg.

The 27mg dose of Concerta is minimally effective without affecting my sleep,
so sometimes I need to boost it. I hate stimulants though, and I wish I could
get along fine without them but it's just not possible. Strattera worked good
but the "sexual side effects" were too weird for me to continue on. Wellbutrin
+ Adderall worked okay (with the benefit of me generally being a bit happier)
but my psychiatrist after moving didn't want me on two medicines that can
raise your blood pressure.

I ended up going to 6 different schools between 8th grade and graduating
across 4 different cities. Despite that, I graduated high school with a 3.5
and started college as a Sophomore. My first semester in college I got a 1.8
and thrown in academic suspension. The next three years would be really rough.
After that, I went to my family doctor and got adderall, and that helped out a
lot at first, but it wasn't a miracle drug and I still had to really force
myself to concentrate in weird ways to get through school, and that's really
where the adderall helped. Towards the end, school got easier and I enjoyed it
more, but I could also sit down and do homework.

I've gone off meds completely for a few months at a time almost once a year,
and I just can't do it. I wish I would have been diagnosed with it as a kid
and had the behavioral therapy along with it instead of having to wing it for
the past 6 years, but that's in the past. I also wish there was a non-
stimulant that worked really well without side effects too, but for now, I'm
happy with the Concerta.

------
mcantor
I'm 26, and I was diagnosed with ADD last year, at the suggestion of my dad,
who was not diagnosed until his 40's. It took me almost a year to start
actively researching ADD, because I grew up in an upper-middle-class community
where it was primarily over-diagnosed in unmotivated kids whose parents were
convinced that brain dysfunction was the only thing that could _possibly_ keep
their children from being A students. To say the very least, I was skeptical.

When I finally began learning about ADD, I was startled by how standard my
story was. Reading _Driven To Distraction_ was a watershed experience for me;
at times I was convinced that they had simply copy-and-pasted my academic
transcript: " _Dreamer_ ," " _Has a creative mind that would produce
incredible results if he applied himself once in a while_ ," " _Inconsistent.
What happened to the A student sitting in my classroom last year?_ "

In perspective, so much suddenly made sense; not just my experiences in high
school, but beyond that as well. I failed only one class in my entire academic
career, a programming course in my second year of college. How ironic and
confusing that my only failure would be in the subject for which I had the
most passion. Now it made sense. Only two or three years ago from today, I
almost lost my job because my output was so inconsistent. I barely scraped by
and recovered, but the experience shook me. Now, I understood.

There are many forms of treatment, all of which I have experimented with. When
it comes to medication, it took me a long time to settle on Adderall, which
lets me focus like a normal person without any appreciable side-effects. The
drug was a game-changer for me, like the first time I put on glasses.

I think I'm glad that I wasn't medicated as a kid, if only because of a deep
uncertainty about medicating something as malleable as a child's brain.
Conversely, going 25 years without diagnosis has also drastically affected
every part of my life. (I have no idea how my dad dealt with it for almost 50
years.) This was also something that I grew to understand as I learned more
about ADD; undiagnosed, it can lead to perennial struggles with depression,
self-esteem, poor impulse control and a host of others. I think the most
important thing about ADD isn't necessarily medication or even "treatment" but
simply _awareness_.

"Laziness" is a symptom, not a root cause. If we can be mindful about the
signs of ADD in childhood, we have already taken a huge step towards improving
the quality of life for people with the disorder, and everyone they interact
with. I'm sure there will be debates about how to treat it for many years to
come, but simple awareness can only help.

~~~
mattdeboard
I literally double-checked to see if this was copy/pasted from an old post of
mine. Getting treatment for ADHD changed my life for the better immediately
and dramatically, as well. And I've even used the, "It's like putting on
glasses for the first time" metaphor.

~~~
mcantor
Glad to know my post resonated with someone! I still struggle almost daily
with ADD-related complications, but getting on the treatment bandwagon was a
huge step forward.

~~~
mattdeboard
Still struggling? That's kind of depressing. Sorry, hope it gets better.

------
rdtsc
Another popular (anecdotal) explanation why this disorder is more prevalent in
America is that somehow the same genetic trait that motivated inviduals to
pack up and move to another continent, when amplified (after hundreds of
years) is somehow responsible for hyperactivity.

Basically "the settlers were a restless folk" they all come to America and
breed with each other, after hundreds of years you end up with a good number
of people who are "too restless to function".

Anway that is one popular theory, not sure if I personally endorse it but it
would seem to be somewhat supported by this find.

Of course the counter-point could be that doctors + parents + pharma companies
are just more eager to diagnose it in America, and I can see that happening
too somewhow.

~~~
felipemnoa
Nahhh. I think it has more to do with people being dead poor in their own
countries and is why they immigrated to America (Occam's Razor), better
opportunities. It is still the reason why people come to America today. Also,
too many people want to use disorders as an excuse for their lack of success.
"See, is not me, I'm actually pretty smart, is this damn disorder that is
holding me back. Not my fault."

~~~
HeyLaughingBoy
The overwhelming majority of "dead poor" people still wouldn't leave their
home country. Most people have very, _very_ strong ties to friends, family and
familiarity and have great difficulty with the concept of uprooting thier
life, no matter how bad, in such a manner.

------
bugsy
> Children with ADHD have a significantly higher rate of missing or duplicated
> DNA segments compared to other children

The problem with this study is they looked at kids who had been diagnosed and
were on long term drug therapy. This is similar to studies that show that ADHD
diagnosees on long term drug therapy have "brain damage", which matches the
brain damage of long term stimulant users. The findings are not an indicator
of ADHD, they are indicators of brain and genetic damage from long term drug
use.

Much more effective than Ritalin, and safer, for treating ADHD is the
prescription drug Desoxyn. It's not used as much because of the stigma of
taking methamphetamine hydrochloride. I mention this because everyone agrees
that methamphetamine is not an innocuous drug to take long term, the same goes
for Ritalin, they both have very similar effects on brain chemistry.

~~~
JunkDNA
This is not at all similar. It would be _highly_ surprising to me to find that
long-term exposure to ritalin leads to deletions and copy number variations in
someone's DNA. Furthermore, it is improbable that a drug causing DNA changes
would cause the same changes across a population in a statistically
significant way. Can you point me to any research that shows this to be the
case?

------
randall
For me, ADHD isn't a disorder as much as a collection of personality traits. I
have a bunch of traits I constantly have to look out for to ensure I complete
work, and I've built a system so that I can cope really effectively, w/o
medicine.

To argue that it's any other case is sorta weird.

~~~
mcantor
I don't think "disorder" and "collection of personality traits" are mutually
exclusive terms.

~~~
randall
I guess to be more specific: I don't think this should be treated as a medical
condition. I'm in the Temple Grandin camp of neurodiversity.

<http://en.wikipedia.org/wiki/Neurodiversity>

~~~
antimora
I agree with you. I don't think just because one's trait isn't optimal to the
modern environment it should be as a mental disorder and try fixing by
medication.

------
spydum
ADHD is a real problem, but the rate at which it's diagnosed, and the rate
that kids are just thrown Ritalin and other drugs is alarming. A child's brain
is a very plastic environment that is still developing. The impact it can have
on the brain is not as predictable as a developed adult.

It would be foolish not to try more sensible approaches like
diet/exercise/parenting FIRST, and if those have no impact, then consider
alternatives. However, this is not how parents of today approach problems.
They want the quick fix: give my child a pill/shot/instant gratification, so I
can get back to my job.

Also, this article is from Sept 2010.. not exactly news is it?

------
RandalMolek
I think this article understates one point. ADHD is already known to be highly
heritable, which already tells you genes are involved.

<http://i.imgur.com/G7jDX.png>

Also, the first association between ADHD and polymorphisms affecting the
dopamine transporter was found in 1995.

<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1801209/>

------
JunkDNA
This study is nearly a year old. Even at that, it is not an example of the
_first_ eidence that ADHD is a genetic disorder. There's at least one other
study from 2009 (<http://www.research.chop.edu/publications/press/?ID=475>)
that had similar evidence.

------
jason25
This is a debate about a pseudoscientific norm set by a bunch of "experts" who
evidently dislike children and have convinced millions of parents their
children are sick because they fidget in class.

------
lightblade
First, I do not believe ADHD is an disorder. It's a certainly a condition, but
it's not an disorder. And so I say this: ADHD is a genetic advantage and not a
generic disorder.

------
jason23
The term ADHD is meaningless. It is simply the level of activity deemed
excessive by the "expert" making the diagnosis.

------
antihero
Interesting. Is there any way I can volunteer my DNA for them to have a play
with? I was on Ritalin all through school.

------
jason23
"ADHD" is not a medical condition. It is the level of activity deemed
excessive by whichever "expert" is making the diagnosis. It was voted into
existence by a show of hands.

------
sparrish
Genetic? I highly doubt th... Squirrel!

