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Is ADHD a Spectrum Disorder?

New research suggests that ADHD comprises several meaningful subgroups — each one tied to a weak connection in the brain’s neural networks. Mapping the regions of the brain that control attention, impulsivity, and emotion, can help explain why scientists are studying the “white matter” connections between these circuits.

10 Comments: Is ADHD a Spectrum Disorder?

  1. I’m dismayed that after all this time that there is still no ‘brain stimulation’ treatment for the “breakdown in the connectivity, the communication networks, and an immaturity in these networks” mentioned in this article, that plagues anyone with ADHD.

    In the same way that people who’ve experienced a stroke find their brain starts makes fresh neural connections around the stroke site – re-routing in order to repair things like speech and movement to pre-morbid functioning…

    I wonder why the ADHD brain cannot be stimulated in such a way to either rediscover these faulty or broken connections, strengthen or even forge them for the first time?

    Does anyone know of any research investigating this avenue?

    In recent years I’ve been very encouraged by the work of Professor Robin Carhart-Harris of the Psychedelic Research Unit (PRU) at Imperial College, London. They are doing extraordinary things in the the field of treatment-resistant depression, PTSD, morbidity fear in the terminally ill, alcohol dependence, and many more exciting innovative clinical trials.

    The benefit of introducing psychedelics *alongside* therapy has been shown to significantly increase number of new neural connections and traffic therein, giving patients not only extraordinary new insight into their condition, but also offering many participants with Major Depressive Disorder, a pressing reset experience, reported by many candidates in Imperial’s (and John Hopkins who they sometimes partner with) trials.

    The PRU is now adding trials for patients with Anorexia Nervosa, and other conditions.

    I can’t help but wonder who – if anyone – has considered what psychedelic treatment may offer those with ADHD – particularly in the area of forging new neural networks. It seems too interesting a possibility to ignore.

  2. Having been diagnosed as ADHD In 2018 my mind went into overdrive my research of ADHD led me to see not only just how abundant undiagnosed ADHD is but also how it vastly differs from person to person. My X partner and I were like chalk and cheese he kept everything together he was so able and yet I could see he too was totally ADHD confirmed last year with his diagnosis.

  3. Effemerald: “Attention Difference HyperActive Drive, for instance, might be a neutral label.”

    I love this! I do think the current label is unfortunate and inaccurate for many. As has already been well-established, many people with ADHD are able to hyperfocus on something that is interesting to them. If you parlay that “something” into a career field, then it is definitely not a deficit! I agree that to label different wiring as a disorder may not be accurate or fair to everyone. I think it’s entirely possible that we will see a re-labeling as science uncovers more about ADD and ADHD. Considering it’s believed that the prevalence of ADD and ADHD are higher than current numbers suggest, are these conditions really so a-typical after all? Only about 2% of the world’s population has green eyes, yet no one ever calls green-eyed people “a-typical” or suggests that it’s a disorder.

  4. Interesting article. This sheds a little more light on what I thought were unrelated aspects of my personality. I have ADD, I would say more of the inattentive variety, though I can see aspects of the other subtypes as well. But I also seem to have an issue with being in a state of hyperarousal–I often am easily startled and jump when I hear an unexpected sound. One of my colleague friends even jokingly likes to make me jump. It’s an annoying trait but I can’t do anything about it. I think this hyperarousal state is also responsible for my light sleep. I don’t often get into a very deep stage of sleep (also confirmed by my fitbit) and will be up all night when it storms while my wife sleeps right through it. I am shy and would like to be more outgoing, but I wouldn’t say I have an anxiety disorder. Never had a panic attack. Just wish I could tamp down this overexcitement part of my brain, while at the same time increase the motivation to get stuff done. At work I spend a lot of time surfing the internet (like right now) instead of focusing on my tasks, and even at home it seems to take me forever to get any home projects finished…

  5. Effemerald (above)

    My brain certainly feels ‘disabled’ and ‘disordered’… haven’t found it to be a ‘blessing in disguise”.
    My brain feels like sludge, my thinking fogged, and decisions taxing.

    Perhaps my perspective comes from having ADD as opposed to ADHD. I am missing the “hyperactive component” that may be considered “beneficial” if focused in a constructive way (as you pointed out in your comment).

  6. I appreciate the introductory explanation of observable brain function and drawing awareness to how ADHD will manifest differently for individuals. We are all individuals – not all “neurotypicals” are identical! This is important because I find people think they can recognize ADHD because of individual cases they’ve met and cross off others because they don’t fit that stereotype.

    However, I especially appreciate the comment above. While I have benefited greatly from this website, I have a problem with the underlying assumption that a certain population with a particular brain type is “disordered” and that we have a “deficit”. Any person put into an environment or particular job completely unsuited to his or her gifts and thinking capacities, will look disordered! Just put a brilliant engineer into a party of theatre artists or a financier into a room of theologians (not to strictly stereotype – there could be cross-over! :)) – but you get my drift. Part of the problem is the actual term and the 2 Ds in ADHD. Attention Difference HyperActive Drive, for instance, might be a neutral label.

    We all have challenges in certain environments – surround yourself with people to whom you are atypical and you’ll probably feel insecure and dysfunctional. Understanding our differences is crucial and this is why I’m so glad for the articles. It feels amazing to know there are others like me, and why I don’t “measure” up in certain areas and what I can do to overcome it for what my civilization today demands of me. Or why certain people will enjoy my personality and others will come away with a negative impression – and what I can do to accommodate and adapt when beneficial. What excesses I may have to moderate in certain circumstances and where I can just “take-off” and fly. Why certain types of pedagogical approaches will NOT help my highly intelligent son learn, without fearing he has a problem, and patience when he needs transitioning from one activity to another, and when what seem to be average parental demands send him for a complete tailspin.

    Understanding one another and ourselves is critical for self-growth and effective relating. Diagonising a large minority of our population as disabled is problematic.

  7. Okay, sounds interesting, I’m not sure I agree 100% with the hypothetical parts. Here’s why, IQ is generally higher in people with ADHD which is the actual transmission speed of the neurological fibers. This cannot be changed, and although the sheathing helps the signal travel faster you mentioned the testing of certain fibers, which fibers are important.
    Here is a slightly tangent theory, what if the brain in someone with ADHD is fundamentally wired differently. So the DNA is structuring the fibers so that it is not establishing the same strong network connections because it is placing emphasis on direct pathway connections (serial) at the expense of parallel connections. This could be evolutionary adaptation for tasking purposes, such as the old hunter gatherer hypothesis. It would stand to make sense, inattention is more the hyper-sensitivity to distraction, but honestly noticing a leaf move at 200m is important when your hunting and a T-Rex could be near. I’d rather have that ADHD kid on point during a patrol because he is going to notice everything including smells, you can smell cigarette smoke over a mile away, not a bad trick, but wouldn’t 1.5 miles be better? Not to mention hearing etc…
    Impulsivity is an issue, or is it the side effect of hyper-reflexes, which is measurable and linked to attention. Try drag racing someone with ADHD, once they “lock in” on that light try and beat there foot to pedal instinct. Yes there are negative consequences but is that exacerbated by they world as it is today?
    Emotional control I would think is a little multi-faceted, one is the dopamine hit you get when you get what you want which would encourage risky behavior. Could be bad, or good if you think far back enough where our adventurous urges brought us out of caves and enabled us to use fire and hunt larger and larger beasts. The other is this, try having heightened hearing in a world that is so noisy, or heightened touch where you skin feels even the slightest breeze (which of course you notice), or eyes that see everything. Increased smell when everything smells different (and you notice) so much so that too much incense or strong smells can even make you sick. The world is an expansive place with all this extra stuff (noise) going on, so why wouldn’t you seek solace or get a little impatient. Could it be that feeling more sad or happy is a direct result of this cause and effect reward system?
    Maybe, just maybe, these differences are a purposeful adaptation that happens in a specific set of off-spring that increase the chances of exploration while the other set of off spring “hold the ground” with brain developed for more parallel thinking.
    Or maybe I’m just a very successful ADHDr/polymath that wants to believe this issue I have is something more than an aberration, much less a malformed brain. Maybe humans have developed in a way that allows a percentage of offspring to develop brains structured differently because of task organization, neither better or worse, just different for their different roles. Yes with maturity I’ve found that I do think more before I do things and yes the safety factor in adventurous activity has increased about 100%, but then again it was time to have kids so maybe there is a correlation with the myelin sheathing there as well. If we survived we reproduced and that worked out okay because I’m here.
    I think there should be more emphasis on why brains develop this way, what actual advantage each type of brain brought to the collective table. Not so much that a certain fiber developed slower, but why it would and is there a corresponding fiber that is perfectly fine and/or developing faster. Maybe reverse engineering what you find; not as if it were a problem but rather as if it were a solution to a problem.

    1. Thank you Bhoff and others! I have two boys and a husband who have been diagnosed with ADHD and will share your thoughts with them. You’ve helped me defame my thinking.

    2. Thank you, I couldn’t agree more. The Farmers are still putting the Hunters down, I’m afraid. Glad you could put this in such a positive light for those of us tired of being considered less than who we really are.

    3. I am merely a lay person (adhd combined type plus comorbidity-dyspraxic..I am also dyscalculic)-diagnosed at 54 at my Uni and through my gp for these splds.I do find your extrapolation makes a good point-I am of average intelligence but some ways I have ideas etc makes others exclaim ! In a good way mostly ☺ I think your point can exist as an expansion from ‘their’ point- but yes,left as is can severely restrict the overall theme back to “retarded” status left with bare facts, when as you say intelligence is often higher or at least average;which is very important and can and should co-exist with the findings as another exploration that goes along with the physical evidence found. “So how do we explain the perceived or actual higher I.Q? ” -Would definitely be a route worth exploring. I think this is where it has similarities with ASD (superficially,) My example is I know 2 ASD brothers …one is at Oxford ..the other is completely dependent on his parents for life and severely affected by his ASD. Thanks for this additional thought…very interesting and feels very likely to be worth looking into partly to de stigmatise and partly to gather more facts.

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