Threat *treats* the ADD brain. Problem: in this morning world, with helicopter parenting normative .... how does one present threats? My son probably longs for challenges and threats, so he's bored... and entertains himself with screens. Doesn't attend school. :-(
Hi Catherine: I use the term "threat treats ADD" as a hook or shorthand for remembering the upside of baseline poor working memory in someone who also fits the other traditional characteristics for the diagnosis of ADHD. Superior threat response brainset. When threat disappears, it is back to the low working memory. I cannot possibly give you all the nuanced details of all that in a short reply. But...
Threat changes dopamine function and presence for everyone. But, for the nonADHDer, such dopamine creates an above-optimal dopamine presence which degrades working memory. Another way of saying this in a memorable way is "ADHDers and nonADHDers 'switch' brains" when threat arrives. Dopamine is triggered and in those situations the nonADHDer becomes an ADHDer due to too much dopamine and the ADHDer becomes a nonADHDer because of improved dopamine but not "over-amped." However, for the 10% or so of ADHDers who also experience high sensory sensitivity, they generally do not have the same threat capabilities.
Working memory capacity (although not totally operating in one area of the brain) is dependent on tonic and phasic dopamine operations. In my world, I do not make a diagnosis of ADHD unless the usual characteristics are clearly presesnt PLUS significantly low working memory capacity.
Since all threats trigger dopamine release and other operations, when those who fit the criteria for ADHD encounter threats, they automatically experience better working memory. For those of us nonADHDers who also may have low working memory capacity but not "look" ADHD, threat will optimize WM for them also (that is a smaller population) For those nonADHDers who have optimal working memory and do not fit the criteria for ADHD (and no sensory sensitivities) their WM will degrade due to excess dopamine operations. See the inverted U-shaped curve of dopamine in my book or online.
The other thing about increased dopamine in the nonADHDer due to threat response operations is feeling "sick." I have written a lot about how above-optimal dopamine also creates a number of "physiological alarm bells." It is unfortunate that the legacy of "dopamine is about pleasure" has been so over-blown compared to the other absolutely survival-important functions of dopamine in threat response and alarm bells. One example of a dopamine alarm bell is its role in triggering increasing feelings of gut discomfort, ranging from "butterflies" to nausea to vomiting in motion sickness, poison responses, pain, eating, alcohol (and all the other dopamine enhancers), standing on a cliffside, etc. (Also covered in my book). This means that for the ADHDer there are fewer alarm bells (disincentives, speed-bumps, etc.) being set-off while doing threat related activities or utilizing dopamine enhancing drugs (cocaine, tobacco, alcohol, etc.)
"Look mom, no speed bumps." Between doing better in threat situations (and thus feeling good/competent, along with not being hit by an ill feeling ("butterflies," queasy, nausea, vomiting, dizzy, etc.), there are fewer disincentives compared to those with optimal dopamine (good working memory). The nonADHDer experiences (unless sensory sensitive) the "side" effects of even mildly over-amped dopamine. So, two major disincetives for the nonADHDer: degraded working memory and its consequences, and feeling "sick" (side effects of too much dopamine). My shorthand advice: "If you do not fit the criteria for ADHD don't get in the cage with someone who does."
I will say a couple of things about kids and threat activities. We are here in our culture having given those threat-capable folks very few alternatives for experiencing the upside of their particular brainset. Shooter games, UFC, football, wrestling, and on and on.... it has been a predictable (if you knew who could and who couldn't benefit from threat) that the alarm-bell free folks would get gigantically exploited by that vulnerability. I have some thoughts on how kids can be assisted in understanding their situation and then brainstorming with professionals on how to find "satisfying" activities that are less dangerous, etc. Knowing why you desire threat (need dopamine enhancers) can allow more informed decisions as kids grow-up and get better at "thinking twice." Intense individual sports and team sports that are not too injury risky. Competition good, non-competition, boring. You may know about the Olympic champion swimmer Phelps. His ADHD was clearly treated by his constant training and when he more or less retired from competition, he found marijuana to be helpful in his life (unfortunately, got in trouble). Later, he was reportedly prescribed and found the right dopamine enhancer med.
Hope that helps. I wish it was much simpler to talk about what I learned in the last 20 years, but it really does take a lot. Dopamine functions are complex but quite well understood now. The use of the phrase "dopamine deficiency" is very misleading. Dopamine functionality goes way beyond just being "the right amount." In addition to CNS dopamine processes, dopamine receptors and operations in many parts of our bodies are affected by the same genes that control operations in the brain. For instance, bronchial dilation is highly influenced by dopamine functions. For many years, a dopamine enhancer (Benzedrine) was used for asthma treatment until it became clear that it was too risky to use with its ability to create tolerance and need.
Again, thank you for your interest and questions. Take care, Ron
I appreciate your idea: Threat *treats* the ADD brain. I've been aware that ADD'ers are good under threat... I just hadn't gone all the way to the idea of: threat treats the ADD brain. With threat, one doesn't need meds. The example of careful fearlessness I've seen from my son: he takes risks; likes climbing on top of things (at age 7 he climbed on to the garage roof); but is is smart with risks that he has never broken a bone. Here is a video of my son at age 5 after he jumped off a 15 foot terrace... https://www.youtube.com/watch?v=pOH-E8Ljd2U
You are welcome. I hope it is helpful. I am updating it to make it current by reviewing all the relevant research since 2013. It will be done by end of year. It can be a bit too scientific at times, so, please feel free to ask questions or provide feedback at the Discussion page on my substack. (Teaser -- so far I have found no significant newer research that questions my hypotheses, but a ton of it supports what I wrote about in the 2013 Book) (Smiles)
Threat *treats* the ADD brain. Problem: in this morning world, with helicopter parenting normative .... how does one present threats? My son probably longs for challenges and threats, so he's bored... and entertains himself with screens. Doesn't attend school. :-(
Hi Catherine: I use the term "threat treats ADD" as a hook or shorthand for remembering the upside of baseline poor working memory in someone who also fits the other traditional characteristics for the diagnosis of ADHD. Superior threat response brainset. When threat disappears, it is back to the low working memory. I cannot possibly give you all the nuanced details of all that in a short reply. But...
Threat changes dopamine function and presence for everyone. But, for the nonADHDer, such dopamine creates an above-optimal dopamine presence which degrades working memory. Another way of saying this in a memorable way is "ADHDers and nonADHDers 'switch' brains" when threat arrives. Dopamine is triggered and in those situations the nonADHDer becomes an ADHDer due to too much dopamine and the ADHDer becomes a nonADHDer because of improved dopamine but not "over-amped." However, for the 10% or so of ADHDers who also experience high sensory sensitivity, they generally do not have the same threat capabilities.
Working memory capacity (although not totally operating in one area of the brain) is dependent on tonic and phasic dopamine operations. In my world, I do not make a diagnosis of ADHD unless the usual characteristics are clearly presesnt PLUS significantly low working memory capacity.
Since all threats trigger dopamine release and other operations, when those who fit the criteria for ADHD encounter threats, they automatically experience better working memory. For those of us nonADHDers who also may have low working memory capacity but not "look" ADHD, threat will optimize WM for them also (that is a smaller population) For those nonADHDers who have optimal working memory and do not fit the criteria for ADHD (and no sensory sensitivities) their WM will degrade due to excess dopamine operations. See the inverted U-shaped curve of dopamine in my book or online.
The other thing about increased dopamine in the nonADHDer due to threat response operations is feeling "sick." I have written a lot about how above-optimal dopamine also creates a number of "physiological alarm bells." It is unfortunate that the legacy of "dopamine is about pleasure" has been so over-blown compared to the other absolutely survival-important functions of dopamine in threat response and alarm bells. One example of a dopamine alarm bell is its role in triggering increasing feelings of gut discomfort, ranging from "butterflies" to nausea to vomiting in motion sickness, poison responses, pain, eating, alcohol (and all the other dopamine enhancers), standing on a cliffside, etc. (Also covered in my book). This means that for the ADHDer there are fewer alarm bells (disincentives, speed-bumps, etc.) being set-off while doing threat related activities or utilizing dopamine enhancing drugs (cocaine, tobacco, alcohol, etc.)
"Look mom, no speed bumps." Between doing better in threat situations (and thus feeling good/competent, along with not being hit by an ill feeling ("butterflies," queasy, nausea, vomiting, dizzy, etc.), there are fewer disincentives compared to those with optimal dopamine (good working memory). The nonADHDer experiences (unless sensory sensitive) the "side" effects of even mildly over-amped dopamine. So, two major disincetives for the nonADHDer: degraded working memory and its consequences, and feeling "sick" (side effects of too much dopamine). My shorthand advice: "If you do not fit the criteria for ADHD don't get in the cage with someone who does."
I will say a couple of things about kids and threat activities. We are here in our culture having given those threat-capable folks very few alternatives for experiencing the upside of their particular brainset. Shooter games, UFC, football, wrestling, and on and on.... it has been a predictable (if you knew who could and who couldn't benefit from threat) that the alarm-bell free folks would get gigantically exploited by that vulnerability. I have some thoughts on how kids can be assisted in understanding their situation and then brainstorming with professionals on how to find "satisfying" activities that are less dangerous, etc. Knowing why you desire threat (need dopamine enhancers) can allow more informed decisions as kids grow-up and get better at "thinking twice." Intense individual sports and team sports that are not too injury risky. Competition good, non-competition, boring. You may know about the Olympic champion swimmer Phelps. His ADHD was clearly treated by his constant training and when he more or less retired from competition, he found marijuana to be helpful in his life (unfortunately, got in trouble). Later, he was reportedly prescribed and found the right dopamine enhancer med.
Hope that helps. I wish it was much simpler to talk about what I learned in the last 20 years, but it really does take a lot. Dopamine functions are complex but quite well understood now. The use of the phrase "dopamine deficiency" is very misleading. Dopamine functionality goes way beyond just being "the right amount." In addition to CNS dopamine processes, dopamine receptors and operations in many parts of our bodies are affected by the same genes that control operations in the brain. For instance, bronchial dilation is highly influenced by dopamine functions. For many years, a dopamine enhancer (Benzedrine) was used for asthma treatment until it became clear that it was too risky to use with its ability to create tolerance and need.
Again, thank you for your interest and questions. Take care, Ron
I appreciate your idea: Threat *treats* the ADD brain. I've been aware that ADD'ers are good under threat... I just hadn't gone all the way to the idea of: threat treats the ADD brain. With threat, one doesn't need meds. The example of careful fearlessness I've seen from my son: he takes risks; likes climbing on top of things (at age 7 he climbed on to the garage roof); but is is smart with risks that he has never broken a bone. Here is a video of my son at age 5 after he jumped off a 15 foot terrace... https://www.youtube.com/watch?v=pOH-E8Ljd2U
Thank you for your generous sharing Dr. Ron
You are welcome. I hope it is helpful. I am updating it to make it current by reviewing all the relevant research since 2013. It will be done by end of year. It can be a bit too scientific at times, so, please feel free to ask questions or provide feedback at the Discussion page on my substack. (Teaser -- so far I have found no significant newer research that questions my hypotheses, but a ton of it supports what I wrote about in the 2013 Book) (Smiles)
Take care, Ron