A ‘Natural Fix for ADHD’

There’s an interesting and nuanced piece about ADHD in the New York Times that’s worth reading—nuanced, that is, except for the headline, A Natural Fix for ADHD, which is quite misleading. It promises something the author, Richard Friedman, doesn’t deliver, unless you consider a “natural fix” for kids who have ADHD to time-travel back to the Paleolithic era.

Dr. Friedman speculates that the behaviors associated with ADHD would have been advantageous in a nomadic, pre-agricultural society, when having a brain hardwired for seeking novelty and excitement could make you a highly successful hunter. Fast forward to the 21st Century and you have an environment in which succeeding in life requires sitting still in elementary school, passing exams in high school, taking in lectures in college, and (for many people) doing a job in an office.

Dr. Friedman’s piece is good because it explores the research about what’s going on in the brain that generates restlessness and the need people with ADHD have for a higher level of stimulation than other people need to stay engaged. But it also recognizes the huge cultural changes—especially in school and work—hat are contributing to the sharp rise in ADHD diagnoses.

Dr. Friedman mentions one patient who found that a desk job at an ad agency was intolerable, so he “threw himself into a start-up company, which has him on the road in constantly changing environments. He is much happier and—little surprise—has lost his symptoms of ADHD.”

He suggests that, similarly, some school environments are better for kids with ADHD. “In school, these curious, experience-seeking kids would most likely do better in small classes that emphasize hands-on-learning, self-paced computer assignments and tasks that build specific skills,” he writes. Would that more kids with ADHD have access to that kind of school.

Still, there’s no “natural fix.” Dr. Friedman, who is the director of the psychopharmacology clinic at the Weill Cornell Medical College, recognizes that stimulant medication is a huge help to some, citing one patient, a student, who finds that it enables her to focus in lectures—something that she isn’t able to do without it—and avoid resorting to alcohol to relieve boredom.

For kids with ADHD the real “fix” is a combination that’s tailored to each child, and it might include support for staying organized, more exercise, medication, and, as ADHD activist David Flink writes in Thinking Differently, helping each child figure out what his strengths are, as well as his weaknesses. As Dr. Friedman concludes:

This will not eliminate the need for many kids with ADHD to take psychostimulants. But let’s not rush to medicalize their curiosity, energy and novelty-seeking; in the right environment, these traits are not a disability, and can be a real asset.