Introduction
In recent decades, ADHD (Attention Deficit Hyperactivity Disorder) has become a sensational label to be debated in medical forums and on social platforms. Enormous amounts of data that are available digitally about ADHD show us a clinical picture and categorize it as a medical defect that needs immediate intervention.
Minimal efforts are made to understand its evolutionary nature and etiology. This disparity causes confusion and misjudgment about ADHD and creates a taboo in society. This article brings in the brighter side of ADHD and argues for rethinking ADHD as an adaptive mechanism that got mismatched in the evolutionary process rather than a health stigma. Such a tangential approach would help better understand the syndrome and create more appropriate scientific management perspectives.
What Is ADHD?
The CDC (Centers for Disease Control and Prevention) defines ADHD as a spectrum of neurodevelopmental disorders that are widely characterized by a combination of persistent behavioral symptoms such as attention difficulties, hyperactivity, and impulsiveness. It is usually first diagnosed in childhood and often continues into adulthood.
Children with ADHD would have trouble paying attention, controlling impulsive behaviors (acting without thinking about the result), or showing overly activeness. These behaviors are also seen in adults.
Attention-deficit or hyperactivity disorder (ADHD) is marked by a progressive pattern of inattention, which may or may not be accompanied by hyperactivity and impulsivity, that commonly interferes with an individual’s functioning and development.
ADHD, despite being an extensively researched entity, remains an absolute mystery. The absolute reason for its existence in child and adolescent mental wellness remains unknown. Diverse scientific evidence suggests that ADHD is genetic, whereas some suggest that it is a biological disorder due to structural changes in the brain. Environmental factors and lifestyle changes also influence the expression of ADHD behavior in an individual.
What Are the Symptoms and Management of ADHD?
Children with ADHD struggle with poor performance at school, develop low self-esteem and often have trouble coping with relationships.
Some of the clinical manifestations of ADHD in children are as follows -
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They show a short attention span for their biological age (difficulty sustaining attention).
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Difficulty listening to others.
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Difficulty in attending to details.
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Being easily distracted.
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Forgetting day-to-day events frequently.
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Children with ADHD often exhibit impulsivity, such as difficulty waiting for their turn in school activities, social sports, and games.
ADHD could also extend and affect adulthood. Some adults have had ADHD symptoms since childhood but have never been diagnosed.
Some of the ADHD symptoms seen in adult individuals are as follows -
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They face difficulty at work (coordinating with coworkers).
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At home, they feel uncomfortable adjusting to family members.
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Also have troubled relationships.
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Symptoms aggravate when the demands for skill development and coordination increase during adulthood.
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ADHD adults experience difficulty organizing schedules and prioritizing multitasking and time.
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They have difficulty focusing on work and become anxious and frustrated.
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They exhibit eccentric mood swings and struggle to cope with stressful situations.
Although presently no exact cure is available for ADHD, counseling therapies and strategic treatments help in lowering clinical symptoms and also enhancing social functioning. ADHD management often includes education, training, psychological counseling, and medications (only in severe conditions). ADHD-supportive organizations and telemedicine platforms provide therapeutic strategies, recommendations, and suggestions for coping with daily tasks from healthcare experts and those with the disorder (success stories), to empower individuals facing difficulties.
What Is the Current Scenario for ADHD?
The conceptual understanding of ADHD among the general audience and healthcare professionals is highly diverse, eventually leading to a greater risk of stigmatization of individuals with an ADHD diagnosis.
This taboo and stigma associated with ADHD greatly impact factors such as treatment adherence and therapeutic efficacy, resulting in unresponsiveness to therapy or symptom aggravation. Hence, the quality of life and ADHD individuals’ mental wellness is greatly compromised.
Present-day researchers and scientists are working on theories that postulate ADHD as an adaptive response to evolutionary patterns influenced by genetic expressions and environmental modifications.
Such clinical study models help analyze the characterization of ADHD expression since not every individual with ADHD shows the same personality traits and behavioral symptoms. They often have vivid degrees of clinical manifestation. Scientific studies on their behavioral patterns are working on identifying personal and progressive strengths that could be used to moderate the condition as an advantage and not as a drawback.
What Is the Evolutionary Perspective of ADHD?
Evolution, in general, means passing on certain traits (physical and behavioral) over generations within a group of species, which preferably helps in the survival and continuation of the species without extinction. These traits have been preserved and retained in the genome of a species since they help that particular species adapt to its environment.
Consider a situation many million years ago when the ancestors of modern-day humans adopted a nomadic lifestyle and lived the life of hunters and gatherers. Their environment was more adventurous and risk-taking compared to the sedentary lifestyle we now lead. Thus, these hunter-gatherers must have developed the impulsivity to sense food and danger, be hyperactive in hunting circumstances, and react unpredictably while facing unknown threats.
Research studies on certain nomadic communities suggest that a particular genetic variant (DRD4 7R) is responsible for active prey-seeking and hyper-reactive responses to threats in these groups. This genetic variant has also been isolated in ADHD individuals.
Thus, researchers have found that the unpredictable behavior (a key characteristic of ADHD) that was once helpful in protecting our ancestors against predator attacks, natural disasters, and unpredictable danger has become an ‘evolutionary adaptive mismatch’ in some individuals expressing ADHD.
Surveys show that people with ADHD struggle to adapt to a more organized, sedentary lifestyle and a society lacking adventure. Confining children to rigid classroom schedules and prolonged durations of passive learning education curriculums are also responsible for increased ADHD.
Hence, individuals more susceptible to developing ADHD through genetic predisposition exhibit hyperactive symptoms when triggered by environmental influences. This differential understanding of ADHD is essential to changing, modifying, and improvising the existing therapeutic interventional approach for ADHD.
Conclusion
ADHD is a manageable lifestyle condition with complex manifestations. It is not a serious disorder to be feared and stigmatized. Understanding ADHD as an evolutionary biological variant rather than a clinical dysfunction would open new perspectives for healthcare providers in diagnosing and treating the disorders. It would help ADHD individuals to understand their strengths and choose a lifestyle where the eccentricity is valued, for example, in sports, adventure tours, the military, or any other job where physical activity and rapid decision-making are highly demanded. Providing a dynamic environment and appropriate lifestyle modifications would facilitate ADHD children and adults to improve the learning skills, assert their talents, and upskill the strengths.
