ADHD as a Stress Response to Early Childhood Trauma

Key Quotes

"between 2000 and 2018 adhd diagnoses in the uk rose approximately 20 fold among boys aged 10 to 16 diagnosis increased from 1 roughly to about 3 5 in 2018 and in men aged 18 to 29 there was a nearly 50 fold increase in adhd prescriptions during the same period and the same applies to the united states where an estimated 15 5 million adults in the us have been diagnosed with adhd approximately one in nine us children have been diagnosed with adhd at some point with 10 5 having a current diagnosis"

Erica Komisar highlights the dramatic increase in ADHD diagnoses and prescriptions in both the UK and the US over a roughly 18-year period. Komisar notes that this surge in diagnoses, particularly among young boys and young adults, prompted her to investigate the underlying causes. This data point serves as the foundational evidence for her subsequent discussion on modern parenting practices.

"what we're doing now by separating mothers and babies by putting babies into daycare with strangers um is by sleep training babies all these weird things that we're doing to babies is we're turning the amygdala on we're making it active precociously too early"

Komisar explains that certain modern parenting practices, such as early separation of mothers and babies, daycare, and sleep training, are prematurely activating the amygdala, the brain's stress-regulating center. Komisar argues that this early activation is detrimental because the amygdala is meant to remain offline for the first few years of life. This premature activation, she suggests, sets a negative trajectory for stress management throughout a child's life.

"what we're seeing in children's brains is that the amygdala is growing very precociously large and the hippocampus which is the off switch is very small so we have this problem and as we say houston we have a problem we have an on switch going full speed gas no brakes and no off switch and that's causing adhd behavioral problems that are hugely rising in children in school a lot of aggression and violence and so that's what's happening"

Komisar describes a concerning imbalance in the developing brains of children, where the amygdala (the "on switch" for stress) becomes oversized and overactive, while the hippocampus (the "off switch") remains underdeveloped. Komisar posits that this imbalance, characterized by a constant state of stress response without a functional off switch, is the direct cause of the rising rates of ADHD and associated behavioral issues like aggression in children.

"what they did find is a genetic tie to something called the sensitivity gene it's a short allele on the serotonin receptor and serotonin as we know is used to regulate happy emotions to regulate emotions right so when you have a short allele it means that you have a harder time picking up the serotonin but it also means that you are more sensitive to stress"

Komisar addresses the genetic component of ADHD by explaining the role of a "sensitivity gene," a short allele on the serotonin receptor. Komisar clarifies that this gene does not directly cause ADHD but makes individuals more sensitive to stress due to a reduced ability to process serotonin, which regulates emotions. This heightened sensitivity, Komisar argues, is a key factor that, when combined with environmental stressors, can lead to mental health challenges.

"what the study shows is if those children who are born with that gene for sensitivity are provided with emotionally and physically present attachment security in the first year it neutralizes the expression of that gene so those children could be as healthy as children born without that gene if however children born with that sensitivity gene were neglected you know abandoned not provided with sensitive and empathic present nurturing it exacerbated that gene"

Komisar explains the concept of epigenetics in relation to the sensitivity gene, stating that environmental factors can control gene expression. Komisar highlights that children born with this gene can have their predisposition to mental illness neutralized if they receive secure, present, and nurturing attachment in their first year. Conversely, Komisar notes that neglect or a lack of sensitive parenting can exacerbate the gene, increasing the risk of mental illness.

"the deal is you don't yell at your children an emotionally regulated parent a healthy parent produces a healthy child so what is a healthy parent a healthy parent is a parent who feels good about themselves who has authentically good self esteem not grandiosity but really feels good about themselves knows their strengths and limitations and overall as a whole person feels good about themselves they have the capacity to regulate their emotions to keep their emotions from going too high and too low remember sailing in the caribbean meaning they can stay calm in a storm"

Komisar defines a healthy parent as someone who is emotionally regulated, possesses authentic self-esteem, and has the capacity to manage their own emotions effectively, remaining calm even in stressful situations. Komisar asserts that such a parent is crucial for producing a healthy child. This emotional stability in the parent, Komisar suggests, creates a secure environment that supports the child's well-being and development.