Hey everyone. About 2 weeks ago I attended a fantastic ADHD conference though the MGH Psychiatry Academy here in Boston… well, actually Cambridge. It was geared toward medical professionals — I was probably the only coach in the room, but that’s fine with me. Basically, the conference was a review what we know about ADHD, presentations on all of the new science from the past year, and the implications of how this knowledge helps those of us with ADHD be effectively treated. Topics included stimulant and non-stimulant meds, CBT, neuro-imaging, the genetics of ADHD, managing ADHD in college students, and so much more. This is the first of what I hope to be many posts over the next few months about what I learned. I hope they are helpful. Please reach out if you are interested in more information. I will do the best I can to send you in the right direction.
Possibly the most interesting and important thing that I learned was about medication and the ADHD brain. (Much of this is from a study that hasn’t even been published yet.) There are really two parts to this.
1. As brain scanning becomes more sophisticated we are better able to isolate population differences between our ADHD brains and the “neurotypical” brain.* In large scale population studies, it has been proven that there is a small but substantial difference in the size of our ADHD brains. Certain regions are, on average, smaller — as I recall about 10-15%. (As a note here, don’t interpret this as a lack of intelligence The last study I saw indicated that ADHD’ers actually have a slightly higher than normal IQ, 100 vs. 107.)
There is also some really interesting information about how our brains work when they are working versus when they are at rest. I will be honest, I’m not sure I fully understand this. But the impression that I got was that the scientist don’t really understand what it means yet, but that they have identified it as a key difference from the neurotypical population.
Bottom line for this part is that we can conclusively say that the ADHD brain is structurally chemically, and functionally different. I could go on at length about the implications of this now being proven fact. I will save most of this for another post, but just note here, that this fact alone should dispel much of the societal issues we still seem to struggle with around the idea of medication. Yes, ADHD is brain-based, but it is physiological in origin.
2. Whether, when, and how to medicate children has always been a difficult question to answer. I do not pretend to have a concrete answer. However, new research indicates that the prospect is not as frightening as we once thought. Historically, the predominant school of thought was that long term use of stimulants would negatively affect a growing brain. Over time with no evidence of this negative outcome emerging, the paradigm shifted. The school of thought evolved to the idea that the stimulants long term effects’ were neutral. Nothing bad, nothing good.
The most current study, using the most cutting edge brain scans, now indicates that the long-term use of stimulants by ADHD’ers seem to play a role in helping to reshape the brain to make it look more like a “normal” brain. The bottom line is that it appears that stimulants can tap in to the neuroplasticity of the brain and do long term good. Pretty cool!
*The idea of population studies is that these results are the averages of huge groups of participants. By saying that the “population” of ADHD’ers exhibit a trait, it does not mean that all ADHD’ers will do so. The point being that these scans are not a tool for individual diagnosis. However, there is hope that science may eventually get there.