Whole Psychiatry & ADD / ADHD

ADD and ADHD are now such common diagnoses that one has to wonder what is going on. Are we diagnosing it more because we are looking for it more? Is it being over- diagnosed? Are other learning disabilities being lumped in to the ADD/ADHD basket? Are there non-medicinal causes of ADD/ADHD, that have increased in Western Society?

Let’s look at these issues, from a Whole Psychiatry perspective, in this section.

First, there is some controversy over whether or not it is actually a bona fide disorder. Hartmann (1993) believes that what we call ADHD is actually a normal variant of human behavior that doesn’t fit in with current cultural norms. He divides people into hunters (ADHD) and gatherers/farmers (obsessive-compulsive personality disorder). His idea is that people who have ADHD have qualities that would be quite adaptive, if not essential, to a hunting society. For example, if one were hunting with someone with ADHD, the distractibility would enable him to spot the subtle movements of prey from the corner of his eye, the impulsivity would allow him to initiate attack (motor) behavior rapidly, and the general decreased reliance on social relationships (people with ADHD are low on intimacy needs and often have conflict with authority and social standards) would serve him well as he would be away from the main social group much of the time. The farmer/gatherer person who is more rigid, rule bound, and can only act in stereotypic ways would clearly be at a disadvantage when hunting. He would ploddingly move through the forest, looking for game, bothered by the unpredictability of it all, and anxious about leaving behind the people he is attached to. When this person spots an animal (which he is less likely to do because he is less distractible), he will consider whether to attack, weighing options carefully, while the prey is likely to move away.

This theoretical approach is useful on several accounts. It improves patients’ self-esteem and corroborates their long-term experience of not fitting in. It seems to support the ADHD/OCD polarity and is consistent with the data on temperamental styles. It seems to make intuitive sense that the fabric of the human species is strengthened by the fact that it is composed of different strands, or temperamental styles, which allow for flexibility in the larger sense. Maybe our kids don’t have ADD/ADHD—maybe our culture has a school deficiency syndrome, meaning, we only have one type of school for so many different types of children!

The second issue to consider is the effect of our heavy chemical and pesticide load on the developing fetus and child. One study in South America was fascinating. Two culturally identical villages were studied for the frequency of ADD/ADHD and learning disorders. One village was atop a mountain, with poor soil, and hence farming required the frequent use of pesticides. The second village lived in a fertile valley, where the soil was rich and pesticides were never used to grow their crops. It turned out the mountaintop village had a significantly higher frequency of children with learning disabilities and ADD/ADHD. It is not surprising that pesticides, which kill insects by destroying their nervous systems (which function just like ours do), would affect the child’s brain during development.

Taking all the above into account then, the Whole Psychiatry approach is to avoid labeling the child if possible, and to assess the child or adult for nutritional deficiencies (e.g., amino acids, fatty acids, minerals), kryptopyroluria (a condition in which people require very high amounts of zinc and other nutrients), eczema (indicative of immune and nutritional factors, and an annoyance that could affect attention), mental retardation, anxiety, schizophrenia, learning disabilities, developmental disorders, lead poisoning, thyroid hormone dysregulation, seizure disorders, sleep apnea, Lyme disease, toxic exposure (e.g., pesticides or any of the 900 new-to–nature chemicals) and head trauma.

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