Why Do Stimulant Medications Affect ADD / ADHD?

Fear Monsters Column - Arpil 2008

Why does taking medical stimulants help people with ADD? Ask ten doctors and you'll get ten answers, most of which will bring to mind the proverbial blind men examining the elephant. It's not their fault. We demand of these good doctors almost god-like answers, including a pill which will if not cure ADD then at least make these kids appear normal. And yes, it's our children's lives we're talking about here so it's really this important. But when it comes to ADD, the only thing most people are sure of is, no one has god-like answers. Including me. So what do I have to offer? As a personality theorist, a lot really, including that a major clue to the actual nature of ADD lies in that medical stimulants help. Why? It's simple really. Stimulants alter people's sense of time and space in a somewhat predictable way. They speed things up and narrow the focus. Moreover, while in theory we're talking about how medical stimulants affect folks with ADD, in reality, we all take stimulants, which gives us all access to this clue.

Not sure what I mean? We consider this. When you take the family to Disneyland and finally get into your seat on one of the rides, what happens next? Obviously, you get stimulated, including that your perception of time speeds up and your focus narrows. And when you get up in the morning and suck down your first cup of coffee, what happens to you then? Why, the same thing, of course; your sense of time speeds up and your focus narrows. And when you hurry to a store so as to be first in the sale line, what happens then? Again, your perception of time speeds up and your focus narrows. And when you watch the Beijing Olympics on TV later this year, what will happen to you? Again, during the pivotal events, your sense of time will speed up and your focus will narrow.

My point here is simple. An inherent part of human nature is we all sense time and space. Not scientifically, mind you, nor even as accurately as watch or clock time. Rather, we each sense time personally, including folks with ADD. Moreover a part of our sensing time and space is that, whenever we get stimulated, our sense of time speeds up and our focus narrows.

What does this have to do with the nature of ADD? Simply put, kids with ADD perceive being stimulated differently than non ADD kids do; more abruptly at first, then more slowly, and in all or nothing increments. Moreover, this difference is especially apparent in situations wherein kids are expected to keep up with other quicker minds, including in almost all classroom settings from about first grade on and especially in situations wherein kids are asked to learn sequences of things, like learning to read and other complex tasks.

What do we know physiologically about kids with ADD when they're asked do this kind of learning? Basically two things. One, that when asked to learn things like reading; in essence, whenever they're called upon to do mentally sequential problem solving, the brains of kids with ADD show slower brain waves compared with the brains of neurotypical kids (Shedding Light on ADHD, The Lancet, Nov. 2003). Two, in these same situations, the brains of kids with ADD show a broader area of involvement as compared with the brains of neurotypical kids (His Brain, Her Brain, INR seminar, Nikita Katz MD, 2007). In other words, in kids with ADD, brain activity gets slower and spread out more thinly as compared to neurotypical kids whose brain activity is stronger and more localized.

The thing to keep in mind here of course is that while brain scans can imply things, they fall apart as far as being factual evidence for what people think and feel. In other words, while brains scans can reveal physiological fractal patterns in things like blood flow, no researcher can claim with certainty to be able to interpret these patterns. We're just not there yet. This means while brain scans can imply things, they cannot replace subjective and objective reporting.

So what kinds of things do people with ADD report? To see, I asked more than a hundred people trained in emergence-based self observation methods a simple question; what's your favorite color? From this, two clear fractal patterns emerged with regard to ADD. In pattern one, people instantly digress then abruptly blurt an answer. In pattern two, people abruptly go blank and cannot self-restart.

What does all this tell us about the nature of ADD? To see, consider this. Picture yourself in winter, standing at a distance from a very big maple tree. Now imagine you have been given a task; you must redraw the patterns of the branches from memory. How would you go about doing this? Most people, when asked to do this, try to memorize a few of the larger patterns of branches. Kids with ADD either reach out in all directions at once and then blurt out an answer or they immediately go blank and then pretend to be memorizing, all the while staring through the tree.

Slower speed. Broader scope. The very bane of mentally sequential learning activities like learning to read. No surprise this is the very kind of learning kids with ADD hate the most. Interestingly enough, no one seems to notice that these same kids excel at the very opposite kind of learning; the kind required to master video games. What's the difference?

Learning to read requires kids repeatedly cycle through a sequence of four mental tasks; recite (pronounce aloud), memorize (commit to short term memory), recall (pronounce to yourself), and interpret (comprehension). In a way, we could call this kind of learning, multi-step mental learning as in, "think about what you're doing now and at the same time, think about what you're going to have to do next" learning. As opposed to the kinds of skills needed to master video games wherein we need to focus on doing one task at a time as quickly as we can, a kind of learning we might call, "no time to think, just do it" learning.

Can you see where this is all going? The psychophysical skills needed to master video games preclude the very type of learning which causes kids with ADD to falter and quit; complex sequences of mental learning. Moreover to understand what's behind this, consider what happens to these kids when they play a video game. Across the board they report their sense of time speeds up while at the same time, their focus shifts from a primarily mental one to a primarily physical one, the fractal pattern Yogi Berra alludes to in his famous comment, "you can't think and bat."

This pattern in fact is quite similar to how stimulant medications affect people with ADD, wherein they feel time speed up and become more aware of their bodies.

A major clue to understanding ADD then lies in discerning the differences between learning to read and mastering video games. What can we say about how these two kinds of learning differ?

• Any learning which involves complex sequences of mental activity will short circuit the brains of people with ADD. This type of learning literally causes the overall rate at which their brains try to process data to slow down, in part, the result of their focus widening beyond their capacity to track. Conversely, any learning which involves intensely focused physical activity will cause the brains of people with ADD to speed up and focus, similarly to what happens to all people when they play video games.
• In essence, these differences can be boiled down to three things; [1] that the nature of the learning is either mental or physical, [2] that the learning requires people to be aware of either sequences of tasks or single step tasks, and [3] that the learning differs markedly in how quickly or slowly people process time.
• What accounts for the difference in how quickly or slowly people process time? Primarily, this is just the result of the actual physics involved, body learning versus mind learning. Said very simply, it takes more time to move the body then to move the mind. Nothing wrong here, it's just simple physics. What this means however is that, by nature, people differ as to which type of learning they are better at; body-based learners versus mind-based learners, and the main difference here is in how people sense time.
• In a general sense then, we could say that people with ADD are more naturally adept at body oriented kinds of learning whereas neurotypical folks are more adept at learning mind oriented tasks. Moreover, this difference has nothing to do with people's native intelligence. It merely describes the type of learning to which each type of person is best suited.
  

So is there any fractal-based evidence to support these claims? There certainly is. Moreover, this fractal-based evidence also reveals the solution to one of the greatest mysteries of all with regard to personality; the nature of the self. What is it that makes us feel we are separate and apart from others? More important, how are our feelings of separateness a factor in both ADD and Asperger's? This will be our topic for next month when we discuss The Nature of the Self as a Factor in ADHD and Asperger's.

[for more thoughts on learning and learning disabilities, click here]