Copyright © 2019 by Sandra Arnau-Dewar All Rights Reserved No part of this book may be reproduced in any form or by an electronic or mechanical means including information storage and retrieval systems, except by the author. The only exception is for reviewers who may quote short excepts in a review. Cover designed by Lisa Bennett Cover photo by Michael Villalonga Arnau III Visit my website: https://www.seekingnovelty.org First Printing November 2019 ISBN: 978-0-578-52811-3 Dedication I dedicate this book to the teachers, physicians, and mental health professionals who helped my family and me overcome challenges and setbacks. Thank you for always going above and beyond the call of duty and for never giving up on us. I’ve changed names to preserve privacy but that does not mean I’ve forgotten your kindness and wisdom. Acknowledgments I would like to thank my children for inspiring me to explore places beyond my own experience. Your curiosity taught me to question everything, including current theory about ADHD. Without your zest for adventure, the concepts that underlie this book would never have been realized. No words can express my love and gratitude to you. I also want to send a shout out to my writing group friends, especially Noelle Jane Myers, Karrie Merriman, and Denise Bowers. Your discussions on e-publishing and indie (independent) authoring were invaluable. Thanks also go to Bonnie Knight for the first read and Jamee Larson for editing the original manuscript. My writing buddy, Susan LeRoy Stewart gave insightful feedback on the final hard copy while Warren Lanning did meticulous line editing of the ebook version. Finally, I’m grateful to cover artist Lisa Bennett for taking my father’s black and white photo of me gazing into a fun house mirror and transforming it into a red-hot metaphor on the theory of novelty seeking. Contents Introduction ix 1. Emergency Room Giggles 1 2. Damned Man 10 3. The Hunter Versus Farmer Theory 18 4. Wake-Up Call 25 5. Desperately Seeking Novelty 34 6. A Disaster Waiting to Happen 41 7. The Garden of Eden 47 8. Married with a Mess 54 9. Me and My Shadow 61 10. The Miracle Worker 66 11. Amazing Disgrace 77 12. Back-to-School Night 81 13. Cockeyed Optimist 90 14. Blind Juggler 97 15. Roadmap 104 16. Is ADHD Contagious? 112 17. Family Portrait 119 18. When the Going Gets Tough 127 19. Evilution 134 20. A House Divided 140 21. All (Wo)men Are Created Equal? 145 22. The Difficult Child 151 23. Quarreling with Mr. Quarles 157 24. Living in Interesting Times 162 25. Chameleon 167 26. At Risk 173 27. When Bad Things Happen to Good People 180 28. The Worm Turns 188 29. It’s Beginning to Look a Lot Like Dysfunction 194 30. In Sickness and in Health 202 31. Sweet Victory 209 32. Divide and Conquer 214 33. Moving Out and Moving On 223 34. Don’t Hang Up! 230 35. Everything Changes but Stays the Same 236 36. What Doesn’t Kill You 242 37. Bridge Over Troubled Water 252 38. Make Way for Ducklings 260 39. Epilogue 265 Notes 275 Introduction When my children, Cindy and Eric, were diagnosed with ADHD in the early 1990s, few people viewed ADHD in a positive light. The go-to guide on ADHD, the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) classified ADHD as a “mental disorder.”1 I accepted the pessimistic outlook at the time, but always had the sneaking suspicion that the diagnosis of mental disorder missed an important fact—that there were positive aspects to having ADHD. Although my children’s hyperac- tive, impulsive, and distractible behavior created problems in school, outside of the classroom they were charming extraverts whose restless energy and exuberant curiosity chal- lenged me to view the world differently. I was a research assistant to evolutionary biologist, John Endler, at Princeton University in the 1970s, so my mind instinctively considered ADHD from the viewpoint of natural selection. Remember that natural selection occurs when a change (mutation) in the genetic code favors survival. My mind kept returning to this question: Would Cindy and Eric’s x • Introduction ADHD behavior have increased their chances of survival in prehistoric times? Classic Darwinian evolution referred to anatomical traits, such as the human ability to walk upright on two feet, which offered benefits because the hands were free to complete tasks, for instance, wielding a heavy stick to ward off preda- tors. Darwin also argued that “mental faculties” were subject to natural selection. Writing in the journal, Anthropology, Simon Dein extended Darwin’s theory, arguing that psychological traits common in ADHD—hyperactivity, impulsivity, and aggres- sion—were assets to our ancestors 45,000 years ago. Hyper- activity and impulsivity enhanced strong muscle development and facilitated a quick response in fight or flight conditions. Aggression offered a first-strike, competitive edge. Finally, distractibility, an ADHD trait not mentioned by Dein, facili- tated the continual scanning of the horizon for danger.2 Imagine the following scenario: two children were strolling near the river in prehistoric Africa when they encountered a large crocodile. The impulsive, quick respond- ing, hyperactive child noticed the crocodile in his peripheral vision and fled to safety, but the thoughtful, slow moving child didn’t notice the crocodile until it sprang into action and clamped powerful jaws around the child’s leg. In a landscape teeming with brutal predators, quick thinking and fast reflexes provided advantages that allowed these individuals to survive long enough to reproduce and leave their genes in the population. Medical lore has described children, most often boys, with impulsive and hyperactive behavior for over 100 years. The name has changed to reflect new theories about its cause. ADHD was known as “hyperkinetic disease” in the 1930s, but in the 1950s, was changed to “minimal brain Introduction • xi dysfunction.” In 1994, the APA published DSM-IV, which utilized the current term, ADHD, and emphasized “attention deficits” as the cause. Virginia Douglas of McGill University first wrote about attention deficits in hyperactive children in 1972, identifying three differences in cognitive function: Attention (the ability to disregard distractions), inhibition (the ability to ignore impulses), and organization (the ability to prioritize information).3 DSM-IV listed three subtypes of ADHD: ADHD, primarily inattentive. ADHD, primarily hyperactive/impulsive. ADHD, primarily hyperactive/impulsive and inattentive combined. Individuals with the inattentive subtype tend to be intro- verts, so their behavior elicits less censure than people with the hyperactive version. Individuals with the inattentive subtype also are prone to distraction, which may adversely affect their ability to finish school and work projects. Cindy and Eric have the 3rd subtype, so I focus on individuals with hyperactive, impulsive, and inattentive behavior in this book. Readers interested in the first subtype, primarily inattentive, also will find this book useful because these individuals encounter many of the same obstacles to success as hyperac- tives do. Few published books viewed ADHD in a positive light when my children were diagnosed. A rare exception was Thom Hartmann’s 1993 book, Attention Deficit Disorder: A Different Perception, which argued that since ADHD often was hereditary, the behaviors were a holdover from our hunter-gatherer days, when humans depended on hunting wild game for food. Although scientists agreed that ADHD was often hereditary, they rejected Hartmann’s “hunter versus farmer” theory.4 Nevertheless, I felt that Hartmann’s hypoth- xii • Introduction esis had merit. To learn more about Hartmann’s theory, see Chapter 3. In the last fifteen years, scientists have begun to trace the genetic code of ADHD and have found, to their dismay, that Hartmann’s theory might be correct. Several genes associated with dopamine, a neurochemical linked to feelings of plea- sure and well-being, are believed to play a role in ADHD behavior. Research led by Nora Volkow suggests that people with ADHD have low levels of dopamine in the reward pathway of the brain, which may explain why these people need stronger and more frequent rewards for motivation.5 Another gene related to ADHD is the dopamine receptor, DRD4 7R, which scientists have nicknamed the “novelty seeking gene.” Brain imaging studies show that people with this gene have unusually low levels of dopamine in the brain. To compensate, these individuals unconsciously seek new experiences, which increases dopamine levels. The brain quickly consumes dopamine, creating a craving for more dopamine, and a need for new experiences.6 Since the millennium two influential ADHD experts, Drs. Russell Barkley and Thomas Brown, have argued that ADHD is not caused by attention deficits, but instead, is caused by differences in executive function (EF). Executive function is the brain’s control center and is responsible for organizing, planning, and prioritizing.7 Although the theory of attention deficits is considered outdated now, the APA has kept the same name. ADHD concepts are complex. Retaining the words “attention deficit” when this theory has been discounted creates confusion. Finding a new name to reflect current theory will increase understanding, but even more important, it offers a chance to eliminate the double whammy of stigma, the words “deficit” and “disorder” in the description of ADHD. Introduction • xiii In keeping with the theories of executive function and adaptation due to natural selection, I propose a name that is neutral and non-biased—executive function adaptation (EFA). I realize that changing the name will create challenges for educators, health care professionals, and insurance compa- nies, but removing the prejudicial language associated with ADHD is in the best interest of people affected by it.