The episode features a clinical expert discussing the dramatic rise in ADHD diagnoses and prescriptions, particularly the 20-fold increase in the UK and 50-fold increase in young adult prescriptions in the US between 2000-2018.

The conversation explores ADHD as a stress response rather than a genetic disorder, examining how early childhood experiences and the fight-or-flight mechanism shape brain development and long-term mental health outcomes.

The expert explains the neuroscience of stress regulation, focusing on the amygdala and hippocampus, and argues that current treatment approaches constitute malpractice by medicating symptoms rather than addressing root causes.

The discussion covers the sensitivity gene, epigenetics, the role of early attachment, and practical parenting strategies for managing childhood stress and behavioral issues without rushing to medication.

The Shocking Rise in ADHD Diagnoses

Between 2000 and 2018, ADHD diagnoses in the UK rose approximately 20-fold, with boys aged 10-16 seeing increases from 1% to 3.5%

Men aged 18-29 experienced a nearly 50-fold increase in ADHD prescriptions during the same period

In the United States, approximately 15.5 million adults have been diagnosed with ADHD, with one in nine US children receiving a diagnosis at some point

The expert was driven to write Being there specifically because of "this huge uptick in ADHD diagnosis and children being medicated so, so early"

ADHD as Fight-or-Flight Stress Response

"One of the first signs that a child is under stress that they cannot manage is when they become aggressive in school. They hit, they bite, they throw chairs... Or they become distracted, which is the flight part of fight or flight"

The amygdala, an almond-shaped part of the brain, regulates stress throughout life and is supposed to remain offline for the first year to three years of life

Early separation from mothers activates the amygdala precociously. "When the amygdala is activated too early is it becomes very active and very large very quickly. The problem is then it shrivels up and burns out"

"When it ceases to be functional, it ceases to be functional for a lifetime" - making early protection of the amygdala critical, described as "the family jewels in the brain of a baby"

Sleep training, letting babies cry it out, and early daycare placement are specifically identified as dangerous because they trigger cortisol flow and premature amygdala activation

The On-Switch, Off-Switch Problem

The brain has an on-switch (amygdala) and off-switch (hippocampus) for stress response, designed for acute rather than chronic stress activation

"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"

"If you stay in a hyper-vigilant state of stress long enough, you go into a hypo-vigilant state of stress, which then causes depression"

There was a movement to remove the "D" from ADHD "because it's not a disorder. It is a stress response"

Malpractice: Medicating Instead of Investigating

"For me, that's malpractice. The way we treat ADHD is malpractice" - the expert argues against silencing children's pain with medication instead of identifying stress sources

"When your child gets an ADHD diagnosis, the first thing you should do is go to a therapist who will do parent guidance with you. Don't rush that child to a psychiatrist to medicate them"

Parents should work with a parent guidance expert to examine "psychosocial stressors" and "dynamics in this child's life that would be causing them to go into a state of stress"

"The problem is that we turn to medication... as a performance" enhancer due to pressure for success in careers and school, particularly affecting generations facing unprecedented competitive pressure

Common Childhood Stressors Behind ADHD

Early daycare placement creates hypervigilant reactions that children "can't turn it off" from

Divorce affects 50% of couples and "is an adversity" and stress on children, regardless of how sensitively handled

Sibling rivalry, birth of another child, moving, illness, mental illness, alcoholism, addiction, and death of family members all cause significant stress

Children with ACE scores of 4+ face dramatically elevated ADHD rates: socioeconomic hardship increases probability by 40%, parental divorce by 35%, familial mental illness by 55-60%, neighborhood violence by 50%, and familial incarceration by 40%

"Stress can be regulated, but it can only be regulated if parents are introspective and self-aware and willing to look at their part in it"

The Sensitivity Gene and Epigenetics

"There is no genetic precursor to mental illness. There is no genetic precursor to ADHD. There is no genetic precursor to depression and no genetic precursor to anxiety" - unlike schizophrenia and bipolar disorder which do have genetic connections

Research found a genetic tie to the "sensitivity gene" - a short allele on the serotonin receptor that makes children more sensitive to stress and has harder time picking up serotonin

If children born with the sensitivity gene receive "emotionally and physically present attachment security in the first year, it neutralizes the expression of that gene" through epigenetics

However, if children with the sensitivity gene are "neglected, abandoned, not provided with sensitive empathic present nurturing, it exacerbated that gene" and correlates to mental illness later

Twin studies showing 74-80% heritability of ADHD are explained by inherited sensitivity rather than direct genetic transmission of the disorder itself

Recognizing and Supporting Sensitive Children

"Someone with ADHD is more sensitive to stress" - they are typically more sensitive to noise, smells, touch, itchy clothing, and separation from parents

Sensitive children "cry more, are harder to soothe, are more clingy, don't like you leaving them, have a harder time separating, have a harder time going to sleep and being left to sleep on their own"

"Sensitivity is an amazing strength if it's met with sensitivity" - the key is matching parental response to child's temperament

People with ADHD diagnoses typically answer yes when asked if they were more sensitive as children to various stimuli and separation experiences

When Medication May Be Appropriate

"If you have tried everything to uncover what the stress is that's causing you to react this way, and you still are feeling that way, then sometimes medication can be a lifesaver"

Stimulant medications "can cause great anxiety, they can cause panic attacks in adolescents. They can cause growth issues" - the expert has patients who "didn't grow because they were put on stimulants when they were young"

"In terms of the consequences of using stimulants, the jury is still out" on long-term effects

The core problem is society's preference for "superficial quick fixes" like drugs and CBT therapy rather than "hard work" of understanding relational dynamics, childhood traumas, and losses

Understanding Anxiety and Depression

"Depression is preoccupation with past losses. Anxiety is preoccupation with future losses that may never occur. What do they have in common? It's all about losses"

"ADHD is a bucket. It's a bucket which you throw people in who have anxiety that has never been treated"

Current generations are "very preoccupied with loss. Loss of status, achievement" because society is preoccupied with "the unimportant things in life" - material success, money, career achievements, fame

The important things in life are "relationships, love, connection, health... family" - but modern culture creates pressure that "makes children literally go off the rails"

Practical Parenting: Managing Tantrums

"An emotionally regulated parent, a healthy parent produces a healthy child" - defined as someone with authentic self-esteem who can regulate emotions and "stay calm in a storm"

"Before you discipline, you always want to be empathic first" - acknowledge the child's feelings before setting boundaries

Use the "broken record" technique: "I can see it's really hard for you, but you still can't have the sweets" - alternating empathy with structure repeatedly

"When you recognize a child's feelings... that's the way that your child knows that you acknowledge them, that they're a person to you, that they're a separate person to you. It's how they feel valuable"

"Even as an adult, if somebody just says no without first recognizing how you feel, you feel very unsatisfied" - empathy before boundaries applies across all relationships