ADHD yeah okay a I don't feel like I don't even have to ask a question here but just to set the stage the reason why I'm so compelled by this is just this I have to say it the shocking rise in yeah diagnosis and prescriptions over the last 10 years uh between 20 2 and 2018 ADHD diagnosises in the UK Rose approximately 20 fold yes among boys age 10 to 16 diagnosis increased from 1% roughly to um about 3.5% in 2018 and in men aged 18 to 29 there was a nearly 50-fold increase in ADHD prescriptions during the same period and the same applies to the United States where an estimated 15.5 million adults in the US have been diagnosed with ADHD approximately one in nine us children have been diagnosed with ADHD at some point with 10.5% having a current diagnosis it I don't know where ADHD was but the conversation around it the prescription ions the diagnosis seem to have really surged into culture in a really really big way what's going on so ADHD was one of the factors that drove me to right right being there um because I was seeing this huge uptick in ADHD diagnosis and children being medicated so so early do you know what the fight ORF flight reaction is that's when the sympathetic nervous system starts to kick into action and yes so well it's basically our evolutionary response to a predatorial threat so if a sablet tooth tiger was chasing you you either stood and fought fight or you ran for Your Life Flight so when our children are under stress they go into fight or flight so 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 um they have trouble you know socially in daycare or preschool or even in school or they become distracted which is the flight part of fight ORF flight so what's happening is their nervous systems the stress regulating part of their brain is getting turned on so we say that the stress regulating part of their brain has to do with a little almond shaped part of the brain called the amydala it's a very primitive part of the brain very old part of the brain and it regulates stress throughout our lives it helps us to manage it what we know is that part of the brain is supposed to remain offline for the first year to three years which is why mothers wear babies on their bodies it's why babies stay close to their mothers in the first 3 years to keep the amydala quiet and only incrementally incrementally expose children to stress and frustration that they can manage so imagine taking small bites of it so you can digest it right and your mother's there to help you digest the stress what we're doing now by separating mothers and babies by putting babies into daycare with strangers um is by sleep training babies all these weird things that we're doing to babies is we're tur turning the amydala on where making it active precociously too early what happens 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 also because it cannot manage that kind of stress so early when it ceases to be functional it ceases to be functional for a lifetime and so it's very important to protect you know what's the expression the Family Jewels it's very these are the family jewels in the brain of a baby this is the jewel the amydala you want to keep the stress to an absolute minimum in the first year which is why sleep training is dangerous it's why letting babies cry it out it's why putting babies into daycare it's why leaving babies for hours on end when they're so so very fragile um is so bad for their brains because it gets the cortisol flowing which is the stress hormone but it makes this part of the brain very active so it grows grows grows and then and ceases to be functional in the future like a PTSD response so what we know is that these children are in hypervigilant states of stress ADHD children ADHD children hyper Vigilant states of stress if you stay in a hyper Vigilant state of stress long enough you go into a hypo vigilance state of stress which then causes depression so what we have now are not disorders so there was a whole movement to take the d off of ADH D because it's not a disorder it is a stress response and instead of asking the right questions which are okay what's causing the stress how do we make sure that our children are not exposed to this kind of stress because they're going into fight or flight so the nervous system as you said the brain has an on switch and an off switch the on switch to stress is the amydala the hippocampus is the off switch and you'd say the stress response is in a negative feedback loop it's it's it's actually important like in other words if a sabled tooth tiger is chasing you very important that you can activate right run or fight so the stress response is supposed to be shortterm it's supposed to be not it's supposed to be acute rather than chronic so we can kind of manifest it we can uh activate it but then it's supposed to be turned off by the turnoff switch the hippocampus what we're seeing in children's brains is that the amygdala is growing very precociously large and the hippocampus which is the off switch is very small so we have this problem as we say Houston we have a problem 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 and violence and so that's what's happening this is a stress response and again instead of asking the right questions like where is this coming from what's causing the stress instead we silence the children's pain we tell we tell parents we'll medicate it and we'll just relieve the symptoms for me that's malpractice the way we treat ADHD is malpractice a child develops goes into fight ORF flight when they are under stress it could be psychosocial stressors at home in the family it could be at school it could be with their friends it could be a learning disability there's so many things that can cause kids stress so instead of medicating them why don't we figure out what's happening to that child deeply that's causing them to go into fight or flight isn't that point of view I got two questions here the first is how do you know that it's stress and the second is if it is stress then that the problem or at least the Inconvenient Truth that that then creates is that the parent is responsible yes that's the there's the Inconvenient Truth for their child's ADHD yes yes that's the Inconvenient Truth it's not so simple sometimes it's the family usually it's the family particularly with small children but when children get to school it could be social as I said you know you can't control whether your children are exposed to social issues or bullying or there's many things that can cause stress in children but when they're very little you are their environment so the Inconvenient Truth is that 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 you go with your partner or spouse and talk to a parent guidance expert about what could be causing this child to feel such stress and look at the psychosocial stressors look at the influences and the Dynamics in this child's life that would be causing them to go into a state of stress like this give me some examples of the type of stresses the everyday stresses that we're now exposing children to that are leading to ADHD in your opinion well again let's start at home at home the stresses might be that they were handed over to a daycare center at an early age um which turned that amygdala response on which turned the stress regulating part of their brain on too early now you have that hypervigilant reaction and they can't turn it off right um it could be a divorce situation 50% of couples divorce which means that div divorce is an adversity you know I have a book coming out in a year about how to divorce and mitigate the impact of the divorce on the child but no matter what a divorce is an adversity on a child and a stress um when parents fight uh dramatically in the home if there's uh tremendous sibling rivalry issues in the home if there's the birth of another child that's stressful right if you have a sibling believe it or not that's a very stressful thing if parents are sensitive about that then it can be mitigated but if parents are insensitive about the birth of a second child and the feelings that your first child may have that can cause stress moving can cause stress illness or mental illness in a parent can cause stress alcoholism any kind of addiction can cause stress a grandparent or uncle or Aunt or even a parent getting sick and dying can cause I mean there are so many things that can cause stress but the point is that 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 if parents hand a child over to a psychiatrist and say fix my child of course psychiatrists will cooperate with you and silence your child's pain but is that really what you want to be doing um because in the end you're just putting your finger in a dyke you're putting your finger in a dam and eventually that dam is going to burst what' you say to some of the evidence around there being a link to a hereditary component in twin studies they found that ADHD is about 74 to 80% heritable making one of the most genetically influenced psychiatric conditions let me tell you a different study that will help you to understand that study which is that we know that 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 what you mean by precursor meaning there's no genetic connection you don't get it in your genes if your father or your mother were depressed you get it by something called the inheritance of acquired characteristics if you're raised by a depressed parent you're more likely to become depressed it's the nature nurture argument okay but what they did find now schizophrenia has a genetic connection bipolar disorder those have genetic but the rest do not anxiety depression ADHD no genetics what they did find is a genetic tie to something called the sensitivity Gene it's a short Al on the serotonin receptor and serotonin as we know is used to regulate happy emotions to regulate emotions right so when you have a short Al it means that you have a harder time picking up the serotonin but it also means that you are more sensitive to stress now those children who are born with this Gene this short Al on the serotonin receptor gene they are more prone to mental illness later on because of that sensitivity to stress what the study shows is if those children who are born with that Gene for sensitivity are provided with emotionally and physically present attachment Security in the first year it neutralizes the expression of that Gene so epigenetics means that we're born with genes like you might have a gene for rheumatoid arthritis or you might have a gene for cancer but it never gets expressed well we all have genes for something but they don't necessarily get expressed that's what epigenetics is it means the environment has to turn on the gene to make it let's rock and roll right um what it showed in this study is that the children who were born with this genetic precursor the sensitivity to stress if they had sensitive empathic nurturing and Pres parents in the first year it neutralized the expression of that Gene so those children could be as healthy as children born without that Gene if however children born with that sensitivity Gene were neglected you know abandoned not provided with sensitive empathic present nurturing it exacerbated that Gene so we know that that sensitivity Gene is tied and correlated to mental illness later on unless the sensitive empathic nurturing mitigates that Gene and what you say to people that point to MRI scans fmis and yeah there's there's all kinds of um neurological tests now where we can see the brain in action so it's not a static thing we can actually see the blood flow to the brain we can see the electrical activity in the brain it's it's amazing actually but some people say that this proves that it's the way your brain is and lots of my friends that ADHD when they talk about their ADHD or the way that they are they say my brain works like this no it's not correct their brain is sensitive to stress someone with ADHD is more sensitive to stress so you could ask them questions like this you could say were you more are you a more sensitive person are you more sensitive to noise to Smells to touch when you were a child did you not like itchy things did you cry more were you more sensitive when your parents would go out for the night were you more sensitive when your mom would go to work or were you more sensitive when you were left at Nursery School um and they're probably going to say yes but if they say no and they still have an ADHD diagnosis I would guarantee almost guarantee they wouldn't say no because people with ADHD are people who are sensitive sensitivity is an amazing strength if it's met with sensitivity if you have a sensitive child so what does a sensitive child look like if you have multiple children then you know because the first thing I'll do when I give a public talk is I'll say okay any everybody here who has a sensitive child and I describe okay sensitive child is a child who cries more is harder to soothe um is more clingy doesn't like you leaving them is harder has a harder time separating has a harder time going to sleep and being left as sleep on their own um is sensitive to things like noise and smells and touch if you grew up in an environment that was stressful and again we've you've identified that stress can come in many forms it could be arguing parents it could be a neighbor or whatever some environmental factor that caused that stress you were sensitive you developed ADHD you become an adult you get diagnosed at 30 years old as having ADHD yeah you're offered medication you take the medication the medication makes you much more functional in your career in your relationships in your life it's a stimulant and so what stimulants do is they cause they can cause great anxiety they can cause panic attacks in uh adolescence uh they can cause growth issues so uh I have patients who come to meet young men who didn't grow because they were put on stimulants when they were young so um in in in terms of the consequences of using stimulants the jury is still out but we know that they cause growth issues they cause panic attacks they cause anxiety disorders they cause depression so they're quite life saving they're quite life-saving for some people in terms of having a they can be they can be so what I would say is 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 the problem is that we turn to medication uh in in adolescence and children and young adults we we turn to it as a performance drug um because there's so much stress in Modern Life and there's such a need for people to perform and be successful in their careers and in school and get good grades there's so much pressure on kids so you know I'm 60 and we didn't have this kind of pressure growing up and so so the generations that follow have so much pressure that pressure makes children literally go off the rails we could talk about the academic pressure the competitiveness the perfectionism um it so ADHD is a bucket it's a bucket which you throw people in who have anxiety that has never been treated and so and there's different ways of thinking about treatment to so we are a society that likes superficial quick fixes we like drugs we like CBT therapy the truth is that this is not a quick fix figuring out relation dynamically what happened to you as a child what your losses were what your traumas were what caused you to feel so anxious what's caused you to go into fight ORF flight is hard work it requires frustration it requires commitment it requires going to someone who can think very deeply with you you know I I want to Define what anxiety is because I think it's really important cuz we rarely Define depression and anxiety um 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 all about loss and you could say the generations now are very preoccupied with loss loss of status achievement but because we're also very preoccupied with gain well we're preoccupied with I would I say the I you know I don't want to judge but I want to say the unimportant things in life um what are the important things in life relationships love connection Health right you would say objectively family these are the important things in life but we've become very preoccupied with material success money uh career achievement Fame I think there was a study that interviewed teenagers um and it was really discouraging because they said that the thing they wanted more in life than anything was to be famous and so we're preoccupied with the wrong things on this point of stress in the link with ADHD I'm looking at some research from the injury.com research education group um it says that children with an a score which is the trauma B score where I think it goes up to 10 different sort of questions with an a score of four or more so four experiences of trauma or more have nearly four times which is 400% more chance of having parent reported ADHD compared to children with no Aces yeah and some of the factors that have big impact is soo socioeconomic hardship increases your probability of having ADHD by 40% parental Divorce by 35% familial mental illness so a parent having a mental illness increases it up to almost 60% 55% I believe and neighborhood violence almost 50% familial incarceration so if a parent goes to prison then that increases your probability of ADHD by about 40% as well and that's published by the I think it's the New England yeah what is this called the National Library of Medicine National Center of biological information yeah so remember what I said that you can't control everything that happens to your child divorces do happen and adversities happen to Children Health health issues happen to Children what you can control is you can control the first three years and be as present as possible for your child so if my kid start screaming in a supermarket one of the prevailing pieces of advice says just walk off or start screaming yourself as the parent to show them do am I supposed to just ignore my child when it's screaming and throwing a tantrum am I meant to drop what I'm doing and go and Cat to them what am I meant to do in these situations have me on speed dial Steven you be careful because if you make a promise like that I promise I promise I'll be on speed you only want to drop your career and focus on raising my children you can no but you can call me youed that's legally binding no you can have me on speed doll how much yeah you can as much as you want so the deal is you don't yell at your children an emotionally regulated parent a healthy parent produces a healthy child so what is a healthy parent a healthy parent is a parent who feels good about thems who has authentically good self-esteem not grandiosity but really feels good about themselves knows their strengths and limitations and overall as a whole person feels good about themselves um they have the capacity to regulate their emotions to keep their emotions from going too high and too low remember sailing in the Caribbean meaning they can stay calm in storm um is sensitive and empathic as a nurturer these are signs of Health in a in a parent so if my kid says I want that pack of sweets and I go you you you can't have that pack of sweets well first you have to so before you discipline you always want to be empathic first so I always say that that if you are going to discipline a child first you have to recognize how they feel I mean recognize recognizing how children feel is important anyway meaning when you recognize a child's feelings if they're sad you mirror their sadness if they're angry you say I can see you're angry if they're happy you look happy with them that kind of reflection is 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 so when you acknowledge their feelings that's the first critical you'd say parenting 101 acknowledge your child's feelings so I would turn to my child and say you want sweets so are you hungry yeah you can say I can see that you really want that packet of sweets I can see how hard it is because you really want it but you know you can't have it before dinner you know that's the rule and then they stop screaming and cry and then they start screaming and you say broken record is a communication style where you say oh I can see it's really hard for you but you still can't have the sweets and you stay with them and you keep empathizing and then setting structure empathizing structure empathizing structure the mistake that parents make is that they go right into the no word they don't use empathy they don't bring empathy in and the truth is that even as an adult if somebody just says no without first recognizing how you feel you feel very unsatisfied right for a child it's critical it's critical that even when you have to say no and particular if you have to say no that you first recognize how they feel I mean that's what all the relationship experts on the show tell me they say if you want to be successful in a romantic relationship then you first must make your partner feel heard and understood that's right even if you disagree in an argument first acknowledge what they said maybe repeat it back to them and then they'll feel heard and understood and it kind of stops the broken record do you think that I'm a traumatized child I don't know I haven't heard about your traumatized background if so if you have a trauma I would say we're all so let me me say this there's this word trauma is used a lot can I just talk about it for a moment there's something called Big tea trauma right big tea traumas like I was in a car accident and I lost my legs or um you know I lost my parents you know my mother died of brain cancer or my my father was an alcoholic and beat me or you know there's there are things that are more concrete that you can like hold on to things that happen to people yeah I was raped or you know those are big tea trauma but believe it or not probably fewer people suffer from Big tea trauma and more people suffer from little tea trauma and little tea trauma is more nuanced it's um it it requires looking with a with a finer tooth comb at at the issues it's more relational it's more I was subtle neglected by my mother my mother wasn't a good listener my mother loved me but my father loved me but he never understood me uh my parents were narcissistic and very self-centered um they were never around you know and so people will come into my office and sit down individuals for therapy and they'll say you know I don't know what's wrong with me I had two parents who stayed together had all the material wealth that I could need I never wanted for Stuff uh you know my parents stayed together and I don't know what's wrong with me and so I say okay so you're telling me nothing big and traumatic happened to you in your life now let's talk about the nuance and we're not very nuanced anymore so we don't want to look at what causes most forms of mental illness depression anxiety uh even ADHD are the relational nuances of a family and what you mean by the nuances it could be the neglect neglect being ignored having a mentally ill parent that no one knows about maybe a depressed mother who sleeps in in the morning and doesn't get up and feed you you know you get up and feed yourself or uh maybe you're a latchkey kid who comes home and and you're isolated and alone or things that people can't see um but you see and so that's why people I would say most people go into therapy not for big tea traumas believe it or not even though the aces study says you know alcoholism drug addiction of course those are big tea traumas most people come into therapy for little te trauma and and the reason why it's it's quite difficult for those people is there's not a lot of reinforcement from society that those are also traumas but in fact they are traumas attachment trauma you know if you were putting dat care and you so I have patients who come to me and say I can remember being put in daycare and you know you're not supposed to remember things until the age of four or five but some patients can remember flashes of memory under five and they'll say I was put into daycare I just all I can remember is screaming my lungs out for my mommy you're not a fan of daycare are you no what's wrong with daycare daycare raises salivary cortisol levels in children the studies show be meaning those babies are put into stressful States uh at a very young age when their brains are developing daycare has been known to increase aggression and anxiety and behavioral problems in school in the school years and those children are more likely to develop attachment disorders remember those first three years when children are so very fragile and vulnerable taking them away from your body as a prim attachment figure and handing them over to strangers and leaving them there for hours on end will cause your child to have to develop pathological defenses and that's what those children are forced to do so it is the least good option of child care so let's talk about what are the better options of child care if you have to use child care you know how we say breast is best and it is for a variety of reasons but the best is your primary attachment figure for the first three years as much as possible primary attachment attachment figure you mean the mother father well no it can be the father okay it's the go-to person who's a sensitive empathic nurturer so when that baby's in distress that baby gets their emotional needs met it can be the father it can be the father but first the father has to learn how to be a sensitive it doesn't come naturally to most men with rare exception I have known some patients where the husband the father was more sensitive than the mother it's possible but in general instinctually fathers are not sensitive empathic nurturers because it's against their evolutionary Instinct their evolutionary Instinct if you were an animal on the plains of Africa you're uh you're you're a an Impala you're a daddy Impala your baby is born and it comes out running cuz they are they're like born and you're all running together you get behind that baby and you're like get going buddy you better get going or you're going to be lunch for that lion that's a father's instinct is to protect it's protective aggression right that's different then the baby impala falls down and the mother comes over and licks the baby and says are you okay honey can I give you a hug can you you know if Impala could talk um so it's a different Instinct so fathers can be taught to be Prim attachment figures but this is why I say it's so very important that we recognize the difference between men and women if we just think they're exactly the same and we put a throw a father into the mix with an infant and the mother's going out and the father's staying home if we don't talk about this stuff and and talk about it openly and say when the baby cries you have to mirror the baby's emotions you have to do skin to skin you have to soothe the baby not encourage resilience not not distract the baby not use discrepant emotions with the baby if the baby's crying don't go oh you're okay you'll be fine no no so it's really important if the father's going to stay home that he learns how to be a mother are we recording 87% of people that subscribe on the clips Channel yeah Taking Liberties what just coming for free and then bouncing what 87% 90% of people on the clips Channel don't subscribe what it says here so I've been doing all this for free you've been consuming all these clips for free listen can we we'll make a deal um I'm really going to make these clips amazing and you're in the clips algorithm on our show so can I ask a favor please can you hit the Subscribe button if you've watched more than one before how how about that if you've watched more than one first one 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