Dr. Ryan Sultan, an Assistant Professor at Columbia University, discusses the evolutionary underpinnings of ADHD, challenging the stigma associated with it. He explores how ADHD traits may have been advantageous in pre-industrial societies and the importance of viewing them through a holistic lens. The conversation dives into the neurobiological aspects and the need for a nuanced approach to managing ADHD, especially when considering its interplay with anxiety and mood disorders. Sultan emphasizes the value of neurodiversity in enhancing teamwork and creativity.
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Evolutionary Psychiatry Introduction
Evolutionary psychiatry suggests mental conditions like ADHD aren't diseases, but systems functioning differently in modern environments.
These systems, like attention regulation in ADHD, may have been advantageous in ancestral environments.
question_answer ANECDOTE
Misdiagnosis Anecdote
Dr. Sultan was misdiagnosed as a teen and told he'd outgrown ADHD, leading to negative self-esteem.
This highlights the misunderstanding and stigma surrounding ADHD.
insights INSIGHT
ADHD in Different Environments
ADHD traits like impulsivity and distractibility might have been beneficial in pre-industrial times for hunting and exploring.
The structured, modern world poses challenges for ADHD brains because it wasn't "designed" for them.
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Today, I’m talking with Dr. Ryan Sultan, a distinguished psychiatrist specializing in ADHD, anxiety, depression, and substance use disorders. He serves as an Assistant Professor of Clinical Psychiatry at Columbia University Irving Medical Center and the New York State Psychiatric Institute. Dr. Sultan is a Senior Psychiatrist at Integrative Psych.
And he has also been exploring the evolutionary basis for ADHD. Now, let’s get to a few things up front here because often when I hear about evolution and ADHD, I know I’m about to hear something about ADHD as a superpower.
That’s not what this conversation is about today. While we will be looking at how ADHD traits might have been useful in a pre-industrial world and why natural selection didn’t weed out our distractible, impulsive brains, the focus is more on how those brains thrived within society instead of looking at them in isolation. This means that our conversation mostly focuses on how these ADHD traits work in conjunction within society rather than trying to view them either negatively or positively. And then we also get into how understanding this evolutionary basis for ADHD can help us understand better ways of managing and treating ADHD.
Regarding the evolutionary basis of ADHD, avoid thinking of it in terms of better or worse and instead try to see how ADHD traits can serve the community as a whole.
With that lens in mind, the impulsivity, novelty-seeking, and hyper-focus of ADHD brains could have been advantages in early human societies, especially for hunting, exploring, and problem-solving in unpredictable environments. With the opposite from the structured, repetitive, sit-still-and-focus world we live in today giving us more difficulties because it wasn’t “designed” with the ADHD brain in mind.
Neurodiversity can benefit everyone. Societies thrive on diverse thinking styles. ADHD brains bring creativity, spontaneity, and out-of-the-box problem-solving, which can be a huge asset when properly supported. We’re better when we work together.
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