"Personally, I think it's amazing that even an adult should swallow a substance about which so little is known, which affects an organ so sensitive, valuable and little understood" -
Peter Hitchens, pontificating on the use of Ritalin in the treatment of ADHD.
I will be posting a very great deal of really quite diverse material on the nature of dopamine imbalances in the next few weeks. In his foreword to the 'The Oxford Book Of The Sea', Jonathan Raban wrote that people tend to write about that which causes them difficulty; as far my relationship to my own imbalance is concerned, a truer word has never been written, and in that regard I must thank my readers for their patience and forbearance. In his foreword to 'Screwtape Proposes A Toast', C. S. Lewis wrote that he was deterred from producing a sequel to 'The Screwtape Letters' by having found the production of the original work to have been, in his words, 'gritty', a word which well describes my own experience of being a sufferer of dopamine imbalances researching these phenomena.
A couple of points about Mr. Hitchens' exhaustive and exhausting polemic -
"Interestingly, the next major discussion of (ADHD) took place after a large number of children tragically suffered physical damage after an epidemic of encephalitis, in the USA in 1917 and 1918 ( a secondary effect of the Spanish influenza pandemic)" -
Far, far too sweeping. Encephalitis lethargica (the 'sleeping' or' sleepy sickness', also known as 'Von Economo's Disease') is an entirely different phenonemon to influenza. Influenza is a very common cause of trauma to the substantia nigra, the section of the midbrain responsible for the production and regulation of dopamine, and one which can and does produce dopamine imbalances; but there is absolutely no hard evidence that the 1917-1927 'sleepy sickness' epidemic, first recorded in Paris and Vienna, was connected to the Spanish flu epidemic in any way whatsoever. There is a theory that infection with Spanish flu might have left a footprint on the brain which might have rendered it susceptible to sleepy sickness, yet none of the patient histories from New York City which were recorded by Oliver Sacks in 'Awakenings', or by Gilbert Onuaguluchi, the Nigerian doctor and academic who wrote 'Parkinsonism' in Glasgow over 50 years ago, still the very best and most humane study of dopamine illness, mention Spanish flu at all. They do mention trauma, from the loss of parents to the loss of tonsils to the loss of children; a factor certainly far more likely to induce dopamine illness than any of the items note immediately below.
"In my view, this history cannot be understood without looking at other major events going in the world at the same time. It was during the post-1960s cultural revolution in Western countries that several things began to affect childhood. Some of them are direct results of that cultural revolution. Others are independent of it, but happened at the same time. They seem to me to provide an alternative explanation of the astonishing growth in the numbers of troublesome children.Some of these features are common to Britain and the USA (where 'ADHD' is most commonly diagnosed). Some are specific to only one. Remember that 'ADHD' is far more commonly diagnosed in boys than in girls, and that its symptoms in girls are almost always different" -
"4.The abolition of school sports and other physical exercise, accompanied by the sale of playing fields.
5.The growing danger on the roads, leading to children no longer walking or bicycling to school, so depriving them of a key form of exercise."
Good God almighty, does this man not know that exercise is the one thing guaranteed to aggravate the symptoms of dopamine illness? That the one thing that sufferers of dopamine illness in any form cannot tolerate is exertion?
"6.The arrival in almost all homes of colour TV, broadcast 24 hours a day and including a growing number of channels aimed at children. The installation in the majority of children's bedrooms of a TV set which the child controls."
Writing of the dopamine impaired patients that he treated in Stobhill General Hospital between 1959 and 1962, Gilbert Onuaguluchi indicated that the advent of television was a virtual godsend.
"7.The invention, and rapid spread of computer games."
A contextless assertion.
"8.The rapid increase in the numbers of mothers going out of the home to work, further reducing adult supervision, example and restraint in the lives of the young." -
If there is one factor guaranteed to turn the drama of dopamine illness into a crisis, it is an unhealthily close relationship between mother and child. Dopamine illness seems to thrive in matriarchies. For some families afflicted by dopamine illness, the period of separation between mother and child caused by Mum going out to work might be the only factor keeping the show on the road.
"9.The increase in the use of highly-processed fast foods in the home, many aimed specifically at children, and rich in sugar, chemicals and other unhealthy ingredients."
Broadly, maybe. As far as the consumption of baked beans is concerned, he might have a point, but as far as anything else is concerned I'd want to see his notes.
"10.The almost total collapse, influenced by many of the factors above, of the idea that children should have fixed bedtimes and should sleep for far longer than adults"
Tell that to the sufferers of sleepy sickness whose illness kept them off their sleep for six months, and who then slept for the next 50 years. The role of sleep in human physiology is vastly important, for sure; but there is absolutely no indication anywhere that strict adherence to normal bedtimes will ameliorate the symptoms of ADHD in any way whatsoever. The nature, indeed perhaps the will, of the illness is that it wishes to overpower the urge to sleep. With an illness like that in your system, the fact that you are sent to bed at seven will not make the slightest difference to your condition.
I'll be revisiting both this topic and Mr. Hitchens in the very near future. For what my opinion's worth, this is not a scientific article but a political one, which renders it contemptible.
Labels: Dopamine Illness