Evolutionary Basis of ADHD with Dr. Ryan Sultan

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.

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.

You can check out Dr. Sultan’s work here: https://www.integrative-psych.org/

William Curb: So we're here to talk about this idea of the evolutionary basis for ADHD. So I think a great place for us to start would just be like, kind of like a general introduction to the idea, because I'm sure some people have an idea of what they've read online or through memes. And that's usually not a great place to start with, where you're getting your information.

Ryan Sultan: It's a fun place to start. Yeah. Absolutely. As long as it's not the end. That's what I tell people that TikTok can start you, but your adventure should go beyond that. So the evolutionary basis of ADHD, I think we can back up and just talk about the idea of evolutionary psychiatry. It's something I've been very excited about for psychiatry, because it has an opportunity to kind of ground psychiatry in a foundational aspect of science, hard science, biology, because it's connecting it to evolution, which is basically the basis of all modern biology. And the idea that gets in there, I'm going to oversimplify it here a lot, that we need to stop thinking about our conditions that we see today, ADHD, depression, anxiety, maybe the way we think of them is, diseases, that's not right.

Cause that, that's not exactly what's been happening. It's that these are systems that we have that are useful for us, mood, attention, that may have functioned in one way in a ancestral environment. And in a modern environment, you know, they can kind of get misfiring in different ways. And so for ADHD, that's the idea that maybe the attention regulation that is a difference, what's called a difference in those of us with ADHD might even have been like advantageous in some ways in a different environment. And we're hearing that as people are talking about neurodivergence and, you know, how to reframe some of these, what we used to just call mental disorders. Yeah.

William Curb: And I think it's important to like, yeah, consider like why would this ever exist in nature? And you go, if you like kind of like tease some things out, you're like, Oh, that makes a little bit more sense.

Like I was reading something actually earlier today that was talking about, like depression being a way like something that kind of naturally occurs when we're sick, because it helps us seclude ourselves from other people, which would be advantageous in tribal society.

Ryan Sultan: I saw you had Steve Harone. Guys, don't listen to me. Steve Harone is, is way more important than I am in the world of ADHD. So go back and listen to him before you listen to me. But the evidence base for this is a little different.

So he is going to be very strong on a high, high level evidence based. The evolutionary psychiatry is a concept, right? It's a concept. It's an idea and it has aspects of our evidence that come together and start to support this overarching idea. But in and of itself would be very difficult to empirically test. So I think it's an important differentiation for people to have.

I'm a researcher at a lab at a university. So, you know, I got to be a good boy and make sure I get that disclosure for people thinking about it to not sort of take it too far.

William Curb: Well, yeah, I think that's like a really good point too. Awesome. Like really solidify because, yeah, there's this theory behind it. But it is there. Yeah. Empirically proving that this is the way like we don't have a basis to actually do that. But we can, you know, with enough supporting evidence to be like, this is a very likely path.

Ryan Sultan: And it's a good story. It makes sense. It fits it. You know, over time, maybe we'll figure out a way to actually test it as we pull together. So you mentioned depression. So there's been some really great work done that observes that depression looks kind of like hibernation, right?

Man, I was high. So like when is depression more common in the winter, especially in areas where there is less sunlight? One of the things you see with depression changes in sleep patterns, often increased sleep, staying at home or doing less less interest in activities, lower energy level, psychomotor retardation, moving a lot.

Like those feel like they're moving towards like a hibernating state. So that's one of the things that people point out and said, hey, is that what that is? And another one that people thought about is, you know, with depression, we used to spend all this time in psychiatry arguing about environmental versus genetic versus heritable, which is ever so slightly different than genetic.

And that would set me genetic. And so we have all these really great ideas. And it used to be like one or the other's right. And you know, it goes on.

Everybody's like, oh, my goodness, actually, multiple things are happening here. And so, you know, one of the things we learned about depression was that people are predisposed to having depression. People have different reasons they're predisposed to having depression.

There are societal things that would predispose you to it, like, for instance, being lonely, not having to go out in a good relationship. But something has to happen. And so something has to be almost like kicking in the face so that you get knocked down. And depression, if you, you know, if anyone is like a DSM nerd, to get a depressive episode, a major depressive episode, which is really the thing we are always most worried about in psychiatry for depression. That's called the big D depression. You get knocked down, but you got to have more than two weeks of symptoms. Why would you maybe have more than two weeks of symptoms?

So one of the hypotheses has been that depression, which has rumination as a symptom for many people, assessing, thinking about something over and over again. What if they got knocked down? And as long as within two weeks, they were able to sort of think about it, figure it out and reengage in the world. We don't consider it a disorder. Maybe because that was something that was that's actually an adaptive version of it. That regulating your mood is a way to do that. It's also a way to tell yourself, hey, something went wrong. I need to reevaluate this.

Like I need to modify my plan because something didn't go well the last time. And so, you know, these are really, I think, very compelling ways to think about our conditions, conditions that we don't really understand. People like Steve Ferrone, Tim Willens, certainly Biedermann have done crazy amounts of work. Jonathan Posner did a lot of imaging work, really getting us to understand ADHD. And it's great. But we don't really have a story to explain it. And it's the same problem in depression and we have the same problem in anxiety.

William Curb: And so when we're like them thinking about with this was like ADHD, we're thinking about this in ways of, I don't really want to say like evolutionary advantage, but reasons that it persisted in our.

Ryan Sultan: Bingo, that's the right way to think about it. Nail on the head. OK, like let's put aside advantage, disadvantage for a second. If we're not going to call it a disorder and say you're broken, let's not suggest any superiority.

Let's just try to be neutral here because like evolution doesn't have an opinion. These types of things, right? So and I can relate to the negative side of that. So, you know, I was diagnosed with what was a we used to call learning disorder at the time. And, you know, some earlier, probably back when it was ADD only with as a separate disorder, I was diagnosed with that. I wasn't treated and I developed a very negative self-esteem issue around that. And it was even reinforced by the psychiatric community. I had a psychiatrist who was a teenager who said to me, you don't have ADHD. You don't have these dyslexia thing or whatever. That's what do you mean? I've been told this for years, you know, like I wasn't treated, but I was like in special life classes and things like that. So they were working with me. No, no, you're too smart for that.

And by your age now, like if you had to, you would have outgrown it. I mean, those are wrong, right? Those are just like myths we have about it, right? But my point is this was one of the negative aspect that I was thinking about. Well, so, you know, what if we think of it in a more sort of neutral manner? What if we think about the idea that we all have attention systems and they operate in different ways? So let's connect this to the science that we know early on in the research about ADHD, which, by the way, is probably the most neuroscience biologically grounded of all the psychiatric conditions. And one of the things that support that it's efficacy with medication, the particular stomach stimulants, the stimulant medications are rock stars at improving ADHD.

We don't have another class of medications for another condition that does anywhere. Well, is that so all you guys at home with ADHD, but we'll be really grateful for that because depression, anxiety, schizophrenia, do not have that. And part of it is that we really seem to think that there is a neurobiological underpinning. So by having a drug that changes your basically your neurochemistry, like you are really targeting the thing that is is creating a struggle for you. What's called where they think that depression are more complicated.

And so you have this system of attention. We know early on that they used to do EG's on kids with ADHD. They're trying to figure out the biology of it.

And EG is normally used for things like seizures. They would notice slow waves. It seems to be the kind of stuff that's associated with not being so awake. Like it's asleep, but you're not like a weak and alert. And you think, hmm, those ADHD kids, when they're not paying attention, they just seem to be sort of like their mind is wandering, they're sort of not really engaged. You know, we even used to confuse it with absence seizures and things like that. You know, so it's this thing where their attention isn't as strong that you would imagine and that.

OK. So then we think about another thing that we've seen, which is that the brains of those with ADHD on average, right? Like not fortunately, we're not going to scan anyone's brain any help.

I don't care how good a neuro imaging doctor you are. We know that when you lump a lot of brains together and you average them, that, you know, there's things we see that are different about the brain, right? Like, you know, prefrontal cortex is part right here. Like that is, you know, maybe the most recently added version of our brain from an evolutionary point of view, you know, that the activity in that area seems to be lower on average in those of the HD, seems to be developed a little bit less. You know, and that's interesting, too, because we've always noticed that these ADHD kids seem to be like three to four years behind their peers, especially when they're growing up.

Yeah, that's why we call the neural developmental conditions. Also, why we mistakenly thought that it didn't exist in adulthood because a good number of them get better. You know, the epidemiology data would say maybe a third don't meet criteria anymore. Though almost everyone still has some kind of symptom. We have these trends with this neurobiology that against there's something different about their brain. And I think one of the most compelling things is if it's such a problem, why is it so reliably common?

And it appears at such a young age. And doesn't it seem like if it was really that problematic, like evolution, natural selection, natural selection is not friendly, right? Like it's not, it's not sentimental. Like, nope, you don't get to reproduce, right?

So why has it been conserved? And you have to say, well, maybe because it is always a problem. And so let's think about how life is different.

Certainly in the last 150 years, since the industrial revolution, life has changed a lot, very fast, sometimes within generations. I'm old enough that I remember having a landline phone. My sister is younger than me. And I don't think she remembers that things have really, really, really changed. And one of the things that have changed particularly is that, you know, what are our days like and our days are significantly more structured than they were before and require you to sit quietly and do things that require sustained attention and a repetitive and boring. We all know that people at ADHD are not good at that.

Whereas in an ancestral time, right? That ADHD kid that gets really easily excited can go run after on a hunt. You know, stimulating that is it's going to pump up their dopamine.

And we know from the neurobiology that when you give the meds, for instance, their dopamine levels look similar in that front of the brain as they do to the ones that don't have ADHD. Maybe they're going to be the individual that instead of picking from one berry and obsessively finishing every little berry on there, they say, I'm bored as I'm going to go check another berry tree. And so they're moving around. And that may actually be a more efficient strategy, right?

If it's diminishing returns, the longer you try to do something, maybe they're going to be the ones that are going to push their tribe to sort of go out on an adventure and check out a new area, which are opportunistic. Also risks, right? We know those with ADHD have a higher risk tolerance. Their whole dopamine system seems to be different, which is why they're so predisposed to substance use. There's a paper that, you know, one of the earliest papers that wrote on ADHD where you saw the comorbidity and, you know, even teens, the comorbidity with substance is much higher because whatever's going on in their neurobiology that maybe, let's say, was useful. Let's use the word useful in some other time period.

Feels a little less useful now, but also predisposes them to a reward system, a thing that is going to hit their reward system, which is one of the main problems of addiction. That's the kind of work that I do now. Maybe their system is just more predisposed to getting pulled into that.

William Curb: Yeah. Because I've recently read a paper about berry picking, optimization and the novelty seeking of going to new bushes and how that actually created like a better system. And you see in ADHD, people more likely to go to the new bush more frequently, whereas more neurotypical people will stay and reuse up the resource until they need to move on.

Ryan Sultan: And so it fits into this larger model of how do we think about all these conditions in a way that is less about them as a disease and more about them as a difference? You know, I think that's important because what is the You know, stigma in psychiatric illness, is it way better than it was before the pandemic? Yes. Is it still there?

Yes. And you see it even at a systemic level. You see it on a systemic level, because if you wanna get neuropsych testing, which while it is not the definitive way to diagnose ADHD, is very useful, you sure it doesn't wanna pay for that, but I wanna deal with that. If you wanna get treatment, they give you a hard time about that. You know, it's harder to get treatment for mental health conditions than it is to get it for non-mental health conditions.

The denial rates are much, or they just don't cover it. And we sort of see it in our own sense of self and how we feel about it. And so I think one of the compelling things about this story, which is again, this is not scientific, is the idea that how do we think about ADHD, not as so much as a disease? How do we think about it in the larger aspect of the neurodivergence movement? And that these are differences, and that maybe we don't need to think of ourselves that way. And also, should we think a little bit about what are ways on a grand level that we can be moving society towards things that are maybe a little more friendly towards the variations of people that exist, especially because many of those things are kind of useful for everyone.

William Curb: Well, and this is making me think also of like, when I talk to coaches and I'm talking about going for like strength-based approaches where you do the things you're good at and have other people that can help you with the things you're not good at, which is true for everyone, but especially with ADHD, there are things we are much better at and things we are much more sad.

Ryan Sultan: Right, the gaps that exist. And the neuropsych testing, one of the things that's cool about it is it'll show you that, right? It takes all the ways that we can dimensionally sort of think about a person and their mind and it sort of splits them up like working memory and you see these aspects of it that are highly associated with the condition and then that is useful for the person. And they're like, oh, that's the reason why, like I can never remember anything on it right now.

William Curb: Yeah, and I think it's also important, like one of the things that I see when people are talking to about this evolutionary idea too is sometimes they kind of go too far in the direction of like, look, we would have been amazing hunter-gatherers. And I'm like, well, I mean, we'd be okay, but if I'm always forgetting where my spear is or where my, you know, sit down, I'm like, where the hell did my berry basket go every five minutes? Like that's still a huge problem. So it is interesting to be like, okay, how do we like contextualize that? So that's like, yeah, this is better in some places, but not everywhere.

Ryan Sultan: And is there other ways that we can adjust modern life? And this is where it gets hard. Are there ways that we can adjust modern life for those with ADHD, for those with neurodivergence to sort of support them in doing what they need to do? That doesn't mean that they can say, oh, I'm not doing anything that relates to repetitive boring tasks ever again, because I have ADHD.

Like that's kind of unreasonable or refusing treatment or something with that. But I pride myself on caring about integrative approaches. It's just, you know, integrative is like separate, disparate things that, you know, putting them together. And like the answer to every mental health condition gets better is a combined treatment. So, you know, one of the things we don't think about enough is the environment that people are in, the society that people are in, are there things we can do on a larger scale than that we already know meds are great.

The number needed to treat, that we just excellent. We know skills are useful for people. We know having resources, life, a person to sort of help you out in a situation. For example, like, you know, my admin for my practice, like Denise, like, I don't know what I would do without her. Like, you know, she is like, like part of my executive functioning system. And, you know, when people got accommodation to school, they're attempting to provide that as well.

William Curb: Yeah, this leads to that like larger conversation of like, how do we actually try and make this idea be something that we can practically use? Because yes, this is great to like think about like, oh yeah, 500 years ago, I wasn't nearly as useless doing my job as I am now, but that's not practically important for me right now. And so being like, how can I apply this then?

Ryan Sultan: And the first thing I actually would tell people, which is maybe not the answer they're gonna expect, everyone with ADHD has a very high risk of comorbidity. I was trying to find like a, one of the early papers I wrote on this, like, because it uses in like a large survey data, it's like 70% depending what study you look at, right?

Of teens. And by the way, I promise you the comorbidity rate only goes higher as you get older, because you accumulate comorbidities, because having ADHD puts you at risk for having other things, substance use disorder, mood disorder, anxiety disorder, right? If you've been struggling in school, and you don't understand why you're always getting in trouble, why you can't get things done on time, why it takes you longer to do that, why your parents feel like they have to repeat things 11 times, that's gonna affect your sense of self, and put you at risk for mood disorders. And it is also gonna give you anxiety because you're gonna be like, did I forget something?

What's going on? Double checking everything that you do as a compensation strategy. So one of the things that I really encourage everyone to do, first with ADHD, like as a foundational way to get help, is just let's make sure that there's not other things that are not being treated, that could be treated, that are actually making it harder for you, even if they are not directly affecting your attention. Mood disorders affect attention, so they can be worsening your attention in a way that is beyond your ADHD. There's data that shows that cannabis use on average seems to worsen attention, and maybe even more efficacy of your stimulant.

If you have anxiety, you're thinking about things all the time, and you're obsessing about them, I think about it, generalized anxiety, that is like, use a computer analogy, let's pretend you only have eight gigs of RAM, that's your working memory, your consciously or unconsciously using two of them. It would be great if we could make them all available to you, because that actually would improve your working memory and help you compensate. And those are hits that we often don't think enough about as a starter on how to help people with ADHD. Because part of the reason they have these conditions is usually as a secondary effect of having lived life with ADHD in our world.

William Curb: This is just a funny thing that I was making me think about. I recently had some changes to my medication, and it was adding in some guanfacine, and that helping with the anxiety aspect of things, and then that making it so that I was more late to things, because I wasn't checking the clock as often anymore, and I was just like, this is a hilarious way that this is treating my ADHD and making one of the symptoms worse by making it so that I can focus better.

Ryan Sultan: Yeah, so it's weird, right? And that's a story that I've certainly heard many times. We've said for many years, people have talked about the idea, and again, this never came out of a paper to my knowledge, but it is certainly war in child psychiatry, is that properly tuned anxiety is protective, particularly for people with ADHD, because they should be a little more anxious than a non-EDHD person about certain things, because it's in an area that they may not have as much of a strength, and by being the right amount of anxious, not too much anxious, too much anxious is paralyzing, and I can't do anything, but the right amount can kind of keep you a little more on track, actually improves your performance.

William Curb: Anxiety is such a funny thing, and such a high core morbidity with ADHD, like I think anxiety is the number one home morbidity, even though there are so many, like the dyslexia that is right up.

Ryan Sultan: The number one, I mentioned the number one is other neurodevelopmental or behavioral conditions, that's probably the number one, and then I guess anxiety is after that, because it's so common with learning differences, it's so common with that.

William Curb: So we're talking evolution part about this, and that this is just, are there competing theories for this idea of the persistence of these traits, or is this kind of like all we've got for this right now?

Ryan Sultan: I would say all the other ideas that I'm aware of are not necessarily mutually exclusive from it, right? ADHD is a genetic condition, sure, yeah, that fits with this. There may be environmental factors that occur either in utero and early childhood that increase the likelihood of it developing, but I think that's a perfectly, that fits right into the way of thinking about it. I mean, look, in extreme levels, extreme levels, deprivation, and people used to get annoyed when they blamed ADHD on parenting.

I think that's, I think that what they're missing is that there are parenting strategies that can improve the situation of ADHD, but that doesn't mean that the lack of them necessarily caused it, but extreme deprivation is another one that we've seen do that. So that's my knowledge.

William Curb: Yeah, and I mean, it makes sense too, because we're just saying like, hey, this is just the persistence of these symptoms. Like they existed at some point, we don't know when they started, or do we have- They might not even have been symptoms.

Ryan Sultan: They might not even have been, symptom has a pathological connotation, traits, qualities, you know, it turned it to something generic, and also don't conflate this idea of the disorder being like evolutionarily. It's gotta think about the system that it's regulating, right? Attention, you gotta think about the system that substance use is regulating, which is like reward systems overlapping with ADHD, mood. You start with that, and you start to think like, well, there's variation that exists in a population in how that system might work, and that variation starts to only look problematic in certain scenarios where you, where someone might have either confounding risk factors, which is like one of the things you're discussing about, or a situation that's pulling at that. And here's another thing that's really interesting.

This is like hot off the press. So the MTA studies for all of our listeners, so back in like, I think like the 90s, like the NIH was really interested in these like big studies where they would look at huge groups of people with a queer condition and try to learn stuff about them. And so they did this for depression and anxiety, and bipolar disorder, schizophrenia.

They did one for kids with ADHD, it was called MTA, and they've been watching these kids for a very long time, and they're just finishing watching them now. So they're probably right around my age, I'm 40. And so you've seen a lot of things in their lives, you've seen outcomes for them.

We know that they're more likely to die of accidental death, which is something we already thought, but you know, that the more you get divorced, the more you get fired. Well, here's a really interesting one that we're trying to make sense of, which is that within the individual, there are symptoms of ADHD, and whether they qualify or not for it, the diagnosis at any given point of time, or if we're watching them and we check in with them, I don't know, maybe a year, every two years, and like that, they don't always meet the criteria, but it's not that they then stay not meeting the criteria, which would be the like you outgrew it idea.

They come back and meet the criteria later, and this on and off thing, not for everyone, but that most of them engaged in this on and off thing, that's a really interesting idea. And so their hypothesis is what they saw was when people were busier, their ADHD symptoms were less fear. And what I think is so interesting about that, relating to neurobiology and like adaptiveness, is that, you know, when you're busy, with just a little bit of stress, a little bit of pressure on you, that's gonna crank up your dopamine system, and cranking up your dopamine system is going to reduce some of your symptoms.

It's gonna make you seem less like you have ADHD. And so I think that's really, really interesting. There's gonna need to be a lot of follow-up studies on that to figure out what does that mean exactly? But that was a very surprising finding for everyone in the field.

William Curb: I mean, it sounds similar to with the findings with like the default mode network stuff where we like kind of don't turn that off. And yeah, we do need that extra little bit of stimulation to stay engaged.

Ryan Sultan: No, I think that's a really good finding that is important, which is this idea of the default mode network and how that might be different in people with ADHD and also that maybe you need to be running that while doing something else to stay engaged. And it also is interesting, I wonder about, you know, because even if you do lots of cardiovascular exercise, which increases dopamine and reduces symptoms of ADHD, it's not like taking anadrol, but like it's a meaningful increase in if you're regularly exercising your baseline is going on.

I wonder about, you know, good exercise. If you get to the point where you're really good at exercise and like a specific exercise like running, you know, you're actually running your default mode network that's doing it. Just like if you're a good driver, you never get home and you're like, you're remembering when I got home, default mode network took you home. You know how to run a car.

William Curb: I hate when that happens where I get like, oh my God, I don't remember the last like five stop lights. What have I been doing?

Ryan Sultan: Yeah, but you're probably thinking about something else.

William Curb: Yeah, which is always funny to be like, yeah, I don't remember what I was thinking about even, but probably wasn't that important actually. The only other thing I wanted to add into is just like, when we were talking about the idea of neurodiversity being like, hey, diversity in itself is a good thing for any system because they all support each other. Like that's how we come up with better ideas. It improves everything. So that's why it's like being like, yeah, this isn't better or worse. It's just we're in the same category with some differences.

Ryan Sultan: There's variation that exists among all of us. I think that's absolutely what you're going to do. One of the things that we know about us as a species and anthropologists have been talking about this forever. Two people working together is greater than the sum of its parts. It's greater than two single people doing their own work. You put two people together and they actually work together.

It's not one plus one, it's like one plus one equals three. There's a synergistic effect that occurs. There's an emergency property that occurs as you get larger in a group. And there's probably a number of things that contribute to that like efficiency around stuff or dividing of tasks in terms of like specialization.

But another aspect of it is that you have neural diversity. And if I were making up a little tribe of 100, 150 people, I definitely would not want no anxious people at all. I would want anxious people because you know what the anxious people are going to do? They're going to say when the winter's coming, they're like, we're not going to have food. We're not going to have food. And the issue of like whatever, the depressed people like, you know, or like, you know, it's winter, I'm getting ready to hibernate. The anxious people, we don't have enough food.

We got to get more food. And nine times out of 10, they were overly anxious, right? And they didn't need to do that.

And one time out of 10, they were right. And your old tribe might do a lot better than the one that didn't do that. I think it's the same argument can be made for having people with ADHD. So you have new strengths that people have that get introduced into a system. And so when you work together, you can really accomplish more. You're better than any one individual.

William Curb: Yeah. Do you have any other things you want to let people know about before we wrap up?

Ryan Sultan: A multimodal way of thinking about treatment, I think is an important thing that, and not just for ADHD, right? This is the right answer for every mental health condition. I can't help myself with bringing that up on, you know, any sort of public forum that I'm at, because I think it's important to general population understand that. Whatever you're getting help for, particularly at ADHD, there's never one answer you want to be pursuing. It's really multiple answers because when you add them together, you really get the best possible outcomes that you can for someone.

William Curb: I mean, that just fits so nicely with what we were just talking about with the society, meaning all these different systems.

Ryan Sultan: Yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah. If you're interested in learning anything about me, you know, my private clinic that I lead is Integrative Psych, integrative-psych.org. And if you're interested in any of my research, I have a lab at Com University, sultanlab.org.

William Curb: Awesome. Well, I'll include links in the show notes. And thank you so much for coming on the show.

Ryan Sultan: Great to meet you. Bye-bye.

This Episode's Top Tips

1. 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.

2. 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.

3. 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.