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Is it genes? Is it me? A mother's maze through ADHD

It's so tempting to think 'I'm off the hook!' when hearing that attention deficit hyperactivity disorder may have something to do with genes. But we're never really off the hook, are we?

November 07, 2010|By Katherine Ellison

Like many parents of a challenging child, I was quietly thrilled the other day to read that a study in the prestigious medical journal the Lancet reported new evidence that attention deficit hyperactivity disorder, my son's main diagnosis, may have something to do with genes.

"I'm off the hook!" it's so tempting to think, when hearing this kind of news. Yes, my chromosomes may be to blame, but at least I wouldn't have to keep kicking myself over the possible ramifications of that fall from the swing set when my child was a toddler, or how much pesticide residue he's accumulated in his short time on Earth, or whether my own distractedness has deprived him of the consistency and structure he so obviously needs.

In fact, ADHD, which conservatively affects at least 4.5 million American children and 9 million adults, is highly hereditary — less than height but more than schizophrenia. It's frankly soothing to keep this in mind, imagining that all that vexing behavior (the seemingly willful forgetfulness, the blowups, all those trips to the principal's office) is simply the unpredictable vestige of some wayward ancestor. Sure enough, once I focused on this possibility, I remembered my great-grandfather Elias, whose impulsive naughtiness rose to the level of squandering a family inheritance at the poker tables of Monte Carlo.

Given the checkered history of psychiatry, my need for such relief is understandable. For decades, a mostly male contingent of psychotherapists has blamed mothers for a wide array of childhood mental illnesses, insisting, without evidence, that "schizophrenogenic mothers" caused psychosis and "refrigerator mothers" engendered autism. For parents of seriously disturbed children, such cruel finger-pointing has added insult to tragic injury, while creating a fervent reception for contrarians such as Judith Rich Harris, the psychologist and author of "The Nurture Assumption: Why Children Turn Out the Way they Do."

Harris' 1999 book argued that parents play only a minor role in children's emotional development compared with genes and the influence of peers. Yet in the decade since then, other studies have raised serious questions about Rich's thesis, and despite the new findings about chromosomes and such, they serve as reminders that nothing in human nature is as black and white as we may yearn to believe.

Consider, for example, McGill University scientist Michael Meaney's pioneering discovery that the extent to which a mother rat licks and grooms her babies can determine whether certain genes in the pups' brains are switched on or off. Even as adults, the better-nurtured rats release less of the stress hormone cortisol when startled. Testing a related hypothesis in humans, Michael Posner at the University of Oregon has shown that unskillful parenting — for instance, being dictatorial or cold — increases the odds that children born with the DRD4-7 allele, implicated in ADHD, will develop an attention disorder.

When I read of Posner's findings, I had to pause, as much as that goes against my nature. Although I'm not dictatorial or cold, I had to admit my parenting sometimes left a lot to be desired. Most seriously, it was often impossible for me to keep calm in the face of my son's constant provocations, a weakness that for years set us up for chronic, spiraling conflict. When I finally recognized my part in the melees and took a battery of tests, I found that I shared my son's ADHD — a discovery that has been a tremendous help for both of us. I not only learned to empathize with him in a new way but took steps, including meditation and therapy, to train my own attention. My focus on my own longstanding issues ended up greatly improving our relationship.

Although our problems haven't disappeared, my son seems happier now and the blowups, the forgotten pens, the trips to the principal's office have all, mercifully, grown less frequent.

In the end, I suppose nothing ever lets parents off the hook. It's just not that kind of a job, especially in recent generations, when brain science has made so much rapid progress that for the most earnest among us, our basic job description (manager, coach, cook, chauffeur) has necessarily expanded to include "investigative researcher." Our motivation, as always, is our hardwired wish for the best for our offspring: the complex, amalgamated products of both their nature and nurture, and ours.

Katherine Ellison is a Pulitzer-prize winning journalist and the author, most recently, of the family memoir "Buzz: A Year of Paying Attention."

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