Physician Gabor Mate Gives His Analysis on ADHD and Anxiety

I was just watching this very disturbing commercial yesterday with children and it was talking about ADHD and it showed a kid that was not paying attention in class and it showed these kids like playing around and doing things they weren't supposed to be doing and then they introduced this medication and then you have the child raising their hand and then you have everyone clapping and you have the child with a big smile on their face and you've medicated your child to be a successful and integrated person in society. Shall I spot off about ADHD for a minute? Yes, please. That was my first book on ADHD. It's the American scattered or scattered minds depending on which edition you get and that was after I was diagnosed with it myself in my 50s. What does it mean? ADHD? Yeah, what is it exactly? Is it real? Oh, it's real. But what does it mean? Well, like if someone has ADHD, it's not like you have herpes, right? Like you can say, oh, you got a disease. What is it? Well, that's the whole point is that the medical profession and a lot of the so-called experts think about it as a disease. Another one of these inherited diseases. In fact, they say it's the most heritable mental illness there is and I say it's neither an illness nor is it heritable. So the hallmark are difficulty paying attention when you're not motivated. Yeah. So kind of tuning out like that kid in the commercial. Like me. Okay. Poor impulse control so that you tend to act out whatever emotion arises. And sometimes the hyperactivity difficulty sitting still and then to fidget and all that. And that described me to a T. But as soon as I learned about the diagnosis, I knew something. This is not a disease and it's not heritable despite the fact that some of my kids were diagnosed with it. What is it? So tuning out is not a disease. So let me ask you a question if I may. Okay. If I were to stress you right now, create stress, emotional difficulty or attention for you right now. What would be your options of dealing with that? Of dealing with me? What would be your options? Actually you'd get upset or I could leave. Exactly. You could fight back, flight or fight. But what if you didn't have those options? Yeah. Then you're stuck. And now what does the brain do when you're stuck like that? It gets distracted. It gets tuned out. Yeah, it tunes out. You want to do other things, think about other things. In other words, it's a coping mechanism. Yeah. It's normal. The idea that your child who is an eight, nine year old ball of energy filled with hormones and life and thoughts and things they enjoy and then you make them sit down all day in this unnatural state in a classroom with fluorescent lights and stare at a teacher that's unmotivated and underpaid and is teaching something in a very boring and non-entertaining way. And then if this kid doesn't lock in like a zombie, we need to medicate them. Yeah, well the other part of it is that if you look at my infancy and it sounds like yours, we spent our first year or two under very difficult circumstances, a lot of stress. Infants can't help but absorb the stress of their parents. Right. They can't help it. What does an infant do? Could I have escaped or fought back? Could you have? Or we could do this tune out. Yeah. But when is this tuning out happening? Our brain is being developed. In our brain, this is the part that nobody taught me in medical school, but it turns out that brain science now teaches us that the human brain develops under the impact of the environment. So the most salient feature of the environment that shapes the circuits of the human brain is actually the relationship with the parents. And if the parents are present and emotionally attuned and available, child brains develop properly. But the parents are stressed. The child absorbs the stress. What can they do with it? They tune out. And that tuning out thing is programmed into the brain. And then 10 years later or 50 years later, we say, you got this disease. No you don't. You've got a coping mechanism that's no longer working for you. It had a function that first came along. So this whole idea. And by the way, if a family comes to me with their ADHD child, I'll say to them, what you've got here is a very sensitive child. That sensitive child is picking up on all the vibes, energies, and stresses in your family. Want to help this child? Deal with the whole family. Look at the parental relationship. Look at what stress is there in your life. Look at how you react to the child. Do you understand the child's behavior or the emotions that the child is having? Or are you just trying to control the child's behaviors? Look at all that. And very often parents will tell me after they've read that book on ADHD, they've totally changed their relationship to their child. The child changes. What a surprise. But you go to the most doctors, you've got this disease. Here's the pill. And by the way, I took those medications and they helped me for a while. So I'm not anti- When you were in your 50s. Yeah, yeah. I'm not anti-medicine. Which ones did you take? I took Ritalin, which I can tell you the story. So one of the hallmarks of ADHD is poor impulse control, right? So I found out about ADHD and even before I was diagnosed, I took Ritalin. And- Why did you take it before you were diagnosed? Because I'm a doctor and I could, hey? Oh, so you diagnosed yourself? Well, I did. So you at least assumed that you had that, didn't you? Yeah, I knew I had it. But not only that, also because I had poor impulse control. I never practiced medicine that way. If you came to me for any problem, my first impulse would never be to write your prescription. Unless it was obvious that you needed it for an infection or something. I'd sit down with you and talk to you about what's going on here. But not me. Poor impulse regulation. So I went to a colleague of mine, a medical colleague. I said, hey, Bev, I think I've got ADHD. Can you give me some Ritalin? So she advised me a prescription. And I took it in a higher than recommended initial dose. Because if a little bit is good, then more must be even better. And again, it's not how I practice medicine. But I came to myself, that's a totally different bargain. So I felt immediately present and calm and grounded. Really? Yeah. And it's a stimulant. Well, it calms the ADHD brain. Then I go home and my wife says, you look stoned. Because you're calm. Yeah. Well, because I got this glassy-eyed expression. And within a couple of days, the Ritalin made me very depressed. That's one of its potential side effects. So I did see a psychiatrist. I was formally diagnosed. And they gave me dextridine. And I took that for a while. That's amphetamine. Yeah, it's amphetamine. It's another stimulant. And it did help me. I became a much more efficient workaholic. I could do even worse. It didn't change any of my emotional issues. But it made me more focused and so on. It helped me write my first book. But I haven't taken them for decades. But because also I know that the brain can change if you treat it right. So the reliance on medications that we have is a real poverty of the spirit, a real poverty of imagination, a poverty of medical education. The average doctor never learns this stuff. The average physician never gets a single lecture on brain development, how the brain develops in interaction with the environment. Let alone do they hear about trauma. They don't hardly at all. So when they see an adult with ADHD or depression or addiction or bipolar conditions or for that matter, autoimmune illness or anything else, they don't think of trauma. They just think of this disease. And they think that the diagnosis explains everything. But the diagnosis don't explain anything. Because think about it. Let's say Gabor or Joe goes to a doctor and they diagnosed ADHD. Well, what are the hallmarks of ADHD? Well, tuning out poor impulse regulation, maybe hyperactivity. Why does Gabor have poor impulse control, hyperactivity and tuning out? Because he's got ADHD. How do we know he's got ADHD? Because he's got poor impulse control and tunes out and he's hyperactive. Why is he hyperactive, tunes out have poor impulse control? He's got ADHD. How do we know he's got ADHD? It's circular. It doesn't explain anything. Diagnosis describe things. And that can be helpful that way. But they don't explain. Yeah. One of the things that people get treated for and they get diagnosed with is anxiety. And that one drives me nuts. It drives me nuts because people pretend that anxiety is a disease. And I'm like, my God, the world should make you anxious if you're a sensitive, introspective person. If you're just looking at the world itself and you don't put it in perspective, the world is filled with anxiety. The anxiety is future problem solving. You're thinking about all the things that can go wrong. You're thinking about your life in a potentially devastating way. And that's not a disease. That's just the way you look at the world and people getting diagnosed with it. Well, I won't quite agree with you on that one. In what way? I felt anxious at times. The world is the same. The world is the same. But the way you look at it is not the same, right? That's the whole point. Yeah, that's what I'm saying. So the world is giving you anxiety. No, the world is not giving me anxiety. Right. You're giving yourself anxiety by looking at the world, right? By how I look at the world. Because I can look at the same world one day and feel grounded and connected. And I may have all kinds of concerns about what's happening in the world, but my nervous system won't be on edge. My adrenaline won't be flowing. I won't be anxious. That's my point is that it's not a disease. It isn't a disease. Remember I talked about those brain circuits of lust and care and age and seeking and so on? One of the brain circuits that we have is described by a very prominent, late neuroscientist, JAC Panksepp, is for panic and grief. Panic and grief are the normal responses of the young human being or the young animal when care isn't available. So when the parents are stressed, distracted, economically or politically or because of their own unresolved trauma or whatever is going on in their lives and they don't respond to the child's distress, they don't pick up the child when they're crying. They make the child be alone when the child is upset. The child's panic circuits get activated as they should be because when the child's panic circuits get activated, they cry for help. So it's necessary for survival. A young animal should feel panic when the adult is unavailable. In a rational world, in a sane world, that child would be responded to. But when children, as in our society, are not responded to in their distress, the panic becomes built into their nervous system and now you have a lot of anxious people. And that's why more and more kids are being diagnosed. You're right. It's not a disease. It's a response to the environment. And the thought process of like leaving a child alone when the child's crying, is that to toughen the kid up? Is the thought process that you don't want to encourage this sort of behavior because then they'll do it all the time and then you'll develop an indulgent child? Like what is the thought process? The thought process is that the child's behavior is the problem. And so we have to fix the behavior by controlling it. Now actually, the opposite is true. Because if you pick up the child when the child has distress, physical or emotional distress, you're teaching the child that the world is safe and they don't have to be anxious about it and they can just ask for help. And it doesn't entrench kind of crying manipulative behavior. How it works, Dr. Daniel Segal who's a psychiatrist at UCLA and a very prolific author and mind researcher, he says in his book, The Developing Mind, that the child uses the mature circuits of the adult brain to regulate its own immature, unregulated circuits. So when the adult shows up in a calm, loving way, that the child downloads that into his own nervous system and then he grows up, he doesn't, he's not going to be an infant forever. Some point he's going to be a mature adult who knows how to take care of themselves. That's a natural process. We don't have to teach kids to be independent. Independent is nature's agenda because the parents are going to die. At some point the mother bear is going to disappear. The bear cub has to be able to look after themselves in a mature, confident way. That's nature's natural agenda. What the mother bear needs to do is to meet the needs of that infant bear so the infant bank care matures. So if we meet the child's needs, they're going to mature out of that helpless state with a sense of self-regulation and calm confidence in their own capacity. But when you don't pick kids up, what you teach them is that the world is not available, that they're alone, and that they're helpless. Talk about a formula for anxiety.