Discussion:
Much of the foregoing views mania as an exaggeration of behaviors related to dominance. Some models may describe mania as an enhancement of any active behavior, an enhancement that is driven by the seasons, sleep patterns, or internal cycles. Because dominance and rivalry issues are common in children and adolescence, those traits are conspicuous because they happen to be the developmental challenges of the moment. I suspect, however, that the dominance themes continue well into adulthood for many manics.
Cantwell (1995) has suggested that environmental triggers may be more common that is usually suspected. Adults certainly respond to job failures and successes or romantic losses and victories with exaggerated despondency or elation. Beck (1988) is likely correct when he suggests that falling in love is basically a manic episode. Winning and losing have highly personal meanings for different people, yet the core idea of "being the best" appears a common foundation for elation or for despair.
There remains the problem of why behavior routines associated with dominance, getting money, gathering the best property, winning at Nintendo, and building things are comparatively intact in some ADHD children and lacking in others. Or, why these skills are intact but there are impairments in doing grammar and interacting appropriately with other people.
Pennington (1991) has suggested that more recently evolved CNS functions are more sensitive to disruption; older systems have greater amounts of resilience. The executive functions of planning, memory retrieval, problem analysis and solving appear comparatively new and most elaborate in humans. He commented that LD children can have normal executive functions. It could well be that mechanisms for dominating others, amassing property and wealth, tool use, and mating are evolutionarily older (Barkow, et al., 1992) in contrast to newer, subtle abilities that adjust personal behavior in response to other people's emotional cues and stated wishes. Thus, it is less surprising that many complex behaviors can be intact while behavior routines, summarized as altruistic and considerate, that are highly valued in modern culture, are impaired in both mania and ADHD but for different reasons.
A similar theme was addressed by Rapoport (1995) who noted that LD children without ADHD can develop their own compensations for their LD problems. Children with both disorders are dependent on tutors less for teaching information and more for discovering effective learning strategies. Applying this analysis to children with both mania and ADHD suggests that ADHD may act so that the manic child also repeats his mistakes more than the same child would without ADHD. One manic father has commented, "I learned by my son's age that my family had no time for my nonsense but my son (14 years old and with ADHD in addition to probable mania) can't."
References in Part 3