Mania and ADHD: An Evolutionary Recasting

CONFERENCE PRESENTATION
Duration: 20 min. + 10 for questions
Audience: Parents, teachers, psychologists, and physicians.
Media: Slides, 5pp handout
ADHD and Mania: An Evolutionary Recasting*

Objectives

The participants will understand:
1) Why high activity level is an asset, not a liability, but one that amplifies impairments while obscuring more critical differences between mania and ADHD.
2) Mania as a disorder of leadership but one in which there is an erosion of reciprocity (also known as grandiosity).
3) ADHD as most productively viewed in regard to impaired executive functions, impairments that will not only be evident in planning and solving problems but also in managing social power and personal displays.
4) Why most clinicians will see clients who have difficulty in both areas.

Content

1) Activity level is usually a sign of health and is positively associated with better word flow, physical attractiveness, and reproductive success. Lessened activity level is associated with illness and depression.

Because of sensory biases, we notice increased movement rather than stillness. Any aggravating or mistaken behavior is more noticeable if it is performed more quickly, intensely, or often. High activity that is targeted correctly leads to applause.

Putting our focus on activity level as a primary signal for mania and for ADHD leads us to miss the factors that make such activity annoying.

2) Mania has been construed as an exaggeration of leadership characteristics. Data exist to support this characterization. However, mania that is associated with grandiosity, a sense of entitlement with no obligation to return favors at fair market value, leads to irritation, mistrust, and legal or clinical interventions.

3) A lapse in executive functions has been persuasively described for ADHD and it may be that an array of other disorders will also have similar lapses in prioritizing, task persistence, planning, and communication. Those same lapses, however, lead to poorly timed and managed social displays for dominance and mating. These gaffs advertise immaturity and untrustworthiness to most audiences. (There are also data that males often have difficulty accurately reading expressions of annoyance by females. There are significant ramifications for males of any age when taught or supervised by a female whether or not married to her!)

4) It will be suggested that clients with grandiosity but intact executive functions will avoid social consequences even for premeditated selfish acts. Likewise, clients who have problems with executive functions but who also play "fair" with others will be far less apt to appear in clinics or divorce courts.
*This presentation is in press, The Journal of Affective Disorders

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