In a recent post I brought up the age-old debate as to whether addiction is a disease or not. In response, Alese raised the bigger issue of neurodiversity. Many scientists believe that a certain amount of individual diversity is built into human behaviour, because it provides an evolutionary advantage for all of us. It may be that our social groupings work best when a small percentage of us are highly detail oriented (autism spectrum), a small percentage are fearlessly aggressive, some tend toward extreme caution. And perhaps some are born with the tendency to seek immediate rewards over long-term gains – those most at-risk for addiction.
This built-in diversity in psychological styles would have to be based on diversity in brain plans. And this neurodiversity would then be considered a survival benefit for the species. That would mean that the psychological syndromes we like to classify as disorders or diseases don’t fit those categories. Not at all. (Even if they don’t make life pleasant for those who “have” them.) Instead, they may be outcomes of adapative variations in the human genome.
When I was in Toronto last month, Jim Kennedy (a highly-renowned research psychiatrist at CAMH) told me an amazing story over dinner. It concerned some research in which he’d participated, examining ADHD (attention deficit hyperactivity disorder), genetics, and migration. I’ll make that long story short:
ADHD is a disorder, if not a disease. Right? Not right? It depends on your perspective. According to Dr. Kennedy, the study of genetically pure (no intermarriage) native populations in the Americas reveals a fascinating pattern of geographically distributed genetics. A gene variant related to ADHD (a certain number of repeats in the part of the DNA linked to dopamine metabolism) shows up at a very low rate in native groups living in northern Canada: 2-3%. The incidence of this variant increases, to something like 10-20% in native groups living in the southern U.S. In Central America, incidence of this variant increases up to 50%, and it exceeds 50% in parts of South America.
What could this possibly mean? Does sunburn cause a genetic predisposition to ADHD?!
According to accepted theory, the Americas were first settled by migration waves from Asia, across a land bridge connecting Siberia with Alaska, at least 12,000 years ago and possibly much earlier. That bridge has since disappeared. This model implies a gateway for migration, starting in northwestern North America and moving south, over many thousands of years.
But why would there be a greater hereditary risk for ADHD as the original settlers of America moved south? ADHD describes a syndrome in which people are more distractible, their attention wanders off target (which means it goes to new targets), and they are more attracted to novelty than to routine. In North American and European classrooms, this is bad news. You’re supposed to be facing the board, listening to the teacher, and doing your assigned work. If a certain proportion of people don’t do this, if they have a “problem” with their attention, and if this problem is related to distinct neural mechanisms AND to genetic predispositions, then the problem gets classed as a mental disorder or disease.
But if this “problem” only arises in certain social contexts – if it can be an advantage in other contexts – then the disease label starts to peel off. Imagine that you are a North American native, it’s 10-15,000 years ago, you live somewhere in northern Canada, and there is nowhere nearby to buy a Gortex jacket or even long underwear. It’s awfully cold for many months of the year. But you happen to have a predispositon to wander off into the woods, peak over the next hill, and to lose attention to the normal duties of hunting and trapping. One fine day, while on your explorations, you look over the crest of a hill and find a long valley extending off to the south. The lands north of you are already settled, so they’re not very interesting to explore. But this valley to the south is completely uninhabited. You let the elders know, and within a generation half your tribe is living there. Your children have a greater likelihood of having the same attraction to novelty, the same low tolerance for routine. After all, they carry many of your genes. When they grow up, they are also more likely to discover greener pastures, and your descendants will continue to migrate southward.
By this process, the genetic makeup that confers an attraction to novelty and a disdain for routine will become correlated with geography. Tribes — or groups within tribes — who have a higher proportion of that genetic variant will be more likely to migrate, and will show up further and further south. Thus, a certain genetic pattern is linked to a certain pattern of migration. In fact, it is the adaptiveness of this pattern that EXPLAINS the migration.
Today, in North America and Europe, we associate that genetic pattern with ADHD – a “disorder”. But for those aboriginal people, it facilitated adaptive waves of migration, moving them further and further away from the frozen North and opening up new possibilities for hunting, farming, and building civilizations.
Conclusion: the psychological qualities of a genetic distinction can’t be defined or labeled in a vacuum. The advantages or disadvantages of that distinction can only be described in context.
Research points to genetic patterns that are correlated with addiction. I’ll get into that topic next post. For now, I want to leave you with the thought that addiction may arise from a predisposition that’s not unhealthy or bad in itself. Its goodness or badness may depend entirely on what our society values and on where and how it fits in.