7 Comments

1. 

   Oskar on July 31, 2016 at 1:38 am

   Nice talk with Neil Brown, with a lot of useful gems for just about any kind of interpersonal control battle—a systemic therapy 101, if you will. I was particularly fascinated by this approach in the psych program and it still makes so much sense to me (I especially recall Watzlawick et al’s masterpiece, ”Change”). I can’t see how Brown’s approach would differ from a generic systemic therapeutic model, though. But I guess that’s what’s the book for.

   Anyway, something that stood out for me was his stating that teenagers are prone to risky, impulsive behavior because of elevated brain dopamine levels. That doesn’t make sense if we juxtapose it with the biological explanation model of ADHD, where the very same impulsivity is thought to stem from low dopamine (and norepinephrine) levels; when supplemented stimulants, ADHD sufferers often calm down and display reduced impulsivity.

   The picture gets even more complicated when considering that drugs that increase dopamine (e.g. anti-Parkinson medicines) can induce manic, uncontrolled, and hedonistic behavior, which would support Brown’s standpoint but weaken the ADD hypothesis.

   Someone must be wrong here. I would love to hear an interview with a neurotransmitter expert 🙂

2. 

   Neil D Brown on August 3, 2016 at 6:21 am

   Thanks for your thoughtful comments Oskar! Yes, Watzlawick et al’s masterpiece, ”Change” has been a powerful influence on my work. After reading it, I knew that every case I saw needed to reach for 2nd order change.
   My son, Daniel Brown, a neuro-psychologist, promised to answer your questions in that area later today.

3. 

   Daniel Brown on August 3, 2016 at 6:37 am

   Hello,

   I am Neil’s son and I happen to be a neuropsychologist. He asked me to respond to this comment in order to offer additional clarification. Indeed, too much or too little of any neurotransmitter can have adverse outcomes. The prevailing theory on ADHD implicates both norepinephrine and particularly dopamine. Specifically, too low of a norepinephrine level is thought to cause attention problems via difficulty filtering what is intended to be focused upon versus all the competing distraction stimuli in a given environment. Too low of a dopamine level is thought to cause impulsiveness via an inhibition ability deficit. The thought w/ dopamine is that sufficient dopamine activity allows people to not feel bad all the time and having too low of a level (this is called being hypo-dopaminergic) causes people to feel bad, so they engage in higher-risk behavior such as drug seeking and other impulsive and compulsive actions than people without ADHD in an effort to produce sufficient feelings of well-being. Serotonin, GABA and other neurotransmitters are also implicated in ADHD, but to a lesser extent. I am not aware of too much dopamine being associated with ADHD, but neurotransmitter activity certainly can get relatively complicated; and, often both too little and too much of a neurotransmitter is thought to be the culprit…but I am not aware of any evidence for this in ADHD.

   Yes, too little dopamine is also implicated in Parkinson’s disease, and drugs like L-dopa are used to treat that; however, it takes time to find the optimal dose, which varies for each patient. When patients are on too high of a dose, they can in fact display mania (that can include impulsive behavior), though in this case, it falls more under the umbrella of psychotic symptoms, which again, would be a result of too much dopamine, rather than lack of impulse control due to too little dopamine, as is thought to be the case with ADHD.

   I hope this helps. Best,

   Dan

4. 

   Brent Jones on August 8, 2016 at 12:13 pm

   Always happy to hear your thoughts, Neil!

5. 

   Oskar on August 9, 2016 at 1:14 am

   Thanks, Neil and Daniel, for your responses! Neil, I’m happy to hear that I was on spot with my Watzlawick notion. Daniel, you should be interviewed by Dr Dave. That was a great walk-through (even though you didn’t directly address the teenagers, but I guess they fall under the hyperdopaminergic umbrella).

6. 

   Cathy Jenner on August 15, 2016 at 8:49 pm

   I agree with Oskar that Dr. David should interview Daniel Brown, too! That was an excellent explanation. I’ve already sent it to some people I know who have ADHD! Thanks so much

7. 

   Daniel Brown on September 9, 2016 at 5:35 am

   Hi Oskar,

   The working theory is the teenagers (or anyone) with ADHD are likely hypo-dopaminergic. I hope that helps.

   Dan