Management of Impulsivity, Inattention, Hyperactivity Induced by Digital Surplus

Management of Impulsivity, Inattention, Hyperactivity Induced by Digital Surplus  (Simulating ADHD) in Children and  Adolescents 


Physicians need to be cautious in prescribing methylphenidate to digitally over stimulated kids who simulate ADHD. This monograph attempts to  

1. Explore causes of ADHD 

2. Emphasise the causative effects of digital overstimulation in ADHD

3. Provide a rational understanding of the cause and effect of the ADHD process on the  brain 

4. Offer rationale for and proposed Empathic Learning Therapy before trying drugs

5. Discourage children from being labelled and branded as ADHD when the issue is only a  matter of varied symptoms  

The standard chunk of Lorem Ipsum used since the 1500s is reproduced below for those interested. Sections 1.10.32 and 1.10.33 from “de Finibus Bonorum et Malorum” by Cicero are also reproduced in their exact original form, accompanied by English versions from the 1914 translation by H. Rackham.

Working Hypothesis 

Digital addiction works just like other addictive conditions. Salience, initiation, navigation,  conclusion – mediated via optimal dopamine response (not too high, not too low) are dysregulated because of continued dopamine drive. Satiety mediated via optimal serotonin  producing reward motive has been dysregulated with serotonin spiking to achieve satiety  competing with the dopamine drive. In this scenario inattention, impulsivity and 

hyperactivity are only symptoms of underlying dysregulation of motivational systems. (1) Why this simulates ADHD is because executive empathic pathways commencing in the  dorsolateral prefrontal cortex (dlPFC) have been overwritten by the repetitive, reflexive,  reactive, cyclical stress survival pathways of the ventero medial prefrontal cortex (vmPFC)  responding to subcortical input from amygdala, hippocampus and hypothalamus. (2) 

In this framework, digital addiction causes a cycle of decreased function of brain reward  systems and recruitment of anti-reward systems that progressively worsen, resulting in the  compulsive use of more digital games etc. Counter-adaptive processes, such as opponent  process, that are part of the normal homeostatic limitation of reward function fail to return  within the normal homeostatic range and repeatedly drive the allostatic state. Excessive  digital gaming and cartoons thus results in the short-term amelioration of the reward  deficit. However, in the long term, there is worsening of the underlying neurochemical  dysregulations that ultimately form an allostatic state (decreased dopamine and opioid  peptide function, increased corticotropin-releasing factor activity). This allostatic state is  reflected in a chronic deviation of reward set point that is fuelled not only by dysregulation  of reward circuits but also by recruitment of brain and hormonal stress responses. (3), (4) 

D1 receptors of dopamine are overcharged by pixel (digital) stimulation causing poor  working memory. D1 receptors function best in a limited middle range of Dopamine  concentration. Too low there is apathy; too high there is impulsivity. Excessive stimulation  causes delay-related firing of the neurons’ non-preferred directions with brain having  increased background “noise”. Increased dopamine, noradrenaline and cortisol in these  children brains inhibit executive empathic functions of the prefrontal cortex producing the 

impulsivity, inattention and hyperactivity of ADHD. Heavy users of smart phones are likely  to develop the left side of their brains, leaving the right side untapped or underdeveloped,  The right side of the brain is linked with concentration and its failure to develop will affect  attention and memory span, which could in as many as 15% of cases lead to the early onset  of dementia.  

Triad of Symptoms  

It is important to distinguish between which one of the triad of symptoms of ADHD  (inattention, impulsivity, hyperactivity) is predominant in a child and decide if drugs will  help. A rule of thumb is – if impulsivity is predominant, child will deteriorate with drugs. Of  the two schools of thought I subscribe to ADHD being a behavioural problem rather than a  sensory process problem. This is controversial. In my work I have avoided labelling  children as ADHD because the labelling involves far too many normal children with slightly  variant behaviour. It is more logical to deal with the triad of impulsivity, inattention and hyperactivity as possible in different proportions – having their onset in diverse  sociological and environmental factors – the most important being alteration of brain tracts, neuronal orientation and brain’s neurochemical balance by digital surplus.  

The confusion in understanding the pathogenesis of ADHD comes from the medical  profession’s insistence that genetically induced neurobiological causes rather than  sociological and environmental factors are the mainstay in the pathogenesis of ADHD. The  biological genetic modus attempts to downplay the greater importance of sociological  human factors. It is thought that familial prevalence of ADHD is not due to genetic factors  but because the same sociological factors that causes ADHD like behaviour in one family  member cause the same in others. But this too is controversial. Digital surplus significantly  contributes to pharmaco-pathogenesis of ADHD like behaviour.  

Dr Manfred Spitzer, a German neuroscientist, published a book titled “Digital Dementia” in  2012 that warned parents and teachers of the dangers of allowing children to spend too  much time on a laptop, mobile phone or other electronic devices. Dr Spitzer warned that  the deficits in brain development are irreversible and called for digital media to be banned  from German classrooms before children become “addicted.” (5)
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