Dr. George Papanicolaou
speaker
129 appearances
2 recordings
1 series
first heard Nov 2024
last heard Jun 2025
Dr. George Papanicolaou’s voice in public audio — every appearance, attributed to the second.
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So welcome, George. Mark, it's always a pleasure. Thanks for having me. I am so excited to talk about attention deficit hyperactivity disorder with you today.
I see every week, probably at least if I see 16 patients a week, two to three of them have ADHD, either as a primary diagnosis, the coming CD4, or it's something they've struggled with, haven't recognized it, or they have recognized it and never done anything about it.
If they've never recognized it, sometimes they're hearing about it for the first time in the office as I go through their case, identify it for them. Why are we having so many cases? Why is it occurring so much more? I do think in this case, there's just a lot more awareness. I do think that there's been...
increased screening, and I do think the new definitions of what ADHD are have broadened the diagnosis. So in this case, I do think that does play a role.
Yeah, we've talked about this before. We both agree that the diagnostic criteria don't account for 400%. But what's going on in our world today, there are some fundamental things about the brain that I think we all maybe need to be reminded of or maybe understand the brain in a different way.
And going back to the idea that there's this hunter-farmer theory, that our brains are really designed to pay attention to a lot of things, which just as a quick aside, I think that the designation attention deficit hyperactivity disorder is the wrong nomenclature. People with ADHD, like me, just pay attention to way too many things.
And it really comes down to being able to organize the information and being able to recall it and assimilate it very quickly. In some ways, we can do that really well. But the brain was really designed to be able to be fast screening, high energy, novelty seeking, creative. That's what you needed to do when you were hunting and gathering. You had to pay attention to everything.
And then we had the theory that in the tribal nomadic societies, telling stories, having vision, being able to rapidly adapt was highly valued. And so those folks that had that tendency were actually important and valuable. They had ADHD. But what happened when we started the Industrial Revolution and we had a lot of the titans of industry,
involved in the development of education at the turn of the century in the industrial age, we created a system that was focused, orderly, routine, and valued compliance. That is absolutely terrible for the ADHD brain. So then we start to have more and more kids involved in this one-size-fits-all educational system, and they can't fit into that system. They can't sit and get Right.
And so they get the it's mostly boys. We get very hyperactive and fidgety. And the school setting just wasn't right for them. So now you add to that. We live in a world with one peak for seven year on. It's your phone, it's your computer, it's text, it's X, it's Facebook, it's Instagram. You're constantly being distracted.
In some ways, an ADHD person could thrive in that environment, but in other ways, And this is a dichotomy of ADHD, something that through real strength also is a weakness and something that can be a disability. And that's where all of this input, this constant input, they can keep up with it. We can keep up with it. But then it's a matter of organizing it.
putting the brakes on the information, putting it into sections in our mental library to recall when we need them. And that gets really difficult. So we have historical evolutionary forces at play. The brain's really designed to be a hunter-gatherer. Then when we design educational systems to be a one-size-fits-all, look at a blackboard, no visuals, and drone on, very difficult.
We've talked about this before, so of course I agree with you on that. That's what we do here at the Ultra Wellness Center, and I agree 100%. The one point I did want to make in that regard was that the brain does have structures, and we have these networks that are really important, and they're disordered in the ADHD brain.
So if you have ADHD, or even if you don't and you're listening to this podcast, and you find yourself trying to get a task done, but you're daydreaming at the same time, you're sort of distracted with other thoughts while you're trying to focus on what you're doing, that's actually a problem. Because that daydreaming network called the default mode network can be turned off.
When you're doing a task, it should be your task-positive network that's fitting right into that. So it's a network, it's a system that gets turned on so you can just pay attention to what you're doing, and that's it. But in the ADHD brains, that toggle switch between daydreaming, egocentric, how's the world affecting me, how do I affect the world piece, that toggle switch doesn't turn it off.
And when you're trying to do a task, you can't keep it. from daydreaming a bit. So it makes what you're doing harder. You have to concentrate harder. You get your work done. You just have to work harder at it.
And I just wanted to make the point that the reason why these systems may be disordered include, why? Inflammation. Nutritional deficiencies, single nucleotide polymorphisms, there's variations in your genes that impact how your dopamine and your serotonin and your norepinephrine flow.
All of that gets disrupted when you have inflammation, when you have trauma, when you have nutritional deficits, 100% agree.
Yeah, this is a great case because I see a lot, not a lot, a disproportionate number of students. We're right outside of Boston, and I've had at least four or five students in the last two years that have been brought in by their parents because they're in their freshman year or sophomore year, and they're anxious and depressed. They're trying to figure out why. My kid's going to Harvard.
My kid's going to Boston College. Why are they suddenly struggling in school? Why are they suddenly anxious and depressed? And this is the case that will illustrate what goes on. Claire is a 20-year-old woman. And she came to me. She had been struggling with focus and emotional regulation, always feeling overwhelmed and stressed for years. It got worse when she went to college.
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