Do environmental factors cause ADHD?

When it comes to attention deficit hyperactivity disorder (ADHD), you may be wondering whether nature or upbringing is the biggest part in causing it.

For example, suppose more than one of your children has been diagnosed with ADHD. You may be wondering if you are doing something to cause it. (You probably aren’t, by the way).

Or, if you or your partner has ADHD and your child is diagnosed, you may be wondering if the diagnosis was inevitable. (In short: inevitable, no. Probably, yes).

The truth is, says Jessica Myszak, a licensed psychologist with The Help and Healing Center, “the cause of ADHD in a person, like many other health conditions, cannot be clearly identified.”

Here’s what we know: ADHD is a neurodevelopmental disorder, which means that a brain with ADHD forms differently than most others.

In other words, “You won’t develop ADHD,” explains Amy Marschall, a licensed clinical psychologist. “The neurological differences seem like something you were born with.”

It is these neurological differences that predispose you to ADHD and its symptoms.

Environmental factors do not directly cause ADHD. At least not alone.

Nature, also known as genetics, plays a major role. But your environment can also contain factors that lead to ADHD.

In fact, Myszak says, “There is clear evidence that certain environmental risk factors are strongly linked to later ADHD diagnosis.”

These environmental factors can be:

  • in-utero or in the uterus, exposure to substances or chemicals
  • Premature birth or low birth weight
  • Environmental toxins
  • Diseases such as bacterial diseases and encephalitis

In utero exposure

Research from 2012 has shown that pregnant women who drink alcohol or smoke tobacco are more likely to have a child with ADHD.

One 2018 study found that children were at higher risk for ADHD if their mothers were heavy smokers, while another study found that mothers who drank at least 4 alcoholic drinks in one session were likely to have a child with ADHD.

The mother’s diet can also play a role, as can infection during pregnancy.

“Special drugs like antidepressants, antihypertensive drugs and caffeine,” says Myszak, can also play a role.

The American Psychiatric Association adds that babies born prematurely or with a low birth weight are also at greater risk of developing ADHD.

Exposure to environmental toxins

These can be toxins to which you are exposed in utero or during your childhood. They can include:

  • lead
  • mercury
  • Pesticides
  • specific chemical compounds

For example the Centers for Disease Control and Prevention (CDC) says that lead appears to be linked to inattention, hyperactivity, and impulsivity. These are all symptoms of ADHD.

The organophosphate pesticide, which is commonly sprayed on lawns and agricultural products, has been described in a Study 2016 affect the neurological development of children. This is why some researchers believe that it could play a role in causing ADHD.

illness

A 2017 study found that bacterial meningitis can also be a risk factor for ADHD. Bacterial meningitis is a serious bacterial disease that is transmitted from person to person and through food.

A 2015 Taiwanese study found that encephalitis, inflammation of the brain due to an infection or an autoimmune reaction, could also be a risk factor for ADHD.

The truth? Researchers aren’t entirely sure what causes ADHD. That’s probably because one thing doesn’t alone cause ADHD.

“Since everyone is an individual, we can never say definitely, ‘X causes Y’,” says Marschall.

One cause is fairly well supported by twin and family studies: Genetics seem to play an important role in causing ADHD.

“Children of siblings with ADHD are 9 times more likely than other children to also have ADHD, with heredity estimates being between 74 and 88 percent,” says Myszak, citing a 2005 study.

But just because genetics predisposes someone to ADHD doesn’t mean they’ll get it.

A 2015 study found that there are many risk factors for ADHD. In most cases, one risk factor was insufficient to cause ADHD.

“Instead, ADHD typically arises from multiple genetic and environmental risk factors that cumulatively increase the likelihood that a person will have ADHD,” explains Myszak.

“It can be very difficult to separate environmental factors from genetic factors, as family members not only share genetics, but also certain lifestyle factors that can also contribute to the risk of ADHD.”

In other words, all of the factors are important as it is the cumulative effects of these factors that cause ADHD.

Yes, there is evidence that other factors also play a role.

“In recent years, more research has been done on the differences in the brains of people with ADHD, and some variants have been consistently identified in ADHD brains,” explains Myszak, referring to a Study 2019. “It’s not enough to change the way we diagnose ADHD, but it’s exciting and promising.”

It also appears that some ADHD diagnoses occur after brain damage, as shown in a 2014 research report. This includes damage caused by:

  • Injuries in early life
  • Head trauma
  • atypical brain development

There are many rumors and myths surrounding ADHD. Many of these harm parents or make them feel guilty for doing something wrong in raising their children.

But these myths seem to be just that: myths.

For example the CDC states that there is no scientific research to support the idea that ADHD is caused by:

  • eat too much sugar
  • watch too much TV
  • poverty
  • Family disputes

ADHD is a neurodevelopmental disorder, and recent research suggests that genetics play an important role. Since genetics can predispose someone to ADHD, it cannot be prevented.

According to Myszak, expectant parents can take a few steps to ensure their baby is overall healthy:

  • Get prenatal care
  • Avoiding drug, alcohol and tobacco use during pregnancy
  • Limiting exposure to environmental toxins such as pesticides and lead

However, you can also take steps to manage the symptoms of ADHD, such as:

  • Build structures and consistent expectations with your child
  • do daily physical activities
  • sleep a lot
  • Avoid stimulating activities, especially before you need to concentrate or sleep

Stimulating activities can include electronics, computers, video games, and television.

“There is currently mixed data on nutrition, so I would advise parents to speak to their pediatrician about what is best for their child,” says Marschall.

Still CDC recommends Building healthy eating habits as part of a routine and a way to stay healthy.

ADHD looks a little different for each person, and symptoms can vary between childhood and adulthood.

However, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the common symptoms of ADHD include:

  • be forgetful
  • easily distracted
  • be prone to reckless behavior
  • Lose things or embarrassed
  • be prone to impulsive behavior
  • lack of motivation for certain activities
  • Difficulty getting things organized
  • Difficulty getting things done

Since ADHD is mostly diagnosed based on behavior, there are no medical tests to detect it. Instead, you or your loved one have a few sessions with a psychologist or psychiatrist. You can evaluate the behavior, talk to teachers and family members, and make a diagnosis.

Treatment for ADHD will depend on your symptoms. However, a 2005 research report found that it generally included a combination of the following elements:

  • medication
  • psychotherapy
  • Behavior management
  • Organizational and social skills training

medication

People with ADHD can be prescribed medication all in one Research report 2018. These include stimulants to help manage impulsive behavior and non-stimulants to aid memory and alertness.

psychotherapy

Talk therapy can help people with ADHD develop the tools to better cope with social situations, relationships, and stress.

Behavior management

Behavioral therapy works with someone with ADHD to strengthen positive behavior and reduce negative behavior. This can help them get better at school, work, and social life.

Organizational and social skills training

People with ADHD can also benefit from organizational or social skills training. Organizational and social skills therapies can include:

A number of ADHD organizations can help connect people with ADHD or parents of children with ADHD with the resources they need. This includes therapy, support groups and workshops for people with ADHD.

You reach:

If your child with ADHD is having trouble at school, it may also be helpful to contact school services or parenting groups.

ADHD doesn’t seem to have just one cause.

Instead, ADHD has a number of causes that make it difficult to know exactly why a person is getting a diagnosis.

Still, genetics and environmental factors play an important role.

The good news is, if you or your child has ADHD, once you are diagnosed, you have many options to help you manage the disease and thrive with it.


Simone M. Scully is a new mom and journalist writing about health, science, and parenting. Find them their website or on Facebook and Twitter.

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