A reader was asking in a preceding post:

Thank you for interesting explanation. So you say that high-rank officials who does not like to be critized should better take the pills you mentioned, since they probably have this sickness you describe?

My answer:

The post was mostly concerned with discussing the role of neurotransmitters in understanding the neurophysiological side of rejection, in particular in connection with the nucleus accumbens, the “reward center” of the brain.

I used ADHD as an example, since here there are strong scientific indications for the involvement of neurotransmitters in the development of ADHD symptoms, among which are e.g. a better memory for negative events and stronger impulsivity.

Hence in particular a person who “does not like to be critized” need not to “have ADHD”. As a matter of fact e.g. people who’s blood-sugar level is very low if they are hungry are also prone to a higher impulsivity.

Moreover ADHD is no “sickness”. As I wrote it is gradually, thus it is a bit problematic to say “a person has ADHD”. I.e. the symptoms of ADHD may be considered by one person as to be completely normal or rather judged as an issue of mentality (“hot-tempered”, “ill-tempered”, “irascible”, “fidgety”) however by another person they may be judged as a “disorder”.

Only if the symptoms are very, very strong one would/should think about medications.

ADHD is usually diagnosed in children, but there are indications that it occurs also in adults. There are two major forms, namely the “fidgety” (hyperactive) and the “dreamy” form, sometimes they are also occurring both. Thus e.g. in a case where a kid is very, very “figety”, i.e. in a case where the children can’t sit still in school, can’t follow the class, because it is constantly distracted, where it is overly hot-tempered and so on – in such a case a medication may help.

But one has to be careful.

In particular one should first of all think of how to integrate such kids. Since -as far as I know- (I dont know anybody personally who takes ADHD drugs, but I know pediatricians who are dealing with ADHD cases) the medication works only in a limited way, in particular the timing of medication is a delicate issue (moreover the long-term effects of taking such drugs are not fully established yet, let alone some of the short-term side-effects). In short these drugs do no wonder, but rather may alleviate the effects. Moreover it is important that the children knows about its condition and learns to live with it, i.e. that it learns to develop strategies, like self-motivation, mediation talks etc.

Another aspect is that there seems to be a correlation between high intelligence and ADHD (given the density of whats on that issue on the internet), i.e. highly intelligent kids seem to have a higher probability to “have ADHD” (it seems its not the other way around, i.e. ADHD kids are not necessarily more intelligent on average) and there seems also to exist a correlation between ADHD kids and “creativity”. However I couldn’t find a half-way reliable and accessible medical ressource on that issue on a first browse. So this might be wrong. It seems also that part of the problem of assessing such a correlation is wether one should include the ability of planning, paying attention etc. into the measurement of intelligence.

But if one assumes that these correlations are true than this could on the other hand imply that ADHD medications could impair creativity and thus this makes among others the use of socalled brain boosters even more questionable.

In short: Instead of thinking of easily handing out brain boosting drugs (I know the Pharma industry won’t like this) one should rather think of how to make the educational systems more flexible with regards to “unusual” cognitive conditions.

An example: In the elementary school math education in Germany a high emphasis is put in learning multiplication tables by rote. In particular children often have to answer columns of columns of -mathematically seen- rather dull questions of basic arithmetics. Such repetitive tasks are not easy for ADHD children, who may understand the involved math but still perform poorly due to being more prone to slips of the pen, due to a lower attention span. So math grades may in these cases reflect the general mathematical aptitudes of such children only very partially.

In view of this I am also very disappointed about current plans in Berlin to make the change to a certain form of high school (the “gymnasium”) highly dependend on grades.

Grades can be seen as an indication of performance that is if you have good grades in school, then there is a high probability that your overall performance is accordingly. However the other way is not necessarily true , i.e. if you have not so good grades then this can -as pointed out above- e.g. be due to special cognitive conditions likewise it may also be due to social circumstances, like last but not least due to missing books and materials (see again the chronicle about dying libraries). Thus it is incomprehensible for me how such a plan can come from a social democratic party.

Instead of imposing rather unsurmountable obstacles (see also the massacre of Erfurt, where the part of the motive was a missing school leaving certificate) one should rather think about how to make higher education more amenable to everybody.

(For the sake of supplying more arguments against the above mentioned Berlin plans:

There are more aspects which illustrate the problematics of grading and which are not related to ADHD or social problematics. Like the fact that it is in general not easy to “measure” certain (mathematical) aptitudes, like elegance or originality of problem solving etc.

Moreover grading is usually used to compare with an average, which might be in itself problematic. Let me give you again an example: When I was about 11 years old we had learned about the decimal and the dual numeral systems. However in a math exam our teacher challenged us to write the number 11 in ternaries, which we hadn’t discussed in class. It took me quite a while to find out how to apply what I had learned about the dual and decimal system to this new system, but it was an interesting question, so I sticked to it. However as a result I had almost no time left for the other questions on the exam. The grading result of this particular exam was thus a shocking “6” – the worst school grade you can get in Germany. And I got this grade although I solved the -what I found not so easy- problem correctly. I must have looked quite disappointed since after class my math teacher took me aside and said that he was very sorry, but my really bad grade was due to the fact that nobody else than me even looked at that ternaries problem, which meant that if he would have assigned too many points to this one particular problem the whole class grade average would have been much too low.

May be as a consolation he added: “You’ll study math”, which I found very absurd at that point. But he was right, I studied it. I still study it.

added on May 1st 2009:

There is an article by Margaret Talbot in the New Yorker which indicates that my above suspicion that ADHD medications may impair creativity may not be totally wrong. A citation from the article where Margaret Talbot spoke with Martha Farah “one afternoon at her research center, which is in a decidedly unfuturistic-looking Victorian house on Walnut Street, in Philadelphia”:

“Both Chatterjee [a collegue of Farah] and Farah have wondered whether drugs that heighten users’ focus might dampen their creativity.”

“Farah told me, “Cognitive psychologists have found that there is a trade-off between attentional focus and creativity. And there is some evidence that suggests that individuals who are better able to focus on one thing and filter out distractions tend to be less creative.”


remark: Farah was one of several scholars who contributed to a recent article in Nature, “Towards Responsible Use of Cognitive Enhancing Drugs by the Healthy. which sounded to be rather in favor of neuroenhancement.

Besides this the article describes in detail the competitve atmosphere in academic circles and the (future) working world in general. A world – which encourages the use of brain boosters for competitive advantage:

“The drive for self-enhancement of cognition is likely to be as strong if not stronger than in the realms of ‘enhancement’ of beauty and sexual function.” (In places like Cambridge, at least.) (p.3)


“Zack Lynch, of NeuroInsights, gave me a rationale for smart pills that I found particularly grim. “If you’re a fifty-five-year-old in Boston, you have to compete with a twenty-six-year-old from Mumbai now, and those kinds of pressures are only going to grow,” he began.”


If you’re a company that’s got forty-seven offices worldwide, and all of a sudden your Singapore office is using cognitive enablers, and you’re saying to Congress, ‘I’m moving all my financial operations to Singapore and Taiwan, because it’s legal to use those there,’ you bet that Congress is going to say, ‘Well, O.K.’ It will be a moot question then. It would be like saying, ‘No, you can’t use a cell phone. It might increase productivity!’ ”

6 Responses to “mental”

  1. Al Aziz Says:

    thank you for lengthy explanation.

    if you admit bad pupil you will have bad school standard.

    what you mean with “timing of medication is a delicate issue” ?

  2. nad Says:

    >Al Aziz Says: if you admit bad pupil you will have bad school standard.

    there were 3 school levels in Berlin: Hauptschule, Realschule and Gymnasium.
    Only with a final Gymnasium degree (Abitur) you can study at a university.
    Teachers in Berlin sofar handed out socalled suggestions/recomendations wether a pupil should attend a Gymnasium or not. So in principle also if your grades were not so perfect and your suggestion said Realschule you could still try the Gymnasium. I know of Universityprofessors who had the Realschul-suggestion. It used to be especially an option for pupils whose overall grade average was not so good, but who were very good at a specific subject.
    The standard of a school depends on what is taught. Of course if you adapt that what you teach to a lower average than you will have a lower standard. But you need not to. I think pupils who want to learn shouldnt be hindered, but rather assisted and helped. With the aid of a teacher they’ll find out if the level is OK for them or not. They actually also have a school type called Gesamtschule in Berlin where all three levels are joined and you have for the various subjects I think A-level, B-level and C-level classes and you can change in between. This sounds good, but unfortunately at these schools the standard is not always so good like at a Gymnasium (at least what I heard from personal conversations, this might be very subjective). The problem being here that in principle you need much more teachers for this kind of very individual training. I know from people in Sweden were this worked very well, but the teacher/pupil ratio was much better. So in Berlin the problem is rather that there is not enough money for more teachers.

    what you mean with “timing of medication is a delicate issue” ?

    medications like methylphenidate work only for a certain amount of time and the time period of being effective seems to be not overly predictable that is a human is no machine.

  3. Al Aziz Says:

    So you want schools, where all go in same school in Berlin ?

  4. nad Says:

    If you want to have a good high school/comprehensive school then you need a lot
    more ressources than there are currently in Berlin. Thats whats my impression. In particular I am concerned about the “lower end” of the school system, the permeability of the school system in general and educational programs outside school, like e.g. the above mentioned libraries.

    As an example I recently met a Berlin Fleischermeisterin (a master butcher). She told me that she invited 16 pupil for an interview for an apprenticeship and asked them how many grams there are in a kilogram and send them all home, because nobody knew.

    This kind of mathematical deficit by the way should also be taken into account, when introducing new political concepts. So for example Abflachung der Progression” (bevel of progressive tax ), should be may be easier explained as “high incomes would pay less tax” etc.

  5. Bibi Says:

    You cited: “It would be like saying, ‘No, you can’t use a cell phone. It might increase productivity!’ ”

    This sounds as if even an average person should better do some brain boosters in order to keep its workplace.

  6. nad Says:

    Bibi wrote:

    This sounds as if even an average person should better do some brain boosters in order to keep its workplace.

    I think wether some person keeps its workplace depends especially on labour conditions. That is if you are in a hire and fire world then even brain boosting may eventually not help.

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