Growing up Smart
Thursday, July 31, 2008
Memories and musings about Growing Up Smart
I don't mean this as braggadocio. I had no hand in being born with an IQ of 180; that was God's will, or the blind workings of chance, as you choose; but it certainly was not to my credit. I am responsible for what I did with those talents. On the record, not as much as might be predicted. I did not conquer the world, nor win a Nobel Prize. I did have some effect on the Cold War, and I will take some of the credit for that key victory of Western Civilization; and I like to think that some of my writings have been valuable to a great many readers.
In any event, this will be a series of informal essays and musings.
Having read http://www.worlddreambank.org/P/PRODODD.HTM I am minded to write my own memories of growing up with a 180 IQ. They are quite different from his. Of course no one can verify any of those numbers to begin with.
My recollections are not his. To begin with, I had no motor skills, and since I was always associated with boys two years older than me, I had little chance to excel. I was a disaster at any game involving a ball. My experience at basketball was inevitable: they would choose sides, I would be chosen last, I would get the ball, someone would shout "Double Dribble!" and they would take it away from me. Football was impossible: that two year difference in age. Baseball was terrifying: this hard object would be hit or hurled at me, and I was more concerned with it not breaking my hands or bashing in my head than with catching it. Far too active an imagination: I could envision terrible things happening to me.
So I read a lot. Like him I cannot remember when I could not read, and I read voraciously: I soon found a way I could get into the adult section of the library and a place I could hide while reading books they would not allow me to take out. But unlike him, I had no gift for languages. I still don't. I think I have mastered English, and I could once write a coherent if wooden essay in Latin, but that's it.
Mental disorders and growing up
I have been working in jails for some time now, with adults and adolescents. For the past two years I have been asking every inmate I see the same screening questions about ADHD symptoms. Old and young, about 90% of the male inmates I see had ADHD problems when young - trouble sitting still, trouble paying attention, trouble getting to sleep a night, impulsivity. This is true for men and guys who grew up in the 1930's through the 1990's. Some of them will say straight out that it is the impulsivity that got them into jail.
An aside on "bipolar disorder": Lest Mr. Martin get fooled, the current wave of "bipolar disorder" should more appropriately be named "bipolar syndrome" and abbreviated BS. Back in the late 1990's drug companies realized that the patents on their miraculous SSRI antidepressants would be running out, and they had no compelling replacements. So there began a veritable Niagara of free Continuing Medical Education (we docs need 25-50 hours of CME per year to keep our licenses) on the subject of this BS. The best treatments, of course, are all still under patent and are all expensive (the less said about lithium, the best treatment for genuine bipolar disorder, the better).
Worse, they are shoving the diagnosis of BS onto children. A recent study estimated that about 8.75% of children and adolescents today would also qualify for a diagnosis of ADHD (I believe this is about right; I'll explain in a minute). A review I just read says that 60-90% of children diagnosed with BS have ADHD, where a study of carefully diagnosed adult bipolar disorder patients showed only 9.5% had also ADHD. Is this over-diagnosis of ADHD? Or is it mistaking ADHD symptoms for "bipolar disorder?" My jail experience says that it is the latter. Throw in cigarettes, marijuana, alcohol, and you have kids and dudes who appear giddy and silly when they are not feeling down. Too easy for a shrink in a hurry to label with the BS diagnosis. End of aside.
I believe that ADHD is like tallness. Just as we vary from short to tall, we vary from slugs to hyper dudes. Why the increase in diagnosis? School used to provide longer recesses and lunches, more time to exercise, and more informal discipline. I was particularly impressed with one man's tale of how nuns used to hit his hand with a ruler to redirect his attention to his work. That man was not an inmate; but today he might get medicated, or expelled (this is how schools work with No Child Gets Ahead).
Davy Crockett set out on his own at 12. Daniela Boone had to be a restless dude. Babe Ruth's granddaughter describes him as having a bad case of ADHD. I read a story about the man who invented giant magnetic resonance - the innovation that gives us hard drives with enormous capacity. He would be a poster child for ADHD. He can't stay at a task for more than a few minutes; he has multiple projects running.
At bottom, the degree to which we diagnose ADHD is an indicator of how much leeway we allow for active kids.
Now, that said, you can measure the differences between people with ADHD and normal people. With CNS imaging, you can see how the frontal lobe cortex is thinner; how it grows more slowly initially and catches up (almost) later. OK. And I can measure your height with a ruler.
How to avoid medicating these guys? Ponder the single mom who cannot wedge out the time to escort her kids to the playground. How letting her kids go out allow is unsafe. How school keeps the kids hemmed in and under-exercised during the day. Ponder the upper middle class parents who believe that this restlessness their kid has is not a variation on the norm, but is a disease that must be treated. (On that note, do you remember a Gordon Dickson novel where this guy was medicated to keep him from growing too tall? He was stunted at eight feet; but then they ran into an extra-terrestrial branch of humanity where they were all nine-foot plus?)
Given our straited society, kids will function better with medications for ADHD. And from beating their heads against rigid boundaries, many will despair and some will benefit from antidepressant medication. And then there are those who have been abused and have PTSD (bipolar, right?). And then there are the substances which make adolescence feel less painful, but add to the psychological load because the kids are not learning to deal with their problems and heal from them (in Narcotics Anonymous, they call this "feel, deal, heal").
Kids have more choices and less firm guidance than kids had in the past. And not just kids: the cumulative rate of depression (the total of people who have become depressed, measured over decades and plotted as a slope) has increased, cohort by cohort since the beginning of the twentieth century. Civilization may be toxic. It certainly presents a challenge. We may have to think of it as "Evolution in Action."
I recall many years ago (about the time of the Manson murders) my friend Poul Anderson called and asked if I'd take him sailing for a week; he was in a fit of black depression and he couldn't shake it. We have a very good cruise of the Southern California islands going to Anacapa, Santa Cruz Island, Santa Barbara Island, and east to Catalina where we anchored on the far side of the Isthmus. It wasn't so crowded in those days and we sailed around the island and down to Avalon where we could anchor free in St. Catherine's Bay not far from the seaplane ramp.
It was a great sail and while we were sailing Poul was in good straits but the depression got to him again when it was over. He was eventually turned back into his old self by -- lithium.
It's pretty clear that my education in these matters is obsolete. I learned about manic-depressive psychosis and several neuroses that had similar symptoms, but in all of my graduate studies including 2 years of Abnormal Psychology I never heard the term "Bi-Polar". Of course there was no DSM in those days. My first encounter with the DSM was many years later when a colleague advising me on setting up a practice showed it to me and pointed out that it was a necessary tool, not for actual diagnosis or clinical work, but for filling out the paperwork to justify one's bills. (That and other such matters convinced me to be a science and science fiction writer even though a leading pediatrician in the Valley liked my notion of a practice devoted to bright kids not doing well in school and had a list of referrals.) I also never heard of ADHD until my excursion into the DSM, which I grant you is a marvelous source of ways to extract money from parents and insurance companies. I also saw "syndromes" that seemed to me indistinguishable from normal teen-age rebellion: I never knew how much money could be made from boys who wouldn't clean up their rooms and talked back to their mothers. (And I note there are entire Institutes devoted to precisely that; some people really got rich at it.)
In that sense, then, I am as much a student of these matters as anyone. I do have some perspective to add. I did grow up in an era when bright kids were prized but expected to behave themselves. I got away with some eccentricities when I got involved in the Whiz Kids radio show, but I didn't get away with much: there were rules for how one behaved with adult authority figures including teachers, and the consequences for breaking those rules were -- at least in Tennessee -- physical and painful, and therefore instructive. At least instructive to me; I certainly learned to control myself, which served me in good stead as a teen ager the night some Memphis PD officers caught us smoking cigars in an undeveloped area in Memphis; apparently we had been talking too loud, and the nearest householder (fifty yards away) called the cops. They were rude and arrogant, and I was much tempted to tell them what I thought of them, but my partner in crime was Professor Moore's son and terrified of scandal; so I said sir and spoke only when spoken too and our names never got into the police report. Not that we were guilty of being anything but teenage boys out talking about our rather innocent experiences on our rather rare dates -- and attempting to smoke White Owl cigars.
A good part of my youth was spent frustrating my parents, who were alarmed that at age 11 or so I saw nothing wrong with making half a cupful of nitroglycerine and detonating it, and other such antics. If there had been a plenitude of school psychologists and diagnosticians, God knows what might have happened (although my mother was not impressed with the psychologists who did get hold of me, and might have protected me). But I am certain that ADHD or Bipolar Syndrome would have been almost automatic. Now perhaps that might have helped: I did waste a lot of time in high school even with the Brothers determined to make me do work that challenged me (and they did understand that loading me with scut work was NOT the solution to the problem of this kid who did all the school work in half an hour and then thought up terrible things to do with tri-iodide's and other interesting chemicals).