Written by Dr. Inez Van Roy on
August 2, 2021
Written by Dr. Inez Van Roy on:

Medically Reviewed by our Medical Affairs Team

Your child’s diagnosis is ADHD and now you’re looking for natural treatments. However, you might ask yourself where this condition came from. The chances are high that you or your partner also show signs of this neurodevelopmental disorder. 

Is ADHD hereditary? Is it genetic, or is it developed through the environment your child is in right now? Available evidence suggests that while there may not be anyone definite answer, many genetic factors and environmental factors influence this complex disorder.

They might play a role in whether you will or won’t have ADHD. Your genes and biology surely do play a big role in that.

What is ADHD (attention deficit hyperactivity disorder)?

ADHD or Attention-Deficit/Hyperactivity Disorder is a neurodevelopmental disorder. It is usually first noticed during infancy or childhood, but about 4% of grown-ups still get an ADHD diagnosis.

The “American Psychiatric Association believes that there are three presentation forms of ADHD. 

  • primarily inattentive presentation
  • Primarily hyperactive-impulsive
  • Combined

Your amount (and kind) of symptoms will define your presentation. The APA is clear to define them as presentation, as these are fluid constructs. Your six-year-old child might think their chair in class is a mountain.

They don’t use it for sitting on, but to climb. In ten years, these symptoms might look very different.  Instead of climbing chairs, they might feel restlessness in their legs, hands, or head.

What are the ADHD symptoms?

The ”American Psychiatric Association” defines three symptom categories symptoms (inattentive, hyperactive, or impulsive. In total, the DSM-5 defines 18 core symptoms. 

People who present inattentive show at least five or six of the following inattentive symptoms:

  • carelessness
  • Difficulty keeping your focus
  • Not listening
  • Often sidetracked
  • Not organized
  • Avoid tasks that take a long time
  • Lose things
  • Easily distracted by other things
  • Forgetfulness, even in daily tasks

People who present hyperactive/ impulsive should present with at least five or six of the following symptoms:

  • Fidgeting
  • Can’t stay seated
  • Feeling restless
  • Difficulty in quiet activities
  • Always “on the go,” seems driven by a motor
  • Talking excessively
  • Can’t wait for your turn in a conversation
  • Interrupting others
  • Has trouble waiting in line

People who are diagnosed with combined presentation ADHD show a combination of the previous symptoms. 

Is ADHD hereditary?

Research is not sure yet what causes ADHD. But, they do agree that there might be a hereditary component to the disease. ADHD can be passed down from parent to child.

That component is not small either. If your parents have ADHD, you are highly likely to develop it as well. Also, if your kid has ADHD, you might have an explanation for your own disorganization.

Family researchers show that if your parents or close family members had ADHD as kids, you have a higher chance to get an ADHD diagnosis as well.

From this research alone, it is not clear if this shows a genetic or an environmental link. Twin and adoption studies also confirmed a potential biological link. 

Adoption studies compared siblings from a family with an ADHD history. The results show a higher chance of having the disorder when you have biological first-degree relatives with ADHD. This even though you are adopted. The adoptive family did not have this higher chance to have those symptoms.

Showing that it is not the environment that causes ADHD. Twenty identical twin studies confirm these results. These studies put heritability at 76%. This number makes ADHD one of the most heritable psychiatric disorders. ADHD can be biologically detected and is clearly not a myth.

What genes cause ADHD?

Having the same DNA, like some twins, is not a 100% guarantee to have ADHD. This implies that there should be an interplay between genetic variants and the environment. Many genetic studies are still investigating which genes play this crucial role. They still don’t have a conclusive answer to this question.

Stimulants that influence dopamine levels seemed to have a positive effect on ADHD symptoms. That was a good starting point for this research. Taking a look at a chemical level, researchers made a theory.

Today we believe that three chemicals might be imbalanced in the ADHD brain, specifically dopamine, serotonin, and norepinephrine. 

These three neurotransmitters are messengers between nerve cells (in our central nervous system) and neurons in our brain. 

These neurotransmitters have an influence on how we pay attention, keep our focus, or how our mood is. In short, the ADHD brain is under-aroused and looking for stimuli. Hyperactivity might be a byproduct of the brain trying to compensate. So which genes have an effect on how our brain processes these chemicals?

Genetic research seems to confirm this hypothesis at least partly. Out of many years of research came the conclusion that six genes play a significant role in ADHD. 

The two dopamine receptor genes that play an important role are:

  • DRD4
  • DRD5

Also, a dopamine transporter gene, DAT1, also shows a significant correlation. In short, your dopamine levels might be low because your brain has difficulty receiving the dopamine and because your transporters are overactive in getting rid of it in your cells. 

Also, the serotonergic system is involved. The transporter gene 5HT and the receptor gene HTR1B are shown to impact ADHD.

Lastly, a gene involved with SNAP-25 also plays a role. This is a protein involved with neuronal processes, and it is shown that low levels might cause more hyperactive behavior.

As we know more about genes, we can help treat the various symptoms of ADHD better.

Which parts of the brain are affected by ADHD?

Children with ADHD tend to have a smaller brain volume; some structures also are not as big as we would expect. The brain regions most impacted seem to be the prefrontal regions, the corpus callosum, the striatum, and the cerebellum. This might suggest possible dysfunctional frontal– striatal–cerebellar circuits.

Although this information is useful, it can’t be used as a diagnostic criterion. The difference observed is too small and could potentially also indicate other problems that are not ADHD. 

In line with these observations, imaging research can also see that brain development and maturity takes more time for these children.

Is ADHD caused by toxins and pollution?

What are other environmental risk factors? Do toxins and pollution give our children increased risk? 

Discussions on how certain toxins and pollutants influence ADHD are still active. People like to debate this question with great passion. This is very logical as we are all exposed to thousands of toxins, pesticides, and pollutants to keep our industries going. And our kids are exposed as well.

Further, they might also come in touch with heavy metals, ozone, and air pollution daily. These chemicals could contribute as an environmental factor to your ADHD diagnosis.

We are clearly worried about our child (or fetus). Their brain is still developing, and logic would say that the impact of these chemicals is more toxic for someone with lower body weight.

There are found correlations with certain toxins and pollutants and ADHD. That does not mean this is a cause. However, there is an association. Lead and PCB are examples of such chemicals that are associated with ADHD. Children and animals in high contact with these chemicals seem to show more symptoms of ADHD.

Lead was used in paints, automotive fuel, and other applications some years ago. Today it is recognized to be very toxic. Even though today the use is highly restricted, for children, tiny amounts might be enough to influence their little brains.

Prenatal exposure to PCB (or Polychlorinated Biphenyls) shows association with ADHD symptoms. Further, research has shown that PCB can influence dopamine in the brain. PCB is used in electrical equipment, plastics, oils, and some paints. 

Lastly, organophosphate pesticides are also associated with ADHD. Children are twice as likely to be diagnosed with higher levels of these metabolites in their urine.

Although these environmental influences might be interesting, we can try to avoid them. They are still not the main cause of why you or your children have ADHD.

Is ADHD impacted by nutritional factors?

Some studies have shown a negative impact of sugar, preservatives, and food coloring on developing ADHD. In contrast to zinc, iron, and fatty acids, which might have a protective impact on developing ADHD.

Adapting the diet of your child could manage some symptoms. Removing artificial coloring agents, preservatives, and sugar can have a small effect.

Sugar doesn’t cause ADHD; however, too much sugar is not advised for a healthy diet anyway. Some researchers have the hypothesis that children with ADHD might consume more as a compensation strategy to get their dopamine levels up and feel the reward from that.

Some supplements, like omega-3 and 6, could help stimulant medication to work. Omega-3’s and omega-6 can be found in fish oils. Eating more salmon, albacore tuna, herring, mackerel, trout, and sardines could boost your values.

In some research, they noticed low levels of zinc in children with ADHD. Others do not confirm this. Even though not everyone confirms this, teachers and parents seem to notice a difference in inattention tied to zinc levels

Eating more seafood, red meat, and poultry can increase zinc levels. Other food products high in zinc are dairy, beans, nuts, whole grains, and fortified cereals. 

Some studies show low levels of iron for children with ADHD. If you suspect low levels of iron, it is advised to go to your medic to get your values reviewed. Taking supplements can always be best discussed with your doctor; he or she can give you advice on what you can do and what supplements are of great quality.

What are other risk factors for developing ADHD?

Other risk factors for developing ADHD are mostly prenatal. Prenatal smoking exposure, alcohol use of both parents, and drug consumption have a negative influence on the baby. Further, high levels of stress and anxiety while pregnant are not advised either.

Other postnatal risk factors include being born prematurely (or having a low birth weight), brain injury, and extreme early deprivation.

How to diagnose ADHD?

An ADHD diagnosis can help pinpoint the symptoms and set up a treatment plan with a specialist. Get in touch with a specialist with a mental health care license to be assessed. 

This could be your medic, therapist, psychologist, or psychiatrist (depending on your state or country). The American Psychiatric Association formulated their diagnostic criteria in the DSM-5, which will be used to assess your behavior.

Adults who experience 5 of these symptoms should seek medical attention. Children who experience 6 or more of these symptoms over a six-month span should also be evaluated by a doctor.

Further, the doctor should find that your quality of life suffers. A medic should not have another explanation. Symptoms need to be present in more than one category of your life, like family, work, or social circle.

Finding the right treatment for you or your child

ADHD is a neurodevelopmental disorder, usually treated with medication, therapy, and/or training.

Five medications are approved by the FDA; they can be administered from 6 years old. Methylphenidate and amphetamine are the approved stimulants. These medications give a boost to dopamine. 

The three approved non-stimulants get prescribed when the child or adult reacts badly to the stimulants. They are Atomoxetine, Guanfacine, and Clonidine.

Helping your family and yourself cope with the consequences is important. You can do this through therapy sessions and training your environment. With therapy, you can bring the structure back in your life; you can work on motivation, attention span, and impulse control.

Stress management can help you and your family manage frustration and other aspects that come with the disorder.

As mentioned before, eating healthy and having an exercise routine is recommended by the FDA. Further, they also recommend you to get the full 8 hours of sleep.

Lastly, when you feel alone in this battle, it is a good idea to visit a support group. You might hear how others manage these challenges and get hope on how to manage these yourself.

Conclusion

So ADHD – is it genetic, developed, or is it hereditary? The answer is complex. Research shows a high probability that it is hereditary.

When you have ADHD, there is a high chance that your child will inherit it from you. There might even be some genetic markers that in the future can be used to diagnose and better treat ADHD.

These markers confirm the hypothesis that people with ADHD have difficulties with their dopamine and serotonin systems. 

Lastly, there is an interplay with environmental factors (f.e. Prenatal exposure to alcohol, drugs, or postnatal exposure to brain trauma or prematurely being born).  

Symptoms of ADHD are not fun to have in your household. However, they can be managed. A doctor can assess your symptoms and adapt medication and treatment to your needs.

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