While it has been a running joke that WebMD suggests cancer as a possible diagnosis to any symptom, this phenomenon is not unrealistic. With the rise of social media platforms, we have seen an increasing trend of self-diagnoses, including autism, attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), borderline personality disorder (BPD), Tourette’s syndrome, and dissociative identity disorder to name a few.
Whether self-diagnoses are valid is a topic up for debate. Nick, a fourth-year Mt. A student diagnosed with ADHD, shared his view on the matter: “I feel like a self-diagnosis can help in the short term. Guessing you might have ADHD would be the first step before getting tested, but I don’t believe you should continue saying it as the truth.” Diagnoses in themselves are often difficult to obtain for several reasons, including lack of accessibility, financial aid, and resources. Self-diagnoses may allow individuals to access much-needed accommodations, but many places require an official diagnosis. Nick acknowledges this conflict, stating: “Accommodations can be abused if self-diagnoses are held as the absolute truth. If you don’t actually have the condition, then you would be taking the spot (and limited resources) from somebody who does. I feel like temporary accommodations with a set date to get tested is pretty fair.”
ADHD in particular faces the challenge of lacking a concrete base for diagnosing. A neurodevelopmental condition that affects a person’s ability to focus and complete everyday tasks, an ADHD diagnosis is made at a registered practitioner’s discretion, aided by established guidelines, test results, and firsthand information. This lack of solid foundation increases the difficulty of receiving a correct diagnosis, and subsequently, accommodations.
However, creating a concrete basis for diagnosing ADHD might lie in our DNA. Scientists estimate that approximately 80 percent of ADHD’s etiology is genetically based, meaning there are genes linked to the condition. A study led by Dr. Callum Dark, researcher at the Peter MacCallum Cancer Center, examined one potential ADHD gene, CHMP7. When mutated, and hence presented at reduced levels, this gene is associated with hyperactivity and smaller brain volume. Hyperactivity is a trait characteristic of two of the three major ADHD types. Research headed by Dr. Michael Mooney, assistant professor at Oregon Health & Science University, in 2020 showed an association between smaller total brain volume — which is critical to note has no correlation to intelligence — and individuals with ADHD. This suggests that there is a morphology associated with ADHD.
Most animals sexually reproduce and thus carry copies of genes from their mother and father. If the copies are the same for both parents, the offspring is homozygous for that particular gene, but if the copies differ, then the individual is heterozygous. Dr. Dark created and examined zebrafish that either carried two regular CHMP7 genes (homozygotes) or one regular and one mutated gene (heterozygotes). Heterozygous fish were found to exhibit hyperactivity as larvae and had significantly reduced brain volumes in comparison to their homozygous counterparts. Even more intriguing, this hyperactivity could be reduced comparable to the homozygotes’ level when the fish were given methylphenidate, a stimulant commonly known as Ritalin in treating ADHD.
These results support the theory of mutated CHMP7 genes being an indicator of ADHD and begs the question: What other genes fit this category? As more ADHD genes are discovered, we draw closer to obtaining an accurate and efficient diagnosing process. Genetic-based diagnoses will help remove ambiguity behind test results, especially as ADHD shares many traits with autism, anxiety, and other conditions. Additionally, this type of diagnosis may remove barriers such as the costs of multiple physician visits, which often start at a whopping rate of over $100 per hour. These changes would allow more people to acquire much-needed diagnoses, an experience Nick reflected on: “Prior to receiving a diagnosis, my old school caused me many issues because they did not know how to deal with me. While I was great at math, I had a hard time with English and was overly hyper and couldn’t pay attention in classes that didn’t interest me.”
Perhaps in the future, obtaining a diagnosis will be as easy as taking a DNA swab, sending it to a lab, and receiving the results within a week. Even if the results differ from what you expected, at least you will not be saying “I got my diagnosis from the Internet!”
To learn more about this topic, check out the original research article “Functional validation of CHMP7 as an ADHD risk gene” at https://www.nature.com/articles/s41398-020-01077-w#Ack1
