Science Friday - NASA Opens Canister With Asteroid Sample | ADHD Prescription Rates Spiked During The Pandemic

Starting point is 00:00:02 Prescriptions for ADHD medications are on the rise. Why? The pandemic was just this big wind gust that brought it all down and revealed a lot of the challenges that had already been there to begin with. It's Friday, January 26th, and you can take a sigh of relief. Because it's finally Science Friday. I'm SciFri producer Shoshana Bucksdown. During the height of the pandemic, there was a spike in prescriptions for ADHD meds. especially among young adults and people assigned female at birth, including women and some trans folks. In a bit, we'll talk about what's driving these trends.

Starting point is 00:00:44 But first, guest host Ariel Duhame Ross talks with science writer Mackie Kerth about the top science news of the week. NASA's announced the Mars helicopter. Ingenuity has taken its last flight. The little helicopter first arrived on Mars in 2021, along with the Perseverance Rover, and since then has taken 72, flights, way longer than the planned 30-day mission, scoping out craters and riverbeds for signs of water on Mars' surface. But during a recent flight, the rover lost communication with the helicopter as it was landing. And once communication was restored, images from the helicopter revealed rotor blade damage,

Starting point is 00:01:23 meaning it's now grounded permanently. And now, a bit more space news. This is an update from NASA's Osiris Rex mission. It was the first U.S. spacecraft to bring fragments of an asteroid. The pieces arrived late last year, which is very cool. One small issue, though, NASA's technicians couldn't get the capsule open. You know, the very important one that holds the space rocks. But now, they've done it. Joining me to talk about that and other top science news of the week is my guest. Maggie Kerth is a science writer and editorial lead for

Starting point is 00:01:59 Carbon Plan, based in Minneapolis, Minnesota. Maggie, thanks for joining us. Yeah, thanks for having me back. Okay. So Maggie, please tell me, why couldn't NASA open this capsule? And how did they finally break it open? Well, so think about this as like one of those times you just really wanted a pickle. And for the life of you, you couldn't get the lid off the jar. But in this case, the jar is a capsule set back to Earth from space and the pickles are 4.5 billion-year-old rocks from the dawn of time. Sounds tasty. Ironically, that's also how old some pickles in my fridge are. The deal with this is that there were 35 fasteners that locked this thing closed.

Starting point is 00:02:43 And when they went to open it up, two of them just wouldn't open. So to get inside, the engineers at NASA actually had to design and build their own bestbook tools from scratch. Wow. Wow. All right. Yeah, they spent like the last few months reinventing a can opener and now they got into it. And they really think these things are worth the trouble though because we are talking about rocks that have a lot to teach us about the earliest days of our solar system. And there's a possibility that they might even contain some of the biological precursors of life that can teach us about how life evolved on planet Earth. Right. So now I really have a sense for, for, for, why they worked so hard to get in there. But what's next for the Osiris Rex spacecraft? Well, Osiris never came back down out of space. It kind of just shot this little capsule off from orbit, and then it was sent off on another mission. So after dropping this capsule from

Starting point is 00:03:48 Benu, this asteroid that it got these rocks from, the spacecraft was then steered off, and it's headed towards a 2029 rendezvous with Apophis, which is a massive asteroid that is going to close enough to Earth that it could even be invisible with the naked eye. Forgive me for this. We'll be keeping an eye on that. Okay, so back down to Earth. For a story about humans giving chimpanzees colds, we often think about it the other way around, right? Animals giving humans diseases. But what's relatively mild for us can actually be pretty deadly for a chimp, right? So tell me what's going on here, Maggie. Well, basically it's that zoonosis risks work both ways.

Starting point is 00:04:33 You know, things that are really mild and don't bother animals can transmit over to us and become deadly. And that happens and vice versa, too. So, for example, a minor human respiratory infection, just something you'd call a cold and take with you into the office, ended up killing 12% of the Ugandan chimpanzee community back in 2017. Rachel Neuer had a really fascinating piece in nature last week where she was looking. looking at these reverse zonoses, the threats that they pose and what scientists are doing to save animals that are at risk. There are international guidelines even for how tourists are supposed to interact with chimpanzees and gorillas in the wild. So for example, we are supposed to stay

Starting point is 00:05:15 seven meters away from the great apes and we're supposed to wear masks. Both of those things sound familiar. Yep. That does sound real, real familiar. It's been really, really hard to get tourists and workers in these national parks to actually do the social distancing and the masking. And a 2020 study of tourist groups even found that nearly everyone included in the research had violated the distance guidelines. So there is just this challenging tangle of incentives that are happening. You know, the animals need the national parks and the tourism that funds those parks in order to be protected. And the tourists want to be able to get up close and personal with these animals to want to go to the parks. And so you kind of have

Starting point is 00:06:11 these spaces where protecting the animals sometimes ends up feeling like you have to put them at risk in order to keep them protected. It's very messy and it's not a simple thing to solve. One of the things, though, when I was reading this article that really stood out to me was the fact that there are some solutions that are really simple and also really frustrating. Most of the guides, it turns out, don't have sick days built into their jobs. So even if they feel lousy, they have to come into work. And simply giving them paid time off could actually end up protecting the creatures that they're trying to take tourists to see. Right. So what I'm hearing is that we need universal paid sick time once again. Once again, yes. Yep. It all just kind of comes right back around, doesn't it?

Starting point is 00:07:06 Yeah. Our next story is sort of the reverse. It's one of those stories about how animals transmit diseases to humans. And you study traces the origins of multiple sclerosis to a genetic mutation that popped up thousands of years ago to protect humans against animal diseases. Tell me more. Yeah, so this is really super interesting. It's a study of DNA from 34,000-year-old human bones and comparing them to modern DNA and kind of looking for how things have changed over time. And what the researchers were finding is that the genes linked to MS trace back to these nomadic people called the Yamaya, who populated much of northern Europe during the Bronze Age. Now the Yamaya were herders and they lived with their goats and their sheep. And generally, this was a time period where more humans were living closer together and having more contact with farm animals. And what you were getting was a lot more diseases. And for these people, genes that made a highly responsive immune system were really helpful. But now you get their descendants in an era of modern sanitation and those same defensive.

Starting point is 00:08:20 seem to have turned on us. This study really helps explain why northern Europeans, these descendants of the Yamaya, have the world's highest prevalence for MS. It's actually doubled that and even southern Europe. Huh. Okay. Well, this comes at an interesting time, right?

Starting point is 00:08:39 Because MS has been in the news a lot more recently. There's a new treatment approach for these types of diseases that actually seems to be pretty promising, and I've been hearing about it. Can you tell me how it works? Yeah. So Cassandra Williard has a story in nature this week that's looking at the hunt for treatments and possibly even cures. And it could affect MS, a lot of other autoimmune diseases. So her story is looking at three teams of scientists who are working on different versions of the same kind of similar idea, basically taking the antigens that the immune system is attacking and using them as a sort of exposure therapy. Basically, you're convincing your malfunctioning immune system. that this particular thing it's being exposed to isn't actually a danger, and that the immune cells trained to hunt it can go ahead and just deactivate.

Starting point is 00:09:32 So is this sort of like allergy shots? Kind of a little bit, yeah. So this is not a totally new concept. In the past, there have been attempts at it, but they've kind of gotten mediocre results. And these new techniques, they're still in really early stages, but they seem a lot more promising. There's three different things that Williard profiled in her article, and they're all really different from each other, so I'm not going to try to explain each of them in detail. But what they all share is this ability to deal with the fact that a disease like MS isn't just a reaction to one antigen. So depending on disease progression, there could be lots and lots of things that get the immune system worked up.

Starting point is 00:10:14 And it was really hard to figure out how to train the body to tolerate all of them when you don't need to. know what all of them are. So these new techniques each have found a different path to multi-antigen tolerance. So it's like using one car to convince your dog that he doesn't have to bark at any cars. So how far along is this research? Has it actually been tested in humans yet? Some of these techniques haven't been tested on humans yet. One of them has been through a small safety trial and is starting to recruit for efficacy trials. But it seems like we're at a point now where we could see the possibility of a solution to a problem that's thousands of years in the making. Let's move on to a story that, well, has been generating a lot of buzz.

Starting point is 00:10:55 Turns out that honeybees are pollen thieves. Who knew these little guys were so lacking in human morals, you know, such criminals? I know. It's really, it's a hard world out there on the mean streets of the flower garden. This is behavior that has been documented in several places in the U.S. But for the first time, researchers have now documented international honeybee theft rings. They filmed honeybees stealing from bumblebees in Italy. Oh. And I don't like to blame the victim, but the bumblebees make it easy.

Starting point is 00:11:32 They carry this pollen attached to like their little furry bodies. And they just aren't very aggressive, particularly the males. They don't fight back. They don't try to stop what's happening. So as part of the study, the researchers followed bee behavior. over three years at three different sites. And at two of the three, the honeybees were law-abiding members of society. It was just that one spot where year after year,

Starting point is 00:11:57 it was like the insect equivalent of a dark alley. So they were trying to figure out what made things different. And what they came up with is it's probably the food options. At the theft site, the primary honeybee food flower was this thing called a woolly thistle. And the bees had really been struggling to get the paw in off of that particular plant. So the scientist's hypothesis is that when food is hard to come by, but potential theft victims are also plentiful, that is when honeybees turn to a life of crime.

Starting point is 00:12:29 Well, now we know. That's all we've got for now. Thank you, Maggie, for being here. Thank you so much for having me. Maggie Kerth is the editorial lead for Carbon Plan and a science writer based in Minneapolis, Minnesota. The rate of prescriptions for ADHD medications rose by 30% during the height of the pandemic. That's from 2020 to 2022. Most of these new prescriptions were given to young adults, people between the ages of 20 to 39, and predominantly to people assigned female at birth, including women and some trans folks. As someone who was diagnosed with ADHD a little over a year ago, I was curious about what's going on here. Joining me now to help make sense of these trends

Starting point is 00:13:14 is my guest. Dr. Julia Schechter is the co-director of Duke University's Center for Girls and Women, with ADHD based in Durham, North Carolina. Dr. Schechter, welcome to Science Friday. Thank you so much for having me. I'm so thrilled to be here. A 30% increase in prescriptions over the course of just two years seems like a lot. What is it about the pandemic that might have prompted adults to seek treatment and diagnosis for ADHD and presumably many for the first time? You know, one of the things that we know about girls and women with ADHD is that their symptoms often are most apparent at times of transition. So, you know, you think about transitioning to a new school year or transitioning to college or transitioning to becoming a parent. And certainly the pandemic

Starting point is 00:14:00 and lockdown was just this monumental transition. Right. And, you know, people were transitioning to working from home and being on Zoom all day or having to teach their kids at the same time and care for loved ones. And all of this external structure and these compensatory strategies that they'd been using to manage their lives, it all just completely fell away. And, you know, I think one really important point to make is that it wasn't that, you know, the pandemic and lockdown caused these women to have ADHD.

Starting point is 00:14:32 They didn't suddenly wake up one morning and have this neurodevelopmental condition. Essentially, these women's lives were already kind of like a house of cards, and the pandemic was just this big wind gusts that brought it all down and revealed a lot of the challenges that had already been there to begin with. Rates of ADHD diagnosis among women, and, you know, more broadly, anyone assigned female at birth have roughly doubled in recent years.

Starting point is 00:14:57 Why is that? So it's a great question. And I don't think we know the answer. I think there's a lot of different factors. I think one is this point of these difficulties were always there, but we're always being recognized. The vast majority of our research on ADHD is done. males. And so what this has done is really centered our understanding of what ADHD looked like on the male presentation. And so for a very long time, girls and women with ADHD were

Starting point is 00:15:30 missed or misdiagnosed with some other condition. And this led to them not being identified and missing out on some really transformational treatment. We can't treat someone unless we can identify them. We also know that it's highly hereditary. So that, you know, if you have a kid with ADHD, this might be a signal that you may have ADHD, right? I think that was another factor of the pandemic, too, is that we talked to some women who are getting diagnosed in adulthood. And they said, you know, the first clue to me was actually when we got our child diagnosed. And, you know, also when I was home and teaching them for pandemic schooling and I was able to, you know, literally be in their virtual classroom and see these difficulties. And suddenly I started to reflect that, huh, this actually is me and I've just been coming up with a lot of strategies to hold it together.

Starting point is 00:16:22 Mom, if you're listening, I hope you're taking some of this in. We've had conversations about this, but we'll keep talking. So what exactly is the difference in experience for folks who are socialized as girls in early childhood that might result in a missed diagnosis? A lot of times girls and women do tend to. have that inattentive presentation as the more predominant feature. And so these, you know, are often girls who are as kids kind of looking out the window and doodling during class. They're not disrupting the class. They're really just not making any sort of waves. And so they kind of get by using compensatory strategies. And that doesn't mean they're not struggling.

Starting point is 00:17:04 Right. I mean, they oftentimes are are doing double the work to write to get by. I mean, I think when you ask people to reflect on their childhood, you ask women to reflect, their childhood, they say, oh, yeah, I turned all my work in, but I was staying up all night to do it. We also know that girls and women can absolutely have the hyperactive and impulsive presentation of ADHD too, but that it can look different in people who identify as girls and women. So, for example, we often see that they are more hyper-reverable and talkative rather than hyperactive and kind of having that ants in the pants sort of presentation. We also know that girls and women with ADHD are more likely to experience co-occurring conditions.

Starting point is 00:17:47 So things like anxiety and depression, and this could be because of untreated ADHD or could exist independently. Bottom line for these girls and women with ADHD, oftentimes things are very complex and not as straightforward and it's harder to assess. And they really end up, you know, suffering in silence. The time period that we're talking about is also interesting because around that time I also saw a ton of videos on social media, especially TikTok and Instagram, where people of all genders were talking about their experiences with ADHD. It's the kind of content that raises awareness, which then makes me wonder if maybe any of these videos had an impact and contributed to this increase. We don't yet have research to indicate the degree to which social media has played a role in these ADHD increases, but it is highly likely that it did to some capacity. And, you know, I think the intersection of ADHD and social media is a double-edged sword, right? Because on the one hand, like you said, it raises awareness about how ADHD can look in women and how it can look different.

Starting point is 00:18:59 It can reduce stigma. We know ADHD impacts people of all genders and races and ethnicities, and that has not always been reflected in the research studies. On the other hand, you know, social media is not always great for, you know, disseminating evidence-based information. And we know that social media can also perpetuate misinformation. You know, ADHD is really complex and, you know, reducing it down to a TikTok can weaken the message, right,

Starting point is 00:19:30 about the very real functional impairment that can come along with ADHD, you know, a post about losing your keys or being late sometimes or having a really messy house. I mean, it can, it can diminish some of the, you know, the additional struggles and burden and significant impact that ADHD can have on people's lives. Right. So the way I finally realized that I have ADHD was by talking to a friend of mine who also has it and learning about their symptoms and then going, wait, that sounds like my experience of the world. And I think that some of these videos, you know, they play that role for folks, you know, for people who maybe never even consider ADHD is a possibility for them. But I can also imagine that some of the symptoms of ADHD being relatable to a lot of folks,

Starting point is 00:20:19 especially in periods of stress, it's not just people with ADHD who could see themselves, in some of these videos, right? I don't think that it's just people with ADHD who have trouble focusing during a Zoom meeting that's taking place at the height of a pandemic. So just to be clear, what does it actually mean to have ADHD? So ADHD is a real neurodevelopmental condition, which means it has to do with your brain structure and brain function. And when someone has it, what that means is that they have elevated levels of challenges with their, regulating their attention and or regulating their behavior. And what does elevated mean? So if you look in our diagnostic and statistical manual, it actually indicates that you have to really show at least

Starting point is 00:21:09 six of the nine symptoms of inattention or hyperactive and impulsive behavior. But in addition to just showing those elevated symptoms, we have to see that they're persistent across time, across settings, There's no other better explanation for these kinds of challenges and that they're really causing problems for people. They're messing things up in some way. And one last thing to mention is that we also need to see that several symptoms were present in childhood. So what we're really thinking for is the symptoms, at least several symptoms prior to age 12.

Starting point is 00:21:43 I want to be clear that, you know, getting medications for ADHD is a process, right? and actually there are quite a bit of regulation around that. But there have been reports of online clinics being rather loosey-goosey in their approach to diagnosing and then prescribing a number of medications, including ADHD medications like Adderall. Do we know how much those online pharmacies might have played a role here? I don't think we know that yet. I think they probably did play some kind of role. And, you know, I've talked to a lot of patients who've kind of gone that route.

Starting point is 00:22:17 And certainly I see these ads on my own social. media, right? On the one hand, we have a really big access to care issue in this country. Like you said, it can be so challenging for people to find providers who are, you know, one, trained in providing, you know, ADHD, especially in adults. And then two, aware of the gender-based differences in ADHD. And then also, you know, three, being able to, you prescribe medication if that is what is indicated. I think finding ways to broaden access to evaluation and treatment for ADHD is critical. However, you know, ADHD is a really complex condition and really requires, you know, proper evaluation to help distinguish between what is ADHD versus what are just kind of normal

Starting point is 00:23:01 variation in attention and behavior and what also might be another psychological condition that can mimic ADHD. And we really don't have the science yet in terms of our ability to reliably diagnose someone extremely quickly, you know, like with a two-question survey that, again, is kind of what I see advertised, you know, on my social media. I think people should be cautious, I think, when, when, you know, pursuing those kinds of avenues for diagnosis and treatment. What I'm getting from you is something that's actually kind of fascinating, right? It sounds like it's possible that clinicians are both over-diagnosing and under-diagnosing patients with ADHD

Starting point is 00:23:39 at the same time. Some folks are falling through the cracks while others are getting diagnosed with something they don't have. Is that what you're saying? Yes, I think that that is definitely true. And again, we just don't know to the degree to which it goes either way. I think what is clear is that especially with the, in relation to women, is that, you know, a lot of these women have been struggling their whole lives. And it wasn't until, you know, these conversations have really spiked recently that they realized that there might be a real neurodevelopmental reason for why they have experienced these symptoms. I think what is very clear. is that we have been missing people, especially women, but certainly there are people that are likely getting this diagnosis without a thorough, proper evaluation to help tease apart. Is it ADHD or is it something else? That's all the time we have.

Starting point is 00:24:34 Thank you so much for being here, Dr. Schechter. Thank you so much for having me. Dr. Julia Schechter is the co-director of Duke University Center for Girls and Women with ADHD, based in Durham, North Carolina. And that's about all the time we have for today. A lot of folks help make the show happen, including Nehima Ahmed. Santiago Flores. Rasha Eriety.

Starting point is 00:24:56 Felissa Mears. Robin Casmer. And many more. In our next episode, a camera that allows humans to see the world through animal eyes. I'm SciFRI producer Shoshana Bucksbaum. Catch you next time.

Science Friday - NASA Opens Canister With Asteroid Sample | ADHD Prescription Rates Spiked During The Pandemic

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