Most people who think they (or their child) might have attention-deficit disorder (ADD), also known as attention-deficit hyperactivity disorder (ADHD), head to a pediatrician or primary care physician for a prescription for stimulants. But this common condition that affects 4.4% of adults and 9.4% of children is highly complex and requires a much deeper investigation than just a brief office visit and a one-size-fits-all treatment plan.
Amen Clinics, the global leader in brain health, has worked with tens of thousands of children and adults with ADD/ADHD for over 30 years. Based on this experience, along with the world’s largest database of functional brain imaging related to behavior, the team at Amen Clinics has identified 10 critical things about ADD/ADHD that many healthcare professionals might be missing and that could be keeping you (or your child) from getting relief from symptoms.
10 Critical Things About ADD/ADHD That Many Healthcare Professionals Might Be Missing
1. Not everyone is hyperactive.
Many people with this condition are never hyperactive. The non-hyperactive or “inattentive” ADD people are often ignored because they don’t bring enough negative attention to themselves. Many of these children, teenagers, or adults earn the unjust labels “willful,” “lazy,” “unmotivated,” or “not that smart.” Among the patients at Amen Clinics, inattentive ADD without hyperactivity tends to be more common in females.
2. ADD/ADHD is a brain issue.
Based on brain imaging studies using a technology called SPECT, which measures blood flow and activity in the brain, Amen Clinics has found that ADD/ADHD is associated with abnormal brain patterns. And there isn’t just one type. There are 7 types of ADD/ADHD. Knowing your type is essential to getting the right help for yourself or your child.
3. Stimulants don’t work for everyone.
Stimulant medications can be helpful for some people with ADD/ADHD, but not for everybody. In fact, giving stimulants to people with certain types of ADD/ADHD makes them worse. In addition, according to the neuropsychiatrists at Amen Clinics, taking prescription medication should never be the first or only thing you do to treat a mental health condition.
One of the most common causes of ADD-like symptoms outside of genetics is head trauma, especially to the prefrontal cortex. SPECT is clearly able to show areas of damage that are not seen on the anatomy studies like CAT scans or MRI studies. When the prefrontal cortex is injured, people have more ADD/ADHD-like symptoms. Many people—even healthcare professionals—do not fully understand how head injuries, sometimes even “minor” ones where no loss of consciousness occurs, can alter a person’s character and ability to learn.
One of the most common causes of ADD-like symptoms outside of genetics is head trauma.
Drug and alcohol abuse are very common problems in teenagers and adults with untreated ADD/ADHD. A 2011 study from researchers at Harvard in the Journal of the American Academy of Child & Adolescent Psychiatry reported that people with the condition are one and a half times more likely to develop substance abuse (including cigarette smoking) compared with people who don’t have ADD/ADHD.
7. Your biology matters.
Amen Clinics has found that what you eat, how well you sleep, and how much you exercise can have a major impact on your symptoms. Most people with ADD/ADHD (but not Type 3 Overfocused) do best with a higher-protein, lower-carbohydrate diet. Getting 30-45 minutes daily of exercise, especially aerobic exercise that increases blood flow to the prefrontal cortex, can be very helpful. Sleep disturbances are very common in people with ADD/ADHD. Many have trouble getting to sleep at night and getting up in the morning. Sleep deprivation leads to overall decreased brain activity. In order to optimize brain function, aim for at least 7 hours each night.
8. Nutritional supplements can increase focus and attention.
Basic supplements that can benefit people with all types of ADD/ADHD include a multivitamin/mineral, omega-3 fatty acids, and vitamin D. There is good scientific evidence that rhodiola, green tea, ginseng, and ashwagandha increase focus and attention.
9. Neurofeedback can be helpful.
A very exciting biological treatment for ADD/ADHD is neurofeedback. This interactive, non-invasive therapy helps strengthen the brain to achieve a more focused state. Amen Clinics patients who have used neurofeedback therapy have reported enhanced focus, decreased impulsivity, and improved moods.
10. When assessing ADD/ADHD, there are many things to consider.
According to the CDC, 6 of 10 children with ADD/ADHD have at least one other mental, emotional, or behavioral disorder. At Amen Clinics, conditions that are evaluated include depression, bipolar disorder, anxiety, obsessive-compulsive disorder, and tic disorders (such as Tourette’s syndrome). In addition, adjustment disorders or family problems; a history of physical, emotional, or sexual abuse; medical factors; and learning/developmental problems need to be evaluated. Only by understanding everything that may be contributing to symptoms and addressing each of these issues can you (or your child) truly get well.
ADD/ADHD, as well as conduct disorders and behavioral disorders, can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk. Suicide is devastating for the loved ones who are left behind. Family and friends often say they didn’t notice any signs of suicidal tendencies, which leaves them wondering what they might have missed. But what if brain imaging could predict who will attempt suicide?
Exciting brain imaging research from 2017 in Nature Human Behavior found that based on brain scans alone, a computer could identify with 94% accuracy rate which study participants had suicidal tendencies.
Earlier research from Amen Clinics, the world’s leader in brain health—including a 2009 brain imaging study in The Journal of Neuropsychiatry and Neurosciences on 12 people who completed suicide and a 2011 brain imaging study in Translational Psychiatry on 21 people who completed suicide—found abnormalities in brain function in these people. Both of these studies found decreased cerebral blood flow in specific areas of the brain, including the prefrontal cortex (see below). The researchers concluded, “This work suggests that SPECT might be useful in predicting risk for suicide completion in subjects with depression or treatment-resistant depression.”
“Finding biological biomarkers in the brain that are associated with suicidal thoughts and behaviors could ultimately save lives,” says Dr. Daniel Amen, founder of Amen Clinics, which has built the world’s largest brain imaging database related to behavior.
“Finding biological biomarkers in the brain that are associated with suicidal thoughts and behaviors could ultimately save lives.” — Dr. Daniel Amen, founder of Amen Clinics
The need to address suicide is becoming more critical as the rates of suicidal ideation are skyrocketing due to the pandemic. Approximately twice as many U.S. adults have seriously considered suicide in the past 30 days compared with 2018, according to the CDC’s Morbidity and Mortality Weekly Report. In the report, more than 1 in 10 of the 5,412 respondents reported seriously considering suicide in the previous 30 days. Even more startling is that over 1 in 4 people ages 18-24 had seriously contemplated ending their own life. And over 30% of unpaid caregivers for adults and 22% of people considered essential workers had suicidal thoughts.
This comes on the heels of already-rising suicide rates, especially among young Americans. Suicide is the 10th leading cause of death overall, but it is the second leading cause of death among 10-24 year-olds, according to the CDC. From 2007-2017, teens ages 15-19 experienced a 76% increase in suicides, and the suicide rate for 10-14 year-olds nearly tripled.
We need to reverse this trend. It’s time to take advantage of advanced brain imaging technology to help detect people who are at risk.
BRAIN ABNORMALITIES SEEN IN SUICIDAL PEOPLE
Brain SPECT imaging, which measures blood flow and activity in the brain, reveals underlying brain abnormalities in people with suicidal tendencies. In addition to the studies mentioned above, Amen Clinics has also done brain scans on over 300 people who attempted suicide and on thousands more who have seriously contemplated dying by suicide.
What do these brain scans show?
People with suicidal thoughts and behaviors tend to have abnormalities in brain activity. What follow-up scans on these patients show is that with the right treatment, there are ways to heal underlying brain health issues and reduce the risk of suicide.
Here are 4 of the most common SPECT findings in Amen Clinics patients with suicidal tendencies along with proven strategies to heal the brain.
Concussions and other traumatic brain injuries are associated with an increase in suicidal tendencies, according to research in the American Journal of Public Health. Head injuries can negatively impact brain function and have been linked to increases in depression, anxiety, substance abuse, which can contribute to suicidal ideation. Head injuries are far more common than you might imagine, and even minor blows to the head can cause trouble weeks, months, or even years later. At Amen Clinics, brain imaging studies show that 40% of patients have signs of a previous head injury. Surprisingly, many of them don’t remember experiencing a head injury, or they think their past head trauma—whether it was from falling off a bike, falling down a flight of stairs, or from playing tackle football—was insignificant. Brain scans show they are highly significant.
Healing head trauma: Hyperbaric oxygen therapy (HBOT), neurofeedback, hormonal therapy (head injuries often disrupt hormone production), and nutritional supplements (ginkgo, acetyl-l-carnitine, huperzine A, N-acetyl-cysteine, alpha lipoic acid, and phosphatidylserine) facilitate the healing process.
Temporal Lobes
Abnormal brain activity in the temporal lobes—especially in the left temporal lobe—is commonly seen on the brain scans of people with suicidal tendencies. According to an Amen Clinics study, 62% of patients who had seriously contemplated suicide or who had made an attempt had abnormalities in the left temporal lobe. The temporal lobes are involved in mood stability, memory, and learning. Problems in the left temporal lobe also include anger and aggression, dark or violent thoughts, sensitivity to slights, word-finding problems, auditory processing problems, reading difficulties, and emotional instability.
Healing temporal lobes: Neurofeedback, nutritional support (higher-protein, lower-carbohydrate diet), the supplements GABA and theanine, music therapy, singing, and anger management can be helpful.
Prefrontal Cortex (PFC)
Low activity in the PFC is a common finding on SPECT in suicidal people. The PFC is involved in impulse control, judgment, and decision-making, but when it is underactive, it is associated with impulsivity, poor judgment, and bad decisions. Having a “sleepy” PFC is one of the hallmarks of ADD/ADHD, and a 2017 review of 26 studies in the World Journal of Psychiatry shows that people with this common condition are at increased risk of suicide. The researchers conclude that early diagnosis and treatment of ADD/ADHD—and the co-occurring psychiatric disorders—can play an important role in the prevention of suicide.
Healing the PFC: Physical exercise, neurofeedback, goal setting, nutritional interventions, support (higher-protein, lower-carbohydrate diet), meditation, green tea, the supplements rhodiola and ginseng, and asking “Then what?” (thinking about the consequences of your actions) are beneficial strategies to strengthen the PFC.
Anterior Cingulate Gyrus (ACG)
The ACG is the brain’s gear shifter, and it helps you shift your attention from one thought to another. Too much activity here, which is commonly seen on SPECT in suicidal people, makes people more likely to get stuck on negative thoughts. A 2020 study in Translational Psychiatry builds on prior research showing that dysfunction in the anterior cingulate cortex (where the ACG is located) is associated with suicidal ideation and suicidal behavior.
Healing the ACG: Nutritional support (higher smart carbohydrates, lower protein), supplements (saffron and 5-HTP), exercise, learning how to stop looping thoughts, learning to distract yourself when you get stuck on negative thoughts, and writing out options when you feel stuck can help balance an overactive ACG.
HEALING THE BRAIN HELPS PREVENT SUICIDE
After over 30 years of treating people who have considered suicide, Dr. Amen says it’s clear that “suicide is a permanent solution to a temporary problem.” When the underlying brain dysfunction is treated, however, people’s symptoms of depression, impulsiveness, hopelessness, helplessness, aggression, and negative thinking patterns improve. Putting the brain in a healthy environment with the healing strategies described above provides hope for people who are suffering from suicidal ideation.
“Suicide is a permanent solution to a temporary problem.” — Dr. Daniel Amen, founder of Amen Clinics
If you are having suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
Suicidal tendencies can’t wait. During these uncertain times, getting the help you need is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk. It’s 3 o’clock in the afternoon and all of a sudden, you get hit hard with a craving. You want—no, you need—a sugar fix (chocolate, cookies, cake, you name it, you’ve got to have it! You don’t want to give in to the craving, but the memories of the sweet taste try to hijack your brain, and dopamine, the pleasure and motivation brain chemical, pushes on an area of your brain that drives you to the kitchen cabinet where your sugar stash is stored.
The cravings win again.
If you have a sweet tooth and haven’t been able to conquer your cravings, you’re not alone. One patient at Amen Clinics, the global leader in brain health, said she would rather get Alzheimer’s disease than give up sugar! Why are sugar cravings so powerful? The neuropsychiatrists at Amen Clinics say the answer lies in the brain.
Why are sugar cravings so powerful? The neuropsychiatrists at Amen Clinics say the answer lies in the brain.
Dopamine: Consuming sugar triggers the release of the neurotransmitter dopamine, which is involved in motivation and salience.
Nucleus accumbens: The pleasure and motivation center of the brain, the nucleus accumbens is located within the basal ganglia. The nucleus accumbens provides the passion and motivation that is one of the main drivers of behavior. Think of the nucleus accumbens as a pleasure button. With every bite of the sweet stuff, the button is pressed. And the same way it can happen with cocaine or other addictive substances, if the pleasure button is overused, it gets worn out and you need more to make you get the same sweet satisfaction.
Deep limbic system: The emotional centers of the brain also play a role in sugar cravings. The memories you have that are associated with, for example, ice cream—birthday celebrations and other happy moments—cause you to seek to repeat this experience. It’s as if the ice cream will help you recapture that wonderful moment in your life.
Prefrontal cortex (PFC): The PFC, which is involved in self-control, impulse control, and judgment, is the brain’s brake. It reminds you that eating ice cream doesn’t fit in your goals and that you’ll feel bad after you eat it.
When cravings hit, there’s a sort of tug of war that happens inside your brain. The pleasure centers, emotional centers, and the neurotransmitter dopamine compel you to head to the freezer for the ice cream. Meanwhile, the PFC tries to put on the brakes.
Which part of your brain do you listen to? It depends.
In a healthy brain, a strong PFC provides good judgment and emotional control so you can say no to the ice cream. When the PFC is underactive, however, the pleasure and emotional centers can hijack the brain and take control. When this happens, you cave to the sugar cravings again… and again… and again.
Even if your brain’s pleasure centers and emotional centers have wrestled control from your prefrontal cortex, you can learn to strengthen your PFC and train your brain so you can overcome sugar cravings. Here’s how.
Even if your brain’s pleasure centers and emotional centers have wrestled control from your prefrontal cortex, you can learn to strengthen your PFC and train your brain so you can overcome sugar cravings.
Low blood sugar levels are associated with overall lower brain activity, including lower activity in the PFC, the brain’s brake. Low brain activity here means more cravings and more bad decisions. Research in the Journal of Personality and Social Psychology shows that self-control failures are more likely to occur when blood sugar levels are low. What causes blood sugar levels to drop? Drinking alcohol, sugary snacks, sweetened beverages, and other high-glycemic foods (think rice, pasta, and cereal). Stabilizing blood sugar levels throughout the day improves self-control. Here are simple tips to help you do it.
Eat protein and healthy fats at every meal.
Have smaller meals throughout the day. This helps eliminate the blood sugar rollercoaster ride that can impact your emotions and increase cravings.
Replace simple sugars and refined carbs with healthier options. For example, swapping candy for a few squares of sugar-free dark chocolate can help you kick the habit.
Try nutritional supplements, such as chromium and alpha-lipoic acid. They have very good scientific evidence that they help balance blood sugar levels.
2. Eliminate artificial sweeteners.
If you really want to decrease your cravings, you need to get rid of artificial sweeteners. You may think of these sweeteners as “free” because they have no calories, but they are up to 600 times sweeter than sugar, which may activate the appetite centers of the brain making you crave even more sugar. If you can learn to go without any sweeteners, your brain will stop craving the sweetness. If you must, replace the artificial stuff with natural sweeteners like stevia or erythritol.
3. Manage your stress.
Anything stressful can trigger certain hormones that activate your cravings, making you believe that you need the ice cream, cake, or licorice. Meditation and hypnosis are powerful stress-management practices that can boost blood flow to the PFC to help rebalance your brain circuitry.
4. Outsmart sneaky cravings triggers.
Nearly everywhere you go, someone is trying to entice you to eat something sweet. Think of the candy displays near the checkout counter at the grocery store, which is intentionally designed to tempt you to make an impulse buy. To control your cravings, you have to control your triggers. Know the people, places, and things that fuel your cravings and plan ahead for your vulnerable times. For example, choose the grocery store aisle that has the display of razors and batteries instead of the candy.
5. Find out about hidden food allergies.
Hidden food allergies and food sensitivities can trigger cravings and make you fall back into old habits. For example, did you know that gluten and milk allergies can decrease blood flow to the brain and decrease your judgment? In addition, food allergies can cause concentration problems and anxiety, which can increase cravings. To find out if you have any food sensitivities, try an elimination diet. Stop eating corn, soy, dairy, gluten, artificial sweeteners, and food colorings for 3 weeks then introduce them back into your diet one at a time and see if you have any reactions.
6. Practice willpower.
Willpower is like a muscle. The more you use it, the stronger it gets. Practice saying no to the things that do not serve you and over time, you will find it easier to do.
7. Get moving.
Physical exercise can cut cravings. A 2012 study in the journal Appetite showed that taking a brisk 15-minute walk decreased cravings for chocolate. Not only that, it also fended off the cravings for an additional 10 minutes following the walk. Because cravings typically only last about 10 minutes, a brief bout of exercise may be all it takes to distract you from the sweets you crave.
8. Make sleep a priority.
Multiple studies, including a 2013 study in Nature Communications, show that lack of sleep increases cravings. “It’s important to get at least 7 hours of sleep each night to help battle cravings. Creating a healthy bedtime routine that promotes relaxation can help,” says Shane Creado, MD, a psychiatrist and sleep medicine specialist at Amen Clinics Chicago and the host of the Overcoming Insomnia online course.
9. Try nutritional supplements to curb cravings.
N-acetylcysteine, alpha-lipoic acid, chromium, dl-phenylalanine, and l-glutamine are 5 natural supplements with scientific evidence showing that they can help take the edge off cravings.
10. Avoid hidden sugars.
Even if you’re no longer adding sugar to the foods you eat and have kicked your cookie habit, you may still be consuming sugars without realizing it. Many so-called health foods contain hidden sugars. For example, many salad dressings, milk alternatives, and pre-made smoothies are loaded with sweeteners. You need to become a pro at reading food labels to root out sneaky sugars.
11. Treat underlying mental health conditions.
Craving sugar, sweets, and refined carbs have been associated with anxiety, depression, ADD/ADHD, schizophrenia, and other psychiatric issues. A number of studies, including a 2019 review in the journal Antioxidants, have found a link between high-sugar consumption and depression. And according to 2016 research in the journal Appetite, a diet containing more high-glycemic foods was associated with a higher incidence of depression and fatigue. In addition, when you’re feeling anxious or stressed, you’re more likely to crave sugar. ADD/ADHD has been associated with dopamine deficiency, which can cause people with this condition to seek out activities and foods—such as sugar—that stimulate dopamine. Addressing these conditions can help you conquer sugar cravings for good.
Anxiety, depression, ADD/ADHD, and other mental health—issues can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.
