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Although attention deficit disorder (ADD), also commonly referred to as attention deficit hyperactivity disorder (ADHD), is a national health crisis that continues to grow, it is highly misunderstood. A lack of understanding, as well as misinformation, can be hugely detrimental in people with ADD/ADHD. Too often those with ADHD are incorrectly labeled as stupid, flakey, spacey, unreliable, unbearable, overly sensitive, troublemaker, or something similar. These hurtful judgments often stem from myths about ADHD that are still present in our culture, despite being untrue. Too often those with ADHD are incorrectly labeled as stupid, flakey, spacey, unreliable, unbearable, overly sensitive, a troublemaker, or something similar. These hurtful judgments often stem from myths about ADHD. Perhaps the best way to truly understand what it feels like to have ADHD is to listen to what people with the condition have to say. Here are 9 things that patients at Amen Clinics have expressed that they wish other people understood about ADHD.9 TRUTHS ABOUT ADHD FROM PEOPLE WHO HAVE IT
1. Telling someone with ADHD to try harder makes things worse.
Brain SPECT imaging shows that when people with ADHD concentrate, blood flow to the prefrontal cortex goes down, which makes concentration worse. ADHD is not a failure of willpower, it’s a neurological condition. Living successfully with ADHD is not about “trying harder” but is rather a process of optimizing the brain and adjusting habits, environment, and structure.2. They aren’t necessarily lazy or procrastinating, they just don’t know where to start.
People with ADHD have brains that work differently than those who don’t have the condition, and differently from lazy people. They tend to struggle with planning and doing parts of a task in order. Tasks in the neurotypical world have a beginning, a middle, and an end. Individuals with ADHD have trouble prioritizing, so they don’t know where and how to start. That’s why complex projects can be very challenging for those with ADHD. They do better receiving assignments in chunks, or a series of smaller assignments, especially on longer projects.3. Having ADHD is exhausting.
Those with ADHD have to work extra hard to stay organized and get things done as they have a million things going on in their mind at once. It’s a moment-to-moment struggle of the brain needing to do mundane tasks yet wanting to avoid them while it monitors the environment for higher stimulation. This continuous inner negotiation is exhausting. All this behind-the-scenes tug-of-war makes self-regulation difficult.4. Focus isn’t the problem.
ADHD is not about a focus problem. It’s about focusing on too many things at once. ADHD is not necessarily a deficit of attention, but rather a problem with regulating one’s attention span to the desired task. So, while mundane tasks may be difficult to focus on, others may be completely absorbing. ADHD people can hyperfocus when interested.5. They don’t mean to be rude.
Brain imaging research shows that ADHD is associated with low activity in the prefrontal cortex, which is responsible for forethought, focus, and executive function. Thus, it is characterized by poor impulse control. People with ADHD may blurt out the first thing that comes to mind, even if it is unkind.6. ADHD is not a joke.
A lighthearted joke about ADHD may be well-intentioned, but it overlooks the severity of the disorder. It’s particularly dismissive of the complex, debilitating, very real disorder that ADHD is. The truth is that ADHD can be devastating.7. It can affect physical intimacy.
Research suggests that roughly 40% of men and women with ADHD will have sexual problems. Lack of focus is a symptom of ADHD. In some cases, that lack of focus can make achieving orgasm more difficult.8. ADHD isn’t all bad.
People with ADHD often are high in energy, enthusiastic, full of ideas, creative, and they often have bursts of energy! They are also spontaneous, adventurous, willing to take risks, and have out-of-the-box thinking. There’s truly no deficit in people with ADHD. Brain differences are normal. The 90% of non-ADHD people in the world referred to as “neurotypical” does not mean they are “normal” or better. Their neurology is simply more accepted and endorsed by the world.9. ADHD isn’t just one thing.
Thanks to brain SPECT imaging, Amen Clinics has identified 7 types of ADHD. Surprisingly, some of them do not involve hyperactivity at all. Ask the person with ADHD in your life what they’d like you to know about their neurological condition. You’ll likely gain a new understanding! ADD/ADHD and other brain health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Are you interested in self-awareness, personal growth, and self-improvement? Don’t we all want greater insights into what makes us tick, so we can become the best version of ourselves? Trent Shelton does. The former pro football player who now inspires millions with his books, motivational speaking, and podcast—has been on a journey of self-exploration and personal development ever since his football career ended prematurely after suffering a concussion. In the decade since then, he has looked inward to better his life and encouraged others to look inside themselves to enhance their lives. But after all that reflection, there was one thing Shelton still hadn’t seen—his brain. “How can you know yourself if you don’t know your brain?” That’s the rhetorical question Shelton asked Dr. Daniel Amen when he visited Amen Clinics to get a brain SPECT scan as part of the Scan My Brain video series. Shelton was curious about a few issues he was experiencing—short-term memory problems, social anxiety, and focus. “I’m a last-minute person,” he admitted with a laugh. He also wanted to take the opportunity to share his brain scan experience with his followers as a way to educate and encourage them. “How can you know yourself if you don’t know your brain?” — Trent Shelton, former pro football player and founder of Rehab Time, upon seeing his brain SPECT scan at Amen ClinicsPERSONAL INSIGHTS FROM BRAIN IMAGING
The former football player’s brain scans provided clues to his concerns. The scans showed signs of previous brain trauma, likely due to the multiple big hits and blows to the head he took as a wide receiver in college and the NFL. Another finding on his brain scans? Decreased blood flow in the prefrontal cortex, which may also be related to those concussions. This pattern is commonly seen in people who tend to procrastinate, miss deadlines, or be late. Individuals with this brain pattern often need a little bit of stress to get motivated to get ready, such as a spouse telling you in no uncertain terms that you’re going to be late. This helped Shelton understand why he’s a last-minute kind of person and how he could benefit from simple ways to boost focus. Shelton had been prepared to see brain trauma due to all those football-related head injuries he’d suffered. What he didn’t expect to see was low activity in the cerebellum, an area involved in processing speed and coordination. As a professional athlete who continues to be active with hiking and HIIT training, he’s highly coordinated. Dr. Amen recommended taking up a racquet sport—such as tennis, table tennis, or pickleball—to help activate the cerebellum and the frontal lobes. These sports require the brain to coordinate hands and feet while calculating spins and choosing shots. Think of it as aerobic chess for the brain. Another bonus of picking up a racquet? A 2018 study in the Mayo Clinic Proceedings shows that people who play racquet sports live longer. Perhaps most surprising to Shelton was the overactivity in his emotional brain. Most people intuitively understand how a concussion can harm the brain, but few of us realize that emotional trauma can inflame the emotional centers of the brain, which is associated with an increased risk of anxiety and depression. In the past, Shelton lost a friend to suicide, and he recently grieved the death of his mother. As Dr. Amen explained, something called ancestral trauma can also be passed down from your parents or grandparents. For example, Shelton’s dad was robbed at gunpoint and shot at. Experiences such as this can alter the genes in a person’s offspring, pre-loading them with generational trauma. Just because a person inherits ancestral trauma, it’s still possible to offset that genetic coding. For example, Dr. Amen suggested that whenever Shelton is feeling anxious that he writes down what he’s thinking and challenges the thought. Practicing this kind of mental hygiene can help turn off—or at least tone down—those genes.How Seeing the Brain Changes Your Mindset
For Shelton, seeing his brain ushered him into a whole new level of personal growth that increased his understanding. “I’m connecting the dots,” he said. “I don’t feel like there’s something wrong with me, with the thoughts that I think, or how I felt in the past. I’m seeing my brain and understanding, okay, this is why. So, it just helps me put 2 and 2 together.” Shelton is one among tens of thousands of people who have visited Amen Clinics for a SPECT scan to better understand their emotional, cognitive, and behavioral issues. In general, with that understanding comes greater self-awareness as well as a stronger commitment to enhancing brain function. And with a better brain comes a better life. As Shelton learned, no self-exploration journey is complete without a view inside the brain. No self-exploration journey is complete without a view inside the brain. Anxiety, focus problems, emotional trauma, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Problems with inattention have, ironically, gotten a lot of attention recently. With many adults working from home right now, some have been able to observe their kids having a hard time staying focused on schoolwork. While other distractions may be in play due to the unusual stressors related to the pandemic, ADD is a developmental disorder (meaning people are born with it), and the symptoms typically become evident during childhood. Unfortunately, unless a child is hyperactive and has behavior issues at school, brain problems related to inattention are often overlooked. Instead, the symptoms may (sadly) be attributed to perceived shortcomings of a child’s mind or personality. As a result, these symptoms—as well as the feelings of inadequacy that come with them—can last into adulthood and can lead to depression, low self-esteem, and anxiety. Unless a child is hyperactive and has behavior issues at school, brain problems related to inattention are often overlooked. Inattentive ADD is the 2nd most common type of ADD and primarily affects women and girls. However, since they tend to be quiet, rather than behaving in ways that make them the center of attention, their ADD symptoms tend to go unnoticed.Inattentive ADD is Real
Through the groundbreaking brain imaging work at Amen Clinics, one of the discoveries is that ADD is not just a single and simple disorder; there are 7 types of ADD. They are: Type 1: Classic ADD, often known as ADHD Type 2: Inattentive ADD Type 3: Overfocused ADD Type 4: Temporal Lobe ADD Type 5: Limbic ADD Type 6: Ring of Fire ADD Type 7: Anxious ADD As children, those with Inattentive ADD likely flew under the radar because they were not inclined to draw attention to themselves, but nonetheless probably struggled to some extent in school. Now as adults, they can be having some similar problems at work and home.How Many of These Inattentive ADD Symptoms Fit for You?
- Having a short attention span for regular, mundane, or routine tasks such as chores (or schoolwork when you were a kid)
- Getting easily distracted… “Squirrel!!”
- Disorganization—Your closet, office, or hobby area is messy, eliciting complaints from your spouse or housemates
- You’re almost always running late
- Procrastination—The closer the deadline, the more motivated you are to do your work
- Problems with following through on tasks you start, resulting in lots of unfinished projects
- You’re generally NOT hyperactive or impulsive
- A tendency to be forgetful and lose things
- Difficulty with attention to details, often making careless mistakes
- Being easily bored or seeming tired, sluggish, and slow-moving
- Daydreaming or appearing spacey or pre-occupied
- Others seem to think you’re not motivated, or that you simply don’t care
Inattentive ADD Brain Function
SPECT brain images show us that the root cause of these symptoms is related to how the brain functions with Inattentive ADD. The images tell us that 3 parts of the brain involved in learning, focus, and motivation tend to be underactive. They are:- The prefrontal cortex (in the front part of the brain) is like the brain’s CEO and is in charge of executive functions such as focus, concentration, planning, forethought, and so on. Ideally, when we concentrate, blood flow in this part of the brain should increase. This helps us stay attentive to the task at hand. BUT in ADD, blood flow actually decreases during concentration which interferes with the ability to stay focused—so the harder you try, the harder it gets!
- The basal ganglia, located deep inside the brain, produces the neurotransmitter dopamine, which is necessary for movement, motivation, attention span, and setting your body’s idle speed.
- The cerebellum, on the back underside of the brain, is involved with physical, emotional, and thought coordination as well as processing speed.
4 Simple Strategies for a More Focused Brain
If you think you might have Inattentive ADD, there are definitely things you can do to improve your brain’s function. Here are 4 ways to help you increase focus, stay on task, and achieve your goals.- Switch to a higher protein, lower carb diet with lots of fresh greens and vegetables to help boost dopamine.
- Engage in regular exercise to increase blood flow to your brain.
- Consider dopamine-boosting supplements, such as green tea extract and ginkgo biloba.
- Try neurofeedback, a non-invasive (and fun) clinical treatment that can retrain your brain waves to improve your focus and concentration.
Does having ADD/ADHD put you at an increased risk of contracting COVID-19? If the ADD/ADHD is untreated, the answer is yes, according to a new study in the Journal of Attention Disorders. The research involving 14,022 people in Israel found that people with untreated ADD/ADHD are about 52% more likely to have tested positive for the coronavirus illness compared with individuals who don’t have ADD/ADHD.
The researchers found, however, that in people with the attention-deficit disorder who are being treated with stimulant medication, the infection rate for COVID-19 is no higher than in those without ADD/ADHD. In these individuals, the infection rate was about 10%.
WHO’S AT RISK?
An estimated 6.1 million children ages 4-17 have been diagnosed with ADD/ADHD and approximately 8 million U.S. adults have the disorder. However, it is estimated that less than 20% of adults with the condition have received a diagnosis. And of those who have been diagnosed, only about 1 in 4 seek treatment. This adds up to millions of adults who are at increased risk of developing COVID-19 due to untreated ADD/ADHD.
WHAT’S ADD GOT TO DO WITH IT?
What is behind the connection between ADD/ADHD and increased risk? It likely lies in the hallmark ADD/ADHD symptoms, including:
- risk-taking behavior
- impulsivity
- forgetfulness
- inattention
- poor attention to detail
- poor judgment
- difficulty with follow-through
During the pandemic, these characteristics can manifest in potentially harmful ways, such as forgetting to wash your hands, impulsively hosting a wild party with a lot of people, or not following health directives. These actions put people at greater risk of exposure to COVID-19 and to developing the illness.
ADD/ADHD ISN’T JUST ONE THING
What most people don’t realize is that ADD/ADHD isn’t just one thing. Over 30 years of brain SPECT imaging studies at Amen Clinics have shown that there are 7 types of ADD/ADHD. One size does not fit all, and each type has its own set of symptoms and requires a personalized treatment plan. What works for one person with ADD/ADHD may not work for another—or could even make the symptoms worse.
At Amen Clinics, brain scans of people with ADD/ADHD consistently point to decreased activity in the prefrontal cortex (PFC). Typically, when a person without ADD/ADHD tries to concentrate, activity increases in the PFC, but when someone with the condition attempts to concentrate, activity decreases. The harder they try, the worse it gets.
The 7 Types of ADD/ADHD are:
Type 1: Classic ADD: When most people think about attention-deficit disorder they think about this type, which is characterized by hyperactivity, restlessness, impulsivity, disorganization, distractibility, and trouble concentrating.
Type 2: Inattentive ADD: This is the second most common type of ADD/ADHD. People with this type tend to be labeled as slow, lazy, spacey, or unmotivated. They can be quiet and distracted.
Type 3: Overfocused ADD: People with this type have all of the core ADD/ADHD symptoms plus tremendous trouble shifting attention and a tendency to get stuck of locked into negative thought patterns or behaviors.
Type 4: Temporal Lobe ADD: The temporal lobes, which are located underneath your temples and behind your eyes, are involved with memory, learning, mood stability, and visual processing of objects. Learning and behavior problems are commonly associated with this type.
Type 5: Limbic ADD: In this type, ADD/ADHD and depression intersect. The core ADD/ADHD symptoms are present in addition to negativity, moodiness, sadness, low energy, and decreased interest in life.
Type 6: Ring of Fire ADD: Unlike those with type 1 who have low activity in certain areas of the brain, these people tend to have excessive activity throughout the brain. On brain SPECT scans, it lights up like a ring of hyperactivity. Symptoms commonly seen in this type include irritability, hyperactivity, excessive talking, overfocus issues, extreme oppositional behavior, and cyclic periods of calm behavior alternating with intense aggressive behavior. Stimulant medication tends to make these people worse.
Type 7: Anxious ADD: In people with this type it is common for ADD/ADHD symptoms to become magnified and to be accompanied by anxiety, a fear of being judged, predicting the worst, being conflict avoidant, and having physical stress symptoms (such as headaches, stomachaches, muscle tension).
Knowing your type of ADD/ADHD is the key to finding the most effective treatment.
ADD/ADHD, anxiety, depression, 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.
By Rishi Sood, MD, ABPN
Imagine waking up every morning feeling sad, exhausted and hopeless. You go to the doctor and after a brief visit, you are prescribed a medication that is intended to increase serotonin (the “happy” chemical). After 4 to 6 weeks you are told that you should see improvement, but your symptoms get worse. You return to the doctor and are told to discontinue the treatment and over the course of several years go through several medication trials and all sorts of psychotherapy, which do not help. More aggressive approaches are tried. However, Transcranial Magnetic Stimulation, ECT, and Ketamine (used in treatment-resistant cases) fail to provide relief. Over this time period, your marriage ends, you become unemployed and the only purpose to continue living is to see your children grow. Unfortunately, this had been Kevin’s journey when he arrived at the Amen Clinics New York in September of 2017.
When I met Kevin for an initial consultation, he shared that we were his last hope. We agreed that we needed to take a deeper look to determine what we were missing. We began by taking a detailed childhood developmental history.
It was evident that Kevin was exposed to early childhood trauma. His earliest memories were of his parents arguing with the quarrels turning violent when his father would drink alcohol. His older sister would intervene, while Kevin would avoid conflict altogether and use video games to escape reality. Kevin was described by peers and teachers as a shy, introverted, well-behaved boy, but what no one could see is how much Kevin struggled with focus. When teachers would lecture, he would zone out or, as he described it “my brain would shut down.” Completing homework took more than four hours when it should have taken one to two hours to complete. Kevin was able to get “average” grades but often felt inferior as his parents would compare him to Asian peers who were excelling in their tight-knit community. His mother would tell him to work harder and berate him for being lazy. During his adolescence, Kevin turned to marijuana to numb his feelings of inadequacy and decrease overall stress.
Hearing this, I began to think of Kevin’s poor brain. I had an idea of what could be going on but needed to actually look at his brain to really have a clear picture.
When we scanned his brain, several subcortical structures were much more active as compared to healthy controls for his age group. A “diamond pattern” was seen in both resting and concentration states. We often see this pattern in individuals who have experienced emotional trauma and suffer from Post-Traumatic Stress Disorder (PTSD). It was as if Kevin’s brain was on high alert ready to defend against any threat when there was no threat.
It was also evident that Kevin had frontal lobe dysfunction which worsened when he concentrated. The frontal lobe is the “Executive Center” of our brain and governs concentration and short-term memory. This explained Kevin’s struggles in school and in his marriage where he reported: “not being able to keep up with daily responsibilities which led to severe disaccord between me and my ex-wife.”
In order to effectively help Kevin, it was imperative that both systems (frontal lobe and subcortical) needed to be targeted. Upon review of prior treatment plans, both systems were in fact targeted but never together.
The first phase of treatment involved quieting the subcortical circuitry without causing further frontal lobe dysfunction. Our research has shown that a particular class of medications (SNRI-Selective Serotonin Norepinephrine Inhibitors) can drastically reduce depressive symptoms when dealing with these specific brain patterns. We started Venlafaxine (SNRI) and within six weeks Kevin began to report less obsessional thinking, and agitation and was no longer in a constant “fight or flight state.”
To help further decrease the high activity in the emotional trauma circuitry, Kevin completed several sessions of Eye Movement Desensitization Processing (EMDR). During the EMDR therapy, Kevin attended to emotionally disturbing material (i.e. witnessing his father physically abusing his mother). The EMDR therapy facilitated the accessing of his traumatic memory network so that information processing was enhanced, with new associations forged between the traumatic memory and more adaptive memories or information. Kevin reported that the memories “no longer controlled me, it was as if I was free from the past.”
Despite his improvement, Kevin continued to report struggling with attention which made sense as we still had work to do on his frontal lobe. Kevin and I agreed to take more of a natural approach, before adding more medication. We started Omega 3 Power and L-Tyrosine to increase dopamine levels. Within two weeks Kevin reported improved concentration and within three months read a novel cover to cover for the first time in his life.
Kevin understood that taking the medication and supplementation provided the scaffolding to aid in recovery. To take his brain health to the next level he would need to do more. Now that the depression had lifted, he was motivated. Kevin began to exercise (High-Intensity Interval Training 3 times per week) and eliminated processed sugar from his diet. This further increased energy levels and enhanced sleep.
In just 6 months, Kevin’s condition had dramatically improved and he reported having a “new lease on life.”
As I reflect on Kevin’s case, I cannot help but wonder, “What would have happened to Kevin had we not looked at his brain?” I do not believe we would have been able to help Kevin. This case highlights how critical it is to understand the interplay of brain systems and how optimization in a specific sequence can lead to dramatic improvement.
We continue in our quest in helping others, with the hope that one day everyone will have the opportunity that Kevin had. When Kevin changed his brain by doing the things we recommended, he changed his life.
About the Author: Rishi Sood, MD, ABPN
Dr. Sood values working with adults and children across all age ranges. He is experienced in mood and anxiety disorders, addiction, ADD/ADHD, impulsive/disruptive behavior disorders, Autism Spectrum, psychotic disorders, OCD, and PTSD. He uses dynamic as well as cognitive-behavioral therapy, interpersonal psychotherapy, family psychotherapy and works to integrate pharmacotherapy and alternative therapies to optimize brain health and function. Behavioral change is a process and Dr. Sood incorporates a motivational interviewing approach into evaluations to support the client and meet them where they are at, offering client-centered care. He firmly believes that clients do well with continued support in their journey toward optimal brain health.
One of the challenges for people who experience both anxiety and focus issues, such as a combination of PTSD and ADD, is to calm the anxiety without decreasing focus. Many anti-anxiety drugs have side effects of sleepiness and relaxation, calming the brain, but as one woman reported, “they also make me dingier.” On the other hand, when a stimulant like Adderall is used alone to help with focus, it can increase anxiety in those who struggle with it. Often we have to use a combination of supplements or medications to help a client achieve “relaxed focus,” an ideal balance in the brain.
Can Green Tea Help Those With Anxiety & ADD?
A study from Japan has found that daily supplements of L-theanine, an amino acid found in tea, may help people with anxiety also focus on their daily activities. A win-win for many with a dual diagnosis of anxiety with attention deficits. L-theanine may help reduce stress, promote relaxation, and improve the quality of sleep. Though it is found in tea, the level is low (less than 2 percent). So the effective dosage levels (of 100 – 200mg/day) cannot be delivered from drinking tea but must come from a supplement. The new study confirmed the dose of 200 mg for “enhanced performance in visual attention task, and reaction time response, among the subjects with higher anxiety.” The l-theanine appears to work by changing the electrical activity in the brain by increasing alpha waves, measured by EEG. Results of the test showed that highly anxious students receiving the L-theanine displayed a slowing of their heart rate, improved attention and better reaction times, compared to members of the same group receiving placebo. This is a significant improvement over many conventional anti-anxiety treatments that often have side effects of drowsiness, slowed reflexes, or impaired concentration.Other Health Benefits of Green Tea
In addition to reducing stress and promoting relaxation, there are other health benefits associated with green tea. In moderation, green tea is great for an energy boost since it has only half the amount of caffeine compared to coffee and the l-theanine will keep you focused and not craving more and more. Not only does green tea help keep weight off, boost exercise ability, help muscle recover faster from a workout, but it improves attention span as well. At Amen Clinics we encourage our patients to drink unsweetened green tea two or three times a day. Researchers from China found that when people drank two to three cups of green tea per day their DNA actually looked younger than those who did not. To get the brain you want, try practicing healthy brain habits. For instance, if you are relying heavily on coffee, make small changes to wean off coffee and add green tea into your diet. You can have better energy and focus by paying attention to the health of your brain. At Amen Clinics, we want to help you learn more about your brain and how you can make it better, not only for yourself but for the generations that follow. Call us today at 888-288-9834 or schedule a visit. Some days it seems your brain just doesn’t want to focus on anything that needs to get done! Brain fog, stress, and distractions can make your mind start to wander and you might feel like being productive is impossible.Simple Changes for Optimal Focus
By making simple changes to your daily diet and habits, you can become more productive. To help improve your brain power, here are six ways to have better mental focus at work:- Supercharge your diet
- Eat less sugar
- Use supplements to supercharge your brain
- Go to bed a little bit earlier
- Eat organic foods
- Process your thoughts