4.7 Talk with your patients about Attention Deficit Disorders and Metabolic Syndrome
For those suffering with attention deficit disorder(s) there’s a high correlation (70%) with weight gain and the development of metabolic disorders [109]. Since mitochondrial dysfunction is a causal factor for the development of attention deficit disorders [110], it’s not surprising that ADHD is associated with an increase in oxidative stress and neuroinflammation [111] the development of type 2 diabetes [112], digestive factors including gut health and the microbiome [113] and dysregulation of neurotransmitter activity [114].
One common misconception is that a person with an overactive mind must also be physically active, and this simply isn’t true. What we do know is that for those with ADD or ADHD, there are multiple factors in play [109]. These include physiological factors such as impaired sleep patterns, abnormal (dysregulated) eating patterns, appetite dysregulation, as well as behavioral factors such as impulsivity, a lack of time/body awareness, and oddly, deliberate suppression of hunger cues [109] or sensations that can result in rebound episodes of binge-eating [114]. When we accept that there are multiple factors that can give rise to ADD and ADHD, then it’s easy to recognize that integrated approaches are optimal to mitigate and modulate some of the associated moods and behaviors.
ADHD and Mood Disorders
A history of emotional instability, as well as conditions related to anxiety and depression, are common for those suffering with ADD and ADHD. This makes sense given the persistent frustration (and fears) associated with completing daily activities, feeling inadequate when compared with peers, and feelings of hopelessness or despair when activities don’t go well. There’s unrelenting worry as well as elevated stress associated with forgetting things, losing things, and letting people down. Sometimes all of these are happening at the same time, multiple times a day.
Where there’s also a history or environment of criticism, punishment, teasing, or ridicule, it’s easy for the fear of failure to take hold. This fear and others can result in low self-confidence, feelings of shame and inferiority, and often episodes of unpleasant emotional flooding. Already predisposed to impulsivity, it’s easy to understand how someone struggling with the misery of ADHD might find UPF and other foods high in sugar, caffeine, or simple carbs extremely attractive. When these products are consumed there’s the immediate increase in dopamine and other neurotransmitter activity, feelings of relief from stress, and let’s face it, pleasure! It’s the relief from relentless stress that increases the risk or likelihood of developing addictions to mood and focus boosting substances and activities.
ADHD and the Brain.
Under normal circumstances, Brian (HPA Axis character in Breakthrough! courses) is pretty challenged to optimize brain and body functioning and keep the peace with Betty (Amygdala character) and the Hippo (Hippocampus) . But unregulated or untreated ADHD stresses Brian to a whole new level. Instead of being able to monitor and regulate systems, he’s engaged in a constant game of neuro Whack-a Mole from the moment we wake until we finally fall back asleep. That’s brings up another problem though. Individuals with ADHD have a horrible time getting to sleep, as well as getting enough sleep. This constant state of sleep deprivation, combined with unrelenting stress increases both appetite and the desire to consume products high in sugar and other energy boosting chemicals.
It may seem counterintuitive that a person suffering with ADHD would crave the thrill of high-risk activities when overstimulation is already a challenge, but many do. The attraction is less the thrill than the experience of being completely present; wholly engaged and consumed by the task of staying alive. An experience that can be enjoyed without the need for overriding cognitive control, self-monitoring, and self-management. Being “in the flow” is the experience of being entirely aligned and absorbed by all the elements of an activity on both conscious and subconscious levels of functioning. Attractive activities are those that do not demand the discipline and self-talk that may be entailed n sitting down and writing a paper, or completing a long-term project. For a cyclist this may involve sensory awareness of wind on striking cheekbones and the sound of tires crossing changing terrain. Awareness of the intuitive muscle-brain magic of being at one with the bike through challenging turns, or the gamesmanship of dodging rocks, potholes or traffic.
Unfortunately, similar “all-consuming risk-taking” sensations can come from much more sedentary activities like gaming, virtual reality experiences, and amusement park rides. It’s pretty easy to understand why sedentary activities like these are so attractive to individuals with ADHD. It’s literally the easiest way to escape the misery of trying to function in a demanding global system that relentlessly promotes multi-tasking and immediacy, coupled with unrealistic expectations.
We probably need to take time to step back and recognize that our brains (and bodies) were not constructed for the accelerated pace of life we’re now trying to sustain. Thousands of years of human evolution spent coexisting with the natural circadian and seasonal pace of our planet, did not prepare us to quickly adapt to the artificial pace of our super-hyped world. While attention deficit disorders are legitimately a brain dysfunction, we have to consider whether or not what we’re asking or expecting of ourselves is reasonable, and supportive of our well being and peace of mind.
Recognition: Are you managing your expectations and commitments or are they running you?
Working with ADHD
Integrated care is essential for working with ADHD, especially when there are health related conditions such as type 2 diabetes, cardiovascular disease, and more. Just like other disorders we’ve discussed, those with ADD or ADHD benefit from a thorough psychiatric evaluation. Along those same lines, medication alone rarely fixes any disorder. It’s important to also consider lifestyle changes that include:
- Physical activity.
- Understanding nutrition and food choices.
- Stress management.
- Time awareness and task management.
- Recovery from other mental health conditions.
- Implementing and practicing organizational skills and techniques.
ADHD – Our Grandparents Gave Us the Best Advice!
Our grandparents often uttered adages (wisdom of the ages) or “sayings” that at times, may have seemed annoying. Annoying until we realize decades later, how much truth there is, and how helpful they really are. The first of these saying is:
One thing at a time. We aren’t designed for multi-tasking and in fact, thinking we might do this well is simply a myth we tell ourselves. Whenever possible just do one thing at a time – particularly if you happen to be driving or fly airplanes for a living.
A place for everything – and everything in its place. Parents and educators used to require that children put things away at the end of one activity before starting another. This was to help children develop self-discipline and establish habits that support organization and avoid cluttered chaos. Take 15 minutes twice a day to pick up, sort, and re-distribute. If you have children, have them participate.
A stitch in time saves nine. Back in the day before the advent of disposable everything, clothes were cherished and meant to last more than a day. Rather than throwing clothes away if a thread pulled loose or a button got loose, people broke out a needle and thread and carefully repaired the item before the seam opened up or the button was lost. Obviously though this saying is really about taking care of small problems before they become bigger (and more expensive) ones. Deal with the small stuff before it becomes big stuff.
For every minute spent organizing, an hour is earned (B. Franklin). Lists and planners are helpful when we’re trying to plan for events, responsibilities, expectations, and task completion. When it’s written down, our brain can relax as long as we have the discipline to maintain the planner and actually use the reminders we write for ourselves! Many people rely on electronic devices for time management and task completion however…for those with attention deficit a written list may help avoid falling down the internet rabbit hole of notifications and distractions. Make realistic schedules, minimize interruptions, and adhere to healthy routines to avoid impulsivity and frustrating brain games of Whack-A-Mole.
We hope you have enjoyed this article. One of over 160 topics in the Turnkey BreakThrough! Course for Mental and Metabolic Health Recovery. Come Take Your Seat at the Table…Wherever Your Table May Be! TM
Heather Hamilton PhD 2023