Attention deficit disorder (ADD) is now called Attention deficit hyperactivity disorder (ADHD) when it became clear there was a hyperactive component.
Despite the stereotype, people with ADHD can be hyper-focused but only focus attention on things of interest.
Dopamine is the neurotransmitter that underlies enjoyment and curiosity – most ADHD pharmaceuticals are stimulants with a play on the dopamine system.
There’s a fine line between street drugs and therapeutics for ADHD: Ritalin is closely related to speed; Adderall closely resembles methamphetamine.
Non-pharmaceutical and behavioral treatments for ADHD may be used in combination with pharmaceuticals with the potential to wean off as possible.
While research for elimination diets has been controversial as a treatment for ADHD, it seems like avoiding simple sugars and exploring allergies to make informed food choices is worthwhile.
Newer studies point to the idea that smartphone use is inducing ADHD in adolescence if used more than 60 minutes per day, and approximately 120 minutes per day in adults.
What Is Attention Deficit Hyperactivity Disorder (ADHD)?
ADHD used to be called attention deficit disorder (ADD) but this was changed in the 1980s when it became clear there was a hyperactive component.
ADHD has a strong genetic component – the probability of AHDH increases the closer in genetics you are related to someone with ADHD.
ADHD has nothing to do with intelligence.
An estimated 1 in 10 children have ADHD – half will resolve with proper treatment, the other half will not.
There’s a question as to whether ADHD is increasing in adults or whether our lifestyles are creating pulls on our attention e.g., phone use, email, social media, etc.
Some markers of ADHD: trouble holding attention, high levels of impulsivity, often high levels of emotionality, challenges with time perception unless given a deadline with consequences, subpar spatial organization, working memory (ability to keep information at the ready to use).
Some people outgrow ADHD over time.
Focus & ADHD
Most people with ADHD can have high levels of focus on things they enjoy.
People with ADHD have the capacity to focus but can’t engage attention on things they don’t really want to do.
Enjoyment and curiosity are the way we describe our experience with things.
From a neurobiological perspective, dopamine underlies enjoyment and curiosity which creates a hyper-focus and state of motivation.
Dopamine release turns on areas that narrow visual and auditory focus.
Dopamine in the context of focus tends to enhance two neural circuits: (1) default mode network (brain areas active when we’re idle); (2) task networks (networks of the brain that make you goal-oriented).
In someone with ADHD or who hasn’t slept well, the default mode network is not synchronized.
Typically, default mode networks and task networks work in opposition under the orchestration of dopamine – in ADHD, these networks are more correlated.
With treatment or age out of ADHD, default networks and task networks work in opposition again.
Dopamine System In People With ADHD.
Low dopamine hypothesis: dopamine levels are insufficient in people with ADHD which leads to unnecessary firing of neurons unrelated to the task at hand.
The low dopamine hypothesis could be why people with ADHD lean on recreational drugs or indulge in non-drug stimulants (i.e., coffee, cigarettes) which increase dopamine in the brain that regulate attention.
Children with ADHD favor sugary foods; adults with ADHD favor stimulants – drug or non-drug.
How To Improve Focus
Adults and children with ADHD have many more “attentional blinks” than those without – there’s a tendency to be over-focused on one thing to the extent that you miss the things around it.
Attentional blinks occur more frequently as we age, with or without ADHD.
Distractibility in people with ADHD could exist because they are so hyper-focused on one thing, they miss other things.
Tips: (1) practice consciously dilating gaze to see more around you; (2) 17-minute mediation session can rewire internal circuitry; (3) blink eyes to reset perception of time – the rate of blinking is controlled by dopamine; (4) fidget spinner/toy.
Dopamine controls attention – blinking is controlled by dopamine – blinking can help you modulate perception of time – blinking and dopamine are inextricably linked and within your control.
Tetrahydrocannabinol (THC) can increase dopamine and level of calm so induce a mellow focus; THC can also change the rate of eye blinking – but it reduces memory so you might focus better but can’t remember what you’re focusing on.
Pharmaceutical Treatments Of ADHD
Many of the pharmaceuticals used to treat ADHD are also used to treat narcolepsy.
Ritalin is one of the first drugs created to treat ADD/ADHD to address low levels of dopamine.
Pharmaceuticals for ADHD closely resemble street drugs: Ritalin is closely related to speed; Adderall closely resembles methamphetamine.
Adderall – a combination of amphetamine and dextroamphetamine – is now the more commonly prescribed drug for ADHD, also increases dopamine.
Treatments of ADHD are stimulants that increase dopamine, norepinephrine, adrenaline.
Consumption of Adderall without prescription is higher than cannabis use: upwards of 25% of people under 30 take Adderall without a clinical diagnosisto improve focus and keep up with work.
If you are a child taking stimulants with ADHD, the brain networks activate at the appropriate times and chemically induces a state of focus, so the child learns what focus is .
Doses should be adjusted across the lifespan with age.
Early treatment if key: neuroplasticity is greatest in early childhood (3-5 years old) and tapers off after age 25
Non-Pharmaceutical Treatments For ADHD
Traditional ADHD pharmaceuticals work by increasing levels of dopamine and norepinephrine.
It’s a fine line between thinking about drugs of abuse and drugs for the treatment.
Best treatments are likely to combine traditional drugs (i.e., Adderall) with behavioral tools to train circuits you are trying to enhance – then possibly tapering off drugs.
Omega-3 can positively modulate pathways for attention and focus.
Dose: above 300mg per day of DHA for attentional effects.
Phosphatidylserine at 200mg per day in children can support improvements in ADHD symptoms in combination with traditional drugs.
Modafinil or armodafinil: weak dopamine reuptake inhibitors.
Alpha-GPC: drugs that increase cholinergic or acetylcholine transmission will increase focus or cognition.
L-tyrosine: leads to an increase in dopamine and can improve focus but dosing is difficult to dial in.
PEA: dopamine stimulating supplement – again, can be difficult to get the dose right.
Racetams: tap into the cholinergic system with high affinity and taps into increased cognitive capacity.
Transcranial magnetic stimulation (TMS): a non-invasive tool that places magnetic stimulation to the brain to lower or increase activity in certain parts of the brain – but precision is not particularly fine.
To read more: Review of atypical compounds for ADHD
Food, Nutrition, And Attention.
People with ADHD are naturally drawn to sugary foods which increase dopamine and can induce some focus.
Elimination diets (oligoantigenic) have been studied in children with ADHD but have been controversial.
Potential things to avoid universally: avoid simple sugars, explore allergies to foods and avoid.
In adults: omega-3s (high in EPAs) have modest effects on improving focus but do allow the person to function better on lower doses of medicine.
EPAs don’t mediate attention and mood but modulate relationship with dopamine.