Wednesday, April 11, 2012

Dopamine and anxiety

Anxiety disorders are probably the most common co-existing disorder for those with inattentive ADHD. What's more dopamine, a neurotransmitter that's extensively involved in ADHD, may also be implicated in anxiety disorders.

According to researchers, some people with anxiety disorders may be suffering from a shortage of dopamine in the amygdala, a part of the brain involved in regulating our "fight or flight" responses to stressful situations

Interestingly when I tried dexamphetamine for ADHD it didn't have much of an effect on my inattention, but it did have a positive effect on my mood and anxiety symptoms. However, I decided to discontinue using the drug as it caused unpleasant rebound symptoms when it wore off.

At present the most frequently prescribed medications for generalised anxiety are the SSRIs (selection serotonin reuptake inhibitors, which include Prozac) which are designed to raise the level of the neurotransmitter serotonin in the brain. However, not everyone responds to SSRIs (in my case they don't seem to have any mental effects at all). Perhaps this research will lead to the development of sustained release drugs will can mildly raise dopamine levels in the amygdala without causing over-arousal or withdrawal symptoms.

Thursday, April 5, 2012

Gender and ADHD

This post will probably raise a few hackles but I came across this article about "ADHD myths" which propagates a few myths of its own.

One of these is the claim that ADHD is just as common among girls and boys.
Now ADHD may be under-diagnosed in girls but doesn't mean the percentage of boys and girls with ADHD are similar for each subtype of ADHD.

In the case of "classic" hyperactive/impulsive ADHD there are definitely more boys than girls with the disorder. You just don't see as many girls with extreme impulsivity or hyperactivity, and with good reason - the parts of the frontal lobes of the brain which control behaviour are usually more developed in girls and boys.

In the case ADHD combined type the gender gap is narrower. While there are probably still more boys than girls have this form of the disorder, it is under-diagnosed in girls and often more difficult to spot. For example, while a boy with ADHD combined type may be physically hyperactive (the most obvious indication of ADHD) a girl may be a "chatty cathy" who talks excessively and is overly dramatic.

In the case of inattentive ADHD, the number of girls and boys with this subtype are about the same. Again, this makes sense from a developmental point of view - inattentive ADHD is not a behavioural disorder like hyperactive/impuslive ADHD, so it doesn't make scientific sense for there to be a big gender difference.

Here's a good article describing how the different subtypes of ADHD tend to appear among girls.

Saturday, March 31, 2012

Hey, easy on the stress! - Inattention ADHD and motivation

People with ADHD like to use stress to overcome procrastination and get things done. That's the message you get from reading most popular books on ADHD. ADDers prefer to leave things to the last minute for example, so adrenaline will provide the essential motivation for the underaroused ADDer to get off his/her rear and get things done.

But as with so many other things you read about in general ADHD literature, it doesn't necessarily apply to those with inattentive ADHD.

ADHD Blogger Tess Messer points to
research showing those with inattentive ADHD tend to have above average levels of the stress hormone cortisol when exposed to moderately stressful situations. By contrast, those with ADHD combined type show normal cortisol levels and those with the hyperactive/impulsive form of ADHD actually have below average levels of cortisol in stressful situations.

In other words, inattentive ADDers appear to be more easily stressed than other ADDers, so what works for the majority of ADDers may not work for those with the inattentive subtype.

Back when I was a young teenager, I tended to leave a lot of tasks for the minute. But by the time I reached university I found this to be so unpleasantly stressful that I actually started projects sooner than most non-ADHD students. Ever since then I've found that the only way to tackle challenging projects is to start them early and try to break them down into small junks. Otherwise I'll simply get overwhelmed and give up.

Stress hormones like cortisol and adrenaline do help with motivation, but at high levels they can significantly worsen your productivity. When you're highly stressed your memory is poor, and it's very difficult to be creative. Similarly, you tend to acquire tunnel vision which makes it hard to work with other people and consider alternative solutions to problems.

Like everyone, inattentive ADDers do need some stress to help with motivation when it comes to difficult or boring tasks, but we certainly don't thrive on ongoing high stress levels, and much of the time our stress levels are already higher than they should

Monday, March 19, 2012


Many popular books and articles about ADHD claim that hyper-focusing is something that ADDers are particularly good at. I've even read articles that list hyper-focusing as a symptom of ADHD. But are ADDers any better at hyper-focusing that other people?

No, not really.

As Jeff points out at Jeff's ADD Mind hyper-focusing isn't a special "gift" that comes with having ADHD, it's something that most people can do when they're engaged in something that really interests them. Book lovers often talk about "not being able to put down" a book that really grabs their interest. Sports fans can spend hours and hours following an absorbing game on TV. It's not that people with ADHD have a special ability to hyper-focus, it's simply that they really struggle to focus on things they don't find interesting. By contrast, people who don't have ADHD can still focus reasonably well on things they find boring.

Maybe there are things that ADDers have a tendency to be better at than non-ADDers (I don't have any strong views either way on this one). However, it's more likely these are in areas that require divergent thinking, like say humour or creativity, rather than things that are related to concentration.

Arguing that a person with an attention deficit is particularly good at attending to things, even if only in certain situations, just doesn't make sense.

Monday, March 12, 2012

Healing beats

Over the last few years, repetitive pre-recorded beats designed to have specific effects on the mind have become very popular on the Internet.

These come in several types including "binaural" and "monaural" beats. Different speeds and frequencies of these repetitive sound recordings can have different effects on the listener. For example, deep-sounding, slower beats tend to be relaxing, while faster, higher pitched beats tend to be arousing. Thus some beats are recommended for helping with issues such as insomnia and anxiety, while others are recommended for improving concentration or mental energy. Having said that, individual responses to these beats vary widely, and what one person finds relaxing another person might find irritating.

In terms of boosting concentration and focus, I've personally found the beats designed for improving IQ to be the most helpful. These seem to be moderately fast beats which relax the body, while making you feel slightly more focused and alert. A good 12 minute sample that can be downloaded for free is the Binaural "IQ increase" mp3 which is available from Longer pre-recording are available for a small fee, although I haven't tried any of these out myself.

Unfortunately, there isn't much scientific evidence that these beats can provide long term benefits for specific mental disorders like ADHD. But given that you can trial them for free (or for a small fee) and there are no reported side effects, I'd recommend giving them a go.

Sunday, March 11, 2012

ADHD and planning

An inability to think ahead is a frequent problem for many people with inattentive ADHD and one that is directly related to the mental sluggishness associated with the disorder.

When your mind is feeling sluggish you tend to drift from one activity to another in an inefficient way. You also tend to miss opportunities to get more than one thing done at a time. However, if thinking ahead becomes a regular habit, than it should be easier for you to get past this mental sluggishness and get things done more efficiently.

A few years back I did a secondary teaching diploma. Unfortunately I haven't been able to find full time teaching work, but I do think the planning aspect of the course has helped some of my ADHD symptoms. Teacher training requires lots of lesson planning and thinking ahead, and since doing the course I find I'm less likely to forget things I need, and generally find it easier to get started on tasks requiring forethought.

I guess any course or activity which involves lots of planning or thinking ahead would be beneficial. Courses in building project management, restaurant or catering management or just organising recreational trips for family or friends are some of the other options to consider. Games like chess, where you have to consider all the different consequences of your actions, might also be useful for stimulating the parts of your brain involved in planning and forethought.

Thursday, March 8, 2012

ADHD and self-esteem

A lot of popular books about ADHD convey the idea that adults with ADHD combined type tend to have low esteem. I'd say it's probably more accurate to say their self-esteem fluctuates. Sometimes their self-esteem crashes after they make big impulsive mistakes, but much of the time they have plenty of self-esteem.

For a start, they tend to be over-represented in work fields like sales and marketing where having a robust ego goes with the territory. If you're timid and self-effacing, then you aren't likely to be a big success in sales.

One of the one famous people believed to have had ADHD combined type was the British Prime Minister Winston Churchill. Having studied the guy at university, I can tell you that he didn't suffer from low self-esteem. If anything, he often overrated his own abilities, and he made a number of over-confident (perhaps impulsive) decisions that turned out badly. For example, he frequently went against the advice of military specialists and got Britain involved in two disastrous military campaigns in Turkey and Norway.

If Churchill suffered from a lack of self-esteem, then it's more likely he would have been criticised for being too indecisive.

It's likely that low-esteem is more common among those with inattentive ADHD. People with people with this form of the disorder, tend to have higher anxiety levels and more have more self-effacing personalities. However, even with this form of ADHD I don't think low-esteem is a particularly big issue.