The Common Ground In ADHD Treatments

I'd like to point you all in the direction of this forum post over at addforums.com.

User bof00 has put together a brief sort of thesis about how, basically, a very specific brain process called BDNF (brain-derived neurotrophic factor) is at the heart of all ADHD treatments. He (she? sorry, bof00!) then cites sources indicating how everything from exercise to omega 3 to meditation to medications have been proven to up the BDNF.

So what is BDNF?

Basically (and this is my half-assed layperson's understanding, mind), BDNF is what makes neuroplasticity happen. Neuroplasticity, of course, being the brain's ability to develop itself into something different, to grow and improve through all stages of life.

Anyway...go read it!

Vyvanse

I have an announcement to make: for the first time in five years, I am once again taking medication for my ADHD.

That's right: I'm now taking Vyvanse, a newer time-release stimulant. It's going very well, but more on that in a minute.

Alternative Treatments

So...have you heard about these alternative treatments for ADHD?

You know...exercise, high-protein diet, omega 3, magnesium, zinc, crawling therapy, music education therapy, neuroplasticity therapeutic approaches, cerebellum development exercises, meditation, medicinal marijuana, homoepathic treatments, chiropractic treatments, neurofeedback, gluten-free diet, or anything you may have heard of as being beneficial as a treatment for ADHD?

ALL LIES!! Scams! Snake oil!

Any positive effects you may have experienced with any of these treatments are purely a figment of your imagination.

/sarcasm

ADHD Medication: Things to Consider

Since I write a blog that's largely concerned with natural coping mechanisms for ADD you, might think I'm opposed to medication. I'm not, actually, but I do have some pretty strong feelings on the subject nonetheless. I thought I should write a post to clarify, and to use as a point of reference, later.

In truth, I believe that medication can be a very fine thing and an important part of many people's coping and recovery. I myself took two kinds of medication at different points in my teenage and young adult years; Ritalin for a couple years in high school and Strattera for a couple years in college. In addition to the extra boost of help these drugs gave me during critical times in my life, they taught me an important lesson about the differences between my brain and those of most people and what it could feel like to live with less disability. A lot of the positive effects of these drugs became permanent as I strove to achieve the same level of performance without them that I had with them.

Procrastination

Image courtesy of Daily Pictures.

The above is a somewhat famous product of that wonderful internet meme, the demotivational poster. As you can see (provided you're not reading this post months or years after the image link breaks), it reads, "Procrastination: Hard work often pays off after time, but laziness always pays off now."

There is, of course, quite a lot of obvious truth in that cynical statement. Still, most of us learn at a young age that what is best for the present moment is not always what is best for the future moment, and that future moments have a nasty habit of turning into new present moments. We also learn that many of those new present moments can, with the help of hard work we've done in the past, yield some very excellent results that don't come of seeking quick rewards. So we figure out how to forego instant gratification for the sake of the sake of long-term security in our lives and the pursuit of complex ambitions with big and/or sustained payoffs.

For those of us with ADD, however, that learning process never quite seems to gel. Sure, everybody struggles with procrastination and discipline throughout their lives, but for us, these troubles are a constant, oppressive companion.

Study of neurology has, in recent years, finally started to confirm what so many of us have felt in our hearts but often never dared say; it really is harder for us. Certain areas in the prefrontal cortex of the brain never activate for us the way they do for others, areas devoted to impulse suppression that should be assisting us in overcoming our procrastination. When people say, "mind over matter," this may very well be the part of the mind they're talking about.

So we get through life as well as we can without it. Those of us that can motivate ourselves enough to be high-functioning usually do it through a complex system of guilt and self-recrimination mechanisms, fueled by the memory of childhood shaming by family and teachers. We don't have the power to overcome our impulses, so we manipulate them with negative emotion, just as adults learned to do with us in childhood. Those of us who have found some level of reprieve through medication know that something magical happens when a pill works for you; something switches on that was never there before, a part of the brain that we've always been aware should be there, but isn't.

All of this should seem to point pretty readily to the conclusion that the issue for us is a pure hiccup in neurological development, an immutable difference in our brain biology. And yet...I don't really feel like the fundamental reasons for my procrastination are all that different from those of most other people.

The language we use to talk about procrastination tends to be unquestioningly harsh and judgmental. We shame people for "laziness" and view a lack of ability to self-motivate, organize, and place the nose to the grindstone as a moral failure, a form of selfishness.

I think this is why, when ADD research comes along and seems to say, "Hey, it's not their fault, their brains don't work," it often triggers a jealous response in people. After all, why should we get a free pass when no one else does? You can often find a similar judgement response to other mental health diagnoses, or even to people with limiting physical ailments.

However, there is a potential paradigm shift occurring in our understanding of "laziness," one that takes a hard look at the simplistic, moralized view of these issues and looks at the psychological roots of procrastination.

One book I highly recommend along these lines is Jane Burka and Lenora Yuen's book, "Procrastination: Why You Do It, And What To Do About It NOW." The essential thesis of this book is that procrastination is caused by fear, sometimes deep-seated insecurities, connected to the action at hand. Fear of failure, essentially, prevents you from trying because hey, if you don't put your best effort into life (or some area of life), at least you can hang on to the idea that if you ever did really try, you'd succeed.

I honestly don't think the psychological roots of ADD procrastination are any different from that. Certainly, there is a biological component; for most people, these fears haven't catalyzed into the same severity of neurological limitations. Those prefrontal brain parts (as I've learned from Dr. Mate) actually filter and control emotional impulses, making them easier to overcome through willpower.

All this means is that if you have ADD, it's all the more important that you deal with the root emotional causes of your avoidance issues. And yet, all too often, ADHD treatment starts and ends with medication, shrugging its shoulders and pointing to the reality of altered brain chemistry as if it were an impassable obstacle.

I know from my own experience that with the right approach, you can greatly lessen the impulse to procrastinate. It's all a matter of convincing yourself that really, those short term gains aren't the best you can ever hope for.