Healing ADD: Assessing and Working with Your ADD Type
Forgetting your wallet- again. Getting stuck scrolling endlessly on social media. Unable to get out of bed. Not motivated to cook so you get take out again. Constantly daydreaming when you should be working. Feeling discouraged when that to do list gets slowly longer day by day while you see your peers accomplishing things you can only dream of. Does this sound like you? ADD is a complex neurological issue with many unique manifestations. Sadly, although there are many strengths associated with an ADD brain type it is often viewed as a solely negative condition. Psychiatric medications are often presented as the only options for treatment. This can lead to both negative self image and ineffective symptom management.
ADD does indicate a particular neurological brain type that cannot be changed. “Healing ADD” is therefore not about changing your underlying neurology, but rather optimizing it. While the negative aspects of an ADD brain type are usually emphasized, there are incredible strengths associated with this brain type as well. This is not an issue to be “cured”, but rather “cultivated”! People with ADD often have incredible innate skills that others are not blessed with. They tend to think “outside the box”- they are innovators, inventors, and can see many unique possibilities as solutions to problems that would not occur to others. Bright, clever, and unique personalities are common in people with ADD. They might not always be the most organized or detail oriented, but can become experts at tasks they feel passionate about due to their ability to hyper focus when they find something that fits into their sense of purpose. More than others, they have a hard time forcing themselves to care about something that they really do not find important or compelling. That is part of why menial, routine tasks are so difficult for people with ADD. These are the people you want on your creative team, pushing through old ideas and groundbreaking original new concepts.
When we talk about managing ADD, we don’t want to dull the shine of these incredible characteristics. We want to help them shine brighter! Often people with ADD have been told that they are not smart, capable, or organized enough to be successful. They may have had difficulty following directions, waiting in line, taking turns to speak in conversations, or had problems with impulsive or acting out behaviors. They could have gotten labeled as “troublemakers”, “disruptive”, or “special ed” growing up, all of which can negatively affect self image. Another possibility is the anxious and obsessive ADD type, having trouble pulling away from negative thoughts and getting stuck ruminated on unnecessary problems. On the other hand, they may have been the daydreamers, constantly zoned out and distracted, doodling instead of listening, not sure what the rules are or what is expected of them, and generally lost in the shuffle of school or work life. They may have gotten by under the radar until they can’t fake it anymore. Then everything starts to fall apart. Regardless of how your ADD had manifested, our social systems are not set up optimally for these brain types, and as a consequence the focus is driven towards the negative attributes rather than the positive.
The first, most important step in healing your ADD is to get self deprecating phrases such as “lazy”, “procrastinator”, “difficult”, etc. out of your vocabulary. Most people with ADD want more than anything to be productive, motivated, focused, and successful. Their struggles are not for lack of discipline or desire. Negative self perception about a struggle that is happening on a neurological level is not an effective strategy for managing these issues. Read that again.
Accepting that your brain simply works differently is essential as a prerequisite to any progress you make at improving your symptoms. This is not a self defeatist statement. I am not asking you to put your feet up and say “Oh well, I guess this is how I am”. Accepting your difference at its core will allow you to take the action needed to optimize your brain health and allow your ADD symptoms to be more positive than negative. Repeat this phrase to yourself as much as you need to: “My struggles are not character flaws- they are a consequence of my neurological type which has not be nurtured properly and that is not my fault. But I can take the responsibility to improve it now.”
Neurologically, the brains of people with ADD respond opposite to people without ADD when they are asked to focus on a task. Their brain scans begins to look similar to the brain of a depressed person, with reduced activity in the frontal cortex. A person without ADD will get increased activity in the frontal cortex when asked to focus on a task. This is very frequently related to low dopamine activity, the neurotransmitter that causes us to feel motivated, excited, and rewarded by completing tasks. Basically, the ADD brain type has a predisposition for low dopamine and low frontal cortex activity, which can be exacerbated in unhelpful ways by nutrition, lifestyle, and mindset factors.
Once we know this, what can we do next?
Boost Dopamine with Nutrition
Because people with ADD tend to have low dopamine activity, boosting dopamine and other neurotransmitter production is the first step to managing symptoms. We create neurotransmitters from amino acids, and we get the raw materials of amino acids from dietary protein. For people struggling with any neurotransmitter imbalance, I recommend eating a minimum of 12 oz of animal protein a day. While you can get amino acids from protein found in plants, it is not an efficient method of meeting your protein needs, which I have discussed in more depth in another article (here). Dietary protein should come primarily from sources such as meat, seafood, eggs and dairy.
It is also important to cut out compounds that may be inhibiting your dopamine production. The most detrimental foods to dopamine (and neurotransmitter production in general) include artificial sweeteners, artificial food coloring, artificial and natural flavorings, refined sugar, refined seed oils (think canola, soybean, safflower, sunflower, corn oil), gluten and soy. Some people are also negatively affected by corn, oats, and other grains. There are those with ADD who actually do best on a low carbohydrate or even ketogenic style diet. The best way to test it is to try it out for yourself- completely cut out a potential dopamine inhibitor for at least 6 weeks and see if you notice a difference.
Sometimes food is not enough to correct a significant deficiency, and supplementing can be helpful in the short term. Specific dose recommendations must be done on an individual basis, but good places to start experimenting are:
-Fish oil (600mg/day up to 4,000mg/day- careful because it can have a blood thinning effect at high doses)
-D3 (I always recommend taking this with A and K like in the Bulletproof brand A,D,K complex. Start with 1,000IUs/day but can increase up to 10,000IUs/day- getting your blood levels tested is usually simple, cheap and can be very helpful to know if this is indicated)
-L-Tyrosine (the direct amino acid precursor to dopamine. Start with 500mg/day in the morning and can be increased up to 5,000mg/day, split between morning and early afternoon)
-D,L Phenylalanine (another amino acid that promotes energy, motivation and focus by increasing dopamine production- start with 500mg/day in the morning and can be increased up to 5,000mg/day, split between morning and early afternoon)
Again, the exact dosages and combinations of these supplements will vary from person to person. Self experimentation is often a necessary part of individualizing any protocol.
Other Neurotransmitter Support
The supplements above are indicated for a classic, inattentive style of ADD- however, not all ADD brains are built the same. For people who have a highly agitated or anxious style of ADD, these supplements (and commonly prescribed psychiatric medications for ADD such as adderoll and Ritalin) may actually make symptoms worse. The other factors involved in an individual’s specific ADD type must also be addressed. In his book “Healing ADD”, Dr. Amen actually identifies SEVEN different types of ADD that each require a different type of treatment plan! To get much more detailed recommendations, I highly suggest his book. However, here is one helpful tip:
For people with an obsessive/compulsive type of ADD who tend to get stuck in negative thoughts and compulsive, destructive behaviors, they may need to support their serotonin production alongside their dopamine production. This also includes any behaviors such as tics, intrusive thoughts, difficulty with seeing and understanding nuance (extreme black and white thinking), and irrational anxieties. Take the dopamine supportive supplements as listed above, but also include the serotonin supportive supplements listed below.
My recommendations for serotonin support include:
-5-HTP (the precursor to serotonin. Start with 50-100mg/day taken in the evening. Can increase to 300mg/day, split between afternoon and evening)
OR (both 5-HTP and St. John’s Worst together are generally not needed- try one and then the other)
-St. John’s Wort (a wonderful herb that does not require conversion by the thyroid to support serotonin production. Start with 300mg/day in the evening and can increase to 1800mg/day, split between afternoon and evening)
For people with an aggressive, agitated type of ADD who tend to engage in oppositional behaviors, become irritable and angry easily, have sensory overload, and may have dark, suicidal and paranoid thoughts, they may need to support their GABA and acetylcholine production alongside their dopamine production. This includes extreme learning and behavioral difficulties, quick temper, rage explosions, panic, and frequent headaches.
My recommendations for GABA and acetylcholine support include:
-L-Theanine (the amino acid precursor to GABA. Start with 200mg/day at bedtime. Can be increased up to 400mg/day)
-Holy basil (this is an adaptogen herb that is very calming for the brain. Start with 500mg/day in the evening and can increase to 2,000mg/day)
-Magnesium glycinate or magnesium threonate (can help calm an overly stressed brain. Start with 400mg/day with dinner and can increase to 1200mg/day. Reduce if you get loose stools)
Lifestyle and Mindset
The importance of exercise: exercise is one of the simplest ways to boost dopamine and improve activity in the frontal cortex. Even 30 minutes 4x/week can make a huge difference in the ADD brain, but some people do best with daily exercise. This does not have to be any type of exercise in particular, and can be accessible to any body size or ability level. Simply enjoying the feeling of moving your body will provide this effect.
Limit consumption of neurotransmitter reducing substances: many people with ADD look to things like alcohol, marijuana, caffeine, nicotine and other, harder drugs as a form of self medication. And understandably- they do it because it works! The problem is, it only works in the short term, by giving a brief boost of reward chemicals to the brain. In the long term, these substances actually work against you by lowering your ability to naturally produce the neurotransmitters you need to feel balanced. Limiting and even eliminating your intake of these substances will be difficult at first, but improve your brain health immensely over time.
Eliminate guilt based thoughts: as I mentioned before, it is very common for people with ADD to have abysmal self worth and a negative self perception. Their brain is often riddled with thoughts to the effect of “I should do x”, “I ought to be able to y”, “I have to be able to do z or I’m a [insert insulting term here]”. The body responds to these types of thoughts as a stress, which inhibits both your physical neurotransmitter production and your capacity to feel intrinsically motivated to do good things for yourself. The reality is, negative reinforcement does not work. It has not been shown to be an effective means of changing behaviors. Praise and encouragement is much more beneficial, especially for people with ADD. One of the worst things you can do to a person with ADD is yell at them or get angry at them and expect a change. That includes getting angry or upset with yourself. Try to reframe your thoughts into motivating ones that promote a sense of innate self worth and excite you to engage in healthy practices. For example, “I know I deserve to be able to x”, “It will really help me if I do y”, “I know it’s in my best interest to do z”.
Do what actually works, not what you think you should: Many methods of successfully working with an ADD brain involves fitting your environment to match your needs, rather than trying to adjust yourself to match someone else’s ideal environment. Even if it feels silly, if yoou are able to be productive and successful, it is something you need to do. Maybe you need a trash can in every room in your house so trash doesn’t accumulate. Maybe you need a line of shelves by your front door where you lay out everything you need to take when you leave the house. Maybe you can’t have doors on your cupboard so you remember to take your supplements when you see them in the morning. Whatever it is, if it works- do it!
Write a statement of a purpose: probably the most abstract but very effective way to boost your dopamine is to engage in actions that give you a sense of purpose. People with ADD are actually quite good at focusing when it is something they actually care about. Take some time to sit down and answer the following questions. You can write by hand, type, or record yourself talking, whatever feels most accessible to you.
-What you are here for?
-Why do you want to optimize your brain health?
-What will it allow you to do differently?
-Why is this important to you?
Again, the point of healing ADD is not to change your innate brain type. It is to optimize your brain function so that your ADD strengths can truly shine. People with ADD have the potential to be trailblazers, and can often see possibilities that other people cannot. Witty and intelligent personalities are common in people with ADD. These strengths are often repressed due to negative experiences in their families, schools and workplaces that have made their sense of self worth dwindle. But we can undo this damage and take clear, simple steps towards improving your brain health, so that they can successfully share their unique abilities with the world.