ADHD & How Anyone Can Improve Their Focus

Episode 37 Sep 13, 2021 Episode Page ↗
Overview

This episode explores ADHD, its biology, myths, and treatments. It covers behavioral and pharmacologic tools to improve focus for individuals with and without ADHD, discussing dopamine's role, attentional blinks, and smartphone impact on attention.

At a Glance
23 Insights
2h 15m Duration
20 Topics
13 Concepts

Deep Dive Analysis

Introduction to ADHD and Focus Enhancement

ADHD: Genetics, Intelligence, and Prevalence

Defining Attention, Focus, and Impulse Control

Hyper-focus, Time Perception, and Working Memory in ADHD

Dopamine's Role in Attention and Neural Circuits

Low Dopamine Hypothesis and Stimulant Self-Medication

Prescription Stimulants: Ritalin, Adderall, Modafinil

Widespread Non-Prescribed Stimulant Use and Risks

How Stimulants 'Teach' ADHD Brains to Focus

Considerations for Early Medication in Childhood ADHD

Diet and ADHD: Elimination Diets and Sugar

Omega-3 Fatty Acids and Phosphatidylserine for ADHD

Modulation vs. Mediation of Biological Processes

Attentional Blinks and Open Monitoring Training

Eye Blinking, Dopamine, and Time Perception

Managing Reverberatory Neural and Physical Activity

Cannabis Use and Interoceptive Awareness in ADHD

Nootropics: Alpha-GPC, L-Tyrosine, PEA, Racetams

Transcranial Magnetic Stimulation (TMS) for ADHD

Smartphone Use and Induced Attentional Deficits

Attention/Focus/Concentration

These terms refer to perception, how we perceive the sensory world. They are essentially the same thing for this discussion, distinguishing them from impulse control.

Impulse Control

This is the ability to limit our perception by pushing out or putting blinders on sensory events in our environment. People with ADHD often have poor impulse control.

Hyper-focus

An intense ability to focus on things one enjoys or is intrigued by. This phenomenon can occur even in people with ADHD, demonstrating their capacity to attend under certain conditions.

Working Memory

The ability to keep specific information 'online' and recycle it in the brain for immediate or short-term use. Deficits in working memory are common in people with ADHD.

Dopamine

A neuromodulator that creates a heightened state of focus, narrows visual and auditory attention, and drives motivation. Its release is crucial for directing attention to specific things in the environment.

Default Mode Network

A network of brain areas active when an individual is not engaged in any specific task, underlying states of idle thinking or mind-wandering.

Task Networks

Networks of brain areas that are active when an individual is goal-oriented, involved in suppressing impulses and directing behavior towards a specific objective.

Low Dopamine Hypothesis of ADHD

This hypothesis proposes that insufficient dopamine levels in particular brain circuits lead to unnecessary firing of neurons, causing distractibility and difficulty focusing in individuals with ADHD.

Modulation vs. Mediation

Mediation means a compound directly causes a biological process (e.g., dopamine mediates motivation). Modulation means a factor indirectly supports or adjusts a process (e.g., sleep modulates attention by making dopamine more available).

Attentional Blinks

A momentary lapse in attention where, after identifying one target, the nervous system misses other information immediately following it. People with ADHD tend to experience more attentional blinks.

Open Monitoring

A state of broad, dilated visual gaze and awareness that allows the brain to process more information faster without experiencing attentional blinks. It can be trained to enhance focus.

Interoceptive Awareness

One's sense of their own internal bodily state, such as heartbeat, breathing, or the contact of skin with a surface. Studies show people with ADHD have similar levels of this awareness as others.

Transcranial Magnetic Stimulation (TMS)

A non-invasive technology that uses magnetic coils placed over specific brain regions to either lower or increase neural activity. It is being explored for treating ADHD by stimulating task-directed prefrontal cortex areas.

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What is ADHD and how is it diagnosed?

ADHD is Attention-Deficit Hyperactivity Disorder, characterized by challenges with attention, impulse control, and sometimes hyperactivity. It should be diagnosed by a psychiatrist, physician, or clinical psychologist based on clear criteria.

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Does ADHD relate to intelligence?

No, ADHD has no relation to intelligence, whether measured by standard IQ tests or other forms like emotional, musical, or spatial intelligence.

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Why can people with ADHD sometimes hyper-focus?

People with ADHD can achieve hyper-focus on activities they genuinely enjoy or are curious about because these activities trigger dopamine release, which narrows attention and boosts motivation.

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What is the 'low dopamine hypothesis' of ADHD?

This hypothesis suggests that low dopamine levels in specific brain circuits lead to excessive, irrelevant neuronal firing, making it difficult to focus and control impulses in ADHD.

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Why do stimulants like Adderall calm children with ADHD?

Stimulants increase dopamine, which helps coordinate neural circuits for focus. In children, whose brains are highly plastic, this chemically induced focus helps them learn what focus feels like and how to engage it.

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Can diet influence ADHD symptoms?

Yes, eliminating simple sugars can have a dramatic positive effect on ADHD symptoms. Some studies also suggest eliminating foods to which a child has mild allergies can improve symptoms.

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How do omega-3 fatty acids affect ADHD?

Omega-3 fatty acids, particularly DHA (above 300mg/day), can modulate attention and focus, potentially allowing for lower medication doses or, in rare cases, eliminating medication.

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What is an 'attentional blink' and how can it be reduced?

An attentional blink is a momentary lapse in attention where identifying one target causes you to miss subsequent information. A single 17-minute session of quiet interoceptive focus (meditation-like) can significantly reduce these blinks.

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How does eye blinking relate to attention and time perception?

Eye blinks reset our perception of time, and the rate of blinking is controlled by dopamine. People with ADHD, having lower dopamine, tend to underestimate time intervals and blink more, contributing to time disorganization.

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How can physical movement help with focus?

Engaging in subtle, repetitive physical movements (like foot tapping or using fidget toys) can shuttle 'reverberatory activity' from pre-motor circuits, allowing other parts of the body and mental attention to remain focused.

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Are people with ADHD less aware of their internal state (interoception)?

No, studies indicate that people with ADHD have similar levels of interoceptive awareness (sense of internal state) as those without ADHD. Their challenges are with cognitive state and external focus.

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What are the risks of prescription stimulants and non-prescribed use?

Prescription stimulants (Ritalin, Adderall, Modafinil) are chemically similar to street drugs and carry risks like addiction, sexual side effects, and cardiovascular problems. Non-prescribed use is widespread and carries the same dangers.

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How does smartphone use affect attention?

Constant context switching and rapid information turnover on smartphones can induce ADHD-like symptoms and diminish capacity for meaningful work. Adolescents should limit use to less than 60 minutes/day, adults to less than 2 hours/day.

1. Limit Adolescent Smartphone Use

Adolescents should limit smartphone use to less than 60 minutes per day to avoid significant decreases in attentional capacity and maintain focus on other tasks.

2. Limit Adult Smartphone Use

Adults should aim to limit smartphone use to two hours per day or less to prevent severe attentional deficits and maintain focus, as excessive context switching on phones diminishes capacity for meaningful work.

3. 17-Minute Interoceptive Stillness

Engage in a 17-minute practice of sitting quietly with eyes closed, focusing on internal states like breathing and skin contact, as this can significantly and near-permanently reduce attentional blinks and improve focus.

4. Practice Panoramic Vision

Consciously dilate your visual gaze to engage panoramic vision (open monitoring), which allows the brain to process more information faster and recognize multiple targets, thereby reducing attentional blinks and improving focus.

5. Pre-Focus Physical Activity

Engage in physical movement or activity before attempting to focus on a mental task, as this can help dissipate “reverberatory activity” in the nervous system, making it easier to sit still and concentrate.

6. Use Fidgeter Toys for Focus

For children and adults with ADHD or difficulty sitting still, use fidgeter toys or subtle physical actions (like tapping a foot or bouncing a knee) to engage pre-motor circuits, which can enhance mental focus by providing an outlet for physical energy.

7. Regulate Blinking for Focus

Consciously control your blinking rate and visual fixation on targets, as blinking influences time perception and dopamine levels, which in turn regulate attention and focus.

8. Deliberately Engage Interest

If struggling to focus on mundane tasks, deliberately delude yourself into believing the material is highly interesting, as this engagement of the “desire to know” circuit (involving dopamine) can enhance focus and memory.

9. Eliminate Simple Sugars (ADHD)

Children with ADHD should avoid high sugar and simple sugar foods as much as possible, as observed by pediatric neurologists to have a dramatic and positive effect on symptoms.

10. Investigate Food Allergies (ADHD)

For children with ADHD, investigate existing mild food allergies, as eliminating these foods (oligo-antigenic diet) may significantly reduce ADHD symptoms, potentially allowing for less or no medication.

11. Supplement Omega-3s for Focus

Adults with ADHD or mild attention deficits should consider supplementing with omega-3 fatty acids, aiming for 1000-2000mg or more of EPA and at least 300mg of DHA daily, as this can modulate attention and potentially reduce medication needs.

12. Phosphatidylserine for ADHD Children

Children with ADHD may benefit from supplementing with 200mg of phosphatidylserine daily for two months, especially when combined with omega-3 fatty acids, to reduce ADHD symptoms.

13. Alpha GPC for Cognitive Focus

To enhance focus and learning, consider supplementing with Alpha GPC (a form of choline) at 300-600mg, as it increases acetylcholine transmission in the brain, which is vital for cognitive focus. (Caution advised, check with doctor for higher doses or underlying conditions).

14. L-Tyrosine for Dopamine

Consider L-Tyrosine (an amino acid precursor to dopamine) to improve focus, but approach with caution due to wide dosage ranges (100-1200mg) and potential for over-stimulation or mood dysregulation, especially with underlying psychiatric conditions.

15. PEA for Dopamine Stimulation

Explore PEA (phenylethylamine) as a dopamine-stimulating supplement to potentially increase focus, but be aware that dosage can be tricky and caution is advised due to its impact on the dopamine system.

16. Racetams for Cognitive Capacity

Investigate racetams like Nupept (e.g., 10mg twice daily) to enhance cognitive capacity, as they stimulate the acetylcholine system, similar to Alpha GPC, and may be beneficial for focus, especially after brain injury or for cognitive decline. (Note: legality varies, consult doctor).

17. Early ADHD Treatment is Key

For children diagnosed with ADHD, early treatment with medication (under physician guidance) can help frontal, task-related circuits develop appropriate functioning and teach kids how to focus in various contexts.

18. Combine Medication with Training

If using prescription ADHD medication, combine it with behavioral training (e.g., visual focus tasks, interoceptive exercises) to leverage the brain’s enhanced plasticity under medication, aiming to train circuits for focus and potentially reduce reliance on drugs over time.

19. TMS for Focus Enhancement

Explore Transcranial Magnetic Stimulation (TMS) as a non-invasive treatment for ADHD and focus enhancement, as it can stimulate specific prefrontal cortex circuits involved in task-directed states, especially when combined with focused learning tasks.

20. Supplement Vitamin D3K2

Supplement with Vitamin D3K2, as D3 is essential for brain and body health (many are deficient even with sun exposure) and K2 regulates cardiovascular function and calcium.

21. Morning Electrolyte Hydration

Dissolve one packet of an electrolyte drink (like Element, which has sodium, magnesium, potassium, and no sugar) in 16-32 ounces of water and drink it first thing in the morning and during physical exercise to ensure proper hydration and electrolyte balance.

22. Utilize NSDR for Energy

Use meditation apps like Waking Up, particularly for Yoga Nidra or Non-Sleep Deep Rest (NSDR) protocols, to restore cognitive and physical energy with sessions as short as 10 minutes by lying still with an active mind.

23. Avoid Self-Diagnosing ADHD

Do not self-diagnose or diagnose others with ADHD; a professional psychiatrist, physician, or clinical psychologist should make the diagnosis based on clear criteria.

People with ADHD can have a hyper-focus, an incredible ability to focus on things that they really enjoy or are intrigued by.

Andrew Huberman

Dopamine is acting like a conductor. Dopamine is saying this circuit should be active, then that circuit should be active.

Andrew Huberman

The pauses in music are just as important as the actual playing of notes.

Andrew Huberman

If you see something that you're looking for or you're very interested in something, you are definitely missing other information.

Andrew Huberman

When you blink, it's a take.

Andrew Huberman

Marijuana seems to increase people's focus, but then they can't remember what they were focusing on.

Andrew Huberman

The brain does not do well with constant context switching, meaning it can do it, but it diminishes our capacity to do meaningful work of any other kind.

Andrew Huberman

17-Minute Focus Enhancement Protocol

Andrew Huberman (referencing published accounts)
  1. Sit quietly with eyes closed.
  2. Do not direct your mind into any particular state or place.
  3. Simply think about your breathing and focus on your interoception (how your body feels).
  4. If your mind drifts, gently bring it back to your breathing and internal state.
  5. Continue for 17 minutes.

Fixation-Focused Training Activity for Elementary School Students

Andrew Huberman (referencing a study)
  1. Engage in a series of physical movements to release excess energy.
  2. Focus visual attention on a relatively close object (e.g., your hand) for 30-60 seconds, consciously overriding the desire to blink if possible.
  3. Shift focus to a point further across the room for a similar duration.
  4. Shift focus to an even further point across the room for a similar duration.
  5. Repeat daily for a few minutes.
Up to 75%
ADHD concordance in identical twins Probability if one identical twin has ADHD.
50-60%
ADHD concordance in fraternal twins Probability if one fraternal twin has ADHD.
10-25%
Likelihood of ADHD with one parent having it Range of probability for offspring.
1 in 10 (10-12%)
Prevalence of ADHD in children Current estimates for children with ADHD.
About half
Resolution rate of childhood ADHD Proportion of cases that resolve with proper treatment.
Up to 25%
College students taking Adderall without diagnosis Estimated percentage.
As many as 35%
Young adults (17-30) taking Adderall without diagnosis Estimated percentage.
< 0.0001
P-value for oligo-antigenic diet study effects Probability value indicating very low chance of results being random.
100 children
Subjects in oligo-antigenic diet study 50 in elimination diet group, 50 in control group.
1,000 milligrams or more
Recommended EPA dosage for mood/cardiovascular benefits Daily intake of EPA component of omega-3 fatty acids.
300 milligrams per day
DHA threshold for attentional effects Threshold level of DHA component of omega-3 fatty acids for attentional benefits.
200 milligrams per day
Phosphatidylserine dosage for ADHD in children Taken for two months, shown to reduce ADHD symptoms in children.
147 and 36 subjects
Subjects in phosphatidylserine studies Two double-blind studies on boys and girls aged 1-6 or 7-12.
Up to 1200 milligrams per day
Alpha-GPC dosage for age-related cognitive decline High dosage, typically spread throughout the day.
300-600 milligrams
Alpha-GPC dosage for general focus/learning More typical dosage for enhancing learning and focus.
10 milligrams twice daily
Nupept dosage Shown to be effective for mild cognitive disorders.
Less than 60 minutes per day
Smartphone use limit for adolescents To avoid decreased attentional capacity, based on a 2014 study of 7,102 adolescents.
Less than 2 hours per day
Smartphone use limit for adults Estimated upper limit to avoid severe attentional deficits.