Can ADD Ruin Your Life? The Answer is Yes.

ADD is a brain based disorder. As such, it is important to learn about your brain and how we look at it. The human brain typically weighs about three pounds and it has the consistency of soft butter. Unfortunately, it is housed in a very hard skull that has many sharp boney ridges and was never meant to hit a soccer ball with your head or be in the ring with a 300 pound mixed martial arts fighter who wants to literally smash your head repeatedly against the canvas. 

The most noticeable structure in human brains is the cerebral cortex, the wrinkly mass that sits atop and covers the rest of the brain. The cortex has four main areas or lobes on each side of the brain: frontal, temporal, parietal, and occipital.

The frontal lobes consist of the motor cortex, which is in charge of movement; the premotor cortex, which plans movement; and the prefrontal cortex (PFC), which is considered the executive part of the brain. The PFC is the most evolved part of the human brain: the center of focus, forethought, judgment, organization, planning, impulse control, empathy, and learning from the mistakes you make. It makes up 30 percent of the human brain, compared to our closest cousin, the chimpanzee, whose PFC is only 11 percent; a dog, whose PFC is just 7 percent; or a cat, whose PFC is only 3.5 percent. It’s a good thing a cat has nine lives, because their PFC isn’t going to do much to keep them out of trouble. 

The temporal lobes, underneath your temples and behind your eyes, are the seat of auditory processing, naming things, getting memories into long-term storage, and emotional reactions. They are called the “What Pathway” in the brain as they name what things are. The parietal lobes, to the top side and back of the brain, are the centers for sensory processing and direction sense. They are called the “Where Pathway” because they help us know where things are. And the occipital lobes, at the back of the cortex, are concerned primarily with vision. Information from the world enters the back part of the brain (temporal and parietal lobes), is processed, and then passes to the front part of the brain for decision-making. The cerebellum at the back bottom part of the brain is involved with motor and thought coordination. It is essential for processing complex information.

Brain SPECT Imaging

Over the last 23 years the Amen Clinics have used a variety of tools to look at and evaluate brain function. The most common of which is a study called brain SPECT imaging. SPECT (single photon emission computed tomography) is a nuclear medicine study that evaluates blood flow and activity patterns in the brain. It looks at how the brain works. It is different than CAT scans and MRIs, which are anatomy studies that look at the structure of the brain. SPECT looks at function and, in my opinion, is much more helpful in psychiatric illnesses like ADD.

SPECT scans basically show us three pieces of information about activity and blood flow in the brain:

? healthy activity

? too little activity

? too much activity. 

A lot has happened in the world of ADD or ADHD over the last 13 years, since I first wrote Healing ADD. It is being diagnosed much more frequently. Statistics from the Center for Disease Control reports that nearly one in five high school age boys and 11 percent of school-age children overall have received a medical diagnosis of ADD.

The frenetic pace of the world is seemingly making it even more common. Children and adults are not just obsessed with smart phones, tablets, and video games, they are often using 2 or 3 of these devices at the same time! There are new medications and non-medication options to help ameliorate the symptoms of ADD. The long term outcome of having untreated ADD is becoming clearer, and it is not good news. Untreated ADD increases the risk of depression, drug abuse, obesity, smoking, Type 2 diabetes, and Alzheimer’s disease. We are also learning more about how diet and exercise can impact ADD. In a replicated study from Europe, 70% of ADD children showed greater than a 50% reduction of symptoms on an elimination diet, which means that food intake can make ADD symptoms better or worse. In another study, exercise significantly enhanced executive function in ADD children. Taking PE out of schools to save money, may actually be costing our society much more in the long run in terms of lost learning and productivity.

In addition, our brain SPECT imaging database has grown from about 10,000 scans in 2001 to over 85,000 scans at the end of 2013, making our experience with both ADD and SPECT much more robust. Looking at the brains of tens of thousands of ADD individuals has taught us many valuable lessons, especially on the variability of ADD in the brain and in clinical practice. Subtyping ADD into 6 types was the major breakthrough I discussed in Healing ADD. In this version I have added a new type based on our brain imaging work and clinical experience, Anxious ADD. In addition, I have included more information on the impact of toxic exposure as one of the potential causes of ADD. Additionally, we have discovered that the cerebellum at the back bottom part of the brain, is more involved in ADD than anyone knew. There is a new section on the importance of the cerebellum, at the back bottom part of the brain, involved with coordination, potentially explaining why physical exercise can be helpful in lessoning the symptoms of ADD.

In our clinical practice at Amen Clinics, using natural treatments has become much more common as a first line therapy. We are definitely not opposed to medication and there are many examples throughout the book where medication has been helpful, even lifesaving. But we are opposed to the indiscriminant use of medication, which we are seeing even more commonly in the new patients who come to our clinics. One child came to our Reston, Virginia office on 17 medications. Ugghh. I will discuss new natural treatment options for each of the ADD types.

In addition, our own method for evaluating and treating psychiatric illnesses in general and ADD in particular has evolved. The traditional way most psychiatrists make diagnoses and decide on treatment is based on symptom clusters found in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM). If you have 6 of 9 of these symptoms and 6 of 9 of those symptoms, without any clear medical issues, then you are given a specific diagnosis, such as ADD or ADHD. Symptom clusters drive diagnosis and subsequent treatment.