November 12, 2010

Ever notice what happens to you or your child when you or they are already emotionally stressed and then drink a cup of coffee or eat a candy bar? Initially you feel a little bit better; and then you crash. From my reading of the medical literature and from my experience working with clients, I believe stress exacerbates ADD and so does sugar and/or caffeine since both can act as stressors. ADD, attention deficit disorder, and ADHD, Attention Deficit Hyperactivity Disorder, have long been associated with an imbalance in dopamine levels in the pre-frontal cortex, the front region of the brain involved in filtering out stimuli and controlling responses as it helps with general decision making, and judgement calls about your environment. With diminished filtering capacity, the pre-frontal cortex of the ADD brain, treats all incoming stimuli as equal in importance. For example a school-age child with ADD, pays equal attention to the teacher, the kid next to him ruffling through his backpack, kids outside the classroom in the hallway, and the sound of the air conditioner coming through the ventilation shaft. Additionally, the imbalance in the prefrontal cortex of the brain will lead to difficulty inhibiting behaviors like speaking out of turn or getting out of a seat. These actions are  typically restrained or curtailed when there is balanced brain chemistry and ADD is absent. An individual with ADD will already exhibit all the classic signs of inattentiveness, hyperactivity, and impulsivity; then add sugar to the mix. The addition of the sugar related stressor overwhelms the brain. As a result of one too many stimuli, the brain shuts down to protect itself. The prefrontal cortex is not the only brain area that interferes with learning in response to stress. The amygdala, the seat of our emotions, plays a role and will be discussed in Part II of this article series.

References

Amen, Daniel. 2001. Healing ADD: The breakthrough program that allows you to see and heal the 6 types of ADD. New York: The Berkley Publishing Group.

Jensen, Eric. 2000. Brain-Based Learning. San Diego, CA: The Brain Store. 76-77, 230.

Sapolsky, Robert. 1999. Stress and your brain- Trauma survivors can lose more than peace of mind: They may also lose some gray matter. Discover, March, p. 116.

_______1996. Why Stress is bad for your brain. Science. Vol. 273, 749-750.

 Wurtman, Judith. 1986. Managing Your Mind and Mood through Food. New York: Harper & Row Publishers.

January 4, 2011

In Part I, I talked about the link between sugar and its effects on the prefrontal cortex in the ADD brain. There is another part of the brain called the amygdala, an almond shaped structure and part of the limbic system, which is the seat of emotion and can modulate the learning state of the mind. Imagine a stressful situation, like seeing a snake in the parking lot, public speaking, or a first date. These are all obvious stressors that can generate a stress response in the body and place the body in a flight or flight response. The effect of drinking coffee, drinking a soda, or eating a candy bar (due to the sugar and caffeine content), or playing video games on your computer late at night (due to fastly blinking LED screens) are all interpreted by the brain as stressors not unlike a dangerous situation. As a result, the amygdala in the brain goes into alarm phase. The amygdala is normally involved in associating emotion with memories as well as consolidating information into long-term memory. But an amygdala on high alert shifts its focus from learning and memorizing to dealing with stress. This response further inhibits the function of the pre-frontal cortex already taxed by ADD.

So far we have talked about sugar and other stressors affecting two major structures that are involved in learning and memory. There is one more major player involved in the stress response, the adrenal glands. A discussion on the adrenal glands and their link to ADD is coming in Part III.

[This article and other sources for additional reading are archived on my website at http://www.addlifepossibilitiescoach.com/articles_and_references -  For more information about ADD and how ADD Coaching can benefit you or someone you know, please visit my website at http://www.ADDLifePossibilitiesCoach.com/ADD_coaching.]

February 27, 2011

In Part I, I talked about the link between sugar and its effects on the pre-frontal cortex in the ADD brain. In Part II, I talked about how the amygdala of the brain shifts its focus away from learning and memorizing in response to stress and how this further inhibits the function of the pre-frontal cortex already challenged in its ability to focus and filter out incoming stimuli due to ADD. Now, I want to direct some attention on the relationship between the adrenal glands and the ADD brain. The adrenal glands are chiefly responsible for releasing hormones in response to stress through the synthesis of corticosteroids such as cortisol, and catecholamines such as epinephrine (also known as adrenaline). While both adrenaline and cortisol are involved in the fight or flight response to stress, cortisol can suppress the immune systems and alter fat, protein, and carbohydrate metabolism. But during stress, cortisol is chiefly responsible for providing an energy source for the brain by increasing blood glucose levels. Additionally, cortisol boosts short term memory; however, long term exposure to increased cortisol levels can be toxic to cells of the hippocampus involved in long term memory (1), leading to damage in the portion of the brain that regulates cortisol and to changes in neurotransmitter activity in the pre-frontal cortex (2,3).

Typically, the amount of cortisol present in the blood undergoes diurnal variation; the level peaks in the early morning (approximately 8 am) to help provide the brain and body energy to get up and start the day and then reaches its lowest level at about midnight-4 am, or three to five hours after the onset of sleep (4). But in children with behavior problems and individuals with ADD, research indicates that they are more likely to exhibit abnormal circadian rhythm due to cortisol imbalance. In these individuals stressful or anxiety-ridden events tend to have a long-lasting effect on cortisol levels, suggesting a reason why circadian rhythm is dysregulated (5). Hence, some individuals with ADD can experience the opposite cycle of high cortisol levels at night giving them the ability to burn the midnight oil and then low levels in the morning or cortisol deficiencies at times of the day the non-ADD brained individual doesn’t usually experience them. This may explain why many with ADD experience poor sleep patterns. Consequently, these same individuals then need caffeine based energy drinks or coffee in the morning to compensate for low cortisol levels. Paradoxically, these low cortisol levels in the morning contribute to aggression, argumentative behavior and hyperactivity, as a mechanism to raise cortisol levels. At the same time, low cortisol leads to apathy and poor school performance because without sufficient cortisol there is not enough energy provided to engage the brain. They engage in all these behaviors to stimulate a rise in cortisol levels that are deficient in order to better balance brain chemistry in the prefrontal cortex and other parts of the brain.

Tooled with this knowledge, there may be better ways to modulate the effects of cortisol on the ADD individual. First, we recall the merits of adjusting sugar intake and increasing dietary consumption of healthy fats like omega-3 fatty acids and protein sources high in amino acids that are natural precursors for neurotransmitters out of balance in the ADD brain. Second, regular exercise has the added benefit of not only naturally raising cortisol in response to the physical stress on the body, but also raises levels of the neurotransmitter, serotonin, which has a calming effect on the brain after exercise. Cardiovascular fitness in general has been associated with overall intelligence. In addition, short spurts of physical activity have shown cognitive benefits by improving attention spans and on-task behavior significantly in school age children. Making kids move around more can sharpen intelligence, enhance creativity and planning skills, and improve math and reading performance. More exercise in the school day could improve school performance despite the time it takes away from reading, writing, and arithmetic (6,7). Finally, another strategy to counter the effects of ADD, exacerbated by cortisol imbalance, is to practice meditation. During meditation, electrical signals, or brain waves, change and brain imaging shows activity increases positively in the lateral pre-frontal cortex, one leading part of the brain implicated in ADD (8). Now that we better understand how stress generators affect learning and the ADD brain, we can adapt and make better choices about how to compensate for the unique brain chemistry ADD presents, and take advantage of the unique gifts this challenge has to offer.

[This article and other sources for additional reading are archived on my website at http://www.addlifepossibilitiescoach.com/articles_and_references -  For more information about ADD and how ADD Coaching can benefit you or someone you know, please visit my website at http://www.ADDLifePossibilitiesCoach.com/ADD_coaching.]

References

1  McAuley M.M, Kenny R.A, Kirkwood T.T., Wilkinson D.D., Jones J.J., Miller. A.  Mathematical Model of aging-related and cortisol induced hippocampal dysfunction. BMC Neuroscience. Vol. 10, No. 1, page 26; March, 2009.

2  Cunningham-Bussel AC, Root JC, Butler T, Tuescher O, Pan H, Epstein J, Weisholtz DS, Pavony M, Silverman ME, Goldstein MS, Altemus M, Cloitre M, LeDoux J, McEwen B, Stern E, Silbersweig D. Diurnal cortisol amplitude and fronto-limbic activity in response to stressful stimuli. Psychoneuroendocrinology. Vol. 34, No. 5, pages 694-704; June, 2009.

3  Arch. General Psychiatry, April, 1998.

4  de Weerth C, Zijl R, Buitelaar J. Development of cortisol circadian rhythm in
infancy. Early Human Development. Vol. 73, No. 1-2, pages 39–52; 2003.

5  Paula L. Ruttle, Elizabeth A. Shirtcliff, Lisa A. Serbin, Dahlia Ben-Dat Fisher, Dale M. Stack, Alex E. Schwartzman. Disentangling psychobiological mechanisms underlying internalizing and externalizing behaviors in youth: Longitudinal and concurrent associations with cortisol. Hormones and Behavior, Vol. 59, No. 1; 2011.

6  Tomporowski, P.D., et al. Exercise and children’s intelligence, cognition, and academic achievement. Educational Psychology Review, Vol. 20, No. 2, pages 111-131; June, 2008.

7  Trudeau, F., Shephard, R. J. Physical education, school physical activity, school sports and academic performance. International Journal of Behavioral Nutrition and Physical Activity, Vol. 5, No. 10; February 25, 2008.

8  Newberg, A. B., Iverson, J. The Neural basis of the complex mental task of meditation: neurotransmitter and neurochemical considerations. Medical Hypotheses, Vol. 61, No. 2, pages 282-291, 2003.