Full Transcript
https://www.youtube.com/watch?v=hFL6qRIJZ_Y
[00:00] welcome to the huberman Lab podcast
[00:02] welcome to the huberman Lab podcast where we discuss science and
[00:03] where we discuss science and science-based tools for everyday
[00:05] science-based tools for everyday
[00:08] life I'm Andrew huberman and I'm a
[00:10] life I'm Andrew huberman and I'm a professor of neurobiology and
[00:12] professor of neurobiology and Opthalmology at Stanford school of
[00:14] Opthalmology at Stanford school of medicine today we are going to talk all
[00:16] medicine today we are going to talk all about attention deficit hyperactivity
[00:19] about attention deficit hyperactivity disorder or
[00:20] disorder or ADHD we are also going to talk about
[00:23] ADHD we are also going to talk about normal levels of focus what are normal
[00:26] normal levels of focus and how all of us
[00:28] levels of focus and how all of us whether or not we have DHD or not can
[00:32] whether or not we have DHD or not can improve our ability to focus our ability
[00:35] improve our ability to focus our ability to rule out distraction turns out those
[00:37] to rule out distraction turns out those are two separate things as well as
[00:39] are two separate things as well as remember information better we are also
[00:42] remember information better we are also going to talk about how we can learn to
[00:45] going to talk about how we can learn to relax while focusing which turns out to
[00:47] relax while focusing which turns out to be a critical component of learning new
[00:50] be a critical component of learning new information and for coming up with new
[00:53] information and for coming up with new creative ideas so whether or not you
[00:55] creative ideas so whether or not you have ADHD or know someone who does or if
[00:59] have ADHD or know someone who does or if you're somebody who feels that they do
[01:01] you're somebody who feels that they do not have ADHD but would simply like to not have ADHD but would simply like to improve their ability to focus or to be more creative this episode is definitely for you as well we are going to talk about drug-based tools that are out there we are going to talk about behavioral tools we will talk about the role of diet and supplementation and we will talk about new emerging brain machine interface devices things like transcranial magnetic stimulation if you don't know what that is don't worry I will explain it to you to you these are non-invasive methods for rewiring your brain in order to make focusing more natural for you and to teach you how to increase your depth of focus now just a quick reminder that anytime we discuss a psychiatric disorder it's important that we remember that all of us have the temptation to self- diagnose or to diagnose others so as I list off some of the symptomology of ADHD some of that symptomology might resonate with you you might think oh maybe have ADHD or you
[02:01] might think oh maybe have ADHD or you might decide that someone you know
[02:02] might decide that someone you know definitely has
[02:04] definitely has ADHD however it is very important that
[02:06] ADHD however it is very important that you don't self-diagnose or diagnose
[02:09] you don't self-diagnose or diagnose somebody else the clear and real
[02:12] somebody else the clear and real diagnosis of ADHD really should be
[02:15] diagnosis of ADHD really should be carried out by a psychiatrist a
[02:17] carried out by a psychiatrist a physician or a very well-trained
[02:19] physician or a very well-trained clinical psychologist there are clear
[02:22] clinical psychologist there are clear criteria for what constitutes full-blown
[02:26] criteria for what constitutes full-blown ADHD however many of us have
[02:29] ADHD however many of us have constellations of symptoms that make us
[02:32] constellations of symptoms that make us somewhat like somebody with ADHD and if
[02:35] somewhat like somebody with ADHD and if you're struggling with Focus nowadays as
[02:37] you're struggling with Focus nowadays as a lot of people are because of stress
[02:40] a lot of people are because of stress because of smartphone use which turns
[02:42] because of smartphone use which turns out can induce adult ADHD we'll talk
[02:45] out can induce adult ADHD we'll talk about that well then pay attention to
[02:48] about that well then pay attention to the symptomology you may actually
[02:49] the symptomology you may actually require professional treatment you might
[02:51] require professional treatment you might not equally important is to remember
[02:53] not equally important is to remember that some of the terms that we cover
[02:55] that some of the terms that we cover like impulse control and attention and
[02:57] like impulse control and attention and concentration are somewhat subjective
[02:59] concentration are somewhat subjective and and they can change over time
[03:01] and and they can change over time sometimes we have a better level of attention than others.
[03:05] maybe it depends on how we slept or other events going on in our life or something that we're entirely unaware of.
[03:11] the important thing to remember is that we can all improve our attentional capacity.
[03:15] we can all rewire the circuits that make heightened levels of focus more accessible to us.
[03:23] we can do that through multiple types of interventions and we are going to cover all those interventions today.
[03:28] before we March into the material I'd like to remind that this podcast is separate from my teaching and research roles at Stanford.
[03:34] it is however part of my desire and effort to bring zeroc cost to Consumer information about science and science related tools to the general public.
[03:40] in keeping with that theme I'd like to thank the sponsors of today's podcast.
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[05:23] California that raises organic grass-fed and finished certified Humane meat I
[05:26] and finished certified Humane meat I tend to eat meat about once a day so
[05:28] tend to eat meat about once a day so typically I'll fast until about noon or
[05:30] typically I'll fast until about noon or 1 and then my lunch consists of a small
[05:32] 1 and then my lunch consists of a small piece of steak or chicken and some salad
[05:35] piece of steak or chicken and some salad and then I tend to eat my carbohydrates
[05:36] and then I tend to eat my carbohydrates in the evening before I go to sleep
[05:38] in the evening before I go to sleep sometimes and especially lately I'm
[05:40] sometimes and especially lately I'm eating my protein earlier in the day
[05:42] eating my protein earlier in the day because I'm playing around with some of
[05:43] because I'm playing around with some of the findings related to protein intake
[05:46] the findings related to protein intake early in the day but regardless I'm
[05:47] early in the day but regardless I'm eating meat about once a day for me it's
[05:50] eating meat about once a day for me it's extremely important that any meat that I
[05:52] extremely important that any meat that I consume come from humanly raised animals
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[06:08] the importance of Omega-3s for heart health, for brain health, for mood, etc.
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[07:55] So let's talk about ADHD, Attention Deficit Hyperactive AC ity disorder.
[07:58] Let's also talk about focus and attention and everybody's ability to focus and attend, not just people with.
[08:07] focus and attend not just people with ADHD we are also going to talk about ADHD.
[08:09] we are also going to talk about tools that would allow anyone whether or tools that would allow anyone whether or not they have ADHD or not to enhance their level of concentration and focus.
[08:17] now ADHD used to be called add attention deficit disorder.
[08:21] we have record of add in the medical literature dating back to as early as 1904.
[08:28] now there's nothing special about 1904 that's just the first time that it showed up in the standard medical literature.
[08:35] we have to believe that add which we now call ADHD existed before 1904 and probably long before 1904.
[08:45] why well because it has a strong genetic component.
[08:48] if you have a close relative that has ADHD there's a much higher probability that you will have ADHD and that probability goes up depending on how closely related to that person you happen to be.
[09:00] so for instance if you're an identical twin and your twin has ADHD there's a very high
[09:07] twin has ADHD there's a very high concordance as we say a very high concordance as we say a very high probability that you will have ADHD up.
[09:13] probability that you will have ADHD up to 75% chance if you have a fraternal twin with ADHD.
[09:16] to 75% chance if you have a fraternal twin with ADHD that number goes down a bit in the 50 to 60% range and so on.
[09:18] twin with ADHD that number goes down a bit in the 50 to 60% range and so on if you have a parent with ADHD that number.
[09:21] you have a parent with ADHD that number ranges anywhere from 10 to 25% likelihood that you will have ADHD if.
[09:24] ranges anywhere from 10 to 25% likelihood that you will have ADHD if you have two parents and so on and so so on.
[09:26] you have two parents and so on and so so on okay so there's a genetic component.
[09:28] on okay so there's a genetic component that genetic component it turns out.
[09:29] that genetic component it turns out relates directly to how specific neural circuits in the brain wire up the chemicals they use and the way they use those chemicals.
[09:31] circuits in the brain wire up the chemicals they use and the way they use those chemicals a topic that we are going to discuss in depth today.
[09:33] those chemicals a topic that we are going to discuss in depth today now if you have a close relative with ADHD that does not mean that you are faded to have ADHD.
[09:35] relates directly to how specific neural circuits in the brain wire up the chemicals they use and the way they use those chemicals a topic that we are going to discuss in depth today now if you have a close relative with ADHD that does not mean that you are faded to have ADHD and if you happen to have ADHD there are ways to overcome those symptoms of lack of attention impulsivity and so on.
[09:38] circuits in the brain wire up the chemicals they use and the way they use those chemicals a topic that we are going to discuss in depth today now if you have a close relative with ADHD that does not mean that you are faded to have ADHD and if you happen to have ADHD there are ways to overcome those symptoms of lack of attention impulsivity and so on.
[09:40] chemicals they use and the way they use those chemicals a topic that we are going to discuss in depth today now if you have a close relative with ADHD that does not mean that you are faded to have ADHD and if you happen to have ADHD there are ways to overcome those symptoms of lack of attention impulsivity and so on.
[09:41] those chemicals a topic that we are going to discuss in depth today now if you have a close relative with ADHD that does not mean that you are faded to have ADHD and if you happen to have ADHD there are ways to overcome those symptoms of lack of attention impulsivity and so on.
[09:44] going to discuss in depth today now if you have a close relative with ADHD that does not mean that you are faded to have ADHD and if you happen to have ADHD there are ways to overcome those symptoms of lack of attention impulsivity and so on.
[09:47] today now if you have a close relative with ADHD that does not mean that you are faded to have ADHD and if you happen to have ADHD there are ways to overcome those symptoms of lack of attention impulsivity and so on.
[09:49] with ADHD that does not mean that you are faded to have ADHD and if you happen to have ADHD there are ways to overcome those symptoms of lack of attention impulsivity and so on.
[09:52] are faded to have ADHD and if you happen to have ADHD there are ways to overcome those symptoms of lack of attention impulsivity and so on.
[09:55] to have ADHD there are ways to overcome those symptoms of lack of attention impulsivity and so on.
[09:57] those symptoms of lack of attention impulsivity and so on.
[10:00] impulsivity and so on another important point about ADHD is that it has nothing to do with intelligence whether or not we're talking about intelligence measured by a.
[10:03] another important point about ADHD is that it has nothing to do with intelligence whether or not we're talking about intelligence measured by a.
[10:05] that it has nothing to do with intelligence whether or not we're talking about intelligence measured by a.
[10:07] intelligence whether or not we're talking about intelligence measured by a.
[10:08] talking about intelligence measured by a standard IQ test a rather controversial standard IQ test a rather controversial issue as many of you probably know there are lots of forms of intelligence that a standard IQ test just wouldn't pick up.
[10:18] emotional intelligence musical intelligence spatial intelligence all sorts of intelligences none of them are related to ADHD being very high functioning.
[10:29] doesn't make you more likely to have ADHD and being ADHD doesn't necessarily mean that you have a low IQ so there are people with ADHD who have low IQs people with ADHD with high IQs people with ADHD with high emotional IQ or with low IQ in the emotional scale it's all over the place.
[10:48] the important point is that your ability to attend and focus does not relate to how smart you are or your IQ of any type not just a standard IQ.
[10:57] the renaming of ADD to ADHD took place in the mid to late 1980s when the psychiatric community and the psychological community started taking better notice of the fact that
[11:10] taking better notice of the fact that so-called hyperactive kids also had attentional issues.
[11:15] this might seem obvious but there's been extensive and ongoing revision of the criteria for designating a psychiatric disorder and this is still an ongoing process even today.
[11:26] so in the mid 80s we started hearing about ADHD and then gradually that term add has been dropped away.
[11:33] however just the renaming of add to ADHD has led to much better diagnosis and detection of ADHD.
[11:43] so right now the current estimates are that about one in 10 children and probably more have ADHD.
[11:51] the current estimates are anywhere from 10% 1 and 10 to as high as 12% now.
[11:58] fortunately about half of those will resolve with proper treatment but the other half typically don't.
[12:04] the other thing that we are seeing a lot nowadays is increased levels of ADHD in adults.
[12:13] is increased levels of ADHD in adults and there's some question as to whether.
[12:15] and there's some question as to whether not those adults had ADHD that went undetected during their childhood or.
[12:17] undetected during their childhood or whether or not ADHD is now cropping up in adulthood due to the way that we are interacting with the world in particular.
[12:25] interacting with the world in particular smart phone use the combination of email text real world interactions multiple apps and streams of media and social media all coming in at once trying to manage life all of the things that are going on are creating a kind of cloud of pulls on our attention.
[12:49] kind of cloud of pulls on our attention and so there is this question to whether or not we are creating ADHD in adults that never had ADHD prior to being an adult.
[12:58] adult so let's talk about attention and first let's just Define what we mean by attention out there in the scientific literature and in discussions about ADHD we will hear things like attention and focus and concentration and impulse control for sake of today's discussion.
[13:15] control for sake of today's discussion attention focus and concentration are
[13:17] attention focus and concentration are essentially the same thing okay we could
[13:20] essentially the same thing okay we could split hairs and the scientific
[13:21] split hairs and the scientific literature does split hairs about these
[13:23] literature does split hairs about these but if we want to understand the biology
[13:25] but if we want to understand the biology and we want to have a straightforward
[13:27] and we want to have a straightforward conversation about ADHD if I say
[13:29] conversation about ADHD if I say attention or Focus I'm basically
[13:31] attention or Focus I'm basically referring to the same thing unless I
[13:34] referring to the same thing unless I specify otherwise okay so people with
[13:37] specify otherwise okay so people with ADHD have trouble holding their
[13:40] ADHD have trouble holding their attention what is attention well
[13:44] attention what is attention well attention is perception it's how we are
[13:48] attention is perception it's how we are perceiving the sensory world so just a
[13:51] perceiving the sensory world so just a little bit of neurobiology 101 we are
[13:52] little bit of neurobiology 101 we are sensing things all the time there's
[13:54] sensing things all the time there's information coming into our nervous
[13:56] information coming into our nervous system all the time for instance right
[13:57] system all the time for instance right now you're hearing sound w waves you are
[14:00] now you're hearing sound w waves you are seeing things you are sensing things
[14:01] seeing things you are sensing things against your skin but you are only
[14:03] against your skin but you are only paying attention to some of those and
[14:06] paying attention to some of those and the ones that you're paying attention to
[14:08] the ones that you're paying attention to are your perceptions so if you hear my
[14:10] are your perceptions so if you hear my voice you are perceiving my voice you
[14:12] voice you are perceiving my voice you are not paying attention to your other
[14:14] are not paying attention to your other Senses at the moment okay you might even
[14:17] Senses at the moment okay you might even be outside in a breeze and until I said
[14:19] be outside in a breeze and until I said that you might not be perceiving that
[14:21] that you might not be perceiving that breeze but your body was sensing it all along
[14:24] breeze but your body was sensing it all along so attention and focus are more or less the same thing
[14:26] along so attention and focus are more or less the same thing but impulse control is something separate
[14:29] less the same thing but impulse control is something separate because impulse control requires pushing out or putting the blinders on to sensory events in our environment
[14:31] is something separate because impulse control requires pushing out or putting the blinders on to sensory events in our environment
[14:34] control requires pushing out or putting the blinders on to sensory events in our environment it means lack of perception
[14:37] the blinders on to sensory events in our environment it means lack of perception impulse control is about limiting our perception
[14:40] environment it means lack of perception impulse control is about limiting our perception people with ADHD have poor attention
[14:43] impulse control is about limiting our perception people with ADHD have poor attention and they have high levels of impulsivity
[14:46] perception people with ADHD have poor attention and they have high levels of impulsivity they are easily distractable
[14:49] attention and they have high levels of impulsivity they are easily distractable but the way that shows up is very surprising
[14:51] impulsivity they are easily distractable but the way that shows up is very surprising
[14:53] distractable but the way that shows up is very surprising you might think that people with ADHD just simply can't attend to anything
[14:54] is very surprising you might think that people with ADHD just simply can't attend to anything
[14:56] surprising you might think that people with ADHD just simply can't attend to anything
[14:57] with ADHD just simply can't attend to anything they really can't focus even if they really want to
[14:59] ADHD just simply can't attend to anything they really can't focus even if they really want to but that's simply not the case
[15:02] anything they really can't focus even if they really want to but that's simply not the case people with ADHD yes they are distractable
[15:03] they really want to but that's simply not the case people with ADHD yes they are distractable yes they are impulsive
[15:06] not the case people with ADHD yes they are distractable yes they are impulsive yes they are easily annoyed by things happening in the room
[15:08] ADHD yes they are distractable yes they are impulsive yes they are easily annoyed by things happening in the room
[15:12] distractable yes they are impulsive yes they are easily annoyed by things happening in the room they sometimes have a high level of emotionality as
[15:14] they are easily annoyed by things happening in the room they sometimes have a high level of emotionality as
[15:15] happening in the room they sometimes have a high level of emotionality as
[15:17] have a high level of emotionality as well not always but often however people.
[15:21] well not always but often however people with ADHD can have a hyperfocus an.
[15:24] with ADHD can have a hyperfocus an incredible ability to focus on things.
[15:27] incredible ability to focus on things that they really enjoy or are intrigued.
[15:30] that they really enjoy or are intrigued by now this is a very important point.
[15:33] by now this is a very important point because typically we think of somebody.
[15:36] because typically we think of somebody with ADHD as being really wild and.
[15:39] with ADHD as being really wild and hyperactive or having no ability.
[15:41] hyperactive or having no ability whatsoever to sit still and attend and.
[15:44] whatsoever to sit still and attend and while that phenotype as we call it that.
[15:47] while that phenotype as we call it that contour of behavior and cognition can.
[15:51] contour of behavior and cognition can exist many people if not all people with.
[15:54] exist many people if not all people with ADHD if you give them something they.
[15:56] ADHD if you give them something they really love like if the child loves.
[15:58] really love like if the child loves video games or if a child loves to draw.
[16:01] video games or if a child loves to draw or if an adult loves a particular type.
[16:04] or if an adult loves a particular type of movie or a person very much they will.
[16:07] of movie or a person very much they will obtain laser focus without any effort so.
[16:11] obtain laser focus without any effort so that tells us that people with ADHD have.
[16:14] that tells us that people with ADHD have the capacity to attend but they can't.
[16:17] the capacity to attend but they can't engage that attention for things that.
[16:19] engage that attention for things that they don't really really want to do.
[16:22] and they don't really really want to do.
[16:24] and as we all know much of life whether or not you're a child or an adult involves doing a lot of things that we don't want to do.
[16:28] much of our schooling involves doing things that we would prefer not to do.
[16:31] and sort of forcing ourselves to do it to attend even though we are not super interested in what we are attending to.
[16:40] there are a couple other things that people with ADHD display quite often.
[16:42] one is challenges with time perception.
[16:46] now time perception is a fascinating aspect of how our brain works.
[16:50] and later we're going to talk about time perception and how you can actually get better at time perception.
[16:56] it's very likely that right now you are doing things that get in the way of optimal time perception.
[17:02] and I will tell you how to adjust your ability to measure time with your brain.
[17:07] people with ADHD often run late.
[17:12] they often procrastinate but what's interesting and surprising is that if they are given a deadline they actually can perceive time very well.
[17:21] can perceive time very well and they often can focus very well if the consequences of not completing a task or not attending are severe enough.
[17:28] it's a little bit like the way that people with ADHD can really focus if they like something well if they're scared enough about the consequences of not attending.
[17:37] oftentimes not always but oftentimes they can attend if they're not really concerned about a deadline or a consequence.
[17:45] well then they tend to lose track of time and they tend to underestimate how long things will take.
[17:52] now many people do that not just people with ADHD but people with ADHD have challenges understanding how to line up the activities of their day in order to meet particular deadlines.
[18:04] even if it's just a simple thing like finishing one set of tasks before lunch.
[18:10] oftentimes they will remember that lunch starts at noon but somehow they aren't able to fill the intervening time in a way that's productive and they can obsess about the upcoming deadline for
[18:21] obsess about the upcoming deadline for instance we will talk about how to.
[18:23] instance we will talk about how to remedy this in addition their spatial.
[18:26] remedy this in addition their spatial organization skills are often.
[18:29] organization skills are often subpar not always but often you will.
[18:32] subpar not always but often you will find that somebody with ADHD uses What's.
[18:35] find that somebody with ADHD uses What's called the pile system in order to.
[18:37] called the pile system in order to organize things they will take many.
[18:40] organize things they will take many belongings and this could be in the.
[18:41] belongings and this could be in the kitchen or in their bedroom or in their.
[18:44] kitchen or in their bedroom or in their office or in any space and they will.
[18:46] office or in any space and they will start piling things up according to a.
[18:48] start piling things up according to a categorization system that makes sense.
[18:50] categorization system that makes sense to them and only them it doesn't really.
[18:53] to them and only them it doesn't really have any logical framework now many.
[18:56] have any logical framework now many people use the pile system and if you.
[18:57] people use the pile system and if you use the pile system that doesn't mean.
[18:59] use the pile system that doesn't mean that you have ADHD in fact if you're.
[19:00] that you have ADHD in fact if you're unpacking a house or you've moved.
[19:02] unpacking a house or you've moved recently or you've received a lot of.
[19:04] recently or you've received a lot of presentence recently the pile system.
[19:06] presentence recently the pile system makes perfect sense to organize your.
[19:08] makes perfect sense to organize your space but people with ADHD tend to.
[19:11] space but people with ADHD tend to organize things according to the pile.
[19:13] organize things according to the pile system all the time and that pile system.
[19:15] system all the time and that pile system doesn't work for them okay so that's the.
[19:18] doesn't work for them okay so that's the key distinction that they use a filing.
[19:20] key distinction that they use a filing system and it's not really files they're.
[19:21] system and it's not really files they're piling things up in a way that makes.
[19:23] piling things up in a way that makes sense to them but then it doesn't work.
[19:25] sense to them but then it doesn't work for them in terms of what task they actually need to perform.
[19:27] they can't find things or if anyone moves one thing then it it's very disruptive to their overall plan because their overall plan doesn't really work in the first place.
[19:35] so that's a common phenotype as we call it a phenotype by the way is just an expression of a particular set of underlying genetic or psychological components.
[19:51] okay so we say the phenotype so a phenotype could be brown hair and green eyes like for me.
[19:53] a phenotype could also be that somebody uses the piling system system.
[19:59] okay the other thing that people with ADH have real trouble with is so-called working memory.
[20:05] now you might think that people with ADHD would have really poor memories but in fact that's not the case.
[20:11] people with ADHD often can have a terrific memory for past events they can remember upcoming events quite well.
[20:19] their memory is clearly working however one aspect of memory in particular that we call working memory is often
[20:25] we call working memory is often disrupted working memory is the ability
[20:28] disrupted working memory is the ability to keep specific information online to
[20:31] to keep specific information online to recycle it in your brain over and over
[20:32] recycle it in your brain over and over again so that you can use it in the
[20:34] again so that you can use it in the immediate or short term a good example
[20:37] immediate or short term a good example of this would be you meet somebody they
[20:39] of this would be you meet somebody they tell you their name they give you their
[20:40] tell you their name they give you their phone number verbally and you have to
[20:42] phone number verbally and you have to walk back to your phone and enter it
[20:44] walk back to your phone and enter it into your phone people without ADHD
[20:47] into your phone people without ADHD might have to put some effort into it it
[20:49] might have to put some effort into it it might feel like a bit of a struggle but
[20:50] might feel like a bit of a struggle but typically they would be able to recite
[20:52] typically they would be able to recite that phone number in their mind over and
[20:53] that phone number in their mind over and over and then put it into their phone
[20:55] over and then put it into their phone people with ADHD tend to lose the
[20:58] people with ADHD tend to lose the ability or lack the ability to remember
[21:01] ability or lack the ability to remember things that they just need to keep
[21:02] things that they just need to keep online for anywhere from 10 seconds to a
[21:05] online for anywhere from 10 seconds to a minute or two okay so a string of
[21:07] minute or two okay so a string of numbers like 643 781 for most people
[21:10] numbers like 643 781 for most people would be pretty easy 643 781 643 781 you
[21:14] would be pretty easy 643 781 643 781 you could probably remember that a minute
[21:16] could probably remember that a minute from now without writing it down but if
[21:19] from now without writing it down but if you add one more number to that 643
[21:22] you add one more number to that 643 7813 it gets tougher okay so there's a
[21:26] 7813 it gets tougher okay so there's a reason why phone numbers typically have
[21:28] reason why phone numbers typically have 7 digits in them of course there's an
[21:30] 7 digits in them of course there's an area code but remembering information
[21:33] area code but remembering information that strings out longer than seven
[21:36] that strings out longer than seven numbers or a sentence or two that's
[21:39] numbers or a sentence or two that's challenging for most people people with
[21:41] challenging for most people people with adhc have severe challenges even with
[21:44] adhc have severe challenges even with much smaller batches of information over
[21:46] much smaller batches of information over even much smaller batches of time
[21:49] even much smaller batches of time deficits in working memory are also
[21:51] deficits in working memory are also something that we see in people who have
[21:52] something that we see in people who have frontal temporal dementia so damage to
[21:54] frontal temporal dementia so damage to the frontal loes or age related
[21:57] the frontal loes or age related cognitive decline
[21:59] cognitive decline and so it will come as no surprise that
[22:01] and so it will come as no surprise that later when we discuss treatments
[22:03] later when we discuss treatments supplements and other tools for ADHD
[22:07] supplements and other tools for ADHD that many of those treatments
[22:08] that many of those treatments supplements and tools for ADHD are
[22:10] supplements and tools for ADHD are similar to the ones that work for age-
[22:13] similar to the ones that work for age- related cognitive
[22:15] related cognitive decline Okay so we've more or less
[22:18] decline Okay so we've more or less established the kind of menu of items
[22:20] established the kind of menu of items that people with ADHD tend to have some
[22:23] that people with ADHD tend to have some have all of them some have just a subset
[22:25] have all of them some have just a subset of them their severity can range from
[22:28] of them their severity can range from from very intense to mild but in general
[22:32] from very intense to mild but in general it's challenges with attention and focus
[22:35] it's challenges with attention and focus challenges with impulse control they get
[22:37] challenges with impulse control they get annoyed easily they have kind of an
[22:38] annoyed easily they have kind of an impulsivity they can't stay on task time
[22:42] impulsivity they can't stay on task time perception can be off they use the
[22:45] perception can be off they use the piling system or a system that doesn't
[22:47] piling system or a system that doesn't work well for them in order to organize
[22:49] work well for them in order to organize their things in physical space and they
[22:52] their things in physical space and they have a hard time with anything that's
[22:53] have a hard time with anything that's mundane that they're not really
[22:55] mundane that they're not really interested in but again I just want to
[22:57] interested in but again I just want to highlight that people with ADHD are able
[23:00] highlight that people with ADHD are able to obtain heightened levels of focus
[23:02] to obtain heightened levels of focus even hyperfocus for things that are
[23:04] even hyperfocus for things that are exciting to them and that they really
[23:06] exciting to them and that they really want to engage in so now you have the
[23:08] want to engage in so now you have the Contour of what ADHD is and if you're
[23:10] Contour of what ADHD is and if you're somebody who doesn't have ADHD you
[23:12] somebody who doesn't have ADHD you should also be asking yourself which
[23:15] should also be asking yourself which aspects of
[23:16] aspects of ADHD are similar to things I've
[23:18] ADHD are similar to things I've experienced before because what we know
[23:22] experienced before because what we know about the healthy brain is that there's
[23:24] about the healthy brain is that there's also a range of abilities to focus some
[23:27] also a range of abilities to focus some people focus very well on any task you
[23:30] people focus very well on any task you give them a task they can just laser in
[23:32] give them a task they can just laser in on that task other people they have to
[23:35] on that task other people they have to kind of fight an internal battle they
[23:36] kind of fight an internal battle they have to convince themselves that it's
[23:38] have to convince themselves that it's important or interesting they have to
[23:39] important or interesting they have to kind of incentivize themselves
[23:41] kind of incentivize themselves internally other
[23:43] internally other people doesn't matter they could be
[23:46] people doesn't matter they could be bored to tears with the information but
[23:48] bored to tears with the information but they can do it just because they are
[23:49] they can do it just because they are quote unquote very disciplined people we
[23:51] quote unquote very disciplined people we tend to admire those people but as
[23:53] tend to admire those people but as you'll see a little bit later it's not
[23:54] you'll see a little bit later it's not clear that that's the best way to run
[23:56] clear that that's the best way to run your attentional system there might be
[23:58] your attentional system there might be something to this business of having
[24:00] something to this business of having heightened levels of attention for the
[24:02] heightened levels of attention for the things that you are most interested or
[24:04] things that you are most interested or excited
[24:06] excited by so let's drill into this issue of why
[24:09] by so let's drill into this issue of why people with ADHD actually can focus very
[24:12] people with ADHD actually can focus very intensely on things that they enjoy and
[24:14] intensely on things that they enjoy and are curious about now enjoyment and
[24:18] are curious about now enjoyment and curiosity are psychological terms
[24:21] curiosity are psychological terms they're not even really psychological
[24:22] they're not even really psychological terms they're just the way that we
[24:23] terms they're just the way that we describe our human experience of liking
[24:26] describe our human experience of liking things wanting to know more about them
[24:28] things wanting to know more about them but from a neurobiological perspective
[24:31] but from a neurobiological perspective they have a very clear identity and
[24:33] they have a very clear identity and signature and that's
[24:36] signature and that's dopamine dopamine is released from
[24:38] dopamine dopamine is released from neurons it's what we call a
[24:40] neurons it's what we call a neuromodulator and as a
[24:42] neuromodulator and as a neuromodulator it changes the activity
[24:44] neuromodulator it changes the activity of the circuits in the brain such that
[24:46] of the circuits in the brain such that certain circuits are more active than
[24:48] certain circuits are more active than others and in particular dopamine
[24:51] others and in particular dopamine creates a heightened state of focus it
[24:54] creates a heightened state of focus it tends to contract our visual world and
[24:57] tends to contract our visual world and it tends to make make us pay attention
[24:59] it tends to make make us pay attention to things that are outside and Beyond
[25:02] to things that are outside and Beyond the confines of our skin it's what we
[25:04] the confines of our skin it's what we call
[25:05] call exteroception dopamine also tends to put
[25:08] exteroception dopamine also tends to put us in a state of motivation and wanting
[25:11] us in a state of motivation and wanting things outside the confines of our skin
[25:14] things outside the confines of our skin so whether or not we're pursuing
[25:15] so whether or not we're pursuing something physical in our world or
[25:17] something physical in our world or whether or not we're pursuing
[25:19] whether or not we're pursuing information in our outside world
[25:21] information in our outside world dopamine is largely responsible for our
[25:24] dopamine is largely responsible for our ability and our drive to do that but
[25:27] ability and our drive to do that but dopamine as an neuromodulator is also
[25:30] dopamine as an neuromodulator is also involved in changing the way that we
[25:32] involved in changing the way that we perceive the world so as I mentioned
[25:34] perceive the world so as I mentioned earlier you have all these senses coming
[25:36] earlier you have all these senses coming in and you can only perceive some of
[25:38] in and you can only perceive some of them because you're only paying
[25:39] them because you're only paying attention to some of them dopamine when
[25:43] attention to some of them dopamine when it's released in our brain tends to turn
[25:46] it's released in our brain tends to turn on areas of our brain that narrow our
[25:49] on areas of our brain that narrow our visual focus and our auditory Focus so
[25:51] visual focus and our auditory Focus so it creates a cone of auditory attention
[25:54] it creates a cone of auditory attention that's very narrow a creates a tunnel of
[25:56] that's very narrow a creates a tunnel of visual attention that's very narrow
[25:58] visual attention that's very narrow whereas when we have less dopamine we
[26:00] whereas when we have less dopamine we tend to view the entire world we tend to
[26:03] tend to view the entire world we tend to see the whole scene that we are in we
[26:04] see the whole scene that we are in we tend to hear everything all at once so
[26:07] tend to hear everything all at once so as I describe this hopefully you're
[26:09] as I describe this hopefully you're already starting to see and understand
[26:12] already starting to see and understand how having dopamine release can allow a
[26:16] how having dopamine release can allow a person whether or not they have ADHD or
[26:19] person whether or not they have ADHD or not to direct their attention to
[26:22] not to direct their attention to particular things in their environment
[26:24] particular things in their environment right so now what we're doing is we're
[26:26] right so now what we're doing is we're moving away from attention as this kind
[26:28] moving away from attention as this kind of vague ambiguous term and we're giving
[26:30] of vague ambiguous term and we're giving it a neurochemical identity dopamine and
[26:33] it a neurochemical identity dopamine and we are giving it a neural circuit
[26:35] we are giving it a neural circuit identity and just to put a little bit of
[26:38] identity and just to put a little bit of flavor and detail on which neural
[26:40] flavor and detail on which neural circuits those are I wanted to discuss
[26:42] circuits those are I wanted to discuss two general types of neural circuits
[26:44] two general types of neural circuits that dopamine tends to enhance so let's
[26:47] that dopamine tends to enhance so let's talk neural circuits and for those of
[26:49] talk neural circuits and for those of you that love hearing Neuroscience
[26:51] you that love hearing Neuroscience nomenclature you're going to eat this
[26:53] nomenclature you're going to eat this part up and for those of you that don't
[26:55] part up and for those of you that don't like a lot of names of brain areas I
[26:57] like a lot of names of brain areas I invite you to tune out or just try and
[26:59] invite you to tune out or just try and grab the top Contour of this I will
[27:02] grab the top Contour of this I will describe it in pretty general terms but
[27:03] describe it in pretty general terms but I will give some detail because I know
[27:05] I will give some detail because I know there are some of you out there who
[27:07] there are some of you out there who really want to dig deeper into what the
[27:09] really want to dig deeper into what the exact structures and connectivities are
[27:11] exact structures and connectivities are okay so there are two main types of
[27:14] okay so there are two main types of circuits that we need to think about
[27:16] circuits that we need to think about with respect to ADHD attention and
[27:18] with respect to ADHD attention and dopamine the first one is called the
[27:20] dopamine the first one is called the default mode Network the default mode
[27:22] default mode Network the default mode network is the network of brain areas in
[27:25] network is the network of brain areas in your brain in my brain and in
[27:27] your brain in my brain and in everybody's brain that is active when
[27:30] everybody's brain that is active when we're not doing anything when we're just
[27:32] we're not doing anything when we're just sitting there idle at rest now it's very
[27:34] sitting there idle at rest now it's very hard to not think about anything but
[27:36] hard to not think about anything but when you're not engaged in any type of
[27:38] when you're not engaged in any type of specific task so you're not driving
[27:40] specific task so you're not driving you're not playing a video game you're
[27:42] you're not playing a video game you're not trying to study you're not trying to
[27:43] not trying to study you're not trying to listen you're just sitting there letting
[27:45] listen you're just sitting there letting your brain kind of go wherever it wants
[27:47] your brain kind of go wherever it wants to go your default mode Network
[27:50] to go your default mode Network underlies that state of
[27:53] underlies that state of mind the other set of circuits that
[27:55] mind the other set of circuits that we're going to think about and talk
[27:57] we're going to think about and talk about with respect to ad PhD are the
[28:00] about with respect to ad PhD are the task networks the networks of the brain
[28:03] task networks the networks of the brain that make you goal oriented or that are
[28:05] that make you goal oriented or that are at least trying to make you goal
[28:07] at least trying to make you goal oriented and those are a completely
[28:09] oriented and those are a completely different set of brain areas however the
[28:12] different set of brain areas however the default mode Network and these task
[28:15] default mode Network and these task networks are communicating with one
[28:18] networks are communicating with one another and they're doing that in very
[28:19] another and they're doing that in very interesting ways so first I want to
[28:22] interesting ways so first I want to describe how these two sets of brain
[28:24] describe how these two sets of brain areas the default mode Network and the
[28:26] areas the default mode Network and the task networks normally interact
[28:28] task networks normally interact okay so little bit of naming here again
[28:31] okay so little bit of naming here again feel free to ignore it if you don't want
[28:33] feel free to ignore it if you don't want this level of detail but the default
[28:35] this level of detail but the default mode Network includes an area called the
[28:38] mode Network includes an area called the dorsal lateral prefrontal cortex frontal
[28:41] dorsal lateral prefrontal cortex frontal cortex no surpris is in the front and
[28:43] cortex no surpris is in the front and you have a dorsal the top and side
[28:46] you have a dorsal the top and side lateral part dorsal lateral prefrontal
[28:48] lateral part dorsal lateral prefrontal cortex you got one on each side of your
[28:50] cortex you got one on each side of your brain right and then you have a brain
[28:52] brain right and then you have a brain area called the posterior singulate
[28:53] area called the posterior singulate cortex and then you have an area called
[28:55] cortex and then you have an area called the lateral parietal lobe again you
[28:57] the lateral parietal lobe again you don't need remember these names but
[28:58] don't need remember these names but these are three brain areas that
[29:00] these are three brain areas that normally are synchronized in their
[29:02] normally are synchronized in their activity so when one of these areas is
[29:04] activity so when one of these areas is active in a typical person the other
[29:06] active in a typical person the other areas would be active as well so it's a
[29:08] areas would be active as well so it's a little bit like a symphony or a band
[29:10] little bit like a symphony or a band like a three-piece band it's like drums
[29:12] like a three-piece band it's like drums guitar and bass they're playing together
[29:15] guitar and bass they're playing together okay that's how it is in a typical
[29:17] okay that's how it is in a typical person in a person with ADHD or even a
[29:20] person in a person with ADHD or even a person who has subclinical ADHD or in
[29:23] person who has subclinical ADHD or in any human being who hasn't slept well
[29:26] any human being who hasn't slept well what you find is the default mode
[29:27] what you find is the default mode network is not synchronized these brain
[29:29] network is not synchronized these brain areas are just not playing well
[29:31] areas are just not playing well together now the task networks include a
[29:36] together now the task networks include a different set of structures it still
[29:38] different set of structures it still involves the prefrontal cortex but it's
[29:39] involves the prefrontal cortex but it's a different part of the prefrontal
[29:41] a different part of the prefrontal cortex okay tends to be the medial
[29:44] cortex okay tends to be the medial prefrontal cortex and there are some
[29:46] prefrontal cortex and there are some other brain areas that the medial
[29:47] other brain areas that the medial prefrontal cortex is communicating to
[29:49] prefrontal cortex is communicating to all the time mainly to suppress impulses
[29:53] all the time mainly to suppress impulses it's shutting down the desire to stand
[29:55] it's shutting down the desire to stand up or to scratch the side of your cheek
[29:57] up or to scratch the side of your cheek or your nose if you're trying not to do
[29:59] or your nose if you're trying not to do that anytime you're restricting your
[30:01] that anytime you're restricting your behavior these task directed networks
[30:03] behavior these task directed networks are very active Okay now normally in a
[30:07] are very active Okay now normally in a person without
[30:09] person without ADHD the task networks and the default
[30:12] ADHD the task networks and the default mode networks are going in kind of
[30:14] mode networks are going in kind of seesaw fashion they are actually what we
[30:17] seesaw fashion they are actually what we call anti-correlated so it's not just
[30:19] call anti-correlated so it's not just that they are not correlated they are
[30:21] that they are not correlated they are actually opposing one another they are
[30:24] actually opposing one another they are anti-correlated in a person with ADHD
[30:26] anti-correlated in a person with ADHD the default mode Network and the task
[30:28] the default mode Network and the task networks are actually more coordinated
[30:31] networks are actually more coordinated that might come as surprising I think
[30:33] that might come as surprising I think that we all have this tendency to kind
[30:36] that we all have this tendency to kind of jump to conclusion and assume that
[30:38] of jump to conclusion and assume that somebody who doesn't have an easy time
[30:40] somebody who doesn't have an easy time paying attention or has ADHD that their
[30:43] paying attention or has ADHD that their brain must be completely incoherent that
[30:45] brain must be completely incoherent that it's not working well and because
[30:47] it's not working well and because everything's out of whack but there's
[30:49] everything's out of whack but there's something interesting about people with
[30:50] something interesting about people with ADHD whereby the task networks and the
[30:55] ADHD whereby the task networks and the default mode networks are actually
[30:56] default mode networks are actually working together in a way that's
[30:58] working together in a way that's correlated and that is what's abnormal
[31:01] correlated and that is what's abnormal so this would be like the guitar bass
[31:03] so this would be like the guitar bass and the drums playing together in a way
[31:06] and the drums playing together in a way where the bass isn't keeping the back
[31:09] where the bass isn't keeping the back beat and the drums aren't keeping the
[31:11] beat and the drums aren't keeping the BackBeat that they're playing together
[31:13] BackBeat that they're playing together they're all playing The Melodies and
[31:14] they're all playing The Melodies and harmonies in a way that just doesn't
[31:16] harmonies in a way that just doesn't sound right that's what's going on in
[31:18] sound right that's what's going on in the brain of somebody with
[31:20] the brain of somebody with ADHD and we can now confidently say
[31:23] ADHD and we can now confidently say based on brain Imaging studies that when
[31:25] based on brain Imaging studies that when somebody gets better when they're
[31:27] somebody gets better when they're treated for ADH HD or when they Agee out
[31:29] treated for ADH HD or when they Agee out of ADHD as sometimes is the case that
[31:33] of ADHD as sometimes is the case that the default mode networks and the task
[31:35] the default mode networks and the task networks tend to become anti-correlated
[31:37] networks tend to become anti-correlated again okay so that's the underlying
[31:40] again okay so that's the underlying neurobiology but you'll notice that I
[31:42] neurobiology but you'll notice that I didn't mention dopamine at all what
[31:45] didn't mention dopamine at all what dopamine is doing in this context is
[31:47] dopamine is doing in this context is dopamine is acting like a conductor
[31:50] dopamine is acting like a conductor dopamine is saying this circuit should
[31:52] dopamine is saying this circuit should be active then that circuit should be
[31:53] be active then that circuit should be active it should be default mode Network
[31:55] active it should be default mode Network and then when the default mode network
[31:56] and then when the default mode network is not active then it should be the task
[31:58] is not active then it should be the task Network so it's really acting as a
[32:00] Network so it's really acting as a conductor saying you go now you go now
[32:02] conductor saying you go now you go now you go now you go and in ADHD there's
[32:04] you go now you go and in ADHD there's something about the dopamine system that
[32:07] something about the dopamine system that is not allowing it to conduct these
[32:10] is not allowing it to conduct these networks and make sure that they stay
[32:12] networks and make sure that they stay what you know the engineers or
[32:14] what you know the engineers or physicists or mathematicians would say
[32:15] physicists or mathematicians would say out of phase to be anti-correlated okay
[32:18] out of phase to be anti-correlated okay out of phase and anti-correlated
[32:19] out of phase and anti-correlated essentially the same thing at least for
[32:21] essentially the same thing at least for purposes of this discussion so that
[32:23] purposes of this discussion so that raises two questions could it be that
[32:27] raises two questions could it be that dopamine is not at sufficiently high
[32:29] dopamine is not at sufficiently high levels or could it be that dopamine is
[32:32] levels or could it be that dopamine is just doing it all wrong in other words
[32:33] just doing it all wrong in other words is there no conductor or is the
[32:35] is there no conductor or is the conductor playing with like little tiny
[32:36] conductor playing with like little tiny toothpicks and so the instruments can't
[32:39] toothpicks and so the instruments can't see what they're supposed to do they
[32:41] see what they're supposed to do they can't get the instruction because it's
[32:42] can't get the instruction because it's just not loud enough so to speak or
[32:45] just not loud enough so to speak or could it be that the information is
[32:46] could it be that the information is getting out but the information that's
[32:47] getting out but the information that's getting out is wrong the conductor is
[32:49] getting out is wrong the conductor is there but the conductor isn't very good
[32:51] there but the conductor isn't very good at
[32:53] at conducting now we can gain insight into
[32:55] conducting now we can gain insight into how this system works and fails and how
[32:59] how this system works and fails and how to treat it by looking at some of the
[33:01] to treat it by looking at some of the current and previous treatments for ADHD
[33:04] current and previous treatments for ADHD as well as some of the recreational
[33:05] as well as some of the recreational drugs that people with ADHD tend to
[33:08] drugs that people with ADHD tend to pursue and like now I'm certainly not a
[33:11] pursue and like now I'm certainly not a proponent of people with ADHD taking
[33:12] proponent of people with ADHD taking drugs recreationally that's not what
[33:14] drugs recreationally that's not what this is about but if you look at their
[33:16] this is about but if you look at their drug-seeking behavior and you couple
[33:19] drug-seeking behavior and you couple that drug-seeking behavior to their
[33:22] that drug-seeking behavior to their desire to remedy their attention deficit
[33:25] desire to remedy their attention deficit you start gaining some really
[33:26] you start gaining some really interesting insight into how dopamine is
[33:30] interesting insight into how dopamine is regulating these circuits in normal
[33:32] regulating these circuits in normal circumstances and in people with ADHD so
[33:36] circumstances and in people with ADHD so what exactly is going on with the
[33:37] what exactly is going on with the dopamine system in people with ADHD and
[33:40] dopamine system in people with ADHD and what's going on with the dopamine system
[33:41] what's going on with the dopamine system in people that have terrific levels of
[33:44] in people that have terrific levels of attention for any task well in the year
[33:48] attention for any task well in the year 2015 an important paper came out the
[33:51] 2015 an important paper came out the first author is Spencer and it came out
[33:53] first author is Spencer and it came out in a journal called biological
[33:54] in a journal called biological Psychiatry and it formalized the so- low
[33:58] Psychiatry and it formalized the so- low dopamine hypothesis of
[34:00] dopamine hypothesis of ADHD the idea that dopamine was somehow
[34:03] ADHD the idea that dopamine was somehow involved or not at the appropriate
[34:05] involved or not at the appropriate levels in people with ADHD had been
[34:07] levels in people with ADHD had been around for a pretty long time but a
[34:11] around for a pretty long time but a formal proposition of the low dopamine
[34:14] formal proposition of the low dopamine hypothesis led to some really important
[34:16] hypothesis led to some really important experiments and understanding of what
[34:18] experiments and understanding of what goes wrong in
[34:19] goes wrong in ADHD it turns out that if dopamine
[34:22] ADHD it turns out that if dopamine levels are too low in particular
[34:25] levels are too low in particular circuits in the brain that it leads to
[34:27] circuits in the brain that it leads to to unnecessary firing of neurons in the
[34:30] to unnecessary firing of neurons in the brain that are unrelated to the task
[34:33] brain that are unrelated to the task that one is trying to do and that is
[34:36] that one is trying to do and that is unrelated to the information that one is
[34:38] unrelated to the information that one is trying to focus on so if you think back
[34:40] trying to focus on so if you think back before you've got this default mode
[34:42] before you've got this default mode Network and a task related Network and
[34:44] Network and a task related Network and they need to be in this kind of concert
[34:46] they need to be in this kind of concert of anti-correlation and an ADHD they're
[34:49] of anti-correlation and an ADHD they're firing together well the problem seems
[34:51] firing together well the problem seems to be that when dopamine is
[34:54] to be that when dopamine is low certain neurons are firing when they
[34:56] low certain neurons are firing when they shouldn't be this is like a band right
[34:59] shouldn't be this is like a band right we'll go back to our band that's a
[35:00] we'll go back to our band that's a guitar a bass and a and a person playing
[35:02] guitar a bass and a and a person playing the drums and it's as if one of those or
[35:05] the drums and it's as if one of those or several of those instruments are playing
[35:07] several of those instruments are playing notes when they shouldn't be playing
[35:09] notes when they shouldn't be playing right the pauses in music are just as
[35:11] right the pauses in music are just as important as the actual playing of
[35:14] important as the actual playing of notes when dopamine is too low neurons
[35:18] notes when dopamine is too low neurons fire more than they should in these
[35:20] fire more than they should in these networks that govern
[35:22] networks that govern attention this is the so-called low
[35:24] attention this is the so-called low dopamine
[35:25] dopamine hypothesis and if you start looking
[35:28] hypothesis and if you start looking anecdotally at what people with ADHD
[35:31] anecdotally at what people with ADHD have done for decades not just recently
[35:35] have done for decades not just recently since the low dopamine hypothesis has
[35:36] since the low dopamine hypothesis has been proposed but what they were doing
[35:39] been proposed but what they were doing in the 1950s and in the 1940s and the
[35:41] in the 1950s and in the 1940s and the 1960s what you find is that they tend to
[35:45] 1960s what you find is that they tend to use recreational drugs or they tend to
[35:49] use recreational drugs or they tend to indulge in
[35:52] indulge in non-drug stimulants so things like
[35:55] non-drug stimulants so things like drinking six cups of coffee or quadruple
[35:58] drinking six cups of coffee or quadruple espressos or when it was more prominent
[36:01] espressos or when it was more prominent smoking a half a pack of cigarettes and
[36:03] smoking a half a pack of cigarettes and drinking four cups of coffee a day or if
[36:06] drinking four cups of coffee a day or if the person had access to it using
[36:08] the person had access to it using cocaine as a recreational drug or
[36:10] cocaine as a recreational drug or amphetamine as a recreational drug all
[36:12] amphetamine as a recreational drug all of those substances that I just
[36:14] of those substances that I just described in particular cocaine and
[36:17] described in particular cocaine and amphetamine but also coffee and
[36:19] amphetamine but also coffee and cigarettes increased levels of multiple
[36:22] cigarettes increased levels of multiple neurotransmitters but all have the
[36:24] neurotransmitters but all have the quality of increasing levels of dopamine
[36:26] quality of increasing levels of dopamine in the brain and in particular in the
[36:29] in the brain and in particular in the regions of the brain that regulate
[36:30] regions of the brain that regulate attention and these task related and
[36:33] attention and these task related and default mode networks okay now young
[36:36] default mode networks okay now young children fortunately don't have access
[36:37] children fortunately don't have access to those kinds of stimulants most of the
[36:40] to those kinds of stimulants most of the time and those stimulants all have high
[36:44] time and those stimulants all have high potential for abuse in adults so we will
[36:46] potential for abuse in adults so we will talk about the potential for abuse in a
[36:48] talk about the potential for abuse in a few minutes but if you look at children
[36:51] few minutes but if you look at children even very young children with
[36:53] even very young children with ADHD they show things like preference
[36:56] ADHD they show things like preference for sugary Foods which also act as
[36:59] for sugary Foods which also act as dopamine inducing stimulants now of
[37:02] dopamine inducing stimulants now of course once they get access to soda pop
[37:05] course once they get access to soda pop and coffee and tea they start to indulge
[37:08] and coffee and tea they start to indulge in those more than other people for a
[37:10] in those more than other people for a long time it was thought that children
[37:11] long time it was thought that children with ADHD consume too many sugary Foods
[37:13] with ADHD consume too many sugary Foods or drank too much soda or adults with
[37:17] or drank too much soda or adults with ADHD would take recreational drugs like
[37:19] ADHD would take recreational drugs like methamphetamine or cocaine or would
[37:22] methamphetamine or cocaine or would drink coffee to excess or smoke
[37:24] drink coffee to excess or smoke cigarettes to excess because they had
[37:26] cigarettes to excess because they had poor levels of attention and because
[37:29] poor levels of attention and because they couldn't make good decisions they
[37:31] they couldn't make good decisions they were too impulsive and so forth and
[37:33] were too impulsive and so forth and while that certainly could be the case
[37:35] while that certainly could be the case knowing what we now know about dopamine
[37:38] knowing what we now know about dopamine and the fact that having enough dopamine
[37:40] and the fact that having enough dopamine is required in order to coordinate these
[37:42] is required in order to coordinate these neural circuits that allow for focus and
[37:45] neural circuits that allow for focus and quality decision making an equally valid
[37:48] quality decision making an equally valid idea is that these children and these
[37:51] idea is that these children and these adults are actually trying to
[37:52] adults are actually trying to self-medicate by pursuing these
[37:54] self-medicate by pursuing these compounds right things like cocaine lead
[37:57] compounds right things like cocaine lead to huge increases in dopamine well what
[37:59] to huge increases in dopamine well what happens with when somebody with ADHD
[38:01] happens with when somebody with ADHD takes that drug it turns out they
[38:04] takes that drug it turns out they actually obtain heighten levels of focus
[38:07] actually obtain heighten levels of focus their ability to focus on things other
[38:08] their ability to focus on things other than things they absolutely care
[38:11] than things they absolutely care intensely about goes up likewise
[38:14] intensely about goes up likewise children who consume anything that
[38:16] children who consume anything that increases their levels of dopamine if
[38:19] increases their levels of dopamine if those children have
[38:21] those children have ADHD they tend to be calmer they tend to
[38:24] ADHD they tend to be calmer they tend to be able to focus more now this is very
[38:26] be able to focus more now this is very different then children who do not have
[38:29] different then children who do not have ADHD when they consume too much sugar
[38:30] ADHD when they consume too much sugar they tend to become super hyperactive
[38:33] they tend to become super hyperactive when they consume any kind of stimulant
[38:34] when they consume any kind of stimulant they tend to go wild and run around like
[38:36] they tend to go wild and run around like crazy I actually have an anecdote about
[38:38] crazy I actually have an anecdote about this just to illustrate it I have a
[38:40] this just to illustrate it I have a friend he has two children that are now
[38:43] friend he has two children that are now in their teens and 20s but when they
[38:44] in their teens and 20s but when they were little one time I brought them some
[38:46] were little one time I brought them some chocolate just as a gift when I showed
[38:48] chocolate just as a gift when I showed up at their house and within 30 minutes
[38:51] up at their house and within 30 minutes we the kids were running around like
[38:53] we the kids were running around like crazy I mean I they were pretty high
[38:55] crazy I mean I they were pretty high energy kids but they were going bonkers
[38:57] energy kids but they were going bonkers and that's actually when the mother my
[39:00] and that's actually when the mother my friend at the time and fortunately still
[39:01] friend at the time and fortunately still now looked at the chocolate and realized
[39:03] now looked at the chocolate and realized that it was chocolate with espresso
[39:05] that it was chocolate with espresso beans in it it was like dark chocolate
[39:06] beans in it it was like dark chocolate espresso beans so I I was really at
[39:08] espresso beans so I I was really at fault there you don't want to give kids
[39:10] fault there you don't want to give kids dark chocolate with espresso beans but
[39:12] dark chocolate with espresso beans but what you're really seeing that
[39:13] what you're really seeing that hyperactivity that is dopamine okay it's
[39:15] hyperactivity that is dopamine okay it's the sugar combined with the caffeine in
[39:18] the sugar combined with the caffeine in this case combined with a few other
[39:19] this case combined with a few other compounds that exist in chocolate that
[39:21] compounds that exist in chocolate that really increase our levels of alertness
[39:23] really increase our levels of alertness and our tendency to want to move around
[39:25] and our tendency to want to move around a
[39:26] a lot okay so dopamine and low levels of
[39:30] lot okay so dopamine and low levels of dopamine apparently are what's wrong in
[39:33] dopamine apparently are what's wrong in people with ADHD that dopamine
[39:35] people with ADHD that dopamine hypothesis is what led to the idea that
[39:38] hypothesis is what led to the idea that treating people children and adults
[39:40] treating people children and adults included with dopaminergic compounds
[39:44] included with dopaminergic compounds would somehow increase their ability to
[39:47] would somehow increase their ability to focus and if you look at the major drugs
[39:50] focus and if you look at the major drugs that were developed and now marketed by
[39:52] that were developed and now marketed by pharmaceutical companies for the
[39:54] pharmaceutical companies for the treatment of
[39:55] treatment of ADHD those drugs
[39:57] ADHD those drugs have names like Rin nowadays it's
[40:00] have names like Rin nowadays it's typically things like
[40:02] typically things like adero modafanil and some of the other
[40:05] adero modafanil and some of the other derivatives they all serve to increase
[40:08] derivatives they all serve to increase levels of dopamine in particular
[40:09] levels of dopamine in particular dopamine in the networks that control
[40:12] dopamine in the networks that control task directed behavior and that
[40:13] task directed behavior and that coordinate the default mode Network and
[40:16] coordinate the default mode Network and these task related networks so many of
[40:19] these task related networks so many of you have probably heard of rlin rlin is
[40:21] you have probably heard of rlin rlin is a prescription stimulant that is
[40:24] a prescription stimulant that is prescribed for ADHD as well as for
[40:27] prescribed for ADHD as well as for narcolepsy narcolepsy is a condition in
[40:30] narcolepsy narcolepsy is a condition in which people tend to fall asleep during
[40:32] which people tend to fall asleep during the daytime quite a lot it's excessive
[40:33] the daytime quite a lot it's excessive daytime sleepiness not due to lack of
[40:36] daytime sleepiness not due to lack of sleep at night but also tend to fall
[40:38] sleep at night but also tend to fall asleep when they get excited if they're
[40:40] asleep when they get excited if they're really emotionally excited or about to
[40:42] really emotionally excited or about to eat or any other kind of activity that
[40:44] eat or any other kind of activity that would normally get somebody really
[40:46] would normally get somebody really aroused and alert people with narcolepsy
[40:48] aroused and alert people with narcolepsy tend to fall asleep or they tend to
[40:50] tend to fall asleep or they tend to become what's called cataplectic they
[40:52] become what's called cataplectic they tend to just sort of go limp in the
[40:53] tend to just sort of go limp in the muscles so it's this invasion of sleep
[40:55] muscles so it's this invasion of sleep into the daytime it's disregulated by
[40:58] into the daytime it's disregulated by emotion you can imagine why a stimulant
[41:00] emotion you can imagine why a stimulant something that would wake you up make
[41:02] something that would wake you up make you very alert focused and motivated
[41:04] you very alert focused and motivated would be a good treatment for
[41:06] would be a good treatment for narcolepsy adero also is used to treat
[41:10] narcolepsy adero also is used to treat ADHD and to treat narcolepsy things like
[41:14] ADHD and to treat narcolepsy things like modafanil also used to treat ADHD and
[41:17] modafanil also used to treat ADHD and narcolepsy so you're sensing a theme
[41:19] narcolepsy so you're sensing a theme here so what are the differences and
[41:21] here so what are the differences and similarities between these drugs and
[41:22] similarities between these drugs and what can that tell us about ADHD well
[41:25] what can that tell us about ADHD well rolin was one of the first generation
[41:28] rolin was one of the first generation drugs that was prescribed for ADHD in
[41:32] drugs that was prescribed for ADHD in order to deal headon with this dopamine
[41:35] order to deal headon with this dopamine hypothesis this idea that in ADHD
[41:37] hypothesis this idea that in ADHD dopamine levels are too low nowadays
[41:41] dopamine levels are too low nowadays adero is the more typically prescribed
[41:43] adero is the more typically prescribed drug for
[41:44] drug for ADHD that has to do with some of the
[41:46] ADHD that has to do with some of the so-called pharmokinetics the rate at
[41:49] so-called pharmokinetics the rate at which those drugs enter the system and
[41:50] which those drugs enter the system and how long they last in the system so for
[41:53] how long they last in the system so for instance rlin was a drug that was
[41:55] instance rlin was a drug that was packaged into various time relas
[41:57] packaged into various time relas formulas whereas initially adderal was
[42:00] formulas whereas initially adderal was only released in a form that had a very
[42:02] only released in a form that had a very short life so uh meaning that it wasn't
[42:05] short life so uh meaning that it wasn't in the bloodstream very long and didn't
[42:07] in the bloodstream very long and didn't affect the brain for very long and so
[42:09] affect the brain for very long and so the dosages could be controlled in a
[42:11] the dosages could be controlled in a more typical way without going into a
[42:13] more typical way without going into a lot of uh tangential detail as you all
[42:16] lot of uh tangential detail as you all know at different times of day you tend
[42:18] know at different times of day you tend to be more or less alert so a long
[42:21] to be more or less alert so a long sustained release drug while that might
[42:23] sustained release drug while that might sound like a really terrific thing if
[42:25] sound like a really terrific thing if that drug is having an effect of making
[42:26] that drug is having an effect of making you more or alert and it's released
[42:28] you more or alert and it's released across very many hours of your day there
[42:31] across very many hours of your day there might be periods of your day when you
[42:33] might be periods of your day when you feel too alert periods of your day when
[42:35] feel too alert periods of your day when you feel just right and periods of your
[42:36] you feel just right and periods of your day when you wished that you were more
[42:38] day when you wished that you were more alert these are some of the
[42:40] alert these are some of the pharmacokinetics kinetics meaning
[42:42] pharmacokinetics kinetics meaning movement of the different compounds
[42:44] movement of the different compounds within the bloodstream and brain that
[42:45] within the bloodstream and brain that could you could imagine in a very real
[42:48] could you could imagine in a very real way would impact whether or not someone
[42:49] way would impact whether or not someone would feel really good on one of these
[42:51] would feel really good on one of these drugs or whether or not they would feel
[42:52] drugs or whether or not they would feel too anxious or too sleepy and so on
[42:56] too anxious or too sleepy and so on let's take a step back for second to
[42:57] let's take a step back for second to just ask what are these drugs we know
[42:59] just ask what are these drugs we know they increase dopamine but what are they
[43:02] they increase dopamine but what are they really well Rin also called
[43:06] really well Rin also called methylphenidate is very similar to
[43:09] methylphenidate is very similar to amphetamine speed or what's typically
[43:12] amphetamine speed or what's typically called speed in the street drug uh
[43:15] called speed in the street drug uh nomenclature
[43:16] nomenclature Aderall which goes by various other
[43:19] Aderall which goes by various other names okay so Aderall Aderall XR M Midas
[43:24] names okay so Aderall Aderall XR M Midas myasis uh things like that
[43:28] myasis uh things like that adol is basically a combination of
[43:29] adol is basically a combination of amphetamine and
[43:32] amphetamine and dextroamphetamine now some of you
[43:34] dextroamphetamine now some of you probably realize this that Aderall is
[43:36] probably realize this that Aderall is amphetamine but I'm guessing that there
[43:37] amphetamine but I'm guessing that there are a good number of you out there
[43:39] are a good number of you out there perhaps even parents and kids that don't
[43:41] perhaps even parents and kids that don't realize that these drugs like cocaine
[43:43] realize that these drugs like cocaine and amphetamine methamphetamine which
[43:45] and amphetamine methamphetamine which are incredibly dangerous and
[43:49] are incredibly dangerous and Incredibly habit forming and have high
[43:51] Incredibly habit forming and have high potential for abuse well the
[43:54] potential for abuse well the pharmaceutical versions of those are
[43:56] pharmaceutical versions of those are exactly what are used to treat ADHD now
[43:59] exactly what are used to treat ADHD now they're not exactly like cocaine or
[44:01] they're not exactly like cocaine or Methamphetamine but they are
[44:02] Methamphetamine but they are structurally and chemically very similar
[44:05] structurally and chemically very similar and their net effect in the brain and
[44:07] and their net effect in the brain and body is essentially the same which is to
[44:09] body is essentially the same which is to increase dopamine primarily but also to
[44:12] increase dopamine primarily but also to increase levels of a neuromodulator
[44:14] increase levels of a neuromodulator called epinephrine or norepinephrine
[44:16] called epinephrine or norepinephrine also called noradrenaline and adrenaline
[44:18] also called noradrenaline and adrenaline those names are the same and to some
[44:20] those names are the same and to some extent to increased levels of serotonin
[44:22] extent to increased levels of serotonin in the brain and blood but not so much
[44:25] in the brain and blood but not so much serotonin that's just kind of a a small
[44:27] serotonin that's just kind of a a small smidgen of effect okay so dopamine way
[44:29] smidgen of effect okay so dopamine way up norepinephrine and adrenaline way up
[44:32] up norepinephrine and adrenaline way up so that's motivation Drive focus and
[44:35] so that's motivation Drive focus and energy and to some extent a little bit
[44:39] energy and to some extent a little bit of Serotonin which is really more about
[44:42] of Serotonin which is really more about feeling calm and relaxed and you could
[44:45] feeling calm and relaxed and you could imagine why that would be a good
[44:46] imagine why that would be a good balancing effect for dopamine and
[44:50] balancing effect for dopamine and norepinephrine so what I'm essentially
[44:52] norepinephrine so what I'm essentially saying is that the drugs that are used
[44:54] saying is that the drugs that are used to treat ADHD are stimulants and they
[44:57] to treat ADHD are stimulants and they look very much like in fact nearly
[45:00] look very much like in fact nearly identical to some of the so-called
[45:01] identical to some of the so-called street drug stimulants that we all hear
[45:04] street drug stimulants that we all hear are so terrible however I do want to
[45:07] are so terrible however I do want to emphasize that at the appropriate
[45:09] emphasize that at the appropriate dosages and working with a quality
[45:12] dosages and working with a quality psychiatrist or neurologist or family
[45:15] psychiatrist or neurologist or family physician does have to be a board
[45:17] physician does have to be a board certified MD that prescribes these
[45:18] certified MD that prescribes these things many people with
[45:20] things many people with ADHD achieve excellent relief with these
[45:24] ADHD achieve excellent relief with these drugs not all of them but many of them
[45:26] drugs not all of them but many of them do especially if these treatments are
[45:27] do especially if these treatments are started early in life so now knowing
[45:30] started early in life so now knowing what these drugs are I want to raise the
[45:32] what these drugs are I want to raise the question
[45:33] question of why prescribe these drugs I mean
[45:36] of why prescribe these drugs I mean everyone has to make a decision for
[45:38] everyone has to make a decision for themselves or for their child as to
[45:39] themselves or for their child as to whether or not they're going to take
[45:40] whether or not they're going to take these things or not I also want to
[45:43] these things or not I also want to acknowledge that many people out there
[45:46] acknowledge that many people out there many many people out there are taking
[45:49] many many people out there are taking these drugs even though they have not
[45:50] these drugs even though they have not been clinically diagnosed with ADHD when
[45:53] been clinically diagnosed with ADHD when I say these drugs I'm specifically
[45:54] I say these drugs I'm specifically referring to rlin and adderal and
[45:56] referring to rlin and adderal and modafino
[45:57] modafino but more typically it's Aderall okay
[46:00] but more typically it's Aderall okay people using cocaine and amphetamine for
[46:02] people using cocaine and amphetamine for recreational purposes that's a
[46:03] recreational purposes that's a completely different beast and it is
[46:05] completely different beast and it is indeed a beast and it's something that I
[46:07] indeed a beast and it's something that I strongly
[46:09] strongly discourage however I am aware that up to
[46:12] discourage however I am aware that up to 25% of college students and perhaps as
[46:16] 25% of college students and perhaps as many as 35% of all individuals between
[46:19] many as 35% of all individuals between the ages of 17 and 30 are taking Aderall
[46:24] the ages of 17 and 30 are taking Aderall on a regular or semi-regular basis in
[46:27] on a regular or semi-regular basis in order to work in order to study and in
[46:31] order to work in order to study and in order to function and focus in their
[46:33] order to function and focus in their daily life even though they have not
[46:35] daily life even though they have not been diagnosed with ADHD there's a whole
[46:37] been diagnosed with ADHD there's a whole black market for this they're getting it
[46:38] black market for this they're getting it from people with prescriptions I'm not
[46:40] from people with prescriptions I'm not here to pass judgment I just want to
[46:42] here to pass judgment I just want to emphasize how these drugs work some of
[46:45] emphasize how these drugs work some of the things that they do to enhance
[46:47] the things that they do to enhance cognition and focus that actually serve
[46:49] cognition and focus that actually serve the brain well in certain individuals
[46:51] the brain well in certain individuals and how they can be very
[46:53] and how they can be very detrimental in other individuals I sort
[46:55] detrimental in other individuals I sort of blew right past it but the fact that
[46:58] of blew right past it but the fact that in upwards of 25% of young people are
[47:01] in upwards of 25% of young people are taking things like Aderall despite not
[47:04] taking things like Aderall despite not having a clinical diagnosis of
[47:07] having a clinical diagnosis of ADHD well that's a ridiculously high
[47:10] ADHD well that's a ridiculously high number a few years ago it was estimated
[47:13] number a few years ago it was estimated that adderal use and rlin use without
[47:16] that adderal use and rlin use without diagnosis of ADHD was second an incident
[47:19] diagnosis of ADHD was second an incident only to cannabis but actually now the
[47:23] only to cannabis but actually now the consumption of Aderall without
[47:25] consumption of Aderall without prescription
[47:27] prescription is higher than the consumption of
[47:30] is higher than the consumption of cannabis in that age group so what that
[47:32] cannabis in that age group so what that means is that there's a lot of stimulant
[47:34] means is that there's a lot of stimulant use in that age group and there are a
[47:36] use in that age group and there are a lot of adults also using and abusing
[47:39] lot of adults also using and abusing stimulants in order to gain Focus now we
[47:42] stimulants in order to gain Focus now we could have a whole discussion about
[47:43] could have a whole discussion about whether or not life is becoming more
[47:44] whether or not life is becoming more demanding whether or not the need for
[47:47] demanding whether or not the need for focus is excessive and that's why people
[47:48] focus is excessive and that's why people are doing that frankly it's it's an
[47:50] are doing that frankly it's it's an interesting discussion but it's not one
[47:52] interesting discussion but it's not one that would deliver us to any answers
[47:54] that would deliver us to any answers rather I'd like to focus on the ways
[47:56] rather I'd like to focus on the ways that people people now and people have
[47:58] that people people now and people have always been self-medicating to increase
[48:00] always been self-medicating to increase Focus right caffeine which I indulge
[48:05] Focus right caffeine which I indulge some I don't think the EXs has long been
[48:08] some I don't think the EXs has long been used as a stimulant to increase dopamine
[48:10] used as a stimulant to increase dopamine increase norepinephrine increase focus
[48:12] increase norepinephrine increase focus and energy and in addition to that it
[48:15] and energy and in addition to that it works through the so-called cyclicamp
[48:17] works through the so-called cyclicamp phosphodiesterase pathway remember
[48:19] phosphodiesterase pathway remember anytime you see you hear an ASE that's
[48:21] anytime you see you hear an ASE that's an enzyme phosphodiesterase is involved
[48:23] an enzyme phosphodiesterase is involved in the conversion of things like
[48:25] in the conversion of things like cyclicamp into energy for cells and so
[48:28] cyclicamp into energy for cells and so forth basically coffee gives you energy
[48:29] forth basically coffee gives you energy it makes you feel good and it increases
[48:32] it makes you feel good and it increases Focus because of the circuits that it
[48:34] Focus because of the circuits that it engages in the
[48:36] engages in the brain people have been taking caffeine
[48:38] brain people have been taking caffeine and continue to take caffeine for ages
[48:42] and continue to take caffeine for ages people also used to smoke cigarettes
[48:45] people also used to smoke cigarettes nicotine in order to gain Focus nowadays
[48:48] nicotine in order to gain Focus nowadays that's less common because of the
[48:49] that's less common because of the concerns quite valid concerns about lung
[48:52] concerns quite valid concerns about lung cancer from smoking but there's a lot of
[48:55] cancer from smoking but there's a lot of vaping out there there are a lot of
[48:58] vaping out there there are a lot of people now consuming nicotine which is
[49:00] people now consuming nicotine which is the active substance in cigarettes and
[49:02] the active substance in cigarettes and in most nicotine Vapes that stimulates
[49:06] in most nicotine Vapes that stimulates the brain to be more focused and more
[49:08] the brain to be more focused and more alert so this the idea of taking
[49:10] alert so this the idea of taking stimulants of consuming things or
[49:12] stimulants of consuming things or smoking things in order to increase
[49:15] smoking things in order to increase alertness is not a new idea it's just
[49:17] alertness is not a new idea it's just that in
[49:19] that in ADHD it's surprising that these things
[49:21] ADHD it's surprising that these things would work right I mean if the problem
[49:23] would work right I mean if the problem is attention deficit hyperactivity
[49:25] is attention deficit hyperactivity disorder what we're really talking about
[49:27] disorder what we're really talking about here or children that are prescribed a
[49:31] here or children that are prescribed a drug that ought to be a stimulant it it
[49:33] drug that ought to be a stimulant it it ought to make them hyper hyperactive and
[49:35] ought to make them hyper hyperactive and rather than doing that it actually
[49:37] rather than doing that it actually somehow serves to calm them a bit or at
[49:40] somehow serves to calm them a bit or at least allow them to focus here's the
[49:43] least allow them to focus here's the reason children have a brain that's very
[49:46] reason children have a brain that's very plastic meaning it can remodel itself
[49:49] plastic meaning it can remodel itself and change in response to experience
[49:51] and change in response to experience very very quickly compared to adults
[49:54] very very quickly compared to adults taking stimulants as a child if you are
[49:57] taking stimulants as a child if you are a child diagnosed with
[49:59] a child diagnosed with ADHD allows that forbrain task related
[50:02] ADHD allows that forbrain task related Network to come online to be active at
[50:05] Network to come online to be active at the appropriate times and because those
[50:08] the appropriate times and because those children are young it allows those
[50:10] children are young it allows those children to learn what focus is and to
[50:12] children to learn what focus is and to sort of follow or enter that tunnel of
[50:15] sort of follow or enter that tunnel of focus Now by taking a drug it's creating
[50:19] focus Now by taking a drug it's creating Focus artificially it's not creating
[50:21] Focus artificially it's not creating Focus because they're super interested
[50:23] Focus because they're super interested in something it's chemically inducing a
[50:25] in something it's chemically inducing a state of focus
[50:27] state of focus and let's face it a lot of childhood and
[50:29] and let's face it a lot of childhood and school and becoming a functional adult
[50:31] school and becoming a functional adult is about learning how to focus even
[50:32] is about learning how to focus even though you don't want to do something in
[50:34] though you don't want to do something in fact when I was in college I had this
[50:35] fact when I was in college I had this little trick that may or may not work
[50:37] little trick that may or may not work for some of you which is if I couldn't
[50:39] for some of you which is if I couldn't focus on the material I was trying to
[50:41] focus on the material I was trying to learn I would delude myself into
[50:43] learn I would delude myself into thinking that it was the most
[50:45] thinking that it was the most interesting thing in the world I would
[50:46] interesting thing in the world I would just kind of lie to myself and tell
[50:48] just kind of lie to myself and tell myself okay this I won't mention the
[50:50] myself okay this I won't mention the subjects
[50:51] subjects um I absolutely love this I would just I
[50:54] um I absolutely love this I would just I would tell myself that I loved it and I
[50:56] would tell myself that I loved it and I noticed that just that selective or
[50:59] noticed that just that selective or deliberate engagement of that desire to
[51:01] deliberate engagement of that desire to know circuit whatever that is in my
[51:03] know circuit whatever that is in my brain no doubt involves dopamine allowed
[51:06] brain no doubt involves dopamine allowed me to focus and remember the information
[51:08] me to focus and remember the information and somewhat surprisingly or perhaps not
[51:10] and somewhat surprisingly or perhaps not surprisingly I would often fall in love
[51:12] surprisingly I would often fall in love with the information I find that that
[51:14] with the information I find that that was my favorite class it was the what I
[51:15] was my favorite class it was the what I wanted to learn the most so that's one
[51:18] wanted to learn the most so that's one way you can do it artificially but kids
[51:20] way you can do it artificially but kids with adhy they can't do that right
[51:21] with adhy they can't do that right they're told to sit still and they end
[51:23] they're told to sit still and they end up getting up 11 times you know they are
[51:25] up getting up 11 times you know they are told that they can't speak out in class
[51:28] told that they can't speak out in class or that uh they have to remain in their
[51:30] or that uh they have to remain in their seats for 10 minutes and they just
[51:32] seats for 10 minutes and they just despite their best effort they simply
[51:34] despite their best effort they simply cannot do it they're highly distractable
[51:37] cannot do it they're highly distractable so what are we to make of this whole
[51:38] so what are we to make of this whole picture that we need more dopamine but
[51:40] picture that we need more dopamine but these kids with ADHD they're getting
[51:43] these kids with ADHD they're getting their dopamine by way of a drug which is
[51:45] their dopamine by way of a drug which is for all the world amphetamines right
[51:47] for all the world amphetamines right it's speed that's really what it is what
[51:50] it's speed that's really what it is what are the longterm consequences what are
[51:51] are the longterm consequences what are the short-term
[51:52] the short-term consequences and what should we make of
[51:55] consequences and what should we make of people taking these drugs without a
[51:57] people taking these drugs without a clinical need what are the consequences
[51:59] clinical need what are the consequences there well in order to get to some of
[52:01] there well in order to get to some of those answers I went to one of my
[52:03] those answers I went to one of my colleagues this is a colleague that I've
[52:05] colleagues this is a colleague that I've actually known for a very long time I
[52:07] actually known for a very long time I was their teaching assistant when they
[52:08] was their teaching assistant when they were an undergraduate they went on to
[52:10] were an undergraduate they went on to get an MD a medical degree as well as a
[52:14] get an MD a medical degree as well as a PhD and have become a pediatric
[52:17] PhD and have become a pediatric neurologist that specializes in the
[52:19] neurologist that specializes in the treatment of epilepsy and ADHD in kids
[52:22] treatment of epilepsy and ADHD in kids of all ages from age three to 21 that's
[52:25] of all ages from age three to 21 that's the age range pretty pretty broad age
[52:27] the age range pretty pretty broad age range and has extensive knowledge in
[52:29] range and has extensive knowledge in this and what makes them particularly
[52:32] this and what makes them particularly interesting for sake of this discussion
[52:35] interesting for sake of this discussion is that they have a child a young boy
[52:38] is that they have a child a young boy who's now showing signs of ADHD and they
[52:41] who's now showing signs of ADHD and they are on the threshold of trying to decide
[52:43] are on the threshold of trying to decide whether or not they will prescribe
[52:46] whether or not they will prescribe Aderall or something similar so we had a
[52:49] Aderall or something similar so we had a discussion about this and prior to
[52:52] discussion about this and prior to learning that their child may have
[52:55] learning that their child may have ADHD I asked the following questions
[52:57] ADHD I asked the following questions first of all I asked what do you think
[52:59] first of all I asked what do you think about giving young kids amphetamine and
[53:02] about giving young kids amphetamine and their answer was you know on the face of
[53:06] their answer was you know on the face of it it seems crazy but provided that the
[53:10] it it seems crazy but provided that the lowest possible dose is used and that
[53:12] lowest possible dose is used and that that dosage is modulated as they grow
[53:15] that dosage is modulated as they grow older and develop those powers of
[53:17] older and develop those powers of attention their observation was that
[53:20] attention their observation was that they've seen more kids benefit than not
[53:24] they've seen more kids benefit than not benefit from that now I'm certainly not
[53:26] benefit from that now I'm certainly not saying what people should do you
[53:27] saying what people should do you obviously have to go to a doctor because
[53:29] obviously have to go to a doctor because as I always say I'm not a doctor I don't
[53:31] as I always say I'm not a doctor I don't prescribe anything I'm a professor so I
[53:33] prescribe anything I'm a professor so I profess things and here I'm professing
[53:34] profess things and here I'm professing that you talk to your doctor if you're
[53:36] that you talk to your doctor if you're considering giving rlin or Aderall or
[53:39] considering giving rlin or Aderall or any type of stimulant to your child of
[53:41] any type of stimulant to your child of course what could be more important than
[53:42] course what could be more important than the health of your child but it was a
[53:44] the health of your child but it was a very interesting answer because
[53:46] very interesting answer because typically we hear yes medicate or don't
[53:48] typically we hear yes medicate or don't medicate rarely do we hear that the
[53:49] medicate rarely do we hear that the medication should be adjusted across the
[53:52] medication should be adjusted across the lifespan and in any particular kind of
[53:53] lifespan and in any particular kind of way now the fact that this person this
[53:56] way now the fact that this person this now friend of mine and colleague of mine
[53:59] now friend of mine and colleague of mine has so much expertise in the way that
[54:01] has so much expertise in the way that the brain works and is considering
[54:03] the brain works and is considering putting their child on such medication I
[54:06] putting their child on such medication I said you know why wouldn't you wait
[54:09] said you know why wouldn't you wait until your kid reaches puberty I mean we
[54:11] until your kid reaches puberty I mean we know that in boys and in girls there are
[54:14] know that in boys and in girls there are increases in testosterone and estrogen
[54:16] increases in testosterone and estrogen during puberty that dramatically change
[54:19] during puberty that dramatically change the way that the body appears but also
[54:22] the way that the body appears but also that dramatically change the way that
[54:23] that dramatically change the way that the brain functions in particular we
[54:25] the brain functions in particular we know this that puberty triggers the
[54:28] know this that puberty triggers the activation of so-called
[54:30] activation of so-called frontotemporal task rated executive
[54:33] frontotemporal task rated executive functioning that's just fancy science
[54:35] functioning that's just fancy science speak for being able to focus being able
[54:37] speak for being able to focus being able to direct your attention being able to
[54:39] to direct your attention being able to control your impulses look at a small
[54:40] control your impulses look at a small child or look at a puppy and then look
[54:42] child or look at a puppy and then look at an older child or look at a dog very
[54:45] at an older child or look at a dog very different levels patterns of spontaneous
[54:47] different levels patterns of spontaneous Behavior young children move around a
[54:48] Behavior young children move around a lot they're Shi they're I don't want to
[54:50] lot they're Shi they're I don't want to say Shifty because that makes it sound
[54:51] say Shifty because that makes it sound like they're up to something bad which
[54:52] like they're up to something bad which they might be but they don't have to be
[54:54] they might be but they don't have to be up to something bad they fidget a lot so
[54:56] up to something bad they fidget a lot so do puppies everything's a stimulus as
[54:58] do puppies everything's a stimulus as animals and humans get older they learn
[55:00] animals and humans get older they learn how to control their behavior and sit
[55:03] how to control their behavior and sit still listen and focus even if they
[55:06] still listen and focus even if they don't want to so giving a drug that
[55:09] don't want to so giving a drug that allows a child to access that Stillness
[55:13] allows a child to access that Stillness early on it's thought will allow them to
[55:16] early on it's thought will allow them to maintain that ability as time goes on
[55:19] maintain that ability as time goes on but I decided to push a little bit
[55:21] but I decided to push a little bit further I said well why would you do it
[55:24] further I said well why would you do it now as opposed to during puberty or
[55:27] now as opposed to during puberty or after puberty and their answer was very
[55:30] after puberty and their answer was very specific and I think very important what
[55:31] specific and I think very important what they said was look
[55:34] they said was look neuroplasticity is greatest in childhood
[55:37] neuroplasticity is greatest in childhood and tapers off after about age 25 but
[55:40] and tapers off after about age 25 but neuroplasticity from age three until age
[55:44] neuroplasticity from age three until age 12 or 13 is exceedingly high and they're
[55:48] 12 or 13 is exceedingly high and they're right when you sit back and you look at
[55:50] right when you sit back and you look at the literature on neuroplasticity you'd
[55:52] the literature on neuroplasticity you'd say childhood plasticity and young adult
[55:54] say childhood plasticity and young adult plasticity is much greater than adult
[55:55] plasticity is much greater than adult plasticity
[55:57] plasticity but that early childhood plasticity is
[55:59] but that early childhood plasticity is Far and Away the period in which you can
[56:01] Far and Away the period in which you can reshape the brain at an accelerated rate
[56:05] reshape the brain at an accelerated rate so this lines up really well with the
[56:07] so this lines up really well with the clinical literature not surprisingly
[56:09] clinical literature not surprisingly they're a clinician that early treatment
[56:12] they're a clinician that early treatment is key if you have the opportunity to
[56:14] is key if you have the opportunity to work with a quality physician and treat
[56:16] work with a quality physician and treat these things early these drugs can allow
[56:19] these things early these drugs can allow these frontal circuits these task
[56:21] these frontal circuits these task related circuits to achieve their
[56:24] related circuits to achieve their appropriate levels of functioning and
[56:26] appropriate levels of functioning and for kids to learn how to focus in a
[56:28] for kids to learn how to focus in a variety of different contexts now is
[56:31] variety of different contexts now is that the only thing that they should be
[56:33] that the only thing that they should be doing of course not so the next question
[56:35] doing of course not so the next question I asked was what should we make of all
[56:37] I asked was what should we make of all this diet related stuff right I've heard
[56:40] this diet related stuff right I've heard before that the so-called Elimination
[56:43] before that the so-called Elimination Diet or ingesting no sugars or no dairy
[56:47] Diet or ingesting no sugars or no dairy or no gluten that all of these things
[56:49] or no gluten that all of these things have been purported to improve symptoms
[56:52] have been purported to improve symptoms of ADHD and people and parents with ADHD
[56:55] of ADHD and people and parents with ADHD go to fanatic lengths to try and find
[56:58] go to fanatic lengths to try and find the exact foods that are causing
[57:00] the exact foods that are causing problems and the exact foods that the
[57:03] problems and the exact foods that the kids can eat in order to try and get
[57:05] kids can eat in order to try and get their brain wired up right and correctly
[57:08] their brain wired up right and correctly and to avoid lifelong
[57:10] and to avoid lifelong ADHD and their answer was really
[57:13] ADHD and their answer was really interesting but before I tell you their
[57:15] interesting but before I tell you their answer I want to tell you the studies
[57:17] answer I want to tell you the studies and the data related to this question of
[57:20] and the data related to this question of whether or not food and the
[57:22] whether or not food and the constellation of foods that one avoids
[57:24] constellation of foods that one avoids and will eat has anything to do with our
[57:27] and will eat has anything to do with our levels of attention and in particular
[57:28] levels of attention and in particular whether or not that can be used as a
[57:30] whether or not that can be used as a leverage point to treat ADHD so you can
[57:33] leverage point to treat ADHD so you can imagine the challenges of exploring the
[57:35] imagine the challenges of exploring the role of diet and nutrition in any study
[57:39] role of diet and nutrition in any study but especially in a study on ADHD why
[57:41] but especially in a study on ADHD why well because as I mentioned before
[57:43] well because as I mentioned before children with ADHD and it turns out
[57:45] children with ADHD and it turns out adults with ADHD tend to pursue sugary
[57:48] adults with ADHD tend to pursue sugary Foods or any types of food that increase
[57:50] Foods or any types of food that increase their levels of dopamine they are
[57:51] their levels of dopamine they are naturally drawn to those Foods whether
[57:53] naturally drawn to those Foods whether or not they realize it or not presumably
[57:55] or not they realize it or not presumably as a way to try and treat their lack of
[57:57] as a way to try and treat their lack of focus and
[57:58] focus and impulsivity so in this study that I'm
[58:01] impulsivity so in this study that I'm about to share with you there was no
[58:03] about to share with you there was no drug treatment it was just a study
[58:05] drug treatment it was just a study manipulating diet and involved 100
[58:08] manipulating diet and involved 100 children 50 in the so-called Elimination
[58:11] children 50 in the so-called Elimination Diet group this special diet where
[58:13] Diet group this special diet where certain foods were eliminated and 50 in
[58:15] certain foods were eliminated and 50 in the so-called control group however
[58:17] the so-called control group however being a well-designed randomized
[58:19] being a well-designed randomized controlled trial the study also included
[58:22] controlled trial the study also included a crossover meaning where the the kids
[58:25] a crossover meaning where the the kids would serve as their own control or
[58:27] would serve as their own control or control group at a certain portion of
[58:29] control group at a certain portion of the study they would be in one group
[58:30] the study they would be in one group where they eliminated certain foods and
[58:32] where they eliminated certain foods and then after a period of time in the study
[58:33] then after a period of time in the study they would swap to the other group this
[58:35] they would swap to the other group this is a powerful way to design a study for
[58:37] is a powerful way to design a study for reasons that you can imagine because you
[58:38] reasons that you can imagine because you start to eliminate changes and effects
[58:41] start to eliminate changes and effects due to individual differences in any
[58:43] due to individual differences in any case 100 children total 50 in each group
[58:46] case 100 children total 50 in each group at any one period in time and the
[58:48] at any one period in time and the effects that they observed were
[58:50] effects that they observed were extremely dramatic in the world of
[58:52] extremely dramatic in the world of statistics and Analysis of scientific
[58:54] statistics and Analysis of scientific data we talk about P value probability
[58:56] data we talk about P value probability values what's the likelihood that
[58:58] values what's the likelihood that something could happen according to
[58:59] something could happen according to chance and typically the cut off would
[59:01] chance and typically the cut off would be something like P less than 0.005
[59:04] be something like P less than 0.005 that's uh less than 0.05 chance
[59:07] that's uh less than 0.05 chance essentially of the effect being due to
[59:10] essentially of the effect being due to chance however in this study every
[59:13] chance however in this study every single one of the effects is p less than
[59:16] single one of the effects is p less than 0.00001 very very infinately small
[59:19] 0.00001 very very infinately small probability that the effects observed
[59:22] probability that the effects observed could be due to chance so what were
[59:23] could be due to chance so what were these effects these effects were
[59:25] these effects these effects were enhanced stability to focus less
[59:27] enhanced stability to focus less impulsivity even less tendency to move
[59:30] impulsivity even less tendency to move when trying to sit still so everything
[59:33] when trying to sit still so everything from mental focus to the ability to
[59:34] from mental focus to the ability to control their bodies improved when they
[59:36] control their bodies improved when they were in The Elimination Diet group what
[59:38] were in The Elimination Diet group what was eliminated well the Elimination Diet
[59:41] was eliminated well the Elimination Diet in this particular study was a so-called
[59:45] in this particular study was a so-called oligoantigenic diet it was a diet in
[59:48] oligoantigenic diet it was a diet in which each kid took a test to determine
[59:51] which each kid took a test to determine which foods they had antibodies for
[59:53] which foods they had antibodies for meaning that they were mildly allergic
[59:56] meaning that they were mildly allergic to now in this study it was very
[59:57] to now in this study it was very important that the kids not be extremely
[59:59] important that the kids not be extremely allergic to any food because as I
[01:00:01] allergic to any food because as I mentioned before they actually served as
[01:00:02] mentioned before they actually served as a control at one point in the study
[01:00:05] a control at one point in the study where they were eating all sorts of
[01:00:06] where they were eating all sorts of foods including foods that they had mild
[01:00:08] foods including foods that they had mild allergies to so basically what the study
[01:00:10] allergies to so basically what the study said was that eliminating foods to which
[01:00:14] said was that eliminating foods to which children have allergies can dramatically
[01:00:17] children have allergies can dramatically improve their symptoms of
[01:00:18] improve their symptoms of ADHD and this study not surprisingly
[01:00:22] ADHD and this study not surprisingly because it was published in such a high
[01:00:23] because it was published in such a high quality Journal Lancet Etc large number
[01:00:25] quality Journal Lancet Etc large number of
[01:00:26] of subjects set the world on fire people
[01:00:29] subjects set the world on fire people were extremely excited about these
[01:00:31] were extremely excited about these results because here in the absence of
[01:00:33] results because here in the absence of any drug treatment there was a
[01:00:35] any drug treatment there was a significant Improvement in ADHD symptoms
[01:00:38] significant Improvement in ADHD symptoms observed and then came the criticisms so
[01:00:41] observed and then came the criticisms so many papers were published after this
[01:00:44] many papers were published after this specifically dealing with reanalysis of
[01:00:47] specifically dealing with reanalysis of these data and I want to be fair in
[01:00:49] these data and I want to be fair in saying that the data in the paper look
[01:00:52] saying that the data in the paper look good but there are criticisms of the
[01:00:55] good but there are criticisms of the overall structural design in the study I
[01:00:57] overall structural design in the study I don't want to go into all the details
[01:00:59] don't want to go into all the details exactly CU it gets really nuanced about
[01:01:01] exactly CU it gets really nuanced about some of the statistics and the way that
[01:01:03] some of the statistics and the way that one examines these types of data but
[01:01:06] one examines these types of data but there was skepticism and in science
[01:01:08] there was skepticism and in science skepticism is healthy especially when
[01:01:10] skepticism is healthy especially when making decisions about whether or not to
[01:01:11] making decisions about whether or not to treat or feed children one food or
[01:01:13] treat or feed children one food or another or give them one drug or
[01:01:16] another or give them one drug or another now I want to return to the
[01:01:18] another now I want to return to the story of my friend who is a pediatric
[01:01:20] story of my friend who is a pediatric neurologist and treats ADHD and has a
[01:01:23] neurologist and treats ADHD and has a child who is on the precipice of perhaps
[01:01:26] child who is on the precipice of perhaps starting to take drugs for the treatment
[01:01:28] starting to take drugs for the treatment of ADHD I asked the simple question do
[01:01:32] of ADHD I asked the simple question do you see an effective diet meaning when
[01:01:35] you see an effective diet meaning when parents control the diet of their
[01:01:36] parents control the diet of their children does it make a positive or
[01:01:39] children does it make a positive or negative or no difference in terms of
[01:01:42] negative or no difference in terms of the way that the kids respond to ADHD
[01:01:44] the way that the kids respond to ADHD drugs like rlin and adderal or whether
[01:01:47] drugs like rlin and adderal or whether or not it can help them avoid treating
[01:01:48] or not it can help them avoid treating with those drugs entirely and her
[01:01:50] with those drugs entirely and her response was very straightforward she
[01:01:52] response was very straightforward she said elimination of simple sugars has a
[01:01:55] said elimination of simple sugars has a dramatic and positive effect she's
[01:01:57] dramatic and positive effect she's observed that over and over and over
[01:01:59] observed that over and over and over again in many dozens if not hundreds of
[01:02:01] again in many dozens if not hundreds of patients okay now that's not a
[01:02:04] patients okay now that's not a peer-reviewed study that's a statement
[01:02:05] peer-reviewed study that's a statement that I'm conveying to you anecdotally
[01:02:07] that I'm conveying to you anecdotally but it's a highly highly informed one I
[01:02:10] but it's a highly highly informed one I said what about these elimination diets
[01:02:12] said what about these elimination diets she said and I found other sources to
[01:02:14] she said and I found other sources to support this that these olgo into genic
[01:02:17] support this that these olgo into genic diets are controversial there are many
[01:02:19] diets are controversial there are many people who really believe in identifying
[01:02:21] people who really believe in identifying all the things that you're allergic to
[01:02:23] all the things that you're allergic to and making sure that you and especially
[01:02:26] and making sure that you and especially kids avoid those Foods however there's
[01:02:28] kids avoid those Foods however there's another Camp that's starting to emerge
[01:02:30] another Camp that's starting to emerge in the peer-reviewed scientific
[01:02:32] in the peer-reviewed scientific literature showing that when kids are
[01:02:35] literature showing that when kids are not exposed to certain foods in
[01:02:37] not exposed to certain foods in particular nuts and things of that sort
[01:02:40] particular nuts and things of that sort they develop allergies to those foods
[01:02:42] they develop allergies to those foods and then when exposed to them later they
[01:02:44] and then when exposed to them later they cause real problems so there's a whole
[01:02:46] cause real problems so there's a whole galaxy of discussion and controversy and
[01:02:49] galaxy of discussion and controversy and outright fighting about allergies in
[01:02:51] outright fighting about allergies in kids and whether or not the oligo
[01:02:52] kids and whether or not the oligo antigenic diet is the appropriate one
[01:02:54] antigenic diet is the appropriate one however out of the four neurologists and
[01:02:57] however out of the four neurologists and psychiatrists that I spoke to about ADHD
[01:03:00] psychiatrists that I spoke to about ADHD in preparation for this every single one
[01:03:02] in preparation for this every single one said children with ADHD as much as
[01:03:05] said children with ADHD as much as possible should be encouraged to avoid
[01:03:08] possible should be encouraged to avoid high sugar and simple sugar foods of
[01:03:10] high sugar and simple sugar foods of most kinds and if they can find
[01:03:13] most kinds and if they can find particular foods that exacerbate their
[01:03:15] particular foods that exacerbate their symptoms obviously eliminating those
[01:03:18] symptoms obviously eliminating those Foods is
[01:03:19] Foods is beneficial and the foods that exacerbate
[01:03:22] beneficial and the foods that exacerbate their symptoms change over time so I
[01:03:26] their symptoms change over time so I don't like giving a complicated answer
[01:03:28] don't like giving a complicated answer but I also don't like giving an
[01:03:30] but I also don't like giving an incomplete answer what this tells me is
[01:03:33] incomplete answer what this tells me is that children especially young children
[01:03:36] that children especially young children who have ADHD should probably not eat
[01:03:40] who have ADHD should probably not eat much sugar in particular simple sugars
[01:03:43] much sugar in particular simple sugars in addition to that exploring whether or
[01:03:45] in addition to that exploring whether or not they have existing allergies to
[01:03:47] not they have existing allergies to Foods they already consume might be a
[01:03:50] Foods they already consume might be a good idea at least that's what this
[01:03:53] good idea at least that's what this paper the pelser at all Lancet paper
[01:03:55] paper the pelser at all Lancet paper seems to speak to and I should mention
[01:03:57] seems to speak to and I should mention that that paper was published in 2011
[01:04:00] that that paper was published in 2011 since then there have been many dozens
[01:04:02] since then there have been many dozens of studies exploring the same thing as
[01:04:04] of studies exploring the same thing as well as metaanalyses of all those data
[01:04:06] well as metaanalyses of all those data and it does appear that diet can have a
[01:04:09] and it does appear that diet can have a highly significant role in eliminating
[01:04:13] highly significant role in eliminating or at least reducing the symptoms of
[01:04:14] or at least reducing the symptoms of ADHD so much so that some of the
[01:04:17] ADHD so much so that some of the children are able to not take medication
[01:04:19] children are able to not take medication at all or eventually wean themselves off
[01:04:22] at all or eventually wean themselves off medication as young adults and as adults
[01:04:25] medication as young adults and as adults one interesting question is whether or
[01:04:27] one interesting question is whether or not adults should modify their diet in
[01:04:29] not adults should modify their diet in order to increase their levels of focus
[01:04:32] order to increase their levels of focus if they're already having normal levels
[01:04:35] if they're already having normal levels of focus but would like more or would
[01:04:36] of focus but would like more or would like to reduce existing adult
[01:04:40] like to reduce existing adult ADHD that's an interesting and even more
[01:04:43] ADHD that's an interesting and even more controversial topic it brings us right
[01:04:45] controversial topic it brings us right into the realm of what are called
[01:04:47] into the realm of what are called omega-3 fatty acids I've talked many
[01:04:49] omega-3 fatty acids I've talked many times on this podcast about the known
[01:04:51] times on this podcast about the known benefits of omega-3 fatty acids in
[01:04:53] benefits of omega-3 fatty acids in particular getting a 1 G 1,000 mg or
[01:04:58] particular getting a 1 G 1,000 mg or more even as much as 2,000 milligrams
[01:05:00] more even as much as 2,000 milligrams each day of the so-called EPA component
[01:05:04] each day of the so-called EPA component of omega-3 fatty acids known to have
[01:05:07] of omega-3 fatty acids known to have anti-depressant effects mood elevating
[01:05:09] anti-depressant effects mood elevating effects known to have important effects
[01:05:13] effects known to have important effects protecting the cardiovascular system I
[01:05:15] protecting the cardiovascular system I think it's now clear that the immune
[01:05:17] think it's now clear that the immune system also benefits that omega-3 fatty
[01:05:20] system also benefits that omega-3 fatty acids that include a gram or more of
[01:05:23] acids that include a gram or more of epas are very beneficial to Al that's
[01:05:26] epas are very beneficial to Al that's done through fish oil liquid fish oil is
[01:05:27] done through fish oil liquid fish oil is going to be the most cost efficient but
[01:05:29] going to be the most cost efficient but there are capsule forms for those of you
[01:05:30] there are capsule forms for those of you that don't like fish oil you can ingest
[01:05:33] that don't like fish oil you can ingest this through other means you can get
[01:05:34] this through other means you can get from certain algae or Krill Etc you have
[01:05:37] from certain algae or Krill Etc you have to make uh make it compatible with your
[01:05:39] to make uh make it compatible with your particular diet whether or not your
[01:05:41] particular diet whether or not your vegan or vegetarian or omnivore
[01:05:43] vegan or vegetarian or omnivore Etc Omega-3s have shown been shown to
[01:05:46] Etc Omega-3s have shown been shown to have all these positive health benefits
[01:05:48] have all these positive health benefits do they have positive effects on focus
[01:05:50] do they have positive effects on focus and attention and the answer is you can
[01:05:54] and attention and the answer is you can find studies that support that statement
[01:05:57] find studies that support that statement and the effects are significant but the
[01:05:59] and the effects are significant but the effects are
[01:06:01] effects are modest you can also find studies that
[01:06:04] modest you can also find studies that show no effect however much like with
[01:06:08] show no effect however much like with Omega-3s and
[01:06:10] Omega-3s and anti-depressants whereby ingestion of
[01:06:14] anti-depressants whereby ingestion of omega-3 fatty acids of a gram or more of
[01:06:17] omega-3 fatty acids of a gram or more of EPA per day allows people with major
[01:06:19] EPA per day allows people with major depression to get away with taking lower
[01:06:21] depression to get away with taking lower doses of anti-depressant medication it
[01:06:24] doses of anti-depressant medication it does seem that ingestion of omega-3
[01:06:26] does seem that ingestion of omega-3 fatty acids in
[01:06:29] fatty acids in adults that include epas of a th000
[01:06:32] adults that include epas of a th000 milligrams or more can allow adults with
[01:06:35] milligrams or more can allow adults with ADHD or mild attention deficit issues
[01:06:39] ADHD or mild attention deficit issues to function well on Lower doses of
[01:06:42] to function well on Lower doses of medication and in rare cases to
[01:06:44] medication and in rare cases to eliminate medication entirely so what
[01:06:47] eliminate medication entirely so what this says is once again that the omega-3
[01:06:50] this says is once again that the omega-3 fatty acids are beneficial will they
[01:06:52] fatty acids are beneficial will they cure or eliminate ADHD I think it's safe
[01:06:55] cure or eliminate ADHD I think it's safe to say no they are playing a supportive
[01:06:58] to say no they are playing a supportive or what we call a modulatory role just
[01:07:00] or what we call a modulatory role just like good sleep plays a supportive and
[01:07:03] like good sleep plays a supportive and modulatory role for essentially
[01:07:05] modulatory role for essentially everything your immune system your
[01:07:06] everything your immune system your ability to think your ability to
[01:07:07] ability to think your ability to regulate your emotion it's modulating
[01:07:09] regulate your emotion it's modulating that process this component of
[01:07:12] that process this component of modulation is extremely important to
[01:07:14] modulation is extremely important to highlight and I think I want to spend a
[01:07:16] highlight and I think I want to spend a moment on it because this is especially
[01:07:18] moment on it because this is especially important in the context of ADHD and all
[01:07:21] important in the context of ADHD and all the information that's out there there
[01:07:22] the information that's out there there are biological processes that are
[01:07:24] are biological processes that are mediated
[01:07:26] mediated by particular compounds like dopamine so
[01:07:29] by particular compounds like dopamine so for instance the ability to feel
[01:07:30] for instance the ability to feel motivated to attend to focus is mediated
[01:07:34] motivated to attend to focus is mediated by the circuits in the brain that
[01:07:36] by the circuits in the brain that release
[01:07:37] release dopamine however attention is also
[01:07:40] dopamine however attention is also modulated by how rested you are if you
[01:07:42] modulated by how rested you are if you want to eliminate your ability to think
[01:07:44] want to eliminate your ability to think well at all just stay up for two nights
[01:07:46] well at all just stay up for two nights and don't sleep at all right if you do
[01:07:49] and don't sleep at all right if you do that you will have modulated the
[01:07:51] that you will have modulated the circuits in your brain that respond to
[01:07:54] circuits in your brain that respond to various things and you will be highly
[01:07:56] various things and you will be highly distractable you will be highly
[01:07:57] distractable you will be highly emotional you will feel like garbage but
[01:07:59] emotional you will feel like garbage but that doesn't mean that sleep mediates
[01:08:02] that doesn't mean that sleep mediates focus and attention it modulates it
[01:08:04] focus and attention it modulates it indirectly likewise I think these
[01:08:06] indirectly likewise I think these omega-3 fatty acids in particular the
[01:08:10] omega-3 fatty acids in particular the epas which are so beneficial for mood
[01:08:12] epas which are so beneficial for mood and apparently also for attention they
[01:08:14] and apparently also for attention they don't directly mediate attention and
[01:08:18] don't directly mediate attention and mood what they do is they modulate those
[01:08:20] mood what they do is they modulate those circuits they make dopamine more
[01:08:22] circuits they make dopamine more available they make whatever dopamine is
[01:08:24] available they make whatever dopamine is available more likely to bind to the
[01:08:27] available more likely to bind to the various receptors that are present on
[01:08:29] various receptors that are present on neurons and so forth and I think this is
[01:08:31] neurons and so forth and I think this is very important because likewise diet in
[01:08:33] very important because likewise diet in any discussion about nutrition has to
[01:08:35] any discussion about nutrition has to include this framework of is the diet
[01:08:38] include this framework of is the diet The Elimination Diet or whether or not
[01:08:40] The Elimination Diet or whether or not it's some other diet or esoteric diet
[01:08:42] it's some other diet or esoteric diet ketogenic diet is it modulating or
[01:08:44] ketogenic diet is it modulating or mediating a process and most likely in
[01:08:47] mediating a process and most likely in the context of ADHD it's modulating that
[01:08:50] the context of ADHD it's modulating that process so if the ADHD is mild or if
[01:08:53] process so if the ADHD is mild or if it's caught early enough or if it's in
[01:08:54] it's caught early enough or if it's in conjunction with pharmacology with a
[01:08:58] conjunction with pharmacology with a prescription treatment well then it
[01:09:00] prescription treatment well then it might help guide the child or adult to a
[01:09:02] might help guide the child or adult to a better place of being able to focus but
[01:09:04] better place of being able to focus but it's not going to be the switch that
[01:09:05] it's not going to be the switch that flips everything now that does not mean
[01:09:08] flips everything now that does not mean that consuming the wrong Foods sugary
[01:09:11] that consuming the wrong Foods sugary Foods or foods that you happen to be
[01:09:12] Foods or foods that you happen to be allergic to is a good idea it will still
[01:09:14] allergic to is a good idea it will still be detrimental so I hope that conceptual
[01:09:17] be detrimental so I hope that conceptual framework helps because if you go online
[01:09:18] framework helps because if you go online if you're somebody with ADHD or not
[01:09:21] if you're somebody with ADHD or not you're are going to be bombarded with
[01:09:23] you're are going to be bombarded with the ADHD diet they only go into genic
[01:09:25] the ADHD diet they only go into genic diet the elimination this the this
[01:09:28] diet the elimination this the this supplement that EPA and you I think it's
[01:09:30] supplement that EPA and you I think it's very important to understand whether or
[01:09:31] very important to understand whether or not you're talking about something
[01:09:33] not you're talking about something mediating a process or modulating a
[01:09:35] mediating a process or modulating a process now drugs like rlin drugs like
[01:09:38] process now drugs like rlin drugs like adderal they are tapping into the
[01:09:40] adderal they are tapping into the circuitries and the neurochemistry that
[01:09:43] circuitries and the neurochemistry that mediate attention and focus they are not
[01:09:45] mediate attention and focus they are not the only Alternatives or the only
[01:09:47] the only Alternatives or the only choices rather for treatment of these
[01:09:49] choices rather for treatment of these circuits and enhancement of the circuits
[01:09:51] circuits and enhancement of the circuits for Focus I'm going to talk about other
[01:09:53] for Focus I'm going to talk about other Alternatives and some Behavioral
[01:09:54] Alternatives and some Behavioral alternativ
[01:09:56] alternativ that are not very welln but are very
[01:09:58] that are not very welln but are very very effective in a few minutes but I
[01:10:01] very effective in a few minutes but I really want to make this clear
[01:10:02] really want to make this clear distinction between modulation and
[01:10:04] distinction between modulation and mediation because it's vital for anyone
[01:10:07] mediation because it's vital for anyone that's trying to modulate or mediate
[01:10:09] that's trying to modulate or mediate anything within their own brain if any
[01:10:11] anything within their own brain if any of you are interested in this oligo
[01:10:13] of you are interested in this oligo antigenic diet as it relates to
[01:10:15] antigenic diet as it relates to ADHD and you want to explore a more
[01:10:18] ADHD and you want to explore a more recent study besides that classic 2011
[01:10:21] recent study besides that classic 2011 Lancet study that's rather controversial
[01:10:23] Lancet study that's rather controversial there's a paper that was published in
[01:10:25] there's a paper that was published in Frontiers in Psychiatry just last year
[01:10:28] Frontiers in Psychiatry just last year 2020 the title of the paper is oligo
[01:10:30] 2020 the title of the paper is oligo antigenic Diet improves children's ADHD
[01:10:33] antigenic Diet improves children's ADHD rating scale scores reliably in added
[01:10:36] rating scale scores reliably in added video rating the added video rating is
[01:10:38] video rating the added video rating is just that they're using an additional
[01:10:40] just that they're using an additional measure of focus and attention again
[01:10:43] measure of focus and attention again that's Frontiers in Psychiatry 2020 I'll
[01:10:46] that's Frontiers in Psychiatry 2020 I'll put a link to it in the caption and
[01:10:48] put a link to it in the caption and that's a more recent study for you to
[01:10:50] that's a more recent study for you to peruse so we've talked about the neural
[01:10:52] peruse so we've talked about the neural circuits of focus and the chemistry of
[01:10:54] circuits of focus and the chemistry of focus but we haven't talked yet about
[01:10:58] focus but we haven't talked yet about what would make us better at focusing
[01:11:00] what would make us better at focusing and what focusing better really is so
[01:11:02] and what focusing better really is so let's take a step back and think about
[01:11:05] let's take a step back and think about how we focus and how to get better at
[01:11:07] how we focus and how to get better at focus and I'm going to share with you a
[01:11:09] focus and I'm going to share with you a tool for which there are terrific
[01:11:11] tool for which there are terrific research data that will allow you in a
[01:11:14] research data that will allow you in a single session to enhance your ability
[01:11:16] single session to enhance your ability to
[01:11:17] to focus in theory
[01:11:20] focus in theory forever what I'm about to read you is
[01:11:23] forever what I'm about to read you is from an excellent book that I recommend
[01:11:25] from an excellent book that I recommend if any of you are interested in
[01:11:26] if any of you are interested in neuroscience and things like meditation
[01:11:28] neuroscience and things like meditation and default mode networks and things of
[01:11:30] and default mode networks and things of that sort the book is called altered
[01:11:34] that sort the book is called altered traits science reveals how meditation
[01:11:37] traits science reveals how meditation changes your mind brain and body and no
[01:11:39] changes your mind brain and body and no I'm not going to try and convince you to
[01:11:40] I'm not going to try and convince you to meditate I'm going to share with you a
[01:11:43] meditate I'm going to share with you a small passage in the book that relates
[01:11:45] small passage in the book that relates some research data related to focus that
[01:11:47] some research data related to focus that are very important if you want to
[01:11:49] are very important if you want to meditate that's your choice that's a
[01:11:50] meditate that's your choice that's a separate matter this is a book by Daniel
[01:11:52] separate matter this is a book by Daniel Goldman and Richard Davidson and I
[01:11:54] Goldman and Richard Davidson and I should just mention that
[01:11:55] should just mention that uh Gman is a well-known author he's
[01:11:57] uh Gman is a well-known author he's written books on emotional intelligence
[01:11:59] written books on emotional intelligence and so forth um Richard Davidson is a
[01:12:02] and so forth um Richard Davidson is a also a PhD uh he's a professor of
[01:12:04] also a PhD uh he's a professor of psychology and Psychiatry and he's at a
[01:12:07] psychology and Psychiatry and he's at a University of Wisconsin Madison he's
[01:12:09] University of Wisconsin Madison he's done terrific work on brain States uh
[01:12:12] done terrific work on brain States uh and modulation of brain States and so
[01:12:14] and modulation of brain States and so forth what we're about to talk about is
[01:12:17] forth what we're about to talk about is when attention works and when attention
[01:12:20] when attention works and when attention falters and what we are specifically
[01:12:23] falters and what we are specifically going to talk about are what are called
[01:12:25] going to talk about are what are called intentional blinks not actual eye blinks
[01:12:27] intentional blinks not actual eye blinks we're going to talk about that in a few
[01:12:29] we're going to talk about that in a few minutes but we're going to talk about
[01:12:30] minutes but we're going to talk about attentional
[01:12:32] attentional blinks I'm paraphrasing here because
[01:12:36] blinks I'm paraphrasing here because Goldman and Davidson wrote about this so
[01:12:38] Goldman and Davidson wrote about this so beautifully I'd rather paraphrase from
[01:12:40] beautifully I'd rather paraphrase from them than try and just make up a new way
[01:12:42] them than try and just make up a new way to say it that is less interesting or
[01:12:44] to say it that is less interesting or less good but I want to credit them
[01:12:46] less good but I want to credit them attentional blinks are really easy to
[01:12:48] attentional blinks are really easy to understand if you think about a where's
[01:12:49] understand if you think about a where's Waldo task you know this task where's
[01:12:51] Waldo task you know this task where's Waldo where you know there a bunch of
[01:12:53] Waldo where you know there a bunch of people and objects and things in a in a
[01:12:55] people and objects and things in a in a picture and somewhere in there is Waldo
[01:12:57] picture and somewhere in there is Waldo with the striped hat and the glasses and
[01:12:59] with the striped hat and the glasses and kind of a skinny dude and you have to
[01:13:01] kind of a skinny dude and you have to find Waldo and so it's a visual search
[01:13:03] find Waldo and so it's a visual search and it's visual search for an object
[01:13:06] and it's visual search for an object that has distinct features but is
[01:13:07] that has distinct features but is embedded in this ocean of other things
[01:13:10] embedded in this ocean of other things that could easily be confused as Waldo
[01:13:12] that could easily be confused as Waldo so you tend to look look look look look
[01:13:13] so you tend to look look look look look look look look look and then you find
[01:13:15] look look look look and then you find Waldo kids can do this they enjoy doing
[01:13:17] Waldo kids can do this they enjoy doing this adults may or may not enjoy it but
[01:13:19] this adults may or may not enjoy it but they can do it too they find Waldo when
[01:13:22] they can do it too they find Waldo when you find Waldo or when you search for a
[01:13:25] you find Waldo or when you search for a Target in some other visual search task
[01:13:28] Target in some other visual search task at that moment your nervous system
[01:13:30] at that moment your nervous system celebrates a little bit and it
[01:13:32] celebrates a little bit and it celebrates through the release of
[01:13:33] celebrates through the release of neurochemicals that make you feel good
[01:13:35] neurochemicals that make you feel good you found it and you pause now the pause
[01:13:38] you found it and you pause now the pause is interesting because when you pause
[01:13:41] is interesting because when you pause what we know from many experiments is
[01:13:44] what we know from many experiments is that in that moment of pause and Mild
[01:13:48] that in that moment of pause and Mild celebration however
[01:13:50] celebration however mild you are not able to see another
[01:13:53] mild you are not able to see another Waldo sitting right next to it so what
[01:13:56] Waldo sitting right next to it so what this means is in attending to Something
[01:13:59] this means is in attending to Something in searching and in identifying a visual
[01:14:02] in searching and in identifying a visual Target your attention blinked it shut
[01:14:05] Target your attention blinked it shut off for a second and there's a more
[01:14:08] off for a second and there's a more formal and more laboratory type way that
[01:14:11] formal and more laboratory type way that we look at this the more typical way to
[01:14:14] we look at this the more typical way to do this is to give someone a string of
[01:14:17] do this is to give someone a string of letters or a string of numbers and
[01:14:19] letters or a string of numbers and beforehand you tell them be on the
[01:14:22] beforehand you tell them be on the lookout for the letters r and
[01:14:26] lookout for the letters r and Z okay you're just G to watch this
[01:14:28] Z okay you're just G to watch this string of numbers go by and there will
[01:14:30] string of numbers go by and there will be a letter r in there and there will be
[01:14:32] be a letter r in there and there will be a letter z in there and try and spot
[01:14:35] a letter z in there and try and spot them both and what you find is when you
[01:14:38] them both and what you find is when you present that string of numbers and then
[01:14:40] present that string of numbers and then they see the r they see the r they
[01:14:43] they see the r they see the r they register it
[01:14:45] register it consciously and they tend to miss the Z
[01:14:48] consciously and they tend to miss the Z just like in the Waldo type example now
[01:14:51] just like in the Waldo type example now of course the numbers are going by
[01:14:52] of course the numbers are going by pretty quickly but they can spot the r
[01:14:56] pretty quickly but they can spot the r they could also spot the Z if you told
[01:14:57] they could also spot the Z if you told them beforehand just spot the Z and the
[01:15:01] them beforehand just spot the Z and the numbers are moving through at the same
[01:15:02] numbers are moving through at the same rate in both conditions so what that
[01:15:03] rate in both conditions so what that means is that in every case you are
[01:15:06] means is that in every case you are capable of seeing the r or the Z it's
[01:15:10] capable of seeing the r or the Z it's when you try and see both that seeing
[01:15:13] when you try and see both that seeing the first one prevents you from seeing
[01:15:15] the first one prevents you from seeing the second one it's what we call an
[01:15:17] the second one it's what we call an attentional blink we do this all the
[01:15:20] attentional blink we do this all the time and people with ADHD tend to have
[01:15:24] time and people with ADHD tend to have many more attentional blinks than people
[01:15:27] many more attentional blinks than people that don't and this is true for children
[01:15:28] that don't and this is true for children and for
[01:15:29] and for adults this is an important point so
[01:15:32] adults this is an important point so important that I want to emphasize it
[01:15:33] important that I want to emphasize it twice in case you attentionally blinked
[01:15:36] twice in case you attentionally blinked if you see something that you're looking
[01:15:38] if you see something that you're looking for or you're very interested in
[01:15:40] for or you're very interested in something you are definitely missing
[01:15:42] something you are definitely missing other
[01:15:44] other information in part because you're over
[01:15:46] information in part because you're over focusing on something and this leads to
[01:15:48] focusing on something and this leads to a very interesting hypothesis about what
[01:15:50] a very interesting hypothesis about what might go wrong in
[01:15:52] might go wrong in ADHD where we've always thought that
[01:15:55] ADHD where we've always thought that they cannot focus and yet we know they
[01:15:57] they cannot focus and yet we know they can focus on things they care very much
[01:15:59] can focus on things they care very much about well maybe just maybe they are
[01:16:03] about well maybe just maybe they are experiencing more attentional blinks
[01:16:06] experiencing more attentional blinks than people who do not have
[01:16:07] than people who do not have ADHD and indeed there are data now to
[01:16:10] ADHD and indeed there are data now to support the possibility that that's
[01:16:12] support the possibility that that's actually what's happening and that
[01:16:14] actually what's happening and that should be exciting to anyone that has
[01:16:16] should be exciting to anyone that has ADHD it should also be exciting to
[01:16:17] ADHD it should also be exciting to anyone that cares about increasing their
[01:16:19] anyone that cares about increasing their focus and their ability to attend what
[01:16:22] focus and their ability to attend what this is saying is that these circuits
[01:16:23] this is saying is that these circuits that underly focus in our our ability to
[01:16:25] that underly focus in our our ability to attend and our ability to eliminate
[01:16:29] attend and our ability to eliminate distraction they aren't just failing to
[01:16:31] distraction they aren't just failing to focus that's just a semantic way of
[01:16:33] focus that's just a semantic way of describing the outcome they are over
[01:16:36] describing the outcome they are over focusing on certain things and thereby
[01:16:38] focusing on certain things and thereby missing other things and so our
[01:16:40] missing other things and so our distractability or the distractability
[01:16:41] distractability or the distractability of somebody with
[01:16:43] of somebody with ADHD could exist because they are over
[01:16:46] ADHD could exist because they are over focusing on certain elements and they
[01:16:49] focusing on certain elements and they are therefore missing other elements
[01:16:51] are therefore missing other elements that they should be attending to so what
[01:16:54] that they should be attending to so what they really need is this property that
[01:16:57] they really need is this property that we call open monitoring now open
[01:16:59] we call open monitoring now open monitoring is something that's described
[01:17:01] monitoring is something that's described in the book that I just referred to and
[01:17:03] in the book that I just referred to and that typically is associated with people
[01:17:05] that typically is associated with people who have done a lot of meditation
[01:17:07] who have done a lot of meditation so-called Vasa meditation or have spent
[01:17:09] so-called Vasa meditation or have spent a lot of time learning how to do what's
[01:17:12] a lot of time learning how to do what's called open gaze visual analysis and
[01:17:15] called open gaze visual analysis and open gaze thinking but there's a simpler
[01:17:17] open gaze thinking but there's a simpler version of this that allows us to bypass
[01:17:18] version of this that allows us to bypass all that first of
[01:17:21] all that first of all your visual system has two modes of
[01:17:25] all your visual system has two modes of processing it can be highly focused a
[01:17:27] processing it can be highly focused a soda straw view so looking for the r in
[01:17:30] soda straw view so looking for the r in this string of numbers in the example
[01:17:31] this string of numbers in the example that I just gave or if you're very
[01:17:33] that I just gave or if you're very excited about something you're in that
[01:17:35] excited about something you're in that soda straw view of the world and you're
[01:17:36] soda straw view of the world and you're missing other things okay that's high
[01:17:38] missing other things okay that's high levels of attention however there's also
[01:17:41] levels of attention however there's also a property of your visual system that
[01:17:43] a property of your visual system that allows you to dilate your gaze to be in
[01:17:45] allows you to dilate your gaze to be in so-called panoramic Vision panoramic
[01:17:47] so-called panoramic Vision panoramic vision is something you can do right now
[01:17:49] vision is something you can do right now no matter where you are and I can do it
[01:17:51] no matter where you are and I can do it right now you won't know that I'm doing
[01:17:53] right now you won't know that I'm doing it but even even though I'm still
[01:17:55] it but even even though I'm still looking directly at you I'm consciously
[01:17:57] looking directly at you I'm consciously dilating my gaze so that I can see the
[01:17:59] dilating my gaze so that I can see the ceiling the floor and the walls all
[01:18:00] ceiling the floor and the walls all around me that panoramic vision is
[01:18:02] around me that panoramic vision is actually mediated by a separate stream
[01:18:05] actually mediated by a separate stream or set of neural circuits going from the
[01:18:07] or set of neural circuits going from the eye into the brain and it's a stream or
[01:18:09] eye into the brain and it's a stream or set of circuits that isn't just wide
[01:18:12] set of circuits that isn't just wide angle view it also is better at
[01:18:14] angle view it also is better at processing things in time its frame rate
[01:18:17] processing things in time its frame rate is higher so you've seen slow motion
[01:18:19] is higher so you've seen slow motion video and you've seen standard video
[01:18:21] video and you've seen standard video slow motion video gives you that slow
[01:18:25] slow motion video gives you that slow motion look because it's a higher frame
[01:18:27] motion look because it's a higher frame rate your thin slicing time
[01:18:31] rate your thin slicing time okay you can use panoramic Vision to
[01:18:34] okay you can use panoramic Vision to access the state that we call open
[01:18:36] access the state that we call open monitoring when people do that they are
[01:18:38] monitoring when people do that they are able to attend to and recognize multiple
[01:18:43] able to attend to and recognize multiple targets within this string of numbers
[01:18:46] targets within this string of numbers they can see the r and they can see the
[01:18:47] they can see the r and they can see the Z and they can see additional things so
[01:18:50] Z and they can see additional things so this is something that can be trained up
[01:18:52] this is something that can be trained up and people can practice whether or not
[01:18:53] and people can practice whether or not they have ad HD or not what it involves
[01:18:56] they have ad HD or not what it involves is learning how to dilate your gaze
[01:18:58] is learning how to dilate your gaze consciously that's actually quite easy
[01:18:59] consciously that's actually quite easy for most people whether or not you wear
[01:19:02] for most people whether or not you wear corrective lenses or contacts or not you
[01:19:04] corrective lenses or contacts or not you can consciously go into open gaze and
[01:19:06] can consciously go into open gaze and then you can contract your field of view
[01:19:08] then you can contract your field of view as well there have also been studies
[01:19:10] as well there have also been studies done where people were taught to think
[01:19:14] done where people were taught to think in a particular way for a very short
[01:19:16] in a particular way for a very short period of time and that forever Chang
[01:19:18] period of time and that forever Chang their ability to limit or reduce the
[01:19:22] their ability to limit or reduce the number of these attentional blinks they
[01:19:24] number of these attentional blinks they are now published accounts in the
[01:19:25] are now published accounts in the literature of a simple practice done for
[01:19:27] literature of a simple practice done for about 15 minutes where subjects were
[01:19:30] about 15 minutes where subjects were asked to just sit quietly eyes closed
[01:19:32] asked to just sit quietly eyes closed and do what is sort of akin to
[01:19:34] and do what is sort of akin to meditation but to not direct their mind
[01:19:36] meditation but to not direct their mind into any particular state or place but
[01:19:38] into any particular state or place but simply to think about their breathing
[01:19:40] simply to think about their breathing and to focus on their so-called
[01:19:41] and to focus on their so-called interoception focus on how their body
[01:19:43] interoception focus on how their body feels if their mind drifted to bring it
[01:19:45] feels if their mind drifted to bring it back okay so it's basically meditation
[01:19:47] back okay so it's basically meditation for about 15 minutes that might not seem
[01:19:50] for about 15 minutes that might not seem like a significant or unusual practice
[01:19:53] like a significant or unusual practice or that it would have any impact at all
[01:19:55] or that it would have any impact at all but remarkably just doing that once for
[01:20:00] but remarkably just doing that once for 17 minutes significantly reduced the
[01:20:03] 17 minutes significantly reduced the number of attentional blinks that people
[01:20:05] number of attentional blinks that people would carry out in other words their
[01:20:07] would carry out in other words their focus got better in a near permanent way
[01:20:10] focus got better in a near permanent way without any additional training there's
[01:20:12] without any additional training there's something about that practice of
[01:20:14] something about that practice of reducing the amount of visual
[01:20:16] reducing the amount of visual information coming in and learning to
[01:20:17] information coming in and learning to pay attention to one's internal State
[01:20:19] pay attention to one's internal State what we call
[01:20:20] what we call interception that allow them an
[01:20:22] interception that allow them an awareness such that when they needed to
[01:20:24] awareness such that when they needed to look for visual targets when they need
[01:20:26] look for visual targets when they need to focus on multiple things in sequence
[01:20:29] to focus on multiple things in sequence they didn't experience the same number
[01:20:31] they didn't experience the same number of attentional blinks and I should
[01:20:33] of attentional blinks and I should mention not incidentally as people age
[01:20:36] mention not incidentally as people age and their working memory gets worse and
[01:20:38] and their working memory gets worse and their ability to focus gets worse the
[01:20:41] their ability to focus gets worse the number of attentional blinks that they
[01:20:42] number of attentional blinks that they carry out goes up and there are now
[01:20:44] carry out goes up and there are now studies exploring whether or not this
[01:20:46] studies exploring whether or not this simple meditation like practice of 15 to
[01:20:49] simple meditation like practice of 15 to 20 minutes or so of sitting and just
[01:20:52] 20 minutes or so of sitting and just quietly resting and paying attention to
[01:20:54] quietly resting and paying attention to one's breathing an internal State can
[01:20:56] one's breathing an internal State can also offset some of that age related
[01:20:58] also offset some of that age related what is called cognitive decline so what
[01:21:01] what is called cognitive decline so what these data tell me is that regardless of
[01:21:04] these data tell me is that regardless of whether or not you're a child or you're
[01:21:06] whether or not you're a child or you're an adult whether or not you have ADHD or
[01:21:09] an adult whether or not you have ADHD or not whether or not you're experiencing
[01:21:11] not whether or not you're experiencing age related cognitive decline or you
[01:21:13] age related cognitive decline or you would simply like to avoid age- related
[01:21:14] would simply like to avoid age- related cognitive
[01:21:15] cognitive decline a simple practice of taking 17
[01:21:19] decline a simple practice of taking 17 minutes sitting and paying attention to
[01:21:22] minutes sitting and paying attention to your internal State just inter accepting
[01:21:25] your internal State just inter accepting registering your breathing registering
[01:21:27] registering your breathing registering the contact of your skin with whatever
[01:21:29] the contact of your skin with whatever surface you're on can forever rewire
[01:21:32] surface you're on can forever rewire your brain to be able to attend better
[01:21:35] your brain to be able to attend better and possibly even offset some of that
[01:21:37] and possibly even offset some of that age related attentional
[01:21:40] age related attentional drift now I don't expect anyone to start
[01:21:43] drift now I don't expect anyone to start meditating regularly I don't expect
[01:21:45] meditating regularly I don't expect anyone to do anything they don't want to
[01:21:47] anyone to do anything they don't want to do but I think most of us could handle
[01:21:49] do but I think most of us could handle one meditation session of 17 minutes or
[01:21:52] one meditation session of 17 minutes or so and so if ever there was a tool that
[01:21:55] so and so if ever there was a tool that stood to rewire our attentional
[01:21:56] stood to rewire our attentional circuitry in a powerful way this seems
[01:21:59] circuitry in a powerful way this seems to be it and in addition the ability to
[01:22:03] to be it and in addition the ability to engage in panoramic Vision to dilate our
[01:22:06] engage in panoramic Vision to dilate our gaze this so-called open monitoring that
[01:22:09] gaze this so-called open monitoring that allows the brain to function in a way
[01:22:10] allows the brain to function in a way that it can detect more information
[01:22:12] that it can detect more information faster that's a powerful tool as well
[01:22:14] faster that's a powerful tool as well and the beauty of that tool is that it
[01:22:16] and the beauty of that tool is that it works the first time and it works every
[01:22:18] works the first time and it works every time now how exactly it works is a
[01:22:21] time now how exactly it works is a little bit unclear is it for in instance
[01:22:25] little bit unclear is it for in instance orchestrating this synchrony or
[01:22:28] orchestrating this synchrony or asynchrony between the default mode
[01:22:30] asynchrony between the default mode Network and the task rated networks we
[01:22:31] Network and the task rated networks we don't know those Studies have not yet
[01:22:33] don't know those Studies have not yet been carried out nonetheless the effects
[01:22:36] been carried out nonetheless the effects are significant they are long lasting
[01:22:39] are significant they are long lasting and they appear to exist after just one
[01:22:41] and they appear to exist after just one session of this quiet 17-minute
[01:22:44] session of this quiet 17-minute interoception which to me makes it seem
[01:22:46] interoception which to me makes it seem like a very worthwhile thing to do for
[01:22:48] like a very worthwhile thing to do for everybody so we just talked about
[01:22:50] everybody so we just talked about attentional blinks which are essentially
[01:22:52] attentional blinks which are essentially blinks of thinking it's your mind
[01:22:54] blinks of thinking it's your mind shutting off for a moment and missing
[01:22:57] shutting off for a moment and missing information now let's talk about actual
[01:23:00] information now let's talk about actual blinks the sort that you do with your
[01:23:02] blinks the sort that you do with your eyelids now this might come across as
[01:23:04] eyelids now this might come across as somewhat obvious but you can do fast
[01:23:07] somewhat obvious but you can do fast what are called spontaneous blinks and
[01:23:10] what are called spontaneous blinks and they are always coordinated between the
[01:23:11] they are always coordinated between the two eyes or you can do long blinks like
[01:23:14] two eyes or you can do long blinks like when you go to sleep at night you do one
[01:23:16] when you go to sleep at night you do one very long blink and I'm not being
[01:23:18] very long blink and I'm not being factious when you go to sleep at night
[01:23:20] factious when you go to sleep at night you are shutting your eyelids and you
[01:23:24] you are shutting your eyelids and you are limiting the amount of information
[01:23:26] are limiting the amount of information coming in and your perception of time
[01:23:29] coming in and your perception of time starts to drift as you go into sleep
[01:23:31] starts to drift as you go into sleep your perception of time changes from
[01:23:35] your perception of time changes from very fast at one moment to very slow
[01:23:37] very fast at one moment to very slow meaning the frame rate at which you are
[01:23:41] meaning the frame rate at which you are analyzing information dreaming Etc is
[01:23:45] analyzing information dreaming Etc is variable when you are in sleep sometimes
[01:23:47] variable when you are in sleep sometimes it's very fast meaning you experience
[01:23:48] it's very fast meaning you experience things in slow motion sometimes it's
[01:23:50] things in slow motion sometimes it's very fast in waking to your
[01:23:54] very fast in waking to your experience of time can sometimes be very
[01:23:56] experience of time can sometimes be very fast sometimes be very slow typically
[01:23:59] fast sometimes be very slow typically the more alert you are the higher the
[01:24:01] the more alert you are the higher the frame rate you're thin slicing your
[01:24:04] frame rate you're thin slicing your experience you've probably had this
[01:24:06] experience you've probably had this happen if you're ever very stressed and
[01:24:07] happen if you're ever very stressed and you're waiting for something or somebody
[01:24:09] you're waiting for something or somebody it seems like it takes forever because
[01:24:12] it seems like it takes forever because your frame rate is higher you're
[01:24:14] your frame rate is higher you're analyzing time more finely conversely if
[01:24:17] analyzing time more finely conversely if you are very relaxed or even sleepy you
[01:24:21] you are very relaxed or even sleepy you wake up and you have to think about all
[01:24:22] wake up and you have to think about all the things you have to do it will seem
[01:24:23] the things you have to do it will seem like the world is going by very very
[01:24:25] like the world is going by very very fast and that you are moving very slow
[01:24:28] fast and that you are moving very slow time is going at the same rate but your
[01:24:30] time is going at the same rate but your perception of time is what's
[01:24:32] perception of time is what's changed Believe It or Not Your
[01:24:35] changed Believe It or Not Your perception of time is also changed on a
[01:24:38] perception of time is also changed on a rapid basis momentto moment basis by how
[01:24:41] rapid basis momentto moment basis by how often you
[01:24:43] often you blink this is a well-established
[01:24:45] blink this is a well-established literature in the world of
[01:24:48] literature in the world of Neuroscience that unlike the literature
[01:24:50] Neuroscience that unlike the literature and claims about blinking and sociopathy
[01:24:53] and claims about blinking and sociopathy which have no basis the science of
[01:24:57] which have no basis the science of blinking as it relates to time
[01:24:58] blinking as it relates to time perception has some very good data to
[01:25:00] perception has some very good data to support it I want to just emphasize one
[01:25:02] support it I want to just emphasize one study in particular which is quite
[01:25:05] study in particular which is quite appropriately titled time dilates after
[01:25:08] appropriately titled time dilates after spontaneous blinking this is a paper
[01:25:09] spontaneous blinking this is a paper that was published in current biology
[01:25:11] that was published in current biology the first author is teron t r hu NE It's
[01:25:15] the first author is teron t r hu NE It's a Wonderful paper they examine the
[01:25:18] a Wonderful paper they examine the relationship between fluctuations in
[01:25:21] relationship between fluctuations in timing and blinking and to make a long
[01:25:25] timing and blinking and to make a long story short what they found is that
[01:25:28] story short what they found is that right after blinks we reset our
[01:25:31] right after blinks we reset our perception of time okay so blinks in
[01:25:34] perception of time okay so blinks in that sense are a little bit like the
[01:25:36] that sense are a little bit like the curtain coming down on a scene between
[01:25:38] curtain coming down on a scene between scenes in a play or takes in a movie you
[01:25:41] scenes in a play or takes in a movie you know when they clap the clap thing they
[01:25:43] know when they clap the clap thing they start it take you know what do they say
[01:25:45] start it take you know what do they say um action and then at the end they do
[01:25:48] um action and then at the end they do the thing and they click it down and
[01:25:49] the thing and they click it down and they say it's a take that's one take
[01:25:52] they say it's a take that's one take when you blink it's a take
[01:25:55] when you blink it's a take Okay now what's interesting and will
[01:25:58] Okay now what's interesting and will immediately make sense to you as to why
[01:26:01] immediately make sense to you as to why this is important is that the rate of
[01:26:04] this is important is that the rate of blinking is controlled by dopamine so
[01:26:08] blinking is controlled by dopamine so what this means is that dopamine is
[01:26:10] what this means is that dopamine is controlling attention blinks relate to
[01:26:12] controlling attention blinks relate to attention and focus and therefore the
[01:26:15] attention and focus and therefore the dopamine and blinking system is one way
[01:26:17] dopamine and blinking system is one way that you constantly modulate and update
[01:26:21] that you constantly modulate and update your perception of time and fortunately
[01:26:24] your perception of time and fortunately it's also one that you can control so
[01:26:27] it's also one that you can control so the basic takeaway of this study was
[01:26:29] the basic takeaway of this study was that blinking controls time perception
[01:26:31] that blinking controls time perception but also that levels of dopamine can
[01:26:34] but also that levels of dopamine can alter your sense of time and stay with
[01:26:37] alter your sense of time and stay with me here and that blinking and dopamine
[01:26:41] me here and that blinking and dopamine are inextricably linked they are working
[01:26:43] are inextricably linked they are working together to control your attention when
[01:26:46] together to control your attention when dopamine levels go up people tend to
[01:26:49] dopamine levels go up people tend to overestimate how long something
[01:26:52] overestimate how long something lasted why because they they are
[01:26:54] lasted why because they they are processing time more finely it's slow
[01:26:57] processing time more finely it's slow motion
[01:26:58] motion mode when dopamine levels are lower they
[01:27:01] mode when dopamine levels are lower they tend to underestimate time
[01:27:03] tend to underestimate time intervals let's remember back to the
[01:27:05] intervals let's remember back to the very beginning of the episode what's
[01:27:07] very beginning of the episode what's going on in people with
[01:27:09] going on in people with ADHD they are not good at managing their
[01:27:12] ADHD they are not good at managing their time they tend to run late or they are
[01:27:14] time they tend to run late or they are disorganized they are not just
[01:27:15] disorganized they are not just disorganized in space meaning in the
[01:27:18] disorganized in space meaning in the physical space around
[01:27:20] physical space around them they are disorganized in time their
[01:27:23] them they are disorganized in time their dop is low we know that as well and so
[01:27:26] dop is low we know that as well and so they are underestimating time intervals
[01:27:29] they are underestimating time intervals and so it makes perfect sense that they
[01:27:31] and so it makes perfect sense that they would be late it makes perfect sense
[01:27:32] would be late it makes perfect sense that they would lose track of time or
[01:27:34] that they would lose track of time or the ability to focus this is really
[01:27:37] the ability to focus this is really exciting because what it means is that
[01:27:39] exciting because what it means is that children with ADHD adults with ADHD or
[01:27:42] children with ADHD adults with ADHD or people with normal levels of focus that
[01:27:44] people with normal levels of focus that want to improve their ability to focus
[01:27:46] want to improve their ability to focus can do so through a training that
[01:27:49] can do so through a training that involves learning how often to Blink and
[01:27:52] involves learning how often to Blink and when and how to keep their visual focus
[01:27:55] when and how to keep their visual focus on a given Target and it turns out this
[01:27:57] on a given Target and it turns out this study has actually been done there's a
[01:28:00] study has actually been done there's a study again I'll link to this study
[01:28:02] study again I'll link to this study entitled Improvement of attention in
[01:28:04] entitled Improvement of attention in elementary school students through
[01:28:06] elementary school students through fixation focused training activity I
[01:28:08] fixation focused training activity I won't go through all the details but
[01:28:10] won't go through all the details but what they found was a short period of
[01:28:14] what they found was a short period of focusing on a visual Target allowed
[01:28:17] focusing on a visual Target allowed these school children to greatly enhance
[01:28:20] these school children to greatly enhance their ability to focus on other types of
[01:28:22] their ability to focus on other types of information and a sign significant
[01:28:24] information and a sign significant component of the effect was due to the
[01:28:26] component of the effect was due to the way that they were controlling the
[01:28:27] way that they were controlling the shutters on their eyes their eyelids and
[01:28:30] shutters on their eyes their eyelids and controlling their blinks so what they
[01:28:32] controlling their blinks so what they did in the study is they had these kids
[01:28:34] did in the study is they had these kids Focus their visual attention on some
[01:28:36] Focus their visual attention on some object that was relatively close like
[01:28:38] object that was relatively close like their hand for a minute or so which
[01:28:40] their hand for a minute or so which actually takes some effort if you try
[01:28:42] actually takes some effort if you try and do that they were allowed to Blink
[01:28:45] and do that they were allowed to Blink however it's known from other work that
[01:28:48] however it's known from other work that if people can consciously override the
[01:28:50] if people can consciously override the desire to Blink at least to the point
[01:28:52] desire to Blink at least to the point where they feel like they have to or
[01:28:54] where they feel like they have to or else Their Eyes Were dry out that
[01:28:55] else Their Eyes Were dry out that actually can increase attention even
[01:28:57] actually can increase attention even further and they had conditions where
[01:28:59] further and they had conditions where they would look at a point further
[01:29:01] they would look at a point further across the room and even further across
[01:29:03] across the room and even further across the room it only took a few minutes each
[01:29:06] the room it only took a few minutes each day to do this 30 seconds in one
[01:29:08] day to do this 30 seconds in one condition or maybe a minute and then at
[01:29:10] condition or maybe a minute and then at another station of looking a little bit
[01:29:11] another station of looking a little bit further out and a little bit further out
[01:29:13] further out and a little bit further out however there was an important feature
[01:29:15] however there was an important feature of this study that is definitely worth
[01:29:18] of this study that is definitely worth mentioning which is before they did this
[01:29:20] mentioning which is before they did this visual Focus task or
[01:29:22] visual Focus task or training they did a series of physical
[01:29:26] training they did a series of physical movements with the kids so that the kids
[01:29:28] movements with the kids so that the kids could sort of eliminate or move out some
[01:29:30] could sort of eliminate or move out some of their desire to move and would
[01:29:33] of their desire to move and would thereby enhance their ability to sit
[01:29:35] thereby enhance their ability to sit still now it's long been known that kids
[01:29:37] still now it's long been known that kids need a recess they need time to run
[01:29:39] need a recess they need time to run around and play and roll around do
[01:29:41] around and play and roll around do whatever it is that they do in order to
[01:29:42] whatever it is that they do in order to be able to sit still at all adults
[01:29:45] be able to sit still at all adults probably need this too frankly but kids
[01:29:46] probably need this too frankly but kids need it more because the circuits in the
[01:29:49] need it more because the circuits in the brain that control reflexive movements
[01:29:52] brain that control reflexive movements and and as we say kind of rhythmic
[01:29:55] and and as we say kind of rhythmic undulating behavior and things like that
[01:29:57] undulating behavior and things like that that's an active suppression and kids
[01:29:59] that's an active suppression and kids have less of that circuitry built up
[01:30:00] have less of that circuitry built up until they hit about age 15 or 16 so
[01:30:04] until they hit about age 15 or 16 so they had the kids move around a bit and
[01:30:06] they had the kids move around a bit and then do this focus training that brings
[01:30:08] then do this focus training that brings me to another treatment that's actively
[01:30:11] me to another treatment that's actively used nowadays in schools for kids with
[01:30:13] used nowadays in schools for kids with ADHD but also starting to be used by
[01:30:17] ADHD but also starting to be used by many kids and by parents in order to
[01:30:20] many kids and by parents in order to keep their kids focusing and not going
[01:30:23] keep their kids focusing and not going crazy in the car or not acting out in
[01:30:26] crazy in the car or not acting out in general and that's the prevalence of
[01:30:29] general and that's the prevalence of these so-called fidgeter toys or things
[01:30:31] these so-called fidgeter toys or things that kids can do actively and
[01:30:32] that kids can do actively and repetitively in order to move out some
[01:30:34] repetitively in order to move out some of their um underlying reverberatory
[01:30:37] of their um underlying reverberatory activity in their nervous system so what
[01:30:40] activity in their nervous system so what you will find is that some kids with
[01:30:42] you will find is that some kids with ADHD are now given a rubber band on
[01:30:45] ADHD are now given a rubber band on their desk literally a rubber band
[01:30:46] their desk literally a rubber band that's attached to their desk and
[01:30:47] that's attached to their desk and they're able to pull on it even snap it
[01:30:49] they're able to pull on it even snap it against the desk if I had done that when
[01:30:51] against the desk if I had done that when I was a kid I think my teachers would
[01:30:52] I was a kid I think my teachers would have thrown me out of class but I think
[01:30:53] have thrown me out of class but I think it's that they're allowing them to do
[01:30:55] it's that they're allowing them to do this now as a way of moving some of
[01:30:57] this now as a way of moving some of their physical energy out or engage
[01:31:01] their physical energy out or engage their physical energy rather as opposed
[01:31:03] their physical energy rather as opposed to trying to sit statue still all the
[01:31:05] to trying to sit statue still all the time and attend and turns out that does
[01:31:08] time and attend and turns out that does enhance these children's ability to
[01:31:10] enhance these children's ability to focus mentally when they have some
[01:31:11] focus mentally when they have some physical activity to attend to and it
[01:31:14] physical activity to attend to and it turns out it also can work for adults
[01:31:16] turns out it also can work for adults I'll share with you a related anecdote
[01:31:19] I'll share with you a related anecdote because it illustrates the underlying
[01:31:20] because it illustrates the underlying mechanism I've had the great privilege
[01:31:23] mechanism I've had the great privilege of being able to do a number of
[01:31:25] of being able to do a number of surgeries brain surgeries during my
[01:31:27] surgeries brain surgeries during my career so one thing you find when you do
[01:31:29] career so one thing you find when you do brain surgeries is that the brain's
[01:31:31] brain surgeries is that the brain's pretty small uh regardless of the
[01:31:33] pretty small uh regardless of the species that you're working on and
[01:31:34] species that you're working on and you're in there and you're trying to do
[01:31:35] you're in there and you're trying to do something very specific and the more you
[01:31:38] something very specific and the more you try and hold your hands really steady
[01:31:40] try and hold your hands really steady the more they want to shake all right so
[01:31:42] the more they want to shake all right so it's not natural for any of our limbs to
[01:31:44] it's not natural for any of our limbs to sit perfectly still depending on how
[01:31:47] sit perfectly still depending on how much coffee you've had how well rested
[01:31:48] much coffee you've had how well rested you are and your sort of Baseline level
[01:31:51] you are and your sort of Baseline level of autonomic arousal some of you may
[01:31:52] of autonomic arousal some of you may find that you can hold out your hand
[01:31:54] find that you can hold out your hand absolutely Rock Solid others will shake
[01:31:56] absolutely Rock Solid others will shake a little bit more doesn't mean you're
[01:31:58] a little bit more doesn't mean you're nervous if you're shaking doesn't mean
[01:32:00] nervous if you're shaking doesn't mean you're calm if you're
[01:32:02] you're calm if you're still what it relates to is the amount
[01:32:05] still what it relates to is the amount of what we call premotor activity the
[01:32:06] of what we call premotor activity the number of commands to move that are
[01:32:08] number of commands to move that are being sent through the system and that's
[01:32:09] being sent through the system and that's what I mean by reverberatory activity
[01:32:12] what I mean by reverberatory activity and it does seem that kids with ADHD and
[01:32:14] and it does seem that kids with ADHD and adults with ADHD have a lot of re
[01:32:17] adults with ADHD have a lot of re reverberatory activity in their nervous
[01:32:19] reverberatory activity in their nervous system and so that's that constant
[01:32:20] system and so that's that constant desire to move it's hard for them to sit
[01:32:22] desire to move it's hard for them to sit still and therefore it's hard for them
[01:32:24] still and therefore it's hard for them to attend to harness their
[01:32:26] to attend to harness their attention when you do a surgery and you
[01:32:29] attention when you do a surgery and you find that your hands are
[01:32:31] find that your hands are shaking what you learn from your mentors
[01:32:33] shaking what you learn from your mentors which I did and what works extremely
[01:32:35] which I did and what works extremely well whether or not you're doing a
[01:32:36] well whether or not you're doing a surgery or not is that you simply tap
[01:32:38] surgery or not is that you simply tap your foot or you bounce your knee a
[01:32:40] your foot or you bounce your knee a little bit which you might think would
[01:32:42] little bit which you might think would make your handshake even more but
[01:32:44] make your handshake even more but provided that it's subtle what it does
[01:32:46] provided that it's subtle what it does it it is it actually shuttle some of the
[01:32:48] it it is it actually shuttle some of the activity from those premotor circuits to
[01:32:50] activity from those premotor circuits to elsewhere in the body and then you're
[01:32:52] elsewhere in the body and then you're able to sit much more still with your
[01:32:54] able to sit much more still with your hand you're able to perform the surgery
[01:32:56] hand you're able to perform the surgery with much more Precision you are able to
[01:32:58] with much more Precision you are able to write with much better handwriting and
[01:33:00] write with much better handwriting and for those of you who engage in public
[01:33:03] for those of you who engage in public speaking if you're ever too nervous
[01:33:04] speaking if you're ever too nervous that's why pacing while you public speak
[01:33:06] that's why pacing while you public speak helps if you're nervous that's why
[01:33:08] helps if you're nervous that's why bouncing your knee behind the podium
[01:33:10] bouncing your knee behind the podium works as well that's why nodding your
[01:33:11] works as well that's why nodding your head and gesticulating can help it's not
[01:33:14] head and gesticulating can help it's not a matter of quote unquote moving energy
[01:33:16] a matter of quote unquote moving energy out of the body that doesn't actually
[01:33:17] out of the body that doesn't actually happen what it is is you're engaging
[01:33:19] happen what it is is you're engaging those premotor circuits that are sending
[01:33:21] those premotor circuits that are sending through commands it's like trying to
[01:33:22] through commands it's like trying to stuff a bunch of stuff through a funnel
[01:33:25] stuff a bunch of stuff through a funnel and it creates this tension so you're
[01:33:26] and it creates this tension so you're giving it an outlet for the neural
[01:33:30] giving it an outlet for the neural circuitry to be able to move something
[01:33:32] circuitry to be able to move something so that you can keep other components of
[01:33:33] so that you can keep other components of your body and your mental attention
[01:33:36] your body and your mental attention engaged and locked onto something what
[01:33:39] engaged and locked onto something what we call Focus one thing related to this
[01:33:42] we call Focus one thing related to this whole business of blinking and focus and
[01:33:44] whole business of blinking and focus and training yourself to focus and not
[01:33:45] training yourself to focus and not blinking Etc is that most all of the
[01:33:49] blinking Etc is that most all of the drugs rlin Aderall and recreational
[01:33:53] drugs rlin Aderall and recreational drugs that increased dopamine even
[01:33:55] drugs that increased dopamine even coffee and tea and other forms of
[01:33:58] coffee and tea and other forms of caffeine they tend to make us blink less
[01:34:01] caffeine they tend to make us blink less and when we get tired we tend to Blink
[01:34:03] and when we get tired we tend to Blink more now this is sort of a duh right but
[01:34:07] more now this is sort of a duh right but being wide-eyed with excitement or fear
[01:34:10] being wide-eyed with excitement or fear or with your eyes barely being able to
[01:34:13] or with your eyes barely being able to keep them open now it should make
[01:34:16] keep them open now it should make perfect sense that these Shutters on the
[01:34:17] perfect sense that these Shutters on the front of your eyes they aren't just
[01:34:19] front of your eyes they aren't just there for winking and they aren't just
[01:34:20] there for winking and they aren't just there for cosmetic purposes they are
[01:34:23] there for cosmetic purposes they are there to regulate the amount of
[01:34:25] there to regulate the amount of information going into your nervous
[01:34:27] information going into your nervous system and they are there to regulate
[01:34:29] system and they are there to regulate how long you are bringing information
[01:34:32] how long you are bringing information into your nervous system and in what
[01:34:35] into your nervous system and in what bins how widely or finely you are
[01:34:37] bins how widely or finely you are binning time is set by how often you
[01:34:40] binning time is set by how often you blink and how widely or specifically you
[01:34:44] blink and how widely or specifically you are grabbing attention from the visual
[01:34:46] are grabbing attention from the visual world is set by whether or not you're
[01:34:47] world is set by whether or not you're viewing things very specifically like a
[01:34:49] viewing things very specifically like a Crosshair or through a soda straw view
[01:34:50] Crosshair or through a soda straw view like this or whether or not you in this
[01:34:53] like this or whether or not you in this panoramic sort of
[01:34:55] panoramic sort of whole environment mode this kind of
[01:34:57] whole environment mode this kind of fishey lens or wide angle lens mode and
[01:35:00] fishey lens or wide angle lens mode and In fairness to the pharmacology in the
[01:35:03] In fairness to the pharmacology in the circuitry while dopamine and heightened
[01:35:06] circuitry while dopamine and heightened levels of alertness and excitement tend
[01:35:09] levels of alertness and excitement tend to make us blink less and attend more
[01:35:12] to make us blink less and attend more there's actually a study that's looked
[01:35:14] there's actually a study that's looked at the other neurochemical systems and
[01:35:17] at the other neurochemical systems and drugs and how those relate to blinking
[01:35:19] drugs and how those relate to blinking and so this will all be obvious by the
[01:35:21] and so this will all be obvious by the title of the paper I'm about to share
[01:35:22] title of the paper I'm about to share with you this is a paper
[01:35:24] with you this is a paper entitled decreased spontaneous eye blink
[01:35:27] entitled decreased spontaneous eye blink rates in chronic cannabis users evidence
[01:35:30] rates in chronic cannabis users evidence for striatal cannabinoid dopamine
[01:35:33] for striatal cannabinoid dopamine interactions okay I'm not going to go
[01:35:34] interactions okay I'm not going to go into all the details here but one thing
[01:35:37] into all the details here but one thing that is somewhat surprising is that many
[01:35:40] that is somewhat surprising is that many people with ADHD use or abuse
[01:35:44] people with ADHD use or abuse cannabis you might think well why would
[01:35:46] cannabis you might think well why would they do that because I thought that a
[01:35:49] they do that because I thought that a increase in dopamine is actually what's
[01:35:51] increase in dopamine is actually what's going to lead to heightened levels of
[01:35:52] going to lead to heightened levels of attention and that's what these people
[01:35:53] attention and that's what these people and children crave well it turns out
[01:35:55] and children crave well it turns out that cannabis also increases dopamine
[01:35:59] that cannabis also increases dopamine Transmission in the brain but because of
[01:36:01] Transmission in the brain but because of the other chemicals it increases namely
[01:36:03] the other chemicals it increases namely serotonin and some components of the
[01:36:05] serotonin and some components of the cannabinoid and opioid system it creates
[01:36:08] cannabinoid and opioid system it creates that kind of alert but mellow feel and
[01:36:13] that kind of alert but mellow feel and again here I'm I'm not a proponent of
[01:36:15] again here I'm I'm not a proponent of this I personally am not a THC or
[01:36:17] this I personally am not a THC or cannabis User it's just not my thing uh
[01:36:20] cannabis User it's just not my thing uh and obviously it's illegal some places
[01:36:21] and obviously it's illegal some places and so you have to determine that for
[01:36:23] and so you have to determine that for self it does have medical purposes and
[01:36:26] self it does have medical purposes and in some places it is legal but THC
[01:36:29] in some places it is legal but THC increases dopamine and increases
[01:36:31] increases dopamine and increases neurochemicals that can also create a
[01:36:33] neurochemicals that can also create a state of calm so it's that sort of
[01:36:34] state of calm so it's that sort of middle ground and this paper has a
[01:36:36] middle ground and this paper has a beautiful demonstration
[01:36:39] beautiful demonstration whereby not just while people are using
[01:36:41] whereby not just while people are using cannabis but depending on how long
[01:36:44] cannabis but depending on how long they've been using cannabis across their
[01:36:45] they've been using cannabis across their lifespan the rates of eye blinking
[01:36:48] lifespan the rates of eye blinking change so if you look at the number of
[01:36:51] change so if you look at the number of years that people have been using
[01:36:53] years that people have been using cannabis on a regular basis either daily
[01:36:55] cannabis on a regular basis either daily or up to uh excuse me weekly or up to
[01:36:57] or up to uh excuse me weekly or up to daily what you find is that for people
[01:37:00] daily what you find is that for people that have not been using cannabis at all
[01:37:02] that have not been using cannabis at all or have only been using it for about two
[01:37:04] or have only been using it for about two years their rates of eye blinks are much
[01:37:07] years their rates of eye blinks are much higher than people who have been using
[01:37:09] higher than people who have been using it chronically for 10 years in other
[01:37:10] it chronically for 10 years in other words people who've been using cannabis
[01:37:12] words people who've been using cannabis for 10 years don't blink very often at
[01:37:14] for 10 years don't blink very often at all now cannabis has well-known effects
[01:37:17] all now cannabis has well-known effects in depleting memory but it does seem to
[01:37:21] in depleting memory but it does seem to engage the focus and blinking system in
[01:37:23] engage the focus and blinking system in a way that increases Focus so basically
[01:37:26] a way that increases Focus so basically what I'm saying is marijuana seems to
[01:37:28] what I'm saying is marijuana seems to increase people's Focus but then they
[01:37:29] increase people's Focus but then they can't remember what they were focusing
[01:37:31] can't remember what they were focusing on something I'd like to discuss just
[01:37:33] on something I'd like to discuss just briefly is the so-called interceptive
[01:37:36] briefly is the so-called interceptive awareness that's present in people with
[01:37:38] awareness that's present in people with ADHD both children and adults
[01:37:40] ADHD both children and adults interceptive awareness is one's sense of
[01:37:43] interceptive awareness is one's sense of One's Own internal State heartbeat
[01:37:46] One's Own internal State heartbeat breathing contact of skin with a given
[01:37:48] breathing contact of skin with a given surface etc for a long time there was
[01:37:51] surface etc for a long time there was this hypothesis this idea that people
[01:37:54] this hypothesis this idea that people with ADHD were just not in touch with
[01:37:56] with ADHD were just not in touch with how they felt that somehow they weren't
[01:37:58] how they felt that somehow they weren't registering all the stuff that was going
[01:38:00] registering all the stuff that was going on inside them changes in heart rate and
[01:38:02] on inside them changes in heart rate and so forth and so they were behaving in a
[01:38:04] so forth and so they were behaving in a way that was disregulated or appeared
[01:38:07] way that was disregulated or appeared disregulated and that if they could just
[01:38:10] disregulated and that if they could just learn to attend to their internal State
[01:38:12] learn to attend to their internal State better that somehow they would function
[01:38:15] better that somehow they would function better in the world now before we
[01:38:17] better in the world now before we described a process literally a
[01:38:19] described a process literally a 17-minute
[01:38:21] 17-minute interceptive exercise that does seem to
[01:38:24] interceptive exercise that does seem to lead to improvements in one's ability to
[01:38:27] lead to improvements in one's ability to focus for a longer period of time
[01:38:30] focus for a longer period of time however it's very unlikely that that was
[01:38:33] however it's very unlikely that that was due to increasing in interceptive
[01:38:35] due to increasing in interceptive Awareness per se it probably wasn't
[01:38:38] Awareness per se it probably wasn't because people gain a much heightened or
[01:38:41] because people gain a much heightened or improved ability to understand what's
[01:38:44] improved ability to understand what's going on internally in fact you can
[01:38:46] going on internally in fact you can imagine how that might actually prevent
[01:38:48] imagine how that might actually prevent one's ability to pay attention to things
[01:38:49] one's ability to pay attention to things in the outside world so while there is
[01:38:52] in the outside world so while there is benefit to just sitting there and being
[01:38:53] benefit to just sitting there and being in Stillness as they say or focusing on
[01:38:56] in Stillness as they say or focusing on one's breathing in internal state for
[01:38:58] one's breathing in internal state for sake of then accessing information in
[01:39:00] sake of then accessing information in the external World a really nice
[01:39:04] the external World a really nice study called interceptive awareness in
[01:39:06] study called interceptive awareness in attention deficit hyperactivity disorder
[01:39:08] attention deficit hyperactivity disorder explored whether or not interceptive
[01:39:10] explored whether or not interceptive awareness was different in people with
[01:39:12] awareness was different in people with ADHD or did not have
[01:39:15] ADHD or did not have ADHD and the findings were essentially
[01:39:19] ADHD and the findings were essentially that there's no difference that people
[01:39:20] that there's no difference that people with ADHD children and adults they are
[01:39:22] with ADHD children and adults they are aware what's going on inside them just
[01:39:25] aware what's going on inside them just as much as anyone else's and the typical
[01:39:28] as much as anyone else's and the typical measure of interceptive awareness is
[01:39:29] measure of interceptive awareness is one's ability to Count Their Own
[01:39:32] one's ability to Count Their Own heartbeats this is actually challenging
[01:39:34] heartbeats this is actually challenging for some individuals and very easy for
[01:39:36] for some individuals and very easy for other individuals regardless of their
[01:39:38] other individuals regardless of their attentional capacity some people just
[01:39:40] attentional capacity some people just can really feel their heartbeat without
[01:39:42] can really feel their heartbeat without taking their pulse other people cannot
[01:39:45] taking their pulse other people cannot and these studies are pretty
[01:39:46] and these studies are pretty straightforward to do you ask people to
[01:39:49] straightforward to do you ask people to sit there and to count their heartbeats
[01:39:50] sit there and to count their heartbeats and then you are monitoring their
[01:39:51] and then you are monitoring their heartbeats and you get to G how accurate
[01:39:54] heartbeats and you get to G how accurate they are so it's important to understand
[01:39:57] they are so it's important to understand that people with ADHD are in touch with
[01:39:59] that people with ADHD are in touch with how they feel it's really a question of
[01:40:03] how they feel it's really a question of whether or not they can take the demands
[01:40:05] whether or not they can take the demands that are placed upon them and enter a
[01:40:07] that are placed upon them and enter a cognitive State a mental state that
[01:40:09] cognitive State a mental state that allows them to access the information
[01:40:11] allows them to access the information they need to access in other words
[01:40:12] they need to access in other words whether or not they can focus but it is
[01:40:13] whether or not they can focus but it is absolutely wrong to think that the child
[01:40:16] absolutely wrong to think that the child that's getting up 11 times during a
[01:40:18] that's getting up 11 times during a short six you know six minute
[01:40:20] short six you know six minute interaction at the table or whether or
[01:40:22] interaction at the table or whether or not uh a child who somehow has to
[01:40:25] not uh a child who somehow has to venture off every moment or a co-worker
[01:40:27] venture off every moment or a co-worker of yours who's an adult who's constantly
[01:40:28] of yours who's an adult who's constantly fidgeting or moving things around that
[01:40:30] fidgeting or moving things around that somehow they are unaware that they are
[01:40:31] somehow they are unaware that they are oblivious they are not oblivious to how
[01:40:33] oblivious they are not oblivious to how they feel chances are they are very
[01:40:35] they feel chances are they are very challenged in the situations that
[01:40:36] challenged in the situations that they're in and they're doing everything
[01:40:38] they're in and they're doing everything they can to try and regulate their
[01:40:39] they can to try and regulate their attention so I think it's an important
[01:40:41] attention so I think it's an important study to highlight because it really
[01:40:43] study to highlight because it really underscores the fact that something else
[01:40:45] underscores the fact that something else is going on and that something else has
[01:40:47] is going on and that something else has everything to do with this ability to
[01:40:49] everything to do with this ability to coordinate these task directed networks
[01:40:51] coordinate these task directed networks and to coordinate that in the proper
[01:40:53] and to coordinate that in the proper away with that default mode Network and
[01:40:56] away with that default mode Network and that is a process as you now know that's
[01:40:59] that is a process as you now know that's regulated exquisitly by certain
[01:41:01] regulated exquisitly by certain neurochemicals and in particular the
[01:41:03] neurochemicals and in particular the neurochemicals dopamine norepinephrine
[01:41:05] neurochemicals dopamine norepinephrine and serotonin and a fourth one I'd like
[01:41:08] and serotonin and a fourth one I'd like to throw into the mix which is
[01:41:09] to throw into the mix which is acetylcholine which is very vital for
[01:41:11] acetylcholine which is very vital for cognitive Focus so now I want to switch
[01:41:14] cognitive Focus so now I want to switch back to talking about some of the drugs
[01:41:16] back to talking about some of the drugs that are typically used to access those
[01:41:18] that are typically used to access those systems prescription drugs and I want to
[01:41:20] systems prescription drugs and I want to talk about some of the new and emerging
[01:41:22] talk about some of the new and emerging nonprescription approach is to
[01:41:24] nonprescription approach is to increasing the levels of dopamine
[01:41:25] increasing the levels of dopamine acetycholine and serotonin in the brain
[01:41:28] acetycholine and serotonin in the brain using various supplement type compounds
[01:41:30] using various supplement type compounds because several of them are showing
[01:41:32] because several of them are showing really remarkable efficacy in excellent
[01:41:35] really remarkable efficacy in excellent peer-reviewed studies so before moving
[01:41:37] peer-reviewed studies so before moving to some of the newer atypical compounds
[01:41:39] to some of the newer atypical compounds and things sold over the counter I'd
[01:41:42] and things sold over the counter I'd like to just briefly return to the
[01:41:45] like to just briefly return to the classic drugs that are used to treat
[01:41:48] classic drugs that are used to treat ADHD these are the ones I mentioned
[01:41:50] ADHD these are the ones I mentioned earlier methylphenidate also called
[01:41:53] earlier methylphenidate also called called rlin modafanil
[01:41:56] called rlin modafanil armodafinil is another one and adol
[01:42:00] armodafinil is another one and adol again all of these work by increasing
[01:42:02] again all of these work by increasing levels of dopamine and
[01:42:04] levels of dopamine and norepinephrine typically they are taken
[01:42:06] norepinephrine typically they are taken orally in pill form or sometimes in
[01:42:10] orally in pill form or sometimes in capsule form the dosages that are
[01:42:12] capsule form the dosages that are appropriate vary according to severity
[01:42:15] appropriate vary according to severity of the condition for a given person and
[01:42:18] of the condition for a given person and the age of the person this is a
[01:42:21] the age of the person this is a complicated landscape for each
[01:42:23] complicated landscape for each individual they have to figure out the
[01:42:25] individual they have to figure out the pharmacology that's best for them some
[01:42:27] pharmacology that's best for them some individuals are even
[01:42:28] individuals are even layering long or time to release Ridin
[01:42:32] layering long or time to release Ridin with adderal and in smaller doses it can
[01:42:35] with adderal and in smaller doses it can get quite complex or it can be quite
[01:42:37] get quite complex or it can be quite straightforward if you are really
[01:42:38] straightforward if you are really interested in these drugs and how they
[01:42:40] interested in these drugs and how they work and you'd like to get a glance at a
[01:42:44] work and you'd like to get a glance at a table of all the results from all the
[01:42:47] table of all the results from all the studies of which there are now hundreds
[01:42:49] studies of which there are now hundreds there's an excellent review about these
[01:42:52] there's an excellent review about these drugs and their use and their comparison
[01:42:55] drugs and their use and their comparison to similarly structured drugs in
[01:42:57] to similarly structured drugs in particular MDMA and cocaine and
[01:43:00] particular MDMA and cocaine and amphetamine meaning Street amphetamine
[01:43:02] amphetamine meaning Street amphetamine to really illustrate the similarities of
[01:43:05] to really illustrate the similarities of action and some of the problems
[01:43:08] action and some of the problems associated with long-term use I don't
[01:43:10] associated with long-term use I don't expect you to read this article in full
[01:43:11] expect you to read this article in full I'm here so that you don't have to go
[01:43:13] I'm here so that you don't have to go read these articles but in case you want
[01:43:15] read these articles but in case you want a ton of information the paper is
[01:43:17] a ton of information the paper is Esposito at all Frontiers in biosciences
[01:43:20] Esposito at all Frontiers in biosciences it's an excellent excellent review of of
[01:43:23] it's an excellent excellent review of of the entire literature it it is quite
[01:43:25] the entire literature it it is quite long uh I can put a link to that study
[01:43:28] long uh I can put a link to that study in our caption and it essentially
[01:43:31] in our caption and it essentially describes all the studies that have been
[01:43:33] describes all the studies that have been done peer-reviewed and published and it
[01:43:36] done peer-reviewed and published and it refers to these drugs in an interesting
[01:43:38] refers to these drugs in an interesting way it doesn't just refer to these drugs
[01:43:40] way it doesn't just refer to these drugs as for treatment of ADHD it actually
[01:43:42] as for treatment of ADHD it actually refers to them using language that
[01:43:44] refers to them using language that ordinarily I'm not very fond of but I'll
[01:43:47] ordinarily I'm not very fond of but I'll agree to here which is so-called smart
[01:43:49] agree to here which is so-called smart drugs or neut
[01:43:51] drugs or neut Tropics it also covers caffeine which
[01:43:55] Tropics it also covers caffeine which again as I mentioned earlier increases
[01:43:57] again as I mentioned earlier increases dopamine
[01:43:58] dopamine norepinephrine and to some extent
[01:44:00] norepinephrine and to some extent serotonin but what I like about this
[01:44:03] serotonin but what I like about this review so much is that in putting these
[01:44:05] review so much is that in putting these drugs of abuse methamphetamine and
[01:44:07] drugs of abuse methamphetamine and cocaine right alongside these drugs like
[01:44:09] cocaine right alongside these drugs like ryin and Aderall and also caffeine we
[01:44:12] ryin and Aderall and also caffeine we start to realize that the distinction
[01:44:14] start to realize that the distinction between drugs of abuse and the
[01:44:16] between drugs of abuse and the distinction between drugs of treatment
[01:44:17] distinction between drugs of treatment is actually a very fine and sometimes
[01:44:19] is actually a very fine and sometimes even a blurry line and in thinking about
[01:44:23] even a blurry line and in thinking about whether or not one wants to use these
[01:44:25] whether or not one wants to use these prescription I want to emphasize
[01:44:27] prescription I want to emphasize prescription not drugs of abuse but
[01:44:28] prescription not drugs of abuse but prescription drugs for treatment of
[01:44:30] prescription drugs for treatment of One's Own attentional
[01:44:32] One's Own attentional capacity I think it is important to
[01:44:34] capacity I think it is important to understand the extent to which they all
[01:44:36] understand the extent to which they all carry more or less the same side effects
[01:44:38] carry more or less the same side effects the one exception being caffeine
[01:44:40] the one exception being caffeine caffeine side effects can be anxiety if
[01:44:42] caffeine side effects can be anxiety if you ingest too much of it insomnia if
[01:44:44] you ingest too much of it insomnia if you drink it too late in the day but
[01:44:46] you drink it too late in the day but typically it will not cause the major
[01:44:48] typically it will not cause the major side effects of the other drugs such as
[01:44:52] side effects of the other drugs such as high propensity for for addiction and
[01:44:54] high propensity for for addiction and abuse amphetamines of any kind as well
[01:44:57] abuse amphetamines of any kind as well as cocaine can cause sexual side effects
[01:45:00] as cocaine can cause sexual side effects because they're Vaso constrictors so uh
[01:45:03] because they're Vaso constrictors so uh you know men have trouble achieving
[01:45:05] you know men have trouble achieving erection um there can often be the
[01:45:07] erection um there can often be the intense desire or libido uh for sex but
[01:45:12] intense desire or libido uh for sex but an inability to actually perform so
[01:45:14] an inability to actually perform so that's an issue with any kind of
[01:45:16] that's an issue with any kind of stimulant so these drugs are not without
[01:45:18] stimulant so these drugs are not without their consequences in addition and here
[01:45:20] their consequences in addition and here I'd lump caffeine back into the into the
[01:45:23] I'd lump caffeine back into the into the mix in addition they almost all carry
[01:45:26] mix in addition they almost all carry cardiac effects right they increase
[01:45:28] cardiac effects right they increase heart rate but they also have effects on
[01:45:31] heart rate but they also have effects on constriction of blood vessels and
[01:45:33] constriction of blood vessels and arteries and veins and so forth in ways
[01:45:34] arteries and veins and so forth in ways that can create cardiovascular problems
[01:45:37] that can create cardiovascular problems now caffeine is a bit of a complicated
[01:45:39] now caffeine is a bit of a complicated one I talked about this on a podcast
[01:45:42] one I talked about this on a podcast long ago but I'll just remind you that
[01:45:44] long ago but I'll just remind you that it turns out that if you are caffeine
[01:45:46] it turns out that if you are caffeine adapted in other words if you are used
[01:45:47] adapted in other words if you are used to drinking caffeine then the ingestion
[01:45:50] to drinking caffeine then the ingestion of caffeine most often will cause vasod
[01:45:52] of caffeine most often will cause vasod dilation it will actually allow more
[01:45:54] dilation it will actually allow more blood flow through however if you are
[01:45:56] blood flow through however if you are not caffeine adapted it will cause vasil
[01:45:58] not caffeine adapted it will cause vasil constriction due to an increased stress
[01:46:01] constriction due to an increased stress response so if you're familiar with
[01:46:03] response so if you're familiar with caffeine caffeine can actually have a
[01:46:05] caffeine caffeine can actually have a little bit more of a relaxation response
[01:46:07] little bit more of a relaxation response although if you drink enough of it it
[01:46:09] although if you drink enough of it it will make you amped up these other drugs
[01:46:11] will make you amped up these other drugs almost always lead to vasil constriction
[01:46:14] almost always lead to vasil constriction increased heart rate dilation of the
[01:46:16] increased heart rate dilation of the Pees less blinking heighten levels of
[01:46:18] Pees less blinking heighten levels of attention which looks very much like
[01:46:21] attention which looks very much like stress and at its EX exes looks very
[01:46:23] stress and at its EX exes looks very much like the effects of street drugs
[01:46:25] much like the effects of street drugs like cocaine and amphetamine because of
[01:46:27] like cocaine and amphetamine because of the large amounts of dopamine that
[01:46:29] the large amounts of dopamine that released in the brain people tend to
[01:46:31] released in the brain people tend to Crave that state over and over and yet
[01:46:34] Crave that state over and over and yet with each subsequent use are able to get
[01:46:37] with each subsequent use are able to get less and less of that euphoric feeling
[01:46:39] less and less of that euphoric feeling or that really really focused feeling so
[01:46:41] or that really really focused feeling so one thing that's being explored quite
[01:46:42] one thing that's being explored quite extensively now in the treatment of
[01:46:44] extensively now in the treatment of ADHD are drug schedules whether or not
[01:46:49] ADHD are drug schedules whether or not people should take Aderall every day or
[01:46:51] people should take Aderall every day or every other day whe whether or not they
[01:46:53] every other day whe whether or not they should take it only every once in a
[01:46:54] should take it only every once in a while whether or not young children can
[01:46:56] while whether or not young children can take it just a few times and engage in
[01:46:59] take it just a few times and engage in behavioral training of the sort that I
[01:47:00] behavioral training of the sort that I talked about before where they're doing
[01:47:02] talked about before where they're doing maybe it's a 17 minute meditation type
[01:47:05] maybe it's a 17 minute meditation type exercise but more likely it would be the
[01:47:07] exercise but more likely it would be the movement followed by the visual focusing
[01:47:10] movement followed by the visual focusing because that's only done for 20 or 30 or
[01:47:12] because that's only done for 20 or 30 or 60 seconds why would you do that well in
[01:47:15] 60 seconds why would you do that well in a chemically enhanced State your brain
[01:47:16] a chemically enhanced State your brain is more plastic the circuits are able to
[01:47:18] is more plastic the circuits are able to modify and learn better
[01:47:22] modify and learn better that's the optimal time to engage in
[01:47:25] that's the optimal time to engage in focus in a very deliberate way so just
[01:47:27] focus in a very deliberate way so just taking a drug and expecting Focus to
[01:47:29] taking a drug and expecting Focus to just work at any point and being able to
[01:47:31] just work at any point and being able to turn focus on and off at will that's an
[01:47:35] turn focus on and off at will that's an unrealistic expectation right more
[01:47:38] unrealistic expectation right more likely the best use of things like adol
[01:47:42] likely the best use of things like adol modafanil
[01:47:44] modafanil armodafinil and Rin is going to be to
[01:47:47] armodafinil and Rin is going to be to combine those treatments with behavioral
[01:47:50] combine those treatments with behavioral exercises that actively Engage The
[01:47:53] exercises that actively Engage The circuits that you're trying to train up
[01:47:54] circuits that you're trying to train up and enhance and then perhaps I want to
[01:47:57] and enhance and then perhaps I want to highlight perhaps tapering off those
[01:47:58] highlight perhaps tapering off those drugs so that then one can use those
[01:48:01] drugs so that then one can use those circuits without any need for chemical
[01:48:03] circuits without any need for chemical intervention so despite any controversy
[01:48:05] intervention so despite any controversy that might be out there I think it's
[01:48:07] that might be out there I think it's fair to say that the consumption of
[01:48:09] fair to say that the consumption of omega-3 fatty
[01:48:11] omega-3 fatty acids can positively modulate the
[01:48:14] acids can positively modulate the systems for attention and focus so then
[01:48:16] systems for attention and focus so then the question becomes how
[01:48:18] the question becomes how much EPA how much DHA does that differ
[01:48:22] much EPA how much DHA does that differ for
[01:48:23] for uh what's helpful for depression Etc and
[01:48:26] uh what's helpful for depression Etc and actually it does differ in reviewing the
[01:48:28] actually it does differ in reviewing the studies for this it appears that a
[01:48:30] studies for this it appears that a threshold level of 300 milligrams of DHA
[01:48:34] threshold level of 300 milligrams of DHA turns out to be an important inflection
[01:48:36] turns out to be an important inflection point so typically fish oils or other
[01:48:39] point so typically fish oils or other sources of
[01:48:40] sources of Omega-3s will have DHA and EPA and
[01:48:44] Omega-3s will have DHA and EPA and typically it's the EPA that's harder to
[01:48:47] typically it's the EPA that's harder to get at sufficient levels meaning you
[01:48:48] get at sufficient levels meaning you have to take quite a lot of fish oil in
[01:48:50] have to take quite a lot of fish oil in order to get above that 1,000 milligram
[01:48:52] order to get above that 1,000 milligram or 2,000 milligram threshold to improve
[01:48:54] or 2,000 milligram threshold to improve mood and other functions but for sake of
[01:48:58] mood and other functions but for sake of attention there are 10 studies that have
[01:49:00] attention there are 10 studies that have explored this in detail and while the
[01:49:02] explored this in detail and while the EPA component is important the most
[01:49:05] EPA component is important the most convincing studies point to the fact
[01:49:07] convincing studies point to the fact that getting above 300 milligrams per
[01:49:10] that getting above 300 milligrams per day of DHA is really where you start to
[01:49:13] day of DHA is really where you start to see the attentional effects now
[01:49:14] see the attentional effects now fortunately if you're getting sufficient
[01:49:15] fortunately if you're getting sufficient EPA for sake of mood and other
[01:49:18] EPA for sake of mood and other biological
[01:49:19] biological functions almost without question you're
[01:49:22] functions almost without question you're getting 300 Mig or more of DHA so that
[01:49:25] getting 300 Mig or more of DHA so that usually checks that box just fine what's
[01:49:28] usually checks that box just fine what's interesting is that there's another
[01:49:29] interesting is that there's another compound phosphole
[01:49:31] compound phosphole steering that has been explored for its
[01:49:34] steering that has been explored for its capacity to improve the symptoms of ADHD
[01:49:37] capacity to improve the symptoms of ADHD again I don't think this is any direct
[01:49:39] again I don't think this is any direct way but rather in a modulatory way but
[01:49:42] way but rather in a modulatory way but it appears that phosphido sering taken
[01:49:44] it appears that phosphido sering taken for two months for 200
[01:49:47] for two months for 200 milligrams per day was able to reduce
[01:49:50] milligrams per day was able to reduce the symptoms of ADHD in children it has
[01:49:53] the symptoms of ADHD in children it has not been looked at in adults yet as at
[01:49:55] not been looked at in adults yet as at least as far as I know but that this
[01:49:58] least as far as I know but that this effect was greatly enhanced by the
[01:50:01] effect was greatly enhanced by the consumption of omega-3 fatty acids so
[01:50:03] consumption of omega-3 fatty acids so now we're starting to see synergistic
[01:50:05] now we're starting to see synergistic effects of omega-3 fatty acids and
[01:50:07] effects of omega-3 fatty acids and phosphido stering again that was 200
[01:50:09] phosphido stering again that was 200 milligrams per day this is something
[01:50:11] milligrams per day this is something that's sold over the-counter in capsule
[01:50:13] that's sold over the-counter in capsule form at least in the US uh there were
[01:50:15] form at least in the US uh there were two studies both were double blind
[01:50:17] two studies both were double blind studies uh carried out for any anywhere
[01:50:19] studies uh carried out for any anywhere from 1 to 6 months on both boys and
[01:50:22] from 1 to 6 months on both boys and girls it really was boys and girls not
[01:50:23] girls it really was boys and girls not men and women this was kids um age 1 to
[01:50:26] men and women this was kids um age 1 to 6 or 7 to 12 and uh it was a fairly
[01:50:31] 6 or 7 to 12 and uh it was a fairly large number of subjects so 147 subjects
[01:50:33] large number of subjects so 147 subjects in one case and 36 in the other the
[01:50:35] in one case and 36 in the other the takeaway is that getting sufficient
[01:50:38] takeaway is that getting sufficient levels of epas in particular this 300
[01:50:40] levels of epas in particular this 300 milligram threshold of
[01:50:41] milligram threshold of DHA plus if you are interested in it and
[01:50:45] DHA plus if you are interested in it and it's right for you 200 Mig of phosph
[01:50:48] it's right for you 200 Mig of phosph steering can be an important augment for
[01:50:50] steering can be an important augment for improving the symptoms of a ADHD you'll
[01:50:53] improving the symptoms of a ADHD you'll also find literature out there and many
[01:50:56] also find literature out there and many claims about so-called goo bboa which
[01:50:59] claims about so-called goo bboa which has been shown to have minor effects in
[01:51:01] has been shown to have minor effects in improving the symptoms of
[01:51:03] improving the symptoms of ADHD not nearly as effective as rlin and
[01:51:08] ADHD not nearly as effective as rlin and adderal GLE bboa is not appropriate for
[01:51:11] adderal GLE bboa is not appropriate for many people I am one such person I don't
[01:51:14] many people I am one such person I don't have ADHD but when I've taken gko even
[01:51:18] have ADHD but when I've taken gko even at very low doses I get absolutely
[01:51:20] at very low doses I get absolutely splitting headaches some people do not
[01:51:22] splitting headaches some people do not experience those headaches but it's
[01:51:23] experience those headaches but it's known to have very potent
[01:51:25] known to have very potent vasoconstrictive and vasodilating
[01:51:27] vasoconstrictive and vasodilating properties that vary depending on when
[01:51:30] properties that vary depending on when you took the compound so for those of
[01:51:32] you took the compound so for those of you that are exploring Ginko bboa and
[01:51:35] you that are exploring Ginko bboa and you will see a lot of claims about Ginko
[01:51:37] you will see a lot of claims about Ginko bboa for attention in ADHD definitely
[01:51:39] bboa for attention in ADHD definitely take the uh vasod dilation Vaso
[01:51:42] take the uh vasod dilation Vaso constriction headache issue into
[01:51:44] constriction headache issue into consideration so I'd like to talk about
[01:51:46] consideration so I'd like to talk about the drug modafanil and the closely
[01:51:49] the drug modafanil and the closely related drug arm modafanil that's a
[01:51:51] related drug arm modafanil that's a modafanil
[01:51:53] modafanil because modafanil and arm modafanil are
[01:51:55] because modafanil and arm modafanil are gaining popularity out there both for
[01:51:57] gaining popularity out there both for treatment of ADHD and narcolepsy but
[01:52:00] treatment of ADHD and narcolepsy but also for communities of people that are
[01:52:04] also for communities of people that are trying to stay awake long periods of
[01:52:05] trying to stay awake long periods of time so it's actively used in the
[01:52:07] time so it's actively used in the military by First Responders it's uh
[01:52:10] military by First Responders it's uh gaining popularity on college campuses
[01:52:13] gaining popularity on college campuses and people are using it more and more as
[01:52:14] and people are using it more and more as an alternative to Aderall and riddlin
[01:52:17] an alternative to Aderall and riddlin and excessive amounts of coffee it does
[01:52:21] and excessive amounts of coffee it does increase focus and to a dramatic extent
[01:52:24] increase focus and to a dramatic extent modafanil T typically was very expensive
[01:52:27] modafanil T typically was very expensive uh you know I don't know if it's still
[01:52:29] uh you know I don't know if it's still this expensive but when one has a
[01:52:31] this expensive but when one has a prescription for it it could still cost
[01:52:33] prescription for it it could still cost as much as $8 or $900 or even $1,000 a
[01:52:36] as much as $8 or $900 or even $1,000 a month our modafanil is a far less
[01:52:40] month our modafanil is a far less expensive version that's chemically
[01:52:42] expensive version that's chemically slightly different than modafanil
[01:52:44] slightly different than modafanil regardless of price people are taking
[01:52:46] regardless of price people are taking modafanil and our modafanil want to
[01:52:49] modafanil and our modafanil want to emphasize that unlike rlin and Aderall
[01:52:52] emphasize that unlike rlin and Aderall modafinil and armodafinil are weak
[01:52:55] modafinil and armodafinil are weak dopamine reuptake Inhibitors and that's
[01:52:58] dopamine reuptake Inhibitors and that's how they lead to increases in dopamine
[01:53:00] how they lead to increases in dopamine so whereas rlin and adderal amphetamine
[01:53:02] so whereas rlin and adderal amphetamine and cocaine lead to Big increases in
[01:53:04] and cocaine lead to Big increases in dopamine also through re-uptake
[01:53:06] dopamine also through re-uptake mechanisms and so forth modafanil is is
[01:53:08] mechanisms and so forth modafanil is is a weaker dopamine
[01:53:11] a weaker dopamine reuptake stimulator and so what that
[01:53:14] reuptake stimulator and so what that means is that it leaves more dopamine
[01:53:15] means is that it leaves more dopamine around to be active at the synapse the
[01:53:18] around to be active at the synapse the the gaps between neurons however it also
[01:53:20] the gaps between neurons however it also activates other systems it acts on on
[01:53:22] activates other systems it acts on on the orexin system which is actually a
[01:53:25] the orexin system which is actually a peptide that we talked about in the
[01:53:26] peptide that we talked about in the episode on Hunger because it regulates
[01:53:29] episode on Hunger because it regulates hunger and appetite and it regulates
[01:53:32] hunger and appetite and it regulates sleepiness and feelings of sleepiness in
[01:53:34] sleepiness and feelings of sleepiness in fact the excuse me ereen also called
[01:53:36] fact the excuse me ereen also called hypocretin system the ereen hypocretin
[01:53:38] hypocretin system the ereen hypocretin system is what's disrupted in narcolepsy
[01:53:42] system is what's disrupted in narcolepsy that was the important discovery of my
[01:53:43] that was the important discovery of my colleagues Emanuel M and SE Nino at
[01:53:47] colleagues Emanuel M and SE Nino at Stanford some years ago they identified
[01:53:49] Stanford some years ago they identified the biological basis of narcolepsy and
[01:53:51] the biological basis of narcolepsy and it's a disruption in this so
[01:53:53] it's a disruption in this so hypocretin system and modafanil is one
[01:53:56] hypocretin system and modafanil is one of the primary treatments for narcolepsy
[01:53:58] of the primary treatments for narcolepsy it also has these other effects on the
[01:54:00] it also has these other effects on the dopamine system and on the
[01:54:01] dopamine system and on the norepinephrine system even though it
[01:54:04] norepinephrine system even though it doesn't lead to quite as intense levels
[01:54:08] doesn't lead to quite as intense levels of dopamine and arousal and focus it
[01:54:11] of dopamine and arousal and focus it does have the property of raising levels
[01:54:13] does have the property of raising levels of attention and focus and that's why
[01:54:15] of attention and focus and that's why people are using it so it's a somewhat
[01:54:17] people are using it so it's a somewhat milder form of Aderall armodafinil for
[01:54:20] milder form of Aderall armodafinil for some people works as well as modafanil
[01:54:22] some people works as well as modafanil and as I mentioned before it's much
[01:54:24] and as I mentioned before it's much lower cost for other people it doesn't I
[01:54:26] lower cost for other people it doesn't I have an experience meaning I do have an
[01:54:29] have an experience meaning I do have an experience that I'll share with you with
[01:54:31] experience that I'll share with you with armodafinil a few years ago I was
[01:54:33] armodafinil a few years ago I was suffering from jet lag really terribly
[01:54:36] suffering from jet lag really terribly and I was traveling overseas I went to a
[01:54:39] and I was traveling overseas I went to a meeting to give a talk I took half of
[01:54:42] meeting to give a talk I took half of the prescribed dose of armodafinil it
[01:54:45] the prescribed dose of armodafinil it was prescribed to me I took that half
[01:54:48] was prescribed to me I took that half dose and I gave my lecture and then I
[01:54:51] dose and I gave my lecture and then I stayed around to answer questions and
[01:54:53] stayed around to answer questions and then 4 hours later a friend of mine came
[01:54:56] then 4 hours later a friend of mine came up to me and said you know you've been
[01:54:58] up to me and said you know you've been talking for 4 and a half hours and uh
[01:55:01] talking for 4 and a half hours and uh there were only a few people still here
[01:55:03] there were only a few people still here luckily there were still a few people be
[01:55:05] luckily there were still a few people be a lot weirder if the room was completely
[01:55:06] a lot weirder if the room was completely empty since it wasn't being recorded So
[01:55:09] empty since it wasn't being recorded So I have firsthand knowledge of the sorts
[01:55:11] I have firsthand knowledge of the sorts of cognitive effects that it can create
[01:55:14] of cognitive effects that it can create I personally would not want to be in
[01:55:15] I personally would not want to be in that state for sake of studying or
[01:55:17] that state for sake of studying or learning or for doing this podcast for
[01:55:20] learning or for doing this podcast for instance and I can honestly say that
[01:55:22] instance and I can honestly say that today all I've ingested is some coffee
[01:55:25] today all I've ingested is some coffee and some yerbamate tea and some water
[01:55:28] and some yerbamate tea and some water I'm not on any of the compounds that
[01:55:29] I'm not on any of the compounds that I've described during the course of
[01:55:31] I've described during the course of today's episode you might ask why I took
[01:55:34] today's episode you might ask why I took half the recommended dose of armodafinil
[01:55:37] half the recommended dose of armodafinil and the reason is that I'm somebody
[01:55:39] and the reason is that I'm somebody who's fairly hyp sensitive to medication
[01:55:42] who's fairly hyp sensitive to medication of any kind what you find if you look in
[01:55:46] of any kind what you find if you look in the literature is that about 5% of
[01:55:48] the literature is that about 5% of people are hyper hyper sensitive to
[01:55:50] people are hyper hyper sensitive to medication they require far lower doses
[01:55:52] medication they require far lower doses of any medication than other people in
[01:55:54] of any medication than other people in order to experience the same effects I'm
[01:55:56] order to experience the same effects I'm somebody that I think is sort of modest
[01:55:59] somebody that I think is sort of modest uh hyper if that sort of oxymoronic
[01:56:01] uh hyper if that sort of oxymoronic statement but a modest hypers
[01:56:04] statement but a modest hypers sensitivity to medication so I've almost
[01:56:06] sensitivity to medication so I've almost always been able to get by on taking
[01:56:07] always been able to get by on taking less of whatever was prescribed for me
[01:56:10] less of whatever was prescribed for me um and feel just fine or in this case to
[01:56:12] um and feel just fine or in this case to feel like it was still too much it
[01:56:13] feel like it was still too much it turned out that the right dose of
[01:56:15] turned out that the right dose of armodafinil for me was 0 Mig now you may
[01:56:19] armodafinil for me was 0 Mig now you may notice that I haven't talked much about
[01:56:21] notice that I haven't talked much about acetal choline
[01:56:22] acetal choline aceto Coline is a neurotransmitter that
[01:56:25] aceto Coline is a neurotransmitter that at the neuron to muscle connections the
[01:56:27] at the neuron to muscle connections the so-call neuromuscular Junctions is
[01:56:29] so-call neuromuscular Junctions is involved in generating muscular
[01:56:30] involved in generating muscular contractions of all kinds for all
[01:56:33] contractions of all kinds for all movements acetool is also released from
[01:56:35] movements acetool is also released from two sites in the brain so a little bit
[01:56:37] two sites in the brain so a little bit of nomenclature here again feel free to
[01:56:39] of nomenclature here again feel free to ignore the nomenclature but there is a
[01:56:41] ignore the nomenclature but there is a collection of neurons in your brain stem
[01:56:43] collection of neurons in your brain stem that send projections forward kind of
[01:56:45] that send projections forward kind of like a sprinkler system that's very
[01:56:47] like a sprinkler system that's very diffuse to release acetycholine and
[01:56:50] diffuse to release acetycholine and those neurons uh reside div in an area
[01:56:52] those neurons uh reside div in an area or a structure that's called the
[01:56:54] or a structure that's called the pedunculopontine nucleus the PPN and
[01:56:57] pedunculopontine nucleus the PPN and then there's a separate collection of
[01:56:58] then there's a separate collection of neurons in the basil 4 brain called
[01:57:01] neurons in the basil 4 brain called unimaginatively nucleus basalis the
[01:57:04] unimaginatively nucleus basalis the nucleus at the base and they also hose
[01:57:07] nucleus at the base and they also hose the brain with acetycholine but in a
[01:57:09] the brain with acetycholine but in a much more specific way so one is sort of
[01:57:12] much more specific way so one is sort of like a sprinkler system and the other
[01:57:14] like a sprinkler system and the other one is more like a fire hose to a
[01:57:15] one is more like a fire hose to a particular location and those two
[01:57:17] particular location and those two sources of aceto choline collaborate to
[01:57:21] sources of aceto choline collaborate to activate particular locations in the
[01:57:23] activate particular locations in the brain and really bring about a
[01:57:25] brain and really bring about a tremendous degree of focus to whatever
[01:57:26] tremendous degree of focus to whatever is happening at those particular
[01:57:28] is happening at those particular synapses so it could be a focus on
[01:57:30] synapses so it could be a focus on visual information or auditory
[01:57:32] visual information or auditory information if you're listening closely
[01:57:34] information if you're listening closely to what I'm saying right now or you just
[01:57:36] to what I'm saying right now or you just heard closely step out from the rest of
[01:57:38] heard closely step out from the rest of my sentence no doubt there was
[01:57:40] my sentence no doubt there was acetylcholine released at the sites in
[01:57:42] acetylcholine released at the sites in your brain where the neurons that
[01:57:44] your brain where the neurons that represent your recognition of the word
[01:57:47] represent your recognition of the word closely occurred okay so now you have an
[01:57:49] closely occurred okay so now you have an example and you have an understanding
[01:57:51] example and you have an understanding and hopefully a picture your mind of how
[01:57:52] and hopefully a picture your mind of how all this is working not surprisingly
[01:57:55] all this is working not surprisingly then drugs that increase col energic or
[01:57:58] then drugs that increase col energic or acetycholine transmission will increase
[01:58:01] acetycholine transmission will increase focus and cognition one such compound is
[01:58:04] focus and cognition one such compound is so-called Alpha GPC which is a form of
[01:58:07] so-called Alpha GPC which is a form of choline and increases acetylcholine
[01:58:09] choline and increases acetylcholine transmission dosage is as high as 12200
[01:58:13] transmission dosage is as high as 12200 milligrams per day which is a very high
[01:58:15] milligrams per day which is a very high dosage spread typically it's 300 or 400
[01:58:18] dosage spread typically it's 300 or 400 milligrams spread out throughout the day
[01:58:21] milligrams spread out throughout the day have been shown to to offset some of the
[01:58:24] have been shown to to offset some of the effects of age related cognitive decline
[01:58:26] effects of age related cognitive decline improve cognitive functioning people
[01:58:27] improve cognitive functioning people that don't have age related cognitive
[01:58:29] that don't have age related cognitive decline that's a very high dose
[01:58:30] decline that's a very high dose typically when people are using Alpha
[01:58:32] typically when people are using Alpha GPC to study or to enhance learning of
[01:58:36] GPC to study or to enhance learning of any kind they will take somewhere
[01:58:37] any kind they will take somewhere between 300 and 600 milligrams that's
[01:58:40] between 300 and 600 milligrams that's more typical again you have to check
[01:58:42] more typical again you have to check with your doctor you have to decide if
[01:58:44] with your doctor you have to decide if the safety margins are appropriate for
[01:58:46] the safety margins are appropriate for you obviously um you'll want to check
[01:58:48] you obviously um you'll want to check that out but Alpha GPC is effective in
[01:58:51] that out but Alpha GPC is effective in creating more focused by way of this
[01:58:53] creating more focused by way of this colonic system it stimulates
[01:58:55] colonic system it stimulates acetylcholine release from both of those
[01:58:57] acetylcholine release from both of those Lo locations the PPN in the back of the
[01:59:00] Lo locations the PPN in the back of the brain and nucleus balis in the front of
[01:59:02] brain and nucleus balis in the front of the brain there are two other
[01:59:05] the brain there are two other over-the-counter
[01:59:06] over-the-counter compounds that are in active use out
[01:59:09] compounds that are in active use out there for treatment of ADHD and in use
[01:59:12] there for treatment of ADHD and in use for simply trying to improve focus and
[01:59:16] for simply trying to improve focus and the first one is El tyrosine it's an
[01:59:17] the first one is El tyrosine it's an amino acid that acts as a precursor to
[01:59:20] amino acid that acts as a precursor to the neuromodulator dopamine and now
[01:59:22] the neuromodulator dopamine and now knowing everything you know about
[01:59:23] knowing everything you know about dopamine attention and the circuits
[01:59:25] dopamine attention and the circuits involved it should come as no surprise
[01:59:26] involved it should come as no surprise as to why people are exploring the use
[01:59:29] as to why people are exploring the use of el tyrosine for that purpose El
[01:59:31] of el tyrosine for that purpose El tyrosine does lead to increases in
[01:59:34] tyrosine does lead to increases in dopamine they are fairly long-lived and
[01:59:38] dopamine they are fairly long-lived and El tyrosine can improve one's ability to
[01:59:40] El tyrosine can improve one's ability to focus however the dosaging can be very
[01:59:44] focus however the dosaging can be very tricky to dial in sometimes it makes
[01:59:46] tricky to dial in sometimes it makes people feel too euphoric or too jittery
[01:59:49] people feel too euphoric or too jittery or too alert that they are then unable
[01:59:51] or too alert that they are then unable to Focus well so the dosage ranges are
[01:59:55] to Focus well so the dosage ranges are huge you see evidence for 100 milligrams
[01:59:58] huge you see evidence for 100 milligrams all the way up to 12200 milligrams it's
[02:00:01] all the way up to 12200 milligrams it's something that really should be
[02:00:01] something that really should be approached with caution especially for
[02:00:03] approached with caution especially for people that have any kind of underlying
[02:00:05] people that have any kind of underlying psych psychiatric or mood disorder
[02:00:07] psych psychiatric or mood disorder because disregulation of the dopamine
[02:00:09] because disregulation of the dopamine system is you know Central to many of
[02:00:12] system is you know Central to many of the mood disorders such as depression
[02:00:15] the mood disorders such as depression but also especially Mania Mania bipolar
[02:00:18] but also especially Mania Mania bipolar disorder schizophrenia things of that
[02:00:20] disorder schizophrenia things of that sort so it's something that really
[02:00:22] sort so it's something that really should be approached with caution
[02:00:23] should be approached with caution nonetheless in exploring what's out
[02:00:25] nonetheless in exploring what's out there and even some studies
[02:00:28] there and even some studies online that were done either animal
[02:00:31] online that were done either animal studies or human studies it's clear that
[02:00:33] studies or human studies it's clear that El tyrosine is being explored for that
[02:00:35] El tyrosine is being explored for that purpose as is pea and phenol ethylamine
[02:00:39] purpose as is pea and phenol ethylamine which is a essentially pea but some
[02:00:42] which is a essentially pea but some related compounds so there's a whole
[02:00:44] related compounds so there's a whole class of dopaminergic or dopamine
[02:00:47] class of dopaminergic or dopamine stimulating supplements that people are
[02:00:49] stimulating supplements that people are using to try and get their dopamine
[02:00:50] using to try and get their dopamine levels up and again it's a it's kind of
[02:00:52] levels up and again it's a it's kind of a fine line between uh too little enough
[02:00:56] a fine line between uh too little enough and too much if you want to get the
[02:00:58] and too much if you want to get the literature on those two compounds there
[02:01:01] literature on those two compounds there I will refer you to um this great
[02:01:02] I will refer you to um this great website at examine.com um just as it
[02:01:06] website at examine.com um just as it sounds and you can put in El tyrosine or
[02:01:08] sounds and you can put in El tyrosine or pea and you can get the details on that
[02:01:11] pea and you can get the details on that but I highly recommend also going to
[02:01:12] but I highly recommend also going to their section on ADHD to see how those
[02:01:15] their section on ADHD to see how those particular comments relate specifically
[02:01:17] particular comments relate specifically to ADHD and cognitive focus and last but
[02:01:21] to ADHD and cognitive focus and last but not least
[02:01:22] not least in terms of these different compounds I
[02:01:24] in terms of these different compounds I do want to mention the
[02:01:26] do want to mention the racetams these are somewhat esoteric and
[02:01:30] racetams these are somewhat esoteric and probably most of you haven't heard about
[02:01:32] probably most of you haven't heard about them but some of you probably know a lot
[02:01:34] them but some of you probably know a lot about them and they are becoming more
[02:01:36] about them and they are becoming more popular they go by names like new pep
[02:01:39] popular they go by names like new pep and things of that sort the racetams are
[02:01:42] and things of that sort the racetams are illegal in certain countries they are
[02:01:44] illegal in certain countries they are gray Market in other countries and they
[02:01:45] gray Market in other countries and they are sold over the counter in this
[02:01:48] are sold over the counter in this country in the US so they have have
[02:01:52] country in the US so they have have different margins for safety you
[02:01:54] different margins for safety you definitely need to consult your doctor
[02:01:56] definitely need to consult your doctor especially if you have ADHD but new pep
[02:02:00] especially if you have ADHD but new pep has been shown when taken you know at 10
[02:02:02] has been shown when taken you know at 10 milligrams twice daily can be more
[02:02:05] milligrams twice daily can be more effective than some of the other
[02:02:06] effective than some of the other racetams what is new pep new pep Taps
[02:02:09] racetams what is new pep new pep Taps into the cholinergic system the
[02:02:11] into the cholinergic system the acetylcholine system in ways very
[02:02:12] acetylcholine system in ways very similar to Alpha GPC but seems to have a
[02:02:15] similar to Alpha GPC but seems to have a slightly higher affinity for some of the
[02:02:18] slightly higher affinity for some of the receptors involved and can lead to those
[02:02:20] receptors involved and can lead to those heightened States of cogn capacity and
[02:02:23] heightened States of cogn capacity and there are these studies one in
[02:02:25] there are these studies one in particular um comparative studies of new
[02:02:27] particular um comparative studies of new peptin paraset and the treatment of
[02:02:29] peptin paraset and the treatment of patients with mild cognitive
[02:02:30] patients with mild cognitive disorders and brain diseases of vascular
[02:02:33] disorders and brain diseases of vascular and traumatic origin that's a mouthful
[02:02:35] and traumatic origin that's a mouthful what this study basically points to is
[02:02:37] what this study basically points to is the fact that people who are
[02:02:38] the fact that people who are experiencing some degree of inability to
[02:02:41] experiencing some degree of inability to focus due to Prior concussion or some
[02:02:44] focus due to Prior concussion or some vascular event a stroke or eskee of any
[02:02:47] vascular event a stroke or eskee of any kind because neurons need blood when the
[02:02:49] kind because neurons need blood when the blood supply is cut off to neurons or
[02:02:50] blood supply is cut off to neurons or when there's a bleed in the brain
[02:02:52] when there's a bleed in the brain subsequent to that often there are
[02:02:55] subsequent to that often there are challenges in maintaining Focus this is
[02:02:56] challenges in maintaining Focus this is very common for people that have done
[02:02:58] very common for people that have done Sports where there's a lot of running
[02:03:00] Sports where there's a lot of running into each other with your head like
[02:03:01] into each other with your head like Rugby Football uh hockey and so forth
[02:03:04] Rugby Football uh hockey and so forth but also people who experienced head
[02:03:05] but also people who experienced head blows or often overlooked as the fact
[02:03:08] blows or often overlooked as the fact that most traumatic head injury is not
[02:03:10] that most traumatic head injury is not actually from Sports even football it's
[02:03:12] actually from Sports even football it's from things like construction work from
[02:03:14] from things like construction work from high impact work of that kind so there
[02:03:17] high impact work of that kind so there does seem to be some efficacy of new pep
[02:03:19] does seem to be some efficacy of new pep and
[02:03:22] uh it's an emerging area and as I
[02:03:24] uh it's an emerging area and as I mentioned in the US these things are
[02:03:25] mentioned in the US these things are sold over the counter again you have to
[02:03:28] sold over the counter again you have to figure out if it's right for you but
[02:03:30] figure out if it's right for you but they are um beginning to show some
[02:03:32] they are um beginning to show some promise and I'm um intrigued by them
[02:03:34] promise and I'm um intrigued by them because of the way that they tap into
[02:03:36] because of the way that they tap into the coleric system which is both
[02:03:38] the coleric system which is both directly involved in focus and the
[02:03:40] directly involved in focus and the ability to focus but is also important
[02:03:44] ability to focus but is also important for things related to age- related
[02:03:46] for things related to age- related cognitive decline so a decline in
[02:03:48] cognitive decline so a decline in coleric transmission or acetycholine as
[02:03:51] coleric transmission or acetycholine as we call it in the brain is one of the
[02:03:53] we call it in the brain is one of the things associated with cognitive decline
[02:03:55] things associated with cognitive decline and it does seem that increasing color
[02:03:57] and it does seem that increasing color energetic transmission can offset some
[02:03:59] energetic transmission can offset some of that cognitive decline and perhaps
[02:04:00] of that cognitive decline and perhaps even more so in conditions such as
[02:04:03] even more so in conditions such as vascular damage or concussion to the
[02:04:05] vascular damage or concussion to the brain if you're interested in atypical
[02:04:07] brain if you're interested in atypical treatments for
[02:04:09] treatments for ADHD compounds to improve focus and
[02:04:12] ADHD compounds to improve focus and related themes and you like reading
[02:04:13] related themes and you like reading about this stuff there's an excellent
[02:04:15] about this stuff there's an excellent review article that I can refer you to
[02:04:17] review article that I can refer you to it's by on at all Ahn uh it was
[02:04:21] it's by on at all Ahn uh it was published in 2016 so it's a little bit
[02:04:23] published in 2016 so it's a little bit behind the times although it's
[02:04:25] behind the times although it's surprisingly comprehensive given that
[02:04:27] surprisingly comprehensive given that which lines up all the various drugs
[02:04:31] which lines up all the various drugs that I've discussed racetams and adderal
[02:04:33] that I've discussed racetams and adderal and rlin and uh various forms of
[02:04:36] and rlin and uh various forms of dopaminergic agents and coleric agents
[02:04:39] dopaminergic agents and coleric agents spells out whether or not they are sold
[02:04:41] spells out whether or not they are sold over the- counter by prescription and
[02:04:43] over the- counter by prescription and really lines them up in all their
[02:04:44] really lines them up in all their effects their drawbacks uh Etc uh I'll
[02:04:48] effects their drawbacks uh Etc uh I'll refer you to that study it's available
[02:04:49] refer you to that study it's available in its full length form online for free
[02:04:53] in its full length form online for free um it's on it all the the journal is
[02:04:55] um it's on it all the the journal is neuroplasticity neural plasticity 2016
[02:04:58] neuroplasticity neural plasticity 2016 should be very easy toine if you put
[02:05:00] should be very easy toine if you put those keywords in and while it is a
[02:05:02] those keywords in and while it is a review it is a very comprehensive review
[02:05:04] review it is a very comprehensive review and if you're really into this stuff and
[02:05:06] and if you're really into this stuff and you also want to learn a thing or two
[02:05:08] you also want to learn a thing or two about how these things interact with
[02:05:09] about how these things interact with neuro feedback Etc there's some
[02:05:11] neuro feedback Etc there's some information in there as well I know I've
[02:05:13] information in there as well I know I've already covered a lot of information but
[02:05:15] already covered a lot of information but there is one more category of technology
[02:05:18] there is one more category of technology for the treatment of ADHD and for enhan
[02:05:21] for the treatment of ADHD and for enhan ment of focus in anyone that I would
[02:05:24] ment of focus in anyone that I would like to emphasize and that's
[02:05:26] like to emphasize and that's transcranial magnetic stimulation
[02:05:28] transcranial magnetic stimulation transcranial magnetic stimulation also
[02:05:30] transcranial magnetic stimulation also called TMS is achieving increasing
[02:05:33] called TMS is achieving increasing popularity nowadays for the treatment of
[02:05:35] popularity nowadays for the treatment of all sorts of neurologic conditions and
[02:05:38] all sorts of neurologic conditions and psychiatric conditions it is a
[02:05:40] psychiatric conditions it is a non-invasive tool it involves taking a
[02:05:43] non-invasive tool it involves taking a coil it's a device with a coil that's
[02:05:45] coil it's a device with a coil that's placed over particular locations in the
[02:05:48] placed over particular locations in the brain and then sends magnetic
[02:05:50] brain and then sends magnetic stimulation
[02:05:52] stimulation into the brain it can actually pass
[02:05:53] into the brain it can actually pass through the skull without having to
[02:05:55] through the skull without having to drill through the skull and nowadays can
[02:05:58] drill through the skull and nowadays can be used to both lower the amount of
[02:06:00] be used to both lower the amount of activity or increase the amount of
[02:06:02] activity or increase the amount of activity in specific brain areas its
[02:06:05] activity in specific brain areas its spatial Precision is not remarkable that
[02:06:09] spatial Precision is not remarkable that doesn't mean it's not of use but it is
[02:06:11] doesn't mean it's not of use but it is not a super fine grain tool okay it's
[02:06:16] not a super fine grain tool okay it's not a cannon but it's also not a needle
[02:06:19] not a cannon but it's also not a needle it is somewhere in between it can direct
[02:06:21] it is somewhere in between it can direct direct the activity of particular brain
[02:06:23] direct the activity of particular brain regions at particular depths and as I
[02:06:26] regions at particular depths and as I mentioned it can increase or decrease
[02:06:27] mentioned it can increase or decrease that activity so for instance I've had a
[02:06:29] that activity so for instance I've had a TMS coil placed on my head not for
[02:06:31] TMS coil placed on my head not for therapeutic purposes even it was I
[02:06:33] therapeutic purposes even it was I wouldn't tell you but rather just for
[02:06:36] wouldn't tell you but rather just for well I'm a neuroscientist and I worked
[02:06:38] well I'm a neuroscientist and I worked in a lab with one for entertainment
[02:06:40] in a lab with one for entertainment exploratory purposes please don't do
[02:06:41] exploratory purposes please don't do this at
[02:06:43] this at home it was placed over my motor cortex
[02:06:46] home it was placed over my motor cortex which generates voluntary action and it
[02:06:50] which generates voluntary action and it was a coil that that time could only
[02:06:52] was a coil that that time could only inhibit neurons and so what I was doing
[02:06:55] inhibit neurons and so what I was doing is I was moving objects around on a
[02:06:57] is I was moving objects around on a table just like I am now it was actually
[02:06:59] table just like I am now it was actually a pencil not a pen and I was tapping the
[02:07:01] a pencil not a pen and I was tapping the pencil and then the TMS coil was turned
[02:07:03] pencil and then the TMS coil was turned on and for the life of me I could not
[02:07:06] on and for the life of me I could not move that pencil okay because it was
[02:07:09] move that pencil okay because it was inhibiting my upper motor neurons in the
[02:07:12] inhibiting my upper motor neurons in the portion of my cortex that controls
[02:07:13] portion of my cortex that controls voluntary activity as soon as the coil
[02:07:16] voluntary activity as soon as the coil was turned off I could return to tapping
[02:07:18] was turned off I could return to tapping the pencil again nowadays it's possible
[02:07:21] the pencil again nowadays it's possible to stimulate motor cortex or any area of
[02:07:23] to stimulate motor cortex or any area of the brain with some degree of precision
[02:07:26] the brain with some degree of precision that could create the impulse to move
[02:07:29] that could create the impulse to move without actually making the decision to
[02:07:31] without actually making the decision to move so you can literally engage certain
[02:07:34] move so you can literally engage certain neural circuits and therefore behaviors
[02:07:35] neural circuits and therefore behaviors and certain thought and emotional
[02:07:37] and certain thought and emotional patterns by way of transcranial magnetic
[02:07:39] patterns by way of transcranial magnetic stimulation this has far-reaching and
[02:07:42] stimulation this has far-reaching and vast implications as you can uh probably
[02:07:45] vast implications as you can uh probably imagine in discussing ADHD with a
[02:07:48] imagine in discussing ADHD with a colleague that uses TMS what they are
[02:07:51] colleague that uses TMS what they are doing is they are taking the TMS coil to
[02:07:55] doing is they are taking the TMS coil to children and adults that have ADHD and
[02:07:59] children and adults that have ADHD and they're using it to stimulate the
[02:08:01] they're using it to stimulate the portions of the prefrontal cortex that
[02:08:03] portions of the prefrontal cortex that we talked about earlier that engage task
[02:08:06] we talked about earlier that engage task directed focused States so rather than
[02:08:09] directed focused States so rather than using a drug that generally increases
[02:08:10] using a drug that generally increases dopamine and some of the other chemicals
[02:08:12] dopamine and some of the other chemicals involved they're you using directed TMS
[02:08:15] involved they're you using directed TMS stimulation of these circuits and
[02:08:18] stimulation of these circuits and fortunately I was quite relieved to hear
[02:08:19] fortunately I was quite relieved to hear this they are combining them that with a
[02:08:22] this they are combining them that with a focused learning task so they're
[02:08:24] focused learning task so they're literally teaching the brain to learn in
[02:08:25] literally teaching the brain to learn in a non-invasive way no drug at all and
[02:08:29] a non-invasive way no drug at all and right now there are experiments clinical
[02:08:31] right now there are experiments clinical trials going on comparing TMS of this
[02:08:33] trials going on comparing TMS of this sort to the drug treatments of the sort
[02:08:35] sort to the drug treatments of the sort that we described earlier that engage
[02:08:38] that we described earlier that engage these circuits through pharmacologic
[02:08:39] these circuits through pharmacologic mechanisms so very exciting times for
[02:08:42] mechanisms so very exciting times for TMS very exciting times for pharmacology
[02:08:45] TMS very exciting times for pharmacology related to ADHD and for enhancing focus
[02:08:49] related to ADHD and for enhancing focus in general and when I say very exciting
[02:08:50] in general and when I say very exciting times I mean no drug is perfect but the
[02:08:55] times I mean no drug is perfect but the constellation of drugs that's out there
[02:08:57] constellation of drugs that's out there is getting much larger but because they
[02:09:00] is getting much larger but because they tap into different aspects of their
[02:09:01] tap into different aspects of their circuitry I do think that we are well on
[02:09:03] circuitry I do think that we are well on our way to identifying the ideal
[02:09:05] our way to identifying the ideal combinations of drug treatments
[02:09:06] combinations of drug treatments technological treatments and behavioral
[02:09:09] technological treatments and behavioral paradigms for increasing focus in both
[02:09:11] paradigms for increasing focus in both children and adults with ADHD and as a
[02:09:14] children and adults with ADHD and as a final final point I also want to mention
[02:09:17] final final point I also want to mention something about technologies that are
[02:09:19] something about technologies that are making it harder for all of us to focus
[02:09:22] making it harder for all of us to focus regardless of whether or not we have
[02:09:23] regardless of whether or not we have pre-existing ADHD or not you can
[02:09:26] pre-existing ADHD or not you can probably guess where this is
[02:09:27] probably guess where this is going everybody noway seems to have a
[02:09:30] going everybody noway seems to have a smartphone I'm sure there are a few
[02:09:32] smartphone I'm sure there are a few individuals out there that don't have a
[02:09:34] individuals out there that don't have a smartphone nonetheless most people have
[02:09:36] smartphone nonetheless most people have them most kids want one as soon as they
[02:09:38] them most kids want one as soon as they can get them and they are small they
[02:09:43] can get them and they are small they grab our attention entirely but within
[02:09:46] grab our attention entirely but within that small box of attention there are
[02:09:49] that small box of attention there are millions of attentional w Windows
[02:09:51] millions of attentional w Windows scrolling by right so just because it's
[02:09:53] scrolling by right so just because it's one device that we look at does not mean
[02:09:55] one device that we look at does not mean that we are focused we are focused on
[02:09:57] that we are focused we are focused on our phone but because of the way in
[02:10:00] our phone but because of the way in which context switches up so fast within
[02:10:02] which context switches up so fast within the phone it's thought that the brain is
[02:10:05] the phone it's thought that the brain is struggling now to leave that rapid
[02:10:07] struggling now to leave that rapid turnover of context right many many
[02:10:10] turnover of context right many many shows many many Instagram Pages many
[02:10:12] shows many many Instagram Pages many many Twitter feeds many many websites
[02:10:14] many Twitter feeds many many websites basically the whole world at least in
[02:10:16] basically the whole world at least in Virtual format is available within that
[02:10:18] Virtual format is available within that small box unlike any other technology
[02:10:21] small box unlike any other technology ology humans have ever dealt with before
[02:10:23] ology humans have ever dealt with before even though there are trillions infinite
[02:10:25] even though there are trillions infinite number of bits of information in the
[02:10:27] number of bits of information in the actual physical world your attentional
[02:10:30] actual physical world your attentional window that aperture of constriction and
[02:10:33] window that aperture of constriction and dilating that visual window is the way
[02:10:35] dilating that visual window is the way in which you cope with all that
[02:10:36] in which you cope with all that overwhelming information typically well
[02:10:39] overwhelming information typically well within the phone your visual aperture is
[02:10:41] within the phone your visual aperture is set to a given width it's about this big
[02:10:44] set to a given width it's about this big typically the phone seem to be getting
[02:10:46] typically the phone seem to be getting bigger but nonetheless it's about that
[02:10:48] bigger but nonetheless it's about that big and within there your intentional
[02:10:51] big and within there your intentional window is grabbing a near infinite
[02:10:54] window is grabbing a near infinite number of bits of information colors
[02:10:56] number of bits of information colors movies if a picture is worth a thousand
[02:10:58] movies if a picture is worth a thousand words a movie is worth a billion
[02:11:00] words a movie is worth a billion pictures the brain loves visual motion
[02:11:03] pictures the brain loves visual motion and so the question is does that sort of
[02:11:07] and so the question is does that sort of interaction on a regular basis lead to
[02:11:10] interaction on a regular basis lead to deficits in the types of attention that
[02:11:12] deficits in the types of attention that we need in order to perform well in work
[02:11:13] we need in order to perform well in work and school relationships Etc and the
[02:11:16] and school relationships Etc and the short answer is yes it does appear so we
[02:11:19] short answer is yes it does appear so we are inducing a sort of a ADHD and while
[02:11:22] are inducing a sort of a ADHD and while the studies on this are ongoing because
[02:11:24] the studies on this are ongoing because prominent use of smartphones really took
[02:11:26] prominent use of smartphones really took off right around 2010 and we're only in
[02:11:29] off right around 2010 and we're only in 2021 long-standing studies take time
[02:11:33] 2021 long-standing studies take time which is essentially to say the same
[02:11:35] which is essentially to say the same thing as long-standing
[02:11:36] thing as long-standing there are some studies and one in
[02:11:38] there are some studies and one in particular that I'd like to highlight
[02:11:39] particular that I'd like to highlight one was actually carried out pretty
[02:11:41] one was actually carried out pretty early in 2014 this is a study that
[02:11:43] early in 2014 this is a study that explored smartphone use at the time they
[02:11:46] explored smartphone use at the time they called it mobile phone use but
[02:11:48] called it mobile phone use but smartphone use and inattention
[02:11:50] smartphone use and inattention difficulties in attending in
[02:11:55] difficulties in attending in 7,12 adolescent this is a huge study a
[02:11:58] 7,12 adolescent this is a huge study a population-based cross-sectional study
[02:12:01] population-based cross-sectional study and you will be probably surprised and
[02:12:04] and you will be probably surprised and somewhat dismayed to hear that in order
[02:12:08] somewhat dismayed to hear that in order to avoid this decrease in attentional
[02:12:11] to avoid this decrease in attentional capacity adolescents needed to use their
[02:12:15] capacity adolescents needed to use their smartphone for less than 60 minutes per
[02:12:18] smartphone for less than 60 minutes per day in order to stay focused and
[02:12:21] day in order to stay focused and centered on their other tasks otherwise
[02:12:23] centered on their other tasks otherwise they started to really run into
[02:12:25] they started to really run into significant issues so 60 Minutes is not
[02:12:27] significant issues so 60 Minutes is not much I'm I have a feeling that most
[02:12:30] much I'm I have a feeling that most young people are using their phone more
[02:12:32] young people are using their phone more than 60 minutes per day I know I am I
[02:12:35] than 60 minutes per day I know I am I think for adults the number is probably
[02:12:37] think for adults the number is probably higher meaning if you're an adult I
[02:12:40] higher meaning if you're an adult I could I'm going to just extrapolate from
[02:12:42] could I'm going to just extrapolate from what I read in this study it seems that
[02:12:44] what I read in this study it seems that probably two hours a day on the phone
[02:12:47] probably two hours a day on the phone would be the upper limit Beyond which
[02:12:49] would be the upper limit Beyond which you would probably experience pretty
[02:12:51] you would probably experience pretty severe attentional
[02:12:53] severe attentional deficits I am a big fan of Cal Newport
[02:12:56] deficits I am a big fan of Cal Newport who wrote the book deep work he's also
[02:12:58] who wrote the book deep work he's also written the excellent book a world
[02:12:59] written the excellent book a world without email I've never met him but I'm
[02:13:01] without email I've never met him but I'm a huge admir of his work and I will uh
[02:13:03] a huge admir of his work and I will uh paraphrase something that he said far
[02:13:05] paraphrase something that he said far more eloquently than I ever could which
[02:13:07] more eloquently than I ever could which is that the brain does not do well with
[02:13:11] is that the brain does not do well with constant context switching meaning it
[02:13:14] constant context switching meaning it can do it but it diminishes our capacity
[02:13:17] can do it but it diminishes our capacity to do meaningful work of any other kind
[02:13:20] to do meaningful work of any other kind and so Cal as I understand is very uh
[02:13:24] and so Cal as I understand is very uh he's a computer science professor at
[02:13:25] he's a computer science professor at Georgetown by the way is very structured
[02:13:28] Georgetown by the way is very structured and very disciplined in his avoidance of
[02:13:31] and very disciplined in his avoidance of cell phone use I think we're all
[02:13:33] cell phone use I think we're all striving to do that I'm not here to tell
[02:13:35] striving to do that I'm not here to tell you what to do but I think whether not
[02:13:37] you what to do but I think whether not you have ADHD or not if you're an
[02:13:39] you have ADHD or not if you're an adolescent limiting your smartphone use
[02:13:42] adolescent limiting your smartphone use to 60 minutes per day or less and if you
[02:13:45] to 60 minutes per day or less and if you an adult to two hours per day or less is
[02:13:50] an adult to two hours per day or less is going to be among the very best ways to
[02:13:53] going to be among the very best ways to maintain just to maintain your ability
[02:13:56] maintain just to maintain your ability to focus at whatever level you can now
[02:13:58] to focus at whatever level you can now and as I always say most of the things
[02:14:01] and as I always say most of the things that we get recognized for in life
[02:14:03] that we get recognized for in life success in life in every Endeavor
[02:14:05] success in life in every Endeavor whether or not it's School relationship
[02:14:08] whether or not it's School relationship sport creative works of any kind are
[02:14:11] sport creative works of any kind are always proportional to the amount of
[02:14:13] always proportional to the amount of focus that we can bring that activity it
[02:14:16] focus that we can bring that activity it is important to rest of course to get
[02:14:17] is important to rest of course to get proper sleep but I stand behind that
[02:14:19] proper sleep but I stand behind that statement and I leave you with that
[02:14:21] statement and I leave you with that study about attention and cell phones
[02:14:24] study about attention and cell phones and how cell phones are indeed eroding
[02:14:26] and how cell phones are indeed eroding our attentional capacities so I realized
[02:14:29] our attentional capacities so I realized I covered a lot of information about
[02:14:30] I covered a lot of information about ADHD and the biology of focus and how to
[02:14:33] ADHD and the biology of focus and how to get better at focusing we talked about
[02:14:36] get better at focusing we talked about the behavioral and psychological
[02:14:38] the behavioral and psychological phenotypes of ADHD we talked about the
[02:14:41] phenotypes of ADHD we talked about the underlying neural circuitry we also
[02:14:44] underlying neural circuitry we also talked about the neural chemistry and we
[02:14:46] talked about the neural chemistry and we talked about the various prescription
[02:14:47] talked about the various prescription drug treatments that are aimed at that
[02:14:50] drug treatments that are aimed at that neurochemistry and aimed at increasing
[02:14:52] neurochemistry and aimed at increasing focus in children and adults with ADHD
[02:14:55] focus in children and adults with ADHD we also talked about over-the-counter
[02:14:57] we also talked about over-the-counter compounds the role of particular types
[02:14:59] compounds the role of particular types of diets and elimination diets and we
[02:15:01] of diets and elimination diets and we talked about interactions between these
[02:15:04] talked about interactions between these various features IND dictating outcomes
[02:15:07] various features IND dictating outcomes for ADHD and enhancing focus in general
[02:15:10] for ADHD and enhancing focus in general we also talked a little bit about
[02:15:11] we also talked a little bit about emerging neurotechnologies and how
[02:15:13] emerging neurotechnologies and how certain Technologies like the smartphone
[02:15:15] certain Technologies like the smartphone are no doubt hindering our ability to
[02:15:18] are no doubt hindering our ability to focus and put us at greater risk of
[02:15:20] focus and put us at greater risk of developing ADHD at all ages I do
[02:15:23] developing ADHD at all ages I do acknowledge the irony and somewhat the
[02:15:26] acknowledge the irony and somewhat the contradiction of doing a 2hour plus
[02:15:28] contradiction of doing a 2hour plus episode on ADHD if indeed people who are
[02:15:31] episode on ADHD if indeed people who are watching this have challenges with
[02:15:33] watching this have challenges with attention I want to emphasize that this
[02:15:35] attention I want to emphasize that this podcast like all of our podcast episodes
[02:15:38] podcast like all of our podcast episodes are timestamped for a specific reason
[02:15:41] are timestamped for a specific reason they are designed to be digested in
[02:15:42] they are designed to be digested in whatever batch one chooses right you
[02:15:45] whatever batch one chooses right you don't have to watch or listen to the
[02:15:46] don't have to watch or listen to the entire thing all at once however if
[02:15:48] entire thing all at once however if you've gotten to this point in the
[02:15:50] you've gotten to this point in the podcast I want to thank you I do hope
[02:15:52] podcast I want to thank you I do hope that you've learned a lot about this
[02:15:55] that you've learned a lot about this condition I hope you've also learned a
[02:15:56] condition I hope you've also learned a lot about your own capacity to focus and
[02:15:59] lot about your own capacity to focus and things that you can do to enhance your
[02:16:00] things that you can do to enhance your focus we even talked about a tool that
[02:16:01] focus we even talked about a tool that takes just one 17 minute session to
[02:16:04] takes just one 17 minute session to enhance your ability to focus thereafter
[02:16:07] enhance your ability to focus thereafter presumably forever if you're enjoying
[02:16:09] presumably forever if you're enjoying this podcast and you're learning from it
[02:16:11] this podcast and you're learning from it please subscribe to our YouTube channel
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[02:17:01] can support the podcast at any level that you like during today's episode we
[02:17:02] that you like during today's episode we talked a lot about supplement based
[02:17:04] talked a lot about supplement based compounds if you're interested in
[02:17:06] compounds if you're interested in supplements and you want to see the
[02:17:07] supplements and you want to see the supplements that I personally take you
[02:17:09] supplements that I personally take you can go to Thorn that's t h o r n slthe
[02:17:13] can go to Thorn that's t h o r n slthe letter huberman and you can see
[02:17:16] letter huberman and you can see everything that I take and you can get
[02:17:18] everything that I take and you can get 20% off any of those supplements or if
[02:17:21] 20% off any of those supplements or if navigate into the Thorne site through
[02:17:23] navigate into the Thorne site through that portal you can get 20% off any of
[02:17:25] that portal you can get 20% off any of the supplements that Thorne makes
[02:17:27] the supplements that Thorne makes supplements aren't for everybody you bu
[02:17:29] supplements aren't for everybody you bu no means have to take supplements but if
[02:17:30] no means have to take supplements but if you are going to take supplements it's
[02:17:32] you are going to take supplements it's important that you take supplements from
[02:17:33] important that you take supplements from a source that's reputable in which the
[02:17:36] a source that's reputable in which the ingredients are a very high quality and
[02:17:38] ingredients are a very high quality and in which the amount of the ingredients
[02:17:40] in which the amount of the ingredients that listed on the bottle actually
[02:17:42] that listed on the bottle actually matches what's in the bottle that's why
[02:17:43] matches what's in the bottle that's why we partnered with Thorn because they
[02:17:45] we partnered with Thorn because they have the highest levels of stringency in
[02:17:46] have the highest levels of stringency in terms of quality and specificity of the
[02:17:48] terms of quality and specificity of the ingredients and finally I want want to
[02:17:51] ingredients and finally I want want to thank you for your time and your
[02:17:52] thank you for your time and your attention and as always thank you for
[02:17:54] attention and as always thank you for your interest in science
[02:17:58] [Music]