Positive Stress or Toxic Stress

There are only so many things that we can do each day. We have to make a decision about what we are going to do now, what we will put off until later, and what we need to remove from our to do list. To evaluate which is which, we have a number of measurement tools, like risk management, personal importance, time pressure, social pressure etc. Importantly, to do a task, we turn importance into stress, and then stress turns into action. The question we are looking at today is – are we using Positive Stress or Toxic Stress?

When we have lots of time and energy, it is fairly easy to select and do a task. If one task seems more consequential, urgent or otherwise important, we do that task first. We then go on to do the things that seem like fun, or seem to clump together, such as vacuuming before mopping the floor – two tasks clumped together optimises for less overall energy.

If a task doesn’t seem important, then we often don’t see any need to do it. A level of urgency stress needs to exist for us to do a thing.

More topics that might be of interest:

Why Stress? Stress makes the world go round.

It is important to recognise that we humans need a level of stress to take actions. When we don’t have any stress, we relax, recover and plan. When the level of need to do a task exceeds the cost of doing that task, we do the thing.

If we are tired, then we don’t have the energy even if we have the time, so we delay doing things until we get some energy back. The problem is when we don’t gert that energy back. This is common in some conditions, like Chronic Fatigue Syndrome, Depression and ADHD.

When the fatigue doesn’t go away, we need a way to make the task that we intellectually know needs to be done seem even more important, so that our system will allow us to use our pressure reserve energy on that task. This often turns in to Toxic Stress, where we use fear and anger to trigger our Adrenaline system so that we can do that thing.

Another method is to use Positive Stress. Positive Stress brings an element of fun, enjoy and choice to the task. Rather than summoning up more energy to do a thing, via fear or anger, we instead bring fund to make the cost of the task cheaper.

AI Generated image of a stressed person on the coach trying to work up the action to vaccuum. The AI Put the vaccuum cleaner on the coach.

Toxic Stress – Immediately gains, but ultimately bad

To compensate for not enough energy, we often use Toxic Stress to increase the perceived urgency of things that we know we have to do. It isn’t just that it is important to eat regularly, we’ll starve if we don’t eat right now. It isn’t just that the floor needs a vaccuum, it is that people will think we are terrible slobs or this messy floor will end in a mouse infestation. It isn’t just it would be nice to see that friend we haven’t seen in a while, it is that that friend will hate us if we don’t see them soon and do the friend duty.

When we use fear or anger as the extra motivator to do a task, we are slipping into a Toxic Stress mentality. It workse really well in the moment, but horribly in the long run.

Using Toxic Stress, we add a threat outcome to the task’s urgency. To combat that threat, our brain converts neurological Dopamine into Noradrenaline, and then Neurological Noradrenaline into Adrenaline to fuel the emergency Freeze, Fawn, Flight and Fight Centre. Our body is triggered to produce body Adrenaline in our two Adrenal glands near our Kidneys, and this is pumped into our blood supply, accelerating our heart and breath. Our body releases stored sugars into our blood supply to feed the Flight and Fight that are likely required by this emergency. This enables our brain to activate the task and our body to fulfill it.

So far, this doesn’t look too bad. We know we need to do a thing, and now we are doing it. The immediate result seems good.

Our brain, due to the emergency threat nature of the task (as we have distorted it to be) redirects the brain Endorphins away from feeling happy and content to managing predicted pain. This changes our perception of the task we are doing, from potentially fun to being awful. As the Adrenaline starts to run low, due to maintaining the threat nature via fear or anger, we haven’t perceived any rewarding part of the task which would promp our brain to make additional Dopamine (the task reward neurotransmitter) to feed the cycle (allows the creation of Noradrenaline and then Adrenaline), nor do we have any Endorphins to see the silver lining and fun part as they were redirected to manage damage from the threat. Fun Endorphins make producing Dopamine easier, while Pain Management Endorphins don’t. Dopamine Brain (Dopamine fueled thinking) helps us understand the problem better, and solve things more intelligently. Adrenaline Brain cares only about survival, not efficient, good or subtle. As a result, we often need to spend extra time afterwards fixing the thing that Adrenaline Brain did poorly. From our Adrenaline Brain’s perspective, we survived, so it did its job.

We come from a long lineage of survivors. Each one of your ancestors survived long enough to have children. After a situation that requires Freeze, Fawn, Flight and Fight, it is wise to stop for a while. In this down time we heal, recouperate, reassess and then start up again. Consider that continuing to do things when you are injurred is not a good survival trait. This is one of the reasons why Survival Mode doesn’t generate extra Dopamine and Noradrenaline – so that you’ll stop doing things and recouperate.

With that task being done via Toxic Stress as a duty , generally poorly, where you’ll likely have to do extra tasks to fix the probems later when we have time and energy (do we ever have that?), and worst of all, running out of thinking and action neurotransmitters faster because we ended up in Survival Mode instead of a self-feeding Creative Mode, we just end up more exhausted and wanting to avoid ever having to do that task again.

Hopefully now the Toxic Stress model’s “horribly later” flaws are revealed. While we get the thing done, because we triggered Survival Mode via Toxic Stress, it was not a good experience and we end up more exhausted at the end of it.

Task Avoidance – Understanding why we don’t want to

I get it. Catastrophising, is easy. It is so simple to make the consequences of not doing something far worse to add enough urgency to the task that we make it happen.

It is more effort to reframe the task into a positive and fun experience. Especially when we don’t want to do it.

But why don’t we want to do it?

Over Optimisation Freeze

If the problem is with choosing a task to do first, then we may have hit the over optimisation freeze. As Voltaire puts it, “Don’t let Perfect become the Enemy of Good”. If you had a good optimisation that you can do right now, you wouldn’t have this problem, so recognise that the process is going to be sub-optimal. We are now looking for good enough, which is much easier.

While it is nice to clump vaccuuming and mopping together, that is only nice if you can do both. Better to vaccuum than do neither.

In a more complex way, we can freeze up on starting any task because we feel that not doing the other things is terribly bad, straying into Toxic Stress territory.

Pick one. If you can’t, write a list of the tasks you think you should do. Either do them from the top, or write a number next to each one in order and web search a random number between 1 and however many you have. Pro tip, stop at 5 tasks in the list, you are likely to have listed the most important things first.

Solutions Incompleteness Theorem

Sometimes we have a task that we know needs to be done, but we don’t have a good enough picture of how to do it, so we avoid getting started. This could be because:

  • We don’t know what the recipient is looking for – ask them.
    • Pro tip: when dealing with someone who won’t define their expectations, offer up a thing you are sure is wrong so that they are required to correct you. If they don’t correct you with useful information, maliciously comply with their bad information. They’ll learn.
  • A step doesn’t seem to make sense at the moment – do the task until you get to that and re-check it, it’ll likely make sense now.
    • Pro Tip: Redoing some eariler steps because you now understand this step after you did those bits is fine, you can refine that process and you learned things. It may seem like a waste of resources, but it was cheaper than not doing any of it at all.
  • Data is missing to make a good task process – an okay task process is generally better than a late more optimal / accurate task process. Prepare as much as you can around the missing data, then go chase that down.
    • Pro tip: If this is for someone else and they continually don’t give you the measurements, quantity or other information you need to meet there requirements, then either this task isn’t actually that important to them so de-prioritise it, or the measurements are that important so make a good enough guess and push the responsibility back to them for not giving you the right ones. Asking them 3 times with some reasonable spacing is fair to shrug off the responsibility for their failure.

Four oh Four – Resources Not Found

The two major variants of this are not the external resources to do the thing, such as money, time, help or parts; and internal such as energy, knowledge, skills and so forth.

Either way, if you don’t have the resource, then you can’t do the task. What you can do, though, is do something to get those resources – so morph the task.

We will cover “energy” under Positive Stress.

Positive Stress – Bringing self sustaining fun to the party

There are a number of ways to make tasks more fun and therefore easier. When we have fun, it is much easier to make enough Dopamine so that we can also make Noradrenaline and Adrenaline while still having Dopamine. This allows us to be more mindful and creative when we are solving and doing tasks, which helps us complete them better, faster and more efficiently. We feel good when this happens, which helps us to make more Dopamine…

The two feel good neurotransmitters are Endorphins and Oxytocin. Endorphins can be triggered by music and joyful movement, thinking interesting thoughts, success, and thinking well of ourselves. Oxytocin can be triggered by being near people and animal companions that we like and trust. Oxytocin, once released, helps us release Endorphins and Dopamine.

Hopefully you can see how using Positive Stress creates a self feeding cycle of neurotansmitters that help us do tasks compared to Toxic Stress which pushes us to do one thing then stop.

It is important to recognise that we only have so many calouries to feed the action tasks, and only so many base resources to make neurotransmitters. When these run out, we have to stop. What that means is, at some point, it doesn’t matter how good the music is, or how much we enjoy the company of someone, when we have run out of system resources, we must rest, eat and recouperate.

Stopping before we run out is good for us. It makes it easier to eat quality food vs junk food; positive rest vs exhaustion; and be able to review what we have achieved and feel good about it rather than exhaustion triggering Adrenaline Brain which will use negative self talk, only looking at what we haven’t achieved yet.

Each of these examples highlight the ideas behind how.

Music is Groovey

When we listen to music we enjoy, whether it is blasting the stereo at full volume (well, 3/4 so as not to damage the speakers), or headphones, we can lift our mood. If you sing and dance, even better. With lifted mood, the access to the neurotransmitters that you need to do the task is far easier to generate and you’ll find the task easier.

Some music is better for some tasks and worse for others. For example, I find that listening to a new music album while trying to be intelectually creative to be distracting rather than helping, while putting on a rock album of Awesome ’80s classics lets me ignore the music enough to create the thing. Oppositely, I quite enjoy listening to a podcast of thought provoking ideas while tinkering in the workshop.

Play around and figure out what works for you.

Body Doubling

Body Doubling is where a person you can trust is present while you do things. They might be working on their own task, or just sitting in a chair watching you with encouragements, or doing the thing with you as well – their mere precense makes it easier to do the task.

Sometimes we can use that second brain to compensate for some of the things we listed above that can get in our way of doing a task. Ask them what you think the missing data might be, or the over and under boundaries of that missing data; ask them if they know how to do that missing step; or work out with them a better way of doing a repeitive task. They might know the answer and help directly, or in trying to explain the problem to them, you might hear enough of a solution from your own mouth that you can use that. Sometimes they can reality check you and agree that the person who should be informing you of the parameters, but isn’t, indicates that this isn’t that important to them.

Gamification and Divide & Conquer

I hated cleaning my room when I was young. I’m still not that much of a fan of it. I find it easier to Gamify the task, or Divide & Conquer it.

For example, I might use Divide & Concquer by putting things away that have locations to put away. Or I will decide, that table needs to be the first thinig I’m cleaning.

To Gamify the task, I might count up how many of these little dubilackies I have, or work on cleaning things based on the colour of the rainbow, or after 20 items have been put away, I can watch an episode of TV. When I was improving my fitness, I watched an action series and every fight scene I had to do 10 push ups, or 10 sit ups. After a few days of this, it was 10 push ups and 10 sit ups.

Reframing, Using Positive Self Talk

We often use negative self talk to bully ourselves into a thinking badly about ourselves or catastrophise the outcome.

What if we used the opposite approach? What if we used positive self talk to nurture ourselves into thinking well about ourselves and enjoying the task?

When we feel like we are required to do a thing, it is easy to trigger a PDA like response (pathalogical demand avoidance, where we refuse to do something that is demanded of us). Instead of focus on why we have to, focus instead on why we want to. I want to find my tools, I want to use that table. I want to have space for this project. I am more efficient and have more fun when I have the space to spread out the project. I make fewer errors when I can see all of the parts, and I love being able to make categorised sections of the parts, which makes it easier to find them when I need them.

As we succeed in doing a thing, recognise that it is working.

When we struggle to do a thing, or make a mistake, look at what you’ve learned about what got in the way, or what went wrong and be happy about the growth that gives you. Wonder if you can use that mistake in this project or perhaps in another project. We can turn bugs into features.

Hack Your Health, Video Review

Netflix’s “Hack Your Health, the secrets of your gut” is a docu/info/tainment that explores how your gut biome and digestive system will affect your weight, body health and propensity to various diseases. This is bringing to the attention of the mainstream public some of the discoveries about gut health that has been discovered over the last 10 to 20 years. It is more accurate than not, highly misleading in parts, and necessarily, although frustratingly, simplistic – considering that it is trying to educate and entertain you in only 80 minutes.

The Good

Here are some of the aspects about gut health that this program covered relatively well.

Our gut biome is a complex system of helpful microbes that break down and digest the foods we consume, which then help us to absorb various nutrients more efficiently. In western countries, full of restricted foods, junk foods, elevated daily stress, over use of antibacterials and poor exercise, our gut biome is relatively small compared to people who live in non-industrial worlds. This is linked to increased health problems, such as obesity, allergies, heart conditions, increased risk of cancer and other various health problems.

It is well recognised that a healthy gut is a diverse microbe gut. The best way to get a diverse gut biome is to eat a big spread of foods with lots of variety. We don’t know enough about the specific microbes to have a hit list of “must haves” and “should avoid”. So diverse is best.

Mental health can be adversely affected by bad gut health. The gut microbes can prompt cravings or avoidances. There is active signalling between the gut biome and the brain.

The information, such as it is, is given in a moderately entertaining medium with some very cute animations.

The Bad

Here are some of the problems that I had with the program.

Many of the factoids were quite misleading.

  • They indicate that 99% of the dna in your body is from bacteria. This is, technically, correct, but highly misleading. 90% of your mass is from cells that have your DNA, while 10% of your mass is from your gut biome. Roughly speaking, half the cells in your body are yours, and the other half, but much smaller in scale, are the biome.
  • They imply that psychiatric conditions are potentially caused by gut biome. We know that some changes in the gut biome can exacerbate symptoms, but rarely cause them per se.
    • Some conditions, like Autism, are hereditary, that is it is from your DNA, inherited from your parents, not due to a gut biome disorder. Autistic people are at higher than average co-occurring gut issues, but there are also many Autistic people who have no gut issues.
    • Another example of a hereditary condition is ADHD. Read all of the above for Autism and it affects ADHD. Concerning behaviours can be exacerbated by biome problems, but fixing the gut biome won’t necessarily “cure” ADHD, unless your ADHD was not so much inherited, but acquired by a deficit in your gut biome.

The program does not give you anything concrete to work with. It says “get a healthy gut biome” without really explaining how, and “try a fecal transplant”, but again without really saying how. At least it does warn about the risk of problematic donors.

A great deal of the program is making promises about how good gut biome science will become far before we actually have the good science to actually give good therapies.

There are some statements from the experts go against the consensus of gut biome science. An example of this is where Jack Gilbert, Microbial Ecologist, states that the probiotics aren’t worth taking as that would be like dropping a houseplant into the amazon [jungle] and hoping it will be okay. This is wrong. If you are missing the specific microbes that are within the probiotic, this is a great way to repopulate your gut biome with these known good microbes. That is kind of the whole point of those medicines. The main problem with those probiotics is that often those aren’t the microbes you are missing – worth a try, just in case, but on average not helpful unless you have depleted your gut biome recently via antibiotics.

While I have mention Gilbert by name and given a specific example of where he was very wrong (according to medical science), all of the experts stated factual errors, which should have been fact checked and corrected before the video went out.

Conclusion

This is an interesting look at some of the research about the gut biome. It is not all correct and some of the claims are sensationally overstated. Unfortunately, it doesn’t tell you what to do to fix much of anything other than “eat a diversity of food”.

While this isn’t quite pseudoscience (fake medicine), it is very much premature science, which media like is overstated beyond what we know to be possible, and there are some specific errors that can misinform.

I’m glad that a program like this exists to try to give people an idea of how the gut microbiome is powerful and an important consideration, but expect it to be pitched to a year 6 primary school class.

Brain Energy, Book Review

“Brain Energy” is a book by Christopher M. Palmer, MD., 2022 [LINK], a psychiatrist and researcher from Harvard, USA. In Brain Energy, Palmer discusses some problems that he perceives in how psychiatry has evolved and the major shortfall in therapeutic care that results from this. Palmer conjectures that all mental disorders are metabolic disorders of the brain, specifically problems in the mitochondria of each cell. Palmer proposes some guidelines on how to address this problem. I agree with much of what Palmer is saying, but disagree on his simple conclusion and solution.

The book can be divided into 3 major parts.

Picture of the book "Brain Energy" by Psychiatrist Christopher M. Palmer, MD
Brain Energy, Christopher M. Palmer, MD

Part 1 – The current state of psychiatry

In this section, Palmer helps the reader understand how mental disorders are often missing the mark as to what is going on, leading to many different names and treatments for the same basic set of problems, which leads to lots of problems in knowing what is actually going on and thus what to do about it. Effectively, it’s not pretty, but it is what we have.

I agree that the current diagnostic manuals have many names for the same thing, because different schools of health noticed similar groups of things, defined them in their own nomenclature and then devised their own treatment plans, mostly that don’t work.

For example, most of the “personality disorders” are just what Autistic ADHDers look like in various spectrum presentations to someone who doesn’t understand Autism and ADHD. In trying to treat a personality disorder, they miss what actually needs to be done to help Autism and ADHD, leading to poor results.

Part 2 – The case that metabolic disorders of the brain are the root behind mental disorders

In this section, Palmer makes a case that behind most persistent mental disorders is an underlying biological problem, specifically metabolic, and then draws a tenuous link to the mitochondria – the power source of each of your cells.

In my opinion, people who experience mental ill health for 2 years or more are almost always dealing with a biological problem first, which has mental ill health symptoms second. In my opinion, people who are dealing with these health differences from childhood or birth, or for more than half a decade, will highly likely need some mental health therapy to manage the behaviours developed to manage the health condition and the consequences that had on their lives.

I am aware that mitochondria has some connection to disorders that affect how much effort people can put towards actions, such as chronic fatigue, fibromyalgia and some kinds of chronic pain disorders. I also know that some kinds of metabolic problems, such as diabetes, can affect the mitochondria. But after that, in my opinion, Palmer is reaching to make it all about the mitochondria.

Part 3 – The case for breaking the silos and looking at the whole situations

In this section, Palmer describes the priority to look at the person’s physical health first, situation second and mental therapy third. While this is not a strict order, this seems to be the majority of people. Palmer is willing to use medications where needed, and prefers to work towards not needing them where possible.

I agree that a person’s whole situation is vital to their health. These are not separate entities. Unfortunately, our Western Health system seems to have siloed far too much health care. Medical doctors take care of basic physical health, no one takes care of diet, dentists take care of the mouth rocks, psychiatrists take care of the brain medications, mental health therapists take care of behaviours and son on.

There are benefits to specialising, because there is so much to know that it is not possible to know it all. The problem arrives when specialists don’t talk to each other, when a person’s health complications span more than one silo, or fall between silos because no one technically specialises in that aspect. This leads to people with complex health issues being mistreated or not treated at all.

Palmer recommends that people go and see a specialist that can help them with their diet, exercise, social, mental health and medication. Which is smart, and I agree. Except that his first section above is pointing out that these people don’t exist and we should have them…

A bit tough to do.

Palmer also doesn’t make it clear enough that medication is not evil and if the appropriate solution, should be taken. It would be very easy to misread what he has said as “the best solution is not medication” and consider medication to be a failure of care.

Conclusion

This was a refreshing read. It mirrored many of my thoughts about the medical system and how mental health is traditionally done. I agree with about 90% of what Palmer says about the system, the whole person health and the kinds of things that fix that. I disagree with the core idea that mitochondria is intimately connected to anything. Sure, it is in every cell and many things are affected by or affect the mitochondria – but that doesn’t make it the root cause.

It is important to note that Palmer is not the only one who has most of these views, or the first one to express it. It is nice to see it compiled into a single fairly simple to read book though.

In my practice here at JD Therapy, we work on that whole body therapy. We try to get an idea of what your experience of your mental health is like, your physical health, your social and work health, and how you see yourself fitting in with the wider society. We look from symptoms and experiences to trying to figure out the underlying problems and then get those addressed.

That may be giving education on diet, exercise, and mental health; upskilling you in social, work or self management; and helping you integrate with various medical professionals better so that they can properly address your biological needs.

Do Not Be Daunted

“Do not be daunted by the enormity of the world’s grief. Do justly now, love mercy now, walk humbly now. You are not obligated to complete the work, but neither are you free to abandon it”.

This is from a book about the Wisdom of the Jewish Sages. It is an interpretation of part of the Torah, where assumed context has been manually added back in.

Text says "Wisdom of the Jewish Sages - Do not be daunted by the enormity of the world's grief. Do justly now, love mercy now, walk humbly now. You are not obligated to complete the work, but neither are you free to abandon it", posted by Joshua Davidson Therapy

I find this to be a profound bit of wisdom, helping me to recall that the work we do is enormous and can be overwhelming, yet continue we must. We shouldn’t think we are doing this on our own, we don’t have to complete it ourselves. We also can’t just walk away and pretend it doesn’t need to be done.

Sometimes, though, it is important to rest and heal. We can do so in the trust that someone else has continued to take up the work, even if we cannot see it.

When we are ready again, we pick up the task and continue. Others also need to be able to rest and heal.

The work is worthy.

Pre-Sleep Anxiety

Pre-Sleep Anxiety is the weird brain state that we can get in to specifically when we are trying to go to sleep, negating the sleep we are desperate for. There is a neurological neurochemical reason for why this happens, and there are some things you can do about it.

Pre-Sleep Anxiety Looks Like

Pre-Sleep Anxiety can look like ruminating on a thing we may have done poorly today, or last week, or last decade.

Pre-Sleep Anxiety can look like trying to solve a real or imagined problem.

Pre-Sleep Anxiety can look like suddenly having inspiration on a brand new thing an wanting to get up and do it… right now.

Pre-Sleep Anxiety can look like being super self critical (negative self talk), feeling very alone, or very sad.

Why do we do this to ourselves?

This is not a trauma response. This is a neurochemical process. This is our brain trying to produce enough noradrenaline and melatonin to go to sleep.

Neurotransmitter Basics: Noradrenaline and Melatonin are needed for sleep

Both noradrenaline and melatonin need to be created in our brain from protein amino acids in our blood for us to go to sleep. If we are too low in noradrenaline, then to help make a bit more our thoughts and feelings kick in with Pre-Sleep Anxiety, stressing ourselves to coax some extra neurotransmitter release, primarily adrenaline with secondary noradrenaline.

This is how we compensate for low noradrenaline during the day, which often feels like anxiety or anger. This is not a good solution for sleep though, as that primary stress release of adrenaline cancels the melatonin, so we now have noradrenaline and adrenaline instead of noradrenaline and melatonin. The melatonin is what pushes our brain “into a sleep ready” state.

Neuronal adrenaline and noradrenaline are subtly different [Neurology LINK]. Adrenaline in the brain is used as a neurotransmitter to handle life emergencies (like running from predators), while noradrenaline in the brain is mostly used to detect threat, manage mood and connect ‘wanting’ to ‘actions’. We don’t want to fall asleep during an emergency, so adrenaline cancels out melatonin, the get “into a sleep ready” state neurotransmitter.

Autistic and ADHD people often have difficulties regulating noradrenaline, where 8 out of 10 are low, 1 out of 10 are high, and rarely is the noradrenaline production neurotypical like average.

Neurochemistry Deep Dive: Why we need enough noradrenaline

For sleep, we have two different groups of neurotransmitters that we need to get our head around. The Dopaminergic Group and the Seratinogic Group.

Dopaminergic Basics

Our brains converts the protein amino acid tyrosine, from our blood, into Dopamine, then we convert that Dopamine to Noradrenaline, and then we convert that Noradrenaline to Adrenaline. Parts of our brain store each of these neurotransmitters in reservoirs, and then release these neurotransmitters as we need them for specialised tasks.

Noradrenaline is used in our brains to asses the situation both in front of us and the near future for risk or opportunity, returning the answer in the form of a mood. It also connects the desire to do a thing to the actions to do that thing. When the noradrenaline is out of the ideal levels, we get insufficient answers to risk and opportunity, so our brain defaults to assuming risk and so we feel anxious or angry. If our noradrenaline is low, we can’t engage the “action” part of our wants.

When we feel anxious or angry, our brain assume we are in danger, and it release reserve adrenaline to manage the emergency. Our brain can substitute this adrenaline for noradrenaline, to get things done. Unfortunately, this doesn’t help our situation assessment, so we still feel anxious and angry.

Serotonergic Basics

Similar to the Dopaminergic process above, our brain converts the protein amino acid tryptophan to Serotonin, and then when it becomes dark, converts Serotonin into Melatonin, which we use to trigger the “sleep state”.

Serotonin does two major things. Firstly, serotonin powers the part of the brain that balances the other neurotransmitters, kind of like an overseer. This is why GP’s often start with something to help serotonin levels. This can fail if your brain can’t make enough without additional help, such as ADHD. The second thing that serotonin does is gives you a pause between trigger and reaction, which can enable you to make a different choice.

Melatonin, as stated, prompts the brain to stop being so awake and go to sleep. It isn’t a sedative, like some chemicals, it just prompts “go to sleep”.

Monoamine Oxidase – why you need enough noradrenaline

Monoamine Oxidase (MAO) is the enzyme we use to metabolise the dopaminergic and Serotonergic neurotransmitters [MAO Wiki LINK], and part of how we turn one neurotransmitter into another. We aren’t going into exactly how that happens here. This is the “mop up” process, ideally once we have used the neurotransmitter for its purpose, but this also manages and gets rid of excess neurotransmitter. There are two different MAOs, A and B, written as MAO-A and MAO-B. Got to love those names.

The same MAO that helps turn Serotonin in to Melatonin also metabolises Noradrenaline. What that means is that as the lights go down and you start to decrease the cognitive load (less complex tasks in preparation for sleep), your brain starts to make Melatonin from Serotonin, and as a side chemical reaction, your Noradrenaline levels go down. This is fine if you have enough Noradrenaline that a bit of a drop just prompts you to want to do less – in fact, that’s really handy for going to sleep. It isn’t good if your Noradrenaline levels go low enough that your brain thinks you are in deficit – that prompts your Serotonin fed Neurotransmitter Manager to throw some moods at you to kick start making more Noradrenaline, which leads us to have Pre-Sleep Anxiety. [PDF LINK, p161-2]

Pre-Sleep Anxiety Intervention

Medication

If you are frequently struggling with Pre-Sleep Anxiety, and it is not directly linked to a specific incident that resulted in a diagnosis of PTSD (and even often if it did) then you will likely need medication to help manage the pre-sleep Noradrenaline variance.

The most common medications that help with this

Melatonin

Most neurotransmitters cannot be ingested by a tablet as they do not pass the Blood Brain Barrier. Melatonin is an exception. The medication provides you with the Melatonin that is identical to the Neurotransmitter that you create to switch your awake and sleep state. Melatonin is very safe, but you should still check with your medical professional to check if this is suitable for you.

This can be available from your chemist in doses generally around 1-2 mg, often with a script from your doctor. You can also have compounded melatonin at much higher doses, depending your specific neurology.

We have an extensive discussion about Beating Insomnia [LINK], which includes how best to use Melatonin.

  • Take it 30 minutes before you go to sleep
  • Wind down your activities to avoid adrenaline rushes
  • You may need some background noise and mild distractions

Agomelatine

Agomelatine is an interesting medication that helps your brain to produce a bit more melatonin with minimal Pre-Sleep Anxiety. It also has some positive next day benefits to general anxiety, social anxiety and depression for many people.

Unfortunately, in Australia, it isn’t covered by the PBS (government assisted costing for medication).

Clonidine

Sometimes the problem with Noradrenaline is that it is too high, and this can cause very similar symptoms to low Noradrenaline. Clonidine is a good medication to start with for decreasing anxiety spikes and wind back the adrenaline response a bit. This medication has downstream positive effects for some sub-variants of ADHD.

Vitamins

If you are deficit in Iron, Vitamin B6 or Vitamin D, this can complicate your ability to sleep, and sometimes that can be mistaken for Pre-Sleep Anxiety. Your GP can give you a blood test to confirm if this is the case.

If you are suspected of or diagnosed with either Autism or ADHD, please note that Iron and B6 are a bit more complicated than for neurotypical people.

  • Iron aka Ferritin: Iron is a key ingredient to making neurotransmitters, including Dopamine, Noradrenaline, Adrenaline, Serotonin and Melatonin. Iron deficiency and increased behavioural difficulties, sleep difficulties and restless legs is well documented with ADHD [LINK] and Autism [LINK].
    • Neurotypical people seem to do well enough with 30 ng/mL of blood ferritin, and generally your GP will only inform you if your pathology results are lower than this. Specifically ask what your ferritin score is, and try to get it higher than 50.
    • Improve your iron by eating meat (any will do, beef has twice as much available iron as fish meat, so adjust your quantities as you need), or if vegetarian / vegan ensure you eat enough green leafy vegetables with acetic acid (to help plant iron become bioavailable) while avoiding dairy in your iron meals.
    • If your ferritin doesn’t increase, consider iron supplements (beware of constipation, and be careful that vitamin C fortified supplements don’t adversely affect your other medication taken at the same time).
    • If you still don’t improve your ferritin, consider an infusion (talk to your doctor).
    • ARFID, difficulties swallowing tablets, and needle fears can complicate all of this.
  • B6 / Pyridoxine: The most common pyridoxine test by pathology is checking your dietary B6 rather than your body store B6 (p5p). Ask your GP to check specifically for body stores.
    • Many GP’s will just do a Vitamin B12 test and assume that your B6 is in line with that (for complicated reasons), and for most people this is good enough. However, for people who have B12 supplements (eg vegans) and for people diagnosed with Autism (many have low absorption for B6, B9 and B12), assuming that B12 levels will be in line with B6 is an error [LINK].
    • To improve your B6, you can try eating more foods with B6 (such as banana), or supplement via vitamin supplements. Chronically low levels can be addressed medically.

Sleep Routine Hacks

Take a look at our existing information on Beating Insomnia [LINK]. In this we discuss, in detail, facts and fictions around sleep, and how to improve your sleep.

Specifically, look to the section around

  • Dimmer lights
  • Calming but interesting activities
  • Medication as appropriate, including Melatonin
  • Pre-Sleep Adrenaline Activities
  • Journaling
  • Noise, and
  • Meditation

The goal in your Sleep Routine Hacks is to keep your adrenaline response moderate to low, but not too low, before you go to sleep.

Additional to the information in the Beating Insomnia page, you may benefit from doing some cardio exercise before or just after dinner. Not only does this increases your fitness, it increases your adrenaline and noradrenaline several hours before you go to sleep, which means that it will be a little higher when you do want to go to sleep, which avoids the anxiety that your system uses to boost the Noradrenaline to help make Melatonin.

This is a Guide, not a Medical Treatment, use this guide when talking to your Doctor

Consent

Consent is very important.

Top panel: Hedghog asks "Hey, did you ever end up asking that girl out?"
Fox replies"Yeah, she said no. But it's okay. I have a plan."
Bottom panel: Hedgehog says "What's your plan?"
Fox replies "I'm gonna leave her alone because she already said no."
Comic by liz climo, go to thelittleworldofliz.com
Comic from thelittleworldofliz.com, created by liz climo

“No” is a complete sentence.

“No” is personal.

“No” is the assumed answer until a clear and willing “yes” is given. If you aren’t sure what the signal is, assume “no”, clarify if that was the correct interpretation. While you may politely enquire why “no”, you can’t push. Pushing to a “yes” is violating consent.

My “no” can stop you from affecting me, but it can’t stop you from not affecting me. For example, I can say “no” to you giving me a cup of coffee, but I can’t say “no” to you drinking your own coffee.

For more, take a look at our page “Consent – Fundamentally Easy” [LINK].

Gene’s Predicting Mental Illness

Monday Open Mic – ask a Question

Question :


What’s your personal belief that species and mental disorders are linked??? Eg Neanderthal, Denisovan etc.

Answer:


TL:DR We know some DNA is a direct marker, while other DNA is just a warning/ caution.

There is some good correlative evidence that having certain DNA segments increases the risk of various mental disorders. Some of those DNA segments are unique to Denisovan, Neanderthal and other sub species of human.
* We are going to use “sub species” to refer to other kinds of humans DNA such as Denisovan, Neanderthal etc.

Correlation is not causation.

There are more DNA segments that are not sub species specific that are correlated more strongly with increased risk of mental illness when compared to the correlations linked to sub species.

For DNA that has a strong correlation to mental ill health, the next important question needs to focus on mechanism for why this impacts your mental health and are there compensatory genes that offset a “bad” gene. For example, if you have a gene that interferes with zinc absorption, that could be bad for your health, however you might have another gene that increases zinc absorption, mitigating or protecting you from that first DNA sequence.


This is interaction of multiple genes affecting the absorption, production, or resistance to certain things is why a single gene is indicative of risk only, not a 100% certainty.

We know that for people who need mental health medication (SSRI, SNRI, antipsychotics, ADHD meds etc) the ability to metabolise the medicine is directly connected to the p450 gene cluster. This controls the production of a list of about 30 enzymes, where 6 enzymes are responsible for the metabolism of about 90% of medications. Fort most mental health meds. The enzymes CYP-2D6 and CYP-2C19 are REALLY important. Most white people (90%) have good expression of these enzymes, so medication generally works as expected. As many as 61% of Algerians [LINK] have “non-normal” (!) presentations of CYP-2D6 and thus likely won’t absorb medications as expected. You can have no enzyme (can’t metabolise), regular, extra (fast metaboliser) or over supply (hyper metaboliser). This sequence is not related to any sub species variants of humans and is far more likely to affect your mental health.

! – It is important to recognise that Western Medicine is “normalised” for mostly Northern European genes. Normal for Algeria is going to be quite different from that medical default of “normal”.

Autism and Suicide

Warning: Contain discussion in and around suicide and self harm.

TL, DR:

* My condolences for Michelle

* The West Australian really F’d up the title

* Autism is a neurological difference, not a disability

* These differences can be directly disabling, or society led disabling.

* The risk fo suicide in Autistic people is very high, mostly due to society

* The is also the risk of self harm

* Co-occurring diagnoses are very common with Autistic people, and untreated can make things much harder than they need to be

Autism is a group of congenital highly hereditary neurological conditions. That is, if your kids are autistic, you probably are too – more on this a bit later. Autistic people have differences to the neurotypical cohort of people that can be advantageous and dis-advantagous. If those disadvantage differences are not adjusted for, by the person and by society, then they are disabling.

Autism itself is not a disability, despite what the zeitgeist opinion is, or what you’ve read in mainstream or even medical texts. It is medically defined as a disorder, which just means “different to the mainstream”, and as a requirement for a medical consideration, contains elements of disadvantage or difficulty to the person.

Difficulty seeing is a disorder. On average, humans can read the standard sized characters at 6 metres, the N6 text at 0.3 metres, and read all the symbols in the Ishihara colour test. If you cannot, your vision is disordered. Frequently we give people disability aids called “glasses”. As a requirement to drive a vehicle, your distant vision must be within certain parameters of 6/6. We allow people to wear glasses when they demonstrate this ability, and we note down on their drivers licence that they must wear their glasses to drive. We do not medically label when people can read at greater than 6/6 unless it causes a difficulty.

Allowing people to wear glasses to pass the driving test is allowing a disability accommodation. We only include, medically, the people who diverge from the average ability to read those who are “worse” at it, because that is an “impairment”.

Autism is not the same. 

For a start, your divergence from the average can be in many different areas. This divergence may be hyper (above average), hypo (below average) or just different. It may trigger a secondary feeling of pleasure (phiic) or anger/dissatisfaction/disgust (phobic). The divergence may be specific or plenary (lots in that category).

The criteria for how we measure Autism has changed over time, but it mostly boils down to primarily difficulty in making friends due to either social-emotional, nonverbal communication, or relationship ability is deficit of the neurotypical, and secondarily at least two of the following “traits”: movement differences, preference for sameness, fixated interests, hyper or hypo sensory perception.

If the person is considered to be atypical enough to warrant the Autism diagnosis, they are given a Level 1, 2 or 3 classification:

Level 1 – difficulties in communication only

Level 2 – difficulties in communication, repetitive behaviours and or inflexible

Level 3 – severe challenges in social communication, extremely inflexible behaviour and likely meltdowns or other odd behaviours

This ignores a great deal of the experience and nuance of Autism. This is like categorising Australian’s as White Females. It is technically true that females are more numerous than males, and it is technically true that the most common skin tone in Australia is the approximation called “white”. So while technically true, this both tells you little about the various peoples of Australia, nor who the individual is. It also disrupts what people expect to see when they think of Australians, making it hard for anyone who doesn’t fit the simplified stamp of white female to be included as Australia, or any specific personal differences from that model to be considered as part of your Australian Thing.

The trap of the above diagnostic and categorisation method is that it doesn’t account for people who have mediated their neurological differences (such as devices for managing disadvantageous sensory differences), or learned around their neurological differences (specific upskilling, fantastic parenting), or inclusive environments (an Autistic person commented to me that they weren’t Autistic when they were bush walking – they were just bush walking) and so on. 

That is, most people who wear glasses don’t think of themselves as disabled, because they get to wear glasses.

Wow, that was a lot of pre-amble.

So that brings us to the graphic.

The “West Australian” is a big local newspaper here in Western Australia. Today they had a title on their digital paper that reads in the big font “Two sons both lost to autism” and in a much smaller font title “mother’s plea for help amid new suicide crisis”. In this exclusive, by Bethany Hiatt, she outlines how Michelle’s two sons, Xavier and Jye, have taken their own lives. 

Michelle wants to “raise awareness that people with autism are so high risk for suicide – which I didn’t know”.

This is very sad. It is awful that Michelle’s sons took their own lives (different times, both this year). What circumstances could have led to this? Clearly, according to the title, it was “autism”. It is fair to jump to this conclusion. It is well known and studied that Autistic People have a much higher rate of taking their own lives than average. The nuance, though, is defining average. Here, average means people who are neurotypical, wealthy, and in positive supportive environments.

Autism is often co-occurring with other diagnoses, such as anxiety, depression, ADHD, social phobia, bipolar affective disorder and so on. This is generally due to autistic people not being properly assessed for their mental health, as mental health is diagnosed by variance from the neurotypical, which Autistic People aren’t. Autistic People are often misdiagnosed, which leads to the wrong treatment plan. Anxiety, depression, etc all have higher than average rates of people taking their own lives, harming themselves, and being in abusive social relationships. So… is that higher rate of death etc due to Autism, or other conditions?

Autism is also often co-occurring with various physical diagnoses. It is very common for medical professionals to dismiss reports from Autistic People of illness. This is partly due to Autistic People expressing differently. How do you describe being in pain? Neurotypicals use a certain tone of voice and facial expression, both of which are rarely used by Autistic People. So instead many Autistic People have used the medical definitions for pain which instead elicits the suspicions of the medical professional that this is “put on” rather than “literally true”. I have had many conversations with Autistic people who have told me about walking home from the hospital or doctors clinic on a broken bone, because they weren’t believed. If describing pain is hard, imagine all of the other symptoms we report to doctors that aren’t believed. Additionally, many autistic people don’t have the same response to medications that neurotypicals have. People who have medical conditions have a higher rate of taking their own lives, especially when they do not feel heard by the system.

Autism is also often co-occurring with disadvantaged socioeconomic circumstances. It can be hard to keep a job when you tell the company the truth they don’t want to hear, or you literally do the task they have had to “ask” you to do, but don’t want you to do, because they are cheating the system. It can be very hard to get work when they won’t accommodate your hearing or visual differences.

Worst of all is the stigma of Autism.

That is the biggest offensive thing about this article. I appreciate the author of the article doesn’t choose the headlines, so I don’t hold them accountable for this. The headline itself is misleading, disabling and stigmatising.

Stigma exists beyond the title though.

Intellectual Disability is 5 times more likely to be diagnosed in Autistic People than it is in Neurotypical people. Sometimes this is an accuracy diagnosis. Often it is not, it is just that the assessor didn’t understand the learning differences and problem solving differences that the Autistic Person being assessed had. Even if all of the co-occurring diagnoses of intellectual disability are accurate, that is still a minor percentage of the Autistic Population.

And yet, the common zeitgeist is that Autistic People are stupid and disabled. Which is generally false.

Sometimes it is very helpful to get some support in buying those glasses so that you can see well enough to drive to work, so that you can afford the glasses… getting help is good, especially when the disadvantage you have is one ability aid away from allowing you to fit into the mainstream. 

To get help for Autism is hard. First of all, it takes several years for a child to be assessed, and often thousands of dollars. Once you have your assessment confirmed, you don’t actually get any help. You have to apply for that. The most common aid given to Autistic People is NDIS.

NDIS requires that you have a permanent disability. Okay, if we are going to call Autism a disability, since it is a congenital neurological difference, it is permanent – you don’t grow out of Autism, you just get better at being you. NDIS, though, requires that your disability continues being a disability. They will fund services and devices that allow your disabled life to be of higher quality, but it doesn’t fund for you to “get better”. The trap of NDIS is that to get their funding help, you have to settle into being disabled – whether you are or not.

It is F’ing hard to get NDIS. It is F’ing hard to get good services with NDIS funding. It is F’ing hard to maintain your funding to maintain your quality of life. You keep having to prove your lifelong diagnosis and needs.

Other Autism support isn’t much better.

Where does that leave us? 

Yes, the suicide rate for Autistic People is much higher than we would like. Mostly it is because the system is awful and people die before they get help, because getting the right help is so F’ing hard, and even when you do get it, it is often the wrong F’ing help, because you got misdiagnosed.

For a start, most Autistic People who are struggling with anxiety and depression likely are not diagnosed with ADHD. ADHD medication helps most Autistic People manage their co-occurring ADHD (most Autistic People are also ADHDers), which dramatically reduces anxiety, depression, self harm and suicide. 

Second, finding your people dramatically helps reduce suicidality. Autism and ADHD are spectrum conditions; that is, you can meet people who are on the “other end” of the spectrum (the spectrum isn’t linear, it is polydimensional) and you won’t get along with these people. When you meet people in your section of the spectrums, it feels really good. When you feel part of a community, your risk of suicide dramatically decreases. (Side note: people who do find each other often fall in love and have kids, which is why the odds of only having one autistic parent is very low, told you I’d get back to this point).

Third, learn to defend yourself from social and system abuse. Autistic People are suckers for toxic people and toxic systems. That means learning to recognise the difference between what someone says and what they do, learning to manage that difference, and learning to walk away from toxic situations. This also applies to systems, where much like people, sometimes we are actually stuck with the toxic thing and have to learn how to manage it.

Lastly, push for systemic change. We need a health system that isn’t so black and white, making moderately disabled people more disabled and ignoring everyone else. We need a health system that helps us get healthy. We need workplaces that not only want Autistic People for their Hyper-focus, Hyper-creativity and so on, but also accommodate the environment so that Autistic People can take breaks from sensory overload, can relax after a hyper-active event (such as hyper-focus) and have clear communication when they ask for it without being belittled.

If we do this, the suicide rate will go down.

Serenity Mantra

Serenity – not just a Firefly spin off; it is the state of being calm, peaceful and untroubled.

The Serenity Mantra is a variant of the Srenity Prayer, but rather than asking for another entity to help you to navigate this, it brings the power of wisdom to yourself.

Here we break down why this is such a poweful idea.

Serenity Mantra:

* May I have the Patience, to Accept the things, I Cannot change
– Be patient, all things change
– Wait for new opportunities and use your strength wiseley
– Acceptance is not approval

* May I have the Courage, to Change the thing, That I Can affect
– Be Brave against the unknown
– Progress feels good and inspires us
– Review what we accepted, week new options and opportunities

* May I have the Wisdom, to tell the Difference, Between the Two
– “Give me a lever long enough and a fulcrum on which to place it, and I shall move the world” – Archimedes
– Work smarter, not harder
– Are you applying effort to the right place?

ADHD Learning

We aren’t born knowing how to navigate this world, earn money or even get food. We need to learn how to do all of this. Learning takes a careful balance of neurotransmitters and thought strategies. Here we look at 12 ADHD Learning Hacks to help you optimise your learning. Not all ADHDers are the same, so while these are generically good for most ADHDers, you might find a step or two that isn’t ideal for you.

To optimise learning, we need balanced neurotransmitters, a positive mood, knowing what ‘good’ or ‘correct’ look like, a framework to grow our knowledge with and connecting our growing understanding to existing knowledge and understanding.

Neurotransmitters – The key to how working brains learn

We humans use a range of neurotransmitters to make our brain work well, learn a skill and then store that memory. When we say “balanced neurotransmitters”, we mean “not too much” and “not too little”, we are looking for a range of “good” in between them. Here we will go through some of the most important neurotransmitters.

Click on the below to expand them into a brief description of what the neurotransmitter does, and how you can tell if it is not in the good zone.

[Link to more about Neurotransmitters]

Dopamine

Dopamine is a key neurotransmitter that ADHDers struggle with. Dopamine helps us to be creative, connect ideas to other ideas and understand the deeper layers of nuance. Too much and our creativity drops, too little and our understanding of nuance and depth drops. We manufacture only so much Dopamine a day and our brains can use it poorly. Medication can often help with Dopamine delivery and retention in our important learning centres. You will often find that there is a time of day that you learn better, are more creative and more expressive. If you can, aim your study and learning for these times. Learning what it feels like when you run out of Dopamine is a key skill for knowing when to take a break – for most it feels like sudden fatigue, confusion and struggling to find the next thought.

[Link to more about Dopamine]

Noradrenaline / Norepinephrine

Norepinephrine (Noradrenaline) helps us get things done, allows our mood to reflect the world in front of us, and identifies priorities. If your Norepinephrine is too high, it can cause paranoid thinking, aggression, mis-prioritisation (the wrong things seems important) and mis-hyperfocus (where you do one thing to the exclusion of all other things – but it is the wrong thing). If your Norepinephrine is too low, it can cause negative self talk, anxiety, angry thinking and interferes with task initiation and completion. Your body responds to low Norepinephrine by giving you social anxiety, fast anger response and tries to push you into Critical Mode.

[Link to more about Noradrenaline]

Adrenaline / Epinephrine

Epinephrine (Adrenaline) plus moderate blood sugar is needed to store long term memories. If your Epinephrine is high, you’ll be triggered into Crisis Mode, and if it is low you’ll be pushed into Depression. Both of these take away from your ability to think clearly and make wise decisions.

[Link to more about Adrenaline]

Endorphins

When our Endorphins are medium to medium high we feel happy and our brain is receptive to new ideas, new connections and growth. If the Endorphins get too high, we can be too receptive and take in false ideas. If our Endorphins are low, we are likely to feel sad or bad and might find pain distracting. If our Endorphins get too low we can feel an absence of happiness, aka anhedonia.

Our Endorphin level is closely linked to having sufficient Dopamine, Norepinephrine and Epinephrine. If these go low, we often become (literally) un-happy. Even if these are at good levels, we need to be doing things we enjoy or thinking about good times to trigger this feeling.

[Link to more about Endorphins]

Neurotransmitter Boosting

Caffeine and Dopamine Foods (fat, sugar, carbohydrate, protein and salt) can help prompt your brain to make and release a bit more, but this does have limits – it is important to learn what it feels like when you have reached the limit of this helping. We also want to avoid too much sugar as that can interfere with long term memory storage. Also be aware that over use of caffeine and food can lead to other problems, so careful moderate use is key. Add in some nutritional other foods as thinking hard uses lots of nutritional resources.

Exercise that elevates both the heart rate and breathing rate for a sustained period of time, that is 10 minutes or more, can elevate Noradrenaline without necesarrily triggering just Adrenaline. This can help bring the energy back in to “doing” the task. This can be a brisk walk or light jog.

A warm shower or some stimming activities can bring in some extra endorphins to bring the happy back. Keep an eye on how much you are pushing through hate & anger – this is counter to positive feelings for learning. Time to refocus and reframe what you are doing. Stop pushing and find something that brings that fun feeling (but keeps your thinking clear) – such as a meditation on a fun memory or environment, feeling nice textures, playing that awesome 80’s mix tape or having a lovely conversation with someone. When the fun comes back, reframe what you are trying to learn / do so that it is empowering rather than awful, and go back and try again, but this time by adding fun features.

Brain Modes

Brain Modes is a shorthand way of looking at what mind state we find ourselves in. We will briefly look at four of them and how they can affect how we learn.

[Link to more about Brain Modes]

Creative Mode

In this state of mind, we feel comfortable, happy and want invest in doing things for a later time. We have the Dopamine to see connections and creative solutions, and sufficient Norepinephrine to put energy into initiating non-critical and non-urgent tasks.

This is an excellent learning state. Our solutions focus on Work Smarter rather Work Harder.

Critical Mode

In this state of mind, we think that there is an urgent and critical thing that needs to be done. This can be triggered by various urgencies (due date, friend coming over, expectations and judgement).

In this state we narrow our creativity, and focus on practical solutions. While creativity is narrowed, it isn’t gone, so we are able to logically and creatively add to solutions, but the emphasis is more on “doing” than “solving”.

This state of mind is quite familiar to ADHDers who hand things in at the last minute. It may be good, but it could have been better. It is important to acknowledge that “good enough” is often good enough, but it doesn’t feel good.

Sometimes people enter Hyper Focus with an urgent feel. This is where “only this task” exists and we can break lots of time limits. It often feels like “one more thing before I stop”.

Our solutions focus on Persistence Wins rather than Work Smarter.

Crisis Mode

In this state of mind, we need something done and we need it now. It can feel very pressured and we have no room to think things through, because this is a Crisis damnit.

Our creativity and learning are minimal. We decrease our solution space to Flight and Fight and there is little to no “think it through”. Dexterity is often down and we will frequently be physically clumsy.

Our solutions focus on Push Harder or Escape rather than Work Smarter.

Flow State

Sometimes we can enter into a state of mind where our enjoyment at learning and achieving triggers more neurotransmitter release. In this state of mind, we find that everything just flows and time can seem meaningless. This can lead to a very positive Hyper Focus with Creativity and Achievement being the central happy feel.

Hacking Learning

We need to acknowledge that ADHDers struggle to get sufficient Dopamine, which can lead to Brain Fog, and poor creativity. Often urgency is used to push us into a Critical Mode where we get the job done, but don’t necessarily learn that much from it. We can also use Anxiety and Anger to push ourselves harder, but this interferes with both Creative Solutions and closes our minds down to Simple Solutions.

What we want to do is to try to focus learning for when our brain has enough Dopamine to be thinking clearly, enough Norepinephrine and Epinephrine that we can get on with doing things and store long term memories. We want to use effective happiness to increase memory storing and if we can enter a Creative Mode or Flow State.

Euphoric feelings from cannabis and alcohol often interfere with memory storage, and learning critically needs memory storage and retrieval.

Here we have 12 learning Hacks that are geared towards ADHD Brains. Not all brains are the same, even amongst ADHDers, so some of these may not be optimal for you.

1 – Start on “Easy Mode”

What: Do things you know you can do, then add something that you want to learn.

How: Practice and refresh a bit of skill of something you have learned, then add new skills to that.

Why: By starting with something you know, your confidence will rise before trying something you are not good at, which helps buffer against a bit of failure and struggle.

Behind the Scenes: Success improves learning by promoting the reward neurotransmitter Dopamine and the happy neurotransmitter Endorphins. Failure, stress and anger raise Norepinephrine and Epinephrine, and if these rise too high, this will block learning.

2 – Focused Learning

What: Build skills sequentially, practice groups in parallel.

How: When you are learning, research about and experiment with one skill at a time. When you gain some confidence in that skill, add another skill, then another until you have a group of bundled skills.

Once you have a bundle of new skills, do something that uses most of those, practicing and consolidating them in parallel.

Start a new group of skills, adding one skill at a time, that are adjacent to the first bundled group. Now practice these in parallel.

If you are going well, add a third group.

If you can, practice all the skills together.

Why: When we can focus on one element, we can link it and explore it better. Greater understanding allows us to incorporate this into how we see the world, the area that we have learned in, and gives us maximum uses for the skill. Linking it to a bundle of skills allows our brain to store these in chunks, and memory chunks are easier to store and recall. Practicing the new knowledge and abilities in groups makes it more interesting, and more challenging, keeping our interest for longer.

Behind the Scenes: Building skills takes a combination of balanced Dopamine and Norepinephrine. Before boredom can set in, learning a new skill until we have a grouping of skills keeps things interesting. To consolidate that set, practicing them all together keeps us winning and rewarding, increasing Dopamine release (the reward “do this again” neurotransmitter) that we can bring in to our executive functions; and increasing the release of Endorphins (the happy neurotransmitter) that helps us store that memory better.

3 The Spacing Effect

What: Take breaks inversely proportional to the effort, aka the harder it is, the sooner you take a break

How: If this new skill is hard for you to learn, then it is going to use up more of your brain fuel. If you start to struggle to do the skill, or you notice you are making foolish rather than ignorant mistakes, stop pushing and take a break.

In your break time, do something very different to what you were doing. If it was a physically active skill, your break should be sedate; while if you were using lots of brain and little body, do some exercise.

If you haven’t been snacking during your learning, eat something.

Then, if you feel you can, get back to that skill.

Why: Learning new things takes lots of brain chemistry fuel. While all humans have limits to how much they can make per hour, ADHDers have a bigger limit. If you run out of brain fuel, you will start to lose skill instead of add new skills, and will risk becoming angry or fearful, which can block learning. Taking a break allows the fuel to regenerate so that you can do some more.

Behind the scenes: ADHDers have difficulties with accessing Dopamine in the areas of the brain that do the learning, and often have a secondary Norepinephrine issue, resulting in anxiety and or anger. If Adrenaline starts to get substituted in, to get things done, then learning stops and action begins. Instead of pushing yourself that hard, take a break and do something else to let the learning neurotransmitters regenerate.

4 Expert Frameworks

What: A framework is a way to connect what we are learning to things that we already know, and a learning framework is a method to quickly learn related skills to create groupings and bundles that support themself.

How: Before you re-invent the wheel, look up to see if someone has already created a learning framework that is compatible with you and what you are trying to learn. If so, use theirs. If you can’t find one that you can use, create one.

To create a framework, consider the core parts of the skill area that you are trying to learn and consider how that can affect other things. A method to do this is by creating an explosion chart.

Why: Memory stores and retrieves better in chunks than individual strands. Learning skills that work well together allows for them to support each other, creating a stronger and more robust skill, that can then be stored and retrieved in chunks.

Behind the scenes: It can be easy to lose focus on what we are trying to learn and what the end goal is. We can easily slip into a hyper-focus and or rabbit holes of interesting skills, and not learn and do what we had intended. A framework not only reinforces the things we just learned, not only improves how we learn them by optimising the sequences of skills, it also keeps us on track to learning what we set out to learn.

5 Fast Feedback Loop

What: Either check with an expert how you are going, or have a way to determine if what you are learning is correct and working

How: Good teachers are able to help you know that what you are learning is good and working. In the absence of a good teacher, try to learn in such a way that you can verify that what you are doing is improving and or accurate.

Why: ADHDers often lose patience with new things when rewards are distant. A quick reward loop keeps things fresh and focused. This is how computer games keep your attention, fast reward mechanisms. We can hijack this idea to help you learn new skills.

Additionally this helps you know that what you are learning is working, which improves skills fast.

Finding out that you are making a mistake early, and how to avoid that, quickly allows for improvement.

Perfect practice makes perfect learning.

Behind the scenes: ADHDers benefit from quick Dopamine from skills acquisition, and knowing that this is working and improving adds in some Endorphins. This then helps positive motivation, keeping Norepinephrine in the positive “we are doing things because this is fun” mood, instead of heading towards critical / crisis mode.

6 Airplane Mode

What: While learning, turn social off

How: Where you can, turn social media off and other aspects of trying to track what people are doing, saying and meaning; focus on the thing you are learning.

The two exceptions to this are parallel body doubling and tandem learning.

Parallel body doubling is where someone is around but not interacting with you in a social sense. They might prompt you to stay focused, check in on yourself or take a break. This should be someone that you are comfortable and feel safe with.

Tandem learning is where the two of you are trying to learn a skill, or you enjoy learning with them.

Why: Socialising takes up a lot of brain processing, which can distract you from learning. Often AuDHDers (Autism and ADHD) have brains that specialise in doing one thing very well, or two or more things poorly. Learning needs you to do one thing really well, so switch off the most distracting and resource hungry multitask – social.

You may learn better with music or television on in the background. Generally this works best if the music or television are very well known so that your brain can effectively ignore it. The more these have people interacting in them, the more it may switch your brain to social mode and out of learning mode.

Behind the scenes: We evolved to survive predators. Mostly non-human predators have been eliminated, leaving only human predators. Neurodivergent people (like ADHDers) have had to learn to navigate around neurotypical people and conventions that seem unnatural to them. This means that socialising is often prioritised over other things, such as learning. Socialising is a resource hog, leaving little resource for skills acquisition.

7 Positive Self Talk

What: Keep track of your self talk, refocus on positive reinforcement as needed

How: Not what your self talk is. ADHDers often have a fairly strong negative self talk track that is used to drive up “motivation”, which can help in getting things done, but often interferes with learning.

This isn’t the time to challenge the thoughts, just to redirect them with a counter talk track.

Self talk like “I can’t do this”, or “I’m no good” can be countered with “I haven’t mastered this yet, but I’m getting there” and “All expertise starts off terrible, so being no good at a thing is a good place to start”.

Why: ADHDers and AuDHDers often compensate for inadequate Dopamine and Norepinephrine by being very self critical. This toxic vehemence drives the person into Critical Mode, which allows things to get done in a more limited sense. While some learning can be done in this mode, it is poor compared to positive mind frame, and risks slipping into Crisis Mode. By re-routing the self talk to “I’m getting there” and “Of course I’m not good yet, I’m learning” we allow ourselves to acknowledge the reality of not being good yet, but also pushes us to see that we are progressing, keeping the brain more focused on Dopamine rewarding rather than Adrenaline Compensating.

8 Refresh Your Skills

What: Memory loves repetition, so refresh what you’ve learned.

How: After you have had a good learning session, take a nice long break from it, at least 2 hours, preferably 6. Go back and look over what you’ve learned, perhaps even doing some practice of it.

The following day, or after an afternoon nap, refresh and quickly practice again.

Why: We experience a great number of things every day. Before our brain puts what we have experienced into long term storage, it does an assessment trying to work out if it is important enough to store in detail, in brief, or just point to an already stored memory with a “mostly like this” message. We want to tell the brain “this is very important, please store it in detail”. Refreshing the skill later the same day and then the following morning is the optimal way for your brain to determine that this is an important thing to store well.

When we add links to many other ideas and skills, we create lots of ways to retrieve that memory. Part of your refresh should be considering how this can be used and what it is similar to.

Also check out Step 10, Have Fun.

Behind the scenes: Medium epinephrine (adrenaline) and medium blood sugar level are important in permanent memory storage. Refreshing the skills is less resource hungry than working the skill out in the first place, allowing more resources and focus to be on long term storage. The repetition informs the memory section that this is a priority, especially if that refresh follows a sleep.

9 Validate Progress

What: When you succeed, acknowledge that you did so. After a while, review how far you have come.

How: Celebrate when you get something right, or when something works.

Look back at your progress, over this learning session, over the last week, over the last year and so on. See how far you have come and celebrate that too.

When you celebrate, it can be a small internal positive feeling, a statement of “nailed it” or similar, or for the big end of learning session review, some bigger self reward.

If your review that you haven’t learned much, or you find that your success is eclipsed by failure, reconsider your learning framework. Something isn’t working here. Stop trying to learn this way and use a different method.

Why: We can often feel like we are not making any progress or that we are failing in what we are trying to do. If we only pay attention to the mistakes, we feel that things are terrible, which can hinder learning.

Quick celebrations trigger Reward Dopamine, which we explained earlier (5). It also reinforces that we are making positive progress, which counters confirmation bias that our negative self talk tries to convince us of (7).

If it does turn out that we aren’t making good progress, then we need a new framework. This validation has to be honest.

10 Have Fun

What: Enjoy the learning experience, bring in the fun even if that means bringing in the silly

How: If validating (9) and noting wins (5) isn’t enough to bring a positive mood, try being silly on your own, or with a study buddy (6). Being silly can be making up a funny repetitive song with the key elements, or drawing a silly memory aid, or using the key idea as a swear word etc. Sometimes putting on fun music can lift the mood, or reading and talking the idea out in an odd place can work.

Why: Having fun makes a positive learning experience and better, more flexible memories.

Behind the scenes: Eliciting fun releases Endorphins which promote Dopamine and positive Norepinephrine. This encourages understanding, experimenting and keeps us going. If we can, we may enter Flow Mode, long term self-sustained learning.

We can store fear memories or happy memories. Fear memories are specialised in staying alive in a crisis, and not much use otherwise. Happy memories are flexible and easy to retrieve. By having a positive fun mood as we learn, we make the learning a positive experience and that allows us to store this as a happy memory.

11 Teach Someone Else

What: Teach someone else how to do the thing you have just learned how to do

How: This can be teaching a study buddy, or a friend later on, or even a teddy bear. Rehearse how you would teach someone later on as a way to refresh the skill yourself.

Why: When you teach someone how to do a thing you have just learned, you reframe the concept and knowledge in your head into a system of learning for someone else, and effectively teach yourself at the same time. This also kicks in the Refreshing Your Skills (8) and gives you some positive feedback that you have learned the skill (5). If your framework is missing some key ideas, it highlights that problem too (4).

Behind the scenes: We may learn well in spirals, but we teach best linearly. Switching spiral layered learning into a linear explanation creates flexible understanding of the skill we are storing. By changing the focus from pulling the skill into our minds and body to teaching an external person, we give our brains a different way of understanding the knowledge and reinforce and consolidate that knowledge.

12 Self Empowerment

What: Acquiring skills is its own reward – there is no wasted knowledge

How: Knowledge brings power and choice. Learning is acquiring more knowledge and skill. Frame your learning towards increasing your choices, your options and your future.

A game you can use during a lesson is to look for the information or idea that you didn’t know before and speculate on how that can be useful. This can work even if you don’t like the class or teacher, because this is for you.

Why: We don’t always choose to start learning, sometimes we are pushed into it. When we do choose to learn, we may stumble on some failures and feel like a failure ourselves. This negative mind set interferes with learning and makes it even harder.

When we embrace the options that we can open up in our future, even if we can’t see it right now, then we can choose to learn. With choice comes self-empowerment, which brings in that positive mind frame we’ve been pushing for in the previous 11 Hacks.

Behind the scenes: PDA (Pathological Demand Avoidance) can kick in when we are told to do something, even learning. This triggers an epinephrine (adrenaline) response that generally turns towards anger and aggression, which can be quite self-damaging.

If we feel like we are struggling, we can also have an epinephrine (adrenaline) response that can become a general push back against a thing. This is a form of ODD (Oppositional Defiance Disorder). We feel that we can’t, so we make it impossible.

Pushing ourselves to learn through this can lead to actions with minimal memory of how, sabotaging our own learning process.

When we embrace that this is for ourselves and that we are going to gain from this, even if it is not in ideal circumstances, puts us on the path to embracing the learning. When we feel empowered by it, we switch the PDA and ODD off. When we follow these 12 Hacks, using small wins, frequent rewards, taking breaks as needed, and feeling good about what we learned, we overcome our ADHD learning impediments.

ADHDers can learn really well. Often, though, ADHDers don’t learn as they want to, they learn as their passion or random interests falls.

Even though these 12 ADHD Learning Hacks can help most ADHDers in most circumstances, they are not a substitute for appropriate medication as your brain needs it.

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