Linking “Fogbrain” with AD/HD

Linking “Fogbrain” with AD/HD

I have again been experiencing highly unproductive days, a more intense version of the so-called “Fogbrain” I’ve been writing about lately. I’ve been going to sleep late, waking up later, and when I was awake I was mostly in a daze. In the past, I would have guessed it was because the number of small chores that I’ve been putting off because of the Big Project Crunch had grown to the point that they were becoming a mental burden; in the post-crunch period, mental exhaustion made it extremely difficult to motivate myself to do anything. What made these unproductive days more, er, “interesting”, was the return of a kind of physical paralysis that accompanied my mental fogginess. Not only were my thoughts unusually disconnected—at the time I wrote the first draft of this article, I was nearly unable to keep my train of thought on a single sentence, which rarely happens—but I was unable to initiate simple actions like getting off the couch even once I was able to form the thought. The last time this happened was maybe six months ago, pre-dating the Fogbrain blog posts.

“Perhaps I’m depressed,” I thought, “because of the number of chores and outstanding “when you get a chance” commitments I have made.” But I didn’t feel depressed. I just was kind of tired and maybe a bit mentally fatigued, and the resulting paralysis was, I thought, “all in my head.” I’d first written about this back in 2006 in the blog post Tricking Myself into Action, when I had a weird conversation with myself. This time was much the same.

The countermeasure I have learned to deploy in this situation is to “turn of my brain” by not letting it be “in charge” anymore, because it’s not capable of doing it. I’ve learned to quiet my mind by not chasing my thoughts around in my head, sort of like not responding to a crazy person who is trying to get your attention. After about a minute of this enforced stillness , my physical body seems to get bored and will get up by itself in search of something to eat or drink. The trick is remembering that this is an option; it usually takes me a while.

Today, I am wondering if there might be some ADD-related aspects of Fogbrain, a topic I’ve been exploring of late. In particular, I’ve been chewing on the following chain of thoughts:

  • I appear to share characteristics with people who have identified themselves as being AD/HD Predominantly Inattentive Type.
  • One theorized factor behind AD/HD is the lack of sensitivity to dopamine, a neurotransmitter that plays a role in reward and motivation centers of the brain.
  • Dopamine has a role in the theory of executive dysfunction

This got me thinking, as I lay immobile on my couch, about what “lack of sensitivity” meant. Does it mean that there as a “normal” level of reward/motivation? Perhaps a normal level of dopamine would mean that one generally felt mentally satiated, and a low level of dopamine would result in a feeling of starvation. It may a stretch, but that constant feeling of starvation over the years would certainly result in behavioral changes. On a conscious level, I know that novelty and availability of high quality information about the world are powerful attractors, whetting my appetite for investigation. Perhaps there is a subconscious aspect to that: the NEED for novelty and stimulation, because my brain feels terrible without it. It’s been like this for so long that it’s always been “just the way my brain feels”: restless, always seeking answers, and never quite satisfied. Perhaps these are just the side effect of long-term dopamine starvation, and curiosity is the way the brain can manufacture more of it. Or curiosity stimulates some other neurotransmitter to compensate for it. The analogy that comes to mind are people who grew up in the Great Depression or other period where life was very difficult due to a shortage of money and food. The extreme need has shaped their outlook on life, creating a great affinity for bargains, doggy bags, and stockpiling resources. To an extent, this has become part of their personality. They’ve found works, and what has gotten them through difficult times. They are loathe to give it up, even if they know that its not really necessary. But then again…what is guaranteed in life? These people know better than most!

Here’s some more current thoughts.

Maybe Fogbrain is more of a brain chemistry state than a failure of character?

While I believe that with willpower that anything is possible, it also doesn’t quite explain why I can’t muster the initiating spark to get me out of the couch and start on some chores. I had assumed that the brain was fighting me because it was boring work, that I was inherently lazy, but maybe it’s actually the brain too low on dopamine to power whatever part of the brain initiates action, or it interferes with this “executive function” aspect of the brain.

I haven’t actually been too worried about “failure of character”, figuring that it might “just be the way I am” and I should just accept whatever productivity I can squeeze out of myself when I can. But it’s interesting to think that maybe there is some brain chemistry aspect to Fogbrain, rather than it being related to my own strength of character.

Perhaps there is something I can do to ensure better brain chemistry balance?

I have been eating very poorly and exercising not-at-all during this last crunch time, working long days and staying up until I saw the morning sun. Perhaps this has something to do with it. I was dehydrated to the point where my back had started to make ominous crackling noises. Hunting around on the net for more insight on dopamine, I came across J.D. Moyer’s post Overstimulation and Desensitization: How Civilization Affects your Brain. The post is filled with interesting anecdotes about dopamine resistance and what can possibly reverse it: reduction of stimulation, turning off the lights earlier, and exercise.

It’s possible that this is a life-long personality pattern that I never saw from the perspective of AD/HD

I came across this fascinating theoretical Integrated Model of ADHD, which presents an EERILY accurate description of many of my major personality traits going all the way back to childhood:

  • My desire to know WHY rather than accept answers on authority
  • A sensitivity to patterns and the excitement in seeing them
  • My weird sleep patterns
  • My intuition+emotion driven decision-making process

It’s all there, and described in theoretical context with brain function. I am not expert enough to evaluate the science behind it, but I do recognize that AD/HD, at least as anecdotally described in this model, is a very strong match for my life. It bears further investigation.

Ramifications

It’s Thursday now, a few days after I started logging the Fogbrain symptoms, which are still with me. Getting extra sleep has helped, as has getting a few of the chores off my plate. I have told myself that in times like this, the one or two things a day rule can apply; I don’t have to do everything at once. If I just do ONE a day, that is probably about as much “executive control” I can muster in the absence of more stimulating projects. The Big Project will start up again next week, so perhaps I should just focus on resting up, getting some exercise, rehydrating, and eating better.

13 Comments

  1. J.D. Moyer 6 years ago

    Thanks for linking to my post. When I hit “fogbrain” my go-to quick fix is pushup or dumbbells … the lactic acid generated by the exercise is a superior brain fuel (better even than glucose).

    Also — great site!

    http://www.pjonline.com/blog_entry/lactic_acid_found_to_have_a_role_as_a_brain_fuel

  2. Bill C 6 years ago

    Hey Dave — one quick thought — wondered if you found any correlation between brain fog and sugar / carb intake? I remember brain fog being associated with early “pre-diabetes.” Did a search for brain fog and diabetes and a number of results come back — maybe try an experiment?

  3. Author
    Dave Seah 6 years ago

    J.D. That’s a fascinating idea!!! Thanks for visiting and posting the link!

    Bill: That’s a great point; I was earlier thinking that maybe I’m actually experiencing the built-up effects not from the mental burden of The Big Project, but actually from poor self care during it! I was eating terrible food, not sleeping regularly, not exercising, drinking too much coffee, and forgetting to drink enough water. I’ll try an experiment!

  4. Jenna 6 years ago

    David, I’m really appreciating following along your musings here on brainfog. Just came across a link from yesterday on NY Magazine: add this idea to the mix, just clench a fist…. even easier than J.D.’s pushups?

    http://nymag.com/scienceofus/2014/05/free-diet-tip-clench-your-fist.html

  5. Author
    Dave Seah 6 years ago

    Jenna: Wow! I love that idea! Thanks for sharing!!! It appeals to my inner curmudgeon, too :-) CLENCHES FIST

  6. Lynn O'Connor 6 years ago

    I’ve been studying common problems, including ADD and ADHD, for some years now, and with colleagues (one a psychopharmacologist, the other a statistician) we developed a measure “the Neurotransmitter Attributes Questionnaire (NAQ)” in which we demonstrate that common disorders are distinguished by gliches in neurotransmitter circuits (as you know, ADD/ADHD is a dopaminergic problem and is easily treated with medications that work as dopamine agonists –meaning they pump up available dopamine in one or another way (ritalin being most common –lots are using Adderall now, but in my opinion the latter is way too much, overkill so to speak, and ritalin is far less problematic). Our first publication on this ongoing study (anonymous online study) is published and available online at: http://sgo.sagepub.com/content/3/2/2158244013492540

    The study is ongoing. If anyone wants to try it out, go to: http://www.eparg.org and click on the study called “emotions and personality” and you’ll be there. It’s entirely anonymous so I can’t find anyone’s scores (meaning if you participate, I can’t find you or your results –sorry), but it’s sort of fun to take anyway.

    Dave I think you’ll fine the published article interesting. The thing about untreated ADD/ADHD is that people get depressed on top of it (adding insult to injury) because they can’t do what they want to do. When they concentrate (they’re very interested in something) their concentration is intense, over the top, but for the rest of the endless boring things we have to do, it’s hell for an ADDer to get the initiative etc to do them. It really is a dopaminergic problem. Exercise is helpful, food, I doubt it. I don’t think there is anything wrong with at least trying out medication; in fact from my perspective, why wouldn’t someone want to give ritalin a try? I’ve seen it do amazing things for people. If someone doesn’t have ADD ritalin might make them anxious etc, but for someone with ADD, it helps them relax and get going. I kid you not.

    ADD/ADHD is one of those “problems” that were NOT problems when we were living in hunter-gatherer cultures. It’s of a variation of the “normal” personality-type wiring, common enough in all human populations. But our culture presents all kinds of problems for those with ADD wiring. And the risk of secondary depression is very real. This is true for both kids and adults. For a child, school is their “job” in today’s world, and it’s often impossible to “do well” in school with ADD wiring. So untreated ADD/ADHD kids end up failures n school and of course that leads to depression –who wants to fail over and over. So secondary depression is in itself a problem.

    Take a look at our article re our rather simple measure –thus far it seems valid. In the publication we have about 900 subjects, by now I think there are over 1500 subjects, including around 100 new people with ADHD. One of my students (who graduated) added to the ADD population, another is right now gathering data from serious college athletes. So we keep gathering data, and we’ll probably publish another article within a year or so.

    LynnOC

  7. Author
    Dave Seah 6 years ago

    Lynn: Thanks for the great resource link! That paper looks like a good starting point for a serious review of ongoing research. I’m starting the tedious process of finding a primary care physician; I’ll see if there is some ADD-related expertise that I can find.

  8. Anita Stout 6 years ago

    Dave Every time I read a post-particularly on your brain fog issues, I feel I could have written it…and I have been diagnosed with ADD. The problem for me isn’t not being able to concentrate, it’s not being able to filter. I see and hear everything at once. It’s like input soup in my head. I start this but am distracted by that. In the process of “that” something else calls to me so in the end, I give up on all of it. I tried Adderall and had great success with it. The problem for me was that it caused an irregular heartbeat so I stopped taking it. My life has slowed down so much that it is depressing. I beat myself up continuously even knowing I’m not consciously deciding not to achieve all that I envision. Might have to seek alternative options. I have too much I want to do! I guess the important thing for us is to concentrate on the quality of what we do accomplish instead of the quantity of what we don’t. We’re all wired differently. It comes with it’s differing challenges. Learning to deal with the hand we’re dealt is just part of life, but certainly not my favorite part. Good luck to you!

  9. Author
    Dave Seah 6 years ago

    Anita: Your description of the difference between concentrating and filtering is interesting.

    I think for me, there’s two ways that my concentration breaks…maybe there’s some correlation to what you experience. I’d be curious if there is!

    I am pretty good about determining the big picture goal, with a sense of what its salient features and concrete benefits would be. If it’s a goal I am excited or curious about, then I can usually at least get started on it. If there problems to solve that involve exploration of the options, experimentation, or a lot of sifting of crud to find the good stuff, then that requires a significant expenditure of willpower. That’s when my ability to start, stay on task, and methodically go through each step is sorely tested. It’s worse when the task is particularly lame…finding a “good e-commerce solution for blogging platform X” is an example of sifting through a ton of crapware is a demotivator, and I tend to get pulled into other directions or don’t start.

    My ability to filter thoughts is probably pretty good. I think of it as a switch. When I want, I can turn on “super associative thinking mode” and just brainstorm and let thoughts and ideas fly around in a blizzard of possibility. It’s one of my strengths, I think, that I’ve trained from an early age to quickly converge on a possible solution set. However, I also came to believe that sticking to an implementation and putting it out there is incredibly important, and my interest in process and documentation is strong enough to fuel my BELIEF that I should maintain strong focus. In actual practice, I need to actually write down what that focus is and refer to it constantly to make incremental progress. Without writing it down, I can’t see what the incremental progress would look like, let alone remember where I was before I was dazzled by some tangential thought. If I also don’t have enough rest, or am bored/annoyed by the incremental task in front of me, then this is a test of my willpower because I am at risk of letting the side thoughts hijack my fleeting moment of clarity in direction. I find that I have to put myself in a very short-term “experimental” mood to get through it, harnessing my desire to document or clarify crappy processes as a short-term reward that I think has true value once I post it somewhere on my blog so I don’t ever have to remember it, and that other people might benefit.

    If I can shake my annoyance and frustration with the task chain and get pulled into it, then concentration isn’t a problem. I guess this is “hyperfocus”, or maybe it’s just regular concentration for people. I feel like I’m being productive when the concentration feels intense and I am not pulled away by other thoughts. My entire world is what I am doing, and I am like a bodyless brain floating in the problem space. I’m knocked out of this state when something blocks progress, or if I am reminded of some future responsibility like a meeting or a deadline. Deadlines I find very distracting mentally, as are meetings, because I take responsibilities perhaps too personally, and maintaining positive relations through following through with promises consumes huge amount of my mental energy. Which is why I have to be careful about making them, and i make as few promises as possible. Each one is like a big lead weight I have to carry around with me.

    “I have too much I want to do!” sounds very familiar, too…I am thinking this all the time. I have been pretty zen about it lately, figuring I’ll get to things as I get to them if I allow myself the play time and not worry about things not getting done or completed instantly. I wonder if this is a coping attitude I developed, as the alternative is to feel terrible about what potentialities have gone unrealized? I know that there’s something MEANINGFUL and BIG that I keep sensing deep in my subconscious, something unrealized, some itch that I want to scratch. However, what I have achieved in my life hasn’t come from the direct pursuit of it, but have been side effects of pursuing other interests for other people. That is the most frustrating part, I suppose, when I let it bother me. But instead of feeling bad about it, I try to align my available forces to push more more in the direction I think I need to go in.

  10. David B 5 years ago

    David

    I love your posts as I spent 47 years a bit like you. Whatever the psychologists call it, I call it high functioning inattentive ADD. I had systems for everything, passed exams without having recollection of being taught anything much (I found systems to cram the knowledge in at the last minute by finding underlying structures not just in the knowledge but in the questions that were asked in the papers), I was called a rebel, a maverick, I questioned everything, couldn’t be satisfied unless I understood it. Managers liked my ideas (which they stole) but not my general negativity. I saw all the problems and solutions and expressed them with political naivety.

    Many times and in many different jobs (because I found them all boring until I could justify to myself something important and unique I could contribute) I was told “your work is great but we needed it last week”, yet I had typically done the work in a 3 day frenzy , after spending 10 days just trying to organise myself and getting distracted by pointless side issues.

    I started to complain to doctors about brain fog and distractibility and they had no idea what I was talking about, sent me to counselling, gave me antidepressants (brain fog worse, sleep better, but the spice taken out of life).

    I began to realise that other successful people didn’t have all these systems, alarms, listen to white noise on headphones, wear ear plugs in open plan offices etc. Somehow they just sat down and did stuff. 4 or 5 things a day, and chat and make coffee. I took over a maternity position once and I found her projects in a complete state of disorganisation (only she was a well regarded high flyer). It took me months to get them into order as I saw it and nearly worked my self into a nervous breakdown trying to manage and reorganise multiple in progress projects so that I knew what was going on. Plenty of my ideas were taken up later but the work suffered and I rattled everyones cage at some point. Getting things done seemed to be so difficult compared to working out the simplest and right thing to do.

    Once the internet came along and everything got worse, too much information available to my constantly seeking mind. Productivity go worse as I searched for data and learning before even launching into the simplest of tasks. I lost jobs, set up on my own, had to seriously address my lack of productivity and distraction and sleep and all sorts of things. I think I became an expert on all things related such as diet and sleep and exercise, Sugar and coffee are a problem, alcohol is a problem. They all subtly effect sleep, concentration general well being and I had no buffer to them unlike others. (An aside – my whole university sport social life was spent trying to avoid drinking. Others would drink many pints on an evening and work the next day, no problem even with hangovers. I would wake up as if I had not slept at all and the next day would be a wipe out, maybe even the one following).

    After years of just wondering why I was not progressing with my life or anything much. I put the data together and went to the doctor, was referred to a psychologist who did not even understand the difference between ADD (inattentive) and ADHD. His boss agreed to see me and said I was depressed. I told him I could walk out of this and have a brilliant day walking in the countryside, taking photos, cooking. But my house is a mess, I haven’t sorted out bills, spoken to my Mum for months, started a paid project all of which I know are high priority. I am mad at myself for not starting important tasks and ruining relationships. Any depression is a result of that and that is probably ADD. He reluctantly refers me to an Adult ADD research project who diagnosed ADD just based on my letter of evidence alone.

    I resisted medication by eventually settled on slow release ritalin (Concerta). I sorted out my concentration issues immediately and brain fog.

    I went to an adult ADD support group and although some people have very different forms and educational experiences, enough adults had eerily similar life histories such that I thought my whole life has been a coping mechanism for low dopamine.

    Bad habits die hard but the Concerta helps me get tasks done and maintain my relationships better. I am on time and generally sleep better and even have sex better. I now have a framework for how to organise my life and what I can and cannot do.

    Its the start of different kind of life, and I don’t have to miss out on the beautiful feeling of really researching and understanding and mastering a subject. I just stop taking it at weekends and holidays and save dopamine boosting things like exercise for when it wears off, which is a danger point as it feels like a really sad feeling laced with anger and a short temper. But I had enough of those any way periodically when i had to carry this disability alone.

    Good luck. Its worth checking out.

  11. Alice J. 5 years ago

    You should check into the possibility of a vitamin deficiency. I’m 30 years old and I just found out I am deficient in B12 due to mal-absorbtion problems. My “fogbrain” along with reoccurring infections and eczema all went away once I was treated with a B12 shot every two weeks and sub-lingual tablets. I’m not a vegetarian so it was not the first thing my doctor thought of. Here’s a link for more info: http://www.health.harvard.edu/blog/vitamin-b12-deficiency-can-be-sneaky-harmful-201301105780

  12. Briana Pierce 5 years ago

    I know this comment is coming a little late, but I just stumbled into the Fogbrain posts and had to share!!

    I also deal with Fogbrain/ADHD inattentive type, as well as some other issues including Hypersomnia (basically being tired ALL THE TIME). In my quest for solutions and understanding, one of the tools that has been most helpful is DNA! 23andme.com offers a $99 test that offers all sorts of useful information (though you have to know where to look)… Long story very short, there are a handful of genes that seriously impact neurotransmitter production – and there are amino acids you can take to fix it. Additionally, diet is so, so, so important – much more so than we usually think about!

    I keep meaning to get a blog post up, but in the meantime, please feel free to email if you want more info. Fun stuff!! :)

  13. Author
    Dave Seah 5 years ago

    DavidB: Wow, thanks for the detailed account. It sounds a lot like me in every respect. As I get my health stuff in order, I’ll see about this.

    AliceJ: Interesting! I have been experiencing weird tingling sensations, though I’m not a vegetarian. WIll keep that in mind!

    Briana Piece: Very interesting! I’ve taken a DNA test with another company, but it was years ago and I’m sure they are more comprehensive now (and maybe cheaper!) I have been feeling VERY BLAH lately.