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Q&A Part 3- Max debunks things
528 Plays2 months ago
Another Q&A in which we cover food, laziness, reflexes, the gutbrain, food again, and medication breaks. It gets deep, it gets philosophical, and Max briefly sings. Check it out!
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Transcript
00:00:07
Speaker
Right, hello. Welcome to the ADHD podcast. um I'm Max Davie. I'm Tess Davie. I've got the format just about right after 18 episodes. um And today we're doing a Q and&A episode. So our final for now episode of Q and&A from the pet Facebook ADHD UK followers, um but with one cheeky little one from our new Facebook group, which we're plugging, the ADHD Science Podcast Facebook group. So a cheeky question at the end from Jamie from that group. I think you're really running with this cheeky thing, aren't you?
00:00:45
Speaker
Yeah, maybe I should use a different adjective. I think you should. Yeah, okay. Excellent question, Jamie. We're going to get it but we get get to it. um Okay? I'm good. Yes. Because I've grabbed you to today, Tess, because it's the first last day before you become full-time employed. I know. Everyone wish me luck. I have no idea how that's going to go. Yeah. It's going to be tiring. That's what full-time employment is. That's my prediction. Let's jump into the episode. Yes. Jingle time.
00:01:14
Speaker
Just a quick warning for anyone who struggles, who is triggered by anything to do with eating, binge eating, that's going to be mentioned quite a bit during the course of this podcast. So if that's something that bothers you, this might not be the episode for you. But yeah, we'll get into that now. What a jingle that was. mate Amazing. Let's go to our first question, which I quite like and you just told me that you're excited for. I'm so excited for this question. Is laziness a thing or is it actually neurobiology?
00:01:40
Speaker
So I think this is the best question, because it kind of goes to the heart of this whole thing about, are we just brains? And if we're just brains, why does anything matter? I was going to say, isn't everything neurobiology? Yeah, everything is neurobiology. Unless you agree, unless you believe in an immortal soul which floats separate to your brain and controls it. No judgment if you do. No judgment if you do, but it doesn't make any sense scientifically, that belief.
00:02:08
Speaker
um if If you accept that that's not literally true, it can be metaphorically true and that's fine if you think that the soul is a sort of thing that's important to you, but it doesn't actually literally exist, that's fine. But basically, if you if we are all neurobiology, then basically that causes a huge problem for free will.
00:02:28
Speaker
Yes. A huge problem for the idea that as human beings we make decisions and we have the appearance and we all feel like we have free will, we make decisions for ourselves. This is very philosophical. It's very philosophical. It's actually the problem of free will which is a big problem in philosophy.
00:02:46
Speaker
yeah however However, we don't need to get deep into that. all The point is, if we accept that we are just neurological bags of neurons and um neurotransmitters and we're just that,
00:03:03
Speaker
that's fine at one level that's true but if you only think of that level there's no such thing as laziness yes there's no such thing as laziness there's no such thing as love there's no such thing as affection there's no such thing as decisions or any anything that gives life meaning and i mean even saying that you would be making the decision to believe that so yeah in a way it kind of disproves itself Yeah, so I think we need to have a concept of laziness. I was going to say loneliness. It's getting a bit too... No, no, don't worry. We need to have a concept of laziness because otherwise choosing to do something when it's hard would have no meaning at all.
00:03:46
Speaker
What do you mean by that? So we need to know that there's two options. We can either be lazy and stay in bed or we can get up and do the thing we ought to do. We need to have the appearance that there is a choice there. yeah Therefore we need to have the concept of laziness existing so that we cannot be lazy sometimes and be lazy other times. yeah If there's no choice there's no such thing as laziness. If there is choice then one of the choices is whether to be active or whether to be less active and that's where laziness becomes. My question is how would you define laziness? I don't know that you have to. I don't think you necessarily could come up with a um ah definition which would which would please absolutely everyone but the point is you need some concept, laziness is a concept that I think is inherently about choices.
00:04:41
Speaker
Right. If there are no choices, that doesn't mean anything it doesn't mean anything to be lazy. I'm still trying to wrap my head around this to be honest. So essentially, free will exists or it doesn't? Yes. Well we have to believe that free will exists. Laziness can't be a thing if free will doesn't exist because laziness is a lack of decision making. Yeah, it's a choice to do something lazier rather than something more active.
00:05:08
Speaker
So is it neurobiology? Yes and no. Great. Spoken by a true graduate of a philosophy degree. um Yes, yeah it is. No, I think functionally laziness has to exist for a society as a concept for society to function. We live in a society. I agree with that. Therefore, laziness has to be a thing. I think if... Go on. No, I'm sorry. I um i think if we didn't...
00:05:35
Speaker
um acknowledge that people do have, well in my belief that people do have free will or at least treat it as if they did, yeah then nobody would be accountable for their actions. Exactly, exactly right. And yes we need to, I mean obviously this this question comes with all sorts of complications such as looking at like you know in ADHD there is exactly dysfunction and the differentiation, whoa, differentiation, differentiation? Yep, cool.
00:06:00
Speaker
I think I just said the same thing three times. Yeah. The differentiation between executive dysfunction and laziness and obviously what we're not going to sit here and do and say we need to hold people accountable for their the the symptoms that their condition has caused them. No. That's not what we're saying. Laziness I personally believe is a thing and it is a thing that people do need to be held accountable for and whether or not we have free will and the whole of life is a simulation we can't just sit back and go, oh, well, damn it. I guess I'm just gonna have to be lazy forever. Lie in bed and eat biscuits all day. Oh, I love that. I know, it is great. Does that make sense then now? Now that you've kind of... I think so, yeah. I hope that we've provided a good enough answer for this because it's... I think it's been very confusing. It's very, very... But essentially... It's a deep question. Ethically laziness has to exist, otherwise we'd all be doing it. Yes.
00:06:57
Speaker
Okay, second question. How do ADHD and hypermobility relate to each other? What is hypermobility? So hypermobility is really where your joints are more lax. So if you think about the way your joints move, some people's joints relatively stiff and only have a small amount of movement. If you've got hypermobility, your joints will have greater range of movement. So like double jointedness? Yeah, like double jointedness is similar. So one of the classic measures of it is how far, if you take your thumb and try and pull it back towards your forearm, how far that will go. And if you can do it while the dog is also
00:07:39
Speaker
Looking your thumb gives you extra points. The dog is here um Yes, so neither of us are double jointed or hypermobile or whatever They are related in that hypermobility is a common feature of people who are also neurodivergent in various different ways. Yeah, I mean, this is a lot more of a biological question, isn't it? Yeah, so it's simply that more people with ADHD are hypermobile, more people who are hypermobile have ADHD. There isn't anything else to this question, but that is the answer.
00:08:13
Speaker
I mean, if you if someone was to ask you why? Well, I think that's a really good question. I mean, it sort of broadly, it links back to ah our discussion of ADHD and autism and the connection between those two, which is broadly speaking that a similar set of genes tend to cause both ADHD and autism. And one of the things we're definitely going to get onto today is the fact that autism is just a cluster of symptoms and isn't a single thing.
00:08:40
Speaker
Yes, and that's the same for a lot of conditions. The same for a lot of conditions. And so is, um, I don't quite remember what the word is, but is, um, hypermobility, is that, is it etiologically heterogeneous? Is that the word? Etiologically heterogeneous.
00:08:57
Speaker
is Okay, and that means it's caused by multiple genes, right? Caused by multiple different things. Different things. Yes, so it's not a single gene that causes hypermobility. Not a single gene, it's multi it's multigenetic, um polygen polygenetic. Yes, that's the other one. Multiple genes can cause it, but also it's only a finding. It's not a diagnosis in itself. There are lots of underlying diagnoses that include hypermobility, so one of the ones that's most talked about in the community is Ehlers-Danlos. What's that?
00:09:26
Speaker
which is a ah disorder of you the connective tissue within your joints. Now at its most the type 1 and type 2 Ehlers-Danlos are quite severe conditions but there is some talk about and this is slightly controversial in medical circles, but there is some talk about type 3 elastin loss which is associated with hypermobility and double jointedness etc, which can cause some difficulties, but it's controversial as to what the criteria are for that.
00:09:57
Speaker
Okay, that kind of makes sense. So it's not like the hypermobility gene, it's one of the genes that causes ADHD. Essentially they're just both caused by a bunch of stuff and sometimes those things overlap. Yeah, like exactly right, exactly right, in the same people. Cool. Thank you. yeah Moving on.
00:10:19
Speaker
Question number three. Retained reflexes. Is it an actual thing and do exercises help? Again, what is that? This is a weird one, and I think this episode could be subtitled Max Debunks Things a Little Bit. um And this is the beginning of the debunking. um i So wrote primitive reflexes are the sort of weird thing that babies do. So if you put your your knuckle against a baby's cheek, not that you would necessarily do that. If you punch a baby. No, no, as in you just gently stroke the baby's cheek with your knuckle, the baby will turn their head and try to latch on, try to
00:10:58
Speaker
like they were breastfeeding or whatever if you put if you um if you drop a baby backwards again don't do this at home kid if you if you were to drop a baby backward they would throw their arms out in a kind of parachute it's what's called a parachute yeah reflex and if you give a baby a lemon they squeeze their face up all funny ah Yeah, and that's not really the same, but I know there's a set of primitive reflexes yeah which are um present in babies and go away over time now okay that way yeah they go away over time. Now, there is this theory among some physiotherapists that people retain these reflexes
00:11:41
Speaker
in an altered form, and that's crucial. They don't retain them in in in exactly the same form. They retain them in some altered form, and people who, and therefore the somehow, this reflex, if you can dull these, these reflexes underpin some of their, some of these people's symptoms, such as ADHD, autism, whatever, and if you can reduce the these retained reflexes,
00:12:08
Speaker
then you will lessen their symptoms. Now there's nothing that I cannot find any scientific evidence for this whatsoever. Yeah it feels a bit strange the idea that an instinct to breastfeed makes you autistic. I mean obviously that's a very simplistic way to put it. It's a deeply odd, I find it a deeply odd theory and I really don't buy it.
00:12:30
Speaker
i Think what they're trying to do to say I think there's always a kernel of truth within these things I think the kernel of truth within it is that people with autism ADHD neurodivergent people have unusual Responses to the sensory world have unusual responses to anything being to touch and to movement and that's true But it's not the same as you still have these reflexes from when you were a baby. It's just that you are either sensory sensitive, sensory high, sensory seeking, or, you have you know, all of these very mainstream concepts from occupational therapy that we talk about all the time. When you say that the reflexes are reformed, what can that, like, look like? Well, i've I've read the list and it doesn't even make any sense to me. It sort of reads to me like, oh, this is a sensory sensitive person, or this is a sensory seeking person. OK. So I think they've just cast perfectly everyday stuff
00:13:27
Speaker
as What I mean by perfectly everyday stuff is the sort of stuff that our OT colleagues deal with all the time and cast them, called them something else, and then put in place exercises that might actually not be terrible, you know, they're not a terrible idea because that's how you deal with sensory needs. I mean, essentially, it's an explanation for common symptoms of both disorders. Yeah, but it's not an explanation that actually holds any water. Okay.
00:13:56
Speaker
I'm still a little confused, what is it about, I mean obviously I'm asking you, you don't believe in the theory, yeah what what is it about ADHD and autism that means that they retain these um reflexes or is it more of a like if you have um These reflexes you're more likely to develop symptoms. Is that I think I think no I don't know and that's the problem is that there's a they sort of claim an association There's not really any evidence for the association and they don't really necessarily They use words like the links the two sort of a linked and that the word linked is used a lot and doesn't really mean anything and
00:14:34
Speaker
Doesn't suggest which way around the causation runs um So it could be either and I think it's often kept in people who write about um Retained reflexes. It's kept deliberately vague because they don't know. Yeah, okay second part of the question. I feel like we should address. Yeah um Do exercises help? Well, that's I suppose what I was saying I mean some of the exercises might help but not It's like, if you give a medicine, which is not, but not treating what it is that you're, is actually going on for the patient, that happens to help because it's treating something slightly different, then yeah, it will help, but you're not giving the right medicine. I mean, what kind of exercises do they do?
00:15:16
Speaker
Well there's all sorts of kind of repetitive stuff. it's it's um It's fairly standard stuff around like um moving and and exercising and it's kind of lots of yoga like things, things borrowed from yoga. it's ah it's ah it's It's a bit of a grab bag of different kind of physical exercises. not necessarily like running, but more the kind of you know moving your body repetitive in a repetitive way to kind of train your body to, I don't know.
00:15:50
Speaker
be a bit more sensitive. And, you know, exercising your body and moving your body into particular places is of benefit because knowing where your body is in space is is helpful just generally for everyone. Exactly. And the meditation and the root and the but kind of having to do something and having a routine is all helpful stuff. It just doesn't have to be this exercise. One of my problems with a lot of these therapy the sort of means of therapy that are adopted by some some of these professionals is that they say they seem to suggest if you don't do these exercises it won't work and actually the point is you do some exercises. You do you spend some time doing a thing which is about your body every day and that's probably of benefit. Do you see what I mean? Yeah, so to answer the question, retained reflexes is it an actual thing
00:16:42
Speaker
He thinks no. I think no. I think it doesn't have a clear enough definition to even begin to answer that question. Yeah. Um, and do exercises help? Yes, but maybe not because it's a thing. Yeah, exactly. Very good. So our next question is more of a statement. So I assume you just wanted to ah just talk about it a bit. Yeah. Okay. So ADHD and binge eating slash emotional eating.
00:17:06
Speaker
Yeah and it sort of depends what we mean by binge eating and emotional eating but you know to an extent all and all eating is emotional eating. um um eating you hear that So depending on how you define emotional eating we don't just eat in order to be full we also eat because it gives us pleasure.
00:17:29
Speaker
yeah and it is an ah opportunity to spend time with other people. So to an extent all eating has an emotional component to it. Yes. I think emotional eating which becomes pathological is when you are eating unhealthily or too much because you feel sad. Yes. And at some level you hope that it will make you feel happier.
00:17:54
Speaker
But it can also manifest itself in, if if you're experiencing specifically an ADHD, if you're understimulated, like if you're watching a movie and it's kind of boring and there's a whole box of chocolates there, you're going to eat them, you're going to eat all the chocolates.
00:18:10
Speaker
because it really just adds another level of sensory experience. Yeah, so I wouldn't call that emotional eating, I would call that eating as a scent as a sensory snack in a sense. Yeah. People talk about sensory snacks um for a sensory diet for people with ADHD quite often because as we've talked about just now,
00:18:29
Speaker
people with ADHD often have an unusual sensory system and if you have it's like movement breaks or it's like fiddling or fidgeting it's just little snacks that can give you a little sensory boost to keep that gap between yeah where you like to be and where you are. It's the most literal definition of a brain snack exactly it's just having a snack but it isn't just it is so it's definitely true that eating the the the the the experience of eating is a sensation that will feed your brain in a sense there's sort of
00:19:04
Speaker
differing opinions about whether if you have a sweet thing, that's more likely to then stimulate you and give you a bit of a high. I think there's some evidence, some people are very kind of dismissive about the idea of a sugar high in ADHD. Certainly for non ADHD people, the thing about sugar high doesn't really exist. But for ADHD people, I think it is plausible that that is part of what's going on. Certainly a people with ADHD, kids with ADHD often have a very sweet tooth. I mean, this might be a bit of a sidetrack, but is is a sugar high actually a thing?
00:19:37
Speaker
Well, that's the thing. For non-ADHD people, for neurotypical people, it's not it's really not really. I mean, you may feel a bit different. You may feel a bit sick if you've eaten lots of sugar. But the actual sugar high isn't the same. For ADHD people, it's a bit less clear. For adults, it doesn't seem like... um I mean, how would you describe it? How would you sort of talk about it? But I think it's fair to say that ah the adults and children with ADHD do seek out sugar.
00:20:05
Speaker
And thats there's something stimulating about the experience of just having had some sugar. Okay. may so So that's overeating in terms of stimulation. Yeah. What do you think the link is in terms of emotional eating we were just talking about? Well, I think, you know,
00:20:21
Speaker
Emotional eating and and and and we kind of bring in binge eating I think to an extent here is is eating which is not which is primarily for emotional reasons when you feel really low and you are feeling really bad and you are using eating Partly as an as a stimulation, but also as an escape so The same is true of all sorts of things exercise can be escaped movies can be escaped eating can be an escape because you have this sense overwhelming sensory Experience that allows you to then just forget your distress um And so I think
00:21:02
Speaker
And I think that feeds on itself almost the more intense the experience comes out and the fuller you get or the more kind of slightly, slightly sick you feel because of whatever you're eating almost feeds on it because you want to see how far it goes. And that's a very ADHD thing is that thing of pushing things further and further to get more and more stimuli. So um I've heard a lot of people describe ADHD people is having a more intense emotional experience. Do you think that that has some sort of link to this? Yeah, um undoubtedly that's part of it. um People with ADHD tend to have more difficulty regulating their emotions. Okay. And so that's obviously connected. Those are positive as well as negative emotions. That's the other thing that's really important. You know ADHD joy is more intense as well as ADHD stress. So yeah, I think that's the final piece of the puzzle already here is you've got the sensory aspects
00:21:55
Speaker
you've got the kind of sensation seeking aspect and then you've got the fact that you are more likely to have very difficult emotions that you need to deal with. I found another piece of the puzzle under the sofa. What's that Tess? Impulsivity. Impulsivity, thank you. Excellent. And there it all gets together and you can see why the relationship with food can be difficult. And so is that that just all falls under the umbrella of binge eating or is binge eating a separate thing?
00:22:20
Speaker
Binge eating has got a clinical definition, but for our purposes, we'll just talk about overeating and emotional eating because I don't want to get too deep into that. Cool. gut brain and how food affects our development so now we go go on what is gut brain so sounds like the worst marvel comic superhero in the world gut brain is here to get you spider-man you can definitely get a spider-man villain um those are the the the lamest although spider-man is the best um agreed so
00:22:53
Speaker
the gut brain so it comes from this really interesting observation that the gut has got lots and lots and lots of neurons so we talk about neurons a lot the kind of nerve cells and the gut has a very very very intense um and complex set of neurons which govern its function so how fast it goes you know, regulating all of the different hormones and and things that break down your food, how much is absorbed, all of those things. And there is an there isn't a relationship between your emotions and your gut. We know this. So that your emotion you know we've known this for hundreds of years that, you know, when your emotions are heightened, your gut is going to be affected by this. you might It might be more active, you might produce more acid, all of those sorts of things.
00:23:41
Speaker
so that it's very literally a brain in your gut like a little well well not exactly a brain exactly and this is the point is that it's often therefore thought that there's something sophisticated about i see neurlog the neurology of the gut and I just don't think we have that evidence so one of the things that it's kind of gone on to say is that therefore because there's lots of neurons in the gut therefore what you eat somehow feeds back into your developmental progress Well, I mean, it's definitely true that if you don't get enough nutrients and proteins and stuff, you won't grow as well. but Yeah, doesn't so you won't grow as well. I mean, I think, obviously and obviously, if you starve someone of absolutely vital ingredients, you know, if they if somebody is starving throughout their childhood, that will affect their like their final the final effect of their development, you know, the final outcome of their development.
00:24:38
Speaker
But what is startling is how good the body is as it grows up. If you think about people growing up in very resource-poor environments like refugee children or children after natural disasters who may have very little calorie intake, it's astonishing that they may end up quite small, but their neurodevelopment is often unaffected by that.
00:25:04
Speaker
They may be traumatised, and that's another thing, but they their neurodevelopment will not be necessarily affected. That's strange because I remember reading a lot of articles as part of my sociology course about how a poor diet can severely affect a child's education. do you I'm not really convinced by that, to be honest with you. It depends on what you mean by a poor diet. So often a poor diet in kind of Facebook terms, in kind of, you know, right you know what I mean, kind of Instagram terms, is a diet which is too full of, well currently people are talking about ultra processed foods. I'm not talking what you do eat, I'm talking what you don't eat.
00:25:42
Speaker
But what does that mean then? So not getting enough vitamins, I mean this isn't my topic of expertise, not getting enough vegetables, you know? Yeah, I know I think, it's great to eat more vegetables, don't worry. Remember that, everyone at home. They're really really good, they're lovely and they might, they probably are helpful but I think we can go too far in saying that a not great, but not disastrous diet yeah is harmful. So if you have no vegetables at all throughout your entire life, and in fact it doesn't even matter if you've got no vegetables, if you have no vitamins at all, you will develop a vitamin deficiency. So you will develop scurvy, or you will develop all of the other vitamin deficiencies. But we don't see that in, even in kids who have got really quite,
00:26:33
Speaker
restricted diets. A lot of autistic kids, for instance, have got very restricted diets. They will only eat Weetabix, Turkey Twizzlers, you know, and Happy Faces, you know, the kind of potato, whatever. And they, and went anything else. And somehow they don't get these extraordinary, you know, these amazingly horrible vitamin deficiency. Well, how's that happened then? Because where have the vitamins come from? Because a lot of these foods are, have got vitamins added to them. So breakfast cereals and other things have got vitamins added.
00:27:04
Speaker
so Yes, ideally, every everyone would eat a fresh freshly cooked, you know, ah broccoli and... I don't know, you love broccoli. God, I only love broccoli when he makes it. I am the boss of broccoli. It's really good. um you know Obviously, it's great food, it's brilliant food, but I think we need to be careful that if people fall short ah of and often quite difficult to attain standard that they feel awful about it and they feel like they're doing hard to their children. Yeah, I mean that's the last thing you want to do, is especially if it's economic cause. It's also not true, I mean the the evidence that if you have slightly lower
00:27:46
Speaker
Vegetable intake your that's going to cause you to have poor and neurodevelopment just doesn't exist Okay, so to return to the question how Gut brain and how food effects out of I mean, it's it's not really a question. So it's it's hard to land on and I think the answer is within a broad range of broadly healthy food as in a diet which is not going to cause you major deficiency either of overall calories or protein or major or you know fat or major food groups and has got a a sufficient amount of vitamins in it to not get you into deficiency states that is almost every diet in the UK the answer is no there is no there is no connection.
00:28:33
Speaker
Okay, and what would you define the gut brain as if I asked you to give a simple definition? Well, I don't know that I would necessarily. I think the gut brain, as far as I understand it, is the innovation, so the nerves which connect to the gut. But it's not a brain in any meaningful sense, so I sort of reject the question because it isn't a brain. It's just a set of nerves that carry signal to and from the gut. They're really important, but they're just not a brain. We've got nerves everywhere haven't we? We've got nerves everywhere. The foot brain. The foot brain? Exactly. Some people have got a foot brain. It's got a foot brain. Bakayo. Bakayo is Saka. Yeah. You watch it. Him man. Alright. No, he's very smart. He's very smart, but he's also got a foot brain because he's so good at football. That's what I'm saying. Okay, right. Cut this bit out.
00:29:25
Speaker
If you loved that last question about guts, you're gonna love this one. Just you waste! Get to spooky season, guts everywhere, who's ready? What is the relationship between ADHD and the gut biome? So once again we have to define something. Did they just add that to Minecraft? What is the gut biome?
00:29:44
Speaker
They may well have done, I don't know. um So the gut biome is the set of organisms which are in your gut. Right. So they are important yeah in your gut function. um So if you have the wrong set of organisms in your gut, you're more likely to have irritable bowel, you're more likely to have constipation, you're more likely to not tolerate things like, you know, not tolerate various foods. Yeah. That's fine.
00:30:11
Speaker
That again, in the same way that the gut brain thing has kind of become a little bit, carried people have got a bit carried away with it, yeah people are currently a bit carried away with the importance of the gut biome. The idea seems to be that if you have the right organisms in your gut, then somehow that will make your brain work better because it will allow you to get the right to not have toxins in your system, which is ah always a red flag for somebody talking nonsense, um or to ah have the right sets of nutrients. But we've already just said that actually the tolerance of the brain for levels of nutrients is really, really wide in terms of neurodevelopment. So it doesn't, I don't, again, it's another one, it's another max debunks. I don't think the gut biome has any direct a direct and um influence on your ADHD.
00:31:04
Speaker
okay so what is the argument for this thing well Sorry, I know this is your least favourite bit. i I just don't think there is any. I mean I think that there are kind of, you know, the case study of somebody who has ADHD and goes to a nutritionist who will give them some probiotics and that will somehow um change their gut biome and their and and they to go away and feel better.
00:31:37
Speaker
and to Just to take a step back from my um skepticism about this overall thing, there is quite a lot of there is quite a lot of studies that have come from, actually, interestingly, a lot of studies from Iran for some reason, into giving probiotics to children. Isn't there a lot of pride probiotics in yogurt? Yes, exactly. For example, lactobacillus and stuff. And does that make their ADHD better? now The evidence is really hard to make sense of because everyone gives a different amount of probiotic to it at a different time and a different dose and different over a different period to a different age group. So it's almost impossible to interpret. there's this whole kind of I've read a ah kind of whole systematic review and I'm like, you can't put these things together because they're totally different.
00:32:24
Speaker
It's okay. um So it doesn't, I really found it very difficult to make sense of, but yeah yes it's plausible that there might be something going on there, but I don't think it's your ADHD itself, it's just that if your gut is more healthy you feel better, yeah so and therefore your behaviour is going to be better and your wellbeing is going to be better. What kind of effect can your gut biome have on your behaviour?
00:32:43
Speaker
Well, i i I don't think it has a direct effect. I just think if your gut is functioning better, you just feel happier. You just you get through your day better. You've got less pain, less discomfort. I think i think that's mainly what it is. So it can... it can I'm just wondering if if this like link supposed link could be caused by... I mean, again, it's that thing of maybe this is affecting symptoms not because it's affecting the ADHD but just because maybe you're restless because your stomach hurts. Yeah exactly. And then people are like oh they're less restless when their stomach doesn't hurt so that means that it's interacting with the ADHD when actually it may have just interacted with the fact that your stomach hurts. Exactly and I so I'm really skeptical about the idea it has a direct effect on your ADHD symptoms however the jury's out there is lots of research out there I just can't really make sense of it at the moment.
00:33:34
Speaker
that makes sense so eat well if you can not sure how it links to ADHD we don't know but don't buy lots of expensive supplements speaking of okay this one's a mouthful so bear with me nutritional neuroscience behind good foods to aid in brain health and what foods cause brain fog for ADHD individuals I feel like we need to break this this one down. We have to break this one down. yeah Okay. So what are good foods to help people to have better brain health? Yes. And I think I've just sort of hammered this, but there really aren't good foods that directly will affect your brain health. That doesn't exist. What about fish? Fish oil. Well, exactly. But again, the evidence is not great. So people give essential oils, fish oils to kids who have ADHD and the evidence that it actually helps is not great.
00:34:27
Speaker
ah fish I think you should eat fish because it's delicious. yeah I don't think you should eat fish because it's going to make you cleverer. Well, no. I mean, I think that's a very that's a primitive way to look at it. But i mean I mean, surely there is a possibility that the type of nutrients that you are putting into your body, because they are essentially chemicals, yeah can affect the other chemicals it could that are in your body. It could. But we just don't have good evidence for that at the moment. one of the things that nutritional So a lot of the nutritional industry, and it is an industry, is based on supplements, based on giving supplements. And a lot of the supplements market themselves as boosting your dopamine levels.
00:35:05
Speaker
right Now the idea is that ADHD is at some level some kind of dopamine deficiency. Okay. And this doesn't make sense in a number of ways. Yeah. Can food direct, can like supplements boost your dopamine? People claim that it can, but there's no real evidence that it can. I mean, you can prove it through placebo. You can be like these vitamins will give you placebo and make you happier. Yeah.
00:35:28
Speaker
if you really love these vitamins it will boost your your dopamine because you'll be happy when you eat the vitamins. So i've got in a minute I'm going to lay out my scepticism and then I'm going to put a bit of a caveat on it. So my scepticism is there isn't any evidence that you can boost dopamine using food. yes Equally Just generally increasing the amount of dopamine in your brain doesn't necessarily make sense as a strategy. Why yeah why would it matter? It's like, ah the way I see it, if you're dyslexic, you haven't got a lack of words. You've got a lack of having the right words in the right place. so Dopamine is probably important in some of the pathways that drive ADHD behaviours within the brain. That's not the same as just saying, oh, let's boost dopamine.
00:36:12
Speaker
Yeah, because boost dopamine implies that you're giving the body more dopamine, which isn't the problem, because when you look at, um is it anti-psychotics? Don't mess with dopamine. They are blocking the re-uptake, so you're not getting more dopamine, it's just there for longer. Yeah, exactly, exactly. So it's much more subtle than just generally increasing dopamine. Yeah, and i I'd be quite surprised if there were anti-psychotic vitamins.
00:36:37
Speaker
effective suppressing your re-op to Well exactly but that I mean I don't think the nutritionists would go as far as saying we can treat schizophrenia with this well no that's But they said they go as far as to say we can treat ADHD with this stuff Yeah, so I'm I don't think I don't think it's great to be honest But let's just have a little segue into what brain fog is and what it means.
00:37:00
Speaker
really quickly i just i'm struggling to before sorry i know this is going to take us on a tangent but that's okay i'm genuinely i'm struggling to wrap my head around the fact that for example a diet of strictly you know cereal in the morning uh-huh sandwich for lunch yeah no veg in the sandwich no and then you know takeaway for dinner is going to lead to the same uh efficient well the same is efficiency the word the same it's certainly there's lots of ways in which that's not a good diet yeah i know but i'm i i just yeah i mean there's definitely a way you can edit this to make it more smooth sure i struggle to wrap my head around the fact that a diet like the one i just described would be as as good in the simplest way of saying it for a developing brain as you know
00:37:51
Speaker
you have yogurt for breakfast and then you have a really healthy sandwich instead of the one I was just talking about and then you have fish for dinner. you know i don't well i think That's just something I'm struggling to wrap my head around, I'm not saying that you're not correct in it. No, I think i mean i think i think we've got to come back to the fact that we don't know we don't know what what diets are good for brain development or other or not. And then there's the fact there are other reasons why food might be better or worse than each other. Yeah. so I mean, it's obviously it's a very, I keep saying this, but it's a very primitive way to look at it as like good food and bad food. Yeah, exactly. So, you know, that you mentioned takeaways. There are lots of reasons why takeaways aren't a great idea as a diet. I mean financially. Financially high in sugar, sat sugar salt, and fat. You know, those are objectively bad for you. You don't necessarily need to bring the brain in.
00:38:41
Speaker
to To say that a diet based on takeaways is a bad idea Yeah, but do you think that certain diets can interfere with brain development? I know that this is a question that we've kind of been around for the past I know I just I think yeah, you know a extremely restrictive diet which which robs you of vital vitamins and essential essential um nutrients yeah could but most but the body is astonishingly good and compensating for what on the surface is not very good diet.
00:39:18
Speaker
Yeah. So you do you think that the effect of diet on brain development is overstated? Massively overstated. Okay. And do you think it, I don't, I'm just throwing this out there. I don't know if, do you think that the brain can like prioritize this brain development when it comes to resource allocation? That's exactly right. If you go back to the kids I was talking about who's grown up refugees in the aftermath of a natural disaster, let's say both of those things, it's astonishing how little effect there is on their overall intelligence, for example, even though they've been through all of this stuff. I mean, on an evolutionary basis, our intelligence as a species has been what's led to our success, so it only makes sense that that would be what the brain would prioritize. Exactly right. In a resource allocation. Exactly. Yes. Okay, now we can move on to the brain fog thing. That makes a bit more sense to me. Great. It's relevant though, because I think that there is genuinely a
00:40:10
Speaker
You know, it may well be that certain foods do make you feel a bit rubbish. Right. Because they make you feel bloated or they make you feel, you know, you just feel sick afterwards. But do you think that's more of like an emotional thing than a direct impact on the brain? It could be both. I mean, I don't think that's necessarily just, I'm not sure that mean not so there's necessarily a distinction. There's not really a line between that because as we said in our first question, everything is the brain. Everything is the brain.
00:40:36
Speaker
Um, so I think, you know, yes, of course it could be a bit of both, but I think brain, you know, Brain fog is a really hard term to define, but I think that obviously it's it's to do with the fact that you can't get to where you want to be. You can't function in a way because your brain feels, you know, the the the most obvious reason why you might have brain fog is you're just too tired. yeah Okay, so let's bring that back to food. How will food give you a similar feeling to being tired?
00:41:08
Speaker
i Would say it's having eaten too much and therefore, you know, your your natural tiredness will just kind of flood you yeah or having eaten stuff that makes you feel a bit sick or having eaten stuff that just gives you kind of a You know odd aftertaste or anything like that. So I think there's another reason why you know, we do feel better after we've eaten better food and Yeah, because you have less of that, I mean, food coma. I don't think I've ever had food coma from eating a salad. No. you know So I think in that way, I mean, if we're talking about, and in that way, could you look at...
00:41:46
Speaker
some it it's a weird way to look at it but it's some people would describe some foods as heavy and some foods as light and that can be literal like i know so you know when you've eaten oh no not the elmo song god elmos is heavy you've got it the wrong way anyway so anyway if you have eaten your full in salad as opposed to eating it You're eating your full in pure beef. Yeah. You're going to feel less weighed down. You're going to feel different. Yeah, exactly. And that's not necessarily because of the quality of the food, but the weight of it, the literal weight of it, do you think that that can cause a difference?
00:42:27
Speaker
Yeah, I think it probably can. And also, okay, it's a really great example. If you eat a salad with some bacon in it versus if you basically fill yourself up exclusively with steak, yeah you're going to feel different after those two things. You're probably going to feel worse if you just eat steak. And in some ways you'll feel wonderful because steak is lovely. yeah but but But you also will have more of a physiological effect. But then the confusing thing that comes into that is how do we define eating your full? Because it's not like yeah one kilogram of salad is going to make me feel just as full as one kilogram of, again, raw meat. yeah yeah yeah um But that you can't make that, just you don't we can't draw a line of this is enough that would it would make me feel full. This is enough that it would make me feel full. So we can't really make that distinction between the types of food that you're eating because there's
00:43:15
Speaker
No, I think that's true and I'm not necessarily an expert enough to know, you know, the the details of what we call satiety, so you know, whether when you feel associateate satiated. But it does depend on the the mixture of of fat and protein and and all of those kind of basic constituents of food that go into it. Okay. But also on your emotional state.
00:43:40
Speaker
Yeah, so essentially we can't compare foods to one another because there's so many factors that go into it Yeah, I think I mean I think we can in that you can make generalized generalization So if you know if you eat food, which is unhealthy and there is such thing as unhealthy food, you're gonna feel a bit worse about it afterwards, partly because you know it's unhealthy. And so therefore you're more likely to have brain fog. You're more likely to have eaten too much carbohydrate and therefore feel sleepy afterwards and so therefore have brain fog. So it is, there's definitely something there that if you tend to go towards vegetables and salads, you will have a lower protein carb and um and and um simple carbohydrate amount in your lunch and you'll feel better afterwards.
00:44:22
Speaker
Do you think there is actually any weight in my physical weight theory because that kind of feels like I've made it up and it doesn't make any sense? No, I don't. I mean, no one's going to eat a kilo of salad. Well, no, exactly. But you could still get brain... I don't know. I don't know. Ignore this. OK, fine. Ignore this bit. We'll move on. But I mean, broadly speaking, to go back to it, there isn't food that will boost your brain health on its own. No.
00:44:53
Speaker
in the longer term, there are foods that will make you feel better than others afterwards, because you're not going to be quite so full, you're not going to feel so sick. There are foods that make you feel rubbish afterwards. It's less chemical and more emotional. It is partly chemical, but what I'm saying is, it's not like a boost due to some neurotransmitter, it's just that some foods make you feel crap afterwards, and others don't. Others make you feel quite nice afterwards. Yeah, so isn't that an emotional thing? Yeah, to an extent, yeah. Okay. Sure. Okay. That's fine. Cool. I was going to say something else actually, but you can pause this for a second. Okay.
00:45:32
Speaker
I was also gonna bring up just briefly, and we can ah we can just go over this really quickly. yeah i'm I'm not expecting for a whole other question on this, but um there's also the link between your physical health, which is obviously very linked to your diet, yeah and your mental health. yeah So it is also, this is me just putting this out there. I don't know if it's true. No facts to back it up. Everything I say on here is just a statement. A baseless statement. So is it true that certain foods can worsen your brain health?
00:46:02
Speaker
by worsening your physical health. Like, even if you're not feeling bad about the food that you've eaten, if it causes, but then i again, oh, actually I don't know because, because the In my opinion, the biggest links between physical health and mental health come from self-consciousness. Yeah, okay. so let's done Because it's really interesting, isn't it? The flip side of the foods to boost your mental health is foods to make your mental health worse. Yes. And you know, the classic one is a kebab. Why is that?
00:46:38
Speaker
Well, because it's something that people tend to eat after they've been out drinking right and therefore they're not actually they're actually not not actually necessarily hungry or they don't have a ah calorie requirement. they're just eating They're often eating it out of habit. It is very unhealthy. It is very high in in fat, very high in salt.
00:46:55
Speaker
um not so high in sugar and it tends to be served you know and then you tend to eat it what traditionally in Britain while you're drunk and therefore it ends it's quite messy and it's just associated I actually really like kebabs really well made kebabs I love kebabs love kaba very good kebab van near where we live culture So actually, that's really interesting. If you eat cut if you eat a kebab after 10 pints right and you wake up in the morning and the half a kebab is in your bedside table, you feel rubbish. that That food has made you feel worse. You didn't need it. right It wasn't a meal.
00:47:31
Speaker
you yeah you Physiologically, it probably just filled you up and made your gut, which is already sloshing around with 10 pints of lager, worse. So that's a classic example of a food that will make you worse. The same food bought as a meal, and we have on on occasions had kebabs from the takeaway as our family meal, yeah is just lovely. yeah It's just delicious.
00:47:54
Speaker
Sure. so And it doesn't make you feel worse there, although it's not that healthy. As a broad way of saying it, the biggest implication that food has on your mental health is the way that it makes you feel emotionally. Yeah, often it's the social context of the food that's the most important thing. Right. So if you're a happy person and you're confident in your diet, it doesn't really matter what you're eating unless it is affecting your physical health enough that it inhibits you from going outside. Exactly. Brilliant. Excellent. Cool. I'm happy.
00:48:23
Speaker
Great. Okay. Are medication breaks of benefit, should we do them? Now before I answer this question, I want to ask you this question because finally I know who it is. It's Jamie Gordon from our new Facebook group, the ADHD Science Podcast Facebook group, where people can ask us questions yes like this question. Yes, Jamie Gordon. It's a really interesting question actually. Are medication breaks of benefit? So we don't necessarily, for most ADHD medication,
00:48:59
Speaker
necessarily suggest medication breaks. right We don't necessarily do so. However, a lot of people take medication breaks and that is okay. So let's talk about, now I'm not talking about melatonin, for instance, so which is a sleep medication. We're talking about ADHD medication. We're talking about medication taken for ADHD, which I think we've been through this before, but quickly, stimulant, non-stimulant medication. Stimulant medication is the commonest form to be given as what we call first line.
00:49:31
Speaker
Yes, that's the one with the hungry brain Well, they agree brain. Yes, they're both the boat I mean the hungry brain is like a metaphor for ADHD generally and they both yeah I was thinking of the word analogy, but I couldn't come out with it analogy um But yes, you're right The stimulants are a more Directly connected to that analogy because they will feed the hungry brain with stimulation, which is what the hungry brain sure eats so the medic the the stimulant medications it is okay to have a break from them and I would encourage it not because you're getting addicted or because you know it's it's not going to work as well as before but because it's worth checking that you still need it.
00:50:13
Speaker
So, but it's more complicated than that because, you know, if you have a break over the weekend, and you're like, well, I was fine over the weekend, so I can't need it during the week. Well, that doesn't make sense. Particularly are gone with different things happening. Yeah, exactly. And non stimulants are the one with the the the subtle underlying effects. Yeah, so the non stimulants we'll talk about in a minute. Okay, sorry. Medication breaks are completely different thing for them. I'm on stimulants, right? Yes. Okay, not to talk about myself, but to talk about myself. I get heart palpitations. I got them all through my last few years of school.
00:50:42
Speaker
I thought that it was anxiety. I took a medication break after I left school. The heart palpitations stopped. I was like, maybe it's just because I'm out of school. Took them again today. Guess who came back? Palpitations. Palpitations. So it turns out that taking a medicine break was good for me because now I know what has been causing this scary symptom that I have. Yeah. And then the question comes, is it worth it to have this symptom in order to have the benefit of the medication? Yeah. Which we can talk about. Which we'll... I'll figure out. We will discuss.
00:51:12
Speaker
but But that's just as a general principle. um And so I think that's one reason why a medication break might be helpful. But you need to do it properly. So you need to say, OK, what's work like without medication, yes not what's a lazy Sunday like without medication? Because that doesn't really make any difference. Unless you can do, what's lazy Sunday like without medication? What's lazy Sunday like with medication? Then that can be helpful. Oh, yeah, of course it can be. So I think just just match those things up.
00:51:40
Speaker
I mean, there are times when I suggest a medication break in patients, sure particularly for children if they are having problems with their appetite, because it's a very common side effect of stimulants, is to have less appetite. And if they're struggling to maintain their weight or people are worried about that, that often will leave off the medication at the weekend.
00:52:00
Speaker
or Actually some people just sometimes just leave off medication the weekend because they feel they don't need it and that's fine Sometimes they're going back onto medication on a Monday morning can be a bit of a wrench yeah but If you can go if some people are perfectly happy to go off on and off it No problem for other people it is more of a problem. Sure. So that's the stimulants. Does that make sense? So we don't necessarily routinely do medication breaks, but there are a number of situations where they can be helpful. Yeah, so So it little With stimulants, medication breaks aren't prescribed because there's something wrong with the medication, but sometimes there's an off balance between the positive and negative benefits and you just want to experiment with an alternative. Exactly. You want to see if being off medication or being on medication is best for you. Sure.
00:52:47
Speaker
The non-stimulants, you probably, you generally should not do medication breaks. Yes. Because they have a long-term cumulative effect and if you take the weekend off taking them on Monday, they will be much less effective. Yes. So the non-stimulants, we generally don't respond we generally generally don't do medication breaks and what we would do basically is take someone off it if we don't think it's working or we think they're having problems.
00:53:13
Speaker
Can I try to explain the difference between stimulants and non stimulants? Yeah, go on. See if I get it right. Yeah, yeah. I've spoken about this before. but So stimulants are more of an immediate effect. huh I mean, both of them produce the same effect technically, I think. Yeah, in terms of symptoms. Yeah, in that you do less sensory seeking, I guess is the best way to say it. Yeah. You're more satisfied with the lower level of stimulation on both medications. The difference is that non stimulants um
00:53:44
Speaker
they have, as well as the overlying effect, they have ah ah ah like a slightly weaker underlying effect that is longer term. And non-stimulants, do you take those multiple times a day or is that...? Generally not, you generally take them once a day. Okay, and that's the same for stimulants.
00:53:59
Speaker
Stimulants, it depends. So that's just on the type of stimulant. Yeah, it depends on the type of stimulant. And some people are on multiple doses. So some people have one during the day and then another in the evening. But most people on stimulants will take one a day. Yeah. And so stimulants and non-stimulants are similar in the fact that they produce the same symptoms or, well, lessen the same symptoms. They lessen the symptoms in quite similar ways. Yeah. But the distinction is the length of effect that they have. Yeah.
00:54:27
Speaker
so Am I right in saying that a non-stimulant is essentially just a stimulant with a little booster at the end? Not really. Okay. Because one of the crucial differences is that the non stimulants don't affect sleep. So you can take a non stimulant whatever time of day you want. Okay. um And so they're not, they're quite different in that way and they don't particularly affect appetite in a reliable way. So I think the better way of thinking of it is that they're, where is the stimulants kind of top up your stimulation level? The non stimulant will basically reduce the amount of stimulation you need a bit more. so Right. So there's two lines. Yeah.
00:55:04
Speaker
just like the two lines on our audacity page right now. Well that's really helpful to the listening audience. Can you imagine a high level of stimulation required by the brain and the relatively low level of stimulation provided by the environment? Yes. The gap between those two things is where ADHD is. Yeah, and that gap is made smaller by both medications. Yeah, just in different directions. But it's made smaller by the stimulants by raising the amount of stimulation that you you're getting. Yeah.
00:55:31
Speaker
and it's made smaller by the non-stimulants by lowering the amount of stimulation that you need. Yeah, and that's broadly correct and I don't think we completely understand the non-stimulants but that's the best metaphor I can think of, the best analogy I can think of. It's a very good metaphor. And I think within the stimulants there seems to be It seems to affect that level of stimulation you require in two ways one is a more immediate thing So sometimes you can take it in the evening if you need to calm down in the evening But then there is also this longer term Lowering of how much stimulation you need over time over weeks. Yes That is another that's where there's two effects going on okay, so I hope that ah answers your question Jamie I
00:56:15
Speaker
Well hang on, I don't think we actually did answer the question for the non stimulant side of things. I think I brought you off track too quickly. don't Medication breaks and non stimulants are generally not useful. Generally not needed. I mean if you're thinking about taking a medication break and you're on stimulants just ask your doctor. Oh yeah definitely. toobo sure Absolutely.
00:56:37
Speaker
yeah All of this whole episode should be, please, if you're worried, ask your clinician. I am not your clinician, although I am a clinician. Yes, he is. Maybe you're listening to this and he is your clinician. Yes, in which case, I'm hello and I'm sorry I haven't got back to you. All right. Well, we hope that's helpful.
00:56:58
Speaker
Yeah. So that's the end of our Q and&A. We will do another one. Come to the Facebook group and join the Facebook group and ask us a question. I've got a couple of questions people have asked. I haven't answered them because I need to do a little little bit of research. I really love making these episodes. I feel like I learned so much. I mean, not that I don't learn so much from the other ones, but I feel like I have a more active role in these. Yeah, that's nice. Yeah. Well, hopefully you can find time in your busy work schedule in the future Tess.
00:57:25
Speaker
Fingers crossed. Keep sending those questions in. I'll be back. Oh, all right. Bye-bye. Bye.