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Change Your Brain Every Day
Why ADHD Hits Harder in Adulthood—and What to Do About It
00:22:06
Think ADHD is just a childhood issue? Think again. In this revealing episode, Amen Clinics psychiatrist Dr. Steven Storage takes the mic to explore how ADHD often shows up for the first time in college, young adulthood, or even midlife. You’ll learn...
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- [00:00]
Dr. Steven Storage
Screen time, if unchecked, can make ADHD substantially worse. If you think about ADHD brains as being deficient in dopamine, it means that the ADHD brain is going to try to chase dopamine where it can get it. One of the most effective ways to get dopamine is to look at a screen. It is literally designed to pull eyes in and it does that through rapid stimulation. It's like being at a slot machine in Las Vegas. And it's not dissimilar with social media. ADHD is primarily genetic. There's a score called heritability. One would mean it's 100% genetic. For ADHD, it's somewhere between 0.7 and 0.9, meaning it's a highly genetic condition, but not a purely genetic condition. So there are other things that can influence whether or not someone develops symptoms of adhd. We talked about some of them already. If you have.
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Dr. Daniel Amen
Every day you are making your brain better or you are making it worse.
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Hannah Amen
Stay with us to learn how you.
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Dr. Daniel Amen
Can change your brain for the better every day.
- [01:09]
Hannah Amen
Are you excited to optimize your brain and help the brains of those you love? Do you want to prevent or treat memory problems, anxiety or depression? Do you want to be happier? That's why I created Amen University to take what I've learned over the last 45 years and help you have a better brain, a better mind and a better body. You can take courses like our 30 day happiness challenge, which was shown in research to increase happiness by 32% in just 30 days, or memory Rescue or Overcoming Anxiety, Depression, Trauma and Grief or Healing Add at home in 30 days and much more. We also have professional courses and courses for kids, including brain thrive by 25, which was found in independent research to decrease depression and improve self esteem. And as a special offer just for our listeners, you can save 20% on your next course. Visit amenuniversity.com and use the code PODCAST20.
- [02:33]
Dr. Steven Storage
Welcome back to the Change youe Brain everyday podcast. I'm Dr. Storage, filling in for Dr. Daniel Amen and Hannah Amen. And today we are going to talk about adhd, specifically how ADHD shows up in young adulthood and early adulthood. One thing that a lot of people don't realize is that although ADHD is a neurodevelopmental condition, meaning for most people it's present from birth. We'll get into exceptions. It doesn't always show up immediately in childhood. And here's the reason why. Think of ADHD as a supply demand issue is blood flow Supply to the prefrontal cortex, keeping up with the demands that are being placed on the prefrontal cortex. So for many children with ADHD when they're in school, perhaps school isn't particularly challenging. Perhaps there aren't that many demands on them. Perhaps they can lean in on just their innate intelligence to get things done without really putting a ton of effort in. Later on, though, those demands may increase and the blood flow supply to the prefrontal cortex might not keep up. I'll give you an example. When I was a resident, a psychiatry resident at Stanford, I would see a lot of undergraduate students there, many of whom, in high school, coasted right. They didn't really notice any issues with executive functioning challenges. And now, freshman year at a university, they felt bombarded by responsibilities and not just academic, but also doing their own laundry, figuring out life and blood flow. Supply was no longer keeping up with demand. And for the first time, they felt as though they had ADHD symptoms. They had ADHD the whole time, but supply was keeping up with demand until it wasn't. So there's other things that can also impact that supply, demand, balance. So things that increase demand, responsibilities, stressors, juggling a whole bunch of different stuff. But things that reduce supply also can cause ADHD to show up later on in life. And what are some examples there? Depression. Right. I mentioned on a previous episode that depressed brains send less blood to the prefrontal cortex. So if suddenly we've had some degree of adhd, but we've managed, supply is keeping up with demand, and now we enter a state of a depression and blood flow supply drops further. Now the ADHD is really showing up. Head injury would be another example. So with most head injuries, doesn't even matter where you've been hit. The end result is that the brain wobbles back and forth within the skull, exerting increased pressure on the front and the back. Increased pressure on the front can show up on a SPECT scan as reduced blood flow, reduced activity to the prefrontal cortex. So there are some people who had some degree of ADHD that post head injury. And this doesn't have to be a major head injury either. I mean, it can be something that felt relatively minor in the moment you felt like you had your bell rung, you didn't lose consciousness. But that can be enough in some cases to now have someone express the phenotype, the. The symptoms of ADHD more prominently. Other examples, this would be later on in life, more like, you know, later mid to late adulthood. Perimenopause in perimenopause, people can experience a reduction in blood flow to the prefrontal cortex and for the first time ever, feel like they're presenting with adhd. So ADHD is primarily genetic. A lot of people ask how, how genetic is it, right? Like if, if my parent has adhd, am I destined to have adhd? So the answer there is, there's a score called heritability, and this is a score that goes from zero to one. Okay, so zero would mean genetics have nothing to do with it at all. Okay, so think of, like, getting your toe infected or something that wasn't necessarily a genetic issue. You just got the infection. That would be a heritability score of zero. One would mean it's 100% genetic. There's no other factor involved. You get the condition because of genetics. For ADHD, it's somewhere between 0.7 and 0.9, meaning it's a highly genetic condition, but not a purely genetic condition. So there are other things that can influence whether or not someone develops symptoms of adhd. We talked about some of them already. If you have a early head injury that could lead to someone presenting as though they have adhd, there's dietary factors that can impact whether someone is exhibiting symptoms of adhd. Early infections, even infections in utero, can impact whether or not someone presents as having adhd. And there are certain things that make the presentation of ADHD worse universally. And a big one that I want to talk about is screen time. I am not anti screen time per se. I'm not anti social media per se. I would be a hypocrite if I were, since I have an Instagram channel where I try to release good educational content. But I'm also aware of the fact that screen time, if unchecked, can make ADHD substantially worse. And there's a reason for that. If you think about ADHD brains as being deficient in dopamine, it means that the ADHD brain is going to try to chase dopamine where it can get it. And one of the best ways or worst ways, one of the most effective ways to get dopamine is to look at a screen. Because if you think about how things like video games are developed or how social media is structured, it is literally designed to pull eyes in, and it's. And it does that through rapid stimulation. So if you ever watch your child play a video game, you're probably going to see lots of flashing lights, lots of action, lots of decision making that's happening, rewards that are coming in. It's like being at a slot machine in Las Vegas. And it's not dissimilar. With social media, I actually have the luxury of seeing how long people watch certain videos that I might post. Most of my videos are something like a minute long. The average watch time is about seven seconds and that's the average. So that means there are some people that are literally just scroll, scroll, scroll. And I'm not offended, but I think a big reason for that is we crave the next dopamine hit. And if things aren't developing fast enough, if there isn't a great, you know, something that's latching us on, we. We move on to something else. And it is harder and harder for kids and teenagers nowadays to sit through a full length feature movie than ever before because it's not moving fast enough. They're used to YouTube shorts, they're used to Instagram reels, they're used to games where things are moving really, really quickly and it's hard to sustain attention for that long.
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Dr. Daniel Amen
I wear a continuous glucose monitor to track how food affects my brain. When blood sugar is stable, I'm focused and clear. When it's not, I'm tired, irritable and craving sugar. That's why I take balance my blood sugar from brain md. It supports healthy glucose levels so I can think clearly and feel my best. Try it@brainmd.com with code podcast 20 for 20% off.
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Dr. Steven Storage
Technology is contributing to ADHD being more and more difficult to manage over time. And if you think about running around with a brain that is already dopamine deficient and you step into a situation where you're swiping and you're getting a dopamine hit really quickly, over and over and over effectively, what your brain is doing in that moment is dumping the dopamine that it has. And you only have so much before you run out and you have to make more if you dump all of your dopamine, when it comes time to focus on something else that might matter that isn't exciting, you don't have the fuel to do it. And it's that much harder. So a big question that comes up all the time is how do I responsibly use screens? How do I responsibly use social media or play video games? Because let's face it, technology is not going anywhere. If anything, it's becoming more and more integral every passing year when you use it. And how you use it makes a big difference. And so the advice I give for, let's say, teenagers, college students, Even, I mean, adults as well, be very intentional about when you're using a screen. So the worst time to use a screen right before you're gonna do something that requires your focus, because of what I said earlier, you dump all your dopamine and now it's time to do the thing that you didn't wanna do ten times harder, right? You're probably not gonna start it or it's gonna be painful, or it's gonna take 15 times longer. So don't use the screen right before you're gonna do something that requires your focus. Similarly, try not to use a screen as a break from something you're doing that requires your sustained focus. This happens all the time, right? People will work for 20 minutes and then feel like they need a mental break. And so they'll pull out their phone and they'll check social media or maybe they'll play a quick video game if they're at home. It is so much harder to switch back to the thing that you were trying to focus on. If you've dumped your dopamine in between. It's way better to take a break that involves movement or getting up to get a drink of water or giving someone a call or something that isn't an immediate dopamine dumping ground. And then the final time that I recommend people to avoid using screens is right before bed. When we use a screen right before bed, the light that's emitted from that screen is extremely confusing to the brain. The light goes into our eyes and activates a part of our brain called the pineal gland, which is responsible for releasing melatonin. But if it's getting light in, it's not going to release melatonin because it thinks that it's still daytime. And so our brain doesn't really know how to differentiate light from a screen versus light from the sun. And even though you can fall asleep scrolling, you won't get into deep restorative sleep. And the next day you'll end up paying for it. So those are the three times that I would recommend avoiding a screen. So right before doing something that requires sustained focus as a break from something that you're doing that requires your focus and right before bed. So then another question I get all the time is, well, what type of content is okay? You know, are there certain types of things that you could do on a screen that are better than other things? And the answer is yes. And some of this depends on the age of the person that we're talking about. So for younger kids, what I recommend is that whatever it is that they're consuming on a screen is ideally something educational, ideally something that's longer form so not YouTube shorts and ideally something that can be co watched with a parent so that the parent can help bring whatever it is that's being consumed on the screen into real time. Right. So oh, look at that. You know Billy, look at that crocodile. Remember when we saw the crocodile at the LA Zoo, bringing it back to the here and now so that that fantasy world on the screen can be linked to things that are based in reality. The other thing I recommend is the least amount of screen time possible. So it's again hard in this day and age, especially if you're a parent. It's very busy and you're running around and you just need a second to get dinner together or something like that. It can be tempting to just put on the TV and let it go for a little bit. And we've all been there and we will all be there at some point probably, but trying to just be intentional about noticing when we're doing that and not making too much of a habit of it and trying to find replacements, right? So maybe putting some puzzle pieces on the ground or some other type of game that your child can play or if it is a TV going again, making sure that the content is on point and that you're at least interjecting from time to time. For teenagers similar ideas. You're probably not going to be co watching as much with your teenager, but trying to limit short form content as much as possible. And if they are going to go on their Instagram and that's a way that they connect socially with their friends, which it very well may be just setting some parameters around that, right? Like we don't want to. Many of us have been in the situation where you start scrolling and then you're doom scrolling and it's been three hours and you're still scrolling and you feel exhausted and you feel tired and your brain is fried and it's late at night and you're not going to get sleep and you're like what did I just do? Many of us have been in that position and so we want to try to help our teenagers learn responsible ways of digesting social media. And so that might mean, hey, you got an hour, right? Like you've got from five until dinner time or whatever and go ahead, you know, catch up on your social media, that's the time. And then let's just be aware of the time and put a stop on it. Because if you don't have that kind of framework. It'll just go forever. So if you're a parent and you want your child to be on a screen less, remember why they're going on a screen in the first place. And it's to chase dopamine. And if you remember that, then you can frame it as someone who has an addiction. It turns out that on a spect scan, a scan that is looking at blood flow and activity in the brain screen addiction looks the same as addiction to hard drugs. Because when we do something that increases dopamine level in our brain and it makes us feel good over time, we need to do more of it to get the same dopamine response. And then if we stop doing it, we feel withdrawal. That's addiction. And so screens hijack the same addiction circuitry in the brain as drugs do. And so if you go into it with that understanding, it creates space for empathy, but it also creates strategy for how you might tackle this with your child. And one thing is, you're probably going to want to wean, you're probably going to want to set parameters on when the child can use technology. And we're going to need to give them things that can replace that dopamine that they were getting from a screen. So what could that look like? A lot of it's going to depend on the kid. But things that increase dopamine connection, you know, going hanging out with friends, like doing something outside, playing a sport, good food that's brain healthy. Board games, I mean, even, even board games, we, we don't play enough of those anymore. But having dedicated time at home as a family to play a board game, your teenager is probably not going to be super stoked about it the first couple times of suggesting it. But keep doing it right, make it a pattern, make it a family tradition. Certain supplements can also increase dopamine. You know, things like L tyrosine can get, is converted to dopamine and can help fill that void, so to speak, or think about what your child might really be into. Are there any hobbies that they'd like to explore? Have an open conversation with them? Do they want to do something that's intense? Do they want to get on some kind of competitive team? Do they want to be on a travel team? Do they want to take up rock climbing? It could be anything. And the idea is to be curious and to explore.
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Dr. Daniel Amen
People come to Amen clinics from all over the world for answers. With 11 clinics in major hubs, Atlanta, Chicago, Dallas, DC, LA, Miami, NY, Orange County, Seattle, San Francisco and Scottdale. Expert brain care is closer than you think. Visit amon clinics.com it's been such an.
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Dr. Steven Storage
Honor joining you guys on this podcast and being able to talk about adhd. Over the last couple weeks, we've covered a lot of ground. We've talked about the different types of adhd, myths around adhd, natural treatments, factors to think about when you're talking about medications, and then also screens and how they impact adhd, and how ADHD can present later on in life when maybe it wasn't as obvious earlier on in life. There's even more to talk about with ADHD, and you can follow me at Dr. Steven Storage on Instagram or on TikTok. Also, if you liked this content, make sure that you subscribe to this podcast. You can also watch the episode on YouTube or listen wherever you listen to podcasts.