Personalised Brain Training and ADD / ADHD

The label “AD(H)D” has come to apply to a combination of behavioural issues beyond the core definition of inattention and hyperactivity.  

Distractibility has a signature in brain activity patterns as measured through qEEG.  So indeed do the other presenting issues, including impulsive aggression, mood regulation, sleep onset and quality, flexibility and motivaton.  

With a Kaiser Neuromap we can identify vulnerability to each of these issues, and more, as they pertain to an individual.  

Neurofeedback for ADHD and Attention Deficit and Hyperactivity Disorder

Every person is different.  DSM labels for mental health issues are often not aligned with specific patterns of brain activation.  With Personalised Brain Training, we take a bespoke approach to understanding the underlying dynamics at play for a particular person.  By analysing individual brain wave activity with a qEEG brain map, we can identify dysrythmic brain areas and provide a more granular and differentiated view of vulnerability to various psychopathologies.

Neurofeedback training provides us with a non-invasive, medication-free method of helping individuals mature cortically and attain balance and optimum performance.  This procedure is enjoyable – we watch movies – and evidence-based.

Children and young adults in particular exhibit delayed maturation of prefrontal areas, and with neurofeedback training we have seen this accelerate within as few as eight sessions.  This effect is noticeable both empirically and cognitively.   

Per the DSM-5 definition, ADD / ADHD presents as inattention and/or hyperactivity.  

Popular literature expands the list of symptoms somewhat to include motivation, impulsive aggression, behaviour issues, sleep onset and quality, emotion and mood regulation, flexibility, working memory and sense of self.  

When viewed this way, ADHD becomes a very broad pool of symptoms.  Everyone is different.  Some present with concomitant behavioural issues, others don’t.  This calls for a differentiated treatment approach, and key to selection is a deeper understanding of individual issues, ideally at a level of brain network interactions.  

With a Kaiser Neuromap, we can identify brain areas that may show vulnerability to each of these additional component pathologies.  This way, we recognise individuality and personalise the treatment process: 

– Following a qEEG brain map, we can target relevant brain areas.

– a holistic approach to bringing out flexibility and ingenuity: optimising performance. 

– Personalised Brain Training for ADHD lets us address a person’s individual challenges

 

 The ‘chemical imbalance’ model of mental health issues has long been debunked.  Neurofeedback training is a medication-free complementary therapy approach to Attention Deficit Disorder. 

It is suitable at all stages of development: 

– Children are able to gain the confidence and discipline to optimise their social and educational development.

– Teenagers and adolescents learn focus and self-esteem at a critical stage.

– Adults better manage the responsibility and stress of career and parenting.

Importantly, sufferers of attention deficit present with different stages of brain development.  ADHD has been associated with weaker function and structure of prefrontal brain circuits.  

Neurofeedback for ADD / ADHD is evidence-based – see here for more research links – :  In line with AAPB and ISNR guidelines for rating clinical efficacy, neurofeedback for ADD / ADHD can be considered “Efficacious and Specific”, the highest level (5). 

Neurofeedback is a form of complementary therapy and should not be seen as a replacement for conventional medicine.  qEEG brain map-based neurofeedback training takes a more holistic approach to brain functioning, rather than just focusing on medical symptoms.  It is not intended as a form of diagnosis nor medical intervention nor medical advice per the disclaimer.

Case Study - ADHD, Suspected Autism, Teenager, Behavioural Issues

Julian, just turned 11, introduced himself with “I’m Julian.  I have ADHD”.  His self-esteem was on the floor. 

Shy and well-behaved, his demeanour contrasted with the behaviour issues his mother deemed most pressing.  Her altercations with Julian were daily, prompted by incidences where things didn’t go as imagined or hoped for by him, and turning into a self-fuelling rage that would spoil the entire weekend.  His focus was poor, conversations marred by distractions (“jibberish”, in her words), relative maturity low for his age group and he fortunately attended a school that catered for his academic performance and social needs.  

A year of psychotherapy almost landed him with an autism assessment, and he hated the various other therapeutic procedures he had to endure that aimed at helping his physical coordination issues. 

Within two weeks, or four sessions, his behaviour had taken a turn; in his mother’s words:

“I wanted to mention that we have noticed improvement with Julian.  He is calmer, less reactive and when he gets frustrated he manages to calm himself down.  Not sure if it’s a temporary thing, but this weekend was all right :)”

Functional connectivity improves with neurofeedback training as measured with a brain map

Far from temporary, his maturation accelerated noticeably in the following weeks.  A family trip was described as “the best vacation we’ve ever had!” by his mother.  While on holiday, he learned to scuba dive, and his parents noticed that he was asking coherent, thoughtful and relevant questions during the instruction.  Anxieties and fears dropped noticeably, attention and focus improved, childish behaviour – such as “class clown” attempts at drawing attention – ceased, and his search for male role models extended into extracurricular activities.  

Julian’s brain maps confirmed the transition he was going through.  He had skipped years of physical maturation that should have taken place, especially in his prefrontal cortex.  Functional connectivity of brain areas responsible for behaviour, focus and sense of self had improved substantially, as – notably – had his motor skills.  Julian’s trajectory has changed from spiralling into lower depths of special needs diagnoses, to establishing a confident, engaged and healthy risk-taking personality.  With these new acquired powers, he is able to shape his own future in a way that helps sustain his progress. 

Does it last?  We all evolve, and life throws us challenges.  Key to improvement is being equipped with the right tools – cortical maturity and functional connectivity in this case – that help us create positive feedback loops within our environment.  Twenty sessions helped liberate this young man immensely.  With neurofeedback training we can address developmental issues.

With neurofeedback training we can help change trajectories: 

Distractibility hinders school development as well as personal relationships.  The social brain gets deprived of interaction and self confidence is affected.  During formative school years, we need the opposite to happen:  A sense of involvement in a group, social sphere and community.  

With neurofeedback training we can help improve focus, reduce social anxieties, address impulsivity and aggression, and strengthen the sense of self.  We are resetting trajectories at important stages.

ADD / ADHD usually presents with a number of other issues beyond the narrow medical definition of inattention and hyperactivity, including:

– distractibility, organisation and planning

– sleep onset and quality

– impulsivity

– aggression and rage

– behaviour issues: opposition, defiance, conduct problems

– tics and habits 

– inability to make and maintain friendships

– perceived learning disability

– anxiety and panic disorder

– mood regulation: depression and mania (bipolar)

– emotional regulation

– risk of psychosis

– self-esteem and sense of self

– dependence and/or abuse of legal and illegal substances

We take a holistic approach to healthy brain self-regulation, rather than categorisation or diagnosis.  In our view, and experience, symptoms resolve when our system is balanced.  Key to this is the stability of core neural networks, including the Default Mode Network.

Neurofeedback lets us train cortical areas that play important roles in our sensory interpretation of our environment and our responses. 

In 1909 the various functional areas of the brain were identified by Brodmann.  Since then, increasingly powerful tools such as fMRI have allowed researchers to determine what functions these areas fulfil, by themselves and in networks with each other.  This research is ongoing and enables us to identify biomarkers, or neuromarkers, for behavioural patterns and vulnerability to pathologies, or mental health issues.

Personalised Brain Training and the Kaiser Neuromap uses the most up-to-date knowledge to apply neurofeedback training as required by the individual.

Neurofeedback training for ADHD is evidence based and produces lasting results:

Attention deficit:  Efficacy is well-documented – there are over 370 research reports on Neurofeedback and ADHD on PubMed.  

In line with AAPB and ISNR guidelines for rating clinical efficacy, neurofeedback can be considered “Efficacious and Specific”, the highest level (5), with a large effect size for inattention and impulsivity in this study.

large-scale study showed that neurofeedback is effective in remediating attentional dysfunction.  Significant clinical improvement in one or more of attentiveness, impulse control, and response variability was observed in 85% of participants after 20-40 training sessions.

Impulse control and attention improved through neurofeedback training, producing “patient outcomes equivalent to those obtained with stimulant drugs”

Neurofeedback “appears to have more durable treatment effects, for at least 6 months following treatment.” 

Neurofeedback was shown to be an effective method to enhance cognitive deficits, reduce ADHD symptoms and behaviour problems in children.  The effect was maintained in a follow-up six months later. 

There are numerous academic studies confirming the efficacy of EEG biofeedback (another name for neurofeedback) with sustained performance gains. 

The American Academy of Pediatrics bases its conclusion that there are “no significant contraindications” to its use on these studies. 

ILF / Othmer Method neurofeedback training was shown to reduce ADHD symptoms, specifically distractibility and impulsiveness, in a study involving 251 children over a course of 30 neurofeedback sessions. 

Training specific brain areas successfully activated error monitoring networks in ADHD patients, associated with symptom improvements.  Dynamic functional connectivity was found to be maintained in a follow-up 11 months later.

Another study attested improved response control and attention in ADHD post Neurofeedback.  

Mood regulation and Motivation:  see here

Working Memory: see here

Sense of Self:  With Personalised Brain Training, we work on the Default Mode Network, the neural basis of self. 

See individual ‘Uses’ tabs on this website for further links to relevant research.

In line with AAPB and ISNR guidelines for rating clinical efficacy, neurofeedback for ADD / ADHD can be considered “Efficacious and Specific”, the highest level (5), with a large effect size for inattention and impulsivity. 

Neurofeedback is an established method for improving ADHD symptoms.  It is evidence-based and non-invasive. 

With a Kaiser Neuromap, we can also benchmark brain development and physical maturity, which is especially relevant in the developing minds of children.  

Key networks are forming, while the connections between our ‘reptilean’ brainstem and our cortex are maturing.  There are several development stages we can detect and address with neurofeedback training.  Sharing a maturity level with our peer group helps with social interaction and our perceived sense of worth within the community, integral parts of character and personality development.

Brain Maps and Personalised Brain Training

Kaiser Neuromap brain maps and Brodmann areas

Brain Maps expose Individual Vulnerabilities

With a Kaiser Neuromap, we can identify character traits, vulnerabilities and strengths. 

Different brain areas and networks govern our behaviour.  For example, there are parts of our brain which control mood regulation; spatial distractibility; physiological arousal; our sense of self; self-critical thoughts; anger and emotional attachment; and there are various sources of anxiety.

A brain map shows us which brain areas are behaving immaturely, and thus expose us to vulnerabilities or mental health issues.

Rather than fitting people into categories – diagnosis – we can assess vulnerability to behaviour patterns.  Every brain is different.  A brain map provides a more granular approach to understanding our strengths and weaknesses.

Neurofeedback process explained, illustrating real-time analysis of brain waves and feedback given

Personalised Brain Training with Neurofeedback

Neurofeedback lets us train dysrythmic brain areas.  With sensors comfortably fitted to the brain areas we want to train, we detect brainwave patterns real-time while watching a movie.  When these patterns are inefficient, the volume drops momentarily.  This is the feedback we are giving our brain, short and instantaneously.  

The brain area we are training recognises this – while our conscious mind is focussed on the movie – and adjusts its behaviour to restore the normal volume.  With repetition, throughout a session, learning occurs.  

Meanwhile our conscious mind is solely focussed on the movie; the training process is passive in this sense.    

The drop in volume is subtle, so we continue to understand the flow of the movie.  No current or electrical stimulation is fed to the brain; sensors simply read brainwaves and the feedback is purely audio-visual.

Neurofeedback is preconscious brain training aimed at enhancing our mental, emotional and spiritual health

Neurofeedback trains our Pre-Conscious Mind

 

Rather than engaging the conscious mind, which slows us down, we are training preconscious processes

This equips us with the ability to live in the moment and attain our potential (if we have to resort to conscious control, we are not living in the moment).

Personalised Brain Training is an advanced qEEG brain map-based approach to neurofeedback training developed by the founders of the field.  Taking Othmer Method / ILF training methods further, it employs Default Network Training protocols as developed by David Kaiser.

We take a holistic approach to healthy brain self-regulation, rather than categorisation or diagnosis. 

Neurofeedback is evidence-based complementary therapy with over 2000 PubMed peer-reviewed research reports

Neurofeedback is Evidence-based

Neurofeedback training is an evidence-based complementary therapy.  Its efficacy was first demonstrated some 50 years ago, and with advances in technology, training protocols have become more efficient and the feedback method – watching movies – thoroughly enjoyable. 

Neurofeedback is evidence-based.  It’s first application was discovered in 1971 when it was used to resolve intractable epilepsy. 

There are over 2,000 peer-reviewed research reports on PubMed demonstrating efficacy across a number of pathologies. 

In the US, it is an accepted complementary treatment for many challenges. 

What is ADD / ADHD?

ADD / ADHD as diagnosed by a medical professional is where someone shows a persistent pattern of inattention and/or hyperactivity, or impulsivity, which interferes with their functioning or development.  From a neurofeedback perspective, we focus training on external distractibility and the lack of inhibition giving rise to impulsive or hyperactive behaviour.  Having calmed the brain in general, and trained brain areas involved in attention to the environment, we provide the person with the ability to filter stimuli by relevance, reinstate drive and focus, and establish a more grounded state from which to develop a sense of self.  This enables them to make plans, and act on these; organise their time and the space they inhabit; and ultimately achieve their potential.  Where a client presents with such a diagnosis, we rely on referral from and close collaboration with the respective medical professional, and you should seek medical advice (which Neurofeedback London-Brighton does not provide) if you believe you have relevant symptoms.

Neurofeedback London-Brighton does not provide diagnosis nor medical interventions.  

ADD/ADHD often presents as a comorbidity, that is, an issue in addition to other behavioural problems such as mood regulation, sleep hygiene, anger management, social invasiveness, personal space issues, working memory and sometimes personality or developmental disorders.  With a brain map, we can obtain a holistic view of the person’s mental traits and vulnerabilities.  While not a diagnostic tool, we can observe vulnerabilities and form a training plan as well as structuring a therapeutic approach.  

Neurofeedback London-Brighton does not provide diagnosis nor medical interventions nor medical advice and is not medically trained.  By engaging in neurotherapy, you confirm that you have sought medical advice and are keeping your relevant medical professional informed of therapy progress.  

Daniel Webster has extensive experience working with children and adults with ADD/ADHD.  Contact Daniel on +44 (0)7966 699430 or daniel@neurofeedback.io to arrange sessions.

School is tougher – the likelihood of getting suspended or expelled are 3x higher; 32% drop out before completing school; only 22% enter College / Uni; and only 5% of those graduate from College / Uni

Sustaining interest in interactions with others becomes equally problematic; they often find it difficult to listen to another person and only take in a fraction of what is being communicated to them.  This sets off a negative feedback loop, as it makes it hard for them to relate to others, as much as others find it frustrating to deal with them, triggering secondary effects such as stress and social anxiety.  Frustration leads to anger and impulsive behaviour, and conduct disorders frequently follow. 

 

Sexual activity begins younger; people with ADD will have three times as many lifetime sexual partners; risk of teen pregnancy is 38%, over 9x higher

Sadly, most people around them can’t recognise that the problem setting off this cascade is not a matter of ill will, but rather dysrhythmia of particular brain areas – in a sense, a physical deficiency.  They, and society as a whole, are even less equipped to deal with this appositely.  People with ADD/ADHD are left to feel inadequate about themselves and without support.  Many even remain undiagnosed throughout their entire life.  Denied adequate support and therapy, their affliction can cause immense strain on relationships, their personal development, and career potential. 

Driving is a greater issue – 4x more licence suspensions, 3x more crashes with injuries; 3x more citations for speeding; double the average accident damage; 7x more likely to have 2 or more crashes, and 3x more likely to have 3 or more crashes.  ADD sufferers are more likely to drive before licensing.

For the purpose of applying neurofeedback training to adults and children with ADD / ADHD or attention deficit hyperactivity disorder, we are primarily interested in the symptoms that pose the issues.  These range from learning disabilities to oppositional defiant disorder, and secondary effects may include issues with self-esteem and confidence as a result of ‘not fitting in’.  

Neurofeedback training is non-invasive and drug- or medication free.  

 

Neurofeedback is a form of complementary therapy and should not be seen as a replacement for conventional medicine.  qEEG brain map-based neurofeedback training takes a more holistic approach to brain functioning, rather than just focusing on medical symptoms.  It is not intended as a form of diagnosis nor medical intervention nor medical advice per the disclaimer.

Note:  Statistics quoted above are from MedScape article by Lenard A. Adler, MD; Julie Cohen, BA

Daniel Amen, of Amen Clinics, explains the diversity of ADD / ADHD from the point of view of fMRI scans.  

A Kaiser Neuromap is a more comfortable, cost-efficient and relevant method to get an overview of the issues faced by an ADHD person.  Instead of limiting ourselves to seven types, we gain a granular overview of functional brain areas and their maturity – these include: 

 – distractibility

 – planning and organisation

 – impulsive aggression – when events don’t unfold the way we expect them to

 – self-harm tendencies, whether physical or more subtle

 – impulsiveness

 – physiological arousal, and the ability to maintain the apposite level

 – ability to self-soothe: rationally calming down from a situation

 – ability to self-nurture: finding emotional security in one’s surroundings.  This is critical to feeling that we are expanding and making the most of our skills and talents

 – anxieties, including social anxiety

 – mood regulation, depression and manic behaviour

 – hyperactivity, motor skills, coordination

 – sense of self, feeling that we are part of something, essential personality development within a community

 – sleep: onset and maintenance, feeling well-rested

Neurofeedback is a Safe, Effective, Non-Invasive Treatment for ADD / ADHD

There are numerous academic studies confirming the efficacy of EEG biofeedback (another name for neurofeedback) with sustained performance gains. 

The American Academy of Pediatrics bases its conclusion that there are “no significant contraindications” to its use on these studies. 

ILF / Othmer Method neurofeedback training was shown to reduce ADHD symptoms, specifically distractibility and impulsiveness, in a study involving 251 children over a course of 30 neurofeedback sessions. 

Training specific brain areas successfully activated error monitoring networks in ADHD patients, associated with symptom improvements.  Dynamic functional connectivity was found to be maintained in a follow-up 11 months later.

Neurofeedback “appears to have more durable treatment effects, for at least 6 months following treatment.” 

Neurofeedback was shown to be an effective method to enhance cognitive deficits, reduce ADHD symptoms and behaviour problems in children.  The effect was maintained in a follow-up six months later. 

Another study attested improved response control and attention in ADHD post Neurofeedback.  

In line with AAPB and ISNR guidelines for rating clinical efficacy, neurofeedback can be considered “Efficacious and Specific”, the highest level (5), with a large effect size for inattention and impulsivity in this study.

A large-scale study showed that neurofeedback is effective in remediating attentional dysfunction.  Significant clinical improvement in one or more of attentiveness, impulse control, and response variability was observed in 85% of participants after 20-40 training sessions.

Neurofeedback training has the relevant goals of:

  • restoring emotional regulation – dampening erratic mood swings, oppositional, defiant and aggressive behaviour;
  • improving focus and concentration including working memory, ability to plan and organise, attention to detail and dominant hand awareness
  • physical calming – reducing hyperactivity and hyper-vigilance as well as headaches from stimulant medication; improving awareness of body and environment
  • addressing disinhibition by calming the mind for improved impulse control
  • establishing a healthy sense of self-worth as self-esteem and confidence are often compromised by repeated criticism of their behaviour and achievements.

It is described as a fun to use process for all ages.

 

Modern Thinking on ADD / ADHD

There are various schools of thought as to how to deal with ADD / ADHD.  The first, and most important step, is to acknowledge that it is a real condition.  When seeking medical advice, which this website does not provide, you can ask about forms of treatments, and whether supplementary actions might be beneficial, such as behavioral training as suggested by the AAP or dietary supplements.  

The Contrarians – Denial is merely a Rebellion against Drugs

Note that contrarian views exist.  Dr. Richard Saul, in his book  “ADHD Does Not Exist:  The Truth About Attention Deficit and Hyperactivity Disorder” takes aim at the pharma industry, medical practitioners, the media and patients themselves and believes it is actually a conglomeration of conditions.  Nevertheless, he seems to acknowledge the ‘it’ – being distractibility and impulsivity.  Focus and disinhibition and the symptoms we are interested in from a neurofeedback perspective.

Harvard professor Jerome Kagan, considered the 22nd most eminent psychologist of the 20th century (ahead of Carl Jung, who ranks 23rd), similarly takes aim at the establishment for overprescribing pills, and suggests a bevarioral therapeutic approach instead:

“Who’s being diagnosed with ADHD? Children who aren’t doing well in school. It never happens to children who are doing well in school. So what about tutoring instead of pills?”

(SpiegelOnline, 2 August 2012)

Again, he acknowledges an issue, and suggests a targeted approach, while reprimanding an over-reliance on drugs. 

 

The Issue is Self Regulation 

Dr. Russell Barkley points out that Will Power is a Limited Resource Pool, that is, when conceptualised as a fuel tank, is particularly prone to depletion in sufferers of ADD / ADHD.  This finite source of conscious discipline has to provide the following functions, and the more is needed, the quicker it empties:

  • Inhibition and Self-Restraint
  • Self-Management to Time
  • Self-Organisation and Problem Solving
  • Emotional Self-Regulation
  • Self-Motivation

 

Neurofeedback helps Restore the Brains Ability to Self Regulate

From a neurofeedback perspective, we view ADD as a brain dysregulation, in particular, an instability.  It is less able to perform the above tasks automatically, without conscious effort.  Instead, the more strain it is put under, the quicker its fuel tank of willpower depletes, and as this continues, and it becomes less and less able to handle organisational tasks, emotional regulation and maintain focus.  In that sense, the more self-discipline is demanded from someone with ADD, the more difficult a task becomes.  This means that a traditional approach to invoke concentration through threats and remonstration will only worsen the situation. 

 

Neurofeedback is a form of complementary therapy and should not be seen as a replacement for conventional medicine.  qEEG brain map-based neurofeedback training takes a more holistic approach to brain functioning, rather than just focusing on medical symptoms.  It is not intended as a form of diagnosis nor medical intervention nor medical advice per the disclaimer.

Personalised Brain Training and ADD / ADHD

Brain Maps and Personalised Brain Training

Kaiser Neuromap brain maps and Brodmann areas

Brain Maps expose Individual Vulnerabilities

With a Kaiser Neuromap, we can identify character traits, vulnerabilities and strengths. 

Different brain areas and networks govern our behaviour.  For example, there are parts of our brain which control mood regulation; spatial distractibility; physiological arousal; our sense of self; self-critical thoughts; anger and emotional attachment; and there are various sources of anxiety.

A brain map shows us which brain areas are behaving immaturely, and thus expose us to vulnerabilities or mental health issues.

Rather than fitting people into categories – diagnosis – we can assess vulnerability to behaviour patterns.  Every brain is different.  A brain map provides a more granular approach to understanding our strengths and weaknesses.

Neurofeedback process explained, illustrating real-time analysis of brain waves and feedback given

Personalised Brain Training with Neurofeedback

Neurofeedback lets us train dysrythmic brain areas.  With sensors comfortably fitted to the brain areas we want to train, we detect brainwave patterns real-time while watching a movie.  When these patterns are inefficient, the volume drops momentarily.  This is the feedback we are giving our brain, short and instantaneously.  

The brain area we are training recognises this – while our conscious mind is focussed on the movie – and adjusts its behaviour to restore the normal volume.  With repetition, throughout a session, learning occurs.  

Meanwhile our conscious mind is solely focussed on the movie; the training process is passive in this sense.    

The drop in volume is subtle, so we continue to understand the flow of the movie.  No current or electrical stimulation is fed to the brain; sensors simply read brainwaves and the feedback is purely audio-visual.

Neurofeedback is preconscious brain training aimed at enhancing our mental, emotional and spiritual health

Neurofeedback trains our Pre-Conscious Mind

 

Rather than engaging the conscious mind, which slows us down, we are training preconscious processes

This equips us with the ability to live in the moment and attain our potential (if we have to resort to conscious control, we are not living in the moment).

Personalised Brain Training is an advanced qEEG brain map-based approach to neurofeedback training developed by the founders of the field.  Taking Othmer Method / ILF training methods further, it employs Default Network Training protocols as developed by David Kaiser.

We take a holistic approach to healthy brain self-regulation, rather than categorisation or diagnosis. 

Neurofeedback is evidence-based complementary therapy with over 2000 PubMed peer-reviewed research reports

Neurofeedback is Evidence-based

Neurofeedback training is an evidence-based complementary therapy.  Its efficacy was first demonstrated some 50 years ago, and with advances in technology, training protocols have become more efficient and the feedback method – watching movies – thoroughly enjoyable. 

Neurofeedback is evidence-based.  It’s first application was discovered in 1971 when it was used to resolve intractable epilepsy. 

There are over 2,000 peer-reviewed research reports on PubMed demonstrating efficacy across a number of pathologies. 

In the US, it is an accepted complementary treatment for many challenges. 

Complementary Measures to Help the Dysregulated Brain

Needless to say that stress and any other physical debilitation will negatively affect the Will Power fuel tank.  This includes the use of alcohol and recreational drugs, and of course illness.  It therefore seems logical that a ‘clean’, healthy lifestyle helps preserve powers indeed increase the resource pool.  Diet plays a role as much as exercise.  De-stressing activities such as yoga and meditation (though often seen as boring by ADD sufferers!) can help.  

To preserve willpower and indeed apply the available pool as efficiently as possible, it is useful to establish routines.  A key issue is that the ADD brain is structurally reward deficient due to its lower dopamine production.  It’s often observed that homework or housework tasks seem impossible to attract the attention of an ADD sufferer, while they have no problem playing computer games for hours on end.  Tasks they can hyperfocus on are typically ones that provide immediate reward, which indeed computer games do.  The trick in capturing focus therefore is to closely link reward with actions, in a sense, increasing accountability in the moment.  

Breaking projects down into smaller tasks, with clear hurdles to clear and consequences if achieved (or not), achieve this mimicking of a computer game ‘flow’.  This is where external help is beneficial – dividing up the task, relating the timing, and administering the reward.

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