Attention Deficit and Hyperactivity Disorder can present in many ways. You might feel the inability to keep your mind and/ or body still. There is a shift of priority from one moment to the next. It might even be a sense of boredom or irritability. For some, it might be the inability to retain information, like phone numbers or peoples’ names. Sometimes it might be impulsivity. Other times, it is just lying in bed at night worrying about what didn’t get done. Point is, you don’t feel great and would like to get better. You’ve identified a problem, but you are not sure how to fix it.
The first thing you should know is that it is not all in your head. There is a tendency to think that mental health issues are purely with the brain, losing sight of the fact it is connected to a body. There are medical conditions that can present with the inability to concentrate and be prone to distraction. You want to check for those factors and not just focus on the head.
Everything that applies to depression and anxiety, also applies to attention deficit issues. It is important to rule out those other conditions before one can conclude there is an attention deficit issue going on. Depression and anxiety can cloud your ability to think clearly and retain information. Once those conditions are ruled out, you can be assessed for attention deficit disorders.
The stimulants are considered the gold standard treatment for attention deficit disorders. The medications work on the dopamine transporter to increase the level of dopamine external to the cells. Like the discussion about serotonin and GABA, it is important to understand the body needs to first make the dopamine before we get into looking at ways to augment it with medication.
Phenylalanine is the starting point in the dopamine pathway. It is converted to Tyrosine by the Phenylalanine Hydroxylase enzyme with cofactors:
Vitamin B6 (P5P)
Iron
BH4 (Tetrahydrobiopterin)
The tyrosine is then converted to L-Dopa by the Tyrosine Hydroxylase using cofactors:
Vitamin B6 (P5P)
Vitamin D
Iron
BH4
The L-Dopa is then converted to Dopamine by the Aromatic Amino Acid Decarboxylase with cofactor:
Vitamin B6 (P5P)
The dopamine can be recycled by the pump, transformed into another neurotransmitter, or degraded. The first stop is Dopamine is converted to Norepinephrine by the Dopamine B-Hydroxylase using cofactors:
Vitamin C
B3
Copper
Dopamine is also degraded by the Monoamine Oxidase (MAO) enzyme, utilizing cofactors:
Vitamin B6 (P5P)
B2
B3
Iron
Magnesium
Dopamine is also degraded by the Catechol-O-Methyl-Transferase (COMT) enzyme, utilizing cofactors:
Magnesium
S-Adenosyl Methionine (SAMe)
You could imagine that deficiencies in these cofactors could impact the bodies ability to drop the dopamine levels. Also, if the enzymes breaking down the dopamine, you can imagine that levels would be decreased.
Cholesterol:
Low levels of pregnenolone is associated with attention issues and brain fog.
The goal of treating attention symptoms is to be sure all aspects of your functioning is in order. As there are many points of failure in making dopamine, it indicates there are multiple ways to approach dealing with the related symptoms. The stimulants are a quick fix, but ensuring general health is critically important in treating the condition.
