Chris: Liz Smith takes the reigns again today with another dive into the intriguing world of the ADHD mind.
Eating with a magpie brain
Part 1: when food isn’t just food
Hi again fellow magpies – and PTs and coaches working with magpies.
Following on from my blog about training with ADHD (which you can find HERE), I’m back with another about an issue I feel very passionate about – ADHD and our relationship with food and nutrition.
I know that food and nutrition is important for optimal training. But for me, ADHD has made that a lot more complex.
In this blog, I’ll explain how and why ADHD can affect our relationship with food and nutrition and in the next one, I’ll cover how PTs and coaches can better understand and help their ADHD clients with the challenges they might face in this area.
It’s not “lack of willpower”
Understanding why clients are struggling, for example, to stick to an agreed food plan, is essential.
A lot of the behaviours and issues I’m going to discuss are blamed on poor willpower, discipline, or poor time management (for example when an ADHD client tells you they haven’t had the time to meal prep that week). I’m going to explain here why this isn’t the case.
Neurotransmitters, ADHD and self-regulation
Our brains have circuits within them used to transmit information between different parts of the brain. The neurons in our brains produce neurotransmitters, which send information through the circuits in the brain from one part to another. Where there are impairments in the actions of these neurotransmitters, these translate into real-life impairments.
ADHDers tend to have the most pronounced impairments in dopamine and noradrenaline.
Dopamine is responsible for our ability to feel pleasure and is a big part of our reward and motivation system.
Noradrenaline is responsible for regulating attention, motivation, reward, concentration and memory.
Here’s the kicker. Noradrenaline is basically made from dopamine, so if there’s a deficiency in the dopamine pathway, you’ll get a deficiency in noradrenaline production as well. If ADHD involves impairments in the production and action of these neurotransmitters, it’s not surprising that individuals with ADHD struggle with concentration and focus, memory and mood, impulsivity and behaviour regulation (including regulating our food intake!), among other things.
But how does this affect food and nutrition, I hear you ask?
ADHD can affect our eating habits in several different ways making it harder to a) change food habits and b) stick to food plans – this affects things like weight or fat loss, if that’s someone’s goal. I’ll use myself as an example here of what that looks like in practice – first in my undiagnosed and unmedicated life, and what that looks like now.
Pre-diagnosis and medication, I lived for caffeine and sugar. No, really, I’m not kidding. If I could have hooked myself up to a drip and that was socially acceptable, I would have. I’d start the day with the best of intentions, but by 2pm most days, all my energy was gone, spent up trying to make my brain focus (on things like getting out of the door for work without forgetting a million things and that’s even before I’d started any work for the day).
The only thing that worked to get me through the rest of my day was an injection of caffeine and/or sugar. And I had no off switch, especially with sugary food.
I didn’t get it. I WANTED to eat better – why couldn’t I?
When food is not just food
I now understand that the impairments in the way my brain worked with ADHD meant that I was constantly needing stimulation to produce the amount of noradrenaline required for me to get things done.
My job as a psychotherapist, which I do absolutely love, requires high amounts of concentration and focus and it’s absolutely unacceptable not to be on time. I also have a lot of things to remember and a lot of paperwork to do.
Pre-medication, despite finding my work very meaningful, I also found it draining a lot of the time because I was highly anxious about dropping the ball.
Because I was so tired and drained when I got home, I didn’t have the energy to cook – and on top of that, I’d be craving dopamine-stimulating foods. Think salty, fatty, sugary, beige – all the things that all you coaches and PTs reading this don’t want your clients with health and fitness goals to be eating too much.
I could hyperfocus on a food and nutrition plan for a couple of weeks – but as soon as I started to run out of energy (because life when you’re constantly trying to corral a magpie brain to do the basic things it needs to do is HARD) or other things took my attention, such as an urgent work situation, it would all just go out of the window and I’d be chasing the dopamine train again.
Healthy foods, fresh fruit and veg – they just don’t get the dopamine train going.
The impulsivity that comes with ADHD makes it much easier to say “f the plan – I need to feel better RIGHT NOW”.
Basically, I was self-medicating my ADHD for years with food and caffeine.
I now know that these behaviours are not a defect, laziness or a deficiency in my self-discipline. I do want to eat and train well – but I now understand that my brain was wired to work against me.
ADHD medication can regulate food intake
I’m now on an ADHD medication called Strattera. The difference this has made, now the dosage is right (which has taken some time) has been nothing short of huge.
I have a steady supply of energy throughout the day. I have one coffee in the morning and that’s it. I can do the things I need to do in the day and have enough energy to cook a quick, healthy meal.
I don’t crave sugar or junk food. Yes, I eat some of those things, but I don’t HAVE to have them NOW.
The Strattera has regulated my appetite as well and I no longer have an issue with not recognising when I’m full, because my brain no longer needs food as a stimulant or soothing mechanism. For the first time in my life, food is – well, just food.
Some of this is habit-driven and that’s something I’ll still have to work on even on medication.
I still find myself reaching for the coffee pot at 2pm – it’s like my brain hasn’t quite caught up that I don’t actually need it, so I need to take that time to pause and reflect. Am I feeling tired? Have I not had enough breaks? Do I need to take some time away from the screen, get some fresh air?
The Strattera hasn’t taken away the impulses around food entirely, but it has given me that bit of space to think “is this really what I need right now?” and that brings the possibility of building new food and nutrition habits.
I still need to make conscious choices about food – medication doesn’t magically fill your fridge with fresh, nutritious food, or cook it for you.
If you’re a PT or coach and you’re struggling to understand why your clients with ADHD keep going off-plan, one “cheat day” turns into a whole week of junk food mania, and have a wealth of what look like excuses, I hope this might have helped fill in some of the blanks.
Next time, I’ll talk about strategies that might help your clients with ADHD to examine their relationship with food and nutrition and how you as a PT or coach can help them to a) move in a positive direction and b) set realistic expectations for both of you and strategies to help.
By Liz Smith
Liz Smith is a counsellor and psychotherapist specializing in neurodiversity, trauma and post-traumatic stress and is a registered member of the BACP. Find out more at https://www.counsellingandtherapyinyorkshire.com
Thanks for reading!
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