Ask Dr B about Binge Eating & Other Addictions Occurring With ADHD & EFD - 054Jan 02, 2018
Hey ADDers! Do you struggle with any addictions or have you in the past? Addictions are a BIG deal for those of us with ADHD and EF deficits for so many different reasons. In fact, the stats on frequency are about twice that of those without ADHD or EF deficits, if these issues aren’t being fully addressed. And, if you’ve made an addiction a moral issue instead of what it is, then this episode is for you!!
In this episode, I talk about:
- The nucleus accumbens (pleasure center of the brain)
- How to increase motivation by increasing dopamine rewards
- Binge eating and relationship to ADHD as well as purpose it is serving
- Promoting a part of yourself from within
- The importance of celebrating your WINS
Developing your Executive Function Skills and shifting your limiting beliefs is the fastest and most effective way to overcome ADHD limitations, find focus, gain confidence, and newfound freedom in your life!
My mission is to put an end to the worldwide needless suffering of adults with ADHD and those with under-developed Executive Function Skills - whether from ADHD, chronic depression or anxiety, trauma, addictions, or chronic illnesses. And, you don't need a formal diagnosis to know you need help developing these executive function skills in order to greatly reduce your suffering.
Full Episode Transcript Today is Episode 54 and another Ask Dr B episode.
Hey ADDers! I’ve missed you all so much!! It’s been over 2 months since my last podcast episode, and I’ve been making my way back to my normal healthy state and energy after a pretty significant exposure to environmental mold. I did an episode on mold a few months ago, and it turns out that the mold problem here was greater than I knew at that time, and is what’s made it impossible for me to generate an episode until now.
A thorough assessment of my space and all systems was done; and the root problem was discovered and addressed. The environment was sanitized and all contaminated equipment was replaced. This is a perfect example of what I thought the problem was, wasn’t the complete problem; meaning that I thought it was a “local” mold problem not a systemic one. Once I knew the complete problem, the solution was obvious and the complete problem has been solved. I look forward to putting this adventure behind my canine companion, Pink and me, and moving forward in 2018 with our health restored.
I’m not used to being at the effect of something that I can’t see but sense and am definitely impacted by because I’m here most of the time. This experience has made me more grateful for all the years of great health that I’ve had, and anticipate having again very soon. I guess I’m sharing this bit of personal news to say that through this experience, I have learned the importance of extending “grace” to myself; to be even more understanding, loving and kind in how I speak to myself and treat myself. Given the circumstances as they’ve been, I’ve been doing the best I can. I hope that whatever your circumstances are right now, you can also learn to extend “grace” to yourself, and understand that you are doing the best that you can right now too, until you can do more. Self-compassion goes a long way to support healing and self-love.
Shifting topics now…
Do you struggle with any addictions, or have you in the past? Addictions are a BIG deal for those of us with ADHD or EF deficits for so many different reasons. In fact, the stats on frequency are about twice that of those adults without ADHD or EF deficits, if those conditions aren’t being fully addressed yet. And, if you’ve made an addiction a moral issue instead of what it is, then this episode is for you!!
I want to give you a little general information about ADHD, EF deficits and addictions first, before going into specifics. As I said, the research shows that the risk of addictions for you is twice what it is for others without your wonderfully configured brain, if you are not addressing your ADHD and EF deficits appropriately. And that doesn’t necessarily mean medication; or only medication. Many of you don’t take medication and are not interested in taking medication as part of your “treatment” for ADHD. I didn’t add medication to my “treatment plan” until I was in my 50’s. Prior to that, I was focused on learning and implementing strategies, structures, guidelines and such, so that I could have the quality of life that is important to me. In my 50’s I entered into that change of life stage that changed everything for me. In Dr. Thomas Brown’s most recent book, he says that many women with ADHD benefit from ADHD medication during peri-menopause and menopause stages of life. That was definitely the case for me.
The question I received a couple months ago that I wanted to address for this episode is about binge eating and ADHD. So, I’m going to offer some information about eating disorders and ADHD first, and then respond to the specific question I received.
In 2003 I presented at the International Association of Eating Disorders Professionals, as known as the IAEDP Symposium in Las Vegas CA on the topic of ADHD and Eating Disorders. It was a wonderful opportunity to interact with professionals who work with adults struggling with various eating disorders and enlighten them about adult ADHD, since it wasn’t part of their curriculum then and still might not be. They didn’t assess for adult ADHD when adults were admitted into their various programs for treatment, and hadn’t studied the correlation between the two conditions. I kept wondering just how many adults had gone into various different programs and emerged only to be unsuccessful at maintaining their health and wellbeing. It’s sad to me. I also presented on ADHD and Eating Disorders for ADDA in 2005, and want to share some of that information with you as well.
Here’s some of what I shared in my 2003 IAEDP presentation entitled “ADHD and Eating Disorders: Important Considerations for Successful Treatment Outcomes:”
· The latest research points to ADHD as a disorder of disinhibition, which is an inability to inhibit motor responses and to self-regulate. People know what to do, and yet they are unable to do what they know. And the very nature of eating disorders requires the ability to inhibit impulses.
· Recent research points to biological vulnerabilities for anorexia and bulimia as familial and inheritable disorders; this may also be true for compulsive and binge eaters.
· ADHD is also familial and inheritable. A substantial number of neurotransmitters have been identified that contribute to the regulation of feeding behaviors, as well as neurotransmitters that regulate inhibition in ADHD. In both cases, people know what to do and yet are unable to do what they know.
· An overview of the latest research on the theory, diagnosis and treatment of ADHD indicates that those with ADHD have a long history of failures in managing their lives in general and specifically their eating disorder. In order to ensure success, their ADHD must be treated first or at least in conjunction with their eating disorder, if their eating disorder is life threatening.
· ADHD research shows that in many cases (but not all) the need for medication is paramount, and that success is less than optimal without it.
· With both ADHD and Eating Disorders, people may be highly motivated to succeed and unable to do so due to neurochemical limitations.
· And lastly, the most successful modifications for ADHD come from changing the surrounding environment to a supportive one; one where they get frequent reinforcement, due to their lack of future-orientation or foresight.
· Celebrating all the daily wins definitely supports and reinforces success.
Here’s some of what I shared in my 2005 presentation at ADDA about ADHD and the Pleasure Pathways with Food:
· With a food addiction there are:
o Compulsive behaviors
o A loss of control with food
o Many efforts to stop
o A loss of time
o A preoccupation with food and getting it
o An effect on one’s obligations
o Continuation despite consequences
o Usually an escalation
o Often social, occupational, and recreational losses, as well as restlessness, distress, anxiety, irritability and despair
· With a food aversion there are:
o Compulsive behaviors
o Excessive control with food
o Efforts to avoid food
o Ridged or judgmental attitudes about food
o A preoccupation with avoiding food which often effects obligations
o Feelings of extreme shame, avoidance of intimacy and relationships is common, as well as distress, anxiety, irritability, despair and terror
· Treatment and successful outcomes are dramatically compromised when ADHD is undiagnosed or untreated; which was true when I presented this talk. People view their circumstances as a personal moral failing, rather than as a professional diagnostic oversight, and so their self-esteem plummets and lives may be unnecessarily placed at risk.
· In order to break this cycle and heal, the problems need to be made real; to name the drivers of this insanity in our society around food. Early childhood traumas and abuse are important considerations.
· The severity of trauma is subjective, because what is traumatic to one person might not be traumatic to someone else. ADHD left undiagnosed or untreated from childhood until adulthood can result in chronic and cumulative storage of trauma leading to addictions and compulsivities.
· Trauma that leads to compulsivities and addictions, can also block intrapersonal and interpersonal connections and intimacy; meaning a healthy relationship with yourself and with others.
· With compulsive overeating there is:
o Loss of control of the ability to stop eating
o Food is used to alter feelings rather than to satisfy hunger
o Often a craving for foods high in carbohydrates, sugars and salt
o Serotonin levels in the brain are raised by eating excessive amounts of highly refined carbohydrates, which can temporarily calm mental and physical restlessness, and contribute to poor focus and concentration
o Eating can be grounding for some; helping them to focus when working, studying, etc.
o Rituals and highly structured living gives the anorexic and others a way to focus their brains and the illusion of control, and often results in feelings of shame, isolation, secrecy and dishonesty
· With binge eating there is:
o Stimulation comes from planning the binge and it’s highly ritualized
o Secrecy increased the level of stimulation, risk and excitement.
o Again, poor focus and concentration due to excessive use of highly refined carbohydrates.
o Relatively short period of time for the binge itself; much more time spent in the planning.
· Binge and Purge:
o Same as binge eater with the addition of the purge.
o Methods can include laxatives, enemas, diuretics, vomiting, exercise
o Purge creates an altered state; calm, euphoric
o Poor focus and concentration due to poor nutritional care.
o Loss of control of ability to begin eating.
o Obsessed thoughts of body image, food, diet and rituals.
o High need for control.
o Use of laxatives, enemas, vomiting, exercise, diuretics to maintain distorted body image.
o Management of physical and cognitive hyperactivity by starvation.
o Poor focus and concentration due to lack of proper nutrition.
o Rituals and structure helps with focus.
· Chronic trauma: problems with affect or mood regulation, problems with attention and dissociation (spacing out), difficulties with self-concept (identity is other dependent and hyper vigilant about safety). Difficulty with interpersonal relationships.
· Ability to self-soothe, self-regulate, self-motivate are all compromised with chronic trauma or neglect.
· Disinhibition and self-regulation
o Those with ADHD are often unaware of their internal cues
o Neurotransmitters regulate inhibition in ADHD and contribute to the regulation of feeding behaviors too
o Indications that a disturbance of serotonin levels and frontal lobe functions are common to both ADHD and Eating Disorders
o Repeated failed attempts reinforce sense of hopelessness and helplessness & lower self-esteem
So much of what I just talked about points to the inability to self-regulate, which is key with executive function deficits as well as ADHD and necessary to avoid falling into the addiction trap.
Things you can do are:
· Create environmental support to implement changes
o You most likely respond well to working in partnerships if you have ADHD or EF deficits
o Set up your home, work and car to remind you and encourage you
o Enlist social support from your family, friends, or co-workers
· For overall treatment:
o If your ADHD and EF deficits haven’t been assessed, diagnosed and treated, be sure to get that done
o Work with your beliefs (the guiding principles in your life), your identity or sense of self (I am), and your spiritual life (beyond yourself)
§ Utilizing strategies from NLP, CBT and DBT
o Affect regulation and feeling management – especially distress tolerance of feelings; change the meanings of things to relieve distress
o Set boundaries with your self and others
o Address any power and control issues you have with yourself or others
o Address any traumas related to your acting out or in with food
o Learn about the meaning you’ve given your trauma so you can move forward and resolve it
o Resolve the fight between your cortex, (which is trying to make your life more manageable), and the frozen state of your limbic memories; (whatever is perceived as a threat to your survival that could be a trigger for you.)
I know this is a lot of pieces of information I’ve shared so far, that you may or may not already know. What I want you to know is that there are real solutions to these challenges once you identify the real problems. How much time do we have? Not much. So let’s get to it.
Now back to being an adult with ADHD or Executive Function Challenges, and a little more information about ADHD and Eating Disorders, a question from a listener, some action steps and a favorite quote of mine.
Having adult ADHD and EF deficits certainly can predispose you to eating challenges because of some additionally important information (this is dense stuff so hang in there with me) -
· The nucleus accumbens is considered the pleasure center of the brain. Even the anticipation of compulsively eating, binging, purging or withholding food will light it up. It’s operation is based chiefly on two essential neurotransmitters: dopamine, which promotes desire, and serotonin, whose effects include satiety (sa-ti-e-ty) and inhibition. It also activates your motivation and allows willpower to translate into action.
· The nucleus accumbens’ function is in the limbic-motor area
o It receives information related to your emotions from the amygdala (bad memories of food) and hypothalamus (good memories of food)
o It’s levels of dopamine increase and decrease according to reinforcing stimuli or aversive stimuli. This helps you remember how to repeat pleasant experiences and how to avoid aversive ones.
· If you are food addicted or food aversive, you do not have adequate levels of dopamine and require higher levels of stimulation and intensity to get high on life.
· Therefore you would seek out more powerful stimuli in order to do so. You would act out or in to self-regulate yourself, because levels of dopamine and serotonin can be altered through use of foods.
· The nucleus accumbens plays a fundamental role in addictions. It causes a huge amount of dopamine to be released when you partake of your drug of choice, making you feel pleasure, and you tend to want to continue to consume.
· It’s also involved in the planning and inhibition of behaviors due to its connection with the prefrontal cortex.
· A little bit about your motivational system
o Dopamine and the nucleus accumbens work together when you receive a reward and also in the prediction of a reward.
o When you anticipate something pleasurable, dopamine is released.
o Due to the connections of the nucleus accumbens with the prefrontal cortex, you are able to generate plans of action to obtain a reward, which is pretty cool. In other words, it has the function of making you anticipate the prize to encourage you to achieve it.
· Increasing your motivation by increasing your rewards
o You can train your brain to have more motivation and produce more dopamine in the nucleus accumbens by giving yourself frequent positive feedback from your progress by setting up goals. Then break your goals or tasks into parts and reward yourself for each one completed. This is the point of looking for and celebrating your WINS. It increases your dopamine levels and you feel more motivated, IF you allow yourself to really feel the celebration rather than just mouthing the words.
So, this is a perfect transition to the celebration of your WINS. And please don't short-change yourself and check out here or think that it’s pointless or stupid to reward yourself for things you’re “supposed to do.” That couldn’t be further from the truth; especially after all I’ve shared with you today about dopamine and your reward circuits. Are you really going to make yourself wait for more dopamine until something HUGE happens to celebrate? Does something HUGE happen everyday? Probably not! But the kind of WINS I’m talking about can and often do. That means that you can increase your dopamine levels and motivation by celebrating your WINS; big and small every day!!
So, what’s it going to be for you today? What are you going to celebrate? Maybe you’ve gotten an insight from this episode; that’s certainly a WIN. Perhaps you’re thinking about the meaning you give to food or your food rituals; that’s a wonderful WIN. Maybe you’re feeling hopeful that a real solution does exist for you; that’s definitely a WIN. You get the point; celebrate all of them; big and small. And none of this “half-hearted celebrating”; you’ve got to mean it. Exaggerate your emotions. YES!!!! WOW!! AWESOME!! You want your acknowledgement and celebration to register in your neurology with the power to move you and shift your state. Many of us need a higher level of stimulation or intensity for things to register. So, if that’s you, give that to yourself and exaggerate your celebration so you can actually feel it.
So transitioning now to today’s question from Shelby, in Michigan:
· She shares and asks: “Hi Dr. B, I've had a lifelong struggle with binge eating. ADD runs in my family and I've noticed the other ADD have this issue as well. Could it be related to ADD? If so, what purpose is it serving? Is it possible to replace it with another, more beneficial behavior?”
Thanks for your question Shelby! It’s a great two-part question!!
First, I hope the information I’ve shared earlier in this episode has answered the first part of your question about binge eating and whether or not it can be related to ADD. Summarizing from earlier in this episode, yes it can be related to ADD. Certainly not everyone who struggles with binge eating has ADHD, however, I think it’s a realistic point of view that those that struggle with binge eating have executive function deficits – in particular, self-awareness, self-regulation and impulse control. So even if inattention or hyperactivity isn’t an issue (two of the core symptoms of ADHD), certainly the missing fundamental executive function skills are a big issue here.
To the second part of your question as to what purpose is the binge eating serving, I touched on this little earlier on and will expand here a little differently. I’m going to say that it’s purpose is going to be specific to the person it is serving. And, in order to respond to your question here, let’s assume for the moment that the part of you that controls the binge eating is actually in charge of helping you to feel happy or satisfied or some other positive feeling (emotion plus meaning given). And that every time you need to feel that feeling, you need to binge eat because the association has been created and bonded together – food and happiness. What fires together, wires together is another way of looking at this.
And since most people I know want to feel happy, this behavior is taking care of that for you, even though it also has a downside that is hurting you. The question I would ask you is, “what does being happy mean to you and do for you?” Then, utilizing a process from NLP called “chunking up,” I would ask you, “what does the answer you gave do for you?” And so on and so on until you have no other higher intention or answer. You want to continue to “chunk up” until you get to whatever is the highest intention or feeling for you about being happy. This is an action step for you to take.
Continuing with this train of thought, let’s say that what feeling happy will do for you is give you a sense of peace. And so, the binge eating then is about that sense of peace. And how else can you get or generate a sense of peace for yourself other than by binge eating? Make a list of possibilities. This is another action step for you to take.
And then using a technique I created that I call “promoting from within,” you would promote that part of you that has been making sure you binge eat and put it in charge of generating your sense of peace – which might be meditation time, or even time when you are free to do nothing but just be. Giving yourself that space in time to just be might be the sense of peace you are seeking but don’t get if you are constantly busy doing something. This is another action step for you to take.
The bottom line is that you need to know what the ultimate purpose or meaning is for the binge eating, what it is trying to do for you, so you can negotiate with it and shift it to a more desirable role that will actually give you what you are seeking at a much deeper level. I hope this is helpful as a place to start with the transformation of your binge eating behavior.
And thank you again Shelby for your question for today’s Ask Dr B episode.
For those of you who relate to Shelby’s question or the other information I’ve shared with you today, YOU are the meaning maker of your life experiences. You may not have control over what experiences come your way, but you certainly have control over what feelings you experience, and what meanings you make of those experiences that will last much longer than the experience itself.
Listen…you’re not broken! You’re not defective or less than either. You are YOU! You have gifts and talents that may be different than others but valuable nonetheless. You are a precious “human being” whose value is a given; because I am not talking about you as the “human doing” that most of society views you as. And you may be missing some skills that are making your life very difficult right now, and yet skills can be learned. You may need to make some changes, and you may be in the very early stages of making those changes, and that’s fine. If you are willing to be a student of your own life and develop a deeper understanding of yourself and how you are put together, and then offer yourself a lot of compassion and patience, plus the time, effort and energy it’s going to take to make the necessary changes, these things will happen for you. I know this is true because my students are learning skills they’ve been missing for most of their lives and it’s amazing to share in the transformation of their thinking, behaviors and aha moments.
Please don’t let yourself be one of the 80% of people who don’t ever make it to more permanent change or even the 80% who want to change but never actually end up making the changes they want for many different reasons. There is training and support available to you to ensure, to the best of my ability, that you don’t become one of the 80% who don’t make it. Rather, that you are one of the 20% who do. If you’d like to know more about what I mean, put your name on the “re-purposed Waitlist” for ADDventures in Achievement so I can call you right away and we can chat about what important changes you want to make and how you can start making them right away. You’ll hear from me within 24 hours of receiving your information unless it’s during my Sabbath time, from Fridays at 2:30 pm PT to Sunday 9 am PT.
It’s clear to me that there are many different points along your journey where you really need support, encouragement, accountability and whatever training and answers you need right then and there to keep you moving forward toward your goal(s). I definitely don’t see this as a solo journey, which is why I decided to “temporarily” make some changes to the enrollment process for my program, ADDventures in Achievement. I’ve re-purposed the Waitlist, so that now, as soon as you get yourself on that Waitlist, I’ll be reaching out to you, so we can determine if this program is right for you. And if it is, you can enroll right now, at the current pricing, instead of waiting until the public re-launch in February 2018, which will include a price increase due to the new content about executive function skills that is formally being added to the program. All the current Working Workshops and Coaching Calls weave in executive function skills, so current members don’t have to wait to benefit from these life-changing skills. This could be you too!
So, if you’re curious about whether or not ADDventures in Achievement is right for you, AND you want to freeze your membership costs at the lowest pricing it will ever be, now is the time to put your name on the Re-purposed Waitlist and I’ll call you at the number you provide or email you within 24 hours to set up a call. This program is definitely the place to be if you want help understanding what’s been holding you back and want to learn the skills to break free of your stuckness and start living the life you’ve only wished for.
Plus, starting this month, our Workshops will become “working workshops” where we will work through the topic or skill together, rather than you having to practice on your own in the beginning when scaffold learning and support are so essential to your success.
How your brain, mind and body works is the uniqueness of you. And if how you are put together currently is “dis-ordered” it doesn’t have to stay that way. Your uniqueness doesn’t have to be a limitation; it can be your strength once you understand YOU and what you need to live as your best self. It’s my hope that you’ll reach out to me now and get what you need.
A quick update on the rebranding of my show; the new voiceover is finished and I’m working on the new artwork. The new name will be “Living Beyond ADHD” which more accurately reflects the topics I talk about. Watch for this change this month.
Each of us is like a puzzle with so many pieces that need to be put together to form the picture of our life and if we get overwhelmed by all the pieces we see in front of us and never put the picture together, it’s a huge loss for everyone. So, please… It’s your responsibility to put your picture together and if you need some help, ask someone – ask me!!
A Favorite Quote:
Zig Ziglar said, “People often say that motivation doesn’t last. Well, neither does bathing. That’s why we recommend it daily.” So, the question I have for you at this point of our journey together is, “Are you ready to make motivation a daily habit? If so, how will you remind yourself every day that being motivated is your new way of life, and what reward will you give yourself for taking action on what’s important to you? How will you celebrate yourself?” Remember that motivation is based on having a good enough reason to take action.
That’s about it for today’s Ask Dr B episode.
It means a lot to me to know that your life is getting a little bit better every time we get together. I do hope that you will take some positive action because for things to change, YOU have to change. And that means taking action. Remember, there’s a PDF transcript of this episode in the resources. Plus, I’d love to get to know you in the community group I created on Facebook or in the ADDventures in Achievement program.
And…if you benefited from today’s episode, take action now and share this show with your friends and family. You can rate the show and not write a review if you prefer or you can do both; I’d love to know what you think of the content, and again, I’m so glad to be back.
So thanks for listening… Until the next time… Bye for now…
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