ADHD, laziness or both?

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I have a photo collection of fat cats on my computer. I’m certain that they have the ideal life. Rolling around, sleeping most of the day, getting petted, drinking milk, being fed by multiple households . Just thinking about how wonderful that must be makes me happy.

I’ve always considered myself to be a lazy person. The kind who sleeps in, never tidies up, watches a lot of TV, eats junkfood, would rather stay in than go out and someone who  always puts things off, ” why do it now? when tomorrow’s just as good”.  Sure there have been times when I’ve temporarily shaken off the laziness and applied myself. (training for the city to surf, programming assignments at uni, marathon cleaning sessions) but this isn’t the day to day me.

When I got the diagnosis of ADHD initially I was glad to have a reason for why I was constantly screwing up. I’m not proud of being a lazy person/underachiever. But over time a feeling has kind of sunk in, that the diagnosis hasn’t really changed much at all. While I do think I do have ADHD, I don’t think its solely responsible for my past failures. I think if you have ADHD then you have less self control/self regulation than the average person. But less self control isn’t no self control. Every day that I don’t apply for jobs and choose to eat pizza instead of cooking is a day where I’ve made conscious decisions to do those things. Bad decisions, but If I don’t take responsibility for them and blame it on ADHD instead that would just make me a  helpless victim of ADHD.

Laziness is a characteristic that’s probably been around since the start of human existence, you’d think natural selection would have eliminated it, but no. The greeks had some ideas on understanding its cause.

What causes the character trait of carelessness?  We can get 
   insight from Aristotle.  According to Aristotle a character 
   trait is caused by repeatedly doing some particular thing.  
   With repetition it becomes a habit, a character trait.  Take 
   the character trait of laziness as an example.  A person 
   acquires the character trait of laziness by repeatedly taking 
   the route of avoiding work, of repeatedly ignoring the voice of 
   conscience, intellect, prudence in regard to what he ought to 
   do.  He has developed the habit of taking the easy road in 
   regard to work.  He just avoids it.  By repeatedly doing this 
   it becomes a way of thinking, a way of dealing with life.  Now 
   a person who is careless, or negligent, is one who habitually 
   doesn't do the things he ought to do.  He is untidy.  The house 
   is a disaster, in total disarray.  He doesn't put anything 
   away.  What explanation can you give for this kind of behavior?  
   Could the explanation lie in that character trait that we call 
   laziness?  Could it be that he is just lazy?  Why doesn't he 
   put things away?  It is too much trouble.  He doesn't want to 
   go to the trouble of putting them away.  It is just too much 
   bother.  And there is a problem, an obstacle.  He doesn't know 
   where to put them.  He has accumulated so much stuff his 
   storage spaces are all full.  Nor does he want to go to the 
   trouble of figuring out the best way of solving the problem. 
   Of organizing and storing them, or where to store them.  That 
   requires the activity called thinking.  He is averse to that.  
   Thinking, analyzing, figuring things out is just not one of his 
   specialties.  It is too much trouble, too much work.  It is 
   just an activity he shys away from.  So when he changes his 
   clothes he just throws the old ones in a pile on a chair.  He 
   has no self-discipline.  He is impulsive.  He does whatever he 
   wishes.  He buys this and he buys that, whatever his heart 
   desires.  He has a whole lot of stuff and no place to keep it.  
   So his stuff is strewn all over the house in piles.  He is just 
   not a methodical person, never has been one.  His mind just 
   doesn't work that way.  Organizing things requires thought, not 
   one of his specialties.  He is not lazy in everything.  He is 
   not lazy in doing things he enjoys doing.  He has plenty of 
   energy for doing things that give him pleasure.  He can show a 
   lot of perseverance in doing things he likes to do, wants to 
   do.  But with regard to drab, mundane tasks that give him no 
   pleasure, he is very procrastinating, dilatory and foot-
   dragging.  He is impulse oriented, mood oriented, feeling 
   oriented.  He doesn't do what he doesn't want to do.  He just 
   habitually avoids doing things that he doesn't feel like doing.  
   It is a way of life for him.  Confusion and disarray don't 
   bother him at all.  It is a way of life.  He doesn't deal with 
   basic problems at their root.  He just lives with them.

And conversely …

   
   A type of person has something in him that the careless, 
   indifferent, negligent person doesn't have.  What is it?  It is 
   something inside himself that requires him to do the right 
   thing, the honest thing, the intelligent thing.  He has that 
   voice within that tells him how he ought to act - and he obeys 
   that voice.  He is a person who habitually obeys the voice of 
   Conscience, Reason, and Prudence within.  He does what he knows 
   he should do even though it may require a lot of work and be 
   hard.  He habitually takes the high road even though it may be 
   the hard road.  He is not daunted by difficulty.  He does the 
   right thing.  He is a person of integrity.  He has a self-
   discipline and moral strength that the careless person doesn't 
   have.  The careless, negligent person who takes the easy, lazy 
   path in doing things reveals a lack of integrity that will 
   likely reveal itself in other ways as well.

Taken from http://www.solitaryroad.com/a1025.html

Things to think about.

First double blind study shows neurofeedback no more effective than placebo- why this isn’t as bad as it sounds

Neurofeedback (NF) is no more effective than placebo in the treatment of ADHD symptoms show the results of the first double blind study to be conducted, one which made use of sham neurofeedback.

Previous studies have had control groups do cognitive exercises, to simulate a level of mental activity similar to that of NF training. However a better control group is one where every factor except the neurofeedback is kept constant. Here the subject undergoes NF training, however a computer simulated EEG is used instead of the user’s own, also known as SHAM neurofeedback. Thus it is possible to differentiate between the benefits of Neurofeedback itself, and other factors involved in the neurofeedback process (e.g. time spent with therapist, time spent focusing on task, clinical setting etc).

In this study even the NF practitioners were unaware of which group (test/placebo) the subjects had been assigned to. Typically reward thresholds are adjusted manually by practitioners, to make the training progressively harder as the subject improves. However as the practitioners were unaware of whether real or sham training was taking place, the thresholds were adjusted by computer software instead.

The study methodology was not typical in comparison to previous neurofeedback studies. According to a quantitative meta analysis of neurofeedback studies, the bulk of them  have involved either beta/theta training or SCP training protocols at specific sites. Instead in this study individualised training protocols were used.This training was designed to normalize deviations from normal QEEG. Sites to train were chosen by analysing QEEG, with the areas trained corresponding to the largest deviations.

Over a period of four months, both the control and test groups took part in 30 treatment sessions. At the end of the treatment period both groups made substantial improvements in reducing ADHD symptoms, and there was no difference in improvement between the NF and sham NF groups. When the subjects/parents were asked whether or not they thought they were given a placebo(SHAM NF) treatment, 75% of the NF group and 50% of the SHAM NF group thought they were given a placebo.

The fact that less than half the subjects/parents in the test group were aware that they were undergoing NF training shows that the computer set reward thresholds may have been set too high/ were improperly managed by the computer software. Or that there may have been a problem with the site selected for training. Typically a NF practitioner would have some control over training, (ability to change sites/ set reward threshold levels) however this wasn’t the case in this study, and the results show this. Because of this in a future larger study to be carried out by the authors, the reward thresholds will be set manually by a NF therapist.

Both those underdoing NF and sham neurofeedback were similarly uncertain as to if they were being given a placebo or not. While this shows that sham neurofeedback is a suitable placebo, i.e It’s not immediately obvious to the patient that they are not being given a placebo,  it also shows that there were problems with the NF training methodology as the subject should have been aware that they were undergoing NF (e.g. felt a sense of control) . The authors noted that they may have had better results if they had stuck to more popular NF methods such as (beta/theta & SCP training).

The result of this study seems to show that SHAM neurofeedback is beneficial. I won’t go as far as concluding that it shows that it’s as beneficial as neurofeedback, as based on what I think was improper Neurofeedback methodology I would say both the test and the placebo groups were given SHAM neurofeedback. So where is the benefit of SHAM neurofeedback coming from? Is it the clinical setting? the time with the practitioner? the effect of paying attention for a certain amount of time? In this case I’m going to go with the latter. I would say that SHAM neurofeedback is beneficial in the same way that meditation is beneficial. By focusing on one thing (e.g. breathing in meditation, maximising reward in NF training) for a certain amount of time, concentration improves, and this could be responsible for the reduction in ADHD symptoms. However I think neurofeedback may be easier than meditation for an ADHD person, as meditation relies on internal regulation, while neurofeedback relies on external feedback.

Summary

ADHD and EEG-neurofeedback: a double-blind randomized placebo-controlled feasibility study
http://search.proquest.com.ezproxy.slv.vic.gov.au/docview/855953055/13D17177F2155D86E50/2?accountid=13905
Study year:2011
Study Demographics:14 children (ages 8-15)
Five of 8 children in the EEG-neurofeedback group and 4 of 6 children in the
placebo feedback group were medicated with psychostimulants
Study Methodology:randomized double blind study, feedback controlled placebo
ADHD defined via DSM-IV-TR criteria.
control group n=6, active group n=8.
Type of neurofeedback training:Individualised protocols. Designed to normalize deviations from normal QEEG. Sites to train were chosen by analysing QEEG, areas trained corresponding to largest deviations.
“The aim of the EEG-neurofeedback training was to normalize power within specific frequency bands and at specific electrode sites”

Frequency of training: 30 sessions over 4 months, 2 sessions a week.
How outcome was measured: EEG signal measured after training, data supplementary.
Efficacy in the present pilot study was measured by the total severity of inattention and hyperactive/impulsive symptoms of ADHD according to the ADHD DSM-IV scale (DuPaul et al. 1998), rated by the investigator in an interview with the parents. Severity of the ADHD symptoms were rated (with a score from 0 to 3) before training, after 6, 10, 20, 30 training sessions, and 6 months after the end of the training period.
Results: 75% of children and their parent(s) in the active neurofeedback group and 50% of children and their parent(s) in the placebo feedback group thought they received placebo feedback training.Analyses revealed significant improvements of ADHD
symptoms over time, but changes were similar for both groups.

HI MUM

My blog now has one reader! whohooo!

Had my first appointment with a psychologist today. Being the first time I saw her we didn’t really talk about much more than my life history. But the advice that she did give me seemed to hit a nerve. I’ve paraphrased what she said below.

When your trying to make yourself do something you don’t want to do, you’re going to feel

      • Angry
      • Irritable
      • Frustrated

 You have to  keep fighting those feelings. You aren’t going to feel motivated. You’ll have zero motivation. You have to tell yourself that you’ve made a commitment to doing this and that you’ll see it through.
It’s going to be harder for you, so you’re going to have to work harder- but when you succeed it’s going to really be an achievement, and really mean something.

It would be nice if we could go through life without those feelings (anger/frustration), but life isn’t like that.

Shortly after this she wrote “Life is suffering” on her whiteboard.

I’ve seen a few counsellors before, and the advice they’ve always given me- has always made sense, but hasn’t really made an impact. There’s never been any light bulb moment, where I have some sort of major realisation. But this time it felt like there was.

I think it was two things. First that she acknowledged just how angry and frustrated I do feel whenever I try to force myself to stay on task. And second that you don’t need to be feeling motivated in order to get things done.


Using Arduino as an ISP to program brand new microcontrollers

Was just about to buy a $5 Atmel AVR programmer from China, and was freaking out about having to wait up to month for shipping. I should have realised this before, but you can program an Arduino to act as an ISP ( In circuit programmer).

The microcontroller I plan to use in my project is an ATMEGA48, which costs  $2.69 from Element14. It runs at 10 MHz, has an ADC and I2C, SPI, USART connectivity.

Using this guide, you can use AVR dude (free software) to turn your code into hex format, and then upload it via SPI using the Arduino as a programmer.

Using an Arduino board to program an ATmega,with external crystal and associated capacitors (18 or 22 picofarads).

I bought $40 worth of electronics from Element14, and they sent it to me via four  couriered packages arriving between 1- 7 days. I didn’t pay anything for shipping, but surely that must cost them a fortune. I know they were shipping parts from different warehouses and I do like that they ship as soon as the parts are available. On the site it tells you how long each of the parts should take to ship. I really like Element14, they seem to be really well run and I even got a call from them saying that if I ever needed any technical help they had people on staff I could talk to. Which is nice.

I ordered the wrong sort of chip, DIC instead of DIP, and it was an instrumentation amplifier too! and cost $11. Urgh, the most expensive part – I’m hoping I won’t actually end up using it, and can substitute a cheaper maybe $5 instrumentation op amp, with similar specs, but since for the amplifier stage of the EEG I am using someone else’s design, I should stick to that- since analog circuits are definitely not my area. Will detail my plans for an EEG shield in the next post, and maybe put it in front of this one.

 

Electric fields, electric eels and how electricity travels through the scalp.

Hope that title confused you. Because this post is going to be on a topic that’s confusing to me. It started when I read this article Neurobiologists Find that Weak Electrical Fields in the Brain Help Neurons Fire Together .

Extracellular electric fields exist throughout the living brain. Their distant echoes can be measured outside the skull as EEG waves. These fields are particularly strong and robustly repetitive in specific brain regions such as the hippocampus, which is involved in memory formation, and the neocortex, the area where long-term memories are held. “The perpetual fluctuations of these extracellular fields are the hallmark of the living and behaving brain in all organisms, and their absence is a strong indicator of a deeply comatose, or even dead, brain,” Anastassiou explains.

Throughout the entire article they referred to electric fields. Electric fields? That’s a term I’m not familiar with, which I guess seems strange after having done more than a few electrical engineering subjects. Was an electrical field the same thing as voltage? A term I did understand, and If I substituted voltage for electric field the article made sense. But I decided to look into this further- meaning I decided to google it.

Thanks hyperphysics!

Thanks hyperphysics!

This was the first thing that came up. Disappointingly mathsy. But it showed that Electric fields and voltage were not the same thing. Rather an electric field is the change in voltage measured over a distance, with the unit of V/m or V/cm or mV/mm etc. etc.

Ok so why measure voltage over distance? In wired circuits, distance (despite circuit noise considerations)  based on what I’d studied, was never taken into account. Something was missing. And that something was made clear in this example I stumbled upon.

Question: Suppose an electric eel is 1 m long, and generates a voltage difference of 1000 volts between its head and tail. What is the electric field in the water around it?

Solution: We are only calculating the amount of field, not its direction, so we ignore positive and negative signs. Subject to the possibly inaccurate assumption of a constant field parallel to the eel’s body, we have 

Aha! So an electric field was something that was useful in describing electricity flowing through a substance like water, as opposed to electricity that flows through wires.

By the way, eels are awesome. Some eels like the Moray eel, have a double retractable jaw (like the creatures in Aliens). And the following info from Wikipedia

 The electric eel has an elongated, cylindrical body, typically growing to about 2 m (6 ft 7 in) in length, and 20 kg (44 lb) in weight. In the electric eel, some 5,000 to 6,000 stacked electroplaques are capable of producing a shock at up to 500 volts and 1 ampere of current (500 watts).  Such a shock could be deadly for an adult human. Juveniles produce smaller voltages (about 100 V).

They are capable of varying the intensity of the electrical discharge, using lower discharges for “hunting” and higher intensities for stunning prey, or defending themselves. When agitated, they are capable of producing these intermittent electrical shocks over a period of at least an hour without signs of tiring.

These fish have always been sought after by some animal collectors, but catching one is difficult, as the only option is usually to make the eels tire by continually discharging electricity. The fish’s electric organs will eventually become completely discharged, allowing the collector to wade into the water in comparative safety.

Keeping electric eels in captivity is difficult and mostly limited to zoos and aquariums, although a few hobbyists have kept them as pets. An electric eel requires an aquarium of at least 750 l (200 gal). It generally must be kept in the tank by itself, although adult electric eels generally tolerate one another. Young eels will often fight if placed in the same aquarium. Electric eels cannot be kept with any other fish, as they will attack them

After reading that I’m more determined than ever to one day have an electric eel as a pet.  Considering that your average bath tub is about 250 L, that should be large enough for a baby one. I’d train it to deliver electric shocks for food (simulating real life conditions!) and have some kind of circuitry so that it could charge my mobile phone. I’d call him/her Zappo and we’d be best of friends. Despite the fact I wouldn’t be able to pet them without the possibility of getting shocked. And when Zappo outgrew the bathtub,we’d travel back to South America, and I’d release him into a nice swamp/creek and it would be a very dramatic/tearful free Willy type of moment.

Alright, enough about eels, and back to electric fields, and how they are useful for describing electrical circuits that involve substances like water. So how does electricity travel through water?

The following image shows how electrical current flows between two probes submerged in water and connected to a battery.
Path of electrical current in water

Path of electrical current in water

With the top probe connected to the batteries’ positive terminal and the bottom probe connected to the negative one. The current radiates outwards from the source(the probes) in all directions, and current flow is represented by the solid black lines in the above picture. The voltage decreases  in value as the current moves away from the source, with measured voltage proportional to 1/distance squared. Thus if the inital voltage is measured to be 160 mV, 1 mm from the source, 10 mm away from the source the voltage measured will be 1.6 mV. The dashed lines in the picture represent  surfaces of equal voltages.

Water can be considered an isotropic homogenous volume conductor. Isotropic meaning that it conducts equally in all directions, homogeneous meaning that it has a uniform composition, and volume conductor refers to the fact that the electrical currents flow in three dimensions.

So that’s how electricity flows through water. Unlike water the human head cannot be considered isotropic or homogenous, as before any current can be picked up by electrodes placed on the scalp, it must travel through different mediums, from the brain, through celebral spinal fluid, bone and finally through the skin of the scalp- all of which have different resistivities.

Any current that can be measured, is due to millions of neurons (in parallel) firing in a synchronised fashion. From studies done by Cooper et al. 1965, and Ebersole 1997, it was shown that neurons in at least an area of 6 cm² of the cortex, had to be firing synchronously in order to produce a measurable EEG signal on the persons scalp.

Unlike the water/battery example above the electrical currents generated in the brain are AC rather than DC. However due to the low frequencies < 40 Hz, in building an electrical model of the brain they can generally be approximated as DC currents. In the same way that the brain itself can be modelled as an isotropic volume conductor, as the measured voltage drop off approximates the 1/(distance squared) rule mentioned above.

Reading anything academic on this subject, and you enter a world of complicated jargon where many different words are used to describe the exact same thing (to my understanding at least).

This all started when I didn’t understand what an electric field was, after further reading I came across the following

  • Dipole source
  • Dipole moment
  • Current flux
  • Current flux density
  • Action potential current source
  • Transcortical potential/ Scalp potential
  • Current source + membrane sink

First of all- anything potential = voltage. The author prefers to say that currents in the brain arise from current sources. Fine, but in real life all current sources are built from voltage sources, thus current source= voltage source.

A dipole = voltage, a more detailed explanation is that a dipole is an idealised point voltage source where “If one imagines an infinitely thin wire insulated over its extent except at its tip to be introducing a current into a uniform volume conductor of infinite extent, then we illustrate an idealized point source.” So it refers to a voltage that originates from an source, which is small enough to be approximated as a point. A dipole moment = voltage separated by distance… which sounds familiar…thus dipole moment = electric field.

The only words which need further looking into are current flux and current flux density. Current flux = current flow. Because we’re looking at a volume conductor, in the same way that electric field is better than voltage to describe electrical activity in a volume,  current flux density(J) is better than current, as it is current divided by area and has the units mA/mm² . It can be calculated by dividing an Electric field by the resistivity of the conductor.  J = E/ η

Resistivity(η) is not the same thing as resistance. Resistance is measured in ohms, and is dependant on resistivity( which is dependent on the conductor) as well as the cross sectional area, and length of the conductor.

Ω=η x length/ cross section area. Thus increasing the cross sectional area of a wire, lowers the resistance, thicker wires have less resistance than thinner ones, and are thus used in high voltage power lines to reduce power losses. Also from the formula, a wire 2x longer has 2x as much resistance.

Hope that makes everything clearer. When I was first trying to make sense of how an EEG worked, I didn’t understand what was happening with the electrode placement because I didn’t understand how voltage/currents flowed through a surface like the scalp. Next major post will be on electrode configuration/placement.

 

Urgh haven’t done anything today

I got up round 10 ish, and since then apart from cooking myself lunch I have done absolutely nothing. Half an hour ago the urge to pop a dex pill was almost overwhelming. Not because I’m physically addicted, but more so because I wanted to get stuff done.

I’m currently building a neurofeedback device, and I’m up to the stage where I have an initial circuit that I want to build, and I should be prototyping it on a breadboard, but I seem to be stuck in an apathetic state of surfing the internet, listening to music & basically doing bugger all.

The fact that I’m going climbing today at 6, seems to stop me from getting started, knowing that i’ll soon have to stop, and probably won’t get much done before then. But wasting an entire day is just plain bad!

But on the positive side, I am into day 3 of my 30 day climbing challenge. With the aim of climbing every day for a month. Aiming to do 4/5 days at the Burnley bouldering wall, and 2/3 days at hard rock in the city.

The Burnley bouldering wall is fantastic! Its free, open to the public, located under a bridge and maintained by the Victorian climbing club. I find it a lot more challenging then rock climbing, and there’s also more fear involved as well when you start to approach the top of the wall, It feels like a long drop to the bottom (even though it isn’t really). The people there are really friendly and have no problems giving pointers to newbies, plus its fun to watch people who know what they’re doing.

The Burnley Climbing wall (# 3/3)

The Burnley Climbing wall (# 3/3)

Giving up ADHD medication

My poor blog. So neglected… If you were a plant you’d be dead by now. Well a lot has happened within the last couple of months. I moved from Sydney to Melbourne. I got diagnosed with ADHD-PI,  I got prescribed ADHD Meds, I’ve taken up rock climbing, I’ve given up on job hunting, I’ve decided to build a neurofeedback device (can’t spend all day watching tv), and finally I’ve decided to stop taking my ADHD medication.

I was prescribed dexamphetamine about 3 weeks ago. Two weeks earlier I was prescribed Pristiq an antidepressant, which my Doctor thought would decrease any slight depression/anxiety side effects that stimulants (like dexamphetamine) tend to cause.

Pristiq for the first 3 days regulated my sleep. I felt tired at 10 ish and then woke up early in the morning, which is unusual for me, as I normally stay up till 2-3 in the morning and wake up round 10-11 ish. But after that I went back to my regular sleeping patterns, and the whole time I didn’t notice any difference in mood/energy. 

So next doctor’s appointment i was prescribed dex. I asked if I could be taken off Pristiq because I didn’t notice any effect, but he said that it would be best to keep on it. I was told to take 4 x 5mg tablets of dex a day, every 4 hours starting from 7am. 

I didn’t stick to that schedule, as I never woke up at 7am. For the first week I took 3 tablets a day at approximately 12pm – 4 pm -7 pm. I also didn’t take the pristiq, because I didn’t think it had any positive effect on me, and I didn’t want to add useless chemicals to my body. 

My experience on Dex has not been pleasant. While the apartment was cleaner than ever, and I was able to concentrate better when reading/writing, the weird side effects seemed to negate the benefits. 

Side effects

  • Less emotional control when medication wears off towards the end of the day. My first day on Dex ended with me getting into an argument with my housemate and then bursting into tears.
  • Weird feelings/mental states. I don’t really know how to describe this one- normally occurs as the medication is wearing off, I get a kind of headache but its not that painful but its a weird feeling that I don’t have anything to compare it to. Normally accompanied by feelings of anger/bad mood.
  • hyper social anxiety. This is probably what the Pristiq might have helped with but It only occurred a couple of times. I think I freaked a shop assistant out over the usual small talk (which I hate) that happens over the cash register. I was really nervous and when speaking it felt like I was listening to myself speak, without actually knowing what I was going to say, and I felt really stressed out. 
  • Muscle pain. While on Dex I felt pain in my arms at random times during the day. It was a combination of the muscles feeling tired/joint pain. The days I didn’t take Dex the pain disappeared so I know that the pain wasn’t exercise/lifestyle related. 

 

So I haven’t taken Dex in 3 days, and I feel better for not having to put up with the side effects. I’ll make a doctors appointment for next week, but for the next month I am going to try to improve my diet/exercise more and see if that enables me to manage my ADHD better.