Focus, starting, and ADHD

If you are trying omega supplements, give them four to six weeks and then decide. Imaging work has picked up changes in how neurons communicate after around four weeks, which is fast as these things go.

Fixing the end point at the start protects you twice over. It takes the sting out of nothing happening by Thursday, and it stops an open ended habit…

In one trial, children were given omegas with a multivitamin, omegas alone, or neither, and after fifteen weeks everybody got both. The omega groups gained on set shifting and attention, and the children who started with nothing caught up once they crossed over.

Two features of that design are worth understanding. Everyone receiving the treatment eventually shows that the improvement follows the treatment…

Sixty two children took methylphenidate with either vitamin D or a placebo, and both groups improved. The two ADHD rating scales showed no difference between them, which leaves the positive headline resting on the clinician's judgement rather than on what parents reported.

That shape repeats all over this literature, so it is worth learning to spot. When a study reports an effect on one measure and not another, the…

People with ADHD are reported to run low on both tryptophan and homocysteine. Low homocysteine is a good thing to have, since it is the high version that damages hearts.

The reflex to correct any number under the reference range is worth resisting. Levels can be tested where there is a reason to test them. Eating a…

Omega supplementation for ADHD began with encouraging results, including a Swedish study where about a quarter of inattentive children seemed to improve. Blinded, placebo controlled work did not reproduce it, and a Cochrane meta-analysis found no effect.

The manufacturers themselves largely moved on to other conditions, which tells you something. None of this makes omegas worthless, and levels do run…

Cutting sugar does not improve ADHD, and nor does stripping out additives. Both have been tested repeatedly, including under conditions where nobody knew which child had eaten what.

The belief survives because parties are where children eat sweets, and parties are also loud, crowded and thrilling. The sugar takes the blame for…

Megavitamins, antioxidant products such as pycnogenol and assorted trace minerals have not beaten placebo for ADHD. They stay popular on the strength of a good story about how they ought to work.

The gap between a mechanism and an outcome is the thing worth teaching, because it will still be useful when the next product appears. Ask what…

Chiropractic neurologic organisation training, the kind involving manipulation of the skull, has no credible theory behind it for ADHD. The main harm is not the treatment itself but the months and the money that go into it.

Families meet this because it is marketed at them at the exact moment they are most willing to try anything. Naming it plainly, once, is usually…

With EEG neurofeedback, the weaker the study, the better the results look. Six large trials using sham feedback, with parents and teachers kept unaware of who received what, found nothing beyond placebo.

That shrinking with rigour is itself the finding. Blinding matters especially here because the outcome is a rating made by adults who have watched…

Brain training makes you better at the game, and at things that resemble the game. It does not seem to reach the parts of life you bought it for.

Cogmed, the several hundred apps, the balance based programmes: they all hit the same wall when someone independent tests them with a proper control…

One senior researcher in this field is approached by ADHD app startups roughly once a month and no longer takes part, on the view that the companies are not seriously trying to build something that works.

You do not have to share his judgement to borrow the question. Before paying for a digital product, ask who tested it, whether those testers were…

For most of childhood somebody else held the diary. Parents remember the dentist, the kit, the letter that needs signing, and then one day nobody is doing that for you and the whole job is yours.

This is often why someone who managed well enough at school comes apart in their twenties. Nothing got worse. The scaffolding came down, and the…

Remembering to do something later is really two jobs stacked on each other. You have to keep hold of the thing itself, and you have to keep some feel for how the hours are passing, and both have to be working at the same moment.

That is why this fails more often than either piece alone, and why it is the failure other people see. Seeing it as two jobs splits the fix in two as…

Not every reminder is the same kind of reminder. Call at three is a clock job, when I next see my manager is a person job, and that thing at the conference next year is a diary job.

Mixing them up is where a lot of honest intentions leak away. A note on the desk will not survive until next March, and an alarm cannot tell you your…

Some things can be done a day late with an apology, and others cannot: the ticket doubles, the window shuts, the form is simply gone. Sorting your obligations into those two piles tells you where the effort is worth spending.

Lateness tends to get treated as one big failing, which makes every missed thing feel equally awful and gives you nowhere to aim. Go through what is…

Add up what forgetting costs you in money over a year. Late fees, the higher interest that comes with a dented credit score, next day delivery bought at eleven at night for a birthday you have known about since January.

Being told to get organised in the abstract lands on nothing. A number lands. Put last year's late charges and rush postage at the top of the page…

It tends to go in a sequence: unreliable first, said kindly, then irresponsible, said less kindly. After that it stops being about the tasks at all and turns into a description of who you are.

By the third stage shame has arrived, and shame makes people avoid the very systems that would help, because setting up a calendar means admitting…

A sticky note is fine for something happening within the hour. Anything further out needs something that goes off by itself, because holding a plan in mind for three days is not a thing memory does.

Most reminder failures are this mismatch rather than a lack of trying. Someone uses a note where an alarm was needed, it fails, and they conclude…

Notice how often a forgotten job turns up in the shower, or halfway up a flight of stairs. That is not coincidence: when nothing is holding your attention, the things you meant to do float up.

Which means those minutes are quietly doing work, and filling every one of them with a phone takes the mechanism away. Keep something to capture with…

When someone hands you a date, the useful move is not writing the date down. Open your calendar there and then and decide the hour the work will actually happen.

A deadline only announces itself at the very end, when there is no room left to do anything about it. Booking the doing rather than the due date…

Fast cuts, saturated colour, constant motion, a level that ticks over just as you were about to stop. Screens are not accidentally gripping for a distractible brain, and preferring them says something about how you are wired rather than about what has gone wrong with you.

There is a second use for knowing this. If those features are what holds attention, they are also the features worth stealing for the things that…

Ask a child how long they were on the tablet and the answer comes back low. Ask their parent and that answer comes back low too. Neither of them is exactly lying to you.

A child does not volunteer that they went over the limit, and a parent doing their best on every other front rounds their own household down. This…

Taking the phone away leaves a hole the exact size of the phone. Something has to go into it, or the evening just becomes an argument you both lose.

Part of why scrolling is so hard to drop is that the reward arrives at unpredictable intervals, which is the pattern that keeps behaviour alive…

Quiet room, clear desk, phone in a drawer, and you are still nowhere near the work. When the outside distractions go, the restlessness does not leave with them. It moves inside.

Headphones and a tidy desk handle half the problem. The other half is a mind looking for something to do, which will supply its own if nothing else…

Plenty of people now describe attention that fails, memory that slips and a day sliced into fragments. That description on its own is not ADHD, and it is worth being careful before anyone hands over a label.

The environment is producing a version of these symptoms in people who do not have the condition, and calling that a diagnosis does two things badly.…

After a long stretch online people are often not fully there. Something faintly hypnotic settles in, and things get said and done that the same person would not say or do in a room.

This is not only teenagers. Adults describe it too: an hour that vanished, a message that reads as though somebody else wrote it, a flatness…

Spend long enough online and people start arriving as types rather than as people: brilliant or worthless, with nothing in between. The flattening happens to how you see yourself as well.

Worth naming as something the environment is doing rather than a fact about your character, because what an environment produces can be changed by…

Not every app is doing the same thing to you. The ones that tend to hurt have comments underneath, a feed chosen for you, and a number attached to how you did.

One young woman described a picture site as the safe one, because there was nowhere for anyone to reply to her. That is a useful way to sort your own…

You are already off your phone somewhere. In lessons, at work, in the pool, driving. That is worth more than it sounds.

It quietly disproves the sentence people say most often about this, that they can never put it down. They already do, most days, for hours at a time.…

For one week note three things each time: how you felt before you opened it, how it felt while you were in it, and how you feel twenty minutes after putting it down.

Most people find the before and the after are not the same, and that the middle was better than either. Usually one or two apps come out fine and one…

Sometimes the scrolling is not really about the scrolling. It is about the coursework, or the conversation, or the thing you have not let yourself think about since March.

You can usually tell by what happens when the phone goes. If the hours quietly move into something else equally absorbing and equally pointless, the…

Nobody is asking you to want less of a lift. The ask is to take some of it from somewhere that does not leave you flat afterwards.

Put that way most people will engage, because it is not a demand to become a calmer sort of person. Cold water, music that actually moves you,…

Screens are easy to start and have no natural end. So the part worth planning is not the getting on, it is the getting off.

Decide in advance what happens at the finish, and make sure something appealing is waiting on the other side. A timer that only tells you to stop…

Some people are in this far enough that an hour a week will not reach them, and the places that could help are expensive or full. Saying so out loud is part of the work, not a failure of it.

Being honest early does two things. It stops you quietly concluding that you are not good enough, when what is actually happening is that the…

What you are on there for matters more than how long you are on. Scrolling to keep up with people you love is a different activity from posting and then watching to see who approved.

Use aimed at status, at likes, at managing how you come across tends to sit alongside feeling worse. Use aimed at staying in touch and sharing what…

Online you can draft, delete, reply an hour later or simply leave. None of that exists in a kitchen, and plenty of people now find real conversation unbearably fast.

So the ordinary friction of talking to someone in person, the pause you fill badly, the thing that comes out wrong, gets read as proof that you are…

Spend long enough in comment sections and cruelty starts to look like the normal way people speak. It is not. You are reading a very odd sample.

Rudeness online is loud, cheap and rewarded, so it fills the space out of all proportion to how common it is. The trouble is that we generalise.…

Most children with ADHD grow into adults with ADHD. Some of it settles as the brain finishes developing into your late twenties, and adult life gives you more say over how your days are arranged, but the underlying difficulty tends to stay.

This is worth knowing because much of the improvement people do get comes from arranging things to suit themselves: the job that fits, the hours that…

It tends to run the same way each time. You struggle with something, you feel awful about it, so you keep away from it, and anyone who raises it gets a sharp answer, which makes you keep away harder.

The relief when you avoid it arrives instantly, which is exactly why the loop tightens. Meanwhile the pile of unopened post has not moved, so next…

The goal was never to enjoy the dull task. It is to arrive at something more like: I hate this and I can still do it well enough.

Both halves are doing work. Moving towards the thing you dislike, rather than away from it, is what loosens the avoidance. And well enough is what…