By Dr. Panchajanya Paul & Dr. Akshay Lokhande
Inattention and distractibility are becoming a growing problem in the modern world. Many struggle to keep a sustained level of focus. This becomes important when one is in an important meeting, interview, or assignment. Children struggling to pay attention in class end up getting poor grades in school. Their shot at higher education and a higher paying job decreases as the gap in salary between white and blue color jobs are widening.
Focus and attention have become even more important in this information age. All high paying jobs requires a high degree of focus and attention. As more work is done online and on computers, our ability to focus becomes even more crucial. Computer work requires focus and attention. It also provides us with countless distractions. We can check email, catch up on the news, check Facebook, share a tweet, post to instagram and so on and on. Thus we are at a double whammy. On the one hand we have to be focused, and on the other hand we are always distracted.
When inattention, distractibility, hyperactivity becomes a persistent problem in one’s work, school, home, family, and social settings; one is said to have a clinical psychiatric illness called Attention Deficit and Hyperactive Disorder (ADHD). Previously mostly children were diagnosed with this condition, but now many adults are also seeking treatment for hitherto undiagnosed and untreated ADHD. What causes ADHD is not clear, but it is believed to be a mix of gene and the environment, like most other psychiatric conditions. There are FDA approved psychiatric medications available for ADHD derived from the amphetamine and methylphenidate salts. These medications work to improve focus and attention. There are behavioral therapies available for ADHD. There are also certain lifestyle changes which can help improve one’s focus and attention. Here are some ways to improve attention:
Morning Exercise: Exercise – especially aerobic exercise improves focus and attention. Exercise stimulates the brain derived growth factor. It keeps our brain young and healthy. Exercise also stimulates neurogenesis- that is the formation of new neural connections. Starting the day with half an hour of intense exercise will increase focus and attention for the rest of the day. The timing is important there. Even though, evening exercise is equally good for overall health benefits, morning exercise works well for ADHD as it dissipates physical and mental tension.
Avoid Sugar: Sugary beverages like coke, candy, cookies, ice-cream- and all food that increases glycemic index will cause fluctuation in the blood sugar levels. The rapid rise in blood sugar will trigger insulin release from the pancreas. The insulin will send back the excess sugar from the blood to the liver for storage. This will cause a rapid fall in blood sugar. These rapid swings of blood sugar will cause disruption in the ability to put attention and focus. Avoid food with high glycemic index; that is all food which raises blood sugar too rapidly. White bread, pasta, pizza, and most fast food fall under this category.
Sleep More: Sleep is rejuvenating for the brain. Adults need around 8-9 hours of sleep on an average. Children and adolescents need 10-11 hours of sleep for their growing brain. People with poor attention span may require longer sleep hours to give their brain rest from the excess activity. Unfortunately, most of them also have problems going to sleep. Instead of sleeping more or equal to the average, they sleep less. Follow sleep hygiene. Avoid distractions before sleep. Stay away from all screens at least one hour from sleep. Turn your phone and all electronic gadgets off and away from the bedroom. The room should be quiet, cold and dark for sound sleep.
Limit Caffeine: Although caffeine contains stimulants which improve focus and attention, – too much caffeine backfires. There is another problem with high caffeine products like coffee. It masks your tiredness. When we are tired, drained out, our body sends us that signal. It tells us to slow down, rest more, and sleep more. But when we drink coffee, we become artificially energized as coffee uses the brain reserves to give instant boost. But when the effects wear off, we feel even more tired, distracted, and inattentive. As we develop tolerance to caffeine, our body will crave for more and more coffee to get the same high. Thus using caffeine to improve mental function is a double aged sword. When used judiciously, coffee can enhance our function. Consider switching to low caffeine products like green tea, and herbal tea- which are healthier options in the long run.
Make a Checklist: When you are low on focus and attention, it is hard to remain on track. Then with the pressure of multitasking, and so many things to do – one can easily get lost thinking where to start and how to finish. Many successful people have solved this problem by making check lists of all activities they have to do. Now with the smart phones, it is easier than ever. List everything that you have to day in that day, and in that week. Store appointments in your calendar. Try with paper calendar, Google calendar, sync with all devices, explore and find what works for you. No single method will work for all. Once you list the entire task, assign them by the priority. Make small goals every day. Once you finish the tasks, you will feel good when you cross out the stuff that is already done. The book Check List manifesto by Dr. Atul Gwande is good read for that.
Structure and Routine: We all are born with certain genetic strengths and vulnerability. After a certain time, we begin to recognize them. Many people with ADHD are also more risk taking and full of creative ideas. But they struggle to stay on one task, get bored quickly and veer off. Most geniuses have more unfinished work than their masterpieces. ADHD people will thrive in an organized setting or if they partner with those who are more organized and consistent. People with ADHD will do better if their life partners are structured, and many unconsciously choose such. If you child struggles with attention, keep their schedule organized and structured. Stick to a routine however boring it feels. ADHD minds has multiple ideas, once tried and tested, stick doggedly to that which works best. On average it takes about 60 days of repeated practice, to make something into a habit. The book – Power of Habit is an excellent read for this.
Beat Boredom: ADHD people gets bored easily. They find it too hard to stick to the same task. Human body and mind was never designed to do the same task all day all week all year. Nor it was designed to sit idle for a constant stretch of time. Boredom plagues the civilized society, and many people are simply too bored too pay attention. If boredom is contributing to your problems of focus and attention- acknowledge that. Go out of your comfort zone; try to take up new challenges at work. It may be more fun, and sometimes less pay, but will be more rewarding.
Move More: The civilized society expects a child to sit at a desk for 8 hours a day. The industrial society expects a worker to do the same work 8 hours a day. The corporate job expects someone to sit on the desk and work on the computer 8 hours a day. People who can do that become ideal students and workers. But this is against human nature. People with inattention and hyperactivity struggle to remain at the same place and same posture for a prolonged time. One way is to move around whenever possible. Take a walk break. Do walking meetings. Type while standing. Many schools which have provided standing desks to children have seen improvement in the class. Drink water throughout the day, this will keep you hydrated, and also force you to take frequent restroom breaks, making you stand and walk.
Avoid Synthetic food: The food we eat and buy from the big grocery stores are often laden with artificial colors, flavors and preservatives. They also contain antibiotics and growth hormone, and other chemicals. Just take the example of the humble bread. A look in the labels will list around 25 ingredients, out of which majority are non-food. There are chemicals manufactured in labs and were never a part of regular human diet. Many people cannot digest them and their accumulation in body causes health problems for them. Many children with problems of ADHD do better on an elimination diet also called Feingold diet which is free of all artificial colors and flavors. It is however expensive and difficult to follow. Try organic food and local produce which are mostly free of unnatural ingredients.
Eat Brain food: There are certain foods which are good for the brains and the nerves. These contain certain compounds which are structural constituents of the brain. Since the brain is mostly made of fat- all these brain food are present in food containing high fat. One of them is choline. Choline if good for the brain and eyes. The important brain neurotransmitter acetyl choline is made of choline. It is present in egg yolks, whole milk, red meat and peanuts. Lack of choline is thought to cause memory problems. Then the other one is Omega 3 fatty acids. These are present in abundance in wild fish especially salmon, mackerel, sardine, and shad. The nerve sheets are covered with a fatty layer called melanin sheath. Other brain foods are organ meat from pasteurized animals, and whole fat dairy products like butter, ghee, cheese. Plant based brain food can be flax seed, chia seeds, avocado, coconuts, walnuts, cashew and pecans.
Get Nature: We were evolutionally designed to spend most of our time outdoors among wild nature. Civilized society has domesticated animals and put them in confinement. Similarly domesticated human now spend most of his time in the confinement of four walls weather its home, office or car. Studies have shown that children spending time outdoors like in parks have fewer behavioral and attention problems. The same should hold true for adults too. The time spend in nature has shown to reduce stress and improve immunity. Another way to be close to nature without leaving home is pick up gardening as a hobby.
Take Notes: If you find yourself dozing off in the meetings or class, start taking notes. Although you can take notes on your smart phone or tab, you run the risk of being distracted by text, emails and social media. Writing on a piece of paper will help you to focus on the moment. You listen to what is being said using sensory cortex, then you process the information in the frontal cortex, then you send signal to the muscles of the hand using motor cortex, you use your cerebellum to keep the writing organized and legible. Thus multiple parts of the brain are recruited in this process and it becomes easier to stay on task. However, if you are more adept on taking notes on your tablet or laptop, you can use the freedom app to block all websites and app for any duration you want.
Practice Mindfulness: Mindfulness is the ability to control one’s mind and be present in the moment. Regular practice of mindfulness has multiple mental and physical health benefits. It is the perfect antidote for inattention, distractibility and hyperactivity. Many organizations provide guided courses on mindfulness meditation. One easy way to control your mind is to focus on your breathing. Whenever, you feel your mind wandering, place your palm on your belly and observe your breathing. If you breadth right, with every inhalation, the belly will expand, and with each exhalation, belly will shrink. This is the rhythm of life. Close your eyes and for five minutes focus on your breadths. When done, you will feel a sense of renewed calm and peace. Beginners will do better by joining a group and taking structured classes.
In summary, problems with attention and focus should not be ignored. Seek professional mental help if these natural methods fail. Psychiatrists generally diagnose ADHD when the problems with inattention and distractibility are persistently present in more than one setting, and impair regular functioning. Safe and effective evidence based treatments are available for ADHD. Both pharmacological medications and Behavioral psychotherapy therapy can help. Many times an underlying anxiety or mood disorder may be contributing to the ADHD which needs to be assessed and treated. All medical insurance companies cover the treatment. Always seek help when in need.
Dr. Panchajanya Paul, MD, ABIHM, FAPA is an American Board certified – Child, Adolescent, and Adult psychiatrist. He is a diplomate of the American Board of Integrative and Holistic Medicine. He is a fellow of the American Psychiatric Association. He holds adjunct faculty position at Emory University School of Medicine; University of Georgia & Georgia Regents University, and University of Central Florida School of Medicine. He is a freelance writer who lives in Atlanta.