I tend to think that a better treatment for these kinds of issues is biological, rather than prescriptive. If one has issues with thinking in a productive way, a new mode of thinking (i.e., "step-by-step") can be only somewhat therapeutic. It fits in the same box. I think this applies to very many different kinds of brain issues.<p>Obviously, the foremost treatment today is various stimulants. But other, more healthful ways of increasing brain energy, such as nailing down blood sugar management, lowering inflammation, and reducing environmental irritants, are probably also helpful. These interventions need not even be expensive or dramatic. Using lower glycemic index carbohydrate sources (i.e., fructose vs starches), consuming Thiamine (Vitamin B1) to improve glucose metabolism in cells, alongside taking in adequate cholesterol for the production of stabilizing neurosteroids such as progesterone, is a more specific description.<p>Quotation from Mind and Tissue, by Ray Peat:<p>```
The brain, with its extremely high energy requirements, is usually the first to suffer from energy deprivation. At slight levels of deprivation, the brain will simply lose functional efficiency, but more serious or prolonged deprivation can produce lingering modification, or even structural damage which is relatively permanent (and may even have transgenerational effects).'
Just as the skin (or muscle) has a lower energy requirement than the brain, the various parts of the brain have different requirements. The parts which are most resistant to damage are the "lowest" and "oldest" parts of the brain, the parts we have in common with frogs. These parts regulate physiological processes, such as breathing, and so it is biologically useful that they should be most resistant to damage. When a person is given an anesthetic, the first parts to stop functioning, or to go to sleep, seem to be just those parts that have the highest energy requirements, and which are least resistant to damage. The anesthetized person keeps breathing, for example, until very high doses of anesthetic are given, but other functions disappear one by one as the dose increases.
The front part of the brain, which is most uniquely human (and "newest) but which doesn't have "specific" function, in the usual sense, is one of the most sensitive parts of the brain. It is a very large piece of tissue, and it seems to be involved in planning and choosing, in governing the other more specific functions (This part of the brain, as well as the cerebral cortex in general, gives us the ability to "disregard" stimuli, to use Lendon Smith's term.) The famous Russian neuro-psychologist, A.R. Luria, has described the behavior of dogs when this tissue is damaged or removed:<p>..destruction of the frontal lobes leads, not so much to a disturbance of memory as to a disturbance of the ability to inhibit orienting reflexes to distracting stimuli: ..such an animal cannot perform tasks involving delayed responses under ordinary conditions, but can do so provided that irrelevant, distracting stimuli are removed (if the animal is kept in total darkness, if tranquilizers are administered, and so on).
The role of the prefrontal cortex in the synthesis of systems of stimuli and the creation of a plan of action is manifested not only in relation to currently acting stimuli, but also in the formation of active behavior directed towards the future?
Various theories of what causes hyperactivity, e.g., low blood sugar, weak radiation from fluorescent lights and TV. 3 or food additives, 4 and the observation that drugs which stimulate the sympathetic or adrenergic nerves (ephedrine or caffeine, for example will relieve the symptoms, are all consistent with the idea that not enough energy is being supplied to permit this tissue to function properly. Low blood sugar will starve the nerves; food additives or any low-level poison can serve as a stressor of nerve tissue, leading to increased energy requirements;<p>many forms of very weak radiation' can lower the efficiency of metabolism, increasing the tissue's energy requirement, and brain tissue is the most sensitive to at least some kinds of radiation.<p>Intestinal irritation can cause disturbances of the nervous system, and should be considered as a possibility in "disorders of attention." Toxins produced by intestinal bacteria can affect the brain directly, but more often act by damaging the liver's ability to regulate blood glucose.
The commonest cause of hypoglycemia is hypothyroidism, and a thyroid deficiency increases the tendency toward a high-adrenaline state, but more importantly, thyroid hormone is the basic regulator of efficient energy production. Memory and attention are impaired by even a slight thyroid deficiency. The Russian paradigm, with its emphasis on energy and inhibition, suggests that thyroid function should be carefully examined in cases of hyperactivity. Too often, western physicians think only about hyperthyroidism in hyperactivity.
```<p>The more recent book "Brain Energy" by Chris Palmer offers similar perspectives in terms of dysfunctional mitochondria as a fundamental causative factor in just about every mental illness.