Sunday, October 28, 2012

Getting ready for Prime Time


Often when speaking with patients i refer to the term 'getting ready for prime time.'
There are several key factors involved in getting oneself ready to do tasks which can be tedious. Tasks that may require lots of focus and attention at home, work or at school. 

Key factors include restfulness, physical activity, nutrition, no distractions and possibly medication. I try to always ask about sleep because the majority of adults with executive functioning challenges often struggle with initiating and maintaining sleep.  Getting enough restorative sleep is now almost a luxury for most Americans and even more so for those with a mind that can be likened to a spinning top. They wake up feeling fatigued and exhausted. I talk to patients about establishing evening routines, having a wind-down period, putting all electronics away, eliminating distractions, listening to white noise and taking a supplement such as melatonin if necessary. 

Physical activity can be extremely beneficial before hunkering down.  Renowned Harvard psychiatrist Dr John Ratey lays out the research done on the transformative
effects of fitness on the brain in his landmark book Spark.  Exercise promotes the release of neurochemicals such as serotonin and dopamine and growth factors. It's like taking a stimulant without actually doing so. There are no negative side effects of exercise (unless of course you overextend yourself).  

Feeling well nourished and hydrated helps as well. A low and steady glycemic index helps maintain mental stability. Protein versus sugar and carbs also helps maintain an even keeled mind set. Keeping well nourished and hydrated is especially important when taking stimulants since they can decrease appetite and cause dry mouth.

Keeping distractions away helps prevent loss of focus and attention. We can easily become distracted by the ringing of a phone, a conversation near by and by a readily available internet connection to our Facebook page, favorite stores and to the news. Pay attention to what can cause loss of attention!

Stimulant medications have been found to be the most effective way of improving executive function when used appropriately. Medications and cognitive behavioral therapy combined is even more effective than medications alone. It's important therefore that you find a health professional who is experienced with these types of medications. It's also important to have a beneficial and on-going relationship with your health care provider. Compliance for many of those with cognitive challenges can be very difficult.

And now, you are ready for 'prime time!'