EP25: ADD and Anxiety in the Youth an Interview with Katie Tolley
In today's episode, we will be discussing a very important topic that is near and dear to me, Attention Deficit Disorder (ADD), and anxiety in our youth. I am lucky enough to have Katie Tolley back on the show. Katie was part of Episode 19: What is Integrative Health? Katie Tolley is part of the team at Turning Point Health Center, which has offices in Annapolis and Columbia, Maryland. She also runs a health and wellness consulting business, KT Consulting. Katie is a Pediatric Nurse Practitioner and child and adolescent mental health specialist. What makes this all even more amazing is that she started learning much more about nutrition and integrative medicine just before her son was diagnosed with ADHD at the age of eight. Get ready for a fascinating and informative discussion with Katie!
Hey there! Welcome to the Alexa Z show! I am so excited to have Katie here today! The topic today is ADD, anxiety in the youth. I am excited but also a little anxious to discuss this topic because my youth was filled with anxiety. Also, many of my clients have children who also suffer from anxiety.
Alexa: Can you explain the difference between ADD and ADHD?
Katie: This topic is so widely talked about, but it is still very misunderstood. I shared an article with some friends yesterday about the aspects of ADD and ADHD and how it affects children. Every day there is another question or another topic that relates to ADD and ADHD in children.
So, to answer your question, on ADD, ADHD, and anxiety, how are they the same and how are they different.
ADD- Attention Deficit Disorder.
ADHD- Attention Deficit Hyper-activity Disorder
Diagnostically, we refer to all as ADHD with or without hyperactivity. The difference can be as simple as whether the child displays hyperactivity or not. When we do not see the outward hyperactivity (fidgeting, doodling, inability to sit still), the child is suppressing/internalizing the hyperactivity. Also, outward hyperactivity can turn into inward anxiety.
Alexa: Even if somebody had ADHD, it doesn't matter. The most important thing is that we are discussing ADD today. So, there are anxieties that are not ADD.
Katie: Absolutely! The everyday life of a modern-day teen can cause anxiety. There is a lot of pressure to get good grades, perform well in sports, perform in extra-curricular activities, get into college, and sometimes to have a job. All of the pressures cause these kids a lot of worries. Screen-time, diet, and sleep also play a huge role in anxiety in our youth. Often, anxiety is misdiagnosed as ADD.
Alexa: As a parent, how do you know that something is going on with your child? How can parents identify there is something serious going on versus regular daily stresses?
Katie: Some kids do just put pressure on themselves. It is normal for a three-year-old not to pay attention and to have difficulty focusing. When the inability to focus or pay attention interferes with daily living, such as the ability to learn, the ability to nourish themselves, the ability to get ready to do an activity, sports, or church, that is when it becomes a serious issue. The symptoms such as fidgeting, inability to focus, or distractability become interferences in the accomplishment of being a successful human being; this is when we enter the diagnostic level.
Alexa: What is the root cause of ADD and anxiety? Where does it come from?
Katie: Do we all have a little bit of ADHD? I say absolutely. Let's use a scale of 1 to 10 to determine our levels of ADHD. Many of us walk around the world at the level of 2 or 3 simply because of screens, jobs, and schedules; it is easy to be distracted because our minds are thinking of multiple things at once. Multitasking is a perfect example of ADHD. You try to go from one thing to another, but you get distracted. Multitasking can be a little difficult.
Alexa: For more on this, listen to my podcast episode on multitasking.
Katie: The root cause can be the inflammatory process
- systemic inflammation,
- Inflammation from:
- different environmental sources,
- inflammation caused by
When the inflammation affects the brain, it is called neuroinflammation. When we see symptoms similar to ADHD, anxiety, ADD, we sometimes wonder if it is ADHD, anxiety, ADD, or are these symptoms telling us about something else.
Alexa: What are some components of inflammation? From the standpoint of ADD, what kind of inflammation are we talking about?
Katie: Inflammation in the brain can surface as
- hard to concentrate
- focused attention
- memory issues
It is vital to address neuro-inflammation in our youth because it will lead to disease processes as they age.
Alexa: Can you talk more about neuro-inflammation?
Katie: Neurotransmitters that play a significant role in ADHD, anxiety, and ADD are dopamines and serotonin. Dopamine is our focus neurotransmitter and helps with memory. Serotonin affects our mood and sleep. If we are not sleeping well, we will have trouble focusing. If we don't have the right balance of serotonin, it will affect our mood and can lead to anxiety and depression issues. The effects of inflammation on our neurotransmitters do not start in the brain; the inflammation begins in the stomach.
Alexa: 50 percent of our dopamine and 90 percent of serotonin starts in our gut. Gut doctors are addressing gut issues, and brain doctors are addressing brain issues, but it does not seem like many doctors are putting all the health issues of their patients together.
Katie: If you are in a particular discipline, you learn that discipline very well, and you don't necessarily connect the other health systems. In integrative medicine, we link all the health systems together. You are correct in that serotonin comes from the gut. Serotonin helps with anxiety. Serotonin also creates melatonin. If we have inflammation in the stomach, and we don't have proper serotonin levels, we will have issues with anxiety, depression, and sleep. Dopamine is made in the gut, dependant on nutrition. Dopamine converts to norepinephrine and epinephrine, which is our energy. If our dopamine is not converting to norepinephrine and epinephrine, then we have a lot of fatigue, physical and mental. Metal fatigue plays a huge role in your memory, focus, concentration. When you are fatigued, hyper-activity may kick in because your body is trying to wake itself up.
Alexa: Can you talk about nutrition? Where do parents start?
Katie: So many people are concerned with eliminating things from their diets. I like to start with what we should add to our diets. It is easy to think, just avoid the foods that bother us! We really need to add nutrition that helps to convert our serotonin into melatonin and dopamine into norepinephrine and epinephrine. Even before I see a patient, they can help themselves by taking:
- Omega 3
- Vitamin D
- Vitamins B-complex
It is not always as simple as adding the above list into your health routine. Some people may have sensitivities. It is essential to see an experienced professional to help you navigate down your health path.
Alexa: You mentioned Lyme and Mold. We talked about inflammation, and the next thing is toxicity.
Katie: When we identify the root causes of inflammation, we can determine what is causing all the symptoms. I believe that ADHD as a group of symptoms that are warning us that something more serious could be going on in our health. When we don't address those symptoms, we become sicker over time. When I first start evaluating a patient, I always check if the patient may have Lyme disease or is the patient getting ill from mold because both have a significant neurotoxic component. Mold and Lyme disease are relatively new to the world of medicine. Chemicals, metals, and other environmental toxins also lead to neuroinflammation.
Alexa: Where is all the mold coming from?
Katie: Mold comes moisture. If you do a google search on where to find mold, it will say food and water-damaged buildings. Here, in the Mid-Atlantic region, our schools are very old and water damaged, so our kids are exposed to those toxins all day long.
Alexa: What about drugs?
Katie: When ADHD was first diagnosed, it was revolutionary when Ritalin came about. In past generations, ADHD went undiagnosed. Awareness of ADHD was not prominent, even though many kids displayed symptoms for ADHD. Instead, kids were seen as lazy, failures, unmotivated, and had no ambition. Prescription drugs such as Adderall, etc. can be helpful. Early in my career, I found that it was challenging to find the right medication for children. The more I learned about integrative medicine, the more I believed that addressing the root cause is imperative. We can prescribe medication that helps elevate dopamine so that the patient can focus. Still, the cause of the inflammation is going to continue to assault the dopamine levels—resulting in the medication and the inflammation to cause a seesaw effect with the patient's dopamine.
Alexa: I work with a lot of people with anxieties, many of who are on anxiety medication. I am not against medication. I wish that people who do need prescriptions have them, and people who don't need them should not be prescribed any.
Katie: I have a patient who is in her mid-teens. She has a lot of anxiety. When she first came to me, she was on heavy-duty anti-anxiety/anti-depressant medications. Some of them were under the label of anti-psychotic. Unfortunately, kids who do not find success with anti-anxiety medication end up on anti-psychotic drugs as an anti-anxiety medicine. I first started to help her address her inflammation through supplements, diet, meditation, psychotherapy, and off of the heavy duty-medication. She continued to have some issues, so I prescribed her a small dosage of Prozac. When we talk about anxiety, we are talking about serotonin. We have to address the gut issues but, at the same time, treat the anxiety to help patients get by day to day. The combination of a little bit of Prozac and integrative therapies, my patient is going to school every day on time, compared to the year before, where she would barely make it day to day. All the heavy-duty medication she was on did not help her because the root cause of the inflammation is always going to win over drugs.
Alexa: Some of my listeners may be thinking, do I have this? Did I pass it to my children?
Katie: I have parents tell that they have ADHD, and their kid has ADHD, and there is nothing I can do about it. There is a substantial genetic component. The genetics that you are born with does not dictate your health, the environment that you put those genetics in will dictate your health. You have total control over what your genetics do base on what you put in, on, and surround your body with. Epigenetics is a new field of study that has developed over the last 15-20 years. Epigenetics is fascinating.
Alexa: This makes so much sense and gives me so much hope. I recently did an episode of cognitive decline because my mom has a cognitive decline. I remember you saying; it is not all about taking bad things out, it's more about adding more good stuff in to remove the bad stuff.
Katie: That is correct. I have an example that we can relate to ADHD teens and your mom, who has dementia. Neuroinflammation that causes ADHD and anxiety is the same inflammation that causes dementia.
Neuroinflammation is a life span issue; if we don't address the problems while we are young, it can result in dementia as we age.
We need to add in to help the brain and neurotransmitters work:
- B vitamins
Be wary of all the health trends. For example, lowering cholesterol, taking cholesterol out of our diets has increased our neuroinflammation. Our bodies need cholesterol.
Alexa: Is that because we are taking out all the good fats?
Katie: Yes! We need to add Omega 3s back into our bodies. Rather than thinking about what we need to avoid, we should focus on what we should add back in to our bodies. It's not cut and dry.
Alexa: This is awesome! I can look back now and see how everything was addressed regarding what I had going on as a kid and what my mother went through her whole life, I am really blessed because I did not know what to do and was accidentally introduced to meditation. My life consisted of exercise, eating right, and an enormous amount of meditation. Those were great nourishing distractions!
The last thing I want to ask you is, should we be scared? As we have been talking, I have become less fearful and more excited for people to get to the root cause of what is going on with their kid.
Katie: I have a friend who listens to some of the things I tell him, some things I tell him are not main-stream. He meditates, but he doesn't do most of the other things I say to do. I love that you say that meditation is what helped you the most! This guy runs a business, but his health is awful! He isn't sure that integrative medicine is the way to go, but he meditates.
We should absolutely not be scared. What we should do is be vigilant, aware, and learn about the topics of neuroinflammation, inflammatory substances, etc. We can reverse inflammation, decrease neuroinflammation; we can increase our focus; we can improve our ability to learn. We can get better. We can meditate. We can change what is going on in our brains. We change our environment, and we change our destiny.
Alexa: This has been absolutely fantastic!