Transcription
Hi, and welcome to Genetics Decoded. I'm your host, Sharon Palmer. Please note that the information we're presenting here is just for general interest only. It's not to be considered medical advice. If you enjoy the podcast, please remember to like and subscribe.
I don't know about you, but recently I've seen so many people being diagnosed with ADHD. Not just children, but people in their 30s, and 40s, and 50s. It's almost like an epidemic. When that happens, I always think, "What on earth is sitting behind that?"
We're seeing wait times. So, people who are trying to find out if they've got ADHD, they're now needing to wait sometimes months or even years to even get an appointment. But what I'm also seeing is that once someone has got that appointment, that diagnostic process seems to be a single consult. So, you wait and wait and wait, you think maybe I've got ADHD. You go in, you might have an appointment for an hour or two, you walk out and you go, "I've just been diagnosed with ADHD, and this is the prescription drug that I'm going to go and fill." And I think we need to be very cautious in this one, you know, take a drug and it's going to solve your problems.
What we're going to look at today is at how genetics can give us much better insight into what might be sitting behind things like ADHD and mental health in general. And the big focus is not going to be on all the genes. There's probably, you know, there's many, many genes that have been tied into risk of ADHD and and mental health. But the focus today is going to be on a single gene called COMT, that's C O M T. It plays a major role in dopamine, and dopamine is what all of this ADHD medication is trying to manipulate. So, let's get a better understanding of what controls dopamine in our brain, and how we can maybe do other things than just take prescription medication.
There is certainly an increased, um, interest in mental health and well-being these days, and that's really important. Because if we look at the statistics, we see that mental health issues are one of the leading causes of disability worldwide. But just because we we're focusing more on a condition, maybe we're putting me more resources into play, it doesn't mean that we have a better understanding of why we've got that issue in the first place.
If we look at things like ADHD and other mental health disorders, we we know that they're multifactorial. There's just, there's not one single thing that's causing the problem. We need to be looking across a whole range of factors. But what is very clear is genetics is playing a major role, not just in the risk of ADHD, but across a whole range of mental health disorders in general.
I was listening to this really interesting podcast, uh, maybe a month or so ago. It's a woman called Mel Robbins. She's a podcaster out of the the US. She herself has just recently been diagnosed with ADHD. So, she's probably in her 40s or 50s. She was diagnosed because her her son was going through the process of being diagnosed himself. And this is what we often see, and I'm seeing it a lot in clinic, is that I'm getting parents whose children are being assessed, they're coming home with all of these lists of signs and symptoms, and then they start thinking, "Hmm, that sounds a lot like me." Or the wife says to the husband, "Like, that's you. I think you have ADHD." And so we're starting to see, you know, more people, um, kind of raise the question, like, "Do I have ADHD?" and going through that that diagnostic process.
But she was interviewing a a a guy called Dr. Chris Palmer, no no relation. And he's a professor at Harvard University. So, he's a professor of Psychiatry. And he was really scathing around the current medical approach to treating not just ADHD, but mental health diseases in general. The medical approach is very much focused on prescribing certain medications and then and then that's it. We don't go any further. And we also know that the, if we look at the overall statistics around outcomes, like how many people really get better through going through that prescription medication pathway, and again, the statistics are really poor. And the more significant the mental health issue, the worse the outcomes. So, often for things around schizophrenia and bipolar, we can be in the single digits for for improvements over time. And that's very disheartening.
If we're seeing that there's a lot of people who are really suffering from mental health issues, and the traditional medical model is not delivering good outcomes, where where does that leave these people? You know, do they try more and more medication? Do they give up and and just think, "Well, it's not working"? But then they have to live with the consequences of that of that disability.
And what we have at our disposal now is the ability to do some genetic screening around a number of the genes that play a role around mental health and well-being. I'm not going to cover all of the genes. That's a that's a pretty extensive look. But what I am going to focus today on is a gene called COMT. That's short for that's C O M T, not C M P, as a lot of people put it, um, often write it. And we know that this gene is playing a major role around dopamine. And we know for the current treatment with dopamine, particularly around medical interventions, the focus is on increasing dopamine levels.
If we look at the research around how does this enzyme called COMT impact on our mental health and well-being, and I've got a list here. I went through the research and I thought, "What, how is this showing up? Why would we want to screen this around mental health and well-being?" And the list is very compelling. It says to me, we should really be going in and looking at this gene when we've got any mental health, um, disorder, because it's going to give us a lot of insight. It is playing a role in schizophrenia, in bipolar disease, in PTSD, so post-traumatic stress disorder, around obsessive compulsive disorders, and around panic disorders. And just look through, you know, some of you may be suffering from those, um, conditions yourself. You may have some family members, or you may may have some friends. But it's pretty widespread the number of people that are experiencing those diseases.
We also know that COMT is playing a really big role in our response to stress. And I think we all see this, right? That some of us are under stress, do pretty well. Like, it doesn't mean that stress is good for us, but we're we we do okay in handling it. And then there's other people that literally fall apart. They they shut down, unable to make any decisions. So, again, the this enzyme is playing a major role in how we're reacting to that stress. And not just reacting to that stress, but also what are how vulnerable are we to that stress? Especially if that stress or that adverse effect is when we're younger, does it have the potential to continue to to reverberate through our life as we become adults?
COMT plays a really big role around addictive behaviors. And it doesn't matter what that addiction is, whether it's, you know, drugs, alcohol, caffeine, even sex. Is that we know that COMT is playing a role. And this is because of, and we're going to see this later on, is this ability to control dopamine in our brain. It's going to impact around cognition. So, what is our ability to focus, to remember things? Our emotions. Are we kind of up and really on, or maybe even a little bit too on? Or are we really flat and depressed and struggle to kind of even get up out of bed? Your COMT is playing a role in these emotions. We know around our behavior, again, whether we're kind of again, really anxious and, you know, have a lot of energy, or whether we're really flat. We've got to go in and look at this COMT gene. We know that it's going to play a role around sleep, around sleep regulation, sometimes having altering our sleep patterns, but maybe even impacting on our ability to to get to sleep. And it also plays a role in pain, in our perception of pain, and our response to pain. And also across a range of neurodegenerative disorders, including Alzheimer's and Parkinson's disease.
So, that's a pretty extensive list. We've got clear definition around certain types of disorders where this is playing a role, and then it's playing a role in our behavior and our mood. And very, very extensive. We want to go in and look to see how this enzyme is impacting each of us as as individuals.
If we look at why COMT is playing such a big role, so broadly across a mental health, um, landscape, is it's because of the ability of COMT to impact on our dopamine levels. And dopamine is one of these really critical neurotransmitters that is in our brain brain, and particularly within what we call the frontal lobe of our brain. As I mentioned a little bit earlier, if we look at the current treatment around ADHD from a medical point of view, the focus is on trying to increase dopamine levels. So, there's a number of drugs that are often prescribed for ADHD. They include things like Ritalin, Adderall, and Dexedrine. And even though the mechanism of action might be slightly different across each of these drugs, some of them are working through production of dopamine, others may be impacting around the breakdown or the transport. Ultimately, they all will have the same effect as trying to increase dopamine levels within the brain.
So, as we've just seen, dopamine is playing a really big role around our emotions and our behavior and around our cognitive function. And what we need to understand is that this ability to to control dopamine within the brain is largely a function of of this enzyme called COMT. So, COMT is the major enzyme that breaks down dopamine within the frontal lobe. In fact, it's responsible for breaking down 60% of that dopamine. So, if you're looking and going, "Well, dopamine is playing a really important role, and COMT is the major enzyme in whether we have a lot or a little," shouldn't we first be going in and really looking at our own natural ability to control dopamine? But before we start taking prescription medication that pushes dopamine high, maybe we should be understanding where that level is to begin with.
Now, if we're from a low level, so there's not a lot of dopamine around, you would expect that that medication would have a positive effect. If there's very little dopamine, you take a drug that pushes dopamine levels up, you would think that you're going to get some benefits. But what about the people who are on the opposite end of the spectrum? The people who already have too much dopamine, and what you do is you put them on a drug that pushes that dopamine even higher? You would be more likely to have some adverse impacts. And particularly, you know, when we look at dopamine, dopamine is one of these neurotransmitters. Is it's what we often refer to as as a "Goldilocks neurotransmitter." You don't want too little of it, but you also don't want too much of it. So, it's not okay to go, "Oh, well, it doesn't matter if we just push it up too high. We'll be it'll be even better. We'll have a whole lot of dopamine there." We know that dopamine is very neurotoxic, so it can destroy our neurons. So, again, we don't want to be pushing it too high.
And then you've got some people, based on their genetics, who are going to have pretty good levels of dopamine. They don't fall into that "too little" category, and they don't fall into that "too much" category. They're pretty much where we want it to be. But when we're prescribing medication, we're not taking into account where those baseline levels of dopamine, um, are. And even though dopamine may really play a role around attention and and our behavior, what we shouldn't be doing is saying, "Everybody who has ADHD has ADHD because they are low in dopamine, and therefore we're just going to give them this drug. We're going to push their dopamine levels up." And that's kind of the approach that we have. If we don't have genetics at our disposal, we just have to make the assumption that everyone's starting on the same level. And, you know, we prescribe this drug, and in some people, we go, "Boy, they had a great outcome." And in other people, we go, "Gee, that didn't seem to to help too much at all."
What we need to do is start with a much better knowledge base around our dopamine levels. One of the best ways for you to find out which category do you fit into? Do I have too little dopamine? Do I have just enough? Do I have too much? Is to really go in and genetically screen your COMT, your C O M T gene, and looking at the activity of the enzyme that it produces. Everyone listening to this now will have this gene, and they will be producing in this enzyme. It's called catechol-O-methyltransferase. And the activity of this enzyme varies from person to person. Now, there, all of us will fit into three categories. We'll either have an enzyme that is working way too quickly, and we're going to remove dopamine at a very rapid rate. We're going to be very vulnerable to not having enough dopamine in our frontal lobe. Then we've got people who have a very, who kind of fit in the middle. The enzyme is working neither too fast or too slow, and they tend to have pretty balanced dopamine levels. And then we've got the other people whose whose enzyme is working way too, um, way too slowly. And what happens, it's not clearing dopamine at the rate that it should do, and dopamine begins to build up. Each one of you will fall into those categories. And with genetic screening, it is very, very easy to tell you which category you fall into. And then we understand the the risk around too much or too little dopamine.
And what we have to be really careful of looking at here, too, is we've got our day-to-day functions. You know, we get up in the morning, we go about our business, and, you know, we have a certain amount of dopamine in our frontal lobe. But to to really know that under stress, what's going to happen is your dopamine levels are going to begin to rise. So, that's just a natural part of the stress response. There's a whole range of different hormones that are triggered during stress, and dopamine is one of them. This level of dopamine where we start from, and the impact of dopamine under stress, can really change the way that we react to stress.
And a lot of people have been hearing about the COMT gene. It's often referred to as the "warrior gene." Warrior, as in, "I'm I'm going to get out there and I'm going to fight, and I'm going to I'm going to step up to the plate, and I'm going to handle stress very well." So, that's the warrior genotype. And then we've got the "worrier," the person that starts to stress and starts to literally come undone under stress. They don't do well. They begin to shut down. They they don't function as effectively. And it's all dependent on this this enzyme.
Now, if you're the person who has a really overactive enzyme, and on a day-to-day basis, your dopamine levels are low, when you get stressed, your dopamine levels begin to rise. And even though you think, "Well, stress is really bad for me," what's ironic is for these people, dopamine levels begin to pick up. They kind of go, "Oh, I'm feeling a little bit better here." And because they suddenly have greater levels of dopamine, they tend to react better under stress. It doesn't mean that that stress is good for them. And again, what we also see happen is during that active stress response and dopamine levels go up, they may be able to come in and make all of these really key decisions. But when that stress goes, and all of those hormone levels drop back, is that sometimes they just feel like they've been run over by a bus. They go from having pretty good levels to their levels really collapsing again. And that contrast can be very, very difficult.
Then we have the other people who on a day-to-day basis have a a a slow enzyme, and their dopamine levels are pretty high. And then, of course, under stress, dopamine starts to build even higher. And as I had mentioned, too much of a good thing is not a good thing. So, they their dopamine levels now get pushed into the "too high" category, and they they begin to their behaviors begin to to change. They don't do well under stress. And that's for each of you to think too. Usually, when I ask this question in clinic, and I'm looking at their at their at their enzyme and their genotype, is it's amazing how many people tell me, even before we kind of go, "Which one are you?" that you know, "Do you do really well under stress, or do you fall apart?" And it very much correlates into their genotype.
Here, but this is where, you know, we have to realize there's our day-to-day baseline, and then there's our response under stress. What we're going to do now is just have a little bit more of a deeper look at, you know, at these different genotypes, and what are the kind of symptoms? What are the impacts that this could have on a day-to-day basis for you to start to think about what symptoms are you experiencing, and how could this tie back into into where your dopamine levels are? Because what I see is when we look at mental health and well-being, even though we're becoming a bit more aware of it, there is still some degree of of shame around it. I see people who who still really are quite reluctant to disclose. It is getting a little bit better. But we we know that there's a lot of symptoms that people experience when we're starting to look at mental health issues. We see issues around anxiety and depression, and changes in mood and behavior.
What I'm going to do now is just kind of try and isolate some of the symptoms that are really associated with both high and low levels of dopamine. Because if we just focus on symptoms alone, it is very hard to know what the underlying risks are. But I find in clinic that once people understand their genotype, and they understand the kind of symptoms that they're more likely to experience when dopamine gets high or low, instead of just going, "Oh, I'm always worried, and I'm always anxious, and I I don't seem to get this be able to get this under control, and there must be something wrong with me because, you know, nobody else reacts like this," there can be a lot of kind of, you begin to, you know, beat up on yourself a little bit. But once my patients have these lists, instead of thinking that they're failing in the way that they're thinking and behaving, they start to go, "Oh, when I experience this, what I know is that my dopamine levels are much likely to be too high or to be too low."
And, you know, the thing is, it's not just about knowing that those, um, that dopamine is high or low. We can go in now, and we can manipulate the activity of this enzyme. So, once we know it's working too quickly, and you're getting all of these signs of too much dopamine or too little dopamine, we can go in through your diet, through herbs, through lifestyle factors, and we can manipulate the activity of this enzyme. And that means that you can go, "I'm starting to feel more anxious, or my my behavior is becoming a little bit more out of control." It's going to be really important for me to keep engaging with these behaviors, or to do them more consistently, or if I've forgotten to do them, to to start doing them, because this is where I'm going to go in and be able to manipulate this enzyme, and therefore manipulate my levels of of dopamine. It gives people people a sense of control. They understand why, they understand what they can do, and then they can put those interventions into into play. So, instead of feeling just a victim of circumstance, you you feel that you can make decisions that are going to really give you the outcomes that you're looking for.
All right, so let's start with what we call it's called the VV genotype, that's V V. And this is the genotype in COMT that is associated with the enzyme that is working way too quickly, and therefore you do not have enough of this dopamine in the frontal lobe. And I'm just going to run through some signs and symptoms here. And if you're struggling from a mental health point of view, start to pay attention to these and see if any of these resonate for you.
One of the things we see is this lack of focus and concentration, and also a decreased ability around our memory. And if you think, "Well, dopamine plays a big role in in being able to focus and pay attention," if your levels are low, you wouldn't think that you're going to be able to do those tasks very well. We also see, you know, a lot of people think of dopamine as the pleasure hormone. We really need to see it more as the motivational hormone. In fact, you know, how we change our behavior to achieve outcomes. And people who don't have a lot of dopamine around often feel like really flat, like they can't seem to get get excited about doing things. You know, knowing that if I get up and I do this, that's going to lead to that, and that's going to have a positive impact. It's very difficult to to to get that motivation. There's a lot of apathy, a lot of boredom, like like nothing interests me. Those are all signs of not having enough dopamine.
We also know that it can lead to a sense of feeling helpless, like "I'm not in control." Um, it can start to impact around mood. So, we can see signs of depression. And the other thing that it really puts you at risk of is these addictions. Now, when we look at people who are addicted to certain substances, and it doesn't really matter whether it's alcohol or drugs or, you know, maybe even caffeine, what these what these substances are doing is they're giving you this dopamine hit. So, if you go from being really low in dopamine, and you do something called take something like, you go out, you have a lot of drinks, and you go, "You know what? I'm feeling so much better now." And that's because of this rising dopamine. When you're feeling really, really flat, and you found something that gives you that dopamine hit, you become addicted to it. And we're also seeing that, you know, people who have designed social media have gotten really good at this, too. You know, all those little like buttons, and, you know, you you hear the little ding, and it's almost like, "Oh, who's who's calling me? Who's texting me? Who's liked my post?" These are all dopamine reactions.
And I remember reading an interview once with, um, someone called Carrie Fisher. Now, any of you who are Star Wars fans, remember she was Princess Leia with the with the hair. She ended up being diagnosed, um, with bipolar disorder. And when she was interviewed, she said the very first time she tried heroin, she knew that she was in an absolute world of trouble, because never, ever before in her life had she ever felt that good. And it can be really difficult for people who don't have a real deficiency in dopamine to have a level of appreciation as to where and how that may make you feel. And then when you find something that just makes you feel so much better, how difficult it is to say, "Oh, I'm not just, I'm just not going to do that anymore because it's unhealthy for me." You know, these are people are finally feeling good in their life. And I think we have to understand why it can be so difficult for these people to to get over their addictions, because, you know, they really do feel quite awful as their dopamine goes back into that that natural level.
We also know that people who are doing thrill-seeking behavior. So, maybe you're someone who likes jumping out of an airplane with a with a parachute. Is every time you do that thrill-seeking behavior, again, there's this, um, there's this surge of dopamine. And I always ask my patients too, sometimes I see people, and it is almost like they go from disaster to disaster to disaster in their life. There's always a crisis. There's always something that needs to draw their attention. And again, what did we say? What happens to dopamine under stress? Your dopamine levels rise again. People can end up putting themselves in situations in where there's a lot of that stress, because on some level, they're getting that rise in dopamine. So, we've got to kind of look at some of those behaviors, and if you keep finding yourself in that situation, is to examine what might sit underneath that as well.
People who have low dopamine have issues around procrastination. So, just can't seem to make a decision one way or the other. And again, that can be really frustrating because you might have gathered all of the information, you may know that it's very important for you to make certain decisions, but then you just simply can't get to the point where you make that decision and change that behavior. On the other hand, you've also got this lack of impulse control, and where it can lead to real reckless behavior as well. So, it's almost can't do, can't do, and then it's like, "You do some weird thing out of out of the blue." And again, this lack of, um, control can be directly tied back into what's happening with your dopamine levels.
So, that's a lot of kind of the, like, the the psychological symptoms that are associated with low dopamine. Now, I want to look at some of the physical symptoms that are associated with low dopamine. And they tend to be around muscle stiffness, muscle spasms, and muscle cramps. And often, when we think of dopamine, one of the diseases that we really think of front and center is Parkinson's disease. So, think of somebody who's got Parkinson's disease. They've got poor control of their muscles. There's a lot of spasms and and lack of ability to control that. And again, it comes back to to dopamine.
It was really interesting, um, I was watching the presidential debate. Remember Biden was on there, and people were really concerned with his behavior. And I saw post that that debate that they were interviewing GPs who specialized in Parkinson's disease, really thinking that maybe Biden had Parkinson's. And again, you know, just that rigidity in in the movement, and, you know, some of those behaviors. And this is where too, I remember there's a, there's a comedian called Billy Connolly. I used to love him. And he he ended up getting a letter from somebody who was a doctor who was in his audience, because when he does his little act, he walks across the stage, and a doctor noticed that there was something strange about his gait and told him that he should maybe investigate whether he had Parkinson's disease. So, if you know what to look for, you can kind of get some insight. But again, a lot of it comes can come back to what is happening with our dopamine levels in our in our brain.
We also know that it can impact around our energy. So, people who are low in dopamine often have very low energy. They can feel really, really fatigued. And again, just because you have low energy and fatigued does not mean that you're low in dopamine. But what we want to do is, once we've got this information at a genetic level, I really do I get my patients to go through and tell me and highlight all the things that they notice around their around their health, their mood, and the behavior. So, that we know that those are the things that show up for them. And these are kind of the warning signs around this dopamine getting out of balance.
At a clinic level, if I say to people, like, we do their genetic screening, and I go, "Okay, this is your COMT enzyme. Your enzyme is working way too quickly, um, and it's stripping this dopamine out of your brain." Know the first thing people want to know is, "Well, can I do something about that? Can I go in and change that, or is this just my lot in life?" And the really good news is that you can go in and you can alter the activity of this enzyme. And it's possible to do that across a range of interventions. We know that there are some key herbs that we can use to slow down the activity of this enzyme. There's also certain foods and beverages that are part of most people's day-to-day diet that are also impacting on the activity of this COMT enzyme.
Um, if we look at things like coffee. Now, coffee contains caffeine. And we often think, "Oh, the effects of of coffee are because of the caffeine intake." But when we look at the impact of coffee on this COMT enzyme, it has nothing to do with the caffeine levels. It has everything to do with the acids in coffee. So, it doesn't matter whether you're drinking normal coffee or decaffeinated coffee. What we know is these acids can slow down the rate of this. So, in some people, there can be some real benefits in keeping caffeine in. And again, we can see these addictions to caffeine. People don't know, "Oh, I'm drinking coffee, and it's it's slowing down my COMT, therefore I'm getting more dopamine." They just know that when they drink a lot of coffee, they feel a whole lot better. And this gives us some understanding of what might sit behind some of those behaviors.
We also know that some of the compounds in green tea can also slow down the activity of this enzyme. So, we can go in from a dietary and a herbal point of view, and we can begin to do things that will have some impact here as well. We've just looked at what happens, like, what are the signs and symptoms of not enough dopamine in the brain. Now, we're going to look at the complete opposite genotype. And these are people who are referred to as the Met-Met genotype, so M E T M E T. And these are the people whose, um, enzyme is working way too slowly, and they don't remove dopamine at a rapid rate.
Now, on a day-to-day basis, these people do pretty well from a mood point of view. You don't want to go too high. So, it's always about kind of looking at your at your clinical history. But usually, their levels are are sitting, you know, okay, or they're starting to head too high. And remember, we were talking about when you're under stress, your dopamine levels begin to go even higher. So, what happens for these people under stress? They go from having, you know, already high dopamine levels to now having even higher dopamine levels. And, you know, dopamine is a a neurotransmitter that kind of excites and turns things on. So, you kind of get these people being pushed to the extremes of other types of behavior.
So, let's have a look at what are the some of the signs and symptoms of when there's too much dopamine in the brain. We see psychosis. So, that's a good one to lead with, right? And again, you think of people, especially with schizophrenia, where where psychotic episodes can be a real issue. And again, you would often think, "Is there just way too much dopamine around?" We also see mania. So, again, it's changing behavior. So, these people are, you know, this manic behavior. And again, when we look at bipolar disorder, people with bipolar are swinging between the two extremes here. There will be times when there's too much dopamine, and they will be in that manic phase. And then there'll be times when there's too little dopamine, and that is when they're really flat and unmotivated. And we know that enzymes and and genes can be playing a role as to how quickly people may cycle from one extreme to the to the other as well. And, you know, in some people, it can be really rapid, and it's it's incredibly debilitating from a a social point of view that, you know, day-to-day, week-to-week, you can be all over the place with your behavior. What's really important is to try and moderate out those extremes from going to really low to very high.
We know that, um, too much dopamine can lead to very aggressive behavior. It can lead to the increased risk of hallucinations. And this is where I look and I go, you know, when you really look at, you know, people who are suffering from schizophrenia and bipolar, you know, their their symptoms can be quite extreme, and it really can be reflected back to just way too much dopamine. We can see an increase in anxiety and agitation. So, think of those people that you see, right? They come in, and they're really agitated. They talk a million miles an hour. They they jump all over the place. You know, people hearing voices. You know, these are all signs of of too much, too much dopamine. We can have paranoia. We can have delusions. And we can also see this emotional detachment, that, you know, very hard to get involved or care about might what be happening out there to someone else. The the focus is much more inward.
From a physical point of view, people who have got too much dopamine, we see a lot of unnecessary movement. So, a lot of moving around. We can see a lot of muscle twitching. We can see repetitive ticks. So, doing the same thing, you know, you might be twisting your hair or or doing something over and over again. We can even see hypersexuality. So, these people, it's just like, can't find enough people to to sleep with. And it's not it's not just so much that they're promiscuous, but it's just part of those those behaviors that we see. There can be issues with nausea and vomiting. We can have insomnia. We can see too much energy. And we can also see this absolute hyperfocus on achieving goals and outcomes.
And again, we we can look at dopamine levels, high or low, and how it impacts on diseases. So, that's kind of looking at the extremes. And most people don't fit into those those extremes. But we know that too little or too much dopamine is going to play a role in your day-to-day. And it's not that everything is all good or everything is all bad. But if if you're wanting to to really be able to go in and focus and do something, having some of this, having a lot of dopamine around can really help. So, this is where you you and I say, "Who do you know who's got this enormous capacity to work, to to go set, to achieve their goals and get it done?" They're much more likely to have high dopamine. And then you've probably got a group of friends, or you got some family members, and you're like, "What is it going to take to get them to get up and do something and make some decisions or take some action that's going to take them forward in your life?" More likely to have low dopamine. And, you know, most of us are sitting somewhere on that scale. But we know that this enzyme that we all have is playing a role as to where on that scale we're going to be. And that then allows us to make some changes around our lifestyle habits and around our diet to try and tweak, to try and get us into a more ideal level.
I hope you learned something today, not just attention deficit hyperactivity disorder, so ADHD, but more broadly around mental health and well-being. To know that we need need to be thinking outside of the box here. You know, you you it's a good thing to go through that process and and get a diagnosis, but to think that the only thing that you need to do is to take that prescription drug, and that's the end of it. There's so much more to consider, and genetics is a very, very good way to get in and go in and have a look.
I know at clinic, we treat a lot of people with mental health issues. I saw someone recently. It was a woman in her 30s who whose anxiety was so high, she literally couldn't get out of the house. She certainly couldn't drive anymore. She has three children, and it's debilitating at a family level. When she first came to see me, her mother had to drive her to the clinic. And we decided to do, we have a a a program at the clinic called the Elevate Program. And the focus is on what are all the drivers around controlling our neurotransmitters that are going to impact on our mood and behavior. And COMT is just one of these things. But what I know is, if you get a a better understanding of what's causing your condition, you can have some really good outcomes.
Because I saw this patient again, just a couple of weeks after she started her program. I went out into the waiting room, and I said, "How are you doing?" And she stood up and she said, "I drove myself here today. It's the first time I've been able to drive for a very, very long time." And she said, "As soon as I got that information around my genetics, and I started to put it into play, I knew that I was on the right track." And she said, "That was such a relief." Because she had been, like a lot of people who were really suffering, she had seen so many people, she'd seen she she'd engaged with so many different modalities, she had tried so many drugs, and she was like, "Nothing is working, but I've got to keep looking because I can't get out of my house."
So, I think if if you're kind of in that situation yourself, don't not go down the pathway of of the medical model, but think outside and start to look at identifying what the drivers are. Because for everybody who might have the similar, um, symptoms, it doesn't mean that the risk or the underlying drivers are going to be universal. You really want to know what's happening with you, and then to engage with the behaviors that are going to give you much, much better outcomes.
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