Uncovering the Truths About ADHD in Adulthood

Are you struggling to maintain focus in your daily tasks? Wondering if your distraction might be Adult ADHD?

In this insightful episode of "me&my health up," host Anthony Hartcher delves into the increasingly recognised condition of Adult ADHD. With diagnosis rates on the rise, partly due to the influence of social media platforms like TikTok, it's crucial to understand what Adult ADHD entails and how to manage it effectively.

Anthony shares a comprehensive overview of ADHD, discussing its symptoms, the role of the brain, and the pros and cons of prescription medications. He also offers valuable
alternatives to medication, focusing on engaging in meaningful activities that naturally boost dopamine levels.

Tune in to discover practical strategies for living a fulfilling life with ADHD, including how to rewire your brain to find meaning in everyday tasks and the importance of avoiding people-pleasing. This episode is packed with actionable advice to help you manage ADHD symptoms and live a purposeful life.

Don't miss out on Anthony's expert insights and holistic health coaching tips that can guide you towards better mental wellness.


About me&my health up & Anthony Hartcher

me&my health up seeks to enhance and enlighten the well-being of others. Host Anthony Hartcher is the CEO of me&my wellness which provides holistic health solutions using food as medicine, combined with a holistic, balanced, lifestyle approach. Anthony holds three bachelor's degrees in Complementary Medicine; Nutrition and Dietetic Medicine; and Chemical Engineering.

Podcast Disclaimer
Any information, advice, opinions or statements within it do not constitute medical, health care or other professional advice, and are provided for general information purposes only. All care is taken in the preparation of the information in this Podcast. [Connected Wellness Pty Ltd] operating under the brand of “me&my health up”..click here for more

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Transcript

Anthony Hartcher: 0:06

Welcome back to another insightful episode of me&my health up. I'm your host, Anthony Hartcher, a clinical nutritionist and lifestyle medicine specialist. Today we're going to be talking about adults ADHD, yes, the numbers are rising significantly in terms of diagnosis. And I think TikTok has contributed somewhat to that. So we're going to be talking about what is ADHD, and what is some of the medical side of things in terms of what they can do around prescription drugs. So we're going to talk about those drugs, what they do, how they work, we're going to talk about the side effects of those drugs. And I'm going to, of course, share and empower and enlighten you with alternatives to the drugs so that you don't have to feel disempowered by taking the drug if you've been diagnosed, or if you think you have ADHD. And I've got a way out in terms of how to stop ADHD. And in terms of my background, as a kid, or the teachers were telling my parents that I had ADHD, I couldn't sit still supposedly, you know, I just wanted to run around. But isn't that being a kid? Isn't that what kids want to do? Run around? So isn't, isn't it more a symptom of the system and the system is letting us down in terms of trying to get kids to be still, isn't that just crazy and ludicrous when kids have boundless energy and they're totally present and they just want to embrace life, yet, they're told to sit down with their backs straighten, their legs folded and their hands on their knees, it is just absolutely ridiculous. And I'm so grateful to my parents that they declined to believe or, or even entertain the idea that I had ADHD as a kid. So yes, I've been there, I've done that, I know what it's like not being able to focus on things. And even as an adult, I certainly experienced this on a regular basis. When someone wants to talk about golf, or someone wants to talk about soccer, or Taylor Swift, I don't have any interest in these subjects. So of course, I'm going to be easily distracted. Of course, I'm going to look around and see in terms of what else is better to draw my attention to because as humans, we are drawn to purpose and meaning we want we seek purpose and meaning it's part of our evolved part of the brain, it results in this area is the prefrontal cortex. And it's what we have above all the rest of the animal kingdom is that we have this evolved part of the brain where we can seek meaning and purpose. And we can live purposeful lives beyond survival. And so ADHD is very much when we're in survival mentality, we're stuck in our animal brain, and we can't free ourselves and get into our evolved brain of the prefrontal cortex. So let's talk about firstly, what is ADHD, it's the attention deficit disorder, right? So it's where we can't stay attentive to a task or some various tasks, for example. And so we, we essentially, we look very distracted because we don't want to focus on that task. It's essentially the area we procrastinate on, or we hesitate to do, or, like we put off, or we get frustrated when we do do it. So these are the tasks and you could probably think of the tasks that make you feel that you have ADHD, attention hyperactive disorder. So you know, like, it's within us to feel that way, when we no longer feel that what we're doing has meaning to us. So if I'm doing like a conversation on golf, I'm not interested in golf, it has no purpose in my life, I have no desire to be a golfer or to play golf. But I love rugby league, for example, I'm happy to talk about rugby league, and you'll have my attention surplus order when you bring up the topic of rugby league. Or if you happen to get on the subject of health, you won't be able to shut me up. And so I've got attention surplus order in these areas that I value most. And so often, it's very often that all of us will experience this Attention Deficit Disorder when we focus on things that are low priority to us that are not not important to us. So if we're doing tasks that are meaningless to us, again, what we value is different between one another we all have a hierarchy of values that we're all different that makes us unique and special. And so we want to be living by what's most important to us. And we'll have this constant attention surplus order to it. For example, this podcast where I'm sharing health information, I have no challenge at all, it's probably a bit of a challenge in terms of finding like, but I find the time to do it, right? It's not as if I procrastinate on doing podcast episode, I enjoy doing them, I get huge amounts and immense satisfaction from doing them. I'm not driven by the numbers. But I'm driven by sharing information and empowering those that are listening to the episode. And I do have downloads so that people are listening to this episode. And I appreciate you listening to this episode because it gives me meaning to doing my podcast and I continue to do it because my mission is to enhance and enlighten the well-being of others. And this is a medium by which I can live that mission. And when I stay on mission, I'm living by meaning, I have attention surplus order. So I've got no distractions when doing this podcast, you can probably see that I can stare at the camera for this whole entire length of this podcast, and barely look away from the camera, I'm looking at you because you're important to me. And I want to enhance and enlighten your well-being through this information. So when I'm focused on tasks that are meaning meaningful to me, I can spend hours doing them, I could do a whole day of researching and writing down my understanding so that I can share it with you. And that I don't have any distractions on those days, because I'm doing tasks that are fulfilling to me, that are really meaningful to me. And there's nothing that's going to distract me. So what I want you to live a meaningful life, I want you to follow about what's most important to you. And when you follow what's most important to you, then you won't have this attention hyperactive disorder, you will be very focused and have attention surplus order. So how can you spend your life doing the things that you love? Well, first of all, you've got to recognise the things that bring you present, what makes you entirely present and focus, is it when you're talking to loved ones, talking to family members, and you really want to understand what they're doing and their days, and you want to find everything about what they're doing because it's truly of interest to you because you care so much about that person is that what brings you attention surplus order, or is it that you want the best for your children and so you're always looking out for information that will help you share that with your children, so that you can guide and direct them so that they grow up as the people that you'd love them to be. Or you just they grew up being the best individuals of themselves rather than you obviously imposing your values onto them, you allow them to grow into who they are. And that is being a great parent by just guiding them to being the best version of them. So I want you to think about now and reflect on what brings you present, when are you most grossly absorbed in doing something and you're not you're not distracted by looking at TikTok or you're not even thinking about looking at social media, you're purely engrossed in the now. And it'll be the things that bring you joy to your heart to your soul. So what are those things that bring you joy to your soul and your heart, I can tell you mine, you probably can tell it's health, right? And so this brings deep connection to what is deeply meaningful to me and I have huge amounts of attention surplus to this area, that as I said, if you wanted to talk to me about things that may interest you like cars, for example, if I hear people talking about cars, I'm straightaway looking at how can I get out of this conversation. And so someone that observing me will say that Anthony's got attention deficit disorder, he can't pay attention to listening about cars. It's, of course, I've got attention deficit disorder because we're wired in such a way to seek a meaningful life. When I hear about cars, I feel that it's not meaningful to me, and I'm not living a meaningful life. So I'm going to look for distractions to get me away. And I read a study that there is a rationale that they believe that the reason why we have have this attention deficit disorder is when we're in survival mode, and we were hunting and gathering, we would look for areas that would bring us food, and that would sustain us that would allow us the resources to survive, such as food and shelter. Now when we found areas that didn't have food or shelter, where it would activate lots of areas of the brain that would again, make us want to look for something else and seek something else so that we could then seek food and shelter that would serve us, that would keep us alive. So we have this hard wiring in our brain to keep us alive. And it's a survival mechanism to because first, you know, we do need food and shelter. And obviously, if we've met food and shelter, then we're going to have a seeking meaning in another way, in a higher form. And that's Maslow's hierarchy of needs, we seek to achieve this thing of being able to, I guess, seek a meaningful life, seek a fulfilled life, beyond the basic needs of food and shelter. And so this ascension into seeking like this higher order of living, like, in a sense, what I'm doing in terms of I want to empower and enlighten the well-being of others. So I'm seeking to share my knowledge and wisdom on health. So that empowers you and that gives me meaning because I'm making a difference in other people's lives. And so what does bring? What does it what brings meaning to you? Is it when you're helping your children? Or is it when you're doing an activity that you love and that you thrive in it could be exercise or a sport, but it's what bring deep meaningful to you that you feel like you're adding some contribution, you're either inspiring others through in a sport, or you're inspiring others through progressing through your career, or you're mentoring others as you're progressing through your career. It's what brings meaningful to, you know, what brings meaning to your heart? What does it and I want you to think about this and really walk away from this episode, as to are you living a life full of those high-priority items that bring meaning to you, you want to fill your day with those high-priority items every day, fill them with these things that are deeply meaningful to you. And you'll feel that you're living a life on purpose, and a life by design. You don't want to live a life by default, where we're succumbing to everyone else's values and succumbing to everyone else's directives. You want to live a life by design where you are in the driver's seat of your life, and you're taking the direction that you want it to go, people could tell me, Oh, Anthony, you should do this as a business idea, you know, you'll make lots of money on YouTube or something like that. If it's not aligned to my values, I'm not going to put up with the pain it takes to in order to achieve that outcome, am I? But with podcasting, I'm willing to put up with all the pain around technical challenges or whatever challenges I have in the way because it's helping me pursue something deeply meaningful, which is enhancing and enlightening your well-being. So what is it for you and I want you to focus on those areas. And these areas that are high value to you, high importance to you are often areas that you perceive that you are lacking in, that there's a void. So, for example, someone that's just lost a relationship, and feels that they don't have a relationship in their life, that's a big void within them that they perceive. And so they will seek a relationship in order to fill that void. So you might have just had a recent breakup, or you might not have been in a relationship for a long time, and you're really looking to get into a relationship. And you're looking at all ways to do this, you're reading books about it. And again, you've got an attention surplus order towards this, right? So you have sensory input coming in through all your senses. And it's filtered by your Thalamus, your thalamus is this filter, and it's filtering it based on what's most important to you. So it's going to block out the noise such as things that are not important to you, and enable that attention surplus order to the thing that's most important to you and take that in and you'll continue to stay absorbed and attentive to that thing that's most important to you. So in terms of how do these drugs work around this attention deficit disorder. So the drugs obviously helping you be more attentive, how do they work, they, what they do is they play with our neurotransmitters, and I'm going to share a way in which you can play with your neurotransmitters that doesn't take popping a pill, it doesn't take that and I've already shared one of these ways, and that is putting your attention to things that are important to you. And putting more of your attention to the things that are most important to you and staying focused on those things and saying no to everything else. So if someone wants you to do something that isn't aligned to what you value that's of high priority to you, say no to it and stay on track. Don't allow them to de-purpose you or to take you off track because that's when if you say yes to something you don't want to do. You're going to be looking for distractions and ways to get out of it. I can guarantee I do this every time when I say yes to something I don't want to do. I can't wait to get out of there, I can't wait to look for that excuse to leave the function. I'm looking for it the whole time, I have this hyperactive attention disorder when I'm doing something that I don't want to do. So don't let that person down by saying yes, you will do it and then have attention hyperactive disorder or lack of attention. Because they will think that you're interested in what they're not interested in. But they need to value you for who you are, and not judge you, for you not having the same interest in that particular area. They need to love you for who you are, and respect you for who you are. So I don't worry about if people think, oh, Anthony doesn't want to do this, and therefore that he doesn't love me, because I know that delusion, a total delusion, I'm just not going to live a life by someone else's needs or wants or desires. Because that's their life, if they believe that love is me doing what they want me to do, that is not love because love is unconditional. Love is condition not conditionally loving someone, it's loving them for who they are. So if they truly love me, they will respect me for who I am and what I value. So don't get caught in this trap of people pleasing. It is the biggest trap you'll get caught in. And it's the primarily written primary reason why there's so many people are getting diagnosed with adult ADHD. So how do the drugs work? The drugs alter these neurotransmitters, they alter the neurotransmitter dopamine. So dopamine is associated with reward, recognition, pleasure, and attention. And so dopamine is very much connected to the things that we value most, right? So if you're doing things of low value, your dopamine is going to drop down what the drug does Ritalin. So Ritalin, methylphenidate, I think methyl phe phenning tate phenitate or something like that. That's what the official drug is. But what it does is it alters the dopamine by keep it by keeping it in the synapse between the neurotransmitters and keeping it acting that synapse between the neurotransmitters so that you can fool the brain into thinking that what you're doing that meaningless task is good and awesome. But you can do this yourself. And let me share a way in which you can do this yourself. So what Ritalin does is keep that dopamine in the synapses. So those those neurotransmitters keep firing and think, O yeah, I'm living a meaningful life. But in actual fact, you're doing something that de-purposes you and it's only the drug that's keeping you focused on that task because it's keeping the dopamine between the synapse and it also does this with norepinephrine. So norepinephrine is associated with that adrenal side of things. It gets that adrenaline going, and when our adrenaline is going, we get razor-sharp focus on getting away from something or seeking something, right? So the noradrenaline is very much associated with pain and pleasure. So we either we really want something which is the prey, or we really don't want something, and that's to get away or avoid pain, which is the predator. And so this norepinephrine is very associated with this pain and pleasure by keeping it in the synapses. This is what this Ritalin does, is that it keeps it firing keeps that those neural connections firing and keeps the I guess, the adrenaline pumping around you, and keeps you chasing something that's not meaningful to you. So why would you want to chase something that's not meaningful to you? For me, it's purposely it's just, it's insane, actually, it's totally insane. And so the side effects of these drugs are associated with excessive amounts of these neurotransmitters residing in the saps the synapses between these neurons, and they just keep firing. And so you've got this norepinephrine that's keeps firing. And so you keep running away from something. But in this case, you run towards something you don't want, which is insane. So you're running towards pleasure, right? Supposedly, it's a pleasure, it's a delusion, and so it's keeping you and so some of the side effects are that you'll get sweaty, or you'll feel your heart palpate because it's driving your adrenals it's driving you towards this something you don't want, or potentially it's trying to keep you away from pain, but mostly it's driving you towards something you don't want to do. Alright, so, as I said, if you say no, that's the same as this drug, in essence, because if by you saying no to something you don't want to do, it enables the space for you to do what you want to do. And you will have a natural connection towards that. You will keep dopamine in in that synapses whilst you're doing that activity because it's fulfilling, but when you're not doing the activity that the body will get to homeostasis again. But if you keep doing that activity, again, the dopamine is going to remain at a level that's, I guess, satiable for you that you feel fulfilled. And same with the norepinephrine, well, that won't be so pushed as hard like the norepinephrine like I'm driven towards this, but I don't need my adrenals running towards this just because I've got this, this magnetic pull towards you and empowering you. I don't need the adrenals to do that. So my heart's not palpating fast or anything, I've just got a nice amount of dopamine, a healthy amount of dopamine, not excessive amounts of dopamine sitting between the synapse just enough to keep them firing, to keep me to say yes, yes, I'm on purpose, I'm living a purposeful life. And so you don't need drugs to do these things. You can do them by just saying no to things that you don't want to do that are not meaningful to you. And by saying yes more often to the things that are meaningful to you. So simple, get in a habit of saying no to things that you don't want to do. That's what, that's the number one thing. And it's the number one thing that will bring you freedom because it's the freedom that ability to choose what you want to do. And that's to say yes to what's most important to you, that saying yes to your heart, yes to your soul, and yes to a meaningful life. And this is when you are most resilient is when you're living and fulfilling a meaningful life. Again, if you're de-purposing and doing things of low value, then you're going to feel waterless, you're going to feel that you have no direction, you're going to feel unfulfilled. And in those moments, you will seek externally for fulfillment, such as sugar, such as fat and sugar combination, such as maybe scrolling on Netflix and get getting your dopamine hits by looking at the number of likes you've got on a post. So these sorts of things are ways in which we seek it externally but we can get these dopamine hits internally when we're connected with what's most important to us. And we're not living a life by default. And that life by default is living someone else's life. Trying to copy someone else, trying to be someone else, be you, be you is the number one takeaway from this from this podcast episode. And you will have attention surplus order, and you will feel fulfilled within and you won't need any fulfillment externally. You don't need any validation externally, the only thing that I look externally for is, has this episode resonated with the audience. And so I sort of seek some feedback in that because I want to deliver value to you. I don't want to stay I want to be talking to myself, right? I want to be talking to you and adding value to you. That's why I always ask for feedback. And I'm seeking feedback just to understand, is this adding value to you? Have you got value from this episode? If you have, I'm going to do more of it. If you haven't I, I won't go into those topics again. So I know this is well researched, it's well Googled, at the moment is adult ADHD. I know TikTok there's certain TikToks that are going viral in terms of how to diagnose whether you have ADHD, well, I'll have all the ADHD symptoms when someone starts talking about golf, or they start talking about Taylor Swift, or they start talking about these things that I'm not interested in such as cars. So I will exhibit all those symptoms because it's de-purposing me, my dopamine is dropping when my dopamine drops, I'm going to look for something more fulfilling. It's like our primitive wiring. When we got to an area that had no food, we had this ADHD will thinking if I don't leave this area, I'm going to die. So it's a survival mechanism. It's hardwiring within us so that we seek fulfillment, fulfillment in terms of nourishment, shelter, and then beyond that we're seeking that actualisation that Maslow talks about in his his pyramid, his hierarchy of needs. I seek actualisation in terms of doing this for you. That's how I get ultimate fulfillment because I've got my basic needs met, I'm no longer hunting and gathering for food. In actual fact, my challenge today is to eat less because we have so much abundance of food around us that we can eat all the time. And we can get hunger cues all the time because we see food. So what I'm doing now is looking for ways in which I can eat less. How do I run a calorie deficit? How do I calorie restrict? How do I do intermittent fasting? Because I know this is going to give me more energy, I know constantly fueling my body and flooding my system is creating this demand or over demand or just putting this strain on my system. And I know that I'll be able to focus more when I've got this fuel in the system, and it can run more efficiently. When I flood my body with fuel, it gets overwhelmed and it overshoots and over, it puts out too much insulin then I get fatigued and whatever, what I found is if I eat less, I have a much more steady energy. And so yes, I've gone on a bit of a tangent here. But what I want to share with you is we are hardwired to have attention deficit disorder when we're doing things that are not meaningful to us. So if you have the symptoms, signs and symptoms of Attention Deficit Disorder, it means that you're doing things of low priority, you aren't doing or living a life that by design of things that are most meaningful to you. And as I said, you can find these things of meaning by looking at the things that bring you presence, that bring you focus. When are you most focus? What are you doing when you're most focused? When aren't you distracted? What are you doing? Do more of that, that's the area that brings you meaning. That area is elevating your dopamine and not allowing it to plummet to levels that you're now questioning whether you're going to survive, because you're de-purposing so much. And we we are human beings that seek meaning and purpose in everything we do. That's why we always ask why. Why is this happened to me, because we're seeking for the meaning and purpose behind what's happened. So let's get back to what you can do about it. I've shared a lot. So you want to make sure that you're doing and the things that you value most saying no to anything else. And if you need to do something, or something needs to get done, you don't like doing it, then delegate it to someone that loves doing it, because it gives them fulfillment in doing that task, and it won't drop your dopamine. And you won't lose focus by delegating something that someone else loves that you don't. So you can do it through delegation, you can do it through abstaining and saying no, I'm not interested and being up just being upfront about it. So that that person then understands who you are. Because if you keep saying yes, they think you like it, and you could be putting on an act and not being you, not being your authentic self. And then when you're not being your authentic self, then you're going to seek fulfillment externally again, right? You're going to then eat more sugar, you're going to drink alcohol, you're going to eat unhealthy, you're going to gamble, you might do drugs. Again, these are all some of the things that we do to boost up dopamine, to give us some meaning because we know what when we have sugar, we do feel a rush because we're hardwired that way because it helps us to survive. It's it's calories and it's instant fuel for us, it's very good fuel and easy fuel for the brain, not good fuel, but easy fuel for the brain to burn. So I really just wanted to share this outline as to yes, you can take the drug and keep living a de-purposing life or doing the things that are unfulfilling. Or you can start dropping the things that are unfulfilling, that going towards things that are fulfilling, and then you don't need the drugs. And then you live a life of meaning and purpose. And there's another way to hack it. If you are doing something that's of low value that you want to think that you're obliged to do. I don't know what it would be. But if there's something that you feel obliged to doing, and you want to keep doing it without taking the drugs, then what you want to do is start hardwiring your brain to how is that you doing that task that you perceive as being unfulfilling. How is that helping you fulfill what's most important to you, and start finding linkages to how it fulfills you and the more of those linkages you find, the more you're going to create these neural connections that are linked to your highest value. And that you will then have more dopamine around those synapses when you're doing that task because you can see meaning behind doing that task now. Whereas before you couldn't see the meaning behind doing that task. You're just focused on all the negatives or the downsides or the lack of connection to what's most meaningful to you. So again, we can rewire our brain by asking ourselves, how is me doing that task going to help me fulfill what's most important to me? What's most valuable to me? How can that task help me do that? And you'll the more you ask that question, the more you'll find the pathways and the answers to finding those connections. And so you can actually, for a period of time, again, it's only going to work for a period of time because ultimately you want to be working towards what's most meaningful to you. It's like this is again a band-aid without taking the drug ultimately because they're not going to be really strong connections, but there'll be enough connections so that you can endure it. And you don't need to seek external pleasures that aren't going to be supporting you long term in terms of health, you know, what I mentioned was bad food and drugs and, and those sort of things, addictions and those sorts of things. And they're the things that we're going to be doing when our dopamine hits rock bottom because we're doing tasks that are unfulfilling to us. So I hope that really helps you around putting this ADHD in perspective and not thinking that there's something wrong with you, it's just feedback to you that what you're doing is low value. So that's all ADHD is telling you is that you're doing a whole lot of tasks in your life that are not important to you. And the ADHD is telling you, you need to now switch your focus to start living the life that you want to live by doing the tasks that are meaningful to you, that are important to you. If you do those priorities, you will then get this attention surplus order. So you will have surplus order in your life, you'll have so much focus, so much attention in in that area that's most meaningful to you, or areas that are most meaningful to you. So I suggest you look into this and start applying it by looking at what is most fulfilling to you, how can you spread that into your days, weeks, months, and years, and keep applying that and it will keep that dopamine elevated. And you won't need to take Ritalin and I want you to start practicing saying no to the things that you don't value. If you want further help in this area, I can really help you in this area. So if you have a diagnosis of ADHD, and you don't want the medication, you don't want the side effects of the medication and you want help in terms of getting focused again, I can help you in this area. So please reach out to me and I can support you in living a meaningful life and a life by design not a life by default. I hope you enjoy this episode of me&my health up, I really had attention surplus order in sharing this information with you and I hope it gave you huge amounts of value. Please give me any feedback if you've got any feedback as to what you'd like to know more about I'm happy to share that, in the meantime continue to health up and if you need help, you can reach out to me I'd be happy to assist. Take care.

Podcast Disclaimer: 33:32

This podcast and any information, advice, opinions or statements within it do not constitute medical healthcare or professional advice and are provided for general information purposes only. All care is taken in the preparation of the information in this podcast. Connected Wellness Proprietary Limited operating under the brand "me&my health up" does not make any representations or give any warranties about its accuracy, reliability, completeness or suitability for any particular purpose. This podcast and any information, advice, opinions or statements within it are not to be used as a substitute for professional medical, psychological, psychiatric, or any other mental healthcare or healthcare in general. me&my health up recommends you seek the advice of a doctor or qualified health provider with any questions you may have regarding a medical condition. Inform your doctor of any changes that you make to your lifestyle and discuss these with your doctor. Do not disregard medical advice or delay visiting a medical professional because of something you hear in this podcast. This podcast has been carefully prepared on the basis of current information. Changes in circumstances after publication may affect the accuracy of this information. To the maximum extent permitted by the law, me&my health up disclaims any such representations or warranties to the completeness, accuracy, merchantability or fitness for purpose of this podcast and will not be liable for any expenses, losses, damages incurred indirect or consequential damages or costs that may be incurred as a result of the information being inaccurate or incomplete in any way and for any reason. No part of this podcast can be reproduced, redistributed, published, copied or duplicated in any form without prior permission of me&my health up.