What is ADHD Attention-Deficit Hyperactivity Disorder Here All You Need to Know About it
these days it’s hard to tell what’s “attention deficit hyperactivity disorder” (ADHD) and what’s just a busy day in
2014. Say you teach yoga, homeschool your children, sing in a choir and remodel the kitchen, all while ɹnishing a novel, redesigning a garden and buying a vintage car—and you do it all with a boundless enthusiasm, tempered by a gnawing restlessness, always moving, moving, moving? First of all, well done: The kitchen looks awesome.
But a behavioral neurologist would inquire about symptoms: Adults with ADHD have difficulty following directions, remembering information, concentrating, organizing tasks, and/or completing work within time limits. Not managed appropriately, these diɽculties can cause associated behavioral, emotional, social,
vocational and academic problems. And you may be too busy to even notice.
About 4% to 5% of American adults suʃer from ADHD, and they work 22 fewer days than their ADHD-free coworkers annually due to their symptoms, according to a national screening survey conducted by Harvard Medical School. According to the Semel Institute for Neuroscience & Human Behavior at UCLA, ADHD is
generally a chronic disorder, with 30%–50% of those individuals diagnosed in childhood continuing to have symptoms into adulthood; and there is evidence that ADHD runs in families.“ADHD isn’t something that pops up when you’re 45 and going through a divorce,” says Daniel G. Amen, M.D., founder of Amen Clinics Inc., two-time board-certiɹed psychiatrist and best-selling author of Unleash the Power of the Female Brain. “You see there was
evidence of it all along.”
Adults with past or current symptoms of ADHD are also at a higher risk for other problems. The American Journal of Psychiatry found that 59% of ADHD patients suʃered from major depression at some point, compared with 40% of the non-ADHD group; the respective ratio for anxiety disorder was 21% versus 8%. All of
which means it’s essential to look at ways of working with ADHD to harness its creative beneɹts—and reduce its embarrassing downsides.
Understanding the complexities of the condition and the effectiveness of traditional as well as alternative treatments begins with the acceptance of the diagnosis of ADHD.
Originally known, rather alarmingly, as “minimal brain dysfunction” and then“attention deɹcient disorder,” the condition has had one misleading moniker after another. Those with ADHD don’t suʃer from a deficit
of attention—if anything, they have a surfeit of it. Vulnerable to distraction because they perceive too much at once, they are unable to ɹlter out extraneous stimuli and focus on what is most important.
The cause may be a lack of blood flow and electrical stimulation to the frontal cortex—the area of the brain involved in prioritizing, focusing and choosing words thoughtfully rather than blurting them out. Scans of people with ADHD usually show reduced activity in this decision-making area of the brain.
Some researchers suggest that “executive functioning disorder” is a better description. “ADHD people think in a tangential, nonlinear, circular way,” says Hal Elliott, M.D., residency program director and associate professor at East Tennessee State University’s QuillenCollege of Medicine in Johnson City. “One thing reminds them of something else, which reminds them of something else. People with ADHD tend to be writers, musicians, visionaries, inventors, and people who rock the boat at work—they come up with better ways to do things. There’s nothing wrong with being a nonlinear person except that it can make you miserable in this linear world we live in.
Do You Have ADHD?
The principal characteristics of attention deficit hyperactivity disorder (ADHD) are inattention, hyperactivity, and impulsivity, according to the National Institute of Mental Health. Behavior can be predominantly inattentive (you make careless mistakes are easily distracted, leave tasks uncompleted), predominantly hyperactive-impulsive (you feel restless and fidgety, interrupt, blurt out comments, have difficulty relaxing or waiting) or both. Of course, everyone exhibits such tendencies once in a while, but most people quit when these actions become inappropriate or detrimental.
The following self-test questions, developed by the World Health Organization can help you identify behavior
consistent with adult ADHD. Answer never (0 points); rarely (1 point); sometimes (2 points); often (3 points); or very often (4 points). A score of 11 points or more indicates the potential benefit of getting an ADHD evaluation by a health care provider. In the last six months:
1. How often have you been distracted by activity or noise around you?
2. How often have you had difficulty getting things in order when you had to do a task that required an organization?
3. How often have you had difficulty waiting your turn in situations when taking turns was required?
4. When you had a task that required a lot of thought, how often have you avoided or delayed getting started?
5. How often have you felt restless or fidgety?
6. How often have you left your seat in meetings or other situations in which you were expected to remain seated?
“Since we still know so little about ADHD, treatment is very trial-and-error,” says Hailing Zhang, M.D., a psychiatrist who treats many adults with ADHD. “But the gold standard is stimulant medication.” Controlled studies show that drugs like methylphenidate (Ritalin, Concerta) and mixed amphetamines (Adderall) increase mental concentration by making the neurotransmitters dopamine and norepinephrine more available to the brain. Drugs related to antidepressants (Wellbutrin, Strattera) can be successful in treating ADHD, too.
But some of these drugs may cause side eʃects like insomnia, stomach pain, loss of appetite, irritability, anxiety or heart problems. They can even be deadly: Canadian authorities banned the use of Adderall for several months in 2005 due to possible sudden deaths, heart-related fatalities, and strokes in children and adults.
And while the FDA considers Strattera an “eʃective drug” with “low risk,” the agency is warning doctors to monitor children and adolescents taking it for suicidal thoughts.
Drain Your Brain
Did feeling stress and overwhelmed? “People with ADHD need time each day without stimulation so they can decompress,” says Hal Elliott, M.D. Restore yourself with activities that relieve the mental and emotional strain,
Spending time outside in green settings can be a valuable part of treatment, says a study published in the American Journal of Public Health.
It’s sometimes easier for those with ADHD to concentrate when they’re engaged in pleasurable activities, and there’s really therapeutic benefit to be had from achieving tangible results. Having a hobby— gardening, woodworking, knitting, any kind of hands-on endeavor—is a great outlet for ADHD energy.
RELAXING MASSAGE AND YOGA
These give busy minds a vacation by drawing awareness back into the body. “The ayurvedic technique known as Shirodhara involves pouring warm herbal oil over the forehead in a specific pattern,” says John Douillard, D.C., National AyurvedicMedical Association board member. “This stills the mind and calms the nervous system.” Available through ayurvedic practitioners and in someday spas, Shirodhara is sometimes referred to as “bliss therapy.”
There are alternatives that show real promise. Naturopath and acupuncturist Trina Seligman, N.D., L.Ac., a guest lecturer at Bastyr University in Seattle, recommends a “foundation” of a broadspectrum, free-form amino acid supplement taken daily to balance a patient’s brain chemistry. To target speciɹc symptoms, Seligman uses speciɹc amino. To improve concentration and diminish restlessness she often prescribes twice-daily single doses of dopamine precursor DL-phenylalanine or norepinephrine precursor L-tyrosine; for depression, she chooses serotonin precursor L-tryptophan; and to reduce anxiety and irritability, GABA or L-theanine.An ayurvedic herb may also help.
Two Australian studies published in Neuropsychopharmacology and Psychopharmacology found that 300 milligrams of Bacopa monniera (aka brahmi) daily improved information-processing speed while slowing the rate at which newly acquired information is forgotten; the herb also reduced anxiety.
Meanwhile, a study in Progress in Neuro-Psychopharmacology & Biological Psychiatry determined that zinc sulfate (150 milligrams per day) can reduce some ADHD symptoms. A classic natural therapy may also be beneɹcial: A Swiss study showed homeopathic treatment comparing favorably to the use of methylphenidate in
children with ADHD. Because the condition is so complex, however, there is no advised standard; an experienced homeopath can determine the best remedy for each individual.
The Holistic Approach
Medication and/or supplementation is only part of proper ADHD management.
“Taking a whole-person approach to brain health can make an enormously positive diʃerence,” says Amen. To which we say, Amen. The following lifestyle adjustments are recommended:
FEED YOUR FOCUS
Keeping blood sugar stable is vital to leveling out symptoms. “If you have ADHD, it can be hard to function on a good day, but if your blood sugar is low or spiking, it makes it even more diɽcult,” says Wendy Richardson, M.A., M.F.T., author of When Too Much Isn’t Enough: Ending the Destructive Cycle of ADHD and Addictive Behavior. So cut out the processed snacks, eat real meals throughout the day and limit sugar and caʃeine. (Caʃeine is a stimulant, but it actually decreases blood ɻow to the brain.) Every breakfast, lunch, and dinner should provide complex carbs, quality protein and healthy fats in the form of fresh, whole foods. Avoid preservatives and other food additives, as they may exacerbate symptoms.
PUMP THE BLOOD
Every ADHD expert emphasizes the importance of regular, vigorous movement. “Exercise is not a choice,” says Amen. “It boosts blood ɻow to the brain and helps the brain make new nerve cells.” In addition, sustained cardiovascular activity steadies blood sugar, contributes to the overall mood and promotes sound sleep— something patients typically need more of. “People with ADHD don’t do boring, so do what you enjoy,” says Amen. “If you’re not sure what to do, walk briskly—don’t stroll.” Get a physician’s OK, then elevate your heart rate for at least 30 minutes, ɹve days a week.
ADHD has nothing to do with laziness or a lack of intelligence, yet people with the condition are often pegged as underachievers. Take advantage of psychotherapy, coaching and support groups to clarify the emotional factors involved and help restore your self-esteem.
HONOR WHO YOU ARE
Often, those with ADHD ɹnd that meeting their needs as a whole person—eating wisely, exercising, doing yoga, taking herbs and supplements, and getting support—enables them to manage the challenges of the condition. And often they begin to realize that many ADHD qualities—like ɻexibility, creativity, and empathy—are massive strengths.
Train Your Brain
“The brain is continually adapting to its environment, growing interconnections between nerves and becoming
more efficient in response to the stimulation we receive,” says Sergio F. Azzolino, D.C., a clinician in San Francisco and vice president of the American ChiropracticNeurology Board. Here are three techniques that can help you reinforce positive brain function:
While psychotherapy typically deals with thoughts and emotions related to the past, coaching focuses on building the future by developing strategies to attain life and career goals. “Many individuals with ADHD are creative, intelligent people who are frustrated with their lack of achievement,” says Pam Milazzo, founder of the
SAIL Institute and former chair of the ADHD Awareness Campaign for the Attention Deficit Disorder Association.
“When they learn strategies that support working memory and executive functioning, they start to see sustained
success.” (For more information, visit the ADD Coach Academy at addca.com or ADD Consults at addconsults.com.)
2. TAI CHI
A tai chi practice may reintroduce the brain and nervous system to a fluid, sustained state of concentration. A
University of Miami School of Medicine study found that taking two 30-minute classes a week for five weeks
reduced ADHD symptoms like anxiety, daydreaming and hyperactivity. The benefits continued during a two-week
follow-up period without classes.
The Journal of Clinical Psychology published findings showing that neurofeedback had an effect comparable to
stimulant medication in helping ADHD adolescents and adults intentionally regulate brain activity. This technique
uses monitoring equipment to display a visual representation of your brain state. Working with a specialist—a health care professional with additional training—you learn to differentiate between different brain wave types, and independently regulate brain wave activity for increased concentration and focus.