Medication and Mindfulness in Treating ADHD
ADHD, the abbreviation for attention deficit hyperactivity disorder, is a mental health condition in which a person has difficulty staying on task, completing tasks, or maintaining attention, or experiences intense physical energy. As understanding and diagnosis of ADHD improve, the condition is being diagnosed sooner in more children; however, some adults are diagnosed with ADHD, although it is believed that these individuals had ADHD in childhood and never received a diagnosis.
How Is ADHD Diagnosed?
There are three primary characteristics of ADHD:
- Inattentiveness: The person with ADHD in unable to stay on task, has difficulty maintaining focus, and/or lacks persistence to complete tasks. This manifests as failing to follow directions, losing or constantly misplacing items, and being unable to complete schoolwork or other tasks.
- Impulsiveness: The person makes decisions quickly, without enough information or without considering all aspects of the decision. The individual desires immediate gratification. This can manifest as interrupting in conversations or being unable to take turns.
- Hyperactivity: The person cannot moderate how much they move, twitch, or fidget. They may be unable to stay seated or constantly desire activity like jogging, biking, or other physical activity. They are unable to moderate the level of physical energy they express. In children, this manifests as running, climbing, and jumping on things, as well as being unable to stay seated and stop twitching in school. Adults may fidget, pace, or feel constantly restless.
When these symptoms are persistent for six months and carry across to at least two separate environments, then a psychologist or psychiatrist will conduct other tests to diagnose ADHD. A physician may also take a medical history and perform a physical in order to rule out any potential underlying physical problems that could lead to symptoms. The psychologist will work to rule out other psychological disorders that may manifest as ADHD.
Although there is no cure for ADHD – the condition typically persists into adulthood – there are several effective treatments that, when appropriately combined, can ease symptoms and allow the child or adolescent to lead a normal life. The most common combination of treatments is medication and psychotherapy, although many people are choosing alternative treatments for themselves or for their children, such as mindfulness and meditation techniques.
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Medication to Treat ADHD
Most medical professionals recognize that, for a complex and chronic condition like ADHD, there must be several types of treatment; medication is one aspect of treatment. That being said, medication is an important aspect of treatment for many people diagnosed with ADHD, as it can manage symptoms and help the person focus on daily life.
Medications are divided into two primary types:
- Stimulants: This class of medications are the first prescribed after an ADHD diagnosis, and they are the most effective for most people with ADHD. The Centers for Disease Control (CDC) notes that 70-80 percent of children who begin therapy with stimulant medications greatly benefit from the fast-acting nature of these medications. In order to avoid dependence, tolerance, and potential addiction, psychiatrists typically start at the lowest possible dose and adjust the dosage as necessary. The most famous stimulant medications approved for treatment in ADHD are Ritalin and Adderall. However, a new medication, Vyvanse, is currently more widely prescribed due to effectiveness.
- Nonstimulants: Some new types of medications that are not stimulant-based have been approved for use in people with ADHD. The first of these medications was approved by the Food and Drug Administration (FDA) in 2003. These medications typically do not work as well as stimulants or as quickly, but they can be effective in people who do not get great benefit from stimulant medications. Some of the types of medicines that are not stimulants used to treat ADHD are atomoxetine (Strattera), clonidine, and some tricyclic antidepressants.
Generalside effects of these medications include:
- Decreased appetite
- Insomnia or changes in sleep patterns
- Changes in mood, including increased anxiety, irritability (stimulants), or depression (nonstimulants)
- Tics or twitches
- Stomachaches or headaches
Most medical practitioners warn that, although medication is very effective in treating symptoms, it is not a substitute for a larger treatment plan. Medication should be coupled with therapy, such as behavioral therapy.
Mindfulness to Treat ADHD
Parents who are concerned about medication and adults with ADHD who wish to move away from medication are finding new methods of treatment for ADHD symptoms. One of the most popular is mindfulness. Although this treatment does not provide the immediate change in symptoms that medication does, working with mindfulness techniques can help some people who struggle with ADHD symptoms.
Mindfulness is a meditation practice based on Eastern philosophies and practices, which guides the meditator to focus on the present moment without judgment. If the individual notices their attention has wandered away, then they guide their concentration back to the present. This practice also encourages the practicing person to observe their thoughts, emotions, and reactions without judgment.
Since scientific studies on mindfulness are fairly new, so there is not much evidence about the effectiveness of the treatment compared to medication. However, treatment and steps to overcome mental health issue are very individual, so mindfulness likely works better for some people than for others. Thanks to brain imaging techniques, some of the effects of mindfulness can be observed; however, the main studies on mindfulness have been conducted on adults, so there is little information available on whether children are helped by these techniques.
- A 2009 study showed that mindfulness improves a person’s ability to pay attention to the present moment by taking advantage of neuroplasticity to train the mind to focus.
- A 2010 study of adults with ADHD showed that mindfulness techniques can improve problem areas, leading to the conclusion that this training is an effective intervention for adults.
- A 2011 study that examined depression and anxiety displaying similar symptoms to ADHD, characterized by frequent lapses in attention and self-regulation, showed that symptoms were improved through mindfulness meditation. Again, the study focused on adults.
- A 2011 study on mindfulness for children, ages 8-12, showed that symptoms dramatically improved with mindfulness practices. The study included the parents of the children studied, because ADHD is an inheritable condition. The parents involved in the study also displayed symptoms of ADHD, which were improved by undergoing mindfulness training with their children.
A program created by the Mindful Awareness Research Center (MARC), called Mindful Awareness Practices for ADHD (MAP), with the help of the University of California, Los Angeles (UCLA), notes that the majority of participants show great signs of improvement in symptoms. The program uses visual cues, as most people with ADHD are visual learners. Participants in the program begin working on meditation for five minutes and eventually increase the practice to 20 minutes. The program uses two principles – focus on the present moment, and remaining open and curious to experiences – to help participants. While MARC has reported success among MAP participants, the changes are self-reported, and the group is self-selecting: Those who are interested in mindfulness are likely to participate, while those who are not interested in mindfulness will not.
Get Help to Overcome ADHD Symptoms
It is important to get help for ADHD and to diagnose this condition as early as possible. Untreated ADHD can lead to serious problems with impulse control and emotional regulation, which can lead to other psychological problems later in life, including depression and anxiety. People with untreated ADHD typically have lower self-esteem, less ability to maintain intimate relationships, and difficulty holding down jobs or staying in school. They are more likely to self-medicate with drugs or alcohol due to these perceived personal failures. When ADHD is appropriately treated with a combination of techniques, including medication and mindfulness, symptoms can be managed, and the person can lead a healthy, happy life.
People who have developed substance abuse issues due to untreated ADHD should find a rehabilitation program that works with co-occurring disorders. As the link between mental health and addiction is understood better, more rehabilitation programs are able to offer this level of care.