“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) can be successful in treating ADHD, too. But some of these drugs may cause side effects like insomnia, stomach pain, loss of appetite, irritability, anxiety or heart problems. 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 “effective drug” with “low risk,” the agency is warning doctors to monitor children and adolescents taking it for suicidal thoughts. There are alternatives that show promise.
The Holistic Approach
Naturopath and acupuncturist Trina Seligman, N.D., L.Ac., a guest lecturer at Bastyr University in Seattle, recommends a “foundation” of a broad-spectrum, free-form amino acid supplement taken daily to balance a patient’s brain chemistry. To target specific symptoms, Seligman uses specific aminos. She often prescribes twice-daily single doses of dopamine precursor DL-phenylalanine or norepinephrine precursor L-tyrosine to improve concentration and diminish restlessness; serotonin precursor L-tryptophan to alleviate depression; or GABA or L-theanine to reduce anxiety and irritability.
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 informationprocessing speed while slowing the rate at which newly acquired information is forgotten. Meanwhile, a study in Progress in Neuro- Psychopharmacology & Biological Psychiatry determined that zinc sulfate (150 mg per day) can reduce some ADHD symptoms.
A classic natural therapy may also be beneficial: 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.
Medication and/or supplementation is only part of proper ADHD management. “Taking a whole-person approach to brain health can make an enormously positive difference,” says Amen. The following lifestyle adjustments are recommended:
Eat right. 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 difficult,” 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 (Pinon Press). So, eat real meals throughout the day and limit simple carbohydrates, sugar and caffeine. (Caffeine is a stimulant, but it actually decreases blood flow 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.
Exercise. Every ADHD expert emphasizes the importance of regular, vigorous movement. “Exercise is not a choice,” says Amen. “It boosts blood flow to the brain and helps the brain make new nerve cells.” In addition, sustained cardiovascular activity steadies blood sugar, contributes to 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, five days a week.
Seek support. 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.