4 of the Best Treatment Options for ADHD
There are many different ways in which ADHD can be improved. Here are four of the most effective treatment options for ADHD.
Option 1: Medication
The most commonly prescribed medication globally is methylphenidate. Like many other ADHD medications it is a stimulant, and works by boosting the amount and/or uptake of neurotransmitters in the brain. This allows the different regions of the the brain to communicate more effectively with each other, which improves our executive functions.
Other medications are not stimulants, and work to treat ADHD in different ways. These are suitable if you are unable to take stimulant medication.
Pills don't teach skills! ADHD medication is not a magic fix, but it will help redress imbalances in underlying brain chemistry associated with ADHD, improving its executive functions. This allows us the extra "space" needed to learn new skills.
Medication options also differ between countries:
In the UK, the following are approved: methylphenidate, dexamfetamine (also known as dextroamfetamine), lisdexamfetamine, atomoxetine, and guanfacine (for children only).
In the USA, the following additional medications are available: clonidine, buproprion, amphetamine, amphetamine sulphate, methamphetamine, mixed amphetamine salts, and dexmethylphenidate.
Elsewhere in the world, the medications used varies widely. This is likely due to a number of factors, including varying diagnostic practices, the availability and cost of medicines, and differences in regional guidelines.
As with any medication, ADHD medications have a small risk of side effects. Most are mild and include things such as decreased appetite, irritability, nausea, a small increase in heart rate and blood pressure, and headaches.
A few are more serious but have only a very small risk of them occurring, or are only a concern if you have other pre-existing conditions. Some of these medications cannot be taken if you are taking certain other medications, or if you have particular medical conditions other than ADHD.
Remember: always work closely with your GP or other healthcare provider to ensure you're doing things safely and effectively.
In order to receive any medications, you will need a formal ADHD diagnosis and to undergo a medical evaluation with your doctor. You will always undergo a "trial" period when you first start taking ADHD medication.
Your doctor will start you off on the lowest dose and it will be gradually increased under medical supervision until you reach the minimum effective dose to treat your symptoms with minimal side-effects.
Don't be disheartened if it takes a while to find the right medication at the correct dose. Some people find the right combination quickly, whereas others may have to trial several different medications and at several different doses before they find what works for them.
Option 2: Exercise
Exercise has been shown to be an effective secondary treatment for ADHD.
During exercise, the brain releases neurotransmitters, including dopamine, which is naturally lacking in those of us with ADHD.
Dopamine (and other neurotransmitters) help the different areas of the brain communicate better with each other, improving executive functions such as working memory. Boosting neurotransmitter production is the main way stimulant medications help treat ADHD.
The recommended amount of exercise for the average adult is 150 minutes a week (30 minutes a day, 5 days a week) for moderate exercise, or 75 minutes of more intensive aerobic exercise. It doesn't matter what form this exercise takes, as long as it increases heart rate.
There are many forms of exercise to try. Some are things that can be done alone, others are team sports. Some can be done at the gym or sports club, others can be done at home (and for some, both!). Some are well-known and obvious, others are more obscure.
Let these spark some interest; try to think of exercise or sport which would continue to maintain attention and excitement:
Swimming | Running | Cycling | Aerobics | Dance | Tennis | Football
Boxing | Martial Arts | Badminton | Rowing | Water Polo | Track and Field
Hockey | Rock Climbing | Basketball/Netball | Skiing/Snowboarding
Hiking | Ultimate Frisbee | Lacrosse | Gymnastics
Choose one or more of the forms of exercise which interest you the most, and brainstorm more if necessary. Research local clubs or sports facilities for information on membership, dates/times of any classes, and any equipment needed.
Most sports facilities will offer free trials so you can have a go before you commit to anything, so consider arranging some tryouts with a few to see which you like.
If you want more information, I've written a whole post about how exercise benefits the ADHD brain here!
Option 3: Mindfulness
Mindfulness can be described as the practice of paying attention in the present moment, intentionally and without judgment.
Mindful meditation uses the practice of non-judgmental observation of our thoughts, emotions and body states to deliberately regulate our attention.
ADHD and meditation may seem an unlikely pairing, but studies have demonstrated its effectiveness in improving a range of ADHD symptoms:
Improved emotional regulation
Improved attention span
Other associated benefits of mindfulness include stress reduction, and increased emotional intelligence, empathy, and respect.
Basic mindful meditation involves sitting somewhere comfortable and with good posture, taking slow and deliberate breaths, paying attention to the breath, and gently pulling attention back to the breath when it inevitably wanders.
At first, only a few minutes will be possible, and it's likely to be difficult to do. But, practice for just a few minutes daily and it will get easier.
It's possible to be mindful in almost everything we do. Since it is simply paying attention to whatever is happening at the present moment, mindfulness can be practiced almost anywhere and at any time. We can mindfully walk, run, sit, eat, listen, speak, and more.
All we need to is cultivate the practice of observing the present moment without judgement.
If you would like to read more about mindfulness and the ADHD brain, I've written a whole post about it here!
Option 4: Therapy / Coaching
Therapy is a very effective treatment for ADHD, especially when used in conjunction with medication. There are many different forms of therapy available, and many are also useful in treating comorbid conditions commonly found alongside ADHD, such as conduct disorder, oppositional defiant disorder, anxiety, and depression.
Cognitive Behavioural Therapy
Also known as CBT, this is a form of psychotherapy that was originally developed for mood disorders. It changes negative patterns of thinking by challenging and addressing "cognitive thoughts" — spontaneous interpretations of events which often come loaded with the unfounded negative assumptions we've built up over a lifetime.
This involves discussion of ADHD and its effects. It can help children, teenagers and adults understand ADHD, come to terms with their diagnosis, and provide support to help them thrive with the condition.
This can help adults with ADHD with the struggles they often face with issues stemming from longstanding patterns of underachievement, failure, academic difficulties, job turnover, and relationship conflict.
Individual talk therapy can help us deal with this emotional baggage, including low self-esteem, the feelings of embarrassment and shame we may have experienced as a child and teenager, and resentment at the nagging and criticism we receive from people close to us.
Parent Training and Education
This is useful for parents of children or teenagers to help them learn specific ways of talking to and working with their ADHD child to improve their attention and behaviour. It aims to increase parents' confidence in their ability to help their child and improve their relationship.
Parents should not feel as though they have been a "bad parent" or that they have failed — ADHD is a challenge to deal with, and most common-sense, conventional parenting methods are not very effective.
This is similar to therapy but distinct from it. In short, coaching is about action, therapy is about coping. Coaching focuses exclusively on the present and future, helping us to recognise our potential, and set and achieve specific goals.
Coaching is a particularly powerful tool for change going forward. Therapy and counselling focus more on the past, whereas coaching is geared towards present goals and future aspirations. Crucially, coaches will not try to suggest solutions or solve problems; instead, they will help the person being coached to generate the answers to their problems themselves, which is a very powerful tool for long-lasting change.
The most powerful changes can be seen when more than one form of these four ADHD treatments are used at the same time; for example, taking ADHD medication regularly and also exercising 5 days a week. The more tools you can have at your disposal when managing your ADHD, the better!