Many parents want to know, “What can I do, in addition to medicine, to make my ADHD child’s life better?” or “What can I do instead of medicine to help my child with ADHD?” Every year in the United States, doctors write over 20 million prescriptions for stimulants to give to kids for attention deficit hyperactivity disorder. Studies consistently show that medications can reduce symptoms quickly, but some kids have undesirable side effects. It’s important to work with your doctor to achieve beneficial medication regimens when appropriate, but it’s also important to work on the other things that can help a child with ADHD. It can be really hard to sort out all of the information available from friends, family, and the internet. It seems all of us have a friend, or a cousin, or a cousin’s friend whose child just got straight A’s after starting a new herb or supplement.
COVER THE BASICS
When considering a treatment plan for ADHD, it’s important to cover the basics. By basics I mean lifestyle habits that have been shown to have very low risk of harmful side effects, and a very high likelihood of being beneficial, not just for ADHD symptoms, but for overall well-being. This is simple stuff, but it really matters.
WATER AND NUTRITION
The brain is 73% water, so it makes sense that being properly hydrated can affect brain function. In one study, two groups of children were found to be mildly dehydrated upon arrival to school. One group was given a big glass of water to drink; the other group was not. Then both groups were given some mental exercises to do. Guess who performed better. You got it- the kids who drank the water. Even mild dehydration can affect concentration, memory, and lead to mood swings and fatigue. Encourage your child to drink plenty of water throughout the day, their first glass of the day should be before leaving for school.
So far, scientific studies have not revealed any specific magical foods that drastically improve ADHD. However, there do seem to be a few ingredients that are questionable when it comes to worsening ADHD. Artificial colors in the food supply have been controversial for years, and scientists have specifically been concerned about the effects of these dyes on behavior. The best way to avoid artificial colors is to reduce prepackaged and processed foods and to read the ingredients on every edible thing that you buy. Avoid anything containing an ingredient with “FD&C” in the name. A diet rich in fruits, vegetables, whole grains, beans, nuts and seeds is great for everyone, not just kids with ADHD. A breakfast of whole grain with some fruit and protein (thinks nuts or seeds on some cereal or oatmeal) will go a long way to keeping your child’s blood sugar and energy stable until lunch.
SLEEP
Sleep disorders are more common in children with ADHD. The National Sleep Foundation found that as many as 80% of teens do not get enough sleep. Sleep-deprived kids often lack focus and may have symptoms of hyperactivity. Studies show that in children who are on medication for ADHD, learning about a good sleep routine combined with sticking to a consistent bedtime routine improved sleep duration, ADHD symptoms, and quality of life. Some common things that disrupt sleep in children include caffeine, heavy meals, exercise or excitement (bedtime pillow fight, anyone?) right before bed. Electronic devices really do stimulate wakefulness (although every child will deny this), and should be turned off at least two hours before bed. That’s correct, that was two hours. Setting up a nightly routine that is done the same way each night and ending with quiet reading with your child just before lights out has been shown to be effective in improving sleep and decreasing ADHD symptoms.
EXERCISE
Most parents have probably already figured out that a good romp in the yard or at the playground can work wonders to help kids blow off some steam. ADHD medications work by increasing dopamine and norepinephrine, two chemicals that work to regulate function in the brain. Exercise increases the same chemicals in the brain, and the effect begins almost immediately after getting on a bike. This probably explains the positive effects of exercise on skills like memory, attention, self-control, and emotional regulation. The problem is, the positive effects of exercise on behavior do not last as long as the medication does, and our lifestyles do not always allow us to take a twenty-minute bike ride every couple of hours.
This doesn’t mean that we can’t reap the benefits of exercise for ADHD. A consistent movement plan including cardiovascular exercise like running, cycling, or swimming is particularly beneficial, but even a short walk or bike ride in the morning (before school) or afternoon (before homework) can help. Exercise has positive effects on the brain almost immediately, not to mention the long term positive effects of having a healthy body and mind (it’s great for mood regulation.) Since physical activity has essentially no negative side effects, it’s a “no-brainer” (sorry).
BEHAVIORAL THERAPY
Having trouble remaining calm when your ADHD child is doing his thing? Maybe you and your child can benefit from behavioral therapy. In behavioral therapy, a family meets with a trained counselor to learn about ADHD, and both parent and child learn to develop systems (think checklists and routines) to help the child improve their skills and behavior. Behavior therapy can improve a child’s behavior, self-control, and self-esteem as well as help parents with their skills and coping mechanisms. Through regular meetings, a parent can learn to become a personal coach for their child. Sometimes the parent needs a coach to help deal with their child’s challenging behaviors – a behavioral therapist can help with that, too. Ask your healthcare provider to help you find a good therapist.
OTHER THERAPIES
Mindfulness and meditation are getting more attention as being useful for a wide variety of conditions from chronic pain, to depression and anxiety, and possibly ADHD symptoms. Mindfulness is simply paying attention in the moment to how you are feeling, what you are thinking, and focusing on your breathing. It can take some practice to learn to just sit and breathe for five to ten minutes, but practicing consistently is associated with improved attention and self-regulation behavior (think calmer, less reactive kid and parent). Many children with ADHD also struggle with anxiety, depression, and sleep – meditation is helpful for those problems, too. Get started with a Mobile app like Headspace and Calm, which have free and low-cost programs for people of all ages. Like going to the gym, meditating only works if you do it consistently. Set a time daily with you and your child, and push play on the app – it’s that easy.
Supplements also get plenty of attention in the ADHD world. A few studies have shown that some children with ADHD symptoms may have lower levels than normal of some nutrients such as iron, zinc, magnesium, vitamin D, and long-chain polyunsaturated fatty acids (PUFA’s or omegas). It is not clear; however, if these nutrients have anything to do with causing the ADHD, or even if taking supplements of these nutrients consistently helps to improve symptoms. Hopefully, scientists will get to work performing studies to clearly answer these questions. In the meantime, be sure to discuss with your doctor before starting any new supplements for your child.
PUTTING IT INTO PRACTICE
Sometimes the simplest things in life are the hardest ones to pull off. Setting up a lifestyle that allows an ADHD child to flourish may include changing our schedules, setting up morning checklists, earlier bedtime routines to promote good sleep, providing healthy meals, and allowing time for exercise and play. This stuff takes effort! But with very low cost and no negative side-effects, they are worth it! I find it helpful to have a big dry erase board in my kitchen with a checklist visible to the whole family to remind us to pursue the simple things that have been proven to promote good health. Even grown-ups like to check things off!
Written by Jennifer Singh, MD
Dr. Singh is an Assistant Professor at LSU Health School of Allied Health where she teaches physician assistant students and medical students. She also owns Singh Wellness, LLC, and provides classes and coaching for helping patients transition to a plant-strong diet to treat and reverse disease. She can be found online at www.jennifersinghmd.com and on Facebook at Jennifer Singh MD.