Staying focused can be a challenge for everyone, but for people with Attention Deficit Hyperactivity Disorder (ADHD or ADD), it can be nearly impossible. In Do You Have ADHD and Not Know It?, we talked about how to determine if you really have ADHD and introduced some treatment methods. Many turn to prescription psychostimulants like Adderall and Ritalin, which work by modulating dopamine—a chemical messenger in the brain associated with focus, energy, and the feeling of pleasure.
“The medications used to treat ADHD can be quite helpful, however they are not without risks,” says One Medical Group’s Ellen Vora, MD. These side effects can range from irritability, decreased appetite, headache, and energy crashes later in the day, to less common but more concerning problems, including cardiovascular and psychiatric issues and substance addiction.
These medications are appropriate for some, but others may benefit more from a holistic strategy. “I strongly advocate taking an integrative approach,” Vora says. “I think it’s important to seek out the root cause of the disorder and address it. This may prevent someone from having to take medication at all.”
Here are Vora’s top six integrative approaches to treating ADHD symptoms.
1. Get enough quality shut-eye.
Sleep is the single most important factor in ADHD management. “When someone isn’t getting adequate deep, restorative sleep, they will likely have difficulty with focus and attention,” she says. And it’s not just about quantity—quality matters. Aim for seven to nine hours a night on a regular schedule. Shut off electronics one hour before bedtime and dim the lights—consider using a candle or nightlight in the bathroom while brushing your teeth to avoid the harsh glare. If your brain refuses to relax, have a pen and notepad handy. “Keep a ‘worry journal’ next to your bed,” Vora says. “If you have trouble falling asleep due to racing thoughts, write them down. This will ease your mind.”
2. Sweat it out.
Not only does exercise increase your energy, focus, and productivity, but it also helps with the number one item on this list—sleep. But you don’t need an expensive gym membership and grueling three-hour workout sessions. Vora suggests starting small. “Some days you may just do 10 to 20 minutes of exercise at home—that’s fine,” she says. “Build small amounts of exercise into your day—take a five minute walk after dinner, take the stairs at work, or hold plank position for one minute when you wake up.” Yoga and tai chi are particularly beneficial for ADHD. Try services like YogaGlo or FitnessGlo, or check out the many free fitness videos available on Hulu and YouTube.
3. Keep your sugar stable.
“When your blood sugar is low, your brain is the first thing to ‘go on strike,'” Vora says. “Blood sugar can be low if you haven’t eaten in a while or if you recently ate a meal high in sugar or refined carbohydrates without protein and fat.” The brain is one of the most metabolically active parts of the body, and when blood sugar crashes, it basically boycotts doing any mentally demanding work.
Maintaining stable blood sugar isn’t hard, it just takes some planning. Be sure to eat three meals and two snacks every day, and strive for a balance of protein and healthy fat like coconut oil, olive oil, or grass-fed, organic butter at every meal. Be sure to always keep snacks handy to prevent blood sugar crashes. Hard-boiled eggs and nuts are both great, balanced sources of protein and fat.
4. Eat real food.
Nutrition matters when it comes to ADHD. “Eat real food and avoid processed foods,” Vora says. “There is evidence that artificial food coloring, preservatives, and additives contribute to ADHD symptoms.” On your next trip to the grocery store, steer clear of candy, skim milk, farmed salmon, and soda—all foods that contain coloring and/or preservatives. Additives are another no-no: Avoid fast food, takeout, and other sources of monosodium glutamate (MSG). If you suspect you have a food intolerance that’s getting in the way of your mental focus, it’s worth trying an elimination diet, but be sure to talk to a skilled health care provider first. Digestive issues, irritable bowel syndrome (IBS), heartburn, frequent headaches, and joint pain are all reasons to second-guess your diet and consider working with a nutrition professional.
5. Be smart about supplements.
Certain supplements have been shown to help with ADHD symptoms, but they are not regulated by the Food and Drug Administration, so it’s important to work with a health care provider who can guide your choices. A few of Vora’s favorites include fish oil, Vitamin D3 (1,000 IUs in the morning), probiotics (one capsule in the morning), magnesium (300-400 mg at bedtime), and unrefined coconut oil (a spoonful in the morning and at bedtime). But you don’t need to stock your shelves with supplements in order to reap the benefits of some ingredients. “Even better than taking supplements is getting nutrition from food,” Vora says. “Eat organ meats like chicken liver, wild cold-water fish, fermented foods, such as raw sauerkraut and kimchi, green leafy vegetables, whole eggs, starchy tubers like sweet potatoes, and pastured meats.”
6. Pick up good habits.
It’s hard to break old habits, but putting in a little effort into being more organized can go a long way. Writing a daily to-do list, dedicating a space in the house and at work to set down your phone, keys, and wallet, and writing down appointments, grocery lists, and travel checklists can help you get organized in no time.
Vora also suggests maintaining focus throughout the day with the Pomodoro Technique, which involves working for 25 minutes at a time and taking three to five minute breaks in between (bonus points for doing something active during the breaks). You can even download an app to guide your time management.
The One Medical blog is published by One Medical, an innovative primary care practice with offices in Boston, Chicago, Los Angeles, New York, Phoenix, the San Francisco Bay Area, Seattle, and Washington, DC.
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