A Whole9 guest post by Emily Deans M.D., a board certified psychiatrist with a practice in Massachusetts and a clinical instructor in psychiatry at Harvard Medical School.
If you have lifelong trouble maintaining focus, can’t organize yourself or others, you fidget all the time, and are forgetful to the point where it regularly interferes with your daily functioning, you may have ADHD. You might avoid tasks that require long-term focus (such as school work) and fail to finish tedious duties at work or home. Kids might be reprimanded for inability to stay still in school, or run around climbing in situations where it is inappropriate. Attention Deficit/Hyperactivity Disorder is a common condition present in about 5-10% in today’s children, often persisting into adulthood. It’s highly inherited, and many of my patients come in to ask about a diagnosis after their children were tested for the condition.
More than most psychiatric issues, however, I think of ADHD as “a disease of civilization.” In most of human history we weren’t required to be still and study or do mental work without breaks for long periods of time. While some children and adults excel at doing exactly that, many more just don’t have the capacity to sit still, and in the modern world, a certain percentage at the far end of the spectrum are labeled as ADHD. Parents of children with ADHD always report how well their kids do in summer camp…the parents often commend the staff of the camp, and while the staff may be terrific, I always wonder if it is the nature of summer camp, lots of running around, sunshine, swimming, and other sports that make it a more successful venue for kids who just need more activity.
ADHD can be very serious, leading to poor achievement in school and alienation from friends. Repeated failures and frustrations add up over a lifetime. Untreated ADHD is associated with higher rates of felony convictions, and ADHD is linked with a number of other conditions, including obesity, depression, and substance abuse. The current standard of care treatments include stimulants to help with focus and/or behavioral treatment geared to help with organization. One obvious suggestion for treatment of ADHD would be the year-round equivalent of summer camp…that is, more activity.
Kids with ADHD are more likely to have abdominal obesity and poor strength, muscular endurance, and coordination than their peers.¹ Therefore, these kids would get dual benefits from exercise, both physical and mental. The scientific data showing that physical activity improves ADHD is small, but generally positive.² As I discussed in my last article Does Exercise Help the Brain?, physical activity enhances brain development and improves cognitive control. Exercise couldn’t hurt the poor coordination and obesity that seem to track right along with ADHD either.
ADHD causes problems in a particular realm of cognition known as “executive functioning.” That is, the regulation of thinking, reasoning, getting tasks done, problem solving, and planning. Exercise has been shown to improve executive functioning and memory in young adults and it also helps decrease impulsive and disruptive behaviors in children, suggesting that exercise may be a therapy for ADHD that will have specific, long-lasting benefits that aren’t found with medication or traditional ADHD behavioral therapy. Indeed, controlled studies of children with ADHD who exercise show they have improvement in behavior and self-regulation in addition to better memory.
Nearly everyone will do better mentally and physically with regular exercise, but for kids with ADHD, exercise is an absolute essential. Sometimes the structured sports are too much for the very dysregulated kid, but any activity will do… walking, biking, running, and group activities in the gym have all been used in studies and all were of moderate help.
As for adults with ADHD, there is pretty much no data on whether exercise can help, but I can’t see how it wouldn’t. The exercise you will stick with is something you find fun enough that excuses won’t get in the way of doing it. Hiking with the family, riding on a trainer while watching your favorite TV show, group fitness classes… anything that will get your body moving in a consistent way. Kids who aren’t into group sports might like skiing, skateboarding, Dance Dance Revolution, or kickboxing.
We live in a modern world that can be very difficult to navigate if we have less ability to grind away at those boring tasks than most people. Adding exercise to the mix is an efficient way to improve mind and body, particularly for those with ADHD.
1: Jeoung, Bog Ja. The relationship between attention deficit hyperactivity disorder and health-related physical fitness in university students. Journal of Exercise Rehabilitation 2014; 10(6):367-371
2: Halperin, Jeffrey M. Et al. Healthy Body, Healthy Mind? The Effectiveness of Physical Activity to Treat ADHD in Children. Child Adolesc Psychiatric Clin N Am 23 (2014) 899-936.
Emily Deans M.D. is a board certified psychiatrist with a practice in Massachusetts and a clinical instructor in psychiatry at Harvard Medical School. She writes articles about nutrition, lifestyle, and mental health at Psychology Today. You can also find her on Twitter at @evolutionarypsy. (Please note: she can’t give medical advice over the internet, so please don’t request it.)
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