Attention Deficit Hyperactivity Disorder (ADHD) symptoms, such as having trouble paying attention, getting easily distracted, and impulsivity can lead to problems on a daily basis. ADHD is a condition that often begins in childhood and persists throughout adulthood. Currently, the most common treatment for ADHD is medication, which has prompted many stakeholders to seek alternate, medication-free treatments. What does this mean for you?
Can yoga, Tai Chi, and playing memory games improve ADHD? If you or your loved one has ADHD, can you ditch your medicine in exchange for mindfulness or memory training? For several years, researchers have been exploring alternate ways to treat ADHD, such as through mindfulness and memory training. Recently, scholars have suggested that mindfulness, which includes paying attention to your thoughts, actions and emotions, may be beneficial to individuals affected with ADHD symptoms. Others have suggested that by increasing memory training, to improve the processing or retention of information, individuals will experience reductions in symptoms. But can these novel alternatives to medicine really help improve ADHD?
While it is not time to ditch your ADHD medicine quite yet, research has shown that mindfulness training for adults shows strong promise (Zylowska et al., 2008) and thus merits a larger randomized controlled clinical study. Later studies that looked at the impact of mindfulness training also echoed similar refrains. For example, Tai Chi was found to improve attention among young adults (Converse, Ahlers, Travers, & Davidson, 2014). Other studies have suggested that in addition to improving attention among adults with ADHD, mindfulness can also improve quality of life and executive control (Hepark, Kan, & Speckens, 2014) and impulsivity (Schoenberg, Hepark, Kan, Barendregt, Buitelaar, & Speckens, 2014). It should be noted however, that all research findings with mindfulness and adult ADHD have indicated that their results were preliminary and called for larger, more controlled studies. This is because the current studies all used small samples, which affects researchers' ability to draw valid conclusions. For example, it is difficult to know how these findings would apply to the larger population (i.e., adults with other psychiatrics or medical problems, minority populations, etc.). Larger trials would enable researchers to determine whether the improvement lasts over time and ensure that proper randomization and controls are in place. Researchers are also calling for replication studies to ensure that their findings hold true for other samples of adults with ADHD. Despite these limitations, preliminary results suggest strong promise for the utilization of mindfulness with adult ADHD.
While mindfulness has shown strong support in the treatment of adult ADHD, the support for memory training as a tool to treat ADHD has been understudied. One study, conducted by Gropper, Gotlieb, Kronitz, and Tannock (2014), randomly assigned college students into either a wait-list control condition or a working memory training condition. At the end of the study, participants in the working memory condition showed much more improvement on working memory measures than those on the wait-list control and reported fewer ADHD symptoms. While it is promising that these gains were still going strong at the two-month follow-up, it is unclear whether the gains were maintained over the long term. In addition, this study had several other limitations that make it challenging to draw valid conclusions (e.g. lacked statistical power to conduct analyses due to sample size, participants knew what condition they were in which may have resulted in bias, etc.). Thus, this study provides some tentative evidence for the use of memory training, but more replications are necessary. While this is the only study that has examined memory training in adults, other researchers have examined memory training in children and adolescents. In a recent review of these studies (Sibley, Kuriyan, Evans, Waxmonsky, & Smith, 2014) reported that there was no evidence to support the claim that working memory will lead to a decrease in ADHD symptoms. As such, the literature on memory training is far less conclusive than the promising use of mindfulness.
What does this mean for those of you with ADHD? While it is not quite time to give up refilling you monthly prescription, scientists are getting closer to finding an alternate form of treating ADHD. You may want to consider speaking to your mental health care provider about the adjunctive benefit of adding mindfulness training to your treatment.
Converse, A.K., Ahlers, E.O., Travers, B.G., and Davidson, R.J. (2014). Tai chi training reduces self-report of inattention in healthy young adults. Front. Hum. Neurosci 8:13. Doi: 10.3389/fnhum.2014.00013
Gropper, RJ, Gotlieb, H., Kronitz, R., Tannock, R. (2014). Working memory training in college students with ADHD or LD. Journal of Attention Disorders, 18(4), 331-345.
Hepark, S., Kan, C.C., & Speckens, A. (2014). Feasibility and effectiveness of mindfulness training in adults with ADHD: A pilot study. Tudschrift Voor Psychiatrie, 56(7), 471-476.
Schoenberg, PLA., Hepark, S., Kan, C.C., Barendregt, H.P., Buitelaar, J.K., & Speckens, AEM. (2014). Effects of mindfulness-based cognitive therapy on neurophysiological correlates of performance monitoring in adult attention-deficit/hyperactivity disorder. Clinical Neurophysiology, 125, 1407-1416.
Sibley, M.H., Kuriyan, A.B., Evans, S.W., Waxmonsky, J.G., & Smith, B.H. (2014). Pharmacological and psychosocial treatments for adolescents with ADHD: An updated systematic review of the literature. Clinical Psychology Review, 34, 218-232.
Zylowska, L., Ackerman, D.L., Yang, M.H., Futrell, J.L., Horton, N.L., Hale, T.S., Pataki, C., & Smalley, A.L. (2008). Mindfulness meditation training in adults and adolescents with ADHD. Journal of Attention Disorders, 11(6), 737-746.