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How to Treat ADHD Without Meds

Attention Deficit Hyperactivity Disorder (ADHD) is a widespread condition that affects individuals across their lifespan, impacting both children and adults. Recent research has highlighted its prevalence among adults, affecting approximately 3-6% of the adult population3. The key symptoms of ADHD are inattention, hyperactivity, and impulsivity symptoms. ADHD can significantly disrupt daily functioning3,5. When left undiagnosed and untreated, ADHD can lead to detrimental consequences, including addiction, strained relationships, limited employment opportunities, and, in severe cases, even suicide2. This article explores alternative treatments and holistic approaches for managing ADHD without relying solely on medication while acknowledging medication’s essential role in treatment options.

Understanding ADHD in Adults

ADHD, or Attention Deficit Hyperactivity Disorder, is a neurodevelopmental condition marked by persistent patterns of inattention, hyperactivity, and impulsivity. While traditionally associated with childhood, ADHD extends its reach into adulthood, affecting various facets of life, from professional endeavors to personal relationships and everyday functioning. Adults with ADHD might encounter difficulties in handling time, staying organized, sustaining concentration, avoiding impulsive behavior, and managing their emotional responses3,5.

Diagnosing ADHD in Adults

An ADHD diagnosis relies on clinical assessments rather than specific tests, emphasizing the importance of distinguishing ADHD from other conditions like anxiety, depression, or substance abuse. The core symptoms in adults may manifest differently as procrastination, mood instability, or low self-esteem. Some individuals might not have received a proper diagnosis during childhood despite experiencing symptoms. ADHD can disrupt daily functioning, including non-occupational roles like parenting. While various rating scales and thorough history-taking aid in diagnosis, physical examinations aim to exclude other potential medical causes3.

ADHD Treatment Options

The spectrum of ADHD treatment options for adults encompasses both pharmacological and psychosocial interventions. Stimulant medications are considered the most effective, although non-stimulant alternatives, such as antidepressants and alpha agonists, are also available3. Psychosocial treatments involve psychoeducation and cognitive-behavioral programs, often combined with medication. Alternative treatments have been very effective and TMS therapy in particular has shown promising results when used to treat ADHD without medication.

The prognosis for adults with ADHD varies, with some individuals eventually “outgrowing” the disorder, particularly with appropriate treatment. Nevertheless, leaving ADHD untreated can result in enduring challenges, including workplace difficulties and an elevated risk of substance abuse. Regular follow-ups and patient education are essential, involving a collaborative healthcare team to ensure proper management and enhanced outcomes3,5.

Common Medications for ADHD

Psychiatric medications are a cornerstone of treatment for Attention Deficit Hyperactivity Disorder (ADHD), offering significant relief from its symptoms. These medications are categorized into two primary groups: stimulants and non-stimulants, each offering distinct advantages and considerations in managing ADHD.

Stimulants:

Stimulant medications are the go-to choice for ADHD treatment, working well for about 70% of people. They help by changing how brain chemicals, like dopamine and norepinephrine work. Stimulants fall into two groups:

  1. Amphetamines: Amphetamine-based medicines like Adderall and Dexedrine help speed up messages between the brain and body, helping people focus better and be less impulsive. Immediate-release and extended-release formulations cater to individual needs.
  2. Methylphenidates: Medications like Ritalin and Concerta in this category increase dopamine and noradrenaline by blocking its reabsorption in the brain. They also come in various forms to suit different needs.

While stimulants are generally safe when used right, they can have side effects, like changes in blood pressure, reduced appetite, mood disturbances, or sleep troubles. Some worry about dependency, but research suggests this isn’t a big concern when ADHD is treated correctly. Keep in mind that stimulants are considered controlled substances, which can make some healthcare providers cautious. Still, they are a crucial and very effective option for ADHD3.

Non-Stimulants:

Non-stimulant medications are considered when stimulants are unsuitable or not tolerated. There are some alternatives to Adderall and other stimulants that can be divided into two categories: antidepressants and alpha agonists.

  1. Antidepressants: Atomoxetine is a common non-stimulant. It helps by increasing norepinephrine levels. While not as strong as stimulants, it’s a good option for people who can’t use stimulants or have anxiety alongside ADHD. Other antidepressants like bupropion or tricyclic antidepressants might be considered.
  2. Alpha Agonists: Medications like clonidine and guanfacine can effectively treat ADHD, although they are more commonly used in children than adults. These drugs have various cardiovascular side effects, including lowering blood pressure and causing sedation.

It’s essential for healthcare providers to evaluate each patient’s unique circumstances and tailor medication choices accordingly. The goal is to strike a balance between symptom management and minimizing side effects, ensuring optimal treatment outcomes for individuals with ADHD3.

Pros and Cons of Stimulants

Pros:

  1. High Efficacy: Stimulant medications boast an impressive effectiveness rate of around 70%, rendering them a potent choice for treating ADHD symptoms
  2. Quick Onset: These medications usually deliver rapid relief and reduce ADHD symptoms within 30 to 60 minutes after ingestion
  3. Variety of Formulations: Stimulants offer various formulations, including immediate-release and extended-release options. This versatility allows personalized treatment plans tailored to individual needs
  4. Enhanced Dopamine Activity: Stimulants boost dopamine availability in the brain, a crucial factor for enhancing attention and impulse control
  5. Controlled Substance: While classified as controlled substances, stimulants may reduce the lifetime risk of substance abuse in individuals with ADHD
  6. Well-Studied: Stimulants have been widely studied, and substantial research supports their safety and efficacy over long-term use.

Cons:

  1. Potential Side Effects: Common side effects may include changes in blood pressure, reduced appetite, and disturbances in sleep patterns.
  2. Risk of Dependency: There exists a concern about dependency, although evidence suggests that proper treatment can mitigate this risk.
  3. Stigma and Hesitation: Due to their controlled substance classification, some healthcare providers and patients may hesitate to consider stimulants as an option to treat ADHD.
  4. Not Suitable for Everyone: Stimulants may not be appropriate for individuals with certain medical conditions, such as hypertension or substance abuse risk factors. They can also exacerbate affective disorders like depression and anxiety in some cases.

Pros and Cons of Non-Stimulants

Pros:

  1. Alternative Option: Non-stimulant medications, like atomoxetine, provide an alternative when stimulants are not suitable or well-tolerated.
  2. Selective Mechanism: Atomoxetine, for instance, selectively inhibits norepinephrine reuptake, minimizing the likelihood of causing dependency.
  3. Comorbid Anxiety: Non-stimulants can particularly benefit individuals with co-occurring anxiety disorders.
  4. Options for Children: Alpha agonists like clonidine and guanfacine, while more commonly used in children, can also be considered for adults.
  5. Lower Risk of Dependency: Generally, non-stimulant options carry a lower dependency risk than stimulants.

Cons:

  1. Lower Efficacy: Non-stimulant medications are typically less effective in treating ADHD symptoms than stimulants.
  2. Slower Onset: They may take longer to produce noticeable effects, often several weeks.
  3. Limited Options: The range of non-stimulant medications for ADHD is more restricted than stimulants.
  4. Cardiovascular Side Effects: Alpha agonists like clonidine and guanfacine can induce cardiovascular side effects, such as lowering blood pressure, which may be problematic for some individuals.

The choice between stimulant and non-stimulant medications should be determined by an individual’s specific needs, tolerance, and potential risks and benefits. Additionally, other factors should be considered such as comorbid conditions such as prescribing medication for adults with ADHD and anxiety. A medical professional should meticulously evaluate each patient’s circumstances to select the most appropriate medication and closely monitor its effects over time.

Related: The Pros and Cons of Mental Health Medications

Psychotherapy for ADHD

People with ADHD can benefit from certain types of psychotherapy, like Cognitive-Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT), as it helps them gain insight into their symptoms. These therapies focus on improving problem-solving skills and coping strategies, managing stress, setting realistic goals, and enhancing communication and social skills7.

The following are some of the psychotherapy options for ADHD6,1:

  • Cognitive Behavioral Therapy (CBT): CBT is a psychological treatment that addresses negative thought patterns and unhelpful behaviors. Research suggests CBT can improve ADHD symptoms, particularly in adolescents. 
  • Cognitive Training: Cognitive training programs like Cogmed Working Memory Training and Brain Game Brian focus on enhancing memory and cognitive flexibility. However, their effectiveness in managing ADHD symptoms is still under investigation.
  • Biofeedback and Neurofeedback: These interventions involve training individuals to control bodily functions through real-time feedback. Neurofeedback, in particular, aims to improve attention and alertness by modulating brain activity. Although promising, it is considered experimental and requires further study. 
  • Dialectical Behavioral Therapy (DBT): DBT is another non-pharmacological intervention initially designed as a psychotherapy for people with borderline personality disorder and has been modified to suit different conditions, such as ADHD. It emphasizes emotional regulation and interpersonal effectiveness, which are areas of concern for many adults with ADHD.
  • Organizational Skills Training: This approach focuses on improving organization, time management, and cooperation skills in children with ADHD. Digital games like “Plan-it Commander” have shown promise in enhancing these skills when used alongside medication.

Related: Practical Benefits of Therapy: How Therapy Can Transform Your Life

Holistic Approaches for Treating ADHD

The following natural ADHD treatments can be very helpful when attempting to manage ADHD without medication. With a concerted effort, they can be applied to daily life and influence positive lifestyle changes6,7.

  • Mindfulness and Self-Compassion Exercises: Mindfulness practices, like meditation, encourage individuals to become more aware of their thoughts, emotions, and behaviors, potentially helping those with ADHD improve attention, regulate emotions, and cultivate self-compassion.
  • Movement and Exercise: Engaging in regular aerobic exercise, in particular, can offer a variety of advantages for individuals dealing with ADHD. This can lead to improved attention, executive functions, and behavioral symptoms. In addition, incorporating activities like yoga and tai chi into an ADHD management plan can also be helpful. Studies suggest aerobic exercise can enhance cognitive function and treat ADHD symptoms, particularly hyperactivity and impulsivity. Individual preferences for physical activity should be considered when choosing these interventions.
  • Sleep Hygiene: Developing good sleep hygiene involves adopting habits and routines that enhance sleep quality. For individuals with ADHD, who may find it challenging to get restful sleep, these practices are crucial for symptom management.
  • Self-Care: Prioritizing self-care entails addressing one’s physical and emotional needs. It can encompass stress management techniques, relaxation exercises, and activities promoting well-being.
  • Diet and Nutrition: Proper nutrition is crucial in managing ADHD symptoms. A healthy diet rich in high-fiber foods, whole grains, fruits, vegetables, lean proteins, fish, and nuts can positively impact mood and mental well-being. On the other hand, processed foods, refined grains, excessive sugar, and high-fat diets can worsen ADHD symptoms and should be steered clear of as much as possible.
  • Supplements and Herbs: Managing ADHD through an integrative approach can involve incorporating supplements and herbs to address specific symptoms or promote overall physical and mental well-being. Examples include melatonin for improved sleep, adaptogens like rhodiola rosea and ashwagandha for stress management, and botanical preparations like Korean red ginseng and ginkgo biloba for symptom improvement.

Alternative Treatments for ADHD

Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) is a noninvasive way to treat Attention-Deficit/Hyperactivity Disorder (ADHD). Unlike regular medications that can have side effects like appetite loss and heart changes, TMS for ADHD works by adjusting how the brain’s dopamine functions. It aims to fix the dopamine imbalance linked to ADHD by controlling the release of dopamine in the brain’s prefrontal cortex and influencing specific genes4.

TMS therapy has proven to be an effective treatment for a wide range of mental health conditions including ADHD. By inducing specific changes in brain function, TMS has the power to ease ADHD symptoms. Those who experienced a positive response have noticed a reduction in impulsive behaviors, mood swings, behavioral problems, and hyperactive behavior.

Benefits of Non-Medication Treatments

Treating ADHD without medication offers various advantages, including a comprehensive and personalized approach, reduced side effects, skill development, and potential long-term improvements in ADHD symptoms and functioning. In addition, when people decide to treat ADHD naturally, it opens the door for individualized approaches, minimized dependency on medication, the potential for complementing medication-based approaches, and overall wellness and lifestyle benefits6.

Importance of Treating ADHD

ADHD is a condition that affects individuals across their lifespan, and its impact extends beyond childhood into adulthood. The consequences of untreated ADHD can be severe, affecting various aspects of life, including relationships, employment, and mental health. While ADHD medication plays a crucial role in managing ADHD, natural treatments and holistic approaches offer valuable options for individuals who prefer non-medication interventions and wish to treat ADHD naturally or complement their treatment plan.

Psychotherapy, such as Cognitive-Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT), equips individuals with ADHD with essential skills to manage their symptoms effectively. Additionally, holistic approaches, including mindfulness practices, regular exercise, good sleep hygiene, self-care, and a balanced diet, can significantly contribute to reducing ADHD symptoms and promote overall well-being.

The choice between medication and non-medication treatments should be based on an individual’s specific needs, tolerance, and potential risks and benefits. Healthcare providers play a vital role in evaluating each patient’s circumstances and tailoring treatment plans to optimize outcomes. Emerging therapies like Transcranial Magnetic Stimulation (TMS) are promising alternatives to traditional medication-centered methods. These novel approaches target the fundamental neurobiology of ADHD, offering better symptom control without the typical medication side effects.

ADHD Treatment in California

To ensure successful ADHD management, our healthcare professionals at Neuro Wellness Spa will collaborate with you to investigate the most suitable and comprehensive treatment approaches, considering your unique characteristics and preferences. This collaborative effort aims to improve your quality of life and well-being, reducing the potential adverse outcomes of untreated ADHD.

Contact Neuro Wellness Spa today to explore treatment options for ADHD. We offer in-person and online psychiatry for medication management, alternative treatments like TMS therapy which targets specific areas of the brain affected by ADHD , as well as in-person and online talk therapy utilizing therapeutic modalities that have proven to be effective for managing and treating ADHD. Take control of your life and discover the strategies and support you need to manage your symptoms effectively. Our team of experts is here to provide personalized care and guide you on your journey towards a healthier, more balanced future. Don’t wait any longer โ€“ start your path to wellness today.

References

  1. Cortese, S., Del Giovane, C., Chamberlain, S., Philipsen, A., Young, S., Bilbow, A., & Cipriani, A. (2022). Pharmacological and non-pharmacological interventions for adults with ADHD: protocol for a systematic review and network meta-analysis. BMJ open, 12(3), e058102. https://doi.org/10.1136/bmjopen-2021-058102
  1. Geffen, J., & Forster, K. (2018). Treatment of adult ADHD: a clinical perspective. Therapeutic advances in psychopharmacology, 8(1), 25โ€“32. https://doi.org/10.1177/2045125317734977
  1. Magnus, W., Nazir, S., Anilkumar, A. C., & Shaban, K. (2023). Attention Deficit Hyperactivity Disorder. In StatPearls. StatPearls Publishing.
  1. Patel, R. K., Saeed, H., Mekala, H. M., & Lippmann, S. (2021). Transcranial Magnetic Stimulation for Adolescents With ADHD. The primary care companion for CNS disorders, 23(3), 20br02602. https://doi.org/10.4088/PCC.20br02602
  1. Posner, J., Polanczyk, G. V., & Sonuga-Barke, E. (2020). Attention-deficit hyperactivity disorder. Lancet (London, England), 395(10222), 450โ€“462. https://doi.org/10.1016/S0140-6736(19)33004-1
  1. Shrestha, M., Lautenschleger, J., & Soares, N. (2020). Non-pharmacologic management of attention-deficit/hyperactivity disorder in children and adolescents: a review. Translational pediatrics, 9(Suppl 1), S114โ€“S124. https://doi.org/10.21037/tp.2019.10.01
  1. Zylowska, L. (2023, February 8). What Is Integrative Medicine for ADHD? A Holistic Health & Wellness Guide. ADDitude. https://www.additudemag.com/integrative-medicine-adhd-holistic-health-wellness-guide/
*TMS is FDA-cleared for depression, migraine, Obsessive-Compulsive Disorder, cigarette cessation, anxious depression, adolescent depression, and chronic post-traumatic/surgical pain. Research indicates that TMS to also be helpful for bipolar depression, anxiety, and cognitive impairment. Other uses for TMS therapy are considered "off-label." However, there is a growing body of research indicating the potential benefits of these off-label applications for a variety of mental health conditions. Please consult with a psychiatrist to learn more about TMS and off-label uses.
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