Attention Deficit Hyperactivity Disorder (ADHD): Symptoms, Causes & Treatment
ADHD is a group of behavioural symptoms thought to be caused by chemical imbalances in the brain and is characterised by inattentiveness, hyperactivity and impulsiveness. Here we look at lifestyle and diet techniques to help you find the most effective ADHD treatment to suit your needs.
What is ADHD?
ADHD, or Attention Deficit Hyperactivity Disorder, is a heterogeneous behavioural condition in which the brain doesn’t function in the way that it should, leading to problems with attention, concentration and impulsivity, in ways that are not appropriate for a person’s age. It is sometimes referred to as hyperkinetic disorder.
It is usually diagnosed in childhood and is estimated to affect 2% to 5% of children and adolescents, of which 30% to 50% of cases continue into adulthood. ADHD appears to affect more boys than girls, however, there is some concern that girls with ADHD may be underdiagnosed because they often present milder symptoms.
While ADHD itself will not develop into other health conditions, the impulsive and chaotic behaviours typical of ADHD can make everyday activities difficult and stressful, such as staying organised, holding down a job, driving a car, or maintaining a relationship. Individuals with ADHD may also display signs of other mental health problems such as anxiety, obsessive-compulsive behaviour or depression.
Symptoms of ADHD
The common symptoms of ADHD are behavioural rather than physical, which can be split into the following groups:
- Gets distracted easily, misses details, makes careless mistakes in schoolwork or other activities
- Forgets and loses things easily
- Finds it hard to focus on one task, and may get bored with a task after a few minutes
- Lacking in organisational skills, and finds it hard to keep to a schedule
- Doesn’t seem to listen when spoken to and struggles to follow instructions
- Daydreams often becomes easily confused and moves slowly
- Fidgets and squirms a lot, unable to sit still during dinner, school, or at home
- Nonstop talking
- Dashes around, touching or playing with anything and everything in sight
- Has trouble doing quiet tasks or activities
- Is constantly in motion, never still
- Is very impatient, has difficulty in queuing or waiting for their turns in games
- May blurt out inappropriate comments
- Shows emotions without restraint
- Acting without regard for consequences
- Often interrupts conversations or other’s activities
Due to the lack of physical symptoms, ADHD can be tricky to diagnose. Phases of restless and inattentive behaviour are fairly common in young children and are not necessarily the result of ADHD. Plus, many of the behavioural concerns above can also be symptomatic of other conditions, such as:
- Seizures or epilepsy-related fits can cause drowsiness and unresponsiveness, triggering unusual behaviour
- Hearing or vision problems make it difficult for children to follow instructions, making them appear inattentive
- Obsessive Compulsive Disorder (OCD) leads to the performance of certain ‘rituals’ that distract attention and may appear unusual
- Tourette’s syndrome causes involuntary movements and outbursts of noise or swearing. Studies suggest that approximately 50% of children with Tourette’s syndrome also have ADHD.
- Autistic spectrum disorders and Asperger’s syndrome cause difficulties understanding and using language
There is some controversy surrounding ADHD and its diagnosis, especially in children. A number of leading neuroscientists have publically stated their belief that ADHD is ‘not a real disease’ and claim that most people display signs of the condition at some point during their lives. Others believe the condition exists but is over diagnosed and are critical about the use of drugs which are being prescribed too readily.
What Causes ADHD?
It is not clear what causes ADHD, although there appears to be a strong biological basis. Twin studies show that the odds of identical twins both having the condition are considerably higher compared to fraternal twins, which suggests that the closer the genes are to each other, the more likely they will share the disorder.
Research has also identified different brain activity between those with the condition and those without. In ADHD patients, the frontal regions of the brain appear to be underactive, which may reduce a person’s ability to regulate emotions and behaviours. In some cases, environmental factors may also play a role. Poor diet and low activity levels have been shown to exacerbate symptoms in some cases, however, it is generally accepted that they are not contributory causes.
Living with ADHD
Living with ADHD is difficult for those with the disorder and for those around them, with everyday activities such as going to the shops or school/work becoming exhausting and stressful. The first step is to create a structured environment at home and school/work. Behavioural modification programmes may also be suitable for some to help improve coping techniques for disruptive and aggressive behaviour. If you or someone you know is living with ADHD, try the following coping strategies:
Tips for Parents of Children With ADHD
- Plan ahead: Structure the day so your child knows what to expect and break down activities into structured steps so they know exactly what they need to do. Saying ‘get ready for school’ may be bewildering to a child with ADHD, but giving clear instructions like ‘brush your teeth’ or ‘put on socks’ will be easier.
- Set boundaries: Make it clear what kind of behaviour is acceptable and what isn’t and be consistent. If rules are broken, take away a privilege, such as a toy or TV programme.
- Reward positive behaviour: Give specific praises, such as ‘thank you for washing the dishes’ to make it clear that you are pleased, and why.
- Exercise: Children with ADHD need lots of physical activity to help them burn off energy and get a good night’s sleep.
- Routine: Sleep deprivation can exacerbate the symptoms of ADHD so try to keep the bedtime routine consistent.
- Talk to your child’s teacher about any extra support they may need to reduce behavioural problems at school.
Tips for Adults with ADHD
ADHD in adults presents difficulties concentrating on tasks, remembering things, and maintaining a schedule. You may find the following tips helpful:
- Make lists, keep a diary, stick reminders on post-its around the house, and make time to plan what you need to do. This will help you stay organised.
- Find ways to relax such as listening to music or practising yoga or meditation.
- Keep active and let off steam by exercising regularly. This will also improve sleep patterns.
- Speak to your employer to discuss anything that could improve your working environment.
- Contact a local or national support group for advice and information from people in a similar situation.
Diet for ADHD
While it is important for everyone to get a healthy, balanced diet, for people with ADHD this can be particularly beneficial because many people notice links between certain types of food and worsening ADHD symptoms. Keeping a food diary can help you to identify patterns of food and behaviour, and make any changes to the diet slowly to determine if they are effective or not.
Foods to Avoid
- Sugar: Sugary foods cause 'spikes' and 'crashes' in blood glucose levels, which result in hyperactivity, drowsiness, mood swings and lack of concentration.
- Caffeine: Caffeine has mild stimulatory properties which increase the heart rate and may exacerbate symptoms of ADHD, particularly hyperactivity.
- Food colourings and additives: In 1975, an allergist suggested that certain artificial colours, flavours and preservatives could cause hyperactivity in some children. Experts recommend that people with ADHD avoid artificial colourings, especially red and yellow, food additives aspartame and MSG, nitrites and sodium benzoate.
- Wheat and dairy, in the case of intolerance: If you suspect that you or your child is intolerant to certain foods, try avoiding these foods and see if it makes a difference in behaviour.
Foods to Eat
- High-protein foods: Beans, eggs, cheese, meats and nuts can all help to improve concentration. Protein is used by the brain to make neurotransmitters, which brain cells then use to communicate with each other.
- Fresh fish: Foods rich in the omega 3 fatty acids EPA and DHA help boost brain health. These include tuna, salmon, mackerel and other cold water white fish, in addition to some nuts and seeds.
- Complex carbohydrates: These help to prevent 'spikes' in blood glucose levels, and when eaten in the evening they may also aid sleep. Good sources include carbohydrate-rich vegetables and fruits.
Supplements for ADHD
Supplements for ADHD can offer an inexpensive and safe alternative to prescription medications. However, these should never replace a proven ADHD treatment without approval from your GP.
Magnesium & Vitamin B
Magnesium and vitamin B are both essential for the proper functioning of the nervous system and brain, and there is emerging evidence that children or adults with ADHD may benefit from a magnesium and vitamin B supplement.
In one study, 76 children with ADHD were given either a combination of magnesium and vitamin B6 or a placebo for 8 weeks. At the end of the trial, symptoms of hyperactivity and aggressiveness were significantly reduced, and school attendance was improved for those taking the supplement.
When treatment was stopped, symptoms reappeared within a few weeks.
Zinc is important for proper brain function and structure and is used in the manufacture of neurotransmitters in the brain. It is also necessary for the metabolism of melatonin, a hormone-like substance that helps to regulate sleep.
Studies show that children with ADHD often have lower levels of zinc and that zinc supplements can reduce hyperactivity, impulsivity and impaired socialisation. Good food sources of zinc include oysters and other seafood, red meat, dairy and nuts.
Omega 3 Oils
Fish oils are one of the best-tested supplements for ADHD and have been found to be beneficial for some, but not all, children with ADHD. The oil is rich in the omega 3 fatty acids EPA and DHA, which provide essential support to the brain and nervous system.
A Swedish study found that daily supplementation with omega 3 reduced ADHD symptoms by half, in 25% of children aged 8 to 18 years old. A separate UK study involving 100 underperforming children found that daily omega 3 capsules over a 6 month period significantly improved symptoms in 40% of children.