Back in Focus

19 ways to manage ADHD without drugs
By Matthew Solan

To Susan Williams of Charlotte, North Carolina, it was like a speed bump she couldn’t get past. That’s how she described the wall she would hit when work deadlines loomed and her focus pinballed from one subject to the next. “Sometimes I was so easily distracted, the simplest task seemed daunting,” says Williams, 60. “If I could just get past that speed bump, I was fine. The anxiety left, and that jerky, start-stop approach to everything vanished. But so often, it was like scaling a great wall.”

We’ve all had days like this. But if this sounds like your standard operating procedure, you may be, like Williams, among the 4 percent of adults who battle attention deficit–hyperactivity disorder (ADHD). ADHD gained the limelight as a childhood problem, but it affects adults too. And for many the condition has gone undiscovered since youth. Either way, childhood ADHD and the grown-up version share the same traits: fidgeting, procrastination, distraction, forgetfulness, impulsiveness. The big difference is how it’s diagnosed. Kids with ADHD are more easily identified because teachers watch closely for erratic behavior, poor test scores, and repeated discipline problems—all of which point to ADHD.

As adults, we don’t have that kind of oversight, but that doesn’t mean ADHD doesn’t rear its ugly head in every aspect of our lives. Even so, most of us wrongly brush off the mental lapses and constant distractions as normal aging or fatigue. If you suffer from poor self-esteem, collect frequent speeding tickets or get into fender-benders, drift in and out of relationships or have had multiple marriages, switch jobs frequently or never seem to advance, you may want to reevaluate what you’ve been dismissing as flakiness. ADHD isn’t just inconvenient. It can be dangerous, impairing your ability to foresee negative consequences and making you more likely to engage in risky behavior like unprotected sex, heavy alcohol and drug use, or gambling. It even manifests as low-back pain, headaches, digestive problems, and skin rashes.

The most common (and most controversial) treatments are prescription stimulants like Ritalin, Concerta, Adderall, and Dexedrine, which boost dopamine levels in the brain. This neurotransmitter enhances your ability to focus and complete tasks, and according to a 2007 study in the Archives of General Psychiatry, not having enough can trigger ADHD symptoms like excessive boredom, apathy, and low energy. While some estimates suggest these drugs are effective in 70 to 80 percent of ADHD patients, like any medication, they have their downsides: headaches, stomach pain, sleep problems, irritability, constipation, and weight loss, not to mention the risk of addiction.

But the biggest problem? These drugs are only short-term solutions. “They treat the symptoms, but not the underlying problems that trigger ADHD. They address the smoke, but not the fire,” says David Perlmutter, MD, author of the The Better Brain Book (Penguin, 2005). These “fires” include stress, anxiety, food allergies, and fatigue. Often by controlling or eliminating these underlying issues, you can manage or even cure your ADHD.

After taking a natural approach to her ADHD, Williams found herself more optimistic and energized. “I didn’t want to get stuck taking fistfuls of drugs,” she says. And while her ADHD isn’t completely gone, “those speed bumps no longer seem so high.”

Supplements. Adults with ADHD are often deficient in the neurotransmitters dopamine and acetylcholine, which affects learning, memory, reasoning, perception, and attention, says Kathy Thorpe, CHom, a certified homeopath in Boulder, Colorado. Boost both naturally by upping your intake of precursors, which your body then converts to these key neurotransmitters. For dopamine, precursors include the amino acids tyrosine and diphenylalanine, vitamin B, and selenium. Acetylcholine requires amino acids like acetyl-L-carnitine, phosphatidylcholine (alpha-GPC), phosphatidylserine, and dimethylaminoethanol (DMAE). The good news is there are brain-boosting supplements available that contain most of these precursors, such as Higher Mind by Source Naturals. You can also get dopamine through food—meat, dairy products, almonds, avocados, bananas, lima beans, pumpkinseeds, and sesame seeds. Acetylcholine-rich foods include eggs (with yolks), fish, dairy products, peanuts, and Brazil nuts. Also make sure you get at least 200 mg of magnesium each day. “Low magnesium can increase ADHD symptoms like irritability, as well as decrease attention and cause greater mental confusion,” says Thorpe.

Fatty acids. Research has shown that adults with ADHD often have low levels of the essential fatty acid docosahexaenoic acid (DHA). “DHA allows for better brain-cell communication and also grows cells that help with memory,” says Perlmutter. You can get DHA from fish like salmon, mackerel, and tuna, or opt for a daily fish-oil supplement that contains of 750 to 1,000 mg of DHA. For vegetarians, Perlmutter suggests DHA supplements derived from algae (found at most health food stores), such as Life’s DHA from Martek.

Herbs. Bacopa monniera (also known as water hyssop or brahmi) has long been used as an herbal brain tonic to improve memory and cognitive function—look for it at a natural pharmacy. A 2007 double-blind study involving 62 adults found that taking 300 mg per day of bacopa extract (about 6 grams of the dried herb) for 90 days improved the ability to store and manage information used for complex cognitive tasks like reading, learning, and comprehension. For stress-related ADHD, Michael Smith, ND, a naturopathic physician with the Carolinas Natural Health Center in Matthews, North Carolina, recommends ashwangandha, a popular ayurvedic herb known for its ability to promote a sense of calm while making you more alert. Individual dosages vary, but start with 100 mg once or twice daily, says Smith. Gotu kola is ideal for quick mental pick-me-ups, like you may need before a big meeting. Drink a cup of tea made from 1 teaspoon gotu kola steeped in 1 cup of hot water twice a day (stir in honey or lemon to mask any bitterness). “Or you can supplement with 500 to 1,000 mg each day,” says Alan Tillotson, PhD, author of The One Earth Herbal Sourcebook (Kensington Books, 2001).

Nutrition. Food allergies are a less obvious but common cause of ADHD. “Your digestive system contains as many neurons as the brain,” says Smith. “So your gut can influence how your brain functions, and digestive problems can disrupt your ability to focus and think clearly.” This is why naturopathic doctors often begin ADHD treatments by assessing one’s diet. Patients are asked to keep a detailed food diary for several weeks, recording what and when they eat, and make note of when ADHD symptoms flare up. “Then we try to identify certain foods or ingredients connected with those episodes,” Smith says. Your ADHD could be triggered by a gluten sensitivity (which affects one out of every 100 people), lactose intolerance, or food additives like artificial colors, sweeteners, and preservatives. It’s often a trial-and-error approach, but adjusting your diet can do the trick. Williams discovered that cutting down sugar and dairy—in particular her late-night ice cream habit—had a significant effect on her concentration throughout the day.

Massage. The power of touch can also reduce ADHD symptoms. In a study conducted by the Touch Research Institutes at the University of Miami, 30 students, median age 13, received 20 minutes of massage therapy twice a week for a month. Researchers found that the therapy improved mood and reduced anxiety, daydreaming, and hyperactivity in most students.

Take in nature. In a 2004 study, University of Illinois researchers found a link between time spent in nature and reduced ADHD symptoms. ADHD children took 20-minute walks in a park, a downtown area, and a residential neighborhood. Those who strolled in the park performed higher than the other groups in standard neurocognitive tests. Researcher Frances E. Kuo, PhD, suggests that regular doses of nature can offer substantial relief, and likely benefit adults too.