ADHD treatments work best when they don’t just target symptoms but also promote health, calm, and productivity. In this guide to integrative medicine for ADHD, learn how conventional treatments for ADHD can complement holistic approaches to support overall health and wellness.
ADHD doesn’t only affect attention. Better considered an executive function and self-regulation deficit, ADHD affects the whole person — the mental, emotional, physical, spiritual, and social self. It increases daily stress and chips away at a positive sense of self. It interferes with self-care and makes it hard to keep healthy habits.
This helps to explain why ADHD is linked to chronic stress, burnout, anxiety, mood disorder, sleep problems, substance use, and other conditions and issues. The reverse is also true: chronic stress and anxiety can worsen ADHD symptoms.
ADHD impacts the whole self, so is treatments must likewise target more than inattention and impulsivity. Integrative medicine is growing in popularity because it’s a treatment approach that addresses symptoms and promotes general health and wellness.
Integrative medicine considers the whole person and leverages all options — holistic thinking, complementary therapies, and conventional treatments — in devising a patient’s care plan.
Studies exploring the effectiveness of integrative approaches for ADHD specifically are limited. Moreover, the most common treatments for ADHD are the conventional – medication and psychotherapy. Still, just as ADHD affects many aspects of wellbeing, a variety of treatments and approaches can do the same.
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As an integrative practitioner, my approach for treating patients with ADHD is this: If the ADHD symptoms are significantly impairing, I start with medication, and then phase in other strategies, often outside of conventional care. If the ADHD symptoms are mild to moderate, the non-medication and lifestyle approaches can be tried first.
Over time, as the other skills and strategies are employed, the need for medication can be re-evaluated and the dose reduced.
An example of an integrative medicine plan for ADHD may combine psychotherapy (a conventional strategy), stress-management skills (holistic thinking), and omega-3 fatty acids (a complementary supplement).
[Read: How Nutrition, Exercise & Sleep Curb ADHD]
Most of the following approaches address ADHD’s secondary symptoms — namely stress, anxiety, mood, low self-esteem, and emotional dysregulation. Treating these factors can help decrease the severity and impairment of ADHD’s core symptoms.
Cognitive behavioral therapy (CBT) helps patients develop a greater understanding of their ADHD symptoms and teaches skills that help with executive dysfunction.
CBT aims to improve patients’ problem-solving and stress-management skills by setting realistic goals and teaching organizational and time-management skills to achieve them. This type of psychotherapy can also improve balanced thinking and communication skills by focusing on one’s unique challenges (e.g., history of trauma or other comorbid mental health conditions).
Like CBT, coaching helps individuals meet their goals and develop skills to address ADHD-related barriers along the way.
Mindfulness — a practice that includes meditation as well as awareness shifts in daily activities — has been shown to improve both inattentive and hyperactive/impulsive symptoms, as well as selected measures of attention, emotion regulation, and executive functions1.
By analysis of automatic habits, the practice allows you to change them in the moment. For example, mindful awareness may help you realize that you are procrastinating, and help you tune in to the emotions that are driving the procrastination.
A facet of mindfulness, practicing self-compassion is particularly important for mental health. Offering yourself some validation and kindness — “This is hard. I’m stressed. I’m struggling” — will make a difference in how stress is experienced.
As you observe your reaction and create inner pause, you can ask: “What can I do to help this situation?” and find possibilities to do so. The answer may be “I need to take a few deep breaths” or “I need to prioritize my tasks.”
Sometimes one can reframe the situation or focus on the positive (e.g., gratitude) to see what is working versus what is not. By making such shifts in awareness and response, you can begin to self-regulate and enhance your resilience.
Seeing ADHD symptoms as neurobiologically driven ways of responding versus the idea that you are defective in some way fosters self-acceptance. The important thing is to see ADHD as a biological difference and condition that needs extra support or accommodation.
Regular sleep, adequate hydration, prioritized self-care, and avoidance of excessive alcohol and other substances can help manage ADHD symptoms. At the same time, the ability to keep up with these practices is often compromised by ADHD itself. It is best for patients and clinicians to identify and target the most problematic areas first.
Exercise has wide-ranging health benefits (physical, cognitive, and emotional) both acutely and when done regularly over time. In particular, aerobic exercise has been shown to improve executive functions, attention, and behavioral symptoms in ADHD2. Other types of mind-body movement, such as yoga or tai chi, can also be helpful for ADHD symptoms.
Stress and anxiety typically make breathing faster and shallower (i.e., chest breathing). Slower and deeper breathing (i.e., belly breathing) is the ideal. Breathing regulates the sympathetic-parasympathetic nervous system balance, so breathwork can counteract stress and change your body state.
Examples of breathing exercises:
Acupuncture, derived from Chinese medicine, aims to treat a variety of conditions by stimulating diverse points on the body (acupoints). This approach focuses on regulating the body organ system to lower inattention and hyperactivity. Some research supporting the use of acupuncture for ADHD is available from Asian countries3. But this approach to ADHD has not been studied widely in Western cultures.
For general wellness, acupuncture is often used to treat pain and stress-related conditions. There is also some evidence supporting it as an adjunctive treatment for anxiety. I have found it helpful for those who struggle with chronic stress and pain.
Poor nutrition and lifestyle habits can increase the level of impairment from ADHD. While specific nutritional approaches for ADHD symptoms don’t have strong research evidence, we do know that processed foods, refined grains, excessive sugar, and high fat worsen mental health.
Eat the foods that support health and mood. Foods like whole grains, fruits, vegetables, lean proteins, fish, and nuts has been shown to improve depressive symptoms4. Colorful fruit and vegetables (high in flavonoids and antioxidants) appear to protect against cognitive decline5, and may support modulation of neurotransmitters, such as dopamine6. Eating protein at each meal and low-glycemic foods (which don’t spike blood sugar quickly) enhance steady blood glucose and cognitive function.
The gut-brain axis refers to the two-way link between these parts of the body (i.e. the emotional and cognitive centers of the brain with intestinal functions). Research tells us that the foods we eat affect the microbiome in the gut, which influences this connection7. Healthy gut flora, for example, can reduce anxiety and serum cortisol levels8. Prebiotic and probiotic foods, like kimchi and sauerkraut, can support gut health.
A variety of supplements and herbs have been studied for their use in treating ADHD. In using supplements, two paths can be taken:
The thinking in using a combination of supplements for ADHD is that multiple nutrients will be involved in the important processes in the brain, such as modulation of key neurotransmitters. Since ADHD symptoms exist on a spectrum from mild to severe, supplementation can be individualized and used with or without medications. When using supplements, practical considerations, like cost or the number of pills needed per day, should be considered.
There are many kinds of integrative providers, with different training backgrounds and attitudes about treating ADHD. A good integrative provider will understand conventional mental health and won’t sell only one approach. They should be willing to work collaboratively with you and your other clinicians.
I recommend beginning your search for integrative providers with these national organizations.
Talk with the provider before making an appointment to understand their approach and to see if they are a good fit for your needs. Many of the providers found here have knowledge of integrative approaches, and are willing to collaborate with other integrative clinicians on a holistic treatment plan.
Keep in mind that medication is a very helpful tool to support the brain processing differences due to ADHD. It is important to collaborate with your doctor to find the most effective medication and dosage for you. There may be times when more medication is needed, and times when it can be decreased or eliminated. We know that the level of impairment that comes with ADHD can fluctuate over a lifespan. The change can happen because one’s environment (school or job tasks) changes, if lifestyle habits are optimized, or if treatment tools are used successfully.
The whole-person approach looks at how ADHD affects all of one’s health and lifestyle, and vice versa. It is important to start treatment gradually and to have support — family, ADHD community, nutritionist, coach, or clinician — along the way to better wellbeing.
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1 Zylowska, L., Ackerman, D. L., Yang, M. H., Futrell, J. L., Horton, N. L., Hale, T. S., Pataki, C., & Smalley, S. L. (2008). Mindfulness meditation training in adults and adolescents with ADHD: a feasibility study. Journal of attention disorders, 11(6), 737–746. https://doi.org/10.1177/1087054707308502
2 Mehren, A., Özyurt, J., Lam, A. P., Brandes, M., Müller, H., Thiel, C. M., & Philipsen, A. (2019). Acute Effects of Aerobic Exercise on Executive Function and Attention in Adult Patients With ADHD. Frontiers in psychiatry, 10, 132. https://doi.org/10.3389/fpsyt.2019.00132
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