Ryan Sheridan, NP
Coping with ADHD: Integrative Tips You Can Try Today (Part 2)
Caffeine can help with wakefulness and focus, but can also have negative side effects that impact ADHD.
Adequate sleep, especially for ADHD, is critical for overall health and symptom management.
Certain vitamins and mineral can be supplemented, if deficient, to help manage ADHD.
Exercise is an absolutely critical component of ADHD treatment.
As we talked about in Part 1, coping with ADHD, or Attention Deficit Hyperactivity Disorder involves making deliberate and targeted changes to behavior and lifestyle. In this article we are going to focus on the relationship between ADHD and caffeine, sleep, supplements or vitamins, and exercise. If you want to recap tips for managing ADHD, addressing ADHD outside of medication, how to quiet your ADHD mind, and explore ADHD’s relationship with food, read Coping with ADHD: Part 1.
Does caffeine affect ADHD?
Caffeine is a central nervous system stimulant that is commonly consumed in the form of coffee, tea, and energy drinks. It is often used to promote wakefulness, improve focus and attention, and reduce fatigue. Keep in mind, though, caffeine is not a substitute for sleep, nor does caffeine actually make up for lack of sleep. Caffeine works by masking out feelings of fatigue, not by actually eliminating them.
For ADHD, there is some evidence to suggest that caffeine may have beneficial effects for individuals, depending on their symptoms. For example, caffeine has been shown to marginally improve attention and decrease impulsivity in some studies. We have to be careful here, because the amount of caffeine and source of caffeine make a huge difference.
The effects of caffeine on ADHD vary depending on the individual and other factors such as genetics, age, and medication use. Additionally, some individuals with ADHD may experience negative side effects from caffeine, such as jitteriness, nervousness, and difficulty sleeping. As a rule of thumb, tea and matcha are better than espresso or energy drinks. This is because from a caffeine perspective, teas and matcha are less likely to spike caffeine levels, which subsequently means there isn’t a crash. Also, teas are less acidic and easier to digest. And we won’t even get into why energy drinks should be avoided for health purposes.
Surprisingly, some folks actually get more tired from caffeine. That’s because their body processes caffeine a little differently than most people. If this is the case, it is better to avoid caffeine altogether. We can test for this, and other genetic variations. I often include this as part of a comprehensive assessment for ADHD.
Individuals with ADHD should have a chat with their healthcare provider about whether caffeine may be a safe and effective option for managing their symptoms. Targeted use of caffeine can be a part of an integrative treatment plan for some individuals with ADHD.
Do people with ADHD need more sleep?
People with ADHD do not necessarily need more sleep than individuals without ADHD. However, individuals with ADHD may have difficulties with sleep, such as difficulty falling asleep, staying asleep, and waking up in the morning. The reasons are not clear or consistent, and it may not be related to ADHD at all.
That being said, some studies have suggested that individuals with ADHD appear to require less sleep than individuals without ADHD. This may be due to the fact that individuals with ADHD often have higher levels of energy and have difficulty slowing down, which can make it harder for them to fall asleep and stay asleep for a full night.
However, it is still important for individuals with ADHD to get enough sleep to support their overall health and well-being. Sleep is essential for proper brain function, emotional regulation, and physical health. Inadequate sleep can worsen symptoms of ADHD, such as inattention and impulsivity. During sleep is when our brains get to recharge, cleanse, and rebuild. So skipping sleep, for whatever reason, is not good for ADHD or health in general.
We know now that everyone, including adults, need eight or more hours of sleep per night. Sure there are exceptions to this, but sleep is a pilar of health. We cannot make up sleep once we’ve missed it and we cannot bank sleep for future use.
For individuals with ADHD, I recommend establishing healthy sleep habits, such as sticking to a regular sleep schedule, creating a relaxing bedtime routine, and avoiding stimulating activities before bed. If sleep difficulties persist, it may be helpful to speak with a provider about potential strategies or treatments to improve sleep.
What vitamins or supplements are good for ADHD?
There is some evidence to suggest that certain vitamins and minerals may be beneficial for individuals with ADHD. I always recommend working with an integrative provider who understands how to properly assess and supplement certain key vitamins and minerals, including for ADHD but for mental health in general. Keep in mind we have to temper out expectations with reality. Supplementing deficiencies will usually provide marginal benefit, it will not cure ADHD outright. However, even a small difference can be life changing. Sometimes, we can avoid the use of medications for ADHD but effective implementing a holistic plan, including supplementation.
Here are some vitamins and minerals (but not all) that have been studied in relation to ADHD:
1. Omega-3 fatty acids: Studies have found that supplementation with omega-3 fatty acids, particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), may improve symptoms of ADHD, such as hyperactivity, impulsivity, and inattention. This is one from which most people can benefit, even if they don’t have ADHD. Studies show marine based omega-3s are superior to plant based omega-3s. Omega-3s help all around health by reducing inflammation, which can help with ADHD, brain fog, and overall cognitive functioning. Taking this won’t be a magic pill, but over time most people report noticing a benefit. Keep in mind, we’re talking about higher doses than you get at CVS. EPA/DHA should be at least 1g each. This can potentially interact with medications, so always chat with your provider to make sure it’s safe for you.
2. Zinc: Some studies have suggested that individuals with ADHD may have lower levels of zinc, and supplementation with zinc may improve symptoms of hyperactivity and impulsivity. Again no magic wand here, but if zinc is on the low end, most people notice a benefit from supplementing. We’d need to check zinc levels to make any sort of recommendation.
3. Iron: Low levels of iron have been associated with ADHD symptoms, and iron supplementation may improve cognitive performance and behavior in some individuals with ADHD. This is interesting, because some individuals who properly supplement their low iron actually report significant changes in ADHD symptoms. Iron, too, should be checked before supplementing for ADHD.
4. Magnesium: Magnesium deficiency has been associated with hyperactivity and poor attention, and magnesium supplementation may improve symptoms of ADHD. Again, we need to do some lab work to see if this makes sense to supplement. Women with ADHD may have lower levels of magnesium, making it even more important to check.
5. Vitamin D: Low levels of vitamin D have been associated with ADHD symptoms, and some studies have suggested that supplementation with vitamin D may improve cognitive function and behavior. Vitamin D is another one of those vitamins that most people find beneficial, even without ADHD. Chat with your provider, but I usually recommend everyone say 2000u in the winter months.
It is so important to speak with a healthcare provider before starting any new supplements, as some supplements may interact with medications or have side effects. There is no magic pill, including supplements. The idea here is to add together a few root-cause solutions that may improve ADHD symptoms overall. Again, a comprehensive exploration to uncover any potential root-causes is the whole idea of holistically treating ADHD with integrative psychiatry.
How can exercise help ADHD?
I write about exercise a lot, perhaps because it is the focus in my doctoral research but also because quite frankly, it works. Exercise can be an effective for managing symptoms of ADHD, and pretty much every mental health condition.
Exercise has been shown to improve various aspects of cognitive function, including attention, working memory, and executive function, which are often impaired in individuals with and without ADHD.
Here are some key ways in which exercise can help with ADHD:
1. Increases available dopamine and norepinephrine levels: Exercise stimulates the release of neurotransmitters such as dopamine and norepinephrine, which are important for regulating attention, motivation, and mood. These neurotransmitters are thought to be deficient or out of whack in individuals with ADHD. Increasing these neurotransmitters can help reduce symptoms of ADHD, like procrastination.
2. Reduces stress and anxiety: Exercise has been shown to reduce stress and anxiety, which are often elevated in individuals with ADHD. By reducing stress and anxiety, exercise can improve mood and reduce distractibility. Even taking a brisk walk once a week has been shown to reduce anxiety.
3. Improves sleep: Exercise can improve sleep quality and reduce sleep disturbances, which can be beneficial for individuals with ADHD who often struggle with sleep. When we exercise our bodies then tell us, through hormones, that we need to recharge. In the absence of exercise, these signals can function less efficiently.
4. Increases self-esteem: Exercise can improve self-esteem and confidence, which can be especially important for children and adolescents with ADHD who may experience social and academic challenges. This ties into the neurotransmitter piece for mood, but also the physical side too. When we physically feel good, we are more likely to feel confident as a result.
5. Provides a healthy outlet for excess energy: Individuals with ADHD often have high levels of energy, which can be directed towards physical activity. Exercise can provide a healthy outlet for this excess energy, reducing restlessness and impulsivity.
Overall, exercise can be a safe and effective way to manage symptoms of ADHD. I like to say that I prescribe exercise, for individuals with ADHD, and anyone with whom I meet.
When we engage in regular physical activity, such as aerobic exercise, for at least 30 minutes per day, 3 to 5 times a week, our lives can be dramatically improved. Keep in mind, for a maximal benefit for ADHD, you shouldn’t be able to hold a conversation while exercising (you’ll be breathing too heavily). Weight lifting is a component as well, to help reduce inflammation but more on that in another blog.
I'll say it again because I believe in it, really: exercise should be part of the prescription for ADHD, and any mental health condition. Exercise is a vital part of any integrative treatment approach for ADHD, and beyond.
Part 2 Conclusion: Coping With ADHD
In conclusion, managing ADHD requires deliberate and targeted changes to behavior and lifestyle. In this article, we have explored the relationship between ADHD and caffeine, sleep, supplements or vitamins, and exercise. To recap tips for managing ADHD, addressing ADHD outside of medication, how to quiet your ADHD mind, and explore ADHD’s relationship with food, please refer to Coping with ADHD: Part 1.
If you have any additional questions about ADHD or integrative psychiatry in general, shoot me an email or reach out through my website. If you're looking for a provider and you're in the Washington, DC area, I'd love to help you on your treatment journey!