Therapy for ADHD: Natural Treatment Option

Live Webinar April 2: Underpinnings of Emotional Dysregulation in Adults: Managing Triggers & Co-Occurring Conditions

Ted Cruz — Mon, 23 Feb 2026 18:30:59 +0000

Reserve your spot in this free webinar, and get the event replay link plus a 15% discount to ADDitude magazine

Not available April 2nd? Don’t worry. Register now and we’ll send you the replay link to watch at your convenience.

Emotional distress includes feelings of anxiety, low mood, worry, rumination, and self-criticism. For people with ADHD, as well as those facing chronic stress, it can stem from changes in relationships, work, caregiving demands, health problems, or challenges to life satisfaction. When we feel prolonged uncertainty, our distress can become self-perpetuating. Heightened emotional reactions lead to overthinking and avoidance, which ultimately limit meaningful action and personal growth.

In this webinar, Doug Mennin, Ph.D., introduces ideas aligned with emotion regulation therapy, a research-based approach designed to help people better understand and respond to emotional distress. Rather than trying to erase difficult emotions, this approach focuses on changing how we relate to them so that we can move forward with greater clarity, flexibility, and purpose.

In this webinar, you will:

Understand emotional distress through a motivation and emotion-regulation lens, including why anxiety and depression often feel so hard to shift
Recognize common patterns like worry, rumination, and self-criticism that keep distress going
Build mindful awareness of emotions, body sensations, and internal conflicts without becoming overwhelmed by them
Develop practical skills to step back from intense thoughts and feelings and see them more clearly
Use emotion-regulation strategies to support meaningful actions, even when emotions are uncomfortable

Have a question for our expert? There will be an opportunity to post questions for the presenter during the live webinar.

Webinar Sponsor

Emotional dysregulation can make everyday triggers feel bigger and harder to manage. Play Attention, inspired by NASA technology and backed by Tufts University research, strengthens executive function and self regulation so adults can respond with greater calm and control. With a personalized plan and expert coaching, Play Attention supports lasting change. Take our ADHD assessment or schedule a consultation today.

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ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

Emotional Dysregulation in Adults: Resources

- - Free Download: Emotional Regulation & Anger Management Scripts
  - Read: Everything You Never Knew About the ADHD Brain
  - Read: Does ADHD Emotional Dysregulation Ever Fade?
  - Read: After the Shame: How to Re-Center Your Bruised Emotions

Meet the Expert Speaker

Doug Mennin, Ph.D., is a Professor of Clinical Psychology and Director of Clinical Training of the Clinical Psychology Ph.D. Program at Teachers College, Columbia University. He earned his Ph.D. from Temple University in 2001 and has previously held positions in the Department of Psychology at New York University, Yale University, and CUNY Hunter College, where he was Co-Director of the Health Psychology and Clinical Science PhD training program. In his academic role, Professor Mennin has trained numerous graduate students and post-baccalaureate research assistants on diagnosis, assessment, and treatment of anxiety and mood disorders. He has published more than 150 articles, chapters, and books and is the developer of Emotion Regulation Therapy (ERT). He regularly leads workshops to help people better understand and respond to their struggles with anxiety, worry, and depression. He currently serves on the editorial board of six journals and has been on the executive boards of the APA Division of Clinical Psychology, the Society for a Science of Clinical Psychology, and is the former Chair of the Scientific Council of the Anxiety and Depression Association of America (ADAA).

Certificate of Attendance: For information on how to purchase the certificate of attendance option (cost $10), register for the webinar, then look for instructions in the email you’ll receive one hour after it ends. The certificate of attendance link will also be available here, on the webinar replay page, several hours after the live webinar. ADDitude does not offer CEU credits.

Closed captions available.

5 Ways to Optimize CBT for ADHD

Nathaly Pesantez — Mon, 09 Feb 2026 10:20:49 +0000

ADHD is not a pathology to be cured. It is a difference to be explored and respected. This truth is self-evident but begs the question: How do we help people manage their ADHD without erasing the traits that shape who they are?

Increasingly, cognitive behavioral therapy (CBT) is being used to support executive functions and reshape environments to encourage behavioral change. At the same time, it works to reduce the shame, avoidance, and perfectionism that so often accompany ADHD.

Unlike other therapies, CBT measures patients’ outcomes in relation to their goals rather than ADHD symptom reduction. It supports patients’ time management, organization, emotional regulation, and other skills – not by encouraging them to change who they are, but by providing tools to improve functioning in ways that are meaningful to them.

CBT is most effective when it is designed collaboratively and personalized to meet a patient’s needs. For therapists, these guidelines for delivering neurodiversity-affirming care are a good place to start:

CBT Techniques for ADHD: Guidance for Therapists

💡Free Guide! 10 Things I Wish Someone Had Told Me About ADHD

1. Normalize ADHD

To aid patients in breaking unhelpful patterns, you must first understand and explain how ADHD impacts thoughts, behaviors, and emotions, Make the connection clear from a framework of difference, not deficits. Here’s an example:

PATIENT: I should be starting my report, but I keep thinking, I can’t do this. I’m a failure. I get anxious, scroll through my phone, and feel worse.

PRACTITIONER: That loop makes sense. With ADHD, large tasks demand a lot of executive functioning. When the first step isn’t clear, the brain sends an “avoid” signal. With that said, what’s a more balanced thought that still feels honest?

PATIENT: Starting is hard when the task is vague, but I’ve handed in reports before. I can begin if I make the first step tiny.

2. Follow the Patient’s Lead

When a patient tries to broadly suppress their ADHD symptoms, they end up consciously or unconsciously masking their identity. While most people mask to some degree, constant camouflaging leads to lower life satisfaction.

Abandon preconceived notions about impairing symptoms or challenges. Instead, ask your patient about their goals and the behaviors they want to change. Say:

What would you prefer to focus on – career, health, relationships, or something else?
What are your goals in this area?
What tasks put you in line with your goals?

💡Read: What Makes a Life Fulfilling? Pursuing Goals Important to You, Not Others.

3. Watch Your Language

Does your patient prefer identity-first language (“ADHD person”) or person-first language (“person with ADHD”)? Do they have a preferred term for their neurotype? For example, Variable Attention Stimulus Trait (VAST), coined by Edward Hallowell, M.D., and John Ratey, M.D., is an alternative term for ADHD that has grown in popularity. Use non-pathologizing terms (also based on patient preference):

INSTEAD OF	SAY
risk	likelihood
comorbid	co-occurring
symptoms	traits, patterns, or experiences

4. Look Beyond the Individual

Is your approach centered on making individuals meet neurotypical standards? Are you exploring opportunities to reshape their environment to help them thrive? For instance, you might suggest that a patient relocate to a quieter corner of their office and schedule brief, daily check-ins with their supervisor.

5. Provide Supports

The skill-building and between-session tasks associated with CBT can be difficult for people with ADHD, possibly triggering rejection sensitivity. To address this barrier to care:

Supply tools. Provide a timer, for example, rather than asking your patient to buy one.
Gauge what can be done. Ask, “On a 10-point scale, with 10 being a done deal, how likely are you write in your thought journal every day?” If their answer is less than eight, adjust the task.
Plan frequent check-ins for accountability and opportunities to troubleshoot.
Suggest options. A paper checklist may help one patient stay organized, while a to-do list app may work better for another. Always give choices and allow patients to experiment autonomously.

CBT Techniques for ADHD: Next Steps from ADDitude

Free Download: Everything You Need to Know About CBT
Read: How CBT Improves Prioritization Skills
Read: How Cognitive Restructuring Erases ADHD Self-Doubt

Saskia Van Der Oord, Ph.D., is a professor of clinical psychology at KU Leuven in Belgium.

Michael Meinzer, Ph.D., is an associate professor of psychology at the University of Illinois, Chicago.

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“Pediatric ADHD Care Is Fragmented”

Melanie Wachsman — Wed, 04 Feb 2026 07:13:42 +0000

When I began my academic career 40 years ago, ADHD or “hyperactivity” was considered a school disorder in children. The treatment was twice-daily immediate-release methylphenidate, designed to help children focus from 8 a.m. to 3 p.m., give or take.

Today, we know that ADHD affects every life domain and that medication alone is usually not sufficient. Most people need multimodal care, and the sequence of treatments matters; however, few patients benefit from these insights because ADHD care is fragmented in the following ways:

Its quality hinges on who diagnoses the ADHD, when, and which services are available and utilized.
How and when care is delivered.
Untreated or undertreated ADHD is far too common.

Providing a Structured Approach

There is no one-size-fits-all approach to ADHD. An effective ADHD treatment plan for children begins with a comprehensive assessment that considers the following:

Co-occurring Conditions and Mimics

ADHD coexists with at least one psychiatric, learning, or behavioral disorder about 80% of the time. Anxiety, depression, sleep disturbance, and other conditions can imitate or amplify symptoms.

Unique Impairments

Treatment should be tailored to each child’s unique impairment and context (e.g., severity, presentation, family dynamics, parental health, care access, etc.) while simultaneously highlighting the child’s strengths. Identifying and building on a child’s talents promotes self-esteem and resilience.

💡Free Guide! Parent-Child Therapies for Better Behavior

Sleep Comes First

Sleep problems and ADHD often overlap and are mutually exacerbating; stimulants can disrupt sleep, and poor sleep can worsen ADHD symptoms. Baseline sleep history and screening for sleep disorders should precede medication trials. If sleep deteriorates, clinicians should adjust the dose or formulation, add melatonin, or reinforce sleep-hygiene routines.

Multifaceted Treatment Is Best

Research has focused extensively on monotherapy — typically medication alone — but this approach rarely suffices beyond the short term. For one, ADHD can change over time. The medication that helps a hyperactive kindergartener may not serve a high school student. Monotherapy is especially inadequate for patients with multiple symptoms, comorbidities, and residual impairments not addressed by medication, like behavioral challenges when a medication wears off.
Multimodal therapy — medication used in conjunction with new behavioral interventions — is not new. The landmark Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) study observed children assigned to different 14-month approaches:

individually titrated medication
intensive behavioral intervention
combined treatment
community care

Medications improved core symptoms, but parents and teachers rated the combined approach highest for overall functioning.

💡Free Download! A Parent’s Guide to ADHD Medication

Sequence Matters

Multimodal treatment works, but sequencing is important. In one study, children were treated during a school year and assigned to different sequences. Starting with behavioral treatment and then adding medication, if needed, produced the best outcomes, including fewer classroom rule violations and disciplinary events. Conversely, starting with medication and adding behavioral treatment later was less effective. ¹

Dosing for Non-Stimulants

For patients who do not respond to stimulants, choose not to take them, or whose comorbid conditions (e.g., tics, sleep disorders) are worsened by stimulants, non-stimulants are an option, and there are several with different mechanisms of action. Finding an optimal dose requires working closely with your provider. Often, combining stimulants with non-stimulants can improve tolerability and mitigate dose-related side effects.

What constitutes effective ADHD treatment will continue to be a central topic of research. Scientific evidence supports care that is personalized, sequenced, and measurement-based. Children respond best to treatment plans that include psychoeducation, behavioral and pharmacological interventions, and a focus on building their strengths to improve functioning not just in school but in life.

ADHD Treatment for Kids & Multimodal Therapy: Next Steps

Learn: ADHD Medications for Children
Read: How a Physician Treats ADHD with Combination Therapy
Watch: “Combined Treatment Options for Pediatric ADHD: Sequencing Your Child’s Care”

Mark A. Stein, Ph.D., is a professor of psychiatry and behavioral sciences at the University of Washington.

Source

^{1 Pelham, W.E., Jr., Fabiano, G.A., Waxmonsky, J.G., Greiner, A.R., Gnagy, E.M., et al. (2016). Treatment sequencing for childhood ADHD: a multiple-randomization study of adaptive medication and behavioral interventions. J Clin Child Adolesc Psychol. https://doi.org/ 10.1080/15374416.2015.1105138}

Study: Self-Compassion Improves Emotional Regulation, ADHD Symptoms

Melanie Wachsman — Sat, 22 Nov 2025 19:03:49 +0000

November 22, 2024

Self-compassion improves emotional regulation skills and reduces the impact of adverse childhood experiences (ACEs) and ADHD symptoms, suggests a new study published in the Journal of Attention Disorders.¹ The researchers recommend integrating self-compassion practices into therapeutic treatments for individuals with ADHD who have experienced trauma.

Greater exposure to ACEs increases the likelihood of developing ADHD symptoms and emotional regulation challenges, while decreasing self-compassion in young adults, according to the study. These findings align with previous research showing that individuals who experience four or more ACEs — including emotional abuse, physical neglect, domestic violence, substance abuse, parental separation, and incarceration of a family member — before age 18 have a relatively higher rate and severity of ADHD symptoms and emotional dysregulation in adulthood.^{2, 3} ACEs also increase the risk of comorbidities, such as anxiety, depression, and substance use, which could obscure or intensify ADHD symptoms.

“The relationship between ACEs and ADHD symptoms is partly explained by increased emotional reactivity and difficulties in stress regulation that result from early adversity,” the researchers wrote. “ACEs often disrupt emotional development by overwhelming a child’s capacity to manage stress, leading to long-term difficulties in emotional regulation, such as heightened emotional reactivity or emotional numbing.”

The researchers analyzed questionnaires on self-compassion and emotional regulation completed by 442 college students aged 18 to 29 from Turkey who also filled out the ACEs Checklist. Roughly 76% of the participants reported one or more ACEs, with about 27% reporting four or more; 4% reported receiving an ADHD diagnosis.

What helps individuals manage their emotions and reframe the impact of ACEs, according to the study? Self-compassion.

“Self-compassion fosters a growth mindset, enabling individuals to view setbacks and opportunities for learning and personal growth,” the researchers wrote. “This positive self-regard builds inner strength and helps individuals cope with difficulties in a calm manner; individuals with higher levels of self-compassion can constructively process childhood adversities. This improves emotional regulation techniques and reduces ADHD-related impairments.”

Further, the study shows that individuals high in self-compassion are more likely to engage in adaptive coping strategies and less likely to engage in self-criticism and negative self-talk, or in maladaptive coping strategies, such as suppression, which can lead to feelings of shame, guilt, and inadequacy.

What Is Self-Compassion?

“Self-compassion allows you to be good enough as you are — with your warts and your foibles,” says Sharon Saline, Psy.D., a clinical psychologist. “Sometimes you may be off-balanced, sometimes more reactive than you’d like, sometimes disorganized, but, fundamentally, you are perfectly imperfect as a human being, just like everyone else.”

The practice of self-compassion encompasses three elements:

Self-kindness means treating oneself with care and understanding during times of pain or failure, instead of harsh self-criticism. It requires accepting one’s humanity and flaws rather than comparing or evaluating oneself to others.
Common humanity recognizes personal challenges as a part of the shared human experience; everyone experiences difficulties.
Balanced awareness identifies and analyzes uncomfortable and painful thoughts and feelings; mindfulness prevents the individual from getting consumed by them.

The researchers recommend integrating self-compassion practices into the following interventions:

Mindfulness and emotional regulation training that fosters resilience
Trauma-informed approaches in educational and practical settings to help identify and support individuals at risk for ADHD symptoms resulting from ACEs
Acceptance and commitment therapy (ACT) to support and develop adaptive coping mechanisms in individuals with a history of ACEs

“Future longitudinal studies will also provide a clearer understanding of how ACEs, self-compassion, and emotion regulation interact over time to influence ADHD symptoms,” they wrote.

How to Practice Self-Compassion

According to Mark Bertin, M.D., a developmental pediatrician in Pleasantville, New York, the idea of self-compassion is straightforward. “Self-compassion is a reality-based antidote for self-criticism and perfectionism,” he says. “We learn to value self-improvement and take responsibility for mistakes, but without inner heckling. Self-compassion helps us realize that self-image and self-doubt are not hardwired mental traits but habits that can change.”

Pushing back against the voice of self-criticism helps individuals focus on better intentions. “Without striving to make anything magical happen, we remind ourselves how we would treat a friend in the same situation,” Bertin says.

To practice self-compassion through mindfulness, Bertin recommends setting a timer for 5 to 15 minutes and following these instructions:

Start by sitting or lying down in a comfortable posture. Close your eyes or shift your gaze to something non-distracting.
Take a few deep breaths. Gather your attention, which may be caught up in self-recrimination, fear, joy, worries, or distractions. For now, focus on the movement of your body with each full breath.
With each inhalation, observe it all. You might say to yourself, “This is what my experience is right now,” or “This is how it feels, for better or worse.” Then consider, “Everyone has moments like this.”
With each exhalation, set an intention. “May I find strength and kindness for myself right now.” Use any phrase that feels natural, or something you would say to comfort a friend.
Don’t be discouraged by distractions. You will get distracted almost immediately. That’s what the mind does. Treat that distraction as a neutral force — it happens, no need for frustration, come back to take the next breath.

Continue in this way for a few breaths or until your timer goes off.

Sources

¹Karaçul, F. E., & Arslan, G. (2025). Adverse childhood experiences and ADHD in college students: exploring the role of emotion regulation and self-compassion. Journal of Attention Disorders. https://doi.org/10.1177/10870547251370427

²Brown N.M., Brown S.N., Briggs R.D., Germán M., Belamarich P.F., Oyeku S.O. (2017). Associations between adverse childhood experiences and ADHD diagnosis and severity. Academic Pediatrics. https://doi.org/10.1016/j.acap.2016.08.013

³Naeem S., Graebe M. (2023). Exploring the link between adverse childhood experiences and ADHD in adults: A perspective from the University of Kentucky. Journal of the American Academy of Child & Adolescent Psychiatry. https://doi.org/10.1016/J.JAAC.2023.09.460

How IFS Therapy Promotes Healing from Trauma

Nathaly Pesantez — Wed, 19 Nov 2025 10:36:17 +0000

Internal Family Systems: Article Contents

What Is Internal Family Systems?
Understanding IFS: Glossary
IFS in Action

What Is Internal Family Systems?

Children with ADHD are more likely to experience abuse, neglect and other adverse childhood experiences (ACEs), research shows.¹ The more ACEs a child endures, the more intense their ADHD symptoms tend to be and the less effectively they will cope with life’s challenging moments.

People with ADHD are also more vulnerable to traumatic experiences like bullying, humiliation, shaming, and chronic criticism – all of which can have a big impact, especially for the undiagnosed and untreated.

Traumatic experiences leave deep marks that shape behavior and beliefs about self-worth over a lifetime. Some people with ADHD develop extreme coping mechanisms – including procrastination, self-criticism, and explosive anger – to protect themselves from further harm.

Getting to know and caring for these protective and wounded parts of ourselves is the focus of Internal Family Systems (IFS), a form of therapy that helps individuals heal from wounds created by trauma. For people with ADHD, these can include:

Frequent criticism: Negative statements such as, “Why can’t you sit still?” or “What were you thinking?” that lead the child to believe there is something wrong with them.
Shame and blame: Comments that suggest a child’s academic or other struggles result from laziness, rather than lagging executive function skills or learning differences.
Overcontrol: Rigid or authoritarian approaches used by parents in response to behaviors they felt powerless to change, resulting in threats or conduct that felt humiliating to a child.

Understanding IFS: Glossary of Terms

IFS Term	Description
Parts	Internal subpersonalities that take on distinct roles in our daily lives. Experiences, especially in childhood, influence the roles that our parts adopt.
Exiles	Parts that carry burdens in the form of extreme thoughts, such as “I can’t get anything right,” and extreme feelings, including pain, anger, humiliation, and shame.
Managers	Parts that run the show and strive to proactively maintain control. They take on responsibility for seeing that the exiles will not be subject to further hurt. Managers may deploy procrastination, avoidance, people-pleasing, self-deprecation, and masking in situations that could lead to pain or instability.
Firefighters	Parts that play a protective and reactive role. When exiles threaten to destabilize the system with their extreme thoughts and feelings, firefighters douse the flames. Behaviors can include self-harm, substance use, and explosive rage. Regulation challenges in ADHD can exacerbate firefighter behaviors.
Burdens	Extreme ideas or feelings sparked by adverse experiences and carried by parts.
Legacy Burdens	Extreme ideas or feelings that pass down through families and cultures.
The Self	The core essence of a person that embodies positive, healing qualities. Accessing The Self is a major goal of IFS.
Self-Energy	The qualities a person possesses when connected to The Self: compassion, creativity, curiosity, confidence, courage, patience, and more.

IFS in Action

A goal of IFS therapy is to help individuals access compassion, curiosity, and patience. These qualities help us grow and heal. But sometimes, trauma and extreme protective parts block access to them. An IFS session might include the following exchange:

PATIENT	I’m so mad at myself. I missed a deadline at work, and all I can hear is that critical inner voice: “You always screw things up.”
THERAPIST	So, when you missed the deadline, your critic part got mad and started in on you. Is that right?
PATIENT	Yes. It’s relentless.
THERAPIST	I wonder what that part thinks would happen if it let up on the criticism? Just ask it.
PATIENT	It fears that I’d fail. Criticism is the only way I get things done.
THERAPIST	So, if it stopped criticizing you, you wouldn’t get anything done and you would fail?
PATIENT	Yes.
THERAPIST	Does that make sense?
PATIENT	Yes. I always forget stuff and I need constant reminders.
THERAPIST	And this part helps to keep you motivated?
PATIENT	I never thought of it that way, but, yes, it does.
THERAPIST	How are you feeling toward this part that helps you by never letting up on the criticism?
PATIENT	I don’t love the criticism, but I wouldn’t get anything done without it.
THERAPIST	Can you extend that feeling of gratitude toward the part? Maybe thank it for working so hard on your behalf?
PATIENT	It likes being acknowledged.
THERAPIST	That’s right. Now, ask the part how old it thinks you are?
PATIENT	It thinks I’m in middle school!
THERAPIST	Give the part an update. Let it know what’s different about you now – the skills you have that you didn’t have then, the circumstances you are in, etc. Also let it know that you are working with an executive function coach to learn effective ways to keep track of tasks.
PATIENT	The part is shocked.
THERAPIST	Ask what it would be like if you could take more responsibility for the reminders.
PATIENT	It would like that. It’s tired but doesn’t trust me.
THERAPIST	That makes sense too, doesn’t it? Your track record in middle school wasn’t stellar, right?
PATIENT	(laughs) You can say that again!
THERAPIST	And there were some vulnerable parts that got hurt then, right?
PATIENT	Yes. And this one doesn’t want that to happen ever again.
THERAPIST	Right. That’s what protective parts do. But they get stuck in time and don’t realize that you can help the vulnerable ones now. Ask the part what it would like if you could do that?
PATIENT	Again, it would love that, but it still doesn’t trust me.
THERAPIST	That’s right. You will need to earn its trust.
PATIENT	Yes.
THERAPIST	Let’s start with a manageable first step. See if the part is willing to observe what you can do now before it takes over with the criticism… What do you think?
PATIENT	We can try.
THERAPIST	Great! Thank the part for being willing to consider that.

Unlike some therapies, IFS recognizes that even extreme coping behaviors serve a purpose and are trying to help. When protective parts feel appreciated, safe, and understood, they grant access to the parts that carry the most pain – and that opens up space for healing.

Internal Family Systems: Next Steps

Read: ACEs and the ADHD-Depression Link
Watch: How to Heal from Trauma Using Internal Family Systems
Read: Does Trauma Cause ADHD? And Vice Versa?

Susan Bauerfeld, Ph.D., recently retired as an Internal Family Systems therapist.

Sources

¹ Brown, N. M., Brown, S. N., Briggs, R. D., Germán, M., Belamarich, P. F., & Oyeku, S. O. (2017). Associations Between Adverse Childhood Experiences and ADHD Diagnosis and Severity. Academic pediatrics, 17(4), 349–355. https://doi.org/10.1016/j.acap.2016.08.013

The ADHD Playlist Prescription

Melanie Wachsman — Sat, 08 Nov 2025 00:14:56 +0000

“Music puts me in another dimension.”
“I have used music all my life to ground myself, get lost in creativity, and process challenging moments.”
“I’ve always had a deep connection to music.”

Music strikes a powerful chord with ADHD brains, which light up like a stadium full of Zippos when following a melody, processing lyrics, noodling on an instrument, or linking songs to distant memories. In short, songs make our brains sing.

Music Sparks Joy

The positive effects of music have real neurochemical underpinnings. Research shows that playing or listening to music lowers cortisol, which decreases stress and anxiety levels and turns up dopamine release. Active participation in group singing, dancing, or instrument playing sparks a release of oxytocin and endorphins, the feel-good chemicals linked to bonding, community, and connection.¹

The effects of music can be measured in blood samples. In one study, youth taking medication for ADHD and depression were guided to freely play rhythmic instruments (no skill required) and visualize positive images and words while listening to music. Compared to children in the control group, who were only given medication, those in the music therapy group showed much higher serotonin levels and significantly lower cortisol levels after treatment.²

Music Is Grounding

Music helps fine-tune our emotional responses. Teens with ADHD who listened to songs as part of a combined cognitive behavioral therapy and music-based intervention saw better symptom control and better cognitive reappraisal — the critical ability to evaluate a situation from a different perspective — after treatment.³

[Get This Free Guide: Music for Healthy ADHD Brains]

Musicians with ADHD may benefit the most. Research shows that experienced guitar or piano players with ADHD score better on measures of sustained and selective attention, working memory, impulse control, and other cognitive domains compared to non-musicians with ADHD.⁴

Music Promotes Focus

If you use background music to get stuff done, know that your behavior is backed by science. In one study, preteens with and without ADHD completed reading tasks with and without background music. ⁵Regardless of whether it was calm or energetic, background music boosted reading comprehension scores significantly for the ADHD group and, interestingly, worsened them for the non-ADHD group.

What type of music works best? That’s highly individual. But research suggests some musical elements may resonate more in ADHD brains. Music with fast, pulsing beats improves sustained attention in adults with ADHD symptoms, according to one study. As one of the researchers said, “The ADHD brain needs strong stimulation to really kick it into gear.”⁶

Music Creates Structure

Music training improves executive functioning overall, with notable effects on inhibitory control—important for those who struggle with impulsivity. Dancing, clapping to a rhythm, or learning to play an instrument all engage and strengthen parts of the brain responsible for motor coordination and timing.

[Free Webinar Replay: “Some Kind of Wonderful: How Music Affects the ADHD Brain”]

But music goes deeper, orchestrating changes in breathing patterns, heart rate, and the sympathetic nervous system. (Ever felt goosebumps during a powerful chorus?) Its effect on the body makes it a useful tool for emotional regulation. In fact, music’s ability to lower stress makes it a powerful pain reliever that can also boost immunity.

How to Harness Good Vibrations

Try these ideas for infusing your life with music to ground you, get in the zone, sleep, stay on track, and work through ADHD-related challenges.

Tune in, turn on. Experiment with genres. Do you focus better with classical music? What about EDM? What if the lyrics are in a foreign language? Does pop music motivate you to wash the dishes but not to study?
Create playlists. Do you lose track of time in the shower? Create a bathroom playlist where each song cues you to the next task. Does your child struggle with transitions? An activity playlist can help them track the passage of time in a novel way. Hate chores? Only clean until your “Mops ‘n’ Hoses” playlist ends.
Can’t sleep? Lullabies aren’t just for children! Play a song on repeat at a low volume to encourage slumber.
Mindful minutes. For a different type of mindful meditation, play a favorite song and focus on a single aspect of the composition, like the backing vocals, drum beat, or baseline. Tune in to how you feel, physically and emotionally, when you listen to music.
Does that ring a bell? Set important information to jingles for easier recall.
Songwriting can provide an outlet for intense emotions when talking feels like “too much.”
A personal anthem. Nervous about an upcoming social gathering? Beating yourself up over a recent slip-up? Identify go-to songs that speak to the positive mindset you want to channel.
Just dance. Like music, movement and exercise offer tremendous benefits for ADHD brains. Dancing is a physical release, and it delivers an assertive signal: “Here I am!”
Talk tracks. Form stronger bonds by asking new acquaintances or old friends about their top songs or albums. Parents: Be curious about the music your child likes and never disparage a teen’s favorite artists or tracks.

ADDitude’s Desert Island Playlist

If you were stranded on a desert island with just one album (and a record player, of course), which one would you choose and why? Read the ADDitude team’s responses below.

“Vs. by Pearl Jam is one of the truly great rock albums of my lifetime and a time machine that transports me back to the delirious, live-out-loud days of being 17 and driving a hot Mustang with the windows down.” — Anni Layne Rodgers, General Manager

“Exile in Guyville by Liz Phair was so gutsy and empowering. It captured the essence of how I felt being a young woman in my early 20s in a way that is still relevant. Depending on your mood, it can be cool and playful or thought-provoking and somber.” — Melanie Wolkoff Wachsman, Senior Consumer Health Editor

“Dónde Están los Ladrones? by Shakira is fun blend of sounds, from heartfelt ballads to rock with Middle Eastern influences, that’s been with me since childhood! — Nathaly Pesantez, Senior Editor

“I started listening to music in earnest in middle school, and Nirvana was the defining band of that era for me. Decades later, blasting Nirvana’s album, Nevermind, and other favorites from that period makes driving around to run errands just a little more fun.” — Eve Gilman, Managing Editor

“I was a kid when I stumbled upon Carole King’s Tapestry in my dad’s vinyl collection. I put on the record because the picture on the cover seemed warm and inviting; her bare feet in the window seat, the cat looking at the camera. What hooked me back then, and now, is the raw realness of King’s voice — not glossy, not perfect, not even always pretty but always honest.” — Nicole Cavacco Kear, Consumer Health Editor

“I like Melophobia by Cage the Elephant because it illustrates how heart-wrenching relationships can be, especially when communication just isn’t working to bring people closer together. The song ‘Come a Lil Closer’ is about poverty and inequality that no one wants to see. The lyrics and music just really resonated with me.” — Carole Fleck, Editor in Chief, ADDitude Magazine

“Starting my professional music career in high school, tracks from Stevie Wonder’s Songs in the Key of Life, were among the first songs I learned thoroughly, and they shaped my harmonic and melodic development.” — Ted Cruz, Editorial Specialist, Webinars

“My fave albums would be Heard It in a Past Life by Maggie Rogers or After It All by Delta Rae. I was introduced to these musicians during the pandemic, and they helped get me through that dark time.” — Hope Goodrich, Web & Social Media Assistant

Listen to ADDitude’s Desert Island Playlist on the ADDitude Spotify channel http://additu.de/desert-island.

ADHD Music Playlist: Next Steps

Download: Focus Your ADHD Brain With 5 Helpful Hacks
Read: “The Minor Falls, the Major Lifts:” Why Music Matters to ADHD Brains
Read: “How Hardcore Feminist Punk Rock Unlocked My AuDHD Brain”

Roberto Olivardia, Ph.D., is a clinical instructor of psychology at Harvard Medical School. He maintains a private psychotherapy practice in Lexington, Massachusetts.

Sources

¹Chanda, M.L., Levitin, D.J. (2013). The neurochemistry of music. Trends Cogn Sci. https://doi.org/10.1016/j.tics.2013.02.007

²Park, J.I., Lee, I.H., Lee, S.J. et al. (2023). Effects of music therapy as an alternative treatment on depression in children and adolescents with ADHD by activating serotonin and improving stress coping ability. BMC Complement Med Ther. https://doi.org/10.1186/s12906-022-03832-6

³Madjar, N., Gazoli, R., Manor, I., Shoval, G. (2020). Contrasting effects of music on reading comprehension in preadolescents with and without ADHD. Psychiatry Res. https://doi.org/10.1016/j.psychres.2020.113207

⁴Rodrigues, A.C., Loureiro, M.A., Caramelli, P. (2013). Long-term musical training may improve different forms of visual attention ability. Brain Cogn. https://doi.org/10.1016/j.bandc.2013.04.009

⁵Lachance, K., & Gosselin, N. (2025). Listening habits and subjective effects of background music in young adults with and without ADHD. Frontiers in Psychology. https://doi.org/10.1016/j.tics.2013.02.007

⁶Woods, K.J.P., Sampaio, G., James, T. et al. (2024). Rapid modulation in music supports attention in listeners with attentional difficulties. Commun Biol. https://doi.org/10.1016/j.tics.2013.02.007

Trump Cut $1 Billion in Mental Health Services for Students. ADDitude Readers Responded.

Lauren Capucci — Fri, 06 Jun 2025 08:57:59 +0000

June 6, 2025

On April 29, the Trump administration announced it was cutting $1 billion in funding for federal grants used to hire and train 14,000 mental health professionals in 260 public school districts across 49 states.

The grants originated in 2022’s Bipartisan Safer Communities Act, a bill that passed the Senate with unanimous consent following the school shooting in Uvalde, Texas, where 22 people died, including 19 elementary school children. The bill was largely seen as important recognition of and support for an escalating mental health crisis among American youth.

In April, the Trump administration eliminated all funding for these grants, blaming Diversity, Equity and Inclusion (DEI) initiatives associated with them. Specifically, the administration objected to grant money being used to train and recruit diverse mental health counselors who reflect the demographic make-up of the students they serve.

Meanwhile, research shows that BIPOC students benefit from access to a diverse cohort of mental health professionals¹, and the inverse is true as well.

“We see studies that show a bias in the way that Black children, in particular, are treated in the health care system compared to white children,” said Tumaini Rucker Coker, M.D., during the ADDitude webinar “Equity in ADHD Care.” “It is directly related to racial bias. Black families are less likely than white families to have concordance or a shared lived experience with their healthcare providers, and studies have shown that Black adults are more likely than white adults to report lower levels of trust in their providers as well.”

[Read: “As Inclusion Disappears, My Mask Reappears”]

Furthermore, “studies show that Black families tend to have worse outcomes with white doctors,” said Napoleon B. Higgins, Jr., M.D., during his ADDitude webinar “Health Equity in ADHD.” “That is that is a sad thing to hear, but if we can educate more providers, maybe we could change that.”

Recently, ADDitude invited its readers’ reflections on news of the $1 billion in cuts to youth mental health services. Nearly 200 people responded, and many of them expressed concern that all students’ mental health may suffer because of the cuts, but especially those with autism, ADHD, and learning differences, who may benefit from seeing school counselors with similar lived experiences.

[Read: “DEI – and Neurodivergence – Are Under Attack”]

ADDitude Readers React to Mental Health Funding Cuts

“As a school social worker and the parent of a child who has an IEP, I consider Trump’s cuts to funding for public school mental health to be gross negligence. I think that it highlights his ignorance on the issues plaguing our youth. I also find it irresponsible. Our kids still are not okay ever since COVID. I believe that it will impact the services that my son receives.”

“Students need to feel safe and be OK within themselves before they can take in the knowledge to learn anything. Cutting access to mental health services means that students who are at-risk learners due to factors outside a school’s or educator’s control may become disengaged learners. This leads to more problematic and potentially anti-social behavior.”

“As a former teacher of students with disabilities, I am concerned. Students need safe places to go and get mental health support. Parents are doing their best but don’t always have the resources to support their children.”

“All three of my children are neurodiverse, and this can take a toll on their mental health. Having supports like counselors, DEI programs, and other accessibility programs is vital. I now have two children in college and one entering high school.”

“I am a school counselor and my son has ADHD. We’re already incredibly behind on providing mental health services to students. These cuts are only going to significantly increase the percentage of students whose health needs are hardly or never addressed.”

“Every child should have the support they need to excel in school. School mental health services are critical for this.”

“I don’t understand why we are defunding mental health awareness, advocacy, and resources. It really doesn’t make any sense to me. It seems like we had made such strides forward in mental health, but now we’re going backward for some reason. I understand cutting expenses to cut spending and improve the national deficit, but it seems like we are cutting very vital and necessary things. It’s like trying to cut back on your own budget by deciding to not buy groceries anymore.”

Understanding Trump’s Funding Freeze: Next Steps

Read: Generation AnXiety — Findings on ADHD & the Mental Health Crisis
Learn:Youth Mental Health Care Is Vital. And Hard to Access.
Watch: Mental Health Out Loud Webinar

SUPPORT ADDITUDE
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Sources

¹
McGuire, TG., Miranda, J. (March-April 2008). New evidence regarding racial and ethnic disparities in mental health: policy implications. Health Affairs.https://doi.org/10.1377/hlthaff.27.2.393

“4 Ways to Harness the Soothing Power of Music”

Nathaly Pesantez — Sun, 01 Jun 2025 09:49:02 +0000

Do you find your foot tapping or your body swaying almost automatically when a good song begins playing? Our bodies naturally want to synchronize with the rhythms in music. This phenomenon is musical entrainment, a useful tool that helps us use music to regulate not just our motor movements, but our heartbeat and breathing, too.

In my clinical experience as a music therapist, I’ve seen how music and other sensory experiences help individuals improve their focus, impulse control, and emotional regulation. Try these fun (and whimsical!) activities, designed to stimulate the sensory pathways (sight, sound, touch, taste, and smell) to relax the body and mind.

The Scarf’s Serenade

Grab a light scarf. Put on some instrumental, relaxing music of your choice. Glide the scarf over your body. The calming and repetitive action works well to regulate hyperactivity, racing thoughts, and impulses, as your attention will be drawn to the sensory experience of the scarf over your skin to the tune of soothing music.

A Symphony of Mist

Put on a relaxing, instrumental music track. (Not sure what to select? Try “Raindrops Keep Falling on My Head” by B.J. Thomas. You’ll see why.) Grab a spray bottle and fill it with water. Spray it over your head and let the mist fall onto your face. The light touch of the mist paired with familiar, rhythmic music activates the parasympathetic nervous system, which is responsible for the body’s calming response. This helps shift the brain and body from a hyper-aroused to a more regulated and calm state.

The Balloon’s Dance

Put on some music and bounce a balloon to the beat. Music adds a predictable auditory rhythm, to which you can naturally sync your movements. Meanwhile, repetitive bouncing will provide a target for your focus and give your body an outlet for restless movement, without being overly stimulating.

Sticks and Sounds

Turn on your favorite music and grab two pencils or chopsticks. Then, tap along to the beat on any surface you can find! If you’re already in the habit of drumming along, keep at it. Tapping is a controlled, safe outlet for movement — you may not realize how it has probably helped you manage restlessness and reduce impulsive behaviors! Moving and grooving to a beat supports body regulation and coordination, promoting a sense of internal calm.

Music Therapy and ADHD: Next Steps

Read: Music Therapy — Sound Medicine for ADHD
Read: Rhythm Notion — 10 Benefits of Music for ADHD Brains
Read: Music Is Magic — 9 Hacks to “Beat” ADHD Symptoms

“We Do the Work. Outside. And Sometimes It Rains.”

Melanie Wachsman — Mon, 26 May 2025 08:58:08 +0000

Sometimes it rains in Northern California, where I practice psychiatry for adults with ADHD. The rain helps the grass and trees grow, a lovely metaphor for the therapeutic process of receiving comprehensive ADHD treatment and growing slowly into a new, relatively unknown, more mature self. But it’s also the simple reality of my office. It is outside, surrounded by trees, with chairs nestled in nature.

Yes, I could be seeing patients inside a clinical office to discuss suppressing or ignoring old behaviors while allowing a deeper self to arise. Or I could just remind them to bring an umbrella to our session today as we delve into these issues.

Three months into the COVID-19 pandemic, I moved across the country with my three young children to Palo Alto, California, for the University and College Mental Health Fellowship in psychiatry at Stanford University. But instead of joining a vibrant academic community, I worked from my apartment. Alone. A few months later, forest fires made the air quality so bad that we couldn’t even go outside.

[Free Download: How to Choose the Right ADHD Treatment Profesional]

As the pandemic began to lift, we wore masks when we treated patients in person. But in doing this emotional work, revisiting the difficult moments of a patient’s childhood, it is so important to see kindness on a psychiatrist’s face. So I made a decision: Whenever possible, I met with patients outside in nature, where masks weren’t required.

Benefits of Nature Therapy

After the pandemic ended, even as we sat in coats under umbrellas during the rainy season, I repeatedly asked my patients, “Do you want to do this in an office?” The answer was always the same: “Absolutely not.”

When patients are diving deeply into old pain, desperately hoping for connection while also fearing it, I can simply say: “What do you see, right now? What do you hear?” They look around at the grass and the trees, hear the birds, feel the sun on their skin, or hear the rain drumming on their umbrella. They discover that their fear is about the past, not the present. Try as they might, they can’t force their fear away any more than they can stop the rain. But they can notice it. They can choose to ignore the narrative it generates in their inner monologue. They can breathe and let the tears fall so that something new can grow.

The rainy season of change can be hard. But it doesn’t last forever. Eventually, spring comes. And the grass grows. To allow growth to change us for the better, we need to trust this deeply in our bodies. For my patients, I’ve found there is great power in learning from the change of the seasons. So we do the work. Outside. And sometimes it rains.

[Read: Go Take a Hike! (No, Really, It Helps.)]

Nature Therapy for ADHD: Next Steps

Free Download: Everything You Need to Know About Cognitive Behavioral Therapy (CBT)?
Read: How Green Time Promotes Better Focus
Read: Never Underestimate the Healing Power of Mother Nature

Aaron Winkler, M.D., is a board-certified psychiatrist in California. He founded and directed the Adult ADHD Clinic at Stanford University before deciding to pursue private practice.

Music Therapy Paired with Mindfulness Exercises Reduces ADHD Symptoms: New Studies

Melanie Wachsman — Tue, 20 May 2025 19:25:56 +0000

May 21, 2025

Listening to music while practicing mindfulness exercises may improve focus, mood, and emotional wellbeing in people with symptoms of ADHD, anxiety, and depression, according to two new studies.

A systematic review examining the relationship between music and ADHD found that music listening activates brain regions involved in sensory processing, motor control, and motivation — networks that are often dysregulated in individuals with attention deficit.¹

Traditional thinking suggests that quiet environments help sustain attention; however, the opposite may be true. The review, published in Behavioral Science, indicated that music, especially calm music with or without lyrics, can improve focus and performance in individuals with ADHD, especially when it is heard before or during tasks. Listening to music can also help filter out distractions, leading to improved learning and mood.

“People with ADHD benefit from ‘rhythmic entrainment,’ using strong, steady rhythms to imprint structure and consistency. This assists with regulation of attention and behavior,” said Roberto Olivardia, Ph.D., Clinical Instructor of Psychology at Harvard Medical School, during his presentation titled, “We Got the Beat: The Impact of Music on ADHD,” at the 2024 Annual International Conference on ADHD.

Listening to music could become counterproductive if it causes overstimulation or if the listener is doing a challenging task that requires significant cognitive resources, the researchers noted.

Music Therapy Boosts Emotional, Social Skills

Music listening may be self-directed or facilitated by a trained music therapist, as part of music therapy. Music therapy sessions often incorporate active music listening, playing instruments, songwriting, or singing, as well as passive music listening.

The review made a compelling case for using music therapy to complement ADHD medications and other recommended therapies, citing evidence for the efficacy of music therapy in reducing symptoms of ADHD. For example, active music-making can enhance working memory and social skills while decreasing aggression. Conversely, passive music listening may improve learning and reduce disruptive behaviors.

“These insights highlight the potential for music to contribute to more holistic, non-pharmacological approaches, offering individuals with ADHD new avenues for enhancing cognitive functioning and overall wellbeing,” the study’s authors wrote.

The systematic review included 20 studies published between 1981 and 2023, reflecting data from 1,170 participants aged 2 to 56 years. Several limitations exist: The studies primarily focused on children and adolescents, rather than adults. Variations in study methods and design also resulted in some inconsistent findings.

“Despite these limitations, this review provides a valuable foundation for future research on the interaction between ADHD and music,” the study’s authors wrote.

Mindfulness Paired with Music Reduces Stress, Improves Mood

Another recent, smaller study, published in Frontiers in Neuroscience, suggests that listening to music while performing mindfulness exercises activates areas of the brain and body related to stress and emotional regulation that could reduce moderate symptoms of anxiety and depression in adults.sup>2

The study, led by a team of researchers from the Yale School of Medicine, assessed the physiological impact of music mindfulness by recording heart rates and EEGs from 38 participants, aged 18 to 65, as they engaged in a bilingual, two-week mindfulness program centered on “focus” and “mindfulness.”

“Anxiety and depression reduce autonomic system activity, as measured by Heart Rate Variability (HRV), and exacerbate cardiac morbidity, while both music and mindfulness have been shown to increase HRV,” wrote the researchers.

They found that music mindfulness quickly improved HRV — a sign of better stress regulation — and changed brain wave patterns (measured by EEG) in areas of the brain linked to emotion, awareness, and decision-making.

Both virtual and in-person sessions incorporated similar guided mindfulness exercises, accompanied by live improvised music, music listening, or no music at all. In addition to wearing mobile heart rate and EEG monitors during each session, participants completed surveys regarding their stress levels, degree of mindfulness, state of consciousness, and level of social connection before and after each session.

The virtual group exhibited a significant decrease in stress and a significant increase in altered states of consciousness during the “focus” sessions, but not the “motivation” sessions. This contrasted with the in-person sessions, where stress decreased and mindfulness and altered state of consciousness increased during both Focus and Motivation sessions.

The researchers said that the differences in music composition features (tempo, key, mode) between “focus” and “motivation” sessions may explain the physiological differences observed in heart rate variability.

In-person sessions with music boosted feelings of social connection more than the virtual sessions did, underscoring the value of live, shared experiences in therapeutic settings.

“Our results imply that, while virtual sessions reduce stress, they do not have as extensive an effect on psychological states as in-person sessions do,” the researchers wrote. “Important aspects of live social interaction may drive feelings of social connection and serve as a key differentiator between live and virtual sessions.”

The researchers also observed gender-specific effects via HRV; women appeared to benefit more physiologically from music mindfulness than men.

While the findings from the Behavioral Science and Frontiers in Neuroscience studies contribute to a growing body of evidence supporting the use of music as a viable adjunct treatment for ADHD and mood disorders, both research teams emphasize the need for further investigation. Future studies would include randomized controlled trials, long-term outcome assessments, and greater representation of adult populations.

Sources

¹Saville, P., Kinney, C., Heiderscheit, A., Himmerich, H. (2025). Exploring the intersection of ADHD and music: A systematic review. Behav. Sci. https://doi.org/10.3390/bs15010065

²Ramirez, C., Alayine, G.A., Akafia, C., Selase, K., Adichie, K. et al. (2025). Music mindfulness acutely modulates autonomic activity and improves psychological state in anxiety and depression. Frontiers in Neuroscience. https://doi.org/10.3389/fnins.2025.1554156

“How Mindfulness and Meditation Build Emotional Regulation in People with ADHD” [Video Replay & Podcast #565]

Ted Cruz — Tue, 13 May 2025 19:24:18 +0000

Episode Description

ADHD brings with it intense emotions, impatience, and stress — and our inability to regulate these feelings affects everyday life as well as our most important relationships. We overreact to situations and feel angry or dejected due to real or perceived criticism. We have trouble calming down and sometimes react in ways that we later regret.

Mindfulness and related contemplative practices offer a powerful counterbalance to these feelings. They are valuable tools that aid in stress reduction, self-awareness, cognitive flexibility, self-compassion, habit change, and more. And here’s the good news: Contrary to popular belief, these practices do not require a still mind and body. When these practices are integrated with a proactive approach to physical health, they can create a stable emotional foundation that supports comprehensive, evidence-based ADHD care.

In this webinar, you will learn:

How ADHD impairs executive function and contributes to emotional dysregulation
About the clinical importance of addressing emotional health as a foundational step in ADHD treatment planning
How unmanaged emotional reactivity disrupts adherence to evidence-based ADHD interventions
How to evaluate the role of mindfulness and contemplative practices in promoting emotional self-regulation and cognitive flexibility
How to apply specific mindfulness-based strategies to support comprehensive, individualized ADHD care across clinical settings.

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Audacy; Spotify; Amazon Music; iHeartRADIO

Meditation for Emotional Regulation: Resources

Free Download: Make Mindfulness Work for You
Read: Meditation for the Bored & Restless: How to Practice Mindfulness with ADHD
Read: The Key to ADHD Emotional Regulation? Cultivating Gratitude, Pride & Compassion
Read: The Ultimate List of Mindfulness Exercises
eBook: Mindfulness & Meditation for ADHD Symptoms

Obtain a Certificate of Attendance

If you attended the live webinar on June 26, 2025 watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Mark Bertin, M.D., is a developmental pediatrician and author of How Children Thrive, Mindful Parenting for ADHD (#CommissionsEarned), Mindfulness and Self-Compassion for Teen ADHD (#CommissionsEarned), all of which integrate mindfulness into evidence-based pediatric care. Dr. Bertin is a faculty member at New York Medical College and the Windward Teacher Training Institute, and has served on advisory boards for APSARD, ADDitude Magazine, The Screen Time Action Network, Common Sense Media, and Reach Out and Read. His blog is available through Psychology Today and elsewhere.

In addition to his clinical and writing work, Dr. Bertin leads workshops and retreats that combine mindfulness and practical support for families and professionals. Join him for Held and Whole: A Restorative ADHD Retreat Rooted in Nature, October 10–12, 2025, in the Catskills. For more information, please visit www.developmentaldoctor.com.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

Webinar Sponsor

Living with ADHD can feel like an emotional rollercoaster – Inflow gets it. Their science-backed program, developed by ADHD experts, teaches mindfulness techniques tailored for ADHD brains so you can learn to pause, process, and respond instead of reacting. Build emotional regulation skills, create calmer routines, and take back control. Take the free ADHD traits quiz to get started.

ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

Dear Mr. Kennedy

Anni Layne Rodgers — Wed, 26 Feb 2025 22:28:54 +0000

Calls to Action: MAHA Commission Testimony & Advocacy

Submit your testimony to the MAHA Commission by contacting MAHA Commission Chair Robert Kennedy, Jr. at https://x.com/SecKennedy, and media@hhs.gov
Join the advocacy efforts organized by CHADD
Contact your national, state, and local representatives to share your testimony and the evidence-based research on ADHD below

February 26, 2025

Dear Secretary Kennedy,

As the Make America Healthy Again Commission begins its evaluation of published research on the chronic health conditions impacting American children, we urge it to consult with the esteemed clinicians associated with the American Professional Society of ADHD and Related Disorders (APSARD), the American Academy of Pediatrics (AAP), and the World Federation of ADHD regarding the established science on ADHD causes and treatments. Consensus within these groups, and among ADHD researchers worldwide, is strong and consistent regarding the following evidence-based findings:

ADHD is a chronic neurodevelopmental condition characterized by inattention, impulsivity, executive dysfunction, and/or hyperactivity that persists into adulthood for approximately 90% of patients.¹
ADHD is a highly genetic condition.^2,^3,⁴Lifestyle factors such as nutrition, exercise, and sleep exert epigenetic changes on DNA that influence how strongly or weakly ADHD genes are expressed. However, diet, physical activity, sleep, or screen use alone do not cause — and have not been shown to “cure” — ADHD.
The 16% increase in ADHD diagnoses over the last decade is due, in large part, to revised diagnostic criteria published in the DSM-5, which changed the maximum age of onset from 7 to 12 and added the first-ever qualifier symptoms for ADHD in adulthood. This wider net, along with improved education, training, and symptom recognition, particularly in historically overlooked girls and women, account for much of the diagnostic uptick, according to studies.^5,⁶
Scientific research has established no causal link between excessive screen time, video game play, or social media use and ADHD.⁷ Some studies suggest these habits may exacerbate inattention and impulsivity.^8,⁹
Scientific research has established no causal link between consumption of sugar, food additives, or food dyes and ADHD, though some studies show a heightened sensitivity among children with ADHD to these foods, which may exacerbate existing symptoms.¹⁰
Scientific research shows that prenatal and/or childhood exposure to tobacco, lead, pesticides, and polychlorinated biphenyls (PCBs) may increase the odds of ADHD in some children, however the studies do not find direct causality.^11,^12,^13,¹⁴
Several research studies have shown that consumption of a Western diet high in processed foods, fats, sugars, and salt is associated with higher rates of ADHD, however these studies demonstrate an association rather than causality.¹⁵
ADHD shortens an individual’s life expectancy by 7.5 years, on average.¹⁶ It is serious, potentially lethal, and associated with elevated risks for comorbid conditions ^17,¹⁸ including anxiety, depression,¹⁹ substance use disorder,²⁰ eating disorders,^21,²² obesity, and oppositional defiant disorder,²³ which commonly derails treatment plans and parenting strategies. People with ADHD are more likely to get into car accidents,²⁴ become hospitalized, and engage in self-harm than are their neurotypical peers.^25,^26,²⁷
In patients with the condition, ADHD medication use reduces the risk of death by 19%, the risk of overdose by 50%,²⁸ the risk of substance abuse by 50%,²⁹ and the risk of motor vehicle accidents by at least 38%.³⁰ Its effective symptom management improves patients’ self-esteem and efficacy, thereby reducing the risk of self-harm and suicide, as well as negative life outcomes such as unwanted pregnancy, incarceration, unemployment, and interruption of education.
The medications used to treat ADHD have been studied rigorously and used safely for 88 years. Amphetamine and methylphenidate safely and effectively reduce ADHD symptoms, with methylphenidate reducing symptoms by 70% to 90% in children and adults with the condition.^31,³² The effect sizes for ADHD medication are .8 to 1.0,³³ which are among the strongest in all of psychiatry. Clinical practice guidelines recommend medication as the first-line treatment for ADHD due to its overwhelming efficacy; for children with ADHD ages 4 to 6, parent behavior training is recommended by the AAP.³⁴
According to the CDC, just 53.6% of all children and teens with ADHD reported they were actively treating their symptoms with medication in 2022. Because stimulant medications are classified as Schedule II drugs under the Controlled Substances Act, they are tightly regulated; supplies are limited to 30 days and prescribing clinicians must authorize monthly refills. The widely reported ADHD medication shortage has disrupted treatment for millions of patients across the country since 2022.³⁵
Caregivers and adults with ADHD surveyed by ADDitude rate medication as the most effective treatment for ADHD, however less than half of parents report that they chose to medicate their children within 6 months of diagnosis. They report changing diet, limiting screen time, supplementing with fish oil, and increasing physical activity before ultimately using medication to achieve the symptom improvement necessary for academic and social success.
The mild to moderate side effects associated with ADHD medication include appetite suppression, irritability or moodiness, sleep problems, and headaches. There is no evidence that ADHD medication use leads to dependency or broader substance abuse; in fact, research shows that ADHD medication use is protective against substance use disorder in individuals with ADHD.³⁶
The non-stimulant medications used to treat ADHD, such as atomoxetine, guanfacine, and clonidine, have an effect size of .4 to .7 and are considered a second-line treatment appropriate for patients who do not tolerate or cannot take stimulants.^37,^38,³⁹
Clinical guidelines promote the use of multimodal treatment plans that pair prescription medication with complementary approaches to ADHD management. The nonpharmacological interventions shown to be most effective at reducing ADHD symptoms in children are behavioral therapy (effect size of .5 to.8 when used on its own),⁴⁰ exercise (effect size of .4 to .6 when used on its own),⁴¹ sleep hygiene and interventions (effect size of .5 to .8 when used on their own),⁴² and dietary interventions (effect size of .2 to .5 when used on their own).⁴³
Behavioral therapy, principally parent training, has an elevated and improved effect when used in conjunction with ADHD medication.⁴⁴ Behavioral therapy is used by just 44% of pediatric patients, in part because it’s not always covered by medical insurance and knowledgeable providers are scarce.
One meta-analysis of randomized, placebo-controlled trials showed that supplementation with high doses of omega-3 fatty acids has a small positive impact on attention and hyperactivity in children.⁴⁵
Research suggests that restricting the consumption of synthetic food dyes does benefit some children with ADHD, though aggregate effects are quite small.⁴⁶
When engaging in vigorous cardiovascular exercise, the brain releases endorphins. Levels of dopamine, norepinephrine, and serotonin also increase with exercise, thus improving focus, working memory, and mood to enable better learning.
Cognitive behavioral therapy (CBT), though more commonly prescribed to adult patients, has been shown to improve core ADHD symptoms in adolescents when used in conjunction with ADHD medication.⁴⁷
Neurofeedback uses an electroencephalogram (EEG) to measure brain activity and train the patient to produce brain wave patterns like those of a non-ADHD brain. Neurofeedback has not shown enough effectiveness in studies to be recommended as a “stand-alone” treatment for ADHD and there is little evidence that neurofeedback reduces ADHD symptoms long-term. In addition, neurofeedback is seldom covered by insurance and involves a significant investment of time and money.^48,^49,⁵⁰
According to research, brain training does not reduce ADHD symptoms. There is no evidence that a patient can train a brain to improve working memory, or any other executive function.^51,^52,⁵³

Thank you for reviewing the evidence-based research highlighted above. We welcome follow-up questions from the Commission as it devises recommendations based on science that may benefit the health and wellbeing of the 22 million Americans with ADHD, whom ADDitude has served for the last 26 years. We support their personal liberty to pursue and maintain the treatments that benefit their ADHD brains, which are a tremendous asset to this nation.

Sincerely,
Anni Rodgers
General Manager, ADDitude

Sources

¹Sibley, M., Arnold, L, Swanson, J. et.al. (13 August 2021). Variable patterns of remission from ADHD in the multimodal treatment study of ADHD. The American Journal of Psychiatry. https://doi.org/10.1176/appi.ajp.2021.21010032

²Faraone, Stephen V. et al. Molecular Genetics of Attention-Deficit/Hyperactivity Disorder, Biological Psychiatry, Volume 57, Issue 11, 1313 – 1323

³Liuyan Zhang, Suhua Chang, Zhao Li, Kunlin Zhang, Yang Du, Jurg Ott, Jing Wang, ADHDgene: a genetic database for attention deficit hyperactivity disorder, Nucleic Acids Research, Volume 40, Issue D1, 1 January 2012, Pages D1003–D1009, https://doi.org/10.1093/nar/gkr992

⁴Gizer, I.R., Ficks, C. & Waldman, I.D. Candidate gene studies of ADHD: a meta-analytic review. Hum Genet 126, 51–90 (2009). https://doi.org/10.1007/s00439-009-0694-x

⁵Mowlem, F.D., Rosenqvist, M.A., Martin, J. et al. Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment. Eur Child Adolesc Psychiatry 28, 481–489 (2019). https://doi.org/10.1007/s00787-018-1211-3

⁶Abdelnour E, Jansen MO, Gold JA. ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis? Mo Med. 2022 Sep-Oct;119(5):467-473. PMID: 36337990; PMCID: PMC9616454.

⁷Nikkelen, S. W., Valkenburg, P. M., Huizinga, M., & Bushman, B. J. (2014). “Media use and ADHD-related behaviors in children and adolescents: A meta-analysis.” Developmental Psychology, 50(9), 2228-2241.

⁸Madigan S, Browne D, Racine N, Mori C, Tough S. Association Between Screen Time and Children’s Performance on a Developmental Screening Test. JAMA Pediatr. 2019;173(3):244–250. doi:10.1001/jamapediatrics.2018.5056

⁹Yifei, P, Xuechun, L,Yu, Y. (2023). Screen use and its association with ADHD symptoms among children: a systematic review. MEDS Public Health and Preventive Medicine, 3.10.23977/phpm.2023.030301

¹⁰Nigg JT, Lewis K, Edinger T, Falk M. Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. J Am Acad Child Adolesc Psychiatry. 2012 Jan;51(1):86-97.e8. doi: 10.1016/j.jaac.2011.10.015. PMID: 22176942; PMCID: PMC4321798.

¹¹Huang L, Wang Y, Zhang L, Zheng Z, Zhu T, Qu Y, Mu D. Maternal Smoking and Attention-Deficit/Hyperactivity Disorder in Offspring: A Meta-analysis. Pediatrics. 2018 Jan;141(1):e20172465. doi: 10.1542/peds.2017-2465. PMID: 29288161.

¹²Goodlad JK, Marcus DK, Fulton JJ. Lead and Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms: a meta-analysis. Clin Psychol Rev. 2013 Apr;33(3):417-25. doi: 10.1016/j.cpr.2013.01.009. Epub 2013 Jan 29. PMID: 23419800.

¹³Nigg JT, Nikolas M, Mark Knottnerus G, Cavanagh K, Friderici K. Confirmation and extension of association of blood lead with attention-deficit/hyperactivity disorder (ADHD) and ADHD symptom domains at population-typical exposure levels. J Child Psychol Psychiatry. 2010 Jan;51(1):58-65. doi: 10.1111/j.1469-7610.2009.02135.x. Epub 2009 Nov 23. PMID: 19941632; PMCID: PMC2810427.

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¹⁶O’Nions E, El Baou C, John A, et al. Life expectancy and years of life lost for adults with diagnosed ADHD in the UK: matched cohort study. The British Journal of Psychiatry. Published online 2025:1-8. doi:10.1192/bjp.2024.199

¹⁷Gnanavel S, Sharma P, Kaushal P, Hussain S. Attention deficit hyperactivity disorder and comorbidity: A review of literature. World J Clin Cases 2019; 7(17): 2420-2426 [PMID: 31559278 DOI: 10.12998/wjcc.v7.i17.2420]

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¹⁹Babinski DE, Neely KA, Ba DM, Liu G. Depression and Suicidal Behavior in Young Adult Men and Women With ADHD: Evidence From Claims Data. J Clin Psychiatry. 2020 Sep 22;81(6):19m13130. doi: 10.4088/JCP.19m13130. PMID: 32965804; PMCID: PMC7540206.

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²¹Nazar BP, Bernardes C, Peachey G, Sergeant J, Mattos P, Treasure J. The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. Int J Eat Disord. 2016 Dec;49(12):1045-1057. doi: 10.1002/eat.22643. Epub 2016 Nov 15. PMID: 27859581.

²²Curtin, Carol & Pagoto, Sherry & Mick, Eric. (2013). The association between ADHD and eating disorders/pathology in adolescents: A systematic review. Open Journal of Epidemiology. 3. 193-202. 10.4236/ojepi.2013.34028.

²³Nock MK, Kazdin AE, Hiripi E, Kessler RC. Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the National Comorbidity Survey Replication. J Child Psychol Psychiatry. 2007 Jul;48(7):703-13. doi: 10.1111/j.1469-7610.2007.01733.x. PMID: 17593151.

²⁴Curry AE, Yerys BE, Metzger KB, Carey ME, Power TJ. Traffic Crashes, Violations, and Suspensions Among Young Drivers With ADHD. Pediatrics. 2019 Jun;143(6):e20182305. doi: 10.1542/peds.2018-2305. Epub 2019 May 20. PMID: 31110164; PMCID: PMC6564068.

²⁵Ward JH, Curran S. Self-harm as the first presentation of attention deficit hyperactivity disorder in adolescents. Child Adolesc Ment Health. 2021 Nov;26(4):303-309. doi: 10.1111/camh.12471. Epub 2021 May 3. PMID: 33939246.

²⁶Hinshaw SP, Owens EB, Zalecki C, Huggins SP, Montenegro-Nevado AJ, Schrodek E, Swanson EN. Prospective follow-up of girls with attention-deficit/hyperactivity disorder into early adulthood: continuing impairment includes elevated risk for suicide attempts and self-injury. J Consult Clin Psychol. 2012 Dec;80(6):1041-1051. doi: 10.1037/a0029451. Epub 2012 Aug 13. PMID: 22889337; PMCID: PMC3543865.

²⁷Ping-I Lin, Weng Tong Wu, Enoch Kordjo Azasu, Tsz Ying Wong, Pathway from attention-deficit/hyperactivity disorder to suicide/self-harm, Psychiatry Research, Volume 337, 2024, 115936, ISSN 0165-1781, https://doi.org/10.1016/j.psychres.2024.115936.

²⁸Li L, Zhu N, Zhang L, Kuja-Halkola R, D’Onofrio BM, Brikell I, Lichtenstein P, Cortese S, Larsson H, Chang Z. ADHD Pharmacotherapy and Mortality in Individuals With ADHD. JAMA. 2024 Mar 12;331(10):850-860. doi: 10.1001/jama.2024.0851. PMID: 38470385; PMCID: PMC10936112.

²⁹Faraone SV, Wilens T. Does stimulant treatment lead to substance use disorders? J Clin Psychiatry. 2003;64 Suppl 11:9-13. PMID: 14529324.

³⁰Chang Z, Quinn PD, Hur K, et al. Association Between Medication Use for Attention-Deficit/Hyperactivity Disorder and Risk of Motor Vehicle Crashes. JAMA Psychiatry. 2017;74(6):597–603. doi:10.1001/jamapsychiatry.2017.0659

³¹Spencer, Thomas et al. A large, double-blind, randomized clinical trial of methylphenidate in the treatment of adults with attention-deficit/hyperactivity disorder, Biological Psychiatry, Volume 57, Issue 5, 456 – 463

³²Barbaresi WJ, Katusic SK, Colligan RC, Weaver AL, Leibson CL, Jacobsen SJ. Long-term stimulant medication treatment of attention-deficit/hyperactivity disorder: results from a population-based study. J Dev Behav Pediatr. 2006 Feb;27(1):1-10. doi: 10.1097/00004703-200602000-00001. PMID: 16511362.

³³Faraone, S. V., & Buitelaar, J. (2010). “Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis.” European Child & Adolescent Psychiatry, 19(4), 353-364.

³⁴Centers for Disease Control and Prevention. (2022, March 8). Treatment recommendations for healthcare providers. https://www.cdc.gov/adhd/hcp/treatment-recommendations/index.html.

³⁵Grossi, G. US ADHD Stimulant Shortage Highlights Growing Challenges in Adult Treatment. AJMC. 2024 Nov. https://www.ajmc.com/view/us-adhd-stimulant-shortage-highlights-growing-challenges-in-adult-treatment

³⁶Quinn PD, Chang Z, Hur K, Gibbons RD, Lahey BB, Rickert ME, Sjölander A, Lichtenstein P, Larsson H, D’Onofrio BM. ADHD Medication and Substance-Related Problems. Am J Psychiatry. 2017 Sep 1;174(9):877-885. doi: 10.1176/appi.ajp.2017.16060686. Epub 2017 Jun 29. PMID: 28659039; PMCID: PMC5581231.

³⁷Newcorn, J. H., Kratochvil, C. J., Allen, A. J., Casat, C. D., Ruff, D. D., Moore, R. J., & Michelson, D. (2008). “Atomoxetine and osmotically released methylphenidate for the treatment of attention deficit hyperactivity disorder: acute comparison and differential response.” American Journal of Psychiatry, 165(6), 721-730.

³⁸Sallee FR, McGough J, Wigal T, Donahue J, Lyne A, Biederman J; SPD503 STUDY GROUP. Guanfacine extended release in children and adolescents with attention-deficit/hyperactivity disorder: a placebo-controlled trial. J Am Acad Child Adolesc Psychiatry. 2009 Feb;48(2):155-65. doi: 10.1097/CHI.0b013e318191769e. PMID: 19106767.

³⁹Connor DF, Findling RL, Kollins SH, Sallee F, López FA, Lyne A, Tremblay G. Effects of guanfacine extended release on oppositional symptoms in children aged 6-12 years with attention-deficit hyperactivity disorder and oppositional symptoms: a randomized, double-blind, placebo-controlled trial. CNS Drugs. 2010 Sep;24(9):755-68. doi: 10.2165/11537790-000000000-00000. PMID: 20806988.

⁴⁰Fabiano GA, Pelham WE Jr, Coles EK, Gnagy EM, Chronis-Tuscano A, O’Connor BC. A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clin Psychol Rev. 2009 Mar;29(2):129-40. doi: 10.1016/j.cpr.2008.11.001. Epub 2008 Nov 11. PMID: 19131150.

⁴¹Cerrillo-Urbina AJ, García-Hermoso A, Sánchez-López M, Pardo-Guijarro MJ, Santos Gómez JL, Martínez-Vizcaíno V. The effects of physical exercise in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis of randomized control trials. Child Care Health Dev. 2015 Nov;41(6):779-88. doi: 10.1111/cch.12255. Epub 2015 May 18. PMID: 25988743.

⁴²Ogundele MO, Yemula C. Management of sleep disorders among children and adolescents with neurodevelopmental disorders: A practical guide for clinicians. World J Clin Pediatr. 2022 Mar 15;11(3):239-252. doi: 10.5409/wjcp.v11.i3.239. PMID: 35663001; PMCID: PMC9134149.

⁴³Nigg JT, Lewis K, Edinger T, Falk M. Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. J Am Acad Child Adolesc Psychiatry. 2012 Jan;51(1):86-97.e8. doi: 10.1016/j.jaac.2011.10.015. PMID: 22176942; PMCID: PMC4321798.

⁴⁴A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry. 1999 Dec;56(12):1073-86. doi: 10.1001/archpsyc.56.12.1073. PMID: 10591283.

⁴⁵Richardson, A. J., Puri, B. K. (2002). “A randomized double-blind, placebo-controlled study of the effects of supplementation with highly unsaturated fatty acids on ADHD-related symptoms in children with specific learning difficulties.” Progress in Neuro-Psychopharmacology & Biological Psychiatry, 26(2), 233-239.

⁴⁶Nigg JT, Lewis K, Edinger T, Falk M. Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. J Am Acad Child Adolesc Psychiatry. 2012 Jan;51(1):86-97.e8. doi: 10.1016/j.jaac.2011.10.015. PMID: 22176942; PMCID: PMC4321798.

⁴⁷Ojinna BT, Parisapogu A, Sherpa ML, Choday S, Ravi N, Giva S, Shantha Kumar V, Shrestha N, Tran HH, Penumetcha SS. Efficacy of Cognitive Behavioral Therapy and Methylphenidate in the Treatment of Attention Deficit Hyperactivity Disorder in Children and Adolescents: A Systematic Review. Cureus. 2022 Dec 17;14(12):e32647. doi: 10.7759/cureus.32647. PMID: 36660538; PMCID: PMC9845961.

⁴⁸Gevensleben, H., Moll, G. H., Rothenberger, A., & Heinrich, H. (2014). Neurofeedback in attention-deficit/hyperactivity disorder – different models, different ways of application. Frontiers in human neuroscience, 8, 846. https://doi.org/10.3389/fnhum.2014.00846

⁴⁹ Arnold, L. E., Lofthouse, N., Hersch, S., Pan, X., Hurt, E., Bates, B., Kassouf, K., Moone, S., & Grantier, C. (2013). EEG neurofeedback for ADHD: double-blind sham-controlled randomized pilot feasibility trial. Journal of attention disorders, 17(5), 410–419. https://doi.org/10.1177/1087054712446173

⁵⁰Ramsay, J. R. (2010). Neurofeedback and neurocognitive training. In J. R. Ramsay, Nonmedication treatments for adult ADHD: Evaluating impact on daily functioning and well-being (pp. 109–129). American Psychological Association. https://doi.org/10.1037/12056-006

⁵¹ Gathercole S. E. (2014). Commentary: Working memory training and ADHD – where does its potential lie? Reflections on Chacko et al. (2014). Journal of child psychology and psychiatry, and allied disciplines, 55(3), 256–257. https://doi.org/10.1111/jcpp.12196

⁵² Chacko, A., Bedard, A. C., Marks, D. J., Feirsen, N., Uderman, J. Z., Chimiklis, A., Rajwan, E., Cornwell, M., Anderson, L., Zwilling, A., & Ramon, M. (2014). A randomized clinical trial of Cogmed Working Memory Training in school-age children with ADHD: a replication in a diverse sample using a control condition. Journal of child psychology and psychiatry, and allied disciplines, 55(3), 247–255. https://doi.org/10.1111/jcpp.12146

⁵³ Hulme, C., & Melby-Lervåg, M. (2012). Current evidence does not support the claims made for CogMed working memory training. Journal of Applied Research in Memory and Cognition, 1(3), 197–200. https://doi.org/10.1016/j.jarmac.2012.06.006

ADHD Therapists Share Their Toughest Cases

Carole Fleck — Fri, 21 Feb 2025 10:28:30 +0000

Adults with ADHD bring deeply personal and unique struggles to their therapists. And, in many cases, personal growth and development hinges on better management of the condition.

ADDitude magazine asked practitioners who specialize in ADHD about their clients’ toughest problems, and the strategies that move them in the right direction. Here is what they said.

Identify the Benefits

Ari Tuckman, Psy.D.

As Russell Barkley, Ph.D., has famously said, ADHD is not about knowing but about doing. This is especially true with co-occurring conditions that make it even harder to get going. I have engaged in some great conversations in session about what to do and how to do it, but then faced disappointing weeks when clients struggled to follow through – again.

It’s easy with ADHD to feel like too much of life is about avoiding negatives, so I make a point of talking about the positives that clients will gain from doing what we discuss. For example, walking into a work meeting feeling confident rather than hoping to be ignored. Or getting into bed earlier tonight so you’ll be more effective tomorrow and then have time after work to meet up with friends.

We all benefit from working toward something that is important and meaningful. Anxiety and depression can steal this sense of purpose, so you need to figure out what that is for you. This will become your source of real, lasting motivation.

Value Persistence Over Perfection

Sharon Saline, Psy.D.

I really enjoy the outside-the-box thinking that people bring to our sessions – their humor, their intelligence, their candor about their strengths and limitations, and their sensitivity. In my office, laughter is often mixed with personal insights, curiosity, and tears.

[Get This Free Download: Get the Adult’s Guide to Treating ADHD]

The main challenges I see in my work with clients with ADHD: consistently inconsistent motivation, a hallmark of ADHD, mixed with perfectionism and helplessness. All of my clients sincerely want to change but wrestle with how. They are willing to try a new technique or take a risk, but they struggle with persistence, unrealistic standards, and self-esteem. They become discouraged and give up.

When this occurs, we begin by exploring the obstacles they face, patterns that might be recurring, and any past successes that could be applied to this situation. We work together to adjust their expectations about “success,” look for something to re-engage them, and then pivot to trying again with new tweaks and a different perspective. This process helps them regroup, aim for steadiness instead of perfectionism, and feel empowered.

Determine the Conditions at Play

Roberto Olivardia, Ph.D.

ADHD rarely travels alone. Yet many patients are unaware of the hand that ADHD plays in the etiology, presentation, and/or course of their other conditions – which may be unidentified or misdiagnosed. This is particularly true of ADHD in adults, since many symptoms mimic and overlap with traits of other disorders.

Patients are perceived as complicated when previous treatment methods seem ineffective. However, a primary reason for this is the clinical underappreciation of ADHD. Even when ADHD has been diagnosed, many patients are told that ADHD treatment is secondary to treatment of “more serious” problems. Meanwhile, untreated ADHD often undermines the treatment of other conditions. Patients feel unfixable.

[Read More from Dr. Olivardia]

My role is to empathically work with a patient to place all the pieces of the diagnostic puzzle on the table. You have to inquire about each of the problems to capture the story of the symptoms. For example, not sleeping for three consecutive days could be a symptom of a manic episode, a cocaine-fueled bender, a depressive episode, or because you were writing your senior honors thesis (and I have experience in this) after your ADHD had you put it off until 72 hours before the deadline.

As clinicians, we always have to ask, “What diagnosis is driving the bus?” – especially when multiple diagnoses are present. Only then can we properly put the puzzle pieces together and deliver to our patients the heartfelt message that they are not broken but simply needed more time and examination for the proper treatment to be effective.

Put On Your Own Oxygen Mask First

Dawn K. Brown, M.D.

Women of color with ADHD carry an immense load. They balance careers, family life, and societal expectations while managing ADHD, not to mention other conditions like anxiety or hormonal imbalances. I always tell my patients that taking care of themselves is not optional. In a world that often expects them to be last, they must intentionally choose to put themselves first. Without that, everything else falls apart.

I begin by helping them create a personal roadmap for managing life with ADHD. For instance, I had a patient who was a single mother with a demanding career. She felt overwhelmed, always chasing her to-do list but never catching up. We started by breaking down her day, prioritizing tasks, and integrating time for self-care. I introduced her to time-blocking: setting specific times for work, family, and herself. She also used organization apps, like Todoist, to break down tasks into smaller, manageable steps. Over time, she learned to delegate more responsibilities at home and let go of the pressure to do everything perfectly.

We also focused on setting boundaries. For many women of color, there’s pressure to be everything to everyone. I encourage my patients to set limits and say “no” without guilt. This might mean communicating with family about their need for quiet time or asking for help at work to lighten the load.

Unite and Conquer

Paul Mitrani, M.D., Ph.D.

My adult clients report frequent problems in relationships, especially when they have ADHD and their partner does not understand the difficulties it brings, like forgetting to do things or neglecting to share responsibilities. When must-dos fall by the wayside, that’s when trouble begins. It’s important for individuals and their partners to think about how to delegate – this is my strength, this is yours, and this is how we’ll partner up. I also work to educate the partner that this is a medical condition and not just the other person forgetting or not seeming to be as interested in things.

How to Set Emotional Boundaries: Next Steps

Free Download: Who Can Treat ADHD?
Read: Realistic Solutions for Managing Life, Time & Emotions
Read: 33 Ways to Prioritize Your Mental Health

Get Unstuck, Untriggered, Unashamed with DBT

Nathaly Pesantez — Thu, 06 Feb 2025 10:30:39 +0000

Dialectical behavioral therapy (DBT) has come a long way from its origins as a treatment for borderline personality disorder. Designed to help individuals learn to manage intense emotions, reduce self-harm, and improve interpersonal relationships, DBT has been modified to address a constellation of conditions, especially those where emotional dysregulation features prominently, like ADHD.

DBT can help obvious forms of emotional dysregulation in ADHD, like overblown reactions. It can also address other ADHD-related challenges like low motivation problems and high procrastination. Its principles and skills target common frustrations with both emotional regulation and executive function that lead to distractibility to disorganization.

What Is DBT?

DBT is a skills-based form of talk therapy designed to help people manage intense emotions, improve relationships, and make thoughtful decisions. It used to treat ADHD, anxiety, depression, and more.

DBT focuses on four core areas:

Emotion Regulation: Understanding and balancing emotions
Distress Tolerance: Managing crises without making them worse
Mindfulness: Staying present and aware in the moment
Interpersonal Effectiveness: Communicating clearly and setting boundaries

1. Master Emotional Regulation

Emotions Are Not the Problem

Many adults say emotional dysregulation is the most impairing aspect of living with ADHD. DBT reminds us that emotions are important because they tell us about our environment and move us to action. Ignoring emotions is not the answer; learning to dance with them is key. With frequent practice, the following skills can improve emotional regulation.

Understand and label emotions. Investigating your emotions will allow you to become clearer about what’s really going on. Labeling is also an act of mindfulness that cools the amygdala and limbic system. You can say to yourself, “I am experiencing ___ right now.”
Accept emotions. Experiencing emotions intensely does not make you an irrational or bad person. Fighting their presence only depletes energy that is better used taking positive action to regulate them.

Improve Your Emotional Baseline

Taking care of your overall emotional health can reduce the frequency and intensity of emotions and improve your regulation of them.

Practice daily mastery. When you actively seek challenges, you are exerting influence on your immediate environment, which builds self-efficacy and self-esteem. So do something every day that improves your sense of competence. Mastery can be found in the mundane, whether it’s doing the laundry or the dishes. (It isn’t important whether the activity you find challenging is also challenging to others.)
Seek pleasant experiences. Focusing on positive experiences will help you break out of negative rumination cycles and build resilience against life’s stressors. Each day, engage in activities that bring you a sense of interest, satisfaction, and joy. These activities can be simple, from gardening and listening to music to watching a show with your family.

[Get This Free Download: Emotional Regulation & Anger Management Scripts]

2. Reverse ADHD Paralysis

“Opposite Action” is a DBT skill for calming emotions that are disproportionate to a situation. It entails doing the opposite of what your emotions tell you to do to interrupt and eventually change your feelings. Feel the urge to yell? Speak softly or adopt a half smile instead. Feel like withdrawing? Call a friend instead.

Opposite action is also helpful for overcoming ADHD paralysis. This skill can help you generate the emotional energy you need to start and complete tasks that you find boring or overwhelming. Are you frozen on the couch and know that you need to wash the dishes? Try wiggling your toes. Bring one leg off. Then the other. Stand on your feet for a few moments. Bring one foot in front of the other and make your way to the sink. Adopt a determined facial expression. Roll up your sleeves. Say aloud, “I’m going to wash this dish.”

3. Cope with Discomfort

Discomfort is a core part of our lives. We feel it when we try to control impulsive behaviors or emotional outbursts. We feel it when fielding comments and criticism. And sometimes when we try to manage this discomfort, we may end up engaging in self-sabotaging behaviors that worsen feelings of shame.

[Read: 13 Ways to Beat ADHD Paralysis]

Enter distress tolerance — a core DBT module that centers on the ability to endure stressful, overwhelming thoughts, feelings, and situations without engaging in self-defeating behaviors. Distress tolerance skills help you cope with tough feelings and reduce their intensity. The following distress tolerance exercises activate the parasympathetic nervous system in real time and downregulate flooded emotional states:

TIPP

Temperature: Hold an ice cube or splash cold water on your face.
Intense exercise: Do jumping jacks or sprint in place.
Paced breathing: Take slow, deep breaths, extending your exhale.
Paired muscle relaxation: Tense a muscle group while inhaling, then release as you exhale.

STOP

Stop. Physically don’t move a muscle. Freeze.
Take a step back. Create some distance, literally and/or figuratively, from the person you’re in conflict with or the frustrating task. Leave the room if possible. Think, “What’s happening here? What are the thoughts and emotions I’m having?”
Observe. Notice what’s happening without holding onto anything.
Proceed mindfully. Move forward with intention and in a way that aligns with your values.

4. Practice a Mindful Life

Mindfulness is at the root of all DBT skills. Learning how to pay attention to the present moment — an ongoing practice — will allow you to balance reason with emotion and act in ways that better serve you. In DBT, this state is called “Wise Mind,” and it is activated by practicing the following skills:

DBT Skills for ADHD: Next Steps

Free Download: What Is Dialectical Behavior Therapy (DBT)?
Read: DBT — The Emotional Control Therapy You Need Now
Read: The Emotional Resilience Playbook for People with Big Emotions

The content for this article was derived from the ADDitude ADHD Experts webinar titled, “How DBT Promotes Emotional Regulation, Distress Tolerance, and Mindfulness” [Video Replay & Podcast #527] with Scott Spradlin, LPC, which was broadcast on October 31, 2024.

33 Ways to Prioritize Your Mental Health

Mon, 16 Dec 2024 10:22:03 +0000

We make time for everything and everyone but ourselves. We consistently prioritize the needs of others. We feel guilty erecting boundaries. And this struggle to carve out space for our own wellbeing is the biggest barrier to mental and emotional health for more than half of adults with ADHD, according to a new survey of 1,898 ADDitude readers.

“I have a hard time putting myself first. I worry about others to my own detriment.”

“I really want to journal but, when I remember to, I spend an hour writing and then find myself thinking, ‘I don’t have time for this!’”

On a 10-point scale, where 10 is extremely satisfied, ADDitude readers rated their mental and emotional health a 5.2. Additional barriers to mental health care cited by readers include the following:

Defining effective self-care strategies: 45%
Sticking with a routine: 45%
Practicing mindful meditation and/or gratitude: 38%
Affording a mental-health practitioner: 23%

“Insurance makes things impossible sometimes. Also, I’ve had to switch mental healthcare doctors many times due to clashes of ideals and personality. One actually said ADHD wasn’t real and that I just needed discipline to work through my ‘laziness’.”

“I have not found a single counselor who is highly familiar with adult ADHD and its nasty companions.”

[Get This Free Download: Make Mindfulness Work for You]

Top Mental Health Apps and Tools

Following are the top apps, websites, podcasts, books, and other resources recommended by ADDitude readers for improving mental and emotional health.

Self-Care Apps

Insight Timer: Guided meditation sessions, music, and courses for mindfulness and relaxation
Balance: Personalized meditation that adapts sessions to your goals and progress
Gratitude: Foster daily gratitude and positivity via journaling
Happify: Activities and games to boost happiness and reduce stress
Headspace: Mindfulness and meditation tools, sleep sounds, mindful movement, and exercise.
Calm: Sleep stories and music, meditation and inspirational stories, mood tracking, and relaxation tools
Healthy Minds: Unlock wellbeing my practicing four skills — awareness, connection, insight, and purpose
Finch: Nurture a virtual pet by completing daily wellness and self-care tasks

Self-Care YouTube Channels, Podcasts, and Websites

How to ADHD: A YouTube channel created by Jessica McCabe that offers practical tools and insights for living with ADHD.
The Happiness Lab: A podcast by Laurie Santos, Ph.D., that explores science-backed strategies for a happier life.
The Teen Anxiety Maze : A podcast by Cynthia Coufal, a teen anxiety coach.
Therapy in a Nutshell : A mental health and strategies podcast, YouTube channel, and website by Emma McAdam, LMFT.
Something Shiny: A podcast by therapists David Kessler and Isabelle Richards that tackles ADHD and relationships with humor and authenticity.
ADDitude ADHD Experts: Leading experts in ADHD and mental health share the latest research and proven strategies.

Self-Care Books

ADHD 2.0 (#CommissionsEarned)by Edward M. Hallowell, M.D., and John Ratey, M.D.
Your Brain Is Not Broken (#CommissionsEarned) by Tamara Rosier, Ph.D.
The Gift of Imperfection (#CommissionsEarned) by Brené Brown
Get Out of Your Mind and Into Your Life (#CommissionsEarned) by Steven C. Hayes and Spencer Smith

Daily Self-Care Approaches

To prioritize self-care, many ADDitude readers incorporate small practices and routines into daily life. Here is their advice.

“Take three deep breaths a few times a day. Connect it to something you are doing anyway; do it after going to the bathroom first thing in the morning or when you get into your car.”

“I have a ‘blow off steam’ playlist that I listen to when I feel wired or hostile. (I also have calming playlists!)”

“As weird as it sounds, I find ChatGPT great for journaling. It asks me questions about what I’ve written and helps me develop a deeper understanding of my thoughts.”

“Exercise is the magic medicine for my mental health. I notice a difference in my energy, focus, attitude, and motivation to get things done when I exercise. I try to walk three days a week and attend a class at my local YMCA three days a week.”

“I write about three good things every morning. It gives me a sense of achievement and agency and calms my anxiety.”

“I have set aside Fridays after work as ‘nothing needs to get done’ time.”

“I try to have 30 minutes of ‘me’ time every day. I take a bath, listen to an audiobook, or watch a show.”

[Read: 31 Ways to Work Out the Kinks in Your Workout Plan]

The Power of Therapy and Medication for Mental Health

Readers report that taking prescribed medications and working with mental health professionals do wonders for their health, and assigned the following “helpfulness” ratings to each tool (on a 5-point scale where 5 is extremely helpful):

Therapist (in-person or online): 4.11
Medication for ADHD: 3.91
Medication for another condition: 3.88
Psychiatrist: 3.67

“ADHD meds have helped so much with emotional regulation that I’m quite upset I didn’t have access to them earlier!”

“Medication for anxiety has largely cleared up my ADHD mess, so much that I’m able to handle other sides that come up (time blindness, forgetfulness, etc.)”

“Accessing a therapist is paramount to understanding your emotions, triggers, and boundaries.”

“Medication can be so helpful, but it can take a while to figure out what works for you. Try some stuff and don’t be afraid to try something else if it is not working or if side effects make life unfun. Also, know that medication is a helpful tool, but it doesn’t do the work for you. It helps you do the work of setting up systems, finding coping skills and accommodations, and looking honestly at how your current patterns are helping or hurting you as you seek to be the best you.”

More Recommended Mental Health Supports

What other supports are helpful for improving mental and emotional health? ADDitude readers contributed the following “helpfulness” ratings:

ADHD coach: 3.67
Yoga or meditation class: 3.50
Spouse, family member, friend: 3.38
Anger-management training: 2.75
Journaling: 3.08

“Get a good yoga teacher who focuses on the emotional benefits of yoga as well as the physical benefits. It is so much more than exercise and is really beneficial for all sorts of ADHD symptoms, too.”

“Find safe spaces to talk about your feelings, even if it is just an online community of strangers. Communities of people with ADHD are great to engage with because they have empathy for what you are experiencing and often really great advice for ways to better your daily life.”

“There is something therapeutic about writing on paper while curled up in a chair. It clears my mind and gets the chaos out of my head.”

“My most helpful experiences come from seeing others with similar struggles and finding that I am normal.”

How to Improve Mental Health: Next Steps

Celebrate Every Step: Join the Small Wins Appreciation Network!
Read: 11 Self Care Strategies for ADHD Brains
Read: “Your ADHD Self-Improvement Plan — 6 Steps to a Better You”
Join Us! ADHD Support Group for Adults