ADHD is a chronic disorder which is not cured; however, its symptoms can be treated effectively in both children and adults. Since comorbidity in ADHD individuals is the rule and not the exception, an integrated treatment plan should follow careful diagnostic assessment of ADHD and associated comorbids. Ideally, treatment program for children should involve parents and teachers, while the adult’s one partner or close relationships, if available.
The multimodal approach includes:
- psycho-education of ADHD and comorbid disorders
- medication for ADHD and comorbid disorders
- cognitive behavior psychotherapy (individual and group)
- family therapy
Specialized personnel undertake the task to educate and support the patient and ideally also the partner or family about ADHD symptoms and impairment. The psycho-education focus on the recognition of the difficulties associated with the disorder and consequently applies the required strategies to improve the family function and to minimize the negative feelings and conflicts. Often this process offers new insights into past difficulties.
Stimulants such as methylphenidate are the most common type of medication used for treating ADHD in Greece. Although it may seem counterintuitive to treat hyperactivity with a stimulant, these medications actually activate brain circuits that support attention and focused behavior, thus reducing hyperactivity. In addition, non-stimulant medication, such as atomoxetine, are also available. ADHD medications usually reduce hyperactivity and impulsivity and improve the ability to focus, work, and learn. Medications also may improve physical coordination.
However, a one-size-fits-all approach does not apply for all people with ADHD. One person might have side effects with a certain medication, while another may not. Sometimes different medications or dosages must be tried before finding one that works for a particular patient. Anyone taking medications must be monitored closely and carefully by caregivers and doctors.
There is a wide range of psychotherapeutic strategies used by psychiatrists and psychologists for intervention. Therefore, there is a great individualization depending on the person with ADHD and his/her symptoms. The psychotherapeutic intervention may include psychotherapy, cognitive therapy, improvement of social skills etc.
Where specialists consider it appropriate and necessary.
Alternative ADHD treatment and supplements
Alternative ADHD treatment options include educational and skills development processes, sports, special diets, and more.
Coaching is not a therapeutic process. It involves an ongoing relationship between a coach and a client with ADHD that is very goal-driven, structured, and focused on helping him/her actively create practical strategies to accomplish specific goals and also develop general skills to be more effective in his/her daily life.
The coaching relationship is highly individualized, focuses on the particular needs of the client, and might encompass many areas of the client’s life: work, stress, time and financial management, relationships and so on. Unlike therapy, where the professional brings a particular orientation and set of therapeutic skills to apply to the problems at hand, the coach and coaching client mutually agree on what approach might work best for the particular client. A coach helps the client understand how ADHD impacts behavior, increases the client’s motivation and active involvement in making changes, and elicits creative strategies to serve his/her needs .
Coaching is based more on a holistic model, intended to improve daily functioning and well-being for individuals without significant psychological impairment. This places coaching more in the field of an educational process as opposed to a treatment process. ADHD coaching does not exist in Greece in the sense that is known abroad
Neurofeedback is a technique of exercising and controlling the brain activity. It works on basis of EEG (electroencephalogram), a device that records the electric activity of the brain. After sensors have been painlessly attached to the head, the brainwaves are measured and these signals are sent to a computer, where they are analyzed and transformed into vivid graphic. Neurofeedback is based on a simple principle. “The brain emits different types of waves, depending on whether we are in a focused state or day-dreaming,” The goal of neurofeedback is to teach the patient to produce the brain-wave patterns associated with focus. The result: some symptoms of ADHD — impulsivity, distractibility, and acting out — diminish. It is not an intervening approach. The prerequisite for a good result is patient’s cooperation with the therapist. Patients can learn to influence their brains in such a way to achieve the desired result. Based on the so-called “operant conditioning”, there is an immediate “reward” for the behavior that was aimed for. This form of self-regulation can result in permanent changes in brainwaves and has led to demonstrable and persisting success in the treatment of ADHD, and other disorders. It can be used in children older than 6 years, adolescents and adults.
ADHD and Diet
The literature as regard to the role of diet on ADHD symptoms is conflicting. Up to now, there is no longitudinal study to confirm the effectiveness of the diet on the clinical expression of the disorder. However no one can argue the usefulness of a balanced diet for any individual with or without ADHD. Poor eating habits do not cause ADHD, nevertheless deficiencies in certain types of foods can worsen ADHD symptoms in children and adults. Getting adequate levels of the right food optimizes brain function.
With caution we report diets that have been proposed but have not been confirmed in a large scale comparative study.
a. Feingold’s Diet
Feingold, an allergist, suggested that hyperactivity can be triggered by synthetic additives – specifically synthetic colours, synthetic flavours and preservatives, as a result of an allergic or toxic reaction to the food. He proposed that elimination of these substances from the individual’s diet may improve ADHD symptoms. Lately, researchers have not supported his views considering that this is an immunologic response, and not an allergic reaction.
b. Elimination of sugar
According to their mothers, some children do become hyperactive after eating candy or other sugary foods. No evidence indicates, however, that this is a cause of ADHD. For best overall nutrition, sugary foods should be a small part of anyone’s diet, though there is probably not much harm for a child or adult with ADHD to try eliminating sugary foods to see if symptoms improve.
c. Vitamin intake
The vitamin intake was based on the assumption that ADHD is the result of a genetic disorder that is responsible for increased demands of the body for vitamins. This has not been confirmed, besides vitamins have the risk of hypervitaminosis, from excess intake, which is also a pathological condition. Despite of that some mothers of children with ADHD and adults with ADHD insist that vitamin intake is beneficial (unproven by studies in a large scale). However hygienic balanced diet and elimination of preservatives have not harmed anybody. Omega 3 is crucial for proper cognitive development, fighting inflammation, protecting the heart, insulating the body from the cold, and maintaining a healthy metabolism and weight. Fibber is crucial for maintaining proper digestive health, and folate has been long touted for its effectiveness in enhancing cognitive development and performance. Before you do anything regarding your diet, please consult your doctor. Any change in your diet might have undesired effect in your medication
Aerobic exercise, Yoga, tae kwon do, ballet, gymnastics and sports
During the pre-adolescent period, it is postulated that exercise may improve cognitive function and maturation of neurons associated with executive function. On a practical level, it causes kids to be less impulsive, which makes them more primed to learn. Team activities or exercise with a social component are especially beneficial. Perhaps, the brain releases several important chemicals such as endorphins, (hormone-like compounds that regulate mood, pleasure, and pain), dopamine, norepinephrine, and serotonin increasing their levels that are in short supply in those with ADHD, thus affecting focus and attention. However, this is unproven and has to be confirmed in a larger scale. According to another study, the achievements of boys with ADHD in the athletic field may increase acceptance by their peers which may lead to self-esteem and self-control improvement.