Mindfulness for ADHD: A Promising New Intervention
In addition to posting at Mental Help Net, I'm also a co-founder and co-contributor to a blog on mindfulness-related research called Scientific Mindfulness. Mindfulness refers to a present moment focus, usually with an attitude of acceptance and openness to whatever experiences show up. The concept is based in Buddhist meditation practice, but it also refers to less formal techniques introduced outside of sitting meditation. It has been shown to be useful with a wide variety of problems, such as chronic pain, anxiety, depression, emotion regulation, and overall quality of life. I've maintained both a personal and professional interest in mindfulness and meditation for the last decade, and it's been interesting to watch the field grow exponentially in that time.
Recently, I've begun to notice a growing trend towards using mindfulness as a treatment for attention deficit/hyperactivity disorder - more commonly known as ADHD, or colloquially known as ADD. ADHD affects 3-5% of children and is related to problems both in school and at home. In addition to the academic problems commonly associated with ADHD, children with ADHD also have more difficult relationships with their parents and with peers.
The most common treatment for ADHD is medication-usually some sort of stimulant such as Ritalin. Stimulants have been shown to improve inattention, impulsivity, and school-related behaviors. However, stimulants also have limitations. Although the majority of people with ADHD appear to respond to stimulants, 20-30% of children show no improvement, and some even get worse. Additionally, among children who do show improvement, it's not a complete remedy and many still struggle compared to children with ADHD. Perhaps the most concerning thing about stimulants is that we're still uncertain of the long-term effects of taking them. There is some evidence that, although children appear to improve in the short-term, these improvements aren't maintained in the long-term; that is, although children with ADHD taking stimulants appear to do better, this may not hold out over time.
Additionally, there is some promising evidence for the use of nonstimulant medications such as antidepressants. However, these approaches are still preliminary. Behavior modification also appears helpful and is often used either alone or in conjunction with medication.
In addition to these treatments, mindfulness-based therapies are a promising new direction for treating ADHD. A group of researchers at the Mindfulness Awareness Research Center at UCLA have developed what they call Mindful Awareness Practices for ADHD (MAP). People with ADHD were taught to meditate and encouraged to increase the length of meditation over time. Participants showed improvements in concentration and hyperactivity. At Duke University, researchers taught mindfulness meditation to a group of adolescents and adults with ADHD. People with and without ADHD medication showed improvements in working memory and the ability to shift attention. Lastly, adults with ADHD who engaged in Metacognitive Therapy, a treatment that incorporates mindfulness without formal meditation practice, showed improvements over a 12-week social skills group intervention.
Although the use of mindfulness in treating ADHD is still very new, results have been promising so far. As there are different groups exploring this treatment in different ways, it is not quite a cohesive movement. However, the people at UCLA seem to have been making the most progress so far. People participating in mindfulness treatments for ADHD appear to improve regardless of whether they are taking medication or not. This means that mindfulness training may be a useful adjunct to medication management, and it may be a useful alternative to those who have no success with or prefer not to take medication to manage their conditions. I don't recommend people with ADHD run out and try only these newer experimental treatments, but it is a trend that is certainly worth keeping an eye on, especially as stimulant medications don't appear to work for everyone. I'm also pleased that there may be other behavioral options for people who don't respond to or prefer not to take medications. The impact of mindfulness on the field of psychotherapy has been pretty impressive so far, and I continue to be interested in watching where it goes.