The Effect of Physical Exercise on the Concentration of Individuals with ADHD
ncbi.nlm.nih.gov
ncbi.nlm.nih.gov
I was lucky enough to discover a few sports (snowboarding, rollerskating, climbing) at the right time i my life that managed, unbeknownst to me, to get me through the parts of life where I needed the most focus (incl. my degree). Things went downhill when I started to work and got a car, which dramatically reduced my physical activity, up until I picked myself up and went running, then skateboarding. This changed my quality of life on so many levels: although I still get both periods of numbness and hyperfocus, the positive feedback loops are much more frequent and negative feedback loops much less so. I still have to take great conscious care about not exerting (physically or mentally) myself too much because there seems to be no warning telling me "hey this is too much" and I regularly wear myself out. Still, I now have control over my life, but the fact that all of this I had to find myself early in my 30s and still get scorned at to this day is terrible: how many are being cast away as either unruly or lazy and left to their own devices?
If those are UK doctors I politely urge you to complain.
Otherwise, try showing them this: https://www.nice.org.uk/guidance/cg72/resources/cg72-attenti...
† Notwithstanding the courage of our teachers and all, this country††'s education system is a complete failure, and those that shine do so in spite of it, not thanks to it.
†† I can't even come to terms with calling it "my country" anymore due to recent events regarding mass surveillance, that go against everything I hold forth and cherished about France, inherited since le Siècle des Lumières.
I'm really sorry to hear that. I urge you to keep trying, because I think you may have had a run of unusually bad luck with doctors. I'm 36 and I've never had a problem getting scripts for my ADD meds. I was diagnosed at age 5, but I have several friends who realized what was going on much later in life, and none of them had any difficulties getting a diagnosis either. I'm in the US, so I don't know if the medical culture is different where you are, but I hope that you can find a more cooperative doctor.
France, where the situation is as described above. Select groups are trying to raise awareness of the issue for children so that they don't end up being classified as spoiled brats, but last time I checked there's basically squat for adults.
I prefer tactile sports such as football and rugby. Running is very boring, as are repetitive sports like throwing (I threw hammer and disc). Softball was always too slow paced for me. I'd be caught staring into space in the outfield.
I think ADHD was not as big an issue when jobs/daily life involved more physical labor and tactile experiences. Nowadays most "important" jobs consist of sitting in front of a computer for eight hours. That doesn't do any favors for us ADHD folks. I know medication has made a world of difference for me. I don't think I'd be able to handle a 9-to-5 programming job without it.
If you can recognize similar patterns, then there's a number of days each month when you can predict ahead of time that you won't need medication.
I moved to a different country a few months after I was diagnosed (and since it's rightly a highly controlled medication in the US, couldn't take a long-term supply with me), so I've been able to observe myself both with and without the medication. If I can find a doctor with good enough English, I'd like to reestablish the prescription. Having that support from the dextro was like night and day, eventual tolerance or not.
I find this very hard to believe, given that amphetamine is known to be quite addictive and tolerance builds quite quickly. Albeit medical doses are small compared to recreational use/abuse, so it may be a manageable issue.
1) I typically pace when talking on the phone
2) In general, going for a walk is a really good way to clear my mind.
3) I will walk around a lot, and quickly, when I am anxious.
4) It is easier for me to sleep when there is rain or a fan on in my room. Any kind of white noise.
5) When I need to think about something particularly abstract, I will take a shower. Going through the routines of cleaning my hair, using soap etc, all while having the physical stimulation of water falling on my back, helps to get me in a very focused and 'zen' state.
I have recently been working from home, and one of the added benefits is I can take a walk and it's not a big deal and no one bothers me. At work it was awkward walking the parking lot and usually people would stop and try to chat. walks significantly lower my anxiety level and help me focus.
I use the White Noise app on my phone with the rain on a tent sound loaded to get to sleep. It's a great little app, takes me significantly less time to sleep.
Showers are great, I also enjoy a long drive during periods of little or no traffic. Really anything where I'm thinking and engaged but also sort of in autopilot - routine acts.
I didn't realize I had ADHD until I was older, and I went to therapy for anxiety and depression. When I was young I struggled a lot, but it was always approached from the angle of discipline and 'just focus and get it done.' I started to develop bad habits of internally beating myself up when I couldn't focus, or I realized a simple homework item was taking me ages - usually because I'd stop to read something out of a novel, or work on a drawing, or just doodle all down the sides of my paper. Then I'd bring myself back, "C'mon, don't be an idiot, this is easy." I developed the same bad habit for depression, "Just cheer up, stop being such a gloomy ass." I often wish I had been more open with my difficulties earlier in life and talked to my parents and teachers about how I was feeling. As a kid, though, that was an unappealing notion.
And I don't have ADHD.
I have tried meditation and yoga, but I could never get the motivation required to build a habit. One of the main problems with meditation is that it is all about stillness, which can be very hard for somebody with ADHD! I mean, relatively speaking, a shower is a bit like a form of meditation for me, so maybe people of ADHD do practice a form of meditation by engaging in these activities.
It's common to alternate sitting and walking meditation during extended sessions, to my knowledge both in south-east Asia and in Japan.
This is the more interesting finding to me and conflicts with my personal experience. Maybe I just haven't been diagnosed for ADHD yet? However if it is true then this raises an interesting problem. Exercise is no longer a universal booster - you have to be damn sure that you're deep in ADHD, because if you're 40% ADHD and 60% normal, then exercise actually does more harm than good, according to the results of this study.
In general, this study seems very limited in scope and participant count. A worthwhile study for sure, but I think it warrants additional research above anything else, and nothing conclusive should be taken from it.
No seriously. Having been diagnosed with ADHD years ago, I found the conclusion fantastic and confirming, and then parent's point stress inducing. I'm hoping I'm at least 51% ADHD.
Granted, I am not a doctor, but I have yet to meet a person that I've felt has the apparently superhuman diagnostic abilities required to identify ADHD.
So I wouldn't worry about it either way. Live your life and try not to die or be unhappy.
There's a crude test though: Take (a small dose) of Ritalin, Adderall or other stimulant that increases activity in the striatum and see:
* Do you mainly feel sweaty, agitated and super-alert: probably no ADHD.
* Do you feel like you're able to think properly for the first time in your life or get sleepy even -> hints to ADHD.
Your crude test really is crude, though: by itself, it invents a condition to match the result of the application of a drug. You could do the same with any drug: "You have VPFP if you use [insert drug here] and feel it improves your life, and you don't otherwise. Let's start writing prescriptions to treat VPFP."
Really, the crux of it is this: When you need to concentrate on something that you aren't interested in, are you able to?
If the drugs or therapies increase your quality of life, you're "ADHD" because you have a prescription. If they make you feel worse, you're not "ADHD" because you don't need ADHD treatments.
This works because people only ask doctors about ADHD if they need help with the symptoms that we all culturally think of as ADHD.
> I can confirm nothing about what ADHD actual is or whether or not I have it.
You don't need to confirm what ADHD actually is or whether or not you have it. What you want to figure out is if ADHD treatments help you live a better life.
Also keep in mind that a lot of people that could benefit from ADHD drugs don't seek treatment, and don't think of themselves as "ADHD", but instead they self-medicate with things like coffee to avoid seeing a doctor and taking the diagnosis.
I sat next to a lad in an informal setting recently (watching a martial arts class), his mother kept nagging him to sit still, not make a noise, etc.. I felt so sorry for him, he could easily have stood at the side and tried to mimic the older childrens movements, or just danced around for a bit, or played a game with his mum. When she told him off for raspberrying I really wanted to start just to show it wasn't inappropriate (it wasn't a quiet segment of the class); social inhibition prevented me. I find that my kids primary school teachers have a similar attitude, they're all female, they seem particularly bothered by some types of "unruly" behaviour which is primarily from the boys. Is there a biological divide between the sexes here too? [On the basis of the above linked study abstract, do more boys have ADHD than girls, is it a spectrum disorder?]
When I pick up my youngest (5-6yo) from school the boys are almost all [always] playing chase around the playground whilst the girls are almost all [always] chatting quietly and standing with their parents (mainly mothers). Mothers of boys seem to tell the boys off for running around, whilst the [far fewer] dads do not.
It's a fact that more boys than girls are diagnosed, but I've noticed that /r/adhd seems overwhelmingly female. I dunno, though, maybe it's just that people are more likely to be talking womanly on a mental disorder site. (They're more likely to be talking about their feelings, for one thing.) And a tendency to associate Facebooky spelling ("isnt",etc) with females might be unfair on my part.
"teachers have a similar attitude, they're all female, they seem particularly bothered by some types of 'unruly' behaviour. Is there a biological divide between the sexes here too?"
Don't get me started... I have ADD, so it's hard for me to write a short comment.
In my life, pretty much all the women teachers have been big into rules for the sake of rules, and applying rules with no thought on the actual point of the rule. I can't really think of any reason for more women than men to be sensors rather than intuitives (most _people_ are sensors), but I suppose there could be a reason for more women teachers to be sensors than men teachers, or rather, for less men teachers to be sensors than the general population. I conjecture that that reason is: men who become teachers do it because they want to talk about equations and right-angle triangles all day, which is an intuitive trait. I want to be a teacher and that's the main reason.
(And women don't need a special reason to want to be a teacher... not the way men do, anyway.)
The results in the original study were nearly the same proportionally and the game was found to favor the performance of an individual with ADHD.
The linked study, in fact, goes on to misrepresent the study it references in stating it was conducted "to quantify the performance of people with ADHD characteristics," when in fact the study stated it was conducted to describe "the development and the testing of a virtual environment that is capable to quantify the influence of red-green versus blue-yellow colour stimuli on the performance of people."
The referenced study concluded: "The game proved to be a user-friendly tool capable to detect and quantify the influence of color on the performance of people executing tasks that require attention and showed to be attractive for people with ADHD"
It could be that forcing someone to overrule their impulses for a period of time might be the solution, rather than the exercise itself.
I would ask for a control group who are forced to do some boring, repetitive activity without physical exertion like meditation and see if the results are mirrored.
It would probably make sense to further split the participants of a study like this into two groups: the ones that enjoy physical exercise and the ones that most of the time don't enjoy physical exercise.
If I were to speculate on the physiology of this, I'd say that for people like me and the PP, the brain either fails to secrete enough endorphins - the feel-good chemicals that are usually released during physical exercise that make it "fun" and an "urge" (I've read once about a study liking physical exercise addiction to addiction to hard drugs, so it makes sense to have a similar mechanism) - or we don't have enough receptors for endorphins. Thankfully I also happen to have an auto-burner metabolism (I can eat anything anytime and just never get fat) and and no genetical predisposition for obesity or diabetes, so I can stay reasonably healthy even when I stop doing any kind of exercise for some periods of time, but other people are not as lucky as me...
Soccer, Basketball, Climbing, Sprinting, and Biking (to the liquer store for example) -- now that's exercise I can get into!
I'd love to know some secret sauce other than luck to head into actually enjoying to exercise.
The other thing is to read a lot of papers on google scholar so you can convince yourself of all the beneficial aspects of doing a cardio.
Plus there is something about water that makes the stress go away( for me atleast).
Now I can swim laps( with pauses after each length).
Learn to float. Then learn to use your limbs to move around without a ground to push against.
Bonus, a swimmer's physique is often rated the most attractive type. Eh? ;)
- Cycling on my trainer at a low level of exertion (Zone 2) while watching a good show isn't boring
- Intramural-type team vs. team sports are usually not boring. Caveat, if you aren't in shape you will be too exhausted to be having fun, but if you stick it out for a little while and get into shape it becomes more fun
http://m.ccp.sagepub.com/content/9/4/479.short
(Free link: http://www.freemeditation.com/wp-content/uploads/2009/08/adh...)
Depends on how much you are into it, and the type of exercise
Running in a treadmill is very different from running into a park, for example. Or where you have to overcome different hurdles and the situation changes every minute.
People usually think lifting weights is boring, I disagree. It is boring if you do it mindlessly and with low weights compared to your 1RM
> volunteers with notably good grades in all subjects, without reports about behavior problems and a good social life at school and at home.
That seems like a relatively mild case of ADHD.
[EDIT: Quote applies to control group, as pointed out by andreasvc. The first three points appear to still stand.]
I'm also wondering how the resulting GC and GE values from "Performance of groups in the whole game" figure are so different, considering that part of the selection process was being able to complete the level in 600 seconds, ±5%.
On a side note, this was very interesting:
> These data seem indicate that after an intense physical exercise, people without ADHD show impairment in attention performance.
Later in life I have come to rely on routine physical exercise as it keeps me on an even keel and productive. Caffeine and Ritalin both just made me go into the zone just the same way hard exercise does. I find that if I do not exercise hard and regular I have a hard time staying productive and I might seek towards other dopamine producing behaviors (Alcohol, junk foods). I have found a middle ground of moderate exercise, but it is never as fulfilling as being full tilt into a training cycle.
edit: Found a quote from the author of The Sports Gene:
"Here at Axon Sports, we talk a lot about the brain’s role in playing sports. From vision to perception to decision making to emotions, the brain plays a critical role in sports success. What have we learned about neurogenetics that can influence an athlete’s performance from a cognitive perspective?
DE: One of the most surprising things I learned in my reporting was that scientists know quite well that not only does the dopamine system in the brain—which is involved in the sense of pleasure and reward—respond to physical activity, but it can also drive physical activity.
One of the scientists I quote in the book suggests that this may be why very active children who take Ritalin, which alters dopamine levels, suddenly have less drive to move around. That’s precisely what he sees when he gives Ritalin to the rodents he breeds for high voluntary running, anyway. And it appears that different versions of genes involved in the dopamine system influence the drive to be active. (Interestingly, native populations that are nomadic and that migrate long distances tend to have a higher prevalence of a particular dopamine receptor gene; the same one that predisposes people to ADHD. I discuss in the book the possible link.) "
I saw most results within 24 hours, others after only 4 days.
If it's say ~8 hours, then scheduling gym classes in the beginning of school days may help these children. If it's 1h it won't matter much, as long as gym isn't at the end of a school day.
I think it's no exaggeration to say that richer countries have been experiencing a rise in mental health issues, and that is in a large part, although not entirely, due to sedentary lifestyles.
It probably doesn't.
http://www.cochrane.org/CD004366/DEPRESSN_exercise-for-depre...
> When only high-quality trials were included, exercise had only a small effect on mood that was not statistically significant.
> Exercise is moderately more effective than no therapy for reducing symptoms of depression.
> Exercise is no more effective than antidepressants for reducing symptoms of depression, although this conclusion is based on a small number of studies.
> Exercise is no more effective than psychological therapies for reducing symptoms of depression, although this conclusion is based on small number of studies.
> The reviewers also note that when only high-quality studies were included, the difference between exercise and no therapy is less conclusive.
> Attendance rates for exercise treatments ranged from 50% to 100%.
> The evidence about whether exercise for depression improves quality of life is inconclusive.
You say
> I think it's no exaggeration to say that richer countries have been experiencing a rise in mental health issues, and that is in a large part, although not entirely, due to sedentary lifestyles.
What makes you think this? Plenty of very active people suffer depression and anxiety. There are a couple of sports people who have talked about their depression. You may have the causal link reversed - depression lowers ability to do stuff, and so depression causes inactivity. That's at least plausible.
The various reviews of exercise-based interventions illustrate how complex it can be to implement trials and interpret their results.
Frankly I'd encourage exercise in a depressed patient, rather than say it "probably doesn't help". There are numerous other benefits that could probably outweigh risks (although these should obviously be assessed on a case-by-case basis) and interventions should seek to minimise nocebo as well as maximise placebo -- ethically of course. It just might work for that patient, and actually that is a perfectly rational basis for treatment sometimes.
That seems pretty clear.
> There are numerous other benefits
Yes, recommend exercise because it is undoubtedly a good thing. Just don't recommend it as a treatment for depression, because "exercise [has] only a small effect on mood that [is] not statistically significant."
http://www.nimh.nih.gov/about/director/2011/antidepressants-...
Doubts about medication are weaker when the depression is more severe btw
Your link repeats some things I've said (untreated suicide carries a risk of suicide; "In more severe forms of depression, antidepressants show greater efficacy." Etc)
Nonetheless the sheer magnitude of the issue is a signal that something widespread is going on. This page says 40 million US adults are affected, or 18% of the population. I've heard similar statistics before.
http://www.adaa.org/about-adaa/press-room/facts-statistics
This article is saying that exercise helps ADHD, which is another increasingly diagnosed mental disorder.
That doesn't prove sedentary lifestyles are the cause, but the evidence seems consistent with that hypothesis.
Yes, it's a vague hunch. I'm just saying it seems credible. I don't think it's very controversial that if you go to a psychiatrist for depression, they will ask how much you exercise, and if you don't, they will recommend it. They don't really have proof that it will help. But they will tell you that. It's the best they can do.
Whether antidepressants or ADHD drugs help is also of some controversy as well, I believe. Certainly they do in many cases, but not in all cases.
There's certainly nothing WRONG with exercise for a typical sedentary person, while there are known side effects to medication. And that doesn't mean they are exclusive -- medication + exercise may be the best solution for many people.
The cochrane collaboration perform meta analysis, so they have included the the research papers that say "exercise is a treatment for depression". Your casual dismissal of a well-respected organisation is odd.
> Yes, it's a vague hunch. I'm just saying it seems credible. I don't think it's very controversial that if you go to a psychiatrist for depression, they will ask how much you exercise, and if you don't, they will recommend it. They don't really have proof that it will help. But they will tell you that. It's the best they can do.
I've just shown you strong evidence that it's not "the best they can do".
They recommend exercise because many mental health meds list weight gain and increased appetite as side effects; and because they're doctors and so they recommend exercise to everyone.
> There's certainly nothing WRONG with exercise for a typical sedentary person, while there are known side effects to medication. And that doesn't mean they are exclusive -- medication + exercise may be the best solution for many people.
You've worded this to suggest there's nothing wrong with exercise alone as a treatment for depression. That is wrong. Depression can be a fatal illness. 12 men per day die to suicide in the UK. It is important to get appropriate treatment.
GE = w/ ADHD GE-EF = w/ ADHD and exercise
GC = w/o ADHD GC-EF = w/o ADHD and exercise
Look how poorly GC-EF performed relative to the other groups in absolute terms. There's visually a much larger difference in concentration for those without ADHD, but who exercised than those that didn't exercise.
If we were to focus on the largest difference of effect shouldn't our conclusion be, 'Intense exercise can make the attention of people without ADHD worse than those with ADHD'?
This is what the authors say, "The results of this study also show that the GC group has a performance that is 42% better than the GC-EF group. These data seem indicate that after an intense physical exercise, people without ADHD show impairment in attention performance. However, this hypothesis requires further studies, which include the assessment of the duration of this effect."
Hmmm ..., color me a skeptical statistician.
I should do more cardio to see if it's the same.
So you're saying that that stuff applies for inattentives too?
Benefits to the point that my wife will bend over backwards to find time for me to exercise, completely out of selfish reasons.
11. Silva AP, Frère AF Virtual environment to quantify the influence of colour stimuli on the performance of tasks requiring attention. Biomed Eng Online. 2011; 10:74 doi: 10.1186/1475-925X-10-7421854630
3 times a week for an hour at least in the evening.
Apart from the fact that exercise always help I think it's the structured, controlled breathing you have to do, that helps to focus.
Physical exercises help improve children's attention and provide greater impulse control; these additional effects appear almost immediately, as confirmed in this study, which helps the concentration of children with ADHD."
By researching the mechanism that makes exercise work, understanding the biochemical basis, and developing a shortcut that triggers the same biochemical effect without actually requiring working out.
For the ADHD brain, which lacks a normal level of dopamine the exercise intensity is offset by the production of dopamine. For me, hard exercise, a proper recovery period of about an hour (nutrition, relaxing) and I enter a period of high productivity for about 4-5 hours. I can intensely focus in this time. After that I have to move around some more (it's also later in the afternoon then when many people are getting a little tired anyway). I can usually settle in to deal with lower cognitive load tasks after that (easier coding, email, report writing, et.) for a few hours.
So, I draw from a couple of resources. From the Lore of Running, by Tim Noakes (a well respected exercise physiologist) he discusses the mental energy required to stick with a training program that involves hard workouts. He notes it is a pretty well observed phenomenon for him (and many others), that doing thinking tasks on hard workout days can be harder. His example was writing and his research work in the midst of training hard.
From Thinking, Fast and Slow, Daniel Kahneman shows how the brain sort of "crashes" when glucose levels fall. He also discusses how we have this finite bucket of cognitive energy and I don't think it is a stretch to say that working out hard drains that bucket. There is enough anecdotal data that supports this at a high level.
And finally, in the book The Sports Gene I was introduced to some fascinating studies in rodents.
"Here at Axon Sports, we talk a lot about the brain’s role in playing sports. From vision to perception to decision making to emotions, the brain plays a critical role in sports success. What have we learned about neurogenetics that can influence an athlete’s performance from a cognitive perspective? DE: One of the most surprising things I learned in my reporting was that scientists know quite well that not only does the dopamine system in the brain—which is involved in the sense of pleasure and reward—respond to physical activity, but it can also drive physical activity. One of the scientists I quote in the book suggests that this may be why very active children who take Ritalin, which alters dopamine levels, suddenly have less drive to move around. That’s precisely what he sees when he gives Ritalin to the rodents he breeds for high voluntary running, anyway. And it appears that different versions of genes involved in the dopamine system influence the drive to be active. (Interestingly, native populations that are nomadic and that migrate long distances tend to have a higher prevalence of a particular dopamine receptor gene; the same one that predisposes people to ADHD. I discuss in the book the possible link.) "
http://www.ncbi.nlm.nih.gov/pubmed/21676789 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3441939/
I think you can coherently weave these together to get a picture of how hard exercise can benefit someone with ADHD. Maybe the mechanisms aren't correct, but the end result is pretty clear to me.