ADHD is a condition characterised by symptoms of inattention, distractibility, disorganisation, forgetfulness, and trouble completing tasks (inattentive type); and overactivity, fidgetiness, excessive talking, impulsivity and interrupting others (hyperactive type). There is also a combined presentation that includes both inattentive and hyperactive symptoms.
Overall it is estimated that ADHD affects around 7-10% of children and 4-5% of adults.
To diagnose ADHD it must be demonstrated that the symptoms started before age 12, which means that it is a Neurodevelopmental condition, but the story doesn’t end there for most people, as there is a high rate of continuity into adulthood. Another important thing to understand about ADHD is that most people with the condition have other problems too, known as comorbidities.
Common examples of comorbidities include: anxiety, depression, alcohol/substance misuse, social/relationship difficulties, and eating disorders. In fact, over half of all adults with ADHD have at least one comorbidity and around a third have at least two. For adults the difficulties can have a huge impact at work and at home.
Medication-based treatments are known to be effective as a first-line treatment for core ADHD symptoms in adults and Cognitive Behavioural Therapy is also known to be efficacious according to a review by the CADDRA Guidelines Workgroup in 2022.
Mindfulness based interventions (MBIs) are also available in ADHD and have attracted considerable research in recent years. MBIs typically involve body-focused practices such as:
- Scanning the body for tension
- Doing a walking meditation, or
- The non-judgemental and accepting awareness of the present moment.
However, the question of whether complementary treatments such as mindfulness are effective can be hard to answer, for a couple of main reasons.
- One reason is that mindfulness-based treatments are often included in Cognitive Behavioural Therapy already, making it harder to separate the effects.
- The other reason is that due to the high comorbidity rate, looking only at whether treatments reduce the core ADHD symptoms, risks missing an important part of the picture.
A recent study into mindfulness
A team at the University of Montreal in Canada (Poissant and colleagues, in 2020) recently investigated how effective mindfulness-based interventions are in adults with ADHD. They used a meta-analysis which involves combining the results from multiple published research papers. Refreshingly they looked at not only the core ADHD symptoms but also the comorbid depressive and executive function symptoms (i.e. skills such as working memory and attention switching).
Their analysis found that mindfulness based interventions resulted in a moderate reduction in core ADHD symptoms and also depression, while a smaller but still statistically significant reduction was also found in executive function difficulties.
The authors of the Montreal study concluded that there was promising evidence that mindfulness-based interventions can be effective in reducing adult ADHD symptoms and depression. Importantly they found that the mindfulness-based interventions were highly variable in length, so further research is needed to know how much mindfulness training is needed to gain a meaningful benefit.
Studies like this do, however, go a long way towards providing evidence for new interventions in adult ADHD to complement medication-based treatments and cognitive behavioural therapy.
For adults with ADHD and practitioners in this field it is exciting that new treatments are emerging and gaining evidence for their effectiveness.
With thanks to Dr Andrew Sheridan - Clinical Lead, Neuropsychology and Clinical Psychology
ADHD WA (Inc.)
For more information regarding ADHD Awareness Month, please visit www.adhdwa.org.au or follow the links below.
1st – 31st October 2022 | ADHD Awareness Month