The Best Ways To Manage ADHD (That Aren't Medication)

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder (meaning it is related to the way the brain and nervous system develop). According to the Centers for Disease Control and Prevention (CDC), it affects people's ability to regulate their attention, impulses, and activity levels. In the U.S., ADHD is a very common condition that significantly impacts children and adults. In fact, per the CDC, approximately 6 million children aged 3 to 17 were diagnosed with ADHD as of 2019, representing around 9.8% of the population within that age group — and the prevalence was higher in boys than in girls.

While the American Academy of Pediatrics (AAP) recommends treating ADHD with a combination of behavior therapy and medication, the second has been the primary treatment option for managing ADHD symptoms. However, while opting for prescribed medication is not only perfectly fine but necessary for some people with this condition, it's important to note that other effective approaches are also available. For instance, behavioral therapies, such as cognitive-behavioral therapy (CBT) and parent and teacher training programs, offer strategies to improve focus, impulse control, and social skills. Plus, these non-medicinal treatments can be especially valuable for individuals who either prefer non-pharmaceutical approaches or experience side effects from medications. This article explores these alternatives for treating ADHD. Yet, remember that the treatment choice should be made in consultation with medical professionals, considering factors like the severity of symptoms, personal preferences, and potential side effects.

There are various treatment options available for ADHD, with the primary approaches being behavioral therapy and pharmacological or medicinal treatment. Ideally, combining both interventions offers the most comprehensive and tailored approach to managing ADHD symptoms (via the CDC). Behavioral therapy focuses on teaching people strategies to enhance attention, impulse control, and organizational skills, providing valuable tools for both children and adults with ADHD that would help them perform better at school or work and support healthier relationships with family and friends. This type of therapy encompasses cognitive behavioral therapy (CBT), parent training programs, and social skills training.

However, according to a study published in the Journal of Central Nervous System Disease, pharmacological treatment stands as the go-to line of approach for managing ADHD symptoms, and it includes stimulant and non-stimulant medications. Stimulants such as Ritalin, Concerta, Adderall, and Dextrostat are the most commonly prescribed drugs for ADHD. These medications enhance the availability of certain neurotransmitters in the brain, promoting improved focus and impulse control. In contrast, non-stimulant medications like atomoxetine, guanfacine, and clonidine are used when stimulants are not well-tolerated or ineffective. They work through different mechanisms to address ADHD symptoms. Nevertheless, per the study, while stimulant medications can be highly effective, they may also come with potential side effects, including appetite suppression, insomnia, and in some cases, a risk of abuse or dependence. This is why careful evaluation, regular monitoring, and dosage adjustments are crucial when using medications to treat ADHD.

According to PsychCentral, neurofeedback (aka "brain training") is an alternative therapy approach used to treat ADHD symptoms based on the idea that the brain's activity can be monitored and controlled to improve focus, attention, and self-regulation. Per a review published in Current Psychiatry Reports, a neurofeedback session evaluates a person's brain activity. First, brain activity is checked and prepared. Then, certain parts of the brain's signals are chosen and measured as the person is doing tasks that require focus and attention. These selected signals are turned into prompts or feedback that the person can see or hear in real time. This helps the person know what their brain is doing. By getting feedback, the person can learn to control their brain activity and change how their brain works, which can affect how they think and act. Over time, the brain is believed to improve its ability to sustain attention and manage impulsivity.

However, research on the effectiveness of neurofeedback for treating ADHD has produced mixed results. Some studies suggest that neurofeedback can significantly improve attention and self-control, while others find more modest or inconsistent effects (via PsychCentral). It's important to note that neurofeedback is considered an alternative therapy and is not yet widely endorsed as a primary treatment for ADHD. Lastly, per another review published in Cells, it is believed that there's a better chance to improve how the brain changes and adapts in people with ADHD when combining neurofeedback with behavioral therapy rather than using brain stimulation alone.

Teacher programs are crucial in supporting children with ADHD to excel in academic settings. They recognize that every student is unique. Thus, by implementing specific strategies in the classroom, educators ensure that children with ADHD are given a fair chance to learn effectively, participate actively, and thrive in the classroom environment. According to Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), effective academic instruction is key to their success. For instance, the site recommends maintaining a consistent routine throughout the lesson, seeing that when students with ADHD know what to expect and can follow a structured sequence, it reduces confusion and allows them to focus on the learning material rather than constantly figuring out what's happening next. Beginning lessons with a quick review of what will be taught and the activities that will be used can provide a clear roadmap. Also, giving explicit instructions about the materials needed helps prevent students from feeling lost.

Furthermore, clearly explaining expected behavior during lessons sets a positive tone, and offering information about how long each activity will last helps them manage their time and attention. Since kids with ADHD have trouble focusing or staying seated, CHADD suggests breaking down assignments into smaller tasks or giving them small breaks between tasks, which reduces the feeling of overwhelm and supports their ability to complete tasks more successfully. Moreover, creating a visually clutter-free classroom environment minimizes distractions, helping students stay focused. Lastly, regular praise for good behavior builds their confidence and motivates positive actions, promoting a more supportive learning atmosphere.

Exercise has become a possible and safe way to help with ADHD symptoms, especially in children. Many studies have examined how short bursts of active exercise, like running or playing sports, can help children with ADHD. For instance, one review published in Child: Care, Health, and Development found that exercise can make a positive difference in managing ADHD symptoms, including paying attention, being less hyperactive, and feeling less anxious. Similarly, a study published in Psychiatry Research found improvements in attention, executive functions, and motor skills. Because of this, people are considering using exercise as a different or extra way to help with ADHD.

According to another review published in The Journal of Neural Transmission, aside from helping the body, exercise also helps how the brain works. Different activities, such as aerobic ones like running (cardio) or calm ones like yoga (non-cardio), have been investigated for their short- and long-term effects on perceptual skills, intelligence, and academic performance. Per the review, exercise leads the body to release chemicals associated with pain relief, decreased depression, and reduced stress hormones. These mechanisms are believed to contribute to the improvements observed in ADHD symptom management. Per Healthline, some of the best types of exercise for kids with ADHD include biking, playing team sports like soccer or basketball, jumping rope, or hiking. As for adults with ADHD, the site lists martial arts, weightlifting, and joining a spinning or boxing class as safe and effective ways to manage ADHD symptoms.

Research has shown a link between magnesium deficiency and worsened ADHD symptoms, highlighting the potential benefits of magnesium supplementation in managing the condition. According to a 2021 review published in Nutrients, research has shown that children with ADHD tend to have lower blood magnesium levels than those without the condition, suggesting that magnesium might be valuable as a therapeutic approach for ADHD.

Furthermore, the review's findings suggest that supplementing magnesium alone or combined with vitamins or other minerals can significantly improve ADHD symptoms. Plus, when used alongside standard treatments, magnesium supplementation has shown benefits in reducing inattention, hyperactivity, and impulsivity in children with ADHD. For example, a study involving 40 children with ADHD published in Magnesium Research examined the effects of an eight-week magnesium and vitamin B6 supplementation treatment and determined that it led to significant modifications to ADHD symptoms, namely reducing hyperactivity and emotional aggressiveness while improving school attention. In addition, the study noted that stopping treatment resulted in ADHD symptoms returning within a few weeks. Similarly, in another study published in the Egyptian Journal of Medical Human Genetics, magnesium supplementation improved the mental functioning of children with ADHD while reporting only minor side effects. Magnesium can be obtained from various dietary sources, including seeds, legumes, nuts (such as almonds, cashews, and peanuts), whole grain breads and cereals (like brown rice and millet), certain fruits, and green leafy vegetables (via the National Institutes of Health).

Various elimination diets have gained attention as potential strategies to alleviate ADHD symptoms. Per a 2022 review published in Nutrients, these diets exclude certain foods to see if and how they affect ADHD symptoms. There are different types of elimination diets, including single-food exclusion diets, which eliminate one suspected food, multi-food exclusion diets, which remove common food allergens, and "few-foods diets," such as the oligoantigenic diet, which is about eating only a few kinds of foods that are less commonly eaten and less likely to cause allergies.

In these diets, most foods are initially avoided for a set period, during which improvements in behavior or cognitive performance are often observed. Then, foods are slowly and cautiously reintroduced, one at a time. The process of systematically excluding and reintroducing foods aims to identify potential triggers for ADHD symptoms. Per the review, research has found that children following these diets experienced at least a 40% improvement in their behavior. Still, while elimination diets show promise in reducing ADHD symptoms for some individuals, further research is required to understand their mechanisms better and determine their applicability and long-term effects.