I remember watching my nine-year-old son receive his diagnosis of attention-deficit/hyperactivity disorder. As I listened to his doctor’s questions—Did he often lose things? Did he often interrupt people? Did he often have trouble finishing tasks?—it struck me that he wasn’t alone in answering all those questions with a “yes.” I was 48 years old, and could have easily filled a large suitcase with all the sunglasses, jewelry, cell phones, and notebooks I’d lost over the years.
Newspaper deadlines had kept my distraction more or less in check during the dozen years I’d been a foreign correspondent, based in Mexico and Rio de Janeiro. A full-time assistant and the constant excitement of scandals, coups, and natural disasters also helped me stay focused. But then I’d moved back to the California suburbs to freelance and raise my two kids—combining hyper-responsibility with minimal structure and even less support, with plenty of bent fenders and burned pots as the embarrassing results. Worse, far worse, was what I feared was the toll on my husband and children of my ready-fire-aim disposition, as, under stress, I’d blurt out insults and threats.
All of which helps explain why I, too, was soon in the patient’s chair, receiving my own diagnosis and officially joining the club—a large and rapidly expanding club—of several million adult Americans who struggle with ADHD.
In the decade since I first found my peeps, I’ve made a point of learning everything I could about this perplexing disorder. I’ve interviewed top experts, read scores of scientific studies and books, and authored and co-authored three books on the topic. I’ve also test-driven every one of the major and most of the minor recommended treatments that belong to what I’ve come to think of as the ADHD industrial complex. This includes medication, neurofeedback, special diets, exercise programs, and, yes, mindfulness meditation, which in recent years has gained increasing prestige as evidence accumulates of its effectiveness as a strategy to manage clinical-grade distraction.
There’s a lot more to say about mindfulness as a treatment for ADHD. But first let’s clear up two common misunderstandings about the neuro-predicament that has become a kooky hallmark of our frazzled era.
10 million + US adults affected by ADHD—an estimated 4.4% of Americans aged 18 to 44 suffer some degree of disability from ADHD, according to a 2006 survey by the National Institutes of Mental Health.
A Genuine Glitch
The most damaging misperception about ADHD is that it’s nothing more than a convenient excuse for slackers, spineless parents, and prescription stimulant addicts. Yet however much the label has in fact been abused, it’s also estimated that more than 16 million American children and adults genuinely suffer from this mostly genetic disorder—more hereditary than schizophrenia, and nearly as hereditary as height.
The classic symptoms of restlessness, impulsivity, and distraction derive from a glitch in the way the brain processes dopamine, a crucial neurotransmitter that affects motivation, interest, and self-control. Longitudinal studies have shown that those of us with authentic ADHD suffer many more accidents, injuries, academic failures, divorces, and periods of unemployment throughout our lives than our “neurotypical” peers. We also, not surprisingly, have significantly higher rates of anxiety, low-self esteem, depression, and suicide attempts. People joke about ADHD, but on balance it’s not really all that funny.
The other big myth about ADHD is that it’s only a problem for kids. True, the disorder typically arises in early childhood, detected by vigilant parents and teachers. At last count, more than 6 million youth—one in nine kids between four and 17 years old—have been diagnosed, according to the Centers for Disease Control and Prevention. To be sure, the number of adults diagnosed is less clear—we’re much less carefully tracked, and many of us have learned to cope with and disguise our symptoms—but researchers believe that serious symptoms persist into adulthood for more than half of all children who have the disorder. A 2006 survey by the National Institutes of Mental Health estimated that 4.4% of Americans aged 18 to 44 suffer some degree of disability from ADHD. That works out to roughly 10 million Americans.
In a startling milestone, in 2015 the number of American adults taking ADHD medications surpassed that of children, accounting for 53% of some 63 million prescriptions, according to data compiled by Shire Plc, which makes the top-selling Vyvanse treatment. The number of adult prescriptions is now increasing twice as fast as that of the overall market.
From this, we can infer that millions of adults are seeking help to cope with distraction. But—alas—we can’t infer that they’re actually being helped. Research suggests that prescription medication, usually in the form of stimulants such as amphetamines or methylphenidate (brand name Ritalin), can help about 80% of those diagnosed with ADHD. But quite often even when people find that the meds improve their focus, they can’t tolerate common side effects including insomnia, loss of appetite, high blood pressure, and irritability. That’s just one reason many experts I’ve interviewed consider medication as simply one potential tactic among many possible approaches, all of which have their strengths and weaknesses (See “What You Can Do about It,” below).
And that brings us back to mindfulness, which is gaining new respect among researchers and clinicians as a therapy for people with ADHD as evidence accumulates of its particularly beneficial impacts.
Life-management skills—impulse control, planning, organizing, keeping track of details in working memory—are part of the brain’s executive function. When it’s not functioning well, everyday life can go haywire.
Peer-reviewed Prestige
Studies abound suggesting benefits of mindfulness for the general population, particularly in reducing stress and anxiety. Given the unique stress and anxiety of living with ADHD, it seemed logical for researchers to explore whether training attention could make life easier for the most attention-challenged people.
“ADHD and mindfulness are two sides of the same coin,” says Mark Bertin, a developmental behavioral pediatrician in upstate New York, who uses mindfulness in his clinical practice treating children and families coping with ADHD.
“ADHD shows what it’s like to live with impaired executive function, which in many ways makes it hard to manage everyday life,” says Bertin, who regularly writes for mindful.org. “On the other side of the coin, mindfulness shows the benefits of better executive function, making everyday life easier to manage.”
By “executive function,” Bertin is referring to key cognitive skills such as impulse control, planning, organizing, and “working memory”—the ability to keep two or more things in mind at the same time. “These are all life-management skills, and when they’re impaired, as with ADHD, it can affect not just work and school but daily activities like eating, driving, and managing your to-do list,” he says. “That causes a lot of stress and overwhelm, and when you’re feeling like that, it makes it even harder to make skillful choices.”
The first research breakthrough came in 2008, with the results of a small study published in the Journal of Attention Disorders, reporting on a trial of using mindfulness as a treatment for ADHD. Eight researchers, led by Lidia Zylowska, a psychiatrist at the University of California at Los Angeles, enrolled 32 adults and adolescents in an eight-week class based in part on Jon Kabat-Zinn’s popular Mindfulness-Based Stress Reduction program. Their results were so encouraging that other researchers soon began testing the same hypothesis. In May 2015, Zylowska and two colleagues summarized several of these subsequent studies, conducted with children, teens, and adults with ADH