Scatterbrained—or something more

It’s estimated that adult ADHD (attention deficit hyperactivity disorder) affects almost 5 percent of the population, with symptoms that include difficulty concentrating, lack of organization, inability to complete work, and memory problems. Left untreated, it can result in stress, depression, obesity, and addictive behaviors such as smoking and drug use.

ADHD is sometimes referred to as ADD (attention deficit disorder). Both terms describe the same thing: a neurobiological condition characterized by a persistent pattern of inattention and/or hyperactivity. The term ADD has been dropped in medical literature in favor of the term ADHD, which is now seen as having three main subtypes:

1. ADHD, predominantly inattentive
2. ADHD, predominantly hyperactive-impulsive
3. ADHD, combined

The condition is usually diagnosed by a set of inattention and hyperactivity symptoms and other criteria listed in the Diagnostic & Statistical Manual for Mental Disorders Fifth Edition (DSM-V). Adult ADHD symptoms are markedly different from childhood symptoms. Inattention symptoms include lack of attention to detail, being easily distracted or forgetful, losing things, and difficulty paying attention or staying on task. Hyperactivity-impulsivity signs include a general feeling of restlessness, a tendency to be easily bored (which shows up as switching jobs or leaving projects uncompleted), taking risks, or spending money impulsively.

Misdiagnoses Are Common

The symptoms of adult ADHD vary widely, are often subtle, and can mimic other conditions. Not surprisingly, the condition is often misdiagnosed as depression, anxiety, and/or bipolar disorder. Some psychiatrists believe brain scans-which measure blood flow, highlight activity in brain regions related to attention, and assess how well different areas are functioning-are necessary for an accurate diagnosis.

Based on information from brain scans, psychiatrist Daniel Amen, MD, has developed a spectrum of classifications. Here’s a brief overview (visit amenclinics.com to learn more):

Type 1-Classic ADD/ADHD. Primary ADD symptoms (short attention span, distractibility, disorganization) plus hyperactivity, restlessness, and impulsivity.

Type 2-Inattentive ADD/ADHD. Primary ADD symptoms combined with low energy and motivation. Type 2 tends to be diagnosed later than Type 1, if at all. It is more common in girls. These are quiet adults, often labeled as “lazy,” “unmotivated,” or “not all that smart.”

Type 3-Over-focused ADD/ADHD. Primary ADD symptoms plus inflexibility, trouble shifting attention, clinging to negative thoughts or behaviors, excessive worrying, holding grudges, argumentative, and saddled with a need for routines.

Type 4-Temporal lobe ADD/ADHD. Primary ADD symptoms plus a short fuse, periods of anxiety, headaches or abdominal pain, history of head injury, family history of rage, dark thoughts, memory problems, and difficulty reading.

Type 5-Limbic ADD/ADHD. Primary ADD symptoms plus chronic mild sadness, negativity, low energy, low self-esteem, irritability, social isolation, poor appetite, and disrupted sleep patterns.

Type 6-Ring of fire ADD/ADHD. Primary ADD symptoms plus moodiness, anger outbursts, inflexibility, rapid thoughts, excessive talking, and extreme sensitivity to sound and light.

Type 7-Anxious ADD/ADHD. Inattentiveness, distractibility, disorganization, anxiety, tension, nervousness, excessive pessimism, and social anxiety. People with this type are prone to physical symptoms of stress, such as headaches and gastrointestinal problems.

Natural Therapies to Try

Because adults with ADHD are more likely to suffer from stress, depression, or other emotional problems, treatment is important. Pharmaceuticals such as Adderall, Ritalin, and Strattera can be effective, but often have significant side effects, including nausea, insomnia, headaches, dizziness, and mood changes.

A number of recent studies have pointed to specific herbs, supplements, and other holistic treatments that can help. If you suspect you or someone you know has ADHD, consult with your health care provider, and try some of these natural alternatives:

Mind Your Zinc Intake
Several studies have found that people with ADHD have lower levels of zinc (low zinc levels have also been linked with Alzheimer’s, Parkinson’s disease, and depression). Because zinc regulates brain chemical activity and improves cognitive function, zinc supplements may help improve symptoms of ADHD. A number of studies have found that zinc reduces signs of hyperactivity and impulsivity, and can increase attentiveness in people with ADHD. Other studies suggest that 30 mg of zinc sulfate daily can reduce the need for medications, increase the effectiveness of medications, and help control symptoms of ADHD.

In addition to supplements, foods that are high in zinc include oysters, red meat, turkey, chicken, beans, nuts, and dairy products.

Feed Your Head Some Fat
The effect of omega-3 fatty acids on the brain has been well documented, and studies suggest that omega-3 fats can improve ADHD symptoms as well-in some cases, better than drugs.

Other essential fatty acids also have benefits: In one study, children who were treated with a mix of omega-3s, omega-6s, and evening primrose oil showed improvements in attention and behavior. In another study, 2,400 mg of fish oil plus 600 mg of evening primrose oil reduced hyperactivity and inattention.

The best dietary sources of omega-3s are fatty fish such as salmon, tuna, herring, mackerel, and sardines. Flax seeds and walnuts also contain omega-3 fats, but in a form that must be converted by the body into useful forms.

Healthy sources of omega-6 fats include evening primrose oil, borage oil, and black currant seed oil, all of which contain GLA (gamma linolenic acid), an omega-6 fat that also helps reduce inflammation. A good supplement or well-balanced blend of oils is your best bet.

“B” Brainy
Like omega-3s, B vitamins are associated with overall brain health and cognitive function. They can improve symptoms of ADHD by increasing the brain’s levels of dopamine, which enhances alertness and focus. In some studies, B vitamins also reduced aggression and antisocial behavior, and improved other symptoms of ADHD.

Other studies suggest that B vitamins are especially effective when used with magnesium, a mineral that has a calming effect on the brain. Several studies have shown that B vitamins and magnesium can relieve ADHD symptoms, including hyperactivity, aggression, and inattention. In one study, after subjects stopped taking B vitamins and magnesium, their symptoms returned. And in another interesting study, researchers found that pregnant women who lacked folate in their diets were more likely to give birth to children with hyperactivity disorders.

The best dietary sources of B vitamins include chicken, turkey, salmon and other fish, egg yolks, leafy greens, peanuts, and fortified grain products (try organic, sprouted versions). Also take a B-vitamin complex supplement-sublingual and liquid forms tend to be more easily absorbed.

Iron: Why You Might Need More
Several studies suggest that people with ADHD may be deficient in iron. In one study using MRI scans, patients with ADHD showed abnormally low levels of iron in the area of the brain that controls consciousness and alertness. In another study, 84 percent of the children with ADHD had significantly reduced iron levels, compared with 18 percent of the control group.

Studies have found that 80 mg of iron, in the form of ferrous sulfate, treated symptoms of ADHD as effectively as drugs. Good dietary sources include red meat, organ meats, oysters or clams, beans, dried fruit, and egg yolks.

The Best Herbs for ADHD
The research on botanicals as possible treatments for adult ADHD is mixed and inconclusive, but a few popular herbs do show promise.

Ginkgo biloba appears to improve ADHD symptoms, including antisocial behavior and hyperactivity. Red ginseng can calm ADHD symptoms-in one study, 1,000 mg of ginseng reduced anxiety and improved social functioning. And ginseng in combination with ginkgo helped improve social problems, hyperactivity, and impulsivity.

Bacopa (also known as Brahmi) is an Indian herb that’s been shown to improve the ability to retain information, and may be helpful in ADHD.

Calming herbs, such as valerian, passionflower, and lemon balm, can soothe irritability and restlessness, and may help promote sleep-important for people with ADHD who suffer from insomnia.

Pycnogenol, the antioxidant-rich extract from French maritime pine trees, can lower stress hormones and has been shown to decrease neurostimulant activity in people who have ADHD.

Brain Foods: Eat More of These
Studies are limited, but most anecdotal evidence suggests that a high-protein, lower-carb diet with a good mix of healthy fats can help reduce symptoms of ADHD. Cutting back on white sugar, white flour, pasta, and potatoes helps keep blood sugar levels-and mood-stable, and some research suggests that chronic excessive sugar intake leads to alterations in brain signaling.

High-protein foods such as beans, eggs, fish, meat, and nuts quickly boost dopamine and norepinephrine levels, leading to increased alertness. And healthy fats such as omega-3s promote overall brain health.

Foods & Preservatives to Avoid
Artificial colors, flavors, and preservatives may exacerbate symptoms of ADHD. Although research on adults is scarce, studies found increased hyperactivity in children after eating foods containing artificial coloring and additives.

Another study suggested preservatives, especially sodium benzoate, can cause hyperactivity even in kids without ADHD. Other studies suggest that salicylates-naturally occurring chemicals in apples, dates, avocados, peanuts, peaches, cauliflower, zucchini, broccoli, and certain other foods-may also increase hyperactivity in children. Visit salicylatesensitivity.com to learn more.

In some cases, food allergies can be part of the problem. If you suspect a hidden allergy, ask your health care provider about food allergy testing.

Mind-Body Healing Resource
Relaxation, meditation, massage, hypnotherapy, progressive muscle relaxation, guided imagery, and biofeedback may help treat ADHD by reducing stress and calming the nervous system. Neurofeedback-a type of biofeedback-has been shown to be effective in adult ADHD.

One of the top experts on mind-body medicine is James S. Gordon, MD, founder of The Center for Mind-Body Medicine in Washington, DC. Visit cmbm.org for self-care resources and to hear Podcasts on a variety of topics-from guided imagery to soft-belly breathing.

Smart supplements for brain health

Garden of LifeVitamin Code Raw Zinc, derived from raw, organic vegetables, contains 30 mg of the mineral-the amount shown in studies to reduce ADHD symptoms.

Irwin NaturalsBrain Awake is formulated to enhance focus and alertness with the brain-protective herb bacopa, B vitamins, and other brain-health nutrients.

Nature’s AnswerLiquid Vitamin B-Complex contains the full spectrum of B vitamins in an easy-to-absorb liquid form. The Natural Tangerine flavor is enhanced with organic agave.

Nordic NaturalsComplete Omega is a full-spectrum omega supplement that contains both omega-3s from coldwater fish and omega-6s from borage oil.

NOW FoodsTrue Focus maximizes mental acuity with a blend of brain-boosters including ginkgo, vitamin B6, and grape seed extract, a potent antioxidant.