Of particular interest to me, as an ADHD Doctor, is the similarity in symptoms that ADHD and Insomnia have in common.  Both cause problems with sleep; both cause impairments in daytime functioning.  In addition to fatigue and irritability,  there are  two other symptoms  sometimes mistakenly attributed to ADHD.  Those symptoms are difficulties with attention and concentration as well as decreased motivation. I have found it an invaluable asset to talk very specifically with my patients about the amount, as well as the quality of the sleep they are getting.  Sometimes my patients problems with inattention, motivation and the inability to focus are really the result of too little sleep. Increase the amount or the quality of sleep you get  and often these symptoms dramatically improve.

As a doctor who has seen thousands of cases of ADHD, it is very easy to look at an unmotivated teenager, one who is not motivated to go to class, to graduate, or even pay attention in school and think they have ADHD.  Fortunately, at our center, our comprehensive ADHD evaluation examines the quality, amount
and duration of sleep for every patient, at each visit.  Knowing this has often prevented me from giving a diagnosis of ADHD, when lack of sleep is really the problem.  I have seen this over and over again. As kids go into their teenage years, they stay up late, occupied with TV, video games, or being on the computer and lose sleep.   This is often the cause of their ADHD like symptoms.  Be aware that many things, including lack of sleep, can look like ADHD. Only a thorough and comprehensive evaluation of the whole person done by a qualified professional can really rule out any other causes before deciding that ADHD is the answer.

CEC SMARTBRIEF, January 02, 2009

A small group of middle-school students who practiced transcendental meditation twice daily at school reduced their stress and anxiety by 50% and improved ADHD symptoms as well, according to a new study published in Current Issues in Education. The changes after three months were much more dramatic than researchers expected, including better attention, memory, organizational and behavioral skills, said lead researcher Sarina J. Grosswald. WCVB-TV (Boston) (12/31)

Adults with ADHD have less stable relationships than those adults without ADHD.  Individuals with ADHD are twice as likely to be divorced and/or sepeated.  Less than half of those surveyed who are currently in relationships say they are “completely satisfied” with their relationship partners or loved ones, compared to 58% of those people surveyed without ADHD.

While medication is often essential to the treatment and management of ADHD, there are several key strategies that must also be in place in order to maximize the outcome of your  medication regimen and optimize your success. Three essential strategies for people with ADHD are adding some type of physical exercise to their life, increasing protein intake to power the brain, and avoiding foods that render many ADHD medications inactive.

We all know that exercise is good for our bodies, but did you know that it is also good for your brain? I often tell my patients that exercise is like a tiny dose of natural Ritalin.  Exercise and ADHD medications both have something in common, they both almost immediately elevate dopamine and norepinepherine in the brain.   In turn, this helps the brain to quiet down impulsivity, decrease the need for instant gratification, as well as wake up the executive function in the pre-frontal cortex of the brain. Waking up the pre-frontal cortex provides mental space between thoughts and actions, and therefore gives you more time to evaluate consequences and make better decisions.  In addition, exercise has been shown to improve mood, decrease problems with sleep as well as decrease stress and restlessness. Exercise is an essential part of treating and regulating ADHD.

Did you know you might be eating foods that actually render your medication useless! Have you ever had a morning where you just can’t figure out why your medication isn’t working like it normally does?  The facts are simple here. Certain foods, especially those high in Citric Acid or/or high in Vitamin C (also called Ascorbic Acid), decrease or renders many popular ADHD medications inactive. So if you are taking stimulant medication with orange juice in the morning, you have just canceled out part of the effect of that dose of medication. Another culprit are multivitamins, if you take your ADHD medications in the morning, you would be wise to take your multivitamins in the evening. I recommend you limit your intake of juice, soda, and lemonade to the evenings only.  In addition, read the labels of your favorite snack bar and breakfast cereal, you might be surprised to find lots of vitamin C in those products as well.  Mornings for most individuals with ADHD are tough enough, so avoid those foods or beverages in the A.M. and you’ll find that things just work better.  

How about foods you should be eating?  The science here is pretty straight forward. Most medications for ADHD work on the regulation of Dopamine in the brain. Protein and foods that contain protein provide the body with the essential building blocks for the production of Dopamine in the body. If you are not eating enough protein (especially in the morning when your brain’s gas tank is on empty) then you are not providing your brain with what it needs to produce Dopamine. Without protein, the ADHD medications just don’t work as well. Increase your intake of dietary protein and you increase your medications ability to help your brain function better. An easy rule of thumb is protein clarifies thoughts and carbohydrates cloud thoughts.  That does not mean eliminate “carbs” all together. It does mean taking a good look at how much high quality protein you are taking in and how many sugary high carbohydrates could be avoided. 

Living with ADHD can be greatly improved with a few simple steps. First, get regular exercise like walking or riding a bike.  Second, avoid foods that contain Vitamin C or high amounts of Citric Acid one hour before and after taking your ADHD medication.  Finally, give your brain some protein, especially in the morning and avoid empty carbohydrate calories, and you will give your brain a terrific performance boost. 

The principal characteristics of ADHD are inattention, hyperactivity, and impulsivity. These symptoms appear early in a child’s life. Because many normal children may have these symptoms, but at a low level, or the symptoms may be caused by another disorder, it is important that the child receive a thorough examination and appropriate diagnosis by a well-qualified professional.

Symptoms of ADHD will appear over the course of many months, often with the symptoms of impulsiveness and hyperactivity preceding those of inattention, which may not emerge for a year or more. Different symptoms may appear in different settings, depending on the demands the situation may pose for the child’s self-control. A child who “can’t sit still” or is otherwise disruptive will be noticeable in school, but the inattentive daydreamer may be overlooked. The impulsive child who acts before thinking may be considered just a “discipline problem,” while the child who is passive or sluggish may be viewed as merely unmotivated. Yet both may have different types of ADHD. All children are sometimes restless, sometimes act without thinking, sometimes daydream the time away. When the child’s hyperactivity, distractibility, poor concentration, or impulsivity begin to affect performance in school, social relationships with other children, or behavior at home, ADHD may be suspected. But because the symptoms vary so much across settings, ADHD is not easy to diagnose. This is especially true when inattentiveness is the primary symptom.

According to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders2 (DSM-IV-TR), there are three patterns of behavior that indicate ADHD. People with ADHD may show several signs of being consistently inattentive. They may have a pattern of being hyperactive and impulsive far more than others of their age. Or they may show all three types of behavior. This means that there are three subtypes of ADHD recognized by professionals. These are the predominantly hyperactive-impulsive type (that does not show significant inattention); the predominantly inattentive type (that does not show significant hyperactive-impulsive behavior) sometimes called ADD – an outdated term for this entire disorder; and the combined type (that displays both inattentive and hyperactive-impulsive symptoms).