ADHD-treningsløsningen (2023)

Hvis du skulle støte på Jackson, min tidligere pasient, ville du møte en kompakt 21-åring i jeans og en utrukket skjorte, som snakker artikulert om planene sine for fremtiden - en typisk amerikansk college-unge, om ikke litt smartere . Det som skiller seg ut med ham er ikke så mye hvor han er i dag, men hvor langt han har kommet for å komme hit og hvordan han gjorde det med en alternativ ADHD-behandling.

Jackson, som har oppmerksomhetsunderskudd hyperaktivitetsforstyrrelse (ADHD eller ADD), løper nesten hver dag - tre mil på dager han også trener motstandstrening, seks mil på de andre. "Hvis jeg ikke gjør det, er det ikke slik at jeg føler meg skyldig," sier han. "Jeg føler at jeg har gått glipp av noe i løpet av dagen min, og jeg vil gjøre det. Fordi jeg fant ut at mens jeg trener, har jeg ikke problemer med å konsentrere meg om noe."

Jackson ble diagnostisert medADHDtidlig, etter at læreren i tredje klasse oppdaget hans forstyrrende oppførsel og manglende evne til å fullføre klassearbeid. Han begynte å taRitalinog holdt seg på en eller annen form for stimulans gjennom hele skoletiden.

Som dagstudent ved et topprangert privat akademi hadde han rett og slett mer arbeid enn han kunne komme gjennom. På et tidspunkt fikk jeg ham til å ta Adderall, Paxil og clonazepam, et langtidsvirkende angstmedikament.

Jackson squeaked gjennom med en 1,8 GPA, alt for lav til å gå på college han håpet å delta, til tross for familieforbindelser. En liten ungdomsskole godtok ham imidlertid, og det var helt greit. Triumfen ved å fullføre skolen, sammen med komforten ved å ha et reisemål neste høst, satte ham på toppen av verden. Faktisk følte han seg så bra den sommeren at han bestemte seg for å slutte med medisinene sine – alt sammen. (Det er unødvendig å si at jeg ikke var i løkken den gangen.) "Jeg la merke til at mange små ting som plaget meg forsvant," rapporterer han.

[Få denne gratis guiden: Flotte idretter og aktiviteter for barn med ADHD]

Sommerens virkelige vendepunkt skjedde i Spania, på tur med kjæresten. Når han gikk rundt i bar overkropp på stranden, med alle de "spanske guttene", ble han inspirert til å gjøre noe med Buddha-magen sin. "Jeg begynte akkurat å løpe," sier han. "Og jeg begynte å føle meg bra."

Jacksons historie appellerer til meg, delvis fordi han kom inntreningfor kroppsbildet hans, men holdt seg til det for den terapeutiske effekten. Til å begynne med gjorde ikke løpingen et innhugg i fysikken hans (takket være pizza og øl), men han holdt seg til det fordi det hjalp ham med å fokusere. I sitt første semester på ungdomsskolen oppnådde han en GPA på 3,9, og etter et år ble han akseptert som overføringsstudent ved høgskolen han opprinnelig ønsket å delta på.

Jackson er tydelig innstilt på sin egen sinnstilstand. Hvis han faller av treningsregimet, vakler konsentrasjonen. Han vet hvordan det får ham til å føle seg, og selve kunnskapen holder ham i gang. "Da jeg begynte å trene, klarte jeg plutselig å konsentrere meg om ting som var viktige for meg," sier han. "Det har aldri vært noen tvil i tankene mine om at trening er relatert til konsentrasjon. Når jeg gjorde denne enorme livsendringen, og forpliktet meg til å trene, var det veldig tydelig for meg at ting begynte å endre seg i livet mitt.»

Ikke alle med ADHD vil oppleve den omfattende effekten av trening som Jackson gjorde. Og jeg ville aldri ha foreslått at han brått skulle slutte å ta medisinene sine, spesielt antidepressiva. Hans erfaring reiser spørsmålet om trening kan erstatte Ritalin eller Adderall eller Wellbutrin, og for de aller fleste tilfeller vil jeg si at svaret er nei. I hvert fall ikke på den måten James Blumenthal, Ph.D., og hans kolleger ved Duke University viste at trening kan stå inn for Zoloft ved behandling av de med en stemningslidelse.

[Klikk for å laste ned gratis: Natural ADHD-behandlingsalternativer]

Likevel er det noe lærerikt i Jacksons motivasjon for å slutte med medisinen. Jeg tror han følte seg ute av kontroll, vel vitende om at han var smart nok til å lykkes, men ikke i stand til å få det til. Konstant frustrasjon kan føre til følelser av demoralisering, og i Jacksons tilfelle ga dette næring til humørsykdommen hans. For ham skapte det å ta medisiner en følelse av avhengighet, noe som forverret disse følelsene. Omvendt ga det å komme inn i en løperutine en følelse av kontroll over hans indre - hans humør, hans angst, hans fokus. For første gang i livet følte han at han kunne styre sin egen fremtid. Han brukte løping som sin medisin.

Engasjer hjernen

I følge den brede vitenskapen tempererer trening ADHD ved å øke nevrotransmitterne dopamin og noradrenalin - som begge spiller ledende roller i å regulere oppmerksomhetssystemet. Med regelmessig fysisk aktivitet kan vi øke basisnivåene av dopamin og noradrenalin ved å stimulere veksten av nye reseptorer i visse hjerneområder.

Trening hjelper også med å balansere noradrenalin i hjernestammens opphisselsessenter. "Kronisk trening forbedrer tonen i locus coeruleus," sier Amelia Russo-Neustadt, M.D., Ph.D., en nevrovitenskapsmann og psykiater ved California State University. "Resultatet er at vi er mindre tilbøyelige til å skremme eller reagere ut av proporsjon til en gitt situasjon. Vi føler oss også mindre irritable.»

På samme måte tenker jeg på trening som å administrere overføringsvæsken for basalgangliene, som er ansvarlig for jevn forskyvning av oppmerksomhetssystemet. Dette området er det viktigste bindingsstedet for sentralstimulerende midler, og hjerneskanninger viser at det er unormalt hos barn med ADHD.

En gruppe forskere, inkludertUniversity of GeorgiaRodney Dishman, Ph.D., undersøkte effekten av trening hos barn med ADHD ved å bruke motoriske funksjonstester som gir indirekte mål på dopaminaktivitet. Resultatene kastet Dishman for en løkke fordi gutter og jenter reagerte forskjellig. Hos gutter forbedret streng trening deres evne til å stirre rett frem og stikke ut tungen, for eksempel, noe som indikerer bedre motorreflekshemning.

Jenter viste ikke denne forbedringen, noe som kan skyldes en lavere forekomst av hyperaktivitet hos jenter. Både gutter og jenter ble bedre med et annet mål relatert til følsomheten til dopaminsynapser, selv om gutter klarte seg bedre etter maksimal (kraftig) trening og jenter etter submaksimal (moderat) trening.

Trening har gunstige effekter på andre områder av hjernen. En overaktiv lillehjernen, for eksempel, bidrar til uro hos ADHD-barn, og nyere studier har vist atADHD medisinersom øker dopamin og noradrenalin bringer dette området tilbake i balanse. Når det gjelder å heve nivået av noradrenalin, jo mer kompleks treningen er, jo bedre. Rotter har ikke lært å gjøre judo i laboratoriet - i hvert fall ikke ennå - men forskere har sett på nevrokjemiske endringer i hjernen deres etter perioder med akrobatisk trening, den nærmeste parallellen til kampsport for rotter. Sammenlignet med rotter som løp på en tredemølle, forbedret deres kohorter som praktiserte komplekse motoriske ferdigheter nivåene av hjerneavledet nevrotrofisk faktor (BDNF) mer dramatisk, noe som tyder på vekst i lillehjernen.

Enhver av kampsportene, ballett, skøyter, gymnastikk, fjellklatring, terrengsykling, padling i whitewater, og beklager å fortelle deg, mamma-skateboard er spesielt bra for voksne og barn med ADHD. Hvorfor, akkurat? Den tekniske bevegelsen som er iboende i denne typen idretter aktiverer et stort utvalg av hjerneområder som kontrollerer balanse, timing, sekvensering, evaluering av konsekvenser, bytte, feilretting, finmotoriske justeringer, hemming og, selvfølgelig, intens fokus og konsentrasjon.

I ytterste konsekvens er det å engasjere seg i disse aktivitetene et spørsmål om å overleve - å unngå en karatekotelett, eller å brekke nakken på balansebjelken, eller å drukne i et virvlende basseng med hvitt vann - og dermed utnytte kampens fokuskraft - eller-fly-respons. Når sinnet er i høy beredskap, er det rikelig med motivasjon til å lære ferdighetene som er nødvendige for disse aktivitetene. Når det gjelder hjernen, er det å gjøre eller dø. Og selvfølgelig vil vi være i det aerobe området mesteparten av tiden vi er involvert i disse aktivitetene, noe som øker våre kognitive evner og gjør det lettere å absorbere nye bevegelser og strategier.

Trening har også en positiv effekt på det limbiske systemet, fordi det bidrar til å regulere amygdala. I sammenheng med ADHD, sløver amygdalaen utløserresponsen som mange opplever, og jevner ut reaksjonen på en ny stimuluskilde, slik at vi ikke går over bord og skriker til en annen sjåfør i et anfall av veiraseri , for eksempel.

I den grad ADHD er mangel på kontroll av impulser og oppmerksomhet, er ytelsen til den prefrontale cortex kritisk. Den banebrytende studien fra 2006, fra Arthur Kramer, Ph.D., ved University of Illinois, brukte MR-skanninger for å vise at å gå så få som tre dager i uken i seks måneder økte volumet av den prefrontale cortex hos eldre voksne.

Og da Kramer testet aspekter ved deres eksekutive funksjon, viste forsøkspersonene forbedring i arbeidsminnet, vekslet jevnt mellom oppgaver og screenet ut irrelevante stimuli. Kramer var ikke på sporet av ADHD, men funnene hans illustrerer en annen måte trening kan hjelpe på.

Alle er enige om at trening øker nivåene av dopamin og noradrenalin. En av de intracellulære effektene av disse nevrotransmitterne, ifølgeYale Universitynevrobiolog Amy Arnsten, Ph.D., skal forbedre prefrontale cortexs signal-til-støy-forhold. Arnsten har funnet ut at noradrenalin forbedrer signalkvaliteten ved synaptisk overføring, mens dopamin reduserer støyen, eller statisk, av urettet nevronskravling. Dette forhindrer mottakercellen i å behandle irrelevante signaler.

Arnsten foreslår også at nevrotransmitternivåer følger et opp-ned U-mønster, noe som betyr at å øke dem til et punkt, hvoretter det er en negativ effekt. Som med alle andre deler av hjernen, må den nevrologiske suppen holde seg på optimale nivåer. Trening er den beste oppskriften.

Svettestrategier

For de fleste av mine pasienter foreslår jeg trening som et verktøy for å hjelpe dem med å håndtere symptomene, sammen med medisinene. Den beste strategien er å trene om morgenen, og ta medisinen omtrent en time senere, når de umiddelbare fokuseffektene av trening begynner å avta. For en rekke pasienter opplever jeg at hvis de trener daglig, trenger de en lavere dose sentralstimulerende midler.

Jeg prøver å trene først om morgenen, både for strukturen den gir og for å sette den riktige tonen for dagen. Mange ganger holder det meg gående. Forskere har ikke kvantifisert hvor lenge økningen i dopamin og noradrenalin varer etter en treningsøkt, men anekdotiske bevis tyder på en time, eller kanskje 90 minutter, med ro og klarhet. Jeg ber folk som trenger medisiner om å ta det når effekten av trening avtar, for å få mest mulig utbytte av begge tilnærmingene.

Sannheten er at alle har et forskjellig nivå av oppmerksomhetsunderskudd, og de bør eksperimentere for å se hvilken kur som fungerer. Mitt håp er at å vite hvordan det fungerer vil tillate en å finne den beste løsningen for seg selv. Jeg vil si 30 minutter med aerobic trening om dagen bør være minimum. Det er ikke mye tid, spesielt med tanke på at det vil hjelpe en med å fokusere nok til å få mest mulig ut av resten av dagen.

[Les dette neste: Trening og ADHD - Tanntråd for hjernen din]

Hvordan behandle ADHD hos barn: neste spørsmål

  1. Hvilke ADHD-medisiner brukes til å behandle barn?
  2. Er ADHD-medisin riktig for barnet mitt?
  3. Hva er vanlige bivirkninger forbundet med ADHD-medisinering?
  4. Hvilke naturlige behandlinger hjelper barn med ADHD?
    • Hva er de mest effektive naturlige ADHD-behandlingene for barn?
    • Hvilke matvarer kan bidra til å kontrollere ADHD-symptomer?
    • Hvilke vitaminer og kosttilskudd bør barnet mitt ta?
    • Hjelper hjernetrening med ADHD?
    • Hvor mye og hvilken type trening hjelper barn med ADHD?
    • Hvilke typer terapi hjelper pasienter med ADHD?
  5. Hva om medisinen slutter å virke?
  6. Hvordan kan jeg finne en ADHD-spesialist i nærheten av meg?

Utdrag fraSPARK: Den revolusjonerende nye vitenskapen om trening og hjernenav John J. Ratey, M.D. og Eric Hagerman. Copyright (c) 2008 av John J. Ratey, M.D. Gjengitt med tillatelse fra Little, Brown and Company, New York, NY. Alle rettigheter forbeholdt.

John Ratey, M.D., er medlem av ADDitudeADHD Medical Review Panel.

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What Does Hypersexuality Feel Like? Hypersexuality can feel like an uncontrollable sensation of sexual fantasies, urges, or behaviors, and it can be difficult to manage and cause distress or impairment. People may notice its effects on occupational and other important areas of life.

What is the root of hypersexuality? ›

The causes of hypersexual behaviour are not well understood. However, sex addiction and hypersexuality may sometimes be caused by traumatic experiences, distress, or by mental illness, such as bipolar disorder. Adults who have been sexually abused as children may display increased sexual behaviour.

Why are people with ADHD so touchy? ›

Novotni suggests that it is the tendency of people with ADHD to feel overwhelmed that leads to their hypersensitive reactions. This, in turn, contributes to their difficulty in coping emotionally.

Why are ADHD people touchy? ›

It is an attribute common in people with ADHD. Symptoms of hypersensitivity include being highly sensitive to physical (via sound, sight, touch, or smell) and or emotional stimuli and the tendency to be easily overwhelmed by too much information.

What does an ADHD shutdown look like? ›

Differences in emotions in people with ADHD can lead to 'shutdowns', where someone is so overwhelmed with emotions that they space out, may find it hard to speak or move and may struggle to articulate what they are feeling until they can process their emotions.

What do people with ADHD crave? ›

Sugar and other high carb foods boost dopamine levels in the brain, leading us to crave them more often when dopamine levels are low. Since children with ADHD have chronically low levels of dopamine, they are more likely than other children to crave and eat sugary or carbohydrate-heavy foods.

Why do people with ADHD drink? ›

Alcohol is a depressant. That is why many people use it to relax. In the case of people afflicted with ADHD, many will use alcohol to calm down the hyperactivity.

Why do ADHD brains crave dopamine? ›

No one knows exactly what causes a person to have ADHD, but some researchers have looked at a neurotransmitter called dopamine as a possible contributor to ADHD. Dopamine allows us to regulate emotional responses and take action to achieve specific rewards. It's responsible for feelings of pleasure and reward.

What are the texting habits of ADHD? ›

Examples of common ADHD texting challenges:

Forgetting to check or reply to messages. Perfectionism; overthinking your texts, sometimes erasing them completely. Misinterpreting tone of voice (sarcasm, joking, etc.) General social anxiety.

Why ADHD partners are hard to love? ›

For many people affected by ADHD, key symptoms like inattention, forgetfulness, and disorganization negatively affect their relationships. The partners without ADHD can misinterpret their partners' intentions, resulting in increased frustration and resentment.

Do people with ADHD have empathy? ›

As we've discussed, unfortunately, many people with ADHD tend to have a lack of empathy. This can be addressed, though, through identifying and communicating about each other's feelings.

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