Medication alone is not the best way to treat ADHD; there have been a lot of studies done about this and it has been shown that the best results are attained when medication is accompanied by Cognitive Behavioural Therapy (CBT) or another therapy suitable for individual patients as well as ADHD coaching (www.chadd.org/coaching). This is especially important when women are only diagnosed in adulthood because they are likely to have used a variety of unhealthy survival strategies by that time and need to systematically wean themselves off these; CBT is the best way to do this and adults respond very well to this form of therapy, especially when coupled with Mindfulness techniques. This is the gold standard for ADHD treatment. 

Antonia Dittner, John Hodsoll, Katharine Rimes, Ailsa Russell, Trudie Chalder (2018): “Cognitive Behavioural Therapy for Adult Attention-Deficit Hyperactivity Disorder: a Proof of Concept Randomised Controlled Trial”

“Cognitive Behavioral Therapy and the Treatment of ADHD” in: Interview About CBT With Dr. J. Russell Ramsay by Keath Low, updated on 13 January 2020 (www.verywellmind.com)

Another therapy that has gained ground in the last 20-25 years in Belgium is Neurofeedback. Usually this therapy is in the form of a video game, music, or movie. During a neurofeedback session, what your brain is actually doing is compared to what you would like it to be doing. When your brain is nearing a more comfortable state, you are rewarded with a positive response on a computer screen. Much like physical exercises develop specific muscles, the more your brain is exercised into reaching a more comfortable, more efficient position, the better it gets at it. As with learning any new skill, it simply requires time and repetition. Martijn Arns, Hartmut Heinrich & Ute Strehl (2014): “Evaluation of Neurofeedback in ADHD: The Long and Winding Road” (Biological Psychology, vol. 93; pgs. 108-115) 

The long-term goal is that the Neurofeedback would lead to being able to function without medication. Results are seen at first about six months after completing treatment and these improvements seem to continue to evolve up to two years after completing treatment. At some point after this, it is usually necessary to have supplementary treatment. To find out more about how Neurofeedback treatment is done in Belgium, read: “Neurofeedback and State Regulation in ADHD” by Dr. Van Den Bergh, MD, Psychiatrist and Psychologist. It is not a first-line treatment for ADHD in Belgium, rather a complimentary one. Like everything else, it works better for some people more than others. Van Doren, J., Arns, M., Heinrich, H., Vollebregt, M. A., Strehl, U., & K Loo, S. (2018). “Sustained Effects of Neurofeedback in ADHD: A Systematic Review and Meta-analysis” (European Child & Adolescent Psychiatry. doi:10.1007/s00787-018-1121-4)

Ryan, M., Brown, T., Vollebregt, M. A., & Arns, M. (2019). “What’s Sleep Got to Do with it? Circadian Rhythm sleep Disorder, ADHD and Neurofeedback” (Asia Pacific Journal of Neurotherapy, 1(1), 85-98).

Nutrition is also a very important element in managing ADHD symptoms. Eating a balanced diet with plenty of brain-friendly food and avoiding sugar as much as possible are key to this. There are a number of books about nutrition that focus on incorporating certain types of food into your diet forever rather than going on a diet for a specific amount of time and this is the best way to approach the topic of a balanced diet.

Examples of books with this positive message are: Rudolph E. Tanzi, Ph.D. and Deepak Chopra, MD: “Super Brain: Unleashing the Explosive Power of Your Mind to Maximize Health, Happiness, and Spiritual Well-Being”

Dr. Stephen Gundry, MD: “The Plant Paradox” and “The Plant Paradox Cookbook” plus “The Plant Paradox Family Cookbook”

Dr. Nicholas Perricone, MD: “The Perricone Promise” and “The Perricone Prescription”

Exercise and sporting activities have a positive effect on one’s overall physical and mental health, from raising levels of serotonin to reducing cholesterol and building a healthy body. The feel-good factor that accompanies exercise of any kind is evidence enough of this. What if you were to incorporate exercise into your daily routine 24/7? Can you imagine what it would do for your mood, your outlook and your self-esteem? It would not have to be very strenuous exercise for lengthy periods each day; there is plenty of research that shows that simply walking for 30 minutes each day can do wonders to one’s mind and body.

Last but not least, Sleep Therapy is an essential element of ADHD management, given that so many people who have ADHD experience sleep problems – getting to sleep, staying asleep, difficulty getting up in the morning, quality of sleep no matter how many hours that they sleep, etc.

In fact, this type of therapy should go to the top of the list because sleep deprivation exacerbates ADHD symptoms significantly and correlates strongly to unhealthy eating habits and obesity. If you suffer from these problems, you should get tested for Obstructive Sleep Apnea and follow the advice given to the letter. For further research about sleep and ADHD, see: Bijlenga, D., Vollebregt, M. A., Kooij, J. J. S., & Arns, M. (2019). “The Role of the Circadian System in the Etiology and Pathophysiology of ADHD: Time to Redefine ADHD” (Attention Deficit and Hyperactivity Disorders, 11(1), 5-19. doi:10.1007/s12402-018-0271-z).