The first issue I want to address is whether or not there is a difference between ADHD (attention deficit hyperactivity disorder) and ADD (attention deficit disorder). The short (but not simple answer) is “no”, ADD and ADHD are the same thing. Until 1987, ADD (attention-deficit disorder) was the term for what is now called ADHD (attention-deficit hyperactivity disorder). Whether or not the adult or child has hyperactive behaviors (and not all do), the diagnosis is still ADHD.
Adults: Although it's called adult ADHD, symptoms start in early childhood and often continue into adulthood without there being an ADHD diagnosis. In adults, this mental health disorder includes a combination of persistent problems: some examples include (but are not limited to), impulsiveness, disorganization, difficulty focusing on a task, poor time management, difficulty prioritizing, inability to multitask effectively, restlessness, mood swings, angry outbursts, low tolerance for frustration, difficulty paying attention, difficulty following through and completing tasks, difficulty coping with stress, etc. Symptoms may range from mild to severe and many adults and children with ADHD suffer poor self-esteem.
Most adults are not aware that they have it and diagnosing the condition can be difficult because many of the symptoms are similar to those of other conditions. Anxiety, depression, or mood disorders are good examples. Because adult ADHD symptoms may not be as obvious as the symptoms in children, there are those adults who are not diagnosed until they are older. Unfortunately, adult ADHD symptoms can lead to unstable relationships, poor work and/or school performance, and other problems. Adults with ADHD are not usually as hyperactive as they were as children, but they still may have to deal with impulsiveness, mood swings, coping with stress and frustration, restlessness, and difficulty paying attention. As with children, adult ADHD treatment includes medications, psychological counseling (psychotherapy), treatment of any co-morbidity, assistance in optimal daily functioning, and, hopefully, complementary alternative medicine, such as Tai Chi.
Children: ADHD starts in childhood in 30 to 70 percent of cases and continues into adulthood. In fact, it’s the most diagnosed behavioral diagnosis of US children. Approximately 10 percent of children worldwide are affected by ADHD. US spending related to ADHD (according to the Journal of the Academy of Child and Adolescent Psychiatry) annually totals approximately “$143 to $266 billion”. Five percent of US college freshman had ADHD in 2010. In 2018 that percentage jumped to 7.4%.
Along with the many symptoms of ADHD, motor and behavioral control is usually poor in these children. Interestingly, research has shown that consistent exercise improves academic performance more than studying and/or spending time in a classroom. Here’s the bad news: if they are not treated for their ADHD, there is a higher risk for substance abuse, mental illness, and/or criminal behavior as they move into adulthood!
Treatment: Studies show that treatment with stimulants is usually effective in adults. However, many don’t desire or tolerate them well. In addition, stimulants aren’t always effective and there is the potential problem of diversion and/or misuse. Patients desire non-pharmacological treatment options. Therefore, the medical community looks for non-pharmacologic treatments, because unfortunately, ADHD seems to be increasing.
EMDR (eye movement desensitization and reprocessing therapy) is another mental health therapy method also being used for the treatment of ADHD. Emotional Distress Syndrome (EDS) is often present in the ADHD brain. EMDR is one method to decreasing, (hopefully eliminating), EDS cycles by overcoming the past “trauma and reflexive negative responses that ADHD can cause”.
In order to attain mental, physical, and emotional stability, resiliency, and functioning (whether you suffer from ADHD or not), everyone needs exercise, a good diet, and adequate sleep. Current treatments include: cognitive behavioral therapy, neurofeedback, meditation, and/or exercise (including martial arts, such as Tai Chi). There appears to be potential benefits in combining motor and attention training, particularly using complementary therapies.
Research: Tai Chi integrates breathing and gentle movements with cognitive skills that are relevant to ADHD. A randomized controlled trial (RCT) consisting of three parallel seven-week interventions, namely “Tai Chi, Active Control (cardio-aerobic fitness), and Inactive Control (no contact)”was undertaken. The test subjects were college students. The results (and high retention rate) suggested that Tai Chi is a feasible, complementary treatment for ADHD.
A Tai Chi Pilot Study published in the Journal of Bodywork and Movement Therapies in April 2001, included adolescents with ADHD. Classes were held twice a week for five weeks. After only 10 sessions, the adolescents displayed less anxiety, daydreaming, inappropriate emotions, and hyperactivity. Their conduct was also improved. The scores on a two week follow-up (without Tai Chi classes) indicated that the improvements continued.
Most children with ADHD take medication which, unfortunately, has side effects such as abdominal discomfort, appetite changes, insomnia, and fatigue. Dr. Stewart Mostofsky, director of Kennedy Krieger’s Center for Neurodevelopmental and Imaging Research, sees ADHD as a brain-based behavioral disorder. Dr. Mostofky hoped to use Tai Chi to reduce the amount of medication the children required. Studies have shown that Tai Chi can help adults with ADHD to have better control over their behavior and actions, but can it help children? This was the first significant study to see how Tai Chi’s affects children with ADHD.
Dr. Mostofsky chose Tai Chi because he determined it was the best choice for children. Dr. Mostofsky, thought Yoga might be too strenuous and meditation too motionless. The Kennedy Krieger Institute ran the study using a grant from the National Institute of Mental Health to determine how Tai Chi can help children control their ADHD symptoms, such as hyperactivity, impulsivity and inattention.
At the end of the study, there was significant improvement in the children’s attention, but less improvement in hyperactivity and impulsivity. Dr. Mostofsky was hopeful that a longer duration Tai Chi study would have significant improvement in all these areas. He felt an eight week study was too short to expect a major change. When the study concluded, the children were given a Tai Chi DVD and/or access to a practice video in order to continue practicing.
My personal experience was in the late 1980s when the Tai Chi organization I was with ran a study with a mental health specialist from a University in the state. We had approximately a dozen adolescents from 13-15 years old with ADHD. We taught the kids a Chen Synthetic 88 posture form. The specialist from the University was impressed with the results and at the end, the kids self-reported on their experience. Each kid talked about how it helped them to concentrate, become less reactive, and less impulsive.
Why does Tai Chi work well as a complementary treatment?
We know that Tai Chi decreases cortisol (a stress hormone), increases dopamine, and helps memory and learning. It also improves motor skills, reaction time, attention/awareness, speed, strength, and body control.
Bottom line: I provided a lot of information on ADHD in this blog. I feel that it is a condition that is so often misunderstood (and misdiagnosed) that it was necessary to provide more information on ADHD before I discussed the part that Tai Chi has to play.
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