On April 29, the Trump administration announced it was cutting $1 billion in funding for federal grants used to hire and train 14,000 mental health professionals in 260 public school districts across 49 states.

The grants originated in 2022’s Bipartisan Safer Communities Act, a bill that passed the Senate with unanimous consent following the school shooting in Uvalde, Texas, where 22 people died, including 19 elementary school children. The bill was largely seen as important recognition of and support for an escalating mental health crisis among American youth.

In April, the Trump administration eliminated all funding for these grants, blaming Diversity, Equity and Inclusion (DEI) initiatives associated with them. Specifically, the administration objected to grant money being used to train and recruit diverse mental health counselors who reflect the demographic make-up of the students they serve.

Meanwhile, research shows that BIPOC students benefit from access to a diverse cohort of mental health professionals¹, and the inverse is true as well.

“We see studies that show a bias in the way that Black children, in particular, are treated in the health care system compared to white children,” said Tumaini Rucker Coker, M.D., during the ADDitude webinar “Equity in ADHD Care.” “It is directly related to racial bias. Black families are less likely than white families to have concordance or a shared lived experience with their healthcare providers, and studies have shown that Black adults are more likely than white adults to report lower levels of trust in their providers as well.”

[Read: “As Inclusion Disappears, My Mask Reappears”]

Furthermore, “studies show that Black families tend to have worse outcomes with white doctors,” said Napoleon B. Higgins, Jr., M.D., during his ADDitude webinar “Health Equity in ADHD.” “That is that is a sad thing to hear, but if we can educate more providers, maybe we could change that.”

Recently, ADDitude invited its readers’ reflections on news of the $1 billion in cuts to youth mental health services. Nearly 200 people responded, and many of them expressed concern that all students’ mental health may suffer because of the cuts, but especially those with autism, ADHD, and learning differences, who may benefit from seeing school counselors with similar lived experiences.

[Read: “DEI – and Neurodivergence – Are Under Attack”]

ADDitude Readers React to Mental Health Funding Cuts

“As a school social worker and the parent of a child who has an IEP, I consider Trump’s cuts to funding for public school mental health to be gross negligence. I think that it highlights his ignorance on the issues plaguing our youth. I also find it irresponsible. Our kids still are not okay ever since COVID. I believe that it will impact the services that my son receives.”

“Students need to feel safe and be OK within themselves before they can take in the knowledge to learn anything. Cutting access to mental health services means that students who are at-risk learners due to factors outside a school’s or educator’s control may become disengaged learners. This leads to more problematic and potentially anti-social behavior.”

“As a former teacher of students with disabilities, I am concerned. Students need safe places to go and get mental health support. Parents are doing their best but don’t always have the resources to support their children.”

“All three of my children are neurodiverse, and this can take a toll on their mental health. Having supports like counselors, DEI programs, and other accessibility programs is vital. I now have two children in college and one entering high school.”

“I am a school counselor and my son has ADHD. We’re already incredibly behind on providing mental health services to students. These cuts are only going to significantly increase the percentage of students whose health needs are hardly or never addressed.”

“Every child should have the support they need to excel in school. School mental health services are critical for this.”

“I don’t understand why we are defunding mental health awareness, advocacy, and resources. It really doesn’t make any sense to me. It seems like we had made such strides forward in mental health, but now we’re going backward for some reason. I understand cutting expenses to cut spending and improve the national deficit, but it seems like we are cutting very vital and necessary things. It’s like trying to cut back on your own budget by deciding to not buy groceries anymore.”

Understanding Trump’s Funding Freeze: Next Steps

• Read: Generation AnXiety — Findings on ADHD & the Mental Health Crisis
• Learn:Youth Mental Health Care Is Vital. And Hard to Access.
• Watch: Mental Health Out Loud Webinar

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Sources

¹
McGuire, TG., Miranda, J. (March-April 2008). New evidence regarding racial and ethnic disparities in mental health: policy implications. Health Affairs.https://doi.org/10.1377/hlthaff.27.2.393

In my clinical experience as a music therapist, I’ve seen how music and other sensory experiences help individuals improve their focus, impulse control, and emotional regulation. Try these fun (and whimsical!) activities, designed to stimulate the sensory pathways (sight, sound, touch, taste, and smell) to relax the body and mind.

The Scarf’s Serenade

Grab a light scarf. Put on some instrumental, relaxing music of your choice. Glide the scarf over your body. The calming and repetitive action works well to regulate hyperactivity, racing thoughts, and impulses, as your attention will be drawn to the sensory experience of the scarf over your skin to the tune of soothing music.

A Symphony of Mist

Put on a relaxing, instrumental music track. (Not sure what to select? Try “Raindrops Keep Falling on My Head” by B.J. Thomas. You’ll see why.) Grab a spray bottle and fill it with water. Spray it over your head and let the mist fall onto your face. The light touch of the mist paired with familiar, rhythmic music activates the parasympathetic nervous system, which is responsible for the body’s calming response. This helps shift the brain and body from a hyper-aroused to a more regulated and calm state.

The Balloon’s Dance

Put on some music and bounce a balloon to the beat. Music adds a predictable auditory rhythm, to which you can naturally sync your movements. Meanwhile, repetitive bouncing will provide a target for your focus and give your body an outlet for restless movement, without being overly stimulating.

Sticks and Sounds

Turn on your favorite music and grab two pencils or chopsticks. Then, tap along to the beat on any surface you can find! If you’re already in the habit of drumming along, keep at it. Tapping is a controlled, safe outlet for movement — you may not realize how it has probably helped you manage restlessness and reduce impulsive behaviors! Moving and grooving to a beat supports body regulation and coordination, promoting a sense of internal calm.

Music Therapy and ADHD: Next Steps

• Read: Music Therapy — Sound Medicine for ADHD
• Read: Rhythm Notion — 10 Benefits of Music for ADHD Brains
• Read: Music Is Magic — 9 Hacks to “Beat” ADHD Symptoms

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Yes, I could be seeing patients inside a clinical office to discuss suppressing or ignoring old behaviors while allowing a deeper self to arise. Or I could just remind them to bring an umbrella to our session today as we delve into these issues.

Three months into the COVID-19 pandemic, I moved across the country with my three young children to Palo Alto, California, for the University and College Mental Health Fellowship in psychiatry at Stanford University. But instead of joining a vibrant academic community, I worked from my apartment. Alone. A few months later, forest fires made the air quality so bad that we couldn’t even go outside.

[Free Download: How to Choose the Right ADHD Treatment Profesional]

As the pandemic began to lift, we wore masks when we treated patients in person. But in doing this emotional work, revisiting the difficult moments of a patient’s childhood, it is so important to see kindness on a psychiatrist’s face. So I made a decision: Whenever possible, I met with patients outside in nature, where masks weren’t required.

Benefits of Nature Therapy

After the pandemic ended, even as we sat in coats under umbrellas during the rainy season, I repeatedly asked my patients, “Do you want to do this in an office?” The answer was always the same: “Absolutely not.”

When patients are diving deeply into old pain, desperately hoping for connection while also fearing it, I can simply say: “What do you see, right now? What do you hear?” They look around at the grass and the trees, hear the birds, feel the sun on their skin, or hear the rain drumming on their umbrella. They discover that their fear is about the past, not the present. Try as they might, they can’t force their fear away any more than they can stop the rain. But they can notice it. They can choose to ignore the narrative it generates in their inner monologue. They can breathe and let the tears fall so that something new can grow.

The rainy season of change can be hard. But it doesn’t last forever. Eventually, spring comes. And the grass grows. To allow growth to change us for the better, we need to trust this deeply in our bodies. For my patients, I’ve found there is great power in learning from the change of the seasons. So we do the work. Outside. And sometimes it rains.

[Read: Go Take a Hike! (No, Really, It Helps.)]

Nature Therapy for ADHD: Next Steps

• Free Download: Everything You Need to Know About Cognitive Behavioral Therapy (CBT)?
• Read: How Green Time Promotes Better Focus
• Read: Never Underestimate the Healing Power of Mother Nature

Aaron Winkler, M.D., is a board-certified psychiatrist in California. He founded and directed the Adult ADHD Clinic at Stanford University before deciding to pursue private practice.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Listening to music while practicing mindfulness exercises may improve focus, mood, and emotional wellbeing in people with symptoms of ADHD, anxiety, and depression, according to two new studies.

A systematic review examining the relationship between music and ADHD found that music listening activates brain regions involved in sensory processing, motor control, and motivation — networks that are often dysregulated in individuals with attention deficit.¹

Traditional thinking suggests that quiet environments help sustain attention; however, the opposite may be true. The review, published in Behavioral Science, indicated that music, especially calm music with or without lyrics, can improve focus and performance in individuals with ADHD, especially when it is heard before or during tasks. Listening to music can also help filter out distractions, leading to improved learning and mood.

“People with ADHD benefit from ‘rhythmic entrainment,’ using strong, steady rhythms to imprint structure and consistency. This assists with regulation of attention and behavior,” said Roberto Olivardia, Ph.D., Clinical Instructor of Psychology at Harvard Medical School, during his presentation titled, “We Got the Beat: The Impact of Music on ADHD,” at the 2024 Annual International Conference on ADHD.

Listening to music could become counterproductive if it causes overstimulation or if the listener is doing a challenging task that requires significant cognitive resources, the researchers noted.

Music Therapy Boosts Emotional, Social Skills

Music listening may be self-directed or facilitated by a trained music therapist, as part of music therapy. Music therapy sessions often incorporate active music listening, playing instruments, songwriting, or singing, as well as passive music listening.

The review made a compelling case for using music therapy to complement ADHD medications and other recommended therapies, citing evidence for the efficacy of music therapy in reducing symptoms of ADHD. For example, active music-making can enhance working memory and social skills while decreasing aggression. Conversely, passive music listening may improve learning and reduce disruptive behaviors.

“These insights highlight the potential for music to contribute to more holistic, non-pharmacological approaches, offering individuals with ADHD new avenues for enhancing cognitive functioning and overall wellbeing,” the study’s authors wrote.

The systematic review included 20 studies published between 1981 and 2023, reflecting data from 1,170 participants aged 2 to 56 years. Several limitations exist: The studies primarily focused on children and adolescents, rather than adults. Variations in study methods and design also resulted in some inconsistent findings.

“Despite these limitations, this review provides a valuable foundation for future research on the interaction between ADHD and music,” the study’s authors wrote.

Mindfulness Paired with Music Reduces Stress, Improves Mood

Another recent, smaller study, published in Frontiers in Neuroscience, suggests that listening to music while performing mindfulness exercises activates areas of the brain and body related to stress and emotional regulation that could reduce moderate symptoms of anxiety and depression in adults.sup>2

The study, led by a team of researchers from the Yale School of Medicine, assessed the physiological impact of music mindfulness by recording heart rates and EEGs from 38 participants, aged 18 to 65, as they engaged in a bilingual, two-week mindfulness program centered on “focus” and “mindfulness.”

“Anxiety and depression reduce autonomic system activity, as measured by Heart Rate Variability (HRV), and exacerbate cardiac morbidity, while both music and mindfulness have been shown to increase HRV,” wrote the researchers.

They found that music mindfulness quickly improved HRV — a sign of better stress regulation — and changed brain wave patterns (measured by EEG) in areas of the brain linked to emotion, awareness, and decision-making.

Both virtual and in-person sessions incorporated similar guided mindfulness exercises, accompanied by live improvised music, music listening, or no music at all. In addition to wearing mobile heart rate and EEG monitors during each session, participants completed surveys regarding their stress levels, degree of mindfulness, state of consciousness, and level of social connection before and after each session.

The virtual group exhibited a significant decrease in stress and a significant increase in altered states of consciousness during the “focus” sessions, but not the “motivation” sessions. This contrasted with the in-person sessions, where stress decreased and mindfulness and altered state of consciousness increased during both Focus and Motivation sessions.

The researchers said that the differences in music composition features (tempo, key, mode) between “focus” and “motivation” sessions may explain the physiological differences observed in heart rate variability.

In-person sessions with music boosted feelings of social connection more than the virtual sessions did, underscoring the value of live, shared experiences in therapeutic settings.

“Our results imply that, while virtual sessions reduce stress, they do not have as extensive an effect on psychological states as in-person sessions do,” the researchers wrote. “Important aspects of live social interaction may drive feelings of social connection and serve as a key differentiator between live and virtual sessions.”

The researchers also observed gender-specific effects via HRV; women appeared to benefit more physiologically from music mindfulness than men.

While the findings from the Behavioral Science and Frontiers in Neuroscience studies contribute to a growing body of evidence supporting the use of music as a viable adjunct treatment for ADHD and mood disorders, both research teams emphasize the need for further investigation. Future studies would include randomized controlled trials, long-term outcome assessments, and greater representation of adult populations.

Sources

¹Saville, P., Kinney, C., Heiderscheit, A., Himmerich, H. (2025). Exploring the intersection of ADHD and music: A systematic review. Behav. Sci. https://doi.org/10.3390/bs15010065

²Ramirez, C., Alayine, G.A., Akafia, C., Selase, K., Adichie, K. et al. (2025). Music mindfulness acutely modulates autonomic activity and improves psychological state in anxiety and depression. Frontiers in Neuroscience. https://doi.org/10.3389/fnins.2025.1554156

Reserve your spot in this free webinar, and get the event replay link plus a 15% discount to ADDitude magazine

Not available June 26th? Don’t worry. Register now and we’ll send you the replay link to watch at your convenience.

ADHD brings with it intense emotions, impatience, and stress — and our inability to regulate these feelings affects everyday life as well as our most important relationships. We overreact to situations and feel angry or dejected due to real or perceived criticism. We have trouble calming down and sometimes react in ways that we later regret.

Mindfulness and related contemplative practices offer a powerful counterbalance to these feelings. They are valuable tools that aid in stress reduction, self-awareness, cognitive flexibility, self-compassion, habit change, and more. And here’s the good news: Contrary to popular belief, these practices do not require a still mind and body. When these practices are integrated with a proactive approach to physical health, they can create a stable emotional foundation that supports comprehensive, evidence-based ADHD care.

In this webinar, you will learn:

• How ADHD impairs executive function and contributes to emotional dysregulation
• About the clinical importance of addressing emotional health as a foundational step in ADHD treatment planning
• How unmanaged emotional reactivity disrupts adherence to evidence-based ADHD interventions
• How to evaluate the role of mindfulness and contemplative practices in promoting emotional self-regulation and cognitive flexibility
• How to apply specific mindfulness-based strategies to support comprehensive, individualized ADHD care across clinical settings.

Have a question for our expert? There will be an opportunity to post questions for the presenter during the live webinar.

Meditation for Emotional Regulation: Resources

• Free Download: Make Mindfulness Work for You
• Read: Meditation for the Bored & Restless: How to Practice Mindfulness with ADHD
• Read: The Key to ADHD Emotional Regulation? Cultivating Gratitude, Pride & Compassion
• Read: The Ultimate List of Mindfulness Exercises
• eBook: Mindfulness & Meditation for ADHD Symptoms

Meet the Expert Speaker

Mark Bertin, M.D., is a developmental pediatrician and author of How Children Thrive, Mindful Parenting for ADHD (#CommissionsEarned), Mindfulness and Self-Compassion for Teen ADHD (#CommissionsEarned), all of which integrate mindfulness into evidence-based pediatric care. Dr. Bertin is a faculty member at New York Medical College and the Windward Teacher Training Institute, and has served on advisory boards for APSARD, ADDitude Magazine, The Screen Time Action Network, Common Sense Media, and Reach Out and Read. His blog is available through Psychology Today and elsewhere.

In addition to his clinical and writing work, Dr. Bertin leads workshops and retreats that combine mindfulness and practical support for families and professionals. Join him for Held and Whole: A Restorative ADHD Retreat Rooted in Nature, October 10–12, 2025, in the Catskills. For more information, please visit www.developmentaldoctor.com.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

Webinar Sponsor

Living with ADHD can feel like an emotional rollercoaster – Inflow gets it. Their science-backed program, developed by ADHD experts, teaches mindfulness techniques tailored for ADHD brains so you can learn to pause, process, and respond instead of reacting. Build emotional regulation skills, create calmer routines, and take back control. Take the free ADHD traits quiz to get started.

ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

Certificate of Attendance: For information on how to purchase the certificate of attendance option (cost $10), register for the webinar, then look for instructions in the email you’ll receive one hour after it ends. The certificate of attendance link will also be available here, on the webinar replay page, several hours after the live webinar. ADDitude does not offer CEU credits.

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Vitamin D insufficiency worsens sleep problems in children with ADHD, but it does not directly affect the condition’s symptoms or functional impairments, a recent study published in Frontiers in Psychology found.¹

Children with ADHD are more likely to experience vitamin D deficiencies than are children without ADHD, according to previous research.² However, this study found no causal relationship or direct link between ADHD symptoms and vitamin D insufficiency.

Scientists did find that low vitamin D levels (below 30 ng/mL) can worsen sleep difficulties, impairing sleep quality and worsening sleep disordered breathing, in children with ADHD.

The researchers wrote that sleep difficulties “increased daytime sleepiness, inattention, and oppositional defiant disorder symptoms in children.” Additionally, it was found that sleep disordered breathing can affect a child’s attention, focus, hyperactivity, memory, and executive functioning, essentially exacerbating ADHD symptoms.

Nearly three-quarters of children with ADHD experience a sleep problem or disorder.³ Additionally, up to half of children with ADHD have sleep problems, such as difficulty sleeping, insomnia, night waking, and hypersomnia.⁴, ⁵

This is the first study, to the researchers’ knowledge, that examines whether vitamin D insufficiency exacerbates sleep problems and symptoms in children with ADHD. Exploring the impact of vitamin D on sleep in children with ADHD is an important area of study since sleep problems in childhood may last into adolescence and adulthood.

“Poor sleep is a self-fulfilling prophecy,” says Joel Nigg, Ph.D., a clinical psychologist and a professor in the departments of psychiatry and behavioral sciences at Oregon Health & Science University. “Just one night of bad sleep can make a child’s inattention and opposition even worse the next day, in turn making it even more difficult to get ready and settled for sleep the next night. The pattern repeats indefinitely if not arrested.”

The case-control study examined data collected from 260 children with ADHD aged 6 to 14 years, 95 with vitamin D sufficiency and 165 with vitamin D insufficiency, from the Department of Child Health at Dalian Municipal Women and Children’s Medical Center in China.

The researchers noted several study limitations. Sleep information was obtained through subjective reports from the subjects’ parents, and researchers noted differences between these and objective sleep measures. Additionally, the study participants were limited to a group of children from Northeastern China. The sample size of 220 children is also too small to extrapolate the findings to other populations. Furthermore, since all participants had ADHD, there was no control group in this study.

The scientists hope to use the data collected from this study to further explore the relationship between ADHD symptom severity, sleep, and vitamin D levels in future studies with a more representative sample and a control group.

Vitamin D, which is mainly sourced from sunlight, can help with sleep difficulties commonly found in people with ADHD, like sleeping late, waking up throughout the night, or waking up very early. In the past few decades, researchers have found that locations with greater sunlight report lower-than-average ADHD prevalence, suggesting a possible connection between ADHD and vitamin D.⁶

Sources

¹ Zhang, P., Liu, Y., Yan, M. et al. (2025). Vitamin D insufficiency and sleep disturbances in children with ADHD: a case-control study. Frontiers in Psychology. https://doi.org/10.3389/fpsyt.2025.1546692

²Kotsi, E., Kotsi, E., Perrea, D.N. (2019). Vitamin D levels in children and adolescents with attention-deficit hyperactivity disorder (ADHD): a meta-analysis. <em>Attention deficit hyperactivity Disord. </em> https://doi.org/10.1007/s12402-018-0276-7

³ Sung, V., Hiscock, H., Sciberras, E., Efron, D. (2008). Sleep problems in children with attention-deficit/hyperactivity disorder: prevalence and the effect on the child and family. Arch Pediatr Adolesc Med. https://doi.org/10.1001/archpedi.162.4.336

⁴ Hvolby A. (2015). Associations of sleep disturbance with ADHD: implications for treatment. Atten Defic Hyperact Disord. doi: 10.1007/s12402-014-0151-0

⁵ Spruyt, K., Gozal, D. (2011). Sleep disturbances in children with attention-deficit/hyperactivity disorder. <em>Expert Rev Neurother.</em>.https://doi.org/10.1586/ern.11.7

⁶ Miller, M.C., Pan, X. Eugene Arnold, L. et al (2021). Vitamin D levels in children with attention deficit hyperactivity disorder: Association with seasonal and geographical variation, supplementation, inattention severity, and theta:beta ratio. Biological Psychology. https://doi.org/10.1016/j.biopsycho.2021.108099

Stimulant medications (amphetamine or methylphenidate) reduce ADHD symptoms better than non-pharmacological interventions, according to a meta-analysis published in The Lancet Psychiatry, which included 113 randomized clinical trials (RCTs) and 14,887 participants aged 19 to 44. ¹

The researchers analyzed self-reports and clinician-reported rating scales submitted at 12, 26, and 52 weeks regarding the efficacy of medication and non-medication treatment for ADHD.

“Stimulants were the only intervention supported by evidence of efficacy in the short term (i.e., at time points closest to 12 weeks) for core symptoms of ADHD in adults (both self-reported and clinician-reported) and were associated with good acceptability (all-cause discontinuation),” they said. (Amphetamines and methylphenidate showed no notable difference in effectiveness.)

Atomoxetine, a selective norepinephrine reuptake inhibitor (SNRI), benefited adults with ADHD during the measured time periods, but atomoxetine had worse overall acceptability compared to placebo.

A small body of evidence suggested that non-medication treatment [i.e., cognitive behavioral therapy (CBT), neurofeedback, and relaxation therapy] benefited people with ADHD over longer periods. However, those studies, the researchers noted, had inconsistent results with variations depending on whether the individual with ADHD or their clinician rated the core symptoms.

“Our findings highlight how both individuals with ADHD and clinicians should be considered as sources of evidence, with ratings of symptoms by both groups measured in RCTs,” the researchers said. “Participants in RCTs might report positive effects of the active intervention to please the interviewer (the Hawthorne effect), or might not correctly report the perceived effects of interventions (especially when they feel under pressure from the clinicians and have difficulties with executive function, as is often the case in people with ADHD).”

Neurofeedback Therapy for ADHD Not Effective

A separate meta-analysis published in JAMA Psychiatry examined the results of neurofeedback treatment in 2,472 people with ADHD aged 5 to 40 years from 38 RCTs. ²

The review, led by the University of Southampton, King’s College London, and the University of Zurich, found insufficient evidence to recommend neurofeedback as a front-line treatment for ADHD. According to the researchers, neurofeedback did not significantly reduce ADHD symptoms of inattention, hyperactivity, and impulsivity, and it did not improve cognitive performance in adults. Their findings did show that adults who used neurofeedback gained a slight improvement in their processing speed.

In addition, the researchers did not identify any differences between neurofeedback and other non-pharmacological treatments, such as physical exercise or cognitive training. Newer neurofeedback techniques, such as functional magnetic resonance imaging (fMRI) and functional near-infrared spectroscopy (fNIRS), also lack the evidence to support their efficacy at treating ADHD symptoms.

Neurofeedback is a distinct form of biofeedback that uses electroencephalography (EEG) to help patients train their brains to improve focus, impulse control, and executive function.

“The effects of neurofeedback don’t really last in the long term,” Stephanie Sarkis, Ph.D., said during the ADDitude webinar “Dispelling Myths About Supplements for ADHD.” “I know people who have used it say they felt more focused after sessions, but then they returned to baseline quickly. Neurofeedback is expensive to get that kind of a result, and insurance doesn’t cover it.”

A 2023 ADDitude survey of more than 11,000 caregivers and adults with ADHD found that 9% of adults and 14% of children have tried neurofeedback for ADHD. Of those respondents, caregivers rated the efficacy of neurofeedback as 2.9, and adults rated it as 2.88, on a five-point scale. In contrast, medication was rated 3.57 by caregivers and 3.52 by adults who responded to the ADDitude survey.

Indeed, the formal effect sizes for ADHD medication are .8 to 1.0, which are among the strongest in all of psychiatry.³ Clinical practice guidelines recommend medication as the first-line treatment for ADHD due to its overwhelming efficacy; for children with ADHD ages 4 to 6, parent behavior training is recommended by the American Academy of Pediatrics (AAP). ⁴

“Despite continuing progress in our scientific understanding of ADHD, little has changed for decades in terms of treatment,” said Edmund Sonuga-Barke, a professor of developmental psychology, psychiatry and neuroscience at King’s College London and joint senior author on the JAMA Psychiatry report. “Effective alternatives to medication as the front-line treatment for core symptoms are still lacking. The development of new, science-driven, and more effective non-pharmacological approaches for the treatment of ADHD, therefore, remains a priority for our field.”

Sources

¹ Ostinelli, E.G., Schulze, M., Zangani, C., Farhat, L.C., Tomlinson, A., Del Giovane, C., et al. (2025). Comparative efficacy and acceptability of pharmacological, psychological, and neurostimulatory interventions for ADHD in adults: a systematic review and component network meta-analysis. Lancet Psychiatry. https://doi.org/10.1016/S2215-0366(24)00360-2

² Westwood, S.J., Aggensteiner, P., Kaiser, A., Nagy, P., Donno, F. et al. (2025). Neurofeedback for attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2024.3702

³Faraone, S. V., & Buitelaar, J. (2010). Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis. European Child & Adolescent Psychiatry.  https://doi.org/10.1007/s00787-009-0054-3

⁴Centers for Disease Control and Prevention. (2022, March 8). Treatment recommendations for healthcare providers. https://www.cdc.gov/adhd/hcp/treatment-recommendations/index.html

In 44 days, the Make America Healthy Again (MAHA) Commission says it will deliver to President Trump a report — based on existing research, public hearings, roundtables, and meetings but not new studies — on the scope, causes, and treatments related to childhood chronic disease. In its founding documents, the MAHA Commission, chaired by Health and Human Services Secretary Robert F. Kennedy, Jr., singled out autoimmune diseases, autism, and ADHD, which it said “pose a dire threat to the American people and our way of life” and “harm us, our economy, and our security.”

Medical professionals and advocates were swift to condemn the commission’s stigmatizing portrayal of ADHD and autism as “a dire threat,” and challenged its suggestion that chronic conditions like these may be caused by “over-utilization of medication, certain food ingredients, certain chemicals and other exposures” — claims not supported by accepted scientific knowledge and research.

Of greatest concern to caregivers and patients with ADHD was the commission’s vow to “assess the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs.” As countless ADDitude readers have said to us: Stimulants are not a threat; they are an essential and effective treatment that mitigates threats to our wellbeing. Many expressed fear that the commission’s actions could restrict access to their prescription medication.

While the commission said it would rely on “transparency and open-source data,” it has not held any reported public hearings or meetings with ADHD experts since it was established in February. News outlets have reported only one closed-door gathering on March 11 with no public invitation or known agenda.

Secretary Kennedy has not responded to ADDitude’s open letter, urging him to consult with ADHD experts and researchers regarding evidence-based findings to effectively treat the condition. However, more than 400 ADDitude readers shared their opinions of the MAHA Commission and its anticipated assessment and final recommendations, which are expected to be delivered to President Trump on August 12.

• 66% of readers said they feel fearful, angry, and/or skeptical of the MAHA Commission
• 23% of readers said they are reserving judgment, feel torn, or are unfamiliar with the MAHA Commission
• 10% expressed excitement or hopefulness about the commission’s work

[New Class! ADHD Treatment Guide for Adults]

Here are some of those opinions, sent to ADDitude in response to the question: What do you think the MAHA Commission assessment, and subsequent recommendations, might mean for your family and others with ADHD, depression, and other related conditions?

Those Who Oppose the MAHA Commission

“I am deeply concerned by this resolution and its negative bias against the medication that has been life-changing for so many people and families. I also find it misaligned with the opinions of the respected researchers like Dr. Russell Barkley who have worked so hard to destigmatize ADHD medication and help people understand that dangerous consequences can come from living without any treatment. I am concerned that this resolution is misrepresenting itself as trying to improve health, when it is actually an effort to restrict treatment options that are already heavily researched and proven.” — an ADDitude reader in Florida

“Health insurance companies will use the commission’s recommendations to make it harder for us to undergo ADHD testing and treatment in every form. They will use it to justify denying requests to receive all types of therapy, medications, etc., and/or increase our payments to receive them. They will use it to justify denying coverage for pre-existing conditions that they no longer feel need to be treated.” — an ADDitude reader in Florida

[Reader Essay: “We Should Never Pull a Life-Saving Medication from a Child.”]

“One assessment by non-experts devoted to a political cause will be wasteful and biased. It will certainly not be worth throwing out an entire body of scientific dispassionate inquiry and knowledge that has accumulated over decades of ADHD research and practice. I can’t imagine what his motive is except to humiliate and dehumanize us.” — an ADDitude reader in Virginia

“This sets us back at least 10 years in mental health care. Referring to any therapeutic treatment as a potential ‘threat’ not only worsens stigma but propagates complete misinformation.” — an ADDitude reader in Colorado

“It is significantly concerning when those without medical knowledge or an understanding of how to look at and critically assess research are making decisions about how to treat health concerns. We are already seeing the impact of unsound decision-making, as previously eradicated illnesses and diseases are making an unwanted comeback. Without informed decision-makers, people will suffer.” — an ADDitude reader in Pennsylvania

“MAHA will probably limit which medications are covered by insurance or Medicaid, making life unaffordable and unbearable for many neurodivergent people who are relying on them just to get through each day. Each person’s body chemistry handles different drug formulas differently, and often it takes trial and error to find the correct med for each person. Taking many of these medications off the table will greatly impact so many.” — an ADDitude reader in North Carolina

“I see a huge threat in this MAHA initiative. It sounds like segregating or eliminating ‘mutants’ at the beginning of a sci-fi movie. Add in the attack on Section 504, and it would seem that anyone who is not physically or neurologically ‘typical’ is not worth helping/saving/protecting. It’s absolutely horrific. I think it could go way beyond limiting treatment, and I believe it would be a massive disservice to our people, and our public health, setting a terrible precedent for who is ‘valuable enough.'” — an ADDitude reader in California

“The very wording of the statement reflects their bias against these vital tools. Their intent is to restrict access and convince people that they don’t work. This will only further harm marginalized communities that already receive care at lower rates.” — an ADDitude reader in Arkansas

“I am terrified of the outcome of this so-called assessment. For several years we’ve tried to find the right drug combination for my daughter. Now we seem to have it, and I’m afraid it will be stripped away in a couple of months. We both have ADHD, take stimulants, as well as meds for anxiety and depression. If they are no longer available to us, I will attempt to migrate to Canada, seeking asylum based on the fact that living in the U.S. would put our health severely at risk.” — an ADDitude reader in Texas

“No different than a Type-1 diabetic who needs insulin to lower blood sugar levels, my son’s brain needs these medications to help balance its chemistry. Without them, I’m certain he would not be able to attend school. Our insurance company makes me fight every month for the medication he has. I can’t imagine more limitations!” — an ADDitude reader in Oregon

“If the recommendations lead to stricter limitations on the prescribing of medications, it may force individuals with ADHD, depression, and other mental health conditions to turn to less effective or more dangerous treatment options. Additionally, limiting prescribed medications could reinforce the stigma surrounding mental health, making it harder for individuals with ADHD and depression to seek help as their treatment options are limited.” — an ADDitude reader

“I exercise, eat healthy, meditate, blah blah blah, and only the meds make my brain work better. I can feel the moment it turns on. Take the meds away, and you have mayhem at work, and at home. It’s mind-bending to ponder the consequences.” — an ADDitude reader in New Mexico

“I can’t even think about this without feeling ill. On the surface, I look like a normal, functioning professional with an advanced degree. I am fortunate to have landed a job with a six-figure salary, but I can’t tell you how many nights I spent curled up crying during the stimulant shortages because I was terrified that I would lose my job if I couldn’t function without my medication. Not to mention how hopeless and embarrassed I felt having to desperately call every local pharmacy to see if they had medication in stock. We need to broaden access — not limit it.”- an ADDitude reader in Michigan

“Politicians should not be interfering with medication access or making decisions on what is or isn’t safe. That’s what the FDA is for. These headlines make me extremely anxious and, in a way, feel less than — like those who want to ban SSRIs and other medications do not care about those of us who need them.” — an ADDitude reader in Michigan

“They are targeting medications that truly make a difference in the day-to-day lives of ADHD brains and their parents. If some of these medications get taken off the market, there will increases in suicides. Taking away what works without viable alternative solutions is a huge mistake. As a scientist, I’m scared of people who are not accepting of scientific proof.” — an ADDitude reader

“Based on the anti-science rhetoric from this new administration, I am afraid they may act to limit the usage of these medications based on their motivated reasoning. They will disregard the body of evidence, and use false-cause, anecdotal, and Texas sharpshooter fallacies to do real harm to Americans who need these medications to function or even survive.” — an ADDitude reader

Those Who Support the MAHA Commission

“I’m hoping for a broad, holistic, ground-up approach where our treatment options outside of medications are expanded and supported and made more financially accessible to make needed medications and prescriptions more effective.” — an ADDitude reader in Georgia

“I want to know that what my kids are taking is actually safe, actually healthy, and actually doing what it should be doing. We should not be afraid of that. If they find that pharmaceutical companies are lying to us, then please, by all means, take the medications out of production and find us alternatives that really do help! I say this as a mother of four children on ADHD and depression/anxiety medications.” — an ADDitude reader in Minnesota

“I tend to be more conservative when it comes to diagnosing and medication management, so I think we need an assessment of the system with new recommendations from a new perspective. In the 30 years I have been a social worker, I have seen many over-diagnosed and over-medicated clients. I think we need to go to a more holistic approach. I feel that meds are often prescribed in isolation, when they should be in combination with therapy or other forms of counseling/support groups. Mental health is a huge crisis, but even more so is the over-medication of the U.S. population. I welcome the oversight.” — an ADDitude reader in Maryland

“Healthcare in the U.S. needs to be reformed and the only way to do that is to shake things up. It would mean we can get rid of things that aren’t working and implement new policies and ideas that will work. It might mean we have to fight harder for the things that matter but when we work together anything is possible!” — an ADDitude reader

Those Undecided on the MAHA Commission

“My initial reaction was fear and disbelief — wondering why this was being investigated and whether I might have trouble accessing my medications. But once I engaged my professional mindset, I realized the potential harm of prescribing antidepressants and other psychiatric medications too freely. When these medications are used as a quick fix rather than addressing underlying issues — such as biological conditions, illnesses, or nutritional deficiencies — it can be dangerous.” — an ADDitude reader in Texas

“I think it’s important for scientists and doctors to continuously assess and research all medications to ensure they’re effective and safe, but the language of referring to these as a potential ‘threat’ is harmful and potentially dangerous. It could increase stigma, reduce access to medications for those who need them, and contribute to a broader uptick in ableism especially toward mental health disorders. I also think that it sets a dangerous precedent of politicizing health issues, which could further contribute toward not only stigma but misinformation from politicians who are not medically trained or certified, harmful policies and legislation targeting people with mental and physical disabilities, and a cultural shift away from accommodations, accessibility, and legal protections for people affected by mental health disorders.” — an ADDitude reader in Colorado

“A review of these medications may lead to more informed prescribing practices, ensuring that treatments are effective and necessary. This could improve patient outcomes and tailor treatment to individual needs, which is crucial for managing conditions like ADHD and depression. However, there are potential risks associated with the recommendations that could affect access to treatment. If the assessment finds that certain medications are being overprescribed or misused, it might result in stricter regulations or guidelines that could limit access for those who genuinely need these medications. Moreover, increased examination and discussion around these medications may inadvertently contribute to stigma.” — an ADDitude reader in Australia

MAHA Commission: Next Steps

• Free Download: The Ultimate Guide to ADHD Medication
• Read: “Disability Is DEI.”
• Reader Reactions: “I’m Truly Scared for What This Could Mean”

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With so many alternative and complementary dietary interventions marketed for ADHD, it’s tough to separate science from hype when seeking to improve symptoms. Some people add supplements like fish oil or zinc to an existing medication regimen; others take supplements alone.

But are supplements considered safe and effective for treating ADHD? And if you’re taking medication, will supplements pose a risk or cause interactions with your medication? This webinar will explore the latest research findings about non-medication approaches to ADHD management. Stephanie Sarkis, Ph.D., psychotherapist and author, will discuss why stimulant medications remain the most effective treatment, along with exercise and behavioral therapy.

In this webinar, you will learn:

• About effective, evidence-based treatment options for ADHD
• About the importance of therapy, exercise, nutrition, and sleep in managing ADHD symptoms
• About the latest research findings involving the efficacy of medication and alternative and supplemental ADHD interventions
• About alternative interventions that claim to help symptoms but can waste time and money

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Audacy; Spotify; Amazon Music; iHeartRADIO

Managing ADHD: Resources

• Free Download: Scorecard of ADHD Treatments
• Sign Up for This Guided Course! The Adult’s Guide to Treating ADHD
• Read: ADHD Medication Overview —  Stimulants, Non-stimulants & More
• Read: 5 Foundational Habits That Benefit ADHD Brains

Obtain a Certificate of Attendance

If you attended the live webinar on April 10, 2025, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Stephanie Moulton Sarkis, Ph.D. is a licensed and board-certified psychotherapist specializing in ADHD, anxiety, and narcissistic abuse. She has authored several books and workbooks, including the best-selling Natural Relief for Adult ADHD: Complimentary Strategies for Increasing Focus, Attention, and Motivation With or Without Medication. She is the host of the Talking Brains podcast and contributes to Psychology Today. Dr. Sarkis has a teletherapy private practice based in Tampa Bay, Florida. www.stephaniesarkis.com

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Cognitive-aerobic exercise improves working memory more than aerobic exercise alone in children and adolescents with ADHD, according to a new study¹ published in Frontiers in Psychology. 

Previous research has shown that exercise relieves ADHD symptoms by increasing endorphins and neurotransmitters in the brain. This new study is the first network meta-analysis to evaluate the efficacy of various exercise interventions on working memory in children with ADHD.

The study’s results indicate the following impacts of various types of exercise on children with ADHD:

• Cognitive-aerobic exercise demonstrates the most significant effect on working memory, or the capacity for holding and using information over a short period of time.
• Ball sports follow closely behind with a moderate to high improvement effect.
• Mindy-body exercises and interactive games display a moderate improvement in working memory.
• Simple aerobic exercise and interactive games exhibit the smallest improvement effect on children with ADHD.

“For developing children, aerobic exercise expands the growth of brain connections, the frontal cortex, and the brain chemicals (such as serotonin and dopamine) that support self-regulation and executive functioning,” said Joel Nigg, Ph.D., a clinical psychologist and a professor in the departments of psychiatry and behavioral sciences at Oregon Health & Science University. “These surprisingly specific findings in typically developing children have led to excitement about the possibility that the right kind of exercise can help ADHD.”²

Further analysis suggests that the effectiveness of cognitive-aerobic exercise in improving working memory in children with ADHD may depend on higher intervention frequency and longer cumulative intervention duration.

Cognitive-Aerobic Exercise for Working Memory

“Cognitive-aerobic exercise,” as defined by the researchers, combines physical activity with mentally stimulating tasks like decision-making and problem-solving, e.g., dual-task exercises, strategy-based games, and exergaming. It may involve activities with rules and objectives that increase the load on the prefrontal cortex, which is closely associated with working memory.

The researchers propose that cognitive-aerobic exercise is particularly powerful because it requires quick decision-making, memory retrieval, and cognitive switching in addition to physical activity, thus “working out” the working memory.

Ball Sports for Working Memory

Ball sports exert a positive impact on working memory, perhaps due to their reliance on strategy and social skills.  “Sports such as soccer or basketball typically require children to remain highly focused while also remembering and analyzing the actions of teammates and opponents, which places a high demand on task memory,” the researchers wrote. “In ball sports, children not only need to plan and execute movements but also continuously adjust strategies and predict the opponent’s actions. These multitasking and real-time adjustment characteristics directly exercise their working memory load, information storage, and response speed.”

This seems consistent with one ADDitude reader’s experience with her son, who has ADHD and plays sports like football and lacrosse.

“The strategizing required when playing these sports is helpful,” said Deborah from New York. “He is receiving many different stimuli at one time, helping him to decipher information and build his executive function skills.”

Mind-Body Exercise for Working Memory

Mind-body exercises (e.g., yoga, Tai Chi) only moderately affect working memory and “may be more significant in improving attention and emotional regulation but… may lack the high cognitive load stimulation required for direct improvements” in working memory, the researchers said.

Interactive Games for Working Memory

Sports-based interactive games primarily enhance social and cooperative skills by motivating children to engage in collaborative tasks or fun competitions in virtual environments. “Although these games have a positive impact on the social behavior and emotional regulation of children with ADHD, the cognitive challenges in these games are limited and generally do not involve high-intensity memory tasks or complex decision-making, making their direct impact on working memory relatively modest,” the researchers wrote.

Traditional Aerobic Exercise

Traditional aerobic exercise involves “repetitive and rhythmic movements, such as swimming or cycling, aimed solely at improving physical endurance and fitness.”

Due to its more straightforward physical activity format, traditional aerobic exercise had the smallest impact on working memory, the researchers proposed.

“Activities like running and skipping, while improving overall physical fitness and stimulating dopamine secretion, can help children with ADHD maintain attention in the short term,” the researchers wrote. “However, since they lack demands for memory and multitasking, they are often insufficient to activate the prefrontal cortex’s executive function areas. As a result, their direct impact on working memory is relatively small.”

The study’s overall findings suggest that “when designing exercise interventions for children with ADHD, priority should be given to exercise types with higher cognitive load,” the researchers wrote.

The meta-analysis analyzed data from 17 studies, which collectively had 419 participants with ADHD, ages 3 to 18. Studies included structured aerobic exercise (e.g., running, swimming), strength training (e.g., resistance training), cognitive exercise, and balance or coordination exercises. The intervention periods ranged from one to 13 weeks, with exercise frequency ranging from one to five times per week and lasting 10 to 90 minutes.

According to researchers, the study had several limitations, including a disproportionately small percentage of female participants. Further research is needed to explore how different kinds of exercise may impact people of various genders and why these types of exercise have different efficacy levels.

The researchers caution that their findings do not mean that children should treat their ADHD exclusively with exercise. According to the American Academy Of Pediatrics (APA), the most effective treatment for ADHD is parental behavior therapy paired with ADHD medication for children over age 6.

Sources

¹ Song, X., Hou, Y., Shi, W., Wang, Y., Fan, F., & Hong, L. (2025). Exploring the impact of different types of exercise on working memory in children with ADHD: a network meta-analysis. Frontiers in Psychology, 16. https://doi.org/10.3389/fpsyg.2025.1522944

² Best, J.R. (2010). Effects of Physical Activity on Children’s Executive Function: Contributions of Experimental Research on Aerobic Exercise. Dev Rev; (4):331-551. https://doi.org/10.1016/j.dr.2010.08.001

Calls to Action: MAHA Commission Testimony & Advocacy

• Submit your testimony to the MAHA Commission by contacting MAHA Commission Chair Robert Kennedy, Jr. at https://x.com/SecKennedy, and media@hhs.gov
• Join the advocacy efforts organized by CHADD
• Contact your national, state, and local representatives to share your testimony and the evidence-based research on ADHD below

February 26, 2025

Dear Secretary Kennedy,

As the Make America Healthy Again Commission begins its evaluation of published research on the chronic health conditions impacting American children, we urge it to consult with the esteemed clinicians associated with the American Professional Society of ADHD and Related Disorders (APSARD), the American Academy of Pediatrics (AAP), and the World Federation of ADHD regarding the established science on ADHD causes and treatments. Consensus within these groups, and among ADHD researchers worldwide, is strong and consistent regarding the following evidence-based findings:

• ADHD is a chronic neurodevelopmental condition characterized by inattention, impulsivity, executive dysfunction, and/or hyperactivity that persists into adulthood for approximately 90% of patients.¹
• ADHD is a highly genetic condition.^2,3,4 Lifestyle factors such as nutrition, exercise, and sleep exert epigenetic changes on DNA that influence how strongly or weakly ADHD genes are expressed. However, diet, physical activity, sleep, or screen use alone do not cause — and have not been shown to “cure” — ADHD.
• The 16% increase in ADHD diagnoses over the last decade is due, in large part, to revised diagnostic criteria published in the DSM-5, which changed the maximum age of onset from 7 to 12 and added the first-ever qualifier symptoms for ADHD in adulthood. This wider net, along with improved education, training, and symptom recognition, particularly in historically overlooked girls and women, account for much of the diagnostic uptick, according to studies.^{5, 6}
• Scientific research has established no causal link between excessive screen time, video game play, or social media use  and ADHD.⁷ Some studies suggest these habits may exacerbate inattention and impulsivity.^{8, 9}
• Scientific research has established no causal link between consumption of sugar, food additives, or food dyes and ADHD, though some studies show a heightened sensitivity among children with ADHD to these foods, which may exacerbate existing symptoms.¹⁰
• Scientific research shows that prenatal and/or childhood exposure to tobacco, lead, pesticides, and polychlorinated biphenyls (PCBs) may increase the odds of ADHD in some children, however the studies do not find direct causality.^{11,12, 13,14}
• Several research studies have shown that consumption of a Western diet high in processed foods, fats, sugars, and salt is associated with higher rates of ADHD, however these studies demonstrate an association rather than causality.¹⁵
• ADHD shortens an individual’s life expectancy by 7.5 years, on average.¹⁶ It is serious, potentially lethal, and associated with elevated risks for comorbid conditions ^{17, 18} including anxiety, depression,¹⁹ substance use disorder,²⁰ eating disorders,^{21, 22} obesity, and oppositional defiant disorder,²³ which commonly derails treatment plans and parenting strategies. People with ADHD are more likely to get into car accidents,²⁴ become hospitalized, and engage in self-harm than are their neurotypical peers.^{25, 26, 27}
• In patients with the condition, ADHD medication use reduces the risk of death by 19%, the risk of overdose by 50%,²⁸ the risk of substance abuse by 50%,²⁹ and the risk of motor vehicle accidents by at least 38%.³⁰ Its effective symptom management improves patients’ self-esteem and efficacy, thereby reducing the risk of self-harm and suicide, as well as negative life outcomes such as unwanted pregnancy, incarceration, unemployment, and interruption of education.
• The medications used to treat ADHD have been studied rigorously and used safely for 88 years. Amphetamine and methylphenidate safely and effectively reduce ADHD symptoms, with methylphenidate reducing symptoms by 70% to 90% in children and adults with the condition.^{31, 32} The effect sizes for ADHD medication are .8 to 1.0,³³  which are among the strongest in all of psychiatry. Clinical practice guidelines recommend medication as the first-line treatment for ADHD due to its overwhelming efficacy; for children with ADHD ages 4 to 6, parent behavior training is recommended by the AAP.³⁴
• According to the CDC, just 53.6% of all children and teens with ADHD reported they were actively treating their symptoms with medication in 2022. Because stimulant medications are classified as Schedule II drugs under the Controlled Substances Act, they are tightly regulated; supplies are limited to 30 days and prescribing clinicians must authorize monthly refills. The widely reported ADHD medication shortage has disrupted treatment for millions of patients across the country since 2022.³⁵
• Caregivers and adults with ADHD surveyed by ADDitude rate medication as the most effective treatment for ADHD, however less than half of parents report that they chose to medicate their children within 6 months of diagnosis. They report changing diet, limiting screen time, supplementing with fish oil, and increasing physical activity before ultimately using medication to achieve the symptom improvement necessary for academic and social success.
• The mild to moderate side effects associated with ADHD medication include appetite suppression, irritability or moodiness, sleep problems, and headaches. There is no evidence that ADHD medication use leads to dependency or broader substance abuse; in fact, research shows that ADHD medication use is protective against substance use disorder in individuals with ADHD.³⁶
• The non-stimulant medications used to treat ADHD, such as atomoxetine, guanfacine, and clonidine, have an effect size of .4 to .7 and are considered a second-line treatment appropriate for patients who do not tolerate or cannot take stimulants.^{37, 38, 39}
• Clinical guidelines promote the use of multimodal treatment plans that pair prescription medication with complementary approaches to ADHD management. The nonpharmacological interventions shown to be most effective at reducing ADHD symptoms in children are behavioral therapy (effect size of .5 to.8 when used on its own),⁴⁰ exercise (effect size of .4 to .6 when used on its own),⁴¹ sleep hygiene and interventions (effect size of .5 to .8 when used on their own),⁴² and dietary interventions (effect size of .2 to .5 when used on their own).⁴³
• Behavioral therapy, principally parent training, has an elevated and improved effect when used in conjunction with ADHD medication.⁴⁴ Behavioral therapy is used by just 44% of pediatric patients, in part because it’s not always covered by medical insurance and knowledgeable providers are scarce.
• One meta-analysis of randomized, placebo-controlled trials showed that supplementation with high doses of omega-3 fatty acids has a small positive impact on attention and hyperactivity in children.⁴⁵
• Research suggests that restricting the consumption of synthetic food dyes does benefit some children with ADHD, though aggregate effects are quite small.⁴⁶
• When engaging in vigorous cardiovascular exercise, the brain releases endorphins. Levels of dopamine, norepinephrine, and serotonin also increase with exercise, thus improving focus, working memory, and mood to enable better learning.
• Cognitive behavioral therapy (CBT), though more commonly prescribed to adult patients, has been shown to improve core ADHD symptoms in adolescents when used in conjunction with ADHD medication.⁴⁷
• Neurofeedback uses an electroencephalogram (EEG) to measure brain activity and train the patient to produce brain wave patterns like those of a non-ADHD brain. Neurofeedback has not shown enough effectiveness in studies to be recommended as a “stand-alone” treatment for ADHD and there is little evidence that neurofeedback reduces ADHD symptoms long-term. In addition, neurofeedback is seldom covered by insurance and involves a significant investment of time and money.^{48, 49, 50}
• According to research, brain training does not reduce ADHD symptoms. There is no evidence that a patient can train a brain to improve working memory, or any other executive function.^{51, 52, 53}

Thank you for reviewing the evidence-based research highlighted above. We welcome follow-up questions from the Commission as it devises recommendations based on science that may benefit the health and wellbeing of the 22 million Americans with ADHD, whom ADDitude has served for the last 26 years. We support their personal liberty to pursue and maintain the treatments that benefit their ADHD brains, which are a tremendous asset to this nation.

Sincerely,
Anni Rodgers
General Manager, ADDitude

Sources

¹Sibley, M., Arnold, L, Swanson, J. et.al. (13 August 2021). Variable patterns of remission from ADHD in the multimodal treatment study of ADHD. The American Journal of Psychiatry. https://doi.org/10.1176/appi.ajp.2021.21010032

²Faraone, Stephen V. et al. Molecular Genetics of Attention-Deficit/Hyperactivity Disorder, Biological Psychiatry, Volume 57, Issue 11, 1313 – 1323

³Liuyan Zhang, Suhua Chang, Zhao Li, Kunlin Zhang, Yang Du, Jurg Ott, Jing Wang, ADHDgene: a genetic database for attention deficit hyperactivity disorder, Nucleic Acids Research, Volume 40, Issue D1, 1 January 2012, Pages D1003–D1009, https://doi.org/10.1093/nar/gkr992

⁴Gizer, I.R., Ficks, C. & Waldman, I.D. Candidate gene studies of ADHD: a meta-analytic review. Hum Genet 126, 51–90 (2009). https://doi.org/10.1007/s00439-009-0694-x

⁵Mowlem, F.D., Rosenqvist, M.A., Martin, J. et al. Sex differences in predicting ADHD clinical diagnosis and pharmacological treatment. Eur Child Adolesc Psychiatry 28, 481–489 (2019). https://doi.org/10.1007/s00787-018-1211-3

⁶Abdelnour E, Jansen MO, Gold JA. ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis? Mo Med. 2022 Sep-Oct;119(5):467-473. PMID: 36337990; PMCID: PMC9616454.

⁷Nikkelen, S. W., Valkenburg, P. M., Huizinga, M., & Bushman, B. J. (2014). “Media use and ADHD-related behaviors in children and adolescents: A meta-analysis.” Developmental Psychology, 50(9), 2228-2241.

⁸Madigan S, Browne D, Racine N, Mori C, Tough S. Association Between Screen Time and Children’s Performance on a Developmental Screening Test. JAMA Pediatr. 2019;173(3):244–250. doi:10.1001/jamapediatrics.2018.5056

⁹Yifei, P, Xuechun, L,Yu, Y. (2023). Screen use and its association with ADHD symptoms among children: a systematic review. MEDS Public Health and Preventive Medicine, 3.10.23977/phpm.2023.030301

¹⁰Nigg JT, Lewis K, Edinger T, Falk M. Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. J Am Acad Child Adolesc Psychiatry. 2012 Jan;51(1):86-97.e8. doi: 10.1016/j.jaac.2011.10.015. PMID: 22176942; PMCID: PMC4321798.

¹¹Huang L, Wang Y, Zhang L, Zheng Z, Zhu T, Qu Y, Mu D. Maternal Smoking and Attention-Deficit/Hyperactivity Disorder in Offspring: A Meta-analysis. Pediatrics. 2018 Jan;141(1):e20172465. doi: 10.1542/peds.2017-2465. PMID: 29288161.

¹²Goodlad JK, Marcus DK, Fulton JJ. Lead and Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms: a meta-analysis. Clin Psychol Rev. 2013 Apr;33(3):417-25. doi: 10.1016/j.cpr.2013.01.009. Epub 2013 Jan 29. PMID: 23419800.

¹³Nigg JT, Nikolas M, Mark Knottnerus G, Cavanagh K, Friderici K. Confirmation and extension of association of blood lead with attention-deficit/hyperactivity disorder (ADHD) and ADHD symptom domains at population-typical exposure levels. J Child Psychol Psychiatry. 2010 Jan;51(1):58-65. doi: 10.1111/j.1469-7610.2009.02135.x. Epub 2009 Nov 23. PMID: 19941632; PMCID: PMC2810427.

¹⁴Eubig PA, Aguiar A, Schantz SL. Lead and PCBs as risk factors for attention deficit/hyperactivity disorder. Environ Health Perspect. 2010 Dec;118(12):1654-67. doi: 10.1289/ehp.0901852. Epub 2010 Sep 9. PMID: 20829149; PMCID: PMC3002184.

¹⁵Howard AL, Robinson M, Smith GJ, Ambrosini GL, Piek JP, Oddy WH. ADHD is associated with a “Western” dietary pattern in adolescents. J Atten Disord. 2011 Jul;15(5):403-11. doi: 10.1177/1087054710365990. Epub 2010 Jul 14. PMID: 20631199.

¹⁶O’Nions E, El Baou C, John A, et al. Life expectancy and years of life lost for adults with diagnosed ADHD in the UK: matched cohort study. The British Journal of Psychiatry. Published online 2025:1-8. doi:10.1192/bjp.2024.199

¹⁷Gnanavel S, Sharma P, Kaushal P, Hussain S. Attention deficit hyperactivity disorder and comorbidity: A review of literature. World J Clin Cases 2019; 7(17): 2420-2426 [PMID: 31559278 DOI: 10.12998/wjcc.v7.i17.2420]

¹⁸Kessler, Ronald & Adler, Lenard & Barkley, Russell & Biederman, Joseph & Conners, C & Demler, Olga & Faraone, Stephen & Greenhill, Laurence & Howes, Mary & Boye, Kristina & Spencer, Thomas & Ustun, Tevfik & Walters, Ellen & Zaslavsky, Alan. (2006). The Prevalence and Correlates of Adult ADHD in the United States: Results From the National Comorbidity Survey Replication. The American journal of psychiatry. 163. 716-23. 10.1176/appi.ajp.163.4.716.

¹⁹Babinski DE, Neely KA, Ba DM, Liu G. Depression and Suicidal Behavior in Young Adult Men and Women With ADHD: Evidence From Claims Data. J Clin Psychiatry. 2020 Sep 22;81(6):19m13130. doi: 10.4088/JCP.19m13130. PMID: 32965804; PMCID: PMC7540206.

²⁰Katelijne van Emmerik-van Oortmerssen, Geurt van de Glind, Wim van den Brink, Filip Smit, Cleo L. Crunelle, Marije Swets, Robert A. Schoevers, Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: A meta-analysis and meta-regression analysis, Drug and Alcohol Dependence, Volume 122, Issues 1–2, 2012, Pages 11-19, ISSN 0376-8716, https://doi.org/10.1016/j.drugalcdep.2011.12.007.

²¹Nazar BP, Bernardes C, Peachey G, Sergeant J, Mattos P, Treasure J. The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. Int J Eat Disord. 2016 Dec;49(12):1045-1057. doi: 10.1002/eat.22643. Epub 2016 Nov 15. PMID: 27859581.

²²Curtin, Carol & Pagoto, Sherry & Mick, Eric. (2013). The association between ADHD and eating disorders/pathology in adolescents: A systematic review. Open Journal of Epidemiology. 3. 193-202. 10.4236/ojepi.2013.34028.

²³Nock MK, Kazdin AE, Hiripi E, Kessler RC. Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the National Comorbidity Survey Replication. J Child Psychol Psychiatry. 2007 Jul;48(7):703-13. doi: 10.1111/j.1469-7610.2007.01733.x. PMID: 17593151.

²⁴Curry AE, Yerys BE, Metzger KB, Carey ME, Power TJ. Traffic Crashes, Violations, and Suspensions Among Young Drivers With ADHD. Pediatrics. 2019 Jun;143(6):e20182305. doi: 10.1542/peds.2018-2305. Epub 2019 May 20. PMID: 31110164; PMCID: PMC6564068.

²⁵Ward JH, Curran S. Self-harm as the first presentation of attention deficit hyperactivity disorder in adolescents. Child Adolesc Ment Health. 2021 Nov;26(4):303-309. doi: 10.1111/camh.12471. Epub 2021 May 3. PMID: 33939246.

²⁶Hinshaw SP, Owens EB, Zalecki C, Huggins SP, Montenegro-Nevado AJ, Schrodek E, Swanson EN. Prospective follow-up of girls with attention-deficit/hyperactivity disorder into early adulthood: continuing impairment includes elevated risk for suicide attempts and self-injury. J Consult Clin Psychol. 2012 Dec;80(6):1041-1051. doi: 10.1037/a0029451. Epub 2012 Aug 13. PMID: 22889337; PMCID: PMC3543865.

²⁷Ping-I Lin, Weng Tong Wu, Enoch Kordjo Azasu, Tsz Ying Wong, Pathway from attention-deficit/hyperactivity disorder to suicide/self-harm, Psychiatry Research, Volume 337, 2024, 115936, ISSN 0165-1781, https://doi.org/10.1016/j.psychres.2024.115936.

²⁸Li L, Zhu N, Zhang L, Kuja-Halkola R, D’Onofrio BM, Brikell I, Lichtenstein P, Cortese S, Larsson H, Chang Z. ADHD Pharmacotherapy and Mortality in Individuals With ADHD. JAMA. 2024 Mar 12;331(10):850-860. doi: 10.1001/jama.2024.0851. PMID: 38470385; PMCID: PMC10936112.

²⁹Faraone SV, Wilens T. Does stimulant treatment lead to substance use disorders? J Clin Psychiatry. 2003;64 Suppl 11:9-13. PMID: 14529324.

³⁰Chang Z, Quinn PD, Hur K, et al. Association Between Medication Use for Attention-Deficit/Hyperactivity Disorder and Risk of Motor Vehicle Crashes. JAMA Psychiatry. 2017;74(6):597–603. doi:10.1001/jamapsychiatry.2017.0659

³¹Spencer, Thomas et al. A large, double-blind, randomized clinical trial of methylphenidate in the treatment of adults with attention-deficit/hyperactivity disorder, Biological Psychiatry, Volume 57, Issue 5, 456 – 463

³²Barbaresi WJ, Katusic SK, Colligan RC, Weaver AL, Leibson CL, Jacobsen SJ. Long-term stimulant medication treatment of attention-deficit/hyperactivity disorder: results from a population-based study. J Dev Behav Pediatr. 2006 Feb;27(1):1-10. doi: 10.1097/00004703-200602000-00001. PMID: 16511362.

³³Faraone, S. V., & Buitelaar, J. (2010). “Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis.” European Child & Adolescent Psychiatry, 19(4), 353-364.

³⁴Centers for Disease Control and Prevention. (2022, March 8). Treatment recommendations for healthcare providers. https://www.cdc.gov/adhd/hcp/treatment-recommendations/index.html.

³⁵Grossi, G. US ADHD Stimulant Shortage Highlights Growing Challenges in Adult Treatment. AJMC. 2024 Nov. https://www.ajmc.com/view/us-adhd-stimulant-shortage-highlights-growing-challenges-in-adult-treatment

³⁶Quinn PD, Chang Z, Hur K, Gibbons RD, Lahey BB, Rickert ME, Sjölander A, Lichtenstein P, Larsson H, D’Onofrio BM. ADHD Medication and Substance-Related Problems. Am J Psychiatry. 2017 Sep 1;174(9):877-885. doi: 10.1176/appi.ajp.2017.16060686. Epub 2017 Jun 29. PMID: 28659039; PMCID: PMC5581231.

³⁷Newcorn, J. H., Kratochvil, C. J., Allen, A. J., Casat, C. D., Ruff, D. D., Moore, R. J., & Michelson, D. (2008). “Atomoxetine and osmotically released methylphenidate for the treatment of attention deficit hyperactivity disorder: acute comparison and differential response.” American Journal of Psychiatry, 165(6), 721-730.

³⁸Sallee FR, McGough J, Wigal T, Donahue J, Lyne A, Biederman J; SPD503 STUDY GROUP. Guanfacine extended release in children and adolescents with attention-deficit/hyperactivity disorder: a placebo-controlled trial. J Am Acad Child Adolesc Psychiatry. 2009 Feb;48(2):155-65. doi: 10.1097/CHI.0b013e318191769e. PMID: 19106767.

³⁹Connor DF, Findling RL, Kollins SH, Sallee F, López FA, Lyne A, Tremblay G. Effects of guanfacine extended release on oppositional symptoms in children aged 6-12 years with attention-deficit hyperactivity disorder and oppositional symptoms: a randomized, double-blind, placebo-controlled trial. CNS Drugs. 2010 Sep;24(9):755-68. doi: 10.2165/11537790-000000000-00000. PMID: 20806988.

⁴⁰Fabiano GA, Pelham WE Jr, Coles EK, Gnagy EM, Chronis-Tuscano A, O’Connor BC. A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clin Psychol Rev. 2009 Mar;29(2):129-40. doi: 10.1016/j.cpr.2008.11.001. Epub 2008 Nov 11. PMID: 19131150.

⁴¹Cerrillo-Urbina AJ, García-Hermoso A, Sánchez-López M, Pardo-Guijarro MJ, Santos Gómez JL, Martínez-Vizcaíno V. The effects of physical exercise in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis of randomized control trials. Child Care Health Dev. 2015 Nov;41(6):779-88. doi: 10.1111/cch.12255. Epub 2015 May 18. PMID: 25988743.

⁴²Ogundele MO, Yemula C. Management of sleep disorders among children and adolescents with neurodevelopmental disorders: A practical guide for clinicians. World J Clin Pediatr. 2022 Mar 15;11(3):239-252. doi: 10.5409/wjcp.v11.i3.239. PMID: 35663001; PMCID: PMC9134149.

⁴³Nigg JT, Lewis K, Edinger T, Falk M. Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. J Am Acad Child Adolesc Psychiatry. 2012 Jan;51(1):86-97.e8. doi: 10.1016/j.jaac.2011.10.015. PMID: 22176942; PMCID: PMC4321798.

⁴⁴A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry. 1999 Dec;56(12):1073-86. doi: 10.1001/archpsyc.56.12.1073. PMID: 10591283.

⁴⁵Richardson, A. J., Puri, B. K. (2002). “A randomized double-blind, placebo-controlled study of the effects of supplementation with highly unsaturated fatty acids on ADHD-related symptoms in children with specific learning difficulties.” Progress in Neuro-Psychopharmacology & Biological Psychiatry, 26(2), 233-239.

⁴⁶Nigg JT, Lewis K, Edinger T, Falk M. Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. J Am Acad Child Adolesc Psychiatry. 2012 Jan;51(1):86-97.e8. doi: 10.1016/j.jaac.2011.10.015. PMID: 22176942; PMCID: PMC4321798.

⁴⁷Ojinna BT, Parisapogu A, Sherpa ML, Choday S, Ravi N, Giva S, Shantha Kumar V, Shrestha N, Tran HH, Penumetcha SS. Efficacy of Cognitive Behavioral Therapy and Methylphenidate in the Treatment of Attention Deficit Hyperactivity Disorder in Children and Adolescents: A Systematic Review. Cureus. 2022 Dec 17;14(12):e32647. doi: 10.7759/cureus.32647. PMID: 36660538; PMCID: PMC9845961.

⁴⁸Gevensleben, H., Moll, G. H., Rothenberger, A., & Heinrich, H. (2014). Neurofeedback in attention-deficit/hyperactivity disorder – different models, different ways of application. Frontiers in human neuroscience, 8, 846. https://doi.org/10.3389/fnhum.2014.00846

⁴⁹ Arnold, L. E., Lofthouse, N., Hersch, S., Pan, X., Hurt, E., Bates, B., Kassouf, K., Moone, S., & Grantier, C. (2013). EEG neurofeedback for ADHD: double-blind sham-controlled randomized pilot feasibility trial. Journal of attention disorders, 17(5), 410–419. https://doi.org/10.1177/1087054712446173

⁵⁰Ramsay, J. R. (2010). Neurofeedback and neurocognitive training. In J. R. Ramsay, Nonmedication treatments for adult ADHD: Evaluating impact on daily functioning and well-being (pp. 109–129). American Psychological Association. https://doi.org/10.1037/12056-006

⁵¹ Gathercole S. E. (2014). Commentary: Working memory training and ADHD – where does its potential lie? Reflections on Chacko et al. (2014). Journal of child psychology and psychiatry, and allied disciplines, 55(3), 256–257. https://doi.org/10.1111/jcpp.12196

⁵² Chacko, A., Bedard, A. C., Marks, D. J., Feirsen, N., Uderman, J. Z., Chimiklis, A., Rajwan, E., Cornwell, M., Anderson, L., Zwilling, A., & Ramon, M. (2014). A randomized clinical trial of Cogmed Working Memory Training in school-age children with ADHD: a replication in a diverse sample using a control condition. Journal of child psychology and psychiatry, and allied disciplines, 55(3), 247–255. https://doi.org/10.1111/jcpp.12146

⁵³ Hulme, C., & Melby-Lervåg, M. (2012). Current evidence does not support the claims made for CogMed working memory training. Journal of Applied Research in Memory and Cognition, 1(3), 197–200. https://doi.org/10.1016/j.jarmac.2012.06.006

Caffeine may be the world’s most common stimulant, almost universally seen as nature’s antidote to memory, fatigue, and focus problems. But caffeine’s common side effects, including higher heart rate, irritability and sleep problems, may outweigh the benefits for adolescents and adults with ADHD. What should adults with ADHD, and caregivers of children and teens with ADHD, know as they weigh caffeine’s role in improving certain symptoms?

In this webinar, you will learn:

• About the neurobiology of the ADHD brain and why caffeine may be considered by some scientists as a supplemental therapy
• What the latest studies say about caffeine, ADHD, and cognitive enhancement
• How caffeine affects memory, focus, and other ADHD symptoms
• About the risks and benefits of consuming caffeine, including its impact on sleep, a known problem for people with ADHD
• Whether caffeine should be used with stimulant medications or in place of stimulants
• How caffeine and exercise can work together to address ADHD symptoms

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Additional Resources

• Read: 10 Supplements and Vitamins for Brain Health
• Read: The Truth About Lion’s Mane, Psychedelics & Caffeine
• Read: The Truth About Caffeine and ADHD

Obtain a Certificate of Attendance

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Meet the Expert Speaker

Dr. Cheyette graduated cum laude in Cognitive Neuroscience from Princeton University and received her medical degree from the UCLA David Geffen School of Medicine. Following specialty training in pediatrics at Cedars-Sinai Medical Center in Los Angeles and in pediatric neurology at Seattle Children’s Hospital, she is now in private practice.

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Accentrate® delivers personalized Brain Ready Nutrition designed to support focus, emotional balance, and overall brain health through a combination of omega-3s, vitamins, and minerals. Featuring LYSOVETA® LPC, Accentrate® Omega products offer 6x higher absorption than traditional fish oil, ensuring faster, longer-lasting benefits to help you perform at your best every day. | fenixhealthscience.com

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Exercise is hugely beneficial to ADHD brains. It can also be pretty boring. And tiring. And inconvenient. And expensive.

All of which makes exercise a game-changing and seldom-used tool for ADHD management. In a recent ADDitude survey, 55% of respondents said they were dissatisfied with their exercise regimen and physical health. The most common obstacles cited by the 1,885 respondents include:

• Sticking to an exercise routine: 59%
• Just getting started: 43%
• Overcoming boredom with exercise: 21%
• Managing a disability that impacts physical activity: 17%
• Pushing myself to try something new: 9%
• Finding an affordable, accessible workout options: 7%

“The motivation to continue with exercise is a major challenge. Boredom is a total killer of any good intentions in this, as in other, life realms.” — Liv, Texas

“I struggle with fatigue and lack of motivation due to over-exertion of executive function demands.” — Tracey, California

[Read: The ADHD Exercise Solution]

Exercise Apps for ADHD Brains

Convenient, low-cost, and rated 2.82 (out of 5) on our helpfulness scale, exercise apps can kickstart and fuel an exercise routine. Whether you prefer yoga, running, or pumping iron, there’s an app that can support your workout goals. Here are our readers’ 10 top recommendations:

• Couch to 5K: a 9-week running program
• Yoga with Adriene: an inclusive yoga program for every body
• Silver Sneakers: Free for adults 65+ with some Medicare plans
• Nike Training Club: A network of at-home workouts from world-class trainers
• MapMyFitness: Find a place to exercise anywhere
• Nerd Fitness: Nutrition, fitness, and motivation
• My Fitness Pal: Convenient tracking of calories, movement, and goals
• Seven: A library of seven-minute workouts
• Strava: The social network for runners
• Bodi: On-demand fitness classes ranging from yoga to power lifting
• Curves: A women’s fitness club
• Classpass: A gateway to independent fitness and exercise classes
• Peloton: Thousands of exercise classes, many of which don’t require a bike

“Fitness Blender is super ADHD-friendly. It has a huge variety of free workout videos of varying length and style. You can search with lots of different filters to find exactly what you want or purchase multi-week courses. There are ‘fitness dice’ with different no-equipment exercises on each side. You roll the dice to discover your mini-workout for the day.” — Alice, Alaska

[Read: Exercise and the ADHD Brain – The Neuroscience of Movement]

“Ladder is an exercise app that offer short workouts with equipment I have at home. It creates a weekly workout plan that has kept me from getting bored and has a coach talking you through and motivating you during your workout.” — Alison, Colorado

How to Start Working Out: Helpful Supports

What motivates people with ADHD to start exercising, and to stick with it, despite boredom, fatigue and other hurdles? ADDitude readers chimed in by rating the supports they find most helpful (out of 5):

• Personal trainer: 3.66
• Accountability partner(s): 3.33
• Gym or fitness class membership: 3.06
• Race or event registration to apply deadline pressure: 3.02
• Spouse, family member, friend: 2.94
• Exercise app: 2.82
• ADHD coach: 2.79
• In-home exercise equipment: 2.72
• Online exercise class subscription: 2.51

“Exercise trainers were incredibly helpful to make me stick to an exercise routine, not to mention learning about proper exercise form, nutrition etc.” — Liv, Texas

“Taking up competitive sport for the thrill factor, accountability, training routine and social interaction was the most helpful.” — Tony, Australia

How to Start Working Out: Reader-Tested Techniques

Anyone with ADHD knows that the slogan “Just do it” doesn’t motivate neurodivergent people to lace up their Nikes. What does work? Here is the most popular advice from our readers:

Exercise Before Coffee

“By exercising first thing, I get it over with right away, and I can move on with my day without exercise looming over my head. It also helps me to eat healthier and have more energy during the day.” — Rachel, Minnesota

“Daily exercise is probably the thing that helps me most with ADHD management, physical and mental health. The first thing I do in the morning is a 30-minute, very low-intensity routine. The key here is to lower the bar, by keeping it simple and easy, and turning it into a daily habit.” — Joanna, France

Invest

“Giving myself permission to spend money on a personal trainer has been the single best thing I’ve done as an adult. It hits all my triggers: I’ve spent money on it, have a scheduled appointment, someone else has to come up with what we are doing, and I have an accountability partner — all in one.” — LN, Wisconsin

Prioritize Fun

“I do dancing because I love it, yoga for relaxation, white water rafting for the adrenaline and fun, and swimming in natural waters because I feel really joyful to mingle with Mother Nature!” — An ADDitude Reader

“I download books and podcasts to listen to while walking the dog. If I only allow myself to listen to the series or book while exercising, I look forward to the next exercise.” — Ellie, Virginia

Do It at Home

“I got an under-the-desk elliptical that I love, as it alleviates the anxious energy I have while I have to sit at my desk, and I can do something productive with my feet instead of having non-stop leg shaking going on.” — Laura, Arizona

Do It Anywhere But Home

“I have to do exercise outside the home because there are too many excuses (laundry, email, cleaning) at home.” — Valeria, Colorado

Incorporate It Into Your Daily Routine

“I take bathroom breaks at work at least one floor away so I use the stairs multiple times a day.” — An ADDitude reader in Washington

“Park 15 minutes away from work, or get off the bus five stops early. The quiet walking time is a very nice way to gear up for the work day.” — Francine, Canada

“Have a dog that demands walks.” — MC, Canada

Identify a Goal

“Start something that has short-term goals that progress to long-term goals as part of the program, like martial arts. That’s how I ended up earning black belts in two different arts.” — An ADDitude Reader

“When I was running, signing up to participate in 5k and 10k races helped.” — Keena, Wisconsin

“Have a Plan A (big workout or run) and a Plan B (small workout or run) if you have no energy for Plan A. That way, I still feel like I’ve achieved my goal, even if it’s just five minutes of exercise.” — Alex, New Zealand

Recruit an Accountability Partner

“I walk with a friend who has limited availability; knowing that encourages me to join her on the two afternoons a week she is available.” — Dianne, Massachusetts

“I enjoy Apple Watch sharing with friends. We can compete and that keeps me from skipping workouts.” — Cassie, South Carolina

“I started horseback riding in spring, and for the health of the horse I have to exercise. Doing it for the horse is extremely helpful.” — Veronika, Germany

How to Start Working Out: Next Steps

• Read: I Can’t Muster Workout Motivation!
• Read: The Best Workout Apps for Your ADHD Brain & Body
• Read: Sports for ADHD – The Activities That Activate Neurodivergent Brains

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Q: Do people with ADHD experience winter depression more often and more severely than do neurotypical individuals? Also, why is my quality of sleep affected in winter?

Winter depression is marked by two or more weeks of low mood, usually starting in the Northern Hemisphere’s fall or winter when there is less daylight, that resolves in the spring or summer when there is more light. There is an association between winter depression, also known as seasonal affective disorder, or SAD, and ADHD.

In the Netherlands, where I live, researchers asked 259 patients with ADHD about seasonal mood swings; 27% reported winter depression compared with 3% in neurotypical people.¹ Other researchers have confirmed this increased rate among people with ADHD.² What’s more, females are four times more likely than males to have winter depression.¹

Sleep problems are also common among people with ADHD: About 80% are late sleepers³ , which means they have a short sleep duration — they fall asleep at a later time and sleep less because they must wake up for work or school.

Q : How does winter depression relate to screen addiction in children with ADHD?

Children with ADHD who are late sleepers and who experience winter depression may turn to video games and the Internet. Screens emit blue light, and they’re often held close to the eye, so the effects are similar to light therapy if you’re staring at them for a while.

[Get This Free Download: How to Sleep Better with ADHD]

Screen use at night can induce delayed circadian rhythms, disrupting your sleep-wake cycle.⁴ Many children with ADHD are already late sleepers, so using screens after 9:30 pm will delay their rhythm even more; this is not recommended. Keep in mind that when sleep gets delayed, mood is affected.

The good news is that winter depression and sleep problems can be easily and quickly treated with artificial light therapy. A 10,000-lux light therapy lamp can be used for 30 minutes a day for 5 to 20 consecutive days. The lamp, or light box, should be used at a close distance to your eyes; the distance is very important for the intensity of the treatment. It’s best to do this every day at the same time, preferably between 7 and 8 am, to reset your biological clock and alter the sleep-wake cycle.

You may also consider using light therapy glasses, which work in the same way as lamps. You can wear these for 30 minutes a day while you’re dressing or eating breakfast; in other words, without disrupting your routine.

Light therapy is a serious antidepressant that often unlocks better mood, improved sleep, and more energy.

[Read: How to Fall Asleep with a Rowdy, Racing ADHD Brain]

Q:  Is vitamin D recommended for people with winter depression?

If your vitamin D is too low, then taking vitamin D is recommended. Vitamin D is generally low in people with ADHD, though we don’t know why.⁵ You get vitamin D from sunlight; in winter, when there is less light, you may need to take a supplement. Another way we can get vitamin D is by eating fatty fish, though many people don’t eat enough to affect levels.

Winter Depression: Next Steps

• Self-Test: Could You Have Delayed Sleep Phase Disorder?
• Read: 9 Sleep Deprivation Solutions for Adults with ADHD
• Read: 6 Tips to Overcoming Winter Depression
  

J.J. Sandra Kooij, M.D., Ph.D., is a psychiatrist and head of the Expertise Center Adult ADHD at PsyQ in the Netherlands.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹Amons, P. J., Kooij, J. J., Haffmans, P. M., Hoffman, T. O., & Hoencamp, E. (2006). Seasonality of mood disorders in adults with lifetime attention-deficit/hyperactivity disorder (ADHD). Journal of affective disorders, 91(2-3), 251–255. https://doi.org/10.1016/j.jad.2005.11.017

²Wynchank, D. S., Bijlenga, D., Lamers, F., Bron, T. I., Winthorst, W. H., Vogel, S. W., Penninx, B. W., Beekman, A. T., & Kooij, J. S. (2016). ADHD, circadian rhythms and seasonality. Journal of psychiatric research, 81, 87–94. https://doi.org/10.1016/j.jpsychires.2016.06.018

³Van Veen, M. M., Kooij, J. J., Boonstra, A. M., Gordijn, M. C., & Van Someren, E. J. (2010). Delayed circadian rhythm in adults with attention-deficit/hyperactivity disorder and chronic sleep-onset insomnia. Biological psychiatry, 67(11), 1091–1096. https://doi.org/10.1016/j.biopsych.2009.12.032

⁴Hartstein, L. E., Mathew, G. M., Reichenberger, D. A., Rodriguez, I., Allen, N., Chang, A. M., Chaput, J. P., Christakis, D. A., Garrison, M., Gooley, J. J., Koos, J. A., Van Den Bulck, J., Woods, H., Zeitzer, J. M., Dzierzewski, J. M., & Hale, L. (2024). The impact of screen use on sleep health across the lifespan: A National Sleep Foundation consensus statement. Sleep health, 10(4), 373–384. https://doi.org/10.1016/j.sleh.2024.05.001

⁵Khoshbakht, Y., Bidaki, R., & Salehi-abargouei, A. (2018). Vitamin D Status and Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis of Observational Studies.. Advances in nutrition, 9 1, 9-20 . https://doi.org/10.1093/advances/nmx002.