Attention deficit / hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioral disorder in the world. It is characterised by core symptoms of inattentiveness, distractibility, hyperactivity, and impulsivity. ADHD affects people of all ages, races and genders, and according to the Centres for Disease Control and Prevention, ADHD diagnoses have been on a steep upward trajectory since it was first formerly adopted in 1987.
Why has there been such a steep rise in ADHD?
There are a variety of reasons given as to why there has been such an increase in ADHD diagnoses over the years, including the fact that there is an improved awareness and understanding of ADHD, the diagnostic criteria have progressed, there is a reduced stigma associated with ADHD, there is better access to healthcare, more effective medication, and various environmental factors have been blamed such as exposure to digital media, changes in lifestyle, dietary factors, and educational demands.
According to clinical psychologist, Yochi Ress, the rise of ADH could be considered to be an evolutionary mismatch, where current societal demands and environmental circumstances do not fit with what evolution had prepared us to cope with: “In many ways, our society suffers from ADHD as a collective – we have so much pressure and we are always on the go, and ‘always on’ with so many digital distractions coming at us non-stop. Sometimes it is easier to ‘switch off’ from the sensory and emotional overload that is part of living in today’s world.”
Traditional treatments for ADHD
ADHD can disrupt various aspects of life, including work, school, daily chores, and relationships. Managing the disorder can pose challenges for both children and adults alike, however, there are effective treatments available. These tried and tested treatments help those who have been diagnosed with ADHD to navigate difficulties and leverage their unique strengths. The traditional treatments included a combination of medication, behavioural therapy, structured routines and environmental modifications.
However, Yochi notes that although these therapies are helpful, there are many new and exciting models and approaches that are currently emerging: “There is an interesting overlap in energy between ADHD and anxiety. When a person is anxious, they are also often distracted and not centred or focused. There is an increase in energy with anxiety too, sometimes pacing up and down, and/or fidgeting. There is a whole new paradigm and approach based on a lot of research about how trauma, which is an anxiety condition, is stored in the body, and needs to be worked on with body-based methods. Plain talk-therapy and cognitive work is simply not enough.”
Yochi explains that Somatic therapy has been ground-breaking. Somatic therapy, also known as somatic experiencing or body-centered therapy, is an approach to psychotherapy that emphasises the connection between the mind and body. It recognises that emotional and psychological experiences are not solely limited to the mind but also manifest in the body.
Says Yochi: “One of the most famous world-leading experts in trauma is Dr Bessel van der Kolk, who wrote the ground-breaking book The Body keeps the score, which is all about how trauma affects the brain, mind, and body, and how we can heal from it. In the book, he explores the connection between ADHD and trauma and explains the importance of helping our children co-regulate within their environment.”
He lists other leaders in the field who have made really interesting strides, including Dr Peter Levine, founder of the Somatic Experiencing treatment approach; Dr Stephen Porges, founder of Polyvagal theory; as well as Dr Gabor Maté, world renowned expert in addiction and trauma medicine, and also ADHD. He notes: “These are some of the best experts in the field, and together, they have resulted in the need to create what is called a ‘trauma-informed society’, which Dr Maté’s latest bestselling book, The Myth of Normal, is all about. We need collective understanding and big shifts in our approach from our legal, medical and educational system to enable greater healing for our society on all levels , in order to truly overcome ADHD.”
The role of being emotionally suppressed
In his book, Dr Maté outlines that emotional suppression or unresolved emotional issues may contribute to the development of exacerbation of ADHD symptoms. The theory suggests that when emotions are consistently suppressed or not effectively processed, it can lead to increased stress levels and internal tension. This chronic stress and tension may affect cognitive functioning, attention regulation, and self-regulation, which are often areas impacted by ADHD.
Yochi explains the mechanics of this theory: “Dr Maté explains that because so few of us have been provided with the safety and permission to fully feel and experience our emotions, in our mind and in our body, what happens is that in the name of respect, authority, or when a child is feeling very overwhelmed, sad, is crying, or feeling anxious – well-meaning parents and teachers tell the child to stop or keep quiet and not talk back. As a result, the child is always shutting down their emotions and remains afraid or overwhelmed by them.
“This then requires the child to develop coping mechanisms to deal with the overwhelm and intensity of their emotions. Often what happens is that the child goes offline and ‘zones out’ in order to avoid having to sit with these difficult and vulnerable emotions. Over time, this dissociative mechanism gets hardwired through habit and repetition, and ends up creating the constantly distracted ADHD picture that is on the rise in our society in both children and adults alike. Add to this the nature of our constantly noisy and ‘on the go’ and distracted world, and you have the perfect ADHD-creating storm.”
Movement and mindfulness
In addition to pharmaceutical interventions, Yochi notes that the latest approaches involve developing emotional literacy or EQ to help overcome ADHD tendencies: “This essentially involves practising mindfulness – especially the kind of mindfulness that is body-based, such as dance and movement forms, or even Yoga or Tai Chi for example. Also, and related to this, there is a new scientific-based group of more effective psychotherapies that are focused more on mindfulness, and include body-based elements that help a child or adult self-regulate their emotions more easily and effectively.”
Yochi says that Dialectical Behavioural Therapy (DBT) is incredibly effective: “DBT methods comprise simple tools and techniques that are easy to learn and apply, practical, and highly effective.” DBT integrates elements of cognitive-behavioural therapy (CBT) with concepts from mindfulness and acceptance-based approaches. It emphasise the importance of balance and dialectics, which refers to finding a middle ground between opposing perspectives. DBT aims to help individuals achieve a balance between acceptance and change. It focuses on validating clients’ experiences and emotions while also encouraging them to develop skills and make positive changes in their life. Mindfulness practices are integrated to enhance self-awareness, non-judgmental observation of thoughts and emotions, and the ability to stay present in the moment.
In addition, Yochi advises that there is increasingly more evidence emerging on how key social interacting is to our overall mental wellbeing, specifically deep and meaningful relationships and being part of a community: “There is a landmark Harvard 80-year longitudinal study investigating the single most important factor for living a successful and meaningful and enriched life, and what came up is that nothing is more important than fulfilling and deep relationships with others, as well as being part of community.
“In relation to this, there is a comparatively new term emerging for regulating ourselves and our stress, anxiety, trauma, and distraction, called ‘Co-regulating’. This term refers to instances when you are so stretched, triggered, overwhelmed, and stressed, that you don’t have the cognitive capacity and resources to regulate yourself. In these circumstances, you need to lean on and draw on someone else. And vice versa. This is part of what community is all about, and is also very relevant and important in creating healthier family, educational and workplace environments and cultures.”