Exercise

• University of Toronto:  Even moderate exercise improves - and sometimes prevents - depression.  New meta-analysis overview at this link with a slightly longer elaboration at this blog post.  This fits nicely with Dr. John Ratey's work on the impact of ADHD on the brain and emotions, as well as learning.  The bottom line is that we should all exercise regularly, and for those with ADHD exercise is a critical part of a good treatment plan because it helps control ADHD symptoms; lessens depression and anxiety.

• ADHD Treatment is Getting a Workout - USA Today article talks about the effects of exercise on focus.  Yes, Kat Orlov is my daughter.

• Spark:  The Revolutionary New Science of Exercise and the Brain by Dr. John Ratey.  Ratey, author of A User's Guide to the Brain and top psychopharmacolgist is truly an expert on the brain.  This book's suggestions about how and why exercise improves focus and academic performance will shock you.  You'll ask "why aren't we all doing this?"

Sleep

• The Complex Relationship Between ADHD and Pediatric Sleep Disorders (Miano).  This article, from The ADHD Report, is about children but provides interesting insight into the complexity of sleep issues and ADHD, as well as the various treatments for sleep disorders.
• Up to date information about how to get the best sleep, as well as the role of the body's circadian rhythms in sleep.  Get in Sync (Experience Life Magazine)  I have started deep breathing before sleep and it really helps.
• Sleep apnea is more common in adults with ADHD than in the general population.  This page provides a very good overview of what sleep apnea is, and what the potential treatments are for it.
• Interesting article about divergent sleep patterns (late/early to bed) in the New York Times
• User's Guide to Sleeping Pills in Scientific American - interesting overview of options, and how they work.  Suggests trying sleep habit/hygiene changes, first
• ADDitude Magazine overview article on sleep and ADHD with some suggestions for improving sleep at this link.
• A study reported by Harvard Health suggests that mindfulness meditation can improve sleep patterns at this link.
• Though this article from PsychologyToday.com does not suggest specifics, it provides an interesting overview of the link between a healthy gut and good sleep suggesting, among other things, that what you eat and when you eat it has a direct impact on the quality of your sleep.
• Unlocking the Sleep-Gut Connection is an article that reviews what's known about the interactions between gut biome and sleep.
• Orlov Improving Your Sleep Worksheet

Blog posts on sleep issues:

• How to Get Bedtimes Aligned with ADHD
• My ADHD Partner Barely Notices Me at Bedtime - 8 Ways to Get the Attention You Want

Fish Oil / Omega-3s

• The research on whether or not fish oil is helpful is mixed, with a general consensus that it might help incrementally if you are low in Omega-3s.  CHADD has a good overview of the issues at this link.
• To determine the best dose, consider getting your blood levels of AA to EPA tested.  The test costs $75 and is available here.  The ideal ratio of 1.5AA:3.0EPA in your blood, and the mail in test kit explains in much more detail.  If you do not wish to take the blood test, then Dr. Hallowell recommends a dose of 2,000mg of high quality fish oil a day.  The older recommendation was up to 5,000mg a day, but at least one study has shown a correlation between large doses of fish oil and prostate cancer.
• What to think about when choosing a fish oil, by Dr. Barry Sears (part of a blog post on fish oil and brain trauma)
• To find a list of top quality fish oils, one option is to go to this fish oil testing site.  Dr. Hallowell and I recommend Zone and OmegaBrite fish oils as some of the the highest quality and lowest in contaminants.

Nutrition and MicroNutrients

• Read this blog post - How to Treat ADHD with Diet and Nutrition Changes
• Overview of a double blind study on micro-nutrients for kids with ADHD.  Improvements were seen in attention and the control of emotions, though not across all ADHD symptoms.  See this write up.
• Russell Barkley, Ph.D.'s excellent review of research about the impact of diet and ADHD can be accessed at this link.  In it, he argues that the sensational testing done in Netherlands in 2011 that suggested that ADHD symptoms are heavily influenced by diet (specifically the Feingold diet) was quite flawed, and that diet has a more nuanced effect on symptoms in certain people (most with sensitivities).
• Dr. Hallowell and Dr. John Ratey include a chapter, Nutrition and ADD: A Cornerstone of Good Treatment, in Delivered from Distraction that provides a solid, sensible overview about eating well with ADHD.
• For the 15% of those with ADHD who have undiagnosed celiac disease, eating gluten-free can significantly reduce ADHD symptoms.  For others, there is no evidence that eating GF improves ADHD smptoms, though it may impact general inflamation.  Our favorite resources for GF eating are here.
• One of Melissa's favorite cookbooks for flavorful gluten-free recipes is The Healthy Gluten-Free Life by Tammy Credicott.  Others that contain many GF recipes (use your judgment) are Forks over Knives (Sroufe) and The Vegetarian's Complete Quinoa Cookbook (Smith)
• At the moment, there is no evidence to suggest that pro-biotics can help manage depression or anxiety that might go along with ADHD.  See this Harvard Health overview.
• The makers of prescription Vayarin, advertised as a 'medical food,' suggest that it has an effect size of .7 against hyperactivity and emotional dysregulation after 3+ months.  However, critics suggest that to get to that number the research needed to be massaged.  See critique here.

Meditation and Mindfulness

• Mindfulness meditation is supported by research as a good technique for learning to manage the impulsivity and restlessness of ADHD.  Here is an easy-to read blog post by Ronald Alexander that introduces you to the basics of how to do it.
• If you wish to try some mindfulness meditation, you can use these recordings from UCLA
• Want to try a little meditating?  Try this candle video from Mayo Clinic.
• An overview of mindfulness apps by Harvard Health

(also see the page on Behavioral Treatments)

CBD Oil

There is no evidence to date that CBD treats ADHD.  See this article in ADDitude Magazine for a recap.

Trigenminal Nerve Stimulation (eTNS)

A device approved by the FDA for treatment of ADHD in 2019 attaches to the head during sleep to send pulse that stimulate the brain.  NOTE that the trial was an 8-week, open trial with a small number of children (no adults) and it demonstrated at the end of 8 weeks a low to moderate response.  This is problematic for a variety of reasons - the research was done by the manufacturer, the research hasn't been replicated, it was a small scale study of extremely limited duration, it wasn't double blind, and it was done on children, not adults.  Further, the device costs about $1000 and is often not covered by insurance.  If you have exhausted all of the other options, then you might wish to consider this.  Otherwise, it's too soon to recommend it.  An article explaining more is at this page.