“Om….Om….Om….”

For those of you familiar with meditation, you might recognize the mantra written above.  Then again, if you are familiar with the concepts of meditation – including its use of mantras – there’s a chance that you wouldn’t be reading this blog.

For those of you who are, the title might raise a few questions.  Can people with ADHD meditate?  Is it even possible for someone with difficulties focusing, and maybe even sitting still, to meditate – let alone gain any benefits from it?  And what about mindfulness meditation?  How is that any different from traditional meditation?

This blog tries to answer some of these questions based on current medical literature.

In the strictly medical sense, meditation is the act of thinking deeply or focusing one’s mind for a period of time as a method of relaxation.  Traditionally, this is done in a (comfortable) seated position with the eyes closed, and may or may not employ the use of a mantra to help focus the meditation.

But what about mindfulness meditation?

Mindfulness meditation, more simply known as mindfulness, can be looked at as a subtype of meditation.  The key is that mindfulness is about being fully present in a given moment.  This means that a person is aware of their inner and outer experiences – thoughts, sensations, emotions, actions and surroundings – as they exist in the moment.  True, some people might find this relaxing, but relaxation is not the main goal.  Instead, the goal is to learn how to accept and handle your current circumstances with less emotional reactivity.

To help you remember this, think of ACA:

A – Awareness.

C – Current moment.

A – Acceptance.

In the broadest of terms, this can be accomplished by focusing on two sets of skills:  the what skills (what you are doing in the present moment) and the how skills (how you are doing it).

What skills:

  • Observe the situation – pay attention, on purpose, to the present moment, including any thoughts, emotions or sensations you are experiencing.
  • Describe the situation – describe what you’ve observed, sticking to the facts and avoiding interpretations or opinions.
  • Participate in the situation.

How skills:

  • Non-judgementally – let go of your opinions, and work to approach things objectively.
  • One-mindfully – focus on one thing at a time, rather than trying to multitask.
  • Effectively – set a goal, and work towards it.

So, now that we’ve touched on what mindfulness is, what does the literature have to say about it?

Multiple studies have been done looking at the feasibility, efficacy and outcomes of mindfulness in various populations.  What’s been found is quite promising.

Mindfulness has been found to alleviate both mental and physical symptoms in multiple settings:

  • Cancer
  • Cardiovascular disease
  • Chronic pain
  • Depression (decreasing relapse rates in addition to improving depressive symptoms)
  • Anxiety

As an added bonus, there have been no reported side effects or consequences of practicing mindfulness!

Given that some people with ADHD also have issues with anxiety or depression, it’s possible that they could find mindfulness practice beneficial.  Of course, they’d have to be sitting still, right?

Not necessarily.  Yoga, with its focus on the breath, purposeful movements, and relaxation techniques, has been shown to have an aspect of mindfulness in its practice.  In other words, it’s a moving mindfulness meditation – a great alternative for someone with difficulties staying still.  And, research has shown that it decreases negative feelings – including aggression, depression and anxiety – as well as improving a person’s ability to remain engaged.

But what about the impact of mindfulness on ADHD and its symptoms?

It turns out that the practice of mindfulness among people with ADHD has been the subject of multiple studies, and the majority have come to the same conclusion: mindfulness meditation is beneficial among adults and kids with ADHD.  However, medicine isn’t one-size-fits-all, and nothing is actually so straight forward as to be black and white.  So, take the following information with a grain of salt, and consider how it applies to your personal situation before jumping into anything head first.

People with ADHD who participated in a mindfulness course (ranging anywhere from 6-12 weeks), reported multiple improvements.  First, they noted a positive impact on anxiety, depression and quality of life – just like people without ADHD.  Second, they reported improvements in attention and executive function.  This included improved emotional regulation, working memory, cognitive inhibition, and performance monitoring – all areas of difficulty in ADHD.  And, this reduction in ADHD symptoms was reported on multiple fronts: by the investigators in the studies, by the participants with ADHD, and on formal tests.

This makes sense if you consider what mindfulness is actually doing.

Mindfulness research has shown that, following mindfulness training, there is an increase in dopamine release in the brain.  ADHD research has linked a deficiency of dopamine in the brain with the symptoms of ADHD.  Tying these two findings together helps explain why people with ADHD who participated in mindfulness activities experienced increased attention, decreased impulsivity, and enhanced performance of tasks involving executive functions.  And, further supporting this explanation is the fact that these improvements were also documented when electrodes were placed on the scalp to monitor brain waves.

However, before you get too excited, remember that I mentioned that this information needed to be taken with a grain of salt.  Specifically, the majority of studies did not differentiate between people who were taking stimulant medication and those that were not.  Instead, the dose of the medication was kept stable for the duration of the study.  As a result, there is very limited data on mindfulness treatment as an alternative to medication.  What there is suggests that mindfulness may be a beneficial treatment for people who are unable to receive pharmacological treatment.  However, more research is needed before a conclusion can be drawn.  So, medication is still considered first-line therapy for people with ADHD.

Additionally, when considering children with ADHD, research suggests that they do not have to be the practitioners of mindfulness to still experience its benefits.  Research into mindful parenting – a practice focused on preserving the parent-child relationship by acknowledging interactions, the emotions driving these interactions, and how they can cause disconnect – has shown a ripple effect.  In other words, working with parents and having them practice mindfulness actually improved their child’s ADHD.  This included improvements in self-control, attention and social behaviour, along with a reduction in hyperactivity.  On top of the benefits reported for the children, it was reported that parents experienced a decrease in parental stress, and improved parental satisfaction in parenting skills and their parent-child relationship.

Furthermore, the data is suggesting that there might be an additive effect of the benefits of mindfulness for people with ADHD if both parents and children practice mindfulness on a regular basis.

To conclude, there are a few things to keep in mind if you chose to incorporate mindfulness into your life:

  1. Mindfulness practice can be incorporated as one aspect of a person’s ADHD treatment plan.  This means that, if you decide to incorporate mindfulness into your ADHD treatment, you shouldn’t stop your ADHD medication or alter other aspects of your treatment plan without talking to your doctor first.
  2. Start slow.  Try starting off with a 5-minute mindfulness meditation.  Or, if this is too long, try one that is only 2-3 minutes.  Practicing mindfulness isn’t about who can meditate the longest the quickest, but about embracing a non-judgemental, moment-to-moment awareness in life and the benefits that this can bring.
  3. Find what works best for you.  Remember, there is more than one way to incorporate mindfulness into your life.  Perhaps sitting meditation doesn’t work for you.  That’s okay.  As was touched on above, there are moving mindfulness meditations.  Yoga and walking mindfulness meditations are both options.  Having trouble staying focused?  Consider using guided meditations to get started.  Lastly, if group or in-person sessions aren’t for you, mindfulness sessions/tutorials can be found online, and have been shown to have comparable benefits to the in-person sessions.
  4. Be kind to yourself.  Practicing mindfulness is like learning to do anything else – it takes time, and you can’t expect to be a master at it right away.  Yes, your mind will wander.  That’s normal and expected.  The key is to acknowledge this when it happens, show yourself kindness and compassion, and then to let the thought go.

 

Amanda Marchak, BSc Materials Engineering, MD Candidate (Class of 2019)

Amanda Marchak completed a Bachelors of Science in Materials Engineering at the University of Alberta, with a special interest in biomedical applications. After realizing that her interests were more clinical-based as opposed to research-based, she began pursuing a medical degree at the University of Calgary. Amanda is set to graduate in 2019, and hopes to pursue a career in pediatrics. As a volunteer at the the CanLearn Society in Calgary, Alberta, she works in collaboration with a team of psychologists and physicians to help provide information to individuals, and their families, about ADHD and Learning Disabilities.