There isn’t much bad you can say about exercise. We all need it. Daily. And yet many of us don’t get it often enough. There are so many competing demands– work, family, hobbies, chores, the list goes on and on.
For many of us the consequence of not being active enough will take years to manifest– Type 2 diabetes, obesity, cardiovascular disease, arthritis. But for some folks who carry the genes for psychiatric disorders such as ADHD, depression or anxiety, the results of not enough exercise can be immediate and significant.
For years I had heard about a summer program that was wildly successful at reducing kids symptoms of ADHD. The camp essentially had these kids exercising 6 hours/day. At first I thought that the poor kids were just too tired to be hyper or act impulsively. For goodness sakes after 6 hours of exercise I could hardly formulate a sentence let alone drive anyone crazy with my ADHD behaviors.
Now I know that there is a lot more going on at that camp. I recently read an interview with John Ratey, MD, who is an Associate Clinical Professor of Psychiatry at Harvard Medical School. The interview was published by Medscape Psychiatry & Mental Health (www.medscape.com) on 10/08/2009. In that interview Dr. Ratey explained the brain science behind the amazing affects of exercise on people with ADHD.
Exercise just so happens to increase the concentrations of norepinephrine and dopamine in the brain. Both of these chemicals are believed to be central to the functioning of the attention system. So exercise literally does some of the same things that Ritalin or Vyvance does– increase these chemicals that help our brain to concentrate. Over time repeated exercise also helps the brain to be capable of producing more of these neurotransmitters all on it’s own. It also increases the post-synaptic receptors for these neurotransmitters, allowing the brain to absorb the increase supply of these two important chemicals.
Exercise does another very important thing in the brain of folks with ADHD. It activates the frontal lobes. Again this is the same mechanism by which stimulant medications work. The symptoms of ADHD are caused, in part, by an under-activiation of the frontal lobe. This is the part of the brain that helps us link cause and effect (and therefore learn from our mistakes), control impulses, regulate our strong emotions and filter what we say or do based on how we think others will feel about it. It also helps us to plan and organize. These are all things that people with ADHD can struggle with quite a bit. And exercise improves the amount of activity in this critical part of the brain.
Dr. Ratey recommends daily exercise and notes that it doesn’t have to be one kind in particular. He says that it can be aerobic (swimming, cyling, running, etc.) or strength training (free weights ,machines, etc.). He also notes that balance training is important in people with ADHD. This is because in addition to the frontal lobe there is another brain area that is known to be impaired in ADHD- the cerebellum. Once thought to be mostly used for balance we now know that the cerebellum is involved in many other activities, some of which relate to ADHD. Balance activities, such as those that are part of yoga, tai chi or core stabalizing exercises that require you to balance on balance boards, etc. are all good for increasing stimulation to that area of the brain.
Dr. Ratey points out one well known example of the power of exercise to mitigate ADHD– Olympic swimmer Michael Phelps. Michael was diagnosed with ADHD at the age of 9 and put on medicine. Despite the medications he simply was not able to stay focused and sit long enough to stay in a traditional school environment. Then he began swimming and when he achieved up to 3 hours of swimming every day he found that he did not need the medication anymore. This is a great example of someone who had very severe symptoms and yet was able to manage them solely through exercise. Granted most of us don’t have 3 hours of time every day to devote to exercising, but an hour is manageable for most people. And an hour could significantly reduce your need for medication or at least lower the dosage required.
The interview also points out another interesting mechanism by which exercise may help people with ADHD. Every person I have ever worked with who has ADHD has had damage to their self-esteem. They often have gone through periods where they felt helpless and hopeless because they kept making the same mistakes or just could not get their life together. Often even though they were smart people they had trouble excelling at school or at their job because of the ADHD symptoms. Dr. Ratey points out that something psychologists call “learned helplessness” can be prevented with exercise. In animal studies if the animals are given exercise before being put into a situation in which they feel helpless (not being able to escape from a cage) they are less likely to develop helpless behaviors than dogs who have not had exercise. So exercising is like giving yourself a vaccination against helplessness, which is something that people with ADHD sorely need.
So we are back to my original point. There just isn’t much bad you can say about exercise. This article discusses what it does for the ADHD brain but other articles in the future will discuss its impact on mood disorders. For now the prescription is to go get active every day. Your body AND your brain will thank you for it.
I hope you have found this information helpful.
Best wishes,
Dr. Jordan
