What if there was a non-pharmaceutical way that—along with other appropriate therapies—helped manage the symptoms of ADHD (Attention Deficit Hyperactive Disorder) with no side effects and strong evidence supporting its benefits? There is. It's exercise.

About 8 to 10 percent of children and adults suffer from ADHD, a biological brain disorder. Children with ADHD are generally hyperactive, have poor impulse control, poor self-discipline, low self-esteem, and have trouble paying attention. Treatment usually includes parent training, behavioral interventions, and medications, such as Ritalin and Adderall. Drugs do not always work, however, and can have side effects. Unfortunately, the incidence of ADHD is rising.

Based on research results, exercise appears to have positive effects on many physical and mental health conditions. Associate Professor Douglas Nordsey, MD, says there is strong evidence demonstrating the ability of exercise to treat mental illness and benefit the health of the nervous system.

John Ratey, MD, an expert on ADHD and author of Spark: The Revolutionary New Science of Exercise and the Brain, says exercise turns on the attention system, or the executive functioning of the brain, which includes sequencing, working memory, prioritization, and inhibiting or sustaining attention. Exercise causes children to be less impulsive, more ready to learn, and less likely to suffer from learned helplessness.

In the short term, exercise increases the production of chemicals (neurotransmitters) in the brain associated with mood, pleasure, focus, and attention. In the long term, exercise builds up the brain's ability to increase these neurotransmitters and improve how they communicate in the brain.

The good news is that it doesn't take a lot of exercise to have beneficial effects. Simply walking 30 minutes four times per week can help. Individuals need to be physically active long enough to get their heart rate up for at least a few minutes. The key is finding an exercise that the individual likes and will stick with.

Dr. Ratey and others advocate team activities or those with a social component for children with ADHD. Activities such as tae Kwando, ballet, or gymnastics helps bring order to children's minds and requires them to pay close attention to their body movements.

Pediatrician David Levine, MD, cautions that exercise is not a replacement for other therapies since we don't yet know enough about ADHD to know who is most likely to benefit from exercise—with or without medicine. However, Dr. Levine says, exercise is very beneficial and physicians should recommend it for everyone.

David Levine, MD, reviewed this article.



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