How To Manage Adhd In Children Without Medications

  • Nayla Nader Masters Public Health - Health Management, Public Health, American University of Beirut

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Introduction

Natural remedies and lifestyle changes are the alternative solutions to medication use for attention-deficit/hyperactivity disorder (ADHD) management, a condition that affects 129 million children and adolescents worldwide.1 

While medications are commonly prescribed to manage symptoms, other alternative approaches are available:1

  • Establishing a routine
  • Following healthy diets
  • Adequate sleep
  • Exercise
  • Limiting screen time
  • Mindfulness and meditation
  • Parent training
  • Cognitive behaviour therapy (CBT)
  • Social skills training
  • Neurofeedback

Whether you are an individual with ADHD, a parent, or a caregiver, this article is for you. It provides a comprehensive approach to managing ADHD without medications, offering practical tips and actionable steps. Continue reading to learn how to naturally treat ADHD using holistic, evidence-based practices.

Is it possible to treat ADHD without medication?

ADHD is one of the most diagnosed mental health conditions in children. It is a lifelong condition that significantly influences various aspects of one’s daily life. While medications are commonly prescribed to regulate symptoms, a growing body of literature shows the effectiveness of using alternative approaches in supporting individuals managing ADHD.2

Living with ADHD can present unique challenges by affecting one’s attention, impulse control, and hyperactivity. ADHD management requires a multifaceted treatment approach, using different strategies to best manage symptoms. All guidelines recommend offering patients with an ADHD diagnosis, psychosocial treatments, and psychoeducation (behaviour therapy, group therapy, education) as a cornerstone of ADHD management. Depending on the age of the patient, alternative treatment options should always be offered, either alone or in combination with medications.2

Lifestyle modifications 

Lifestyle modifications are fundamental components of a holistic approach to managing ADHD without resorting to medications. Establishing consistent routines, ensuring sufficient sleep, following healthy eating habits, exercising regularly, and practising mindfulness are all integral elements of a solid ADHD management plan.    

Establishing a routine

Establishing consistent daily routines is an effective alternative treatment method for ADHD management.

Predictable schedules can provide children with ADHD with a sense of control, order and stability, helping them to regulate and navigate the challenges of impulsivity and inattention. Generally, you could try to have a schedule and follow it every day, incorporating designated times for naps, bedtime, play, screen use, homework, meals, and snacks. Having an organised and predictable schedule will reduce anxiety and prevent any tantrums.  

Healthy eating habits and supplements 

Many benefits arise from following healthy diets. However, the role of nutrition in ADHD and abiding by an ADHD-specific diet to improve symptoms have not been scientifically proven so far.3  

There is some evidence suggesting that children following healthy balanced diets, such as the Mediterranean and DASH diets, while avoiding the consumption of artificial dyes experienced a reduction in their ADHD symptoms.3 

It is more likely that people with ADHD suffer from vitamin and mineral deficiencies.4 Dietary deficiencies can affect behaviour and mood. Studies have correlated low iron, vitamin B, and vitamin D levels to ADHD symptoms. Low levels of vitamin B2 and B6 have been linked to the worsening of symptom severity.5 Iron and vitamin D deficiencies are associated with an increase in inattention, impulsivity, and hyperactivity.4, 6 It is therefore recommended to supplement an individual with vitamins B and D, magnesium, iron, or zinc, in case of a deficiency, as this will help to reduce ADHD symptoms.4

Children with ADHD have lower levels of omega-3 fatty acids compared to other neurotypical children. Fatty acids are needed to produce brain chemicals that protect our neurons. A systematic review of 16 trials was conducted, evaluating the role of fatty acids in children with ADHD. The study showed that the administration of fatty acid supplementation was very promising – improvements in ADHD symptoms were reported, mainly in the areas of hyperactivity, impulsivity, attention, learning, and working memory.7 

Vayarin®, composed of fatty acids, was an FDA-approved supplement that was administered as part of the ADHD management plan. Although it was considered successful in reducing symptoms in ADHD children, it has been discontinued since 2019, suggesting that it has not been as effective.

Evidence from research is not sufficient to recommend the administration of supplements for the management of ADHD.8 Do keep in mind that children and adults who eat healthy and balanced diets consume a variety of essential vitamins and minerals, meet their nutritional needs, and therefore do not need supplements. If you believe that you or your child have a nutritional deficiency, you should consult with a healthcare professional before incorporating supplements into your diet. 

Adequate sleep

Quality sleep is vital for our well-being, and it is particularly crucial for individuals with ADHD. 25% to 55% of people with ADHD suffer from sleep disturbances, including difficulties when settling down, delayed bedtime, insomnia, poor sleep quality, and night awakenings. Interventions aiming at improving sleep can benefit people with ADHD and should be an integral part of the ADHD management plan.

Research showed that an additional 30 minutes of sleep per night can reduce agitation and impulsivity. On the other hand, children with ADHD who do not get adequate sleep will experience a worsening of their symptoms the next day. Implementing healthy sleep habits will positively affect attention, mood, and cognitive function:9

  • Establish consistent sleep routines – regular sleep and waking schedules  
  • Create a favourable sleep environment by controlling the room temperature and lighting 
  • Limit screen time before bedtime
  • Practice relaxation techniques before bedtime

Exercise and physical activity

Multiple studies showed that regular physical activity is a powerful intervention in ADHD management. Exercise increases the levels of brain chemicals like dopamine and norepinephrine, which play key roles in improving all ADHD symptoms - attention, hyperactivity, impulsivity, mood regulation and behavioural problems.10

Engaging in physical activity of any kind, especially cardio, has been shown to improve, in the short and long run, behaviour and attention in children with ADHD.11 

Several studies highlighted the importance of outdoor play. Symptoms were significantly better and less severe when the child played in outdoor green settings when compared to indoor play. Children should be allowed to engage in after-school and leisure activities in natural outdoor green settings.12  

Limiting screen time

Excessive screen time can be harmful for all children, especially for those with ADHD. The growing body of literature demonstrates the link between screen utilisation and ADHD. The constant influx of stimuli from screens, whether through computers, tablets, gaming devices or smartphones, can exacerbate ADHD and worsen its symptoms.

A recent large-scale study conducted in 2022 highlighted the correlation between screen time utilisation and symptoms of ADHD in more than 11 000 children aged 9 to 11.13 

Screens and digital devices are part of our daily lives. It is, therefore, advisable to limit your child’s screen time and be aware of the content your child views. The American Academy of Child and Adolescent Psychiatry recommends that: 

  • Toddlers spend less than 1 hour co-watching educational programs with a caregiver
  • Children 2-5 years old spend 1 hour or less on a weekday and up to 3 hours on a weekend day in front of a screen
  • Children and adolescents between 6 -17 years spend 2 hours or less on a weekday in front of a screen

The American Academy of Pediatrics updated its guidelines on screen time and recommended controlling the quality of interaction with digital media rather than just limiting the time spent in front of a screen. 

Mindfulness and meditation

Research indicates that mindfulness and meditation can be particularly beneficial for individuals with ADHD. Regular sessions reduce stress and improve attention, impulse control, and emotional regulation.14  For better results, practice with a trainer who is experienced in working with ADHD children.

Psychosocial treatment

Since 1998, psychosocial interventions have been grounded as evidence-based strategies for ADHD management in children.1 

Parent training

This type of therapy teaches parents the skills required to improve parent-child relationships and parenting techniques to better help a child with ADHD. Parents are taught to identify and encourage positive behaviours, use reward systems, and give positive feedback that encourages certain behaviours while ignoring or redirecting unwanted behaviours.1

Cognitive behavioural therapy (CBT)

A well-established therapeutic approach, CBT, targets the patient’s unwanted behaviour and helps them change it. CBT does not treat core ADHD symptoms, but through structured sessions, it teaches patients to control their behaviour, improve emotional regulation, develop coping strategies, and improve ADHD daily struggles like time management and procrastination.1,2,15

Social skills training

Children with ADHD face many social challenges. The most important is the lack of social skills needed to make or retain friends, having strained relationships with other children, and sometimes displaying inappropriate social behaviours. Social skills training takes place as group training, where a therapist uses role-play to teach children social skills and appropriate social behaviours that can be used in their daily lives. 

Neurofeedback

A promising intervention gaining recognition in ADHD is neurofeedback, an approach which aims to help individuals learn to modulate their brain function, improving focus and cognitive control. In simpler terms, neurofeedback is a type of training for your brain. It gives your brain real-time information, which can be either visual or auditory - your brain activity is measured using electrodes placed on your head and is transformed into visual or acoustic signals. When your brain does something helpful like focusing well, you will hear a positive sound or see a rewarding image. Over time, your brain starts to figure out how to stay focused and calm. You will learn to control your brainwaves and with time, you will see improvements in attention and self-control.2 

Summary

Unfortunately, there is no miracle cure for ADHD. It is a lifelong chronic condition that is best managed using a combination of different approaches. Adults with ADHD can lead successful and productive lives by learning to cope with their challenging symptoms, embrace their strengths, practice lifestyle modifications, benefit from therapy, and consider medications when needed. 

Natural remedies may benefit children with ADHD differently. You should keep in mind that while some alternative treatment strategies were proven to be beneficial in improving ADHD symptoms, some still require additional research before being considered as approved ADHD treatments. Evidence-based alternative treatments include mindfulness, psychosocial treatment, mainly parent training, behavioural therapy, social skills training and neurofeedback. Establishing and following a routine, getting enough sleep, following a balanced diet, limiting screen time, and making sure your child spends enough time playing outdoors, engaging in unstructured play, and practising a sport that they like are all effective methods for regulating and reducing ADHD symptoms. 

It is important to note that while medications may be a suitable option for some, managing ADHD with no drugs provides alternative options for those who prefer to resort to natural strategies or complement their existing treatment plan.

References

  1. Shrestha M, Lautenschleger J, Soares N. Non-pharmacologic management of attention-deficit/hyperactivity disorder in children and adolescents: a review. Transl Pediatr [Internet]. 2020 Feb [cited 2023 Nov 22];9(Suppl 1):S114–24. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082245/
  2. Drechsler R, Brem S, Brandeis D, Grünblatt E, Berger G, Walitza S. Adhd: current concepts and treatments in children and adolescents. Neuropediatrics [Internet]. 2020 Oct [cited 2023 Nov 22];51(5):315–35. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508636/
  3. Breda V, Cerqueira RO, Ceolin G, Koning E, Fabe J, McDonald A, et al. Is there a place for dietetic interventions in adult ADHD? Progress in Neuro-Psychopharmacology and Biological Psychiatry [Internet]. 2022 Dec 20 [cited 2023 Nov 23];119:110613. Available from: https://www.sciencedirect.com/science/article/pii/S0278584622001051
  4. Child Mind Institute [Internet]. [cited 2023 Nov 23]. What we know about ADHD and food. Available from: https://childmind.org/article/what-we-know-about-adhd-and-food/
  5. Landaas ET, Aarsland TIM, Ulvik A, Halmøy A, Ueland PM, Haavik J. Vitamin levels in adults with ADHD. BJPsych Open [Internet]. 2016 Nov [cited 2023 Nov 23];2(6):377–84. Available from: https://www.cambridge.org/core/journals/bjpsych-open/article/vitamin-levels-in-adults-with-adhd/CF5E8D5617C297921498B26872335597
  6. Bener A, Kamal M, Bener H, Bhugra D. Higher prevalence of iron deficiency as a strong predictor of attention deficit hyperactivity disorder in children. Ann Med Health Sci Res [Internet]. 2014 [cited 2023 Nov 23];4(Suppl 3):S291–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212392/
  7. Derbyshire E. Do omega-3/6 fatty acids have a therapeutic role in children and young people with ADHD? J Lipids [Internet]. 2017 [cited 2023 Nov 23];2017:6285218. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603098/
  8. Lange KW, Lange KM, Nakamura Y, Reissmann A. Nutrition in the management of ADHD: a review of recent research. Curr Nutr Rep [Internet]. 2023 Sep 1 [cited 2023 Nov 23];12(3):383–94. Available from: https://doi.org/10.1007/s13668-023-00487-8
  9. Hvolby A. Associations of sleep disturbance with ADHD: implications for treatment. Atten Defic Hyperact Disord [Internet]. 2015 [cited 2023 Nov 23];7(1):1–18. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340974/
  10. Xie Y, Gao X, Song Y, Zhu X, Chen M, Yang L, et al. Effectiveness of physical activity intervention on adhd symptoms: a systematic review and meta-analysis. Frontiers in Psychiatry [Internet]. 2021 [cited 2023 Nov 23];12. Available from: https://www.frontiersin.org/articles/10.3389/fpsyt.2021.706625
  11. Gapin JI, Labban JD, Etnier JL. The effects of physical activity on attention deficit hyperactivity disorder symptoms: the evidence. Prev Med. 2011 Jun;52 Suppl 1:S70-74. Available from: https://pubmed.ncbi.nlm.nih.gov/21281664/
  12. Kuo FE, Faber Taylor A. A potential natural treatment for attention-deficit/hyperactivity disorder: evidence from a national study. Am J Public Health [Internet]. 2004 Sep [cited 2023 Nov 23];94(9):1580–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448497/
  13. Yang A, Rolls ET, Dong G, Du J, Li Y, Feng J, et al. Longer screen time utilization is associated with the polygenic risk for Attention-deficit/hyperactivity disorder with mediation by brain white matter microstructure. eBioMedicine [Internet]. 2022 Jun 1 [cited 2023 Nov 23];80:104039. Available from: https://www.sciencedirect.com/science/article/pii/S2352396422002201
  14. Mitchell JT, Zylowska L, Kollins SH. Mindfulness meditation training for attention-deficit/hyperactivity disorder in adulthood: current empirical support, treatment overview, and future directions. Cogn Behav Pract [Internet]. 2015 May [cited 2023 Nov 24];22(2):172–91. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4403871/
  15. Sprich SE, Knouse LE, Cooper-Vince C, Burbridge J, Safren SA. Description and demonstration of cbt for adhd in adults. Cogn Behav Pract [Internet]. 2012 Feb 1 [cited 2023 Nov 24];17(1):10.1016/j.cbpra.2009.09.002. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874265/

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Nayla Nader

Registered Pharmacist, Masters of Public Health

Nayla is a pharmacist and public health specialist with a passion for education, community work, and medical writing. She has several years of experience in academia, teaching pharmacology to nursing students, conducting data analysis and report writing. Whether in the classroom, the community or on paper, Nayla is committed to simplifying complex health concepts and translating them into information accessible to all.

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