Resilience Medicine is a Holistic and Integrative Approach to medicine. In this article you will learn about the Resilience Medicine treatment approach to ADHD.
Attention Deficit Hyperactivity Disorder (ADHD) is the most common neurodevelopmental disorder in children, affecting up to 15% of kids and between 8-10% of adults.
It is characterized by significant issues with maintaining attention, impulsivity, and, sometimes but not always, hyperactive behavior. These symptoms frequently lead to behavioral challenges that impact academic or work performance, productivity, relationships, mood and daily functioning in a variety of areas.
Despite its increasing prevalence, ADHD is often missed, especially if there is no major hyperactivity, and inadequately treated. Most treatment centres in the UK focus on medication alone or alongside generic CBT techniques which are often not effective, without looking at the wider picture.
Untreated ADHD also doubles the risk of developing substance abuse disorders and increases the risk of developing other mental health conditions like anxiety and depression. It also increases the risk of having adverse life experiences like divorce and financial problems due to a deterioration in overall ability to function.
Thankfully a holistic treatment approach to ADHD can dramatically improve quality of life, reduce stress and anxiety, and improve symptoms quickly to enhance your ability to function in daily life and thrive.
There is also a genetic link between ADHD and other conditions such as EDS, a connective tissue disorder often undiagnosed, that puts people at increased risk of experiencing chronic pain, fatigue, sleep and digestive problems.
These issues can further impact functioning in ADHD when all left unrecognized.
People with adhd, especially adults with ADHD who have not been adequately treated for many years, often develop other health issues like depression or an anxiety disorder.
These issues need to be understood and addressed together, addressing the multifactorial causes of symptoms in the context of neurodiversity.
This approach is rarely taken in standard medical care leading to more stress trying to manage all of these symptoms individually with often multiple ineffective medications by different doctors without understanding the whole picture.
This is very overwhelming, especially for neurodiverse people and often results in poor treatment outcomes.
A personalized Holistic Treatment approach helps to break this cycle to improve your quality of life and daily functioning and dramatically improve your symptoms.
Medical cannabis can be very helpful for many people who have ADHD for helping in some cases with core symptoms, using specific ratios of THC:CBD and strains or cultivars tailored to each person and also to help with secondary symptoms like sleep, mood and anxiety.
It is generally very well tolerated when prescribed appropriately by an expert physician.
In some cases where low dose stimulant medication is effective for the core symptoms of ADD/ADHD but causes side effects, adding a small dose of medical cannabis can help reduce side effects and provide a good medicine combination.
Medical Cannabis works on our endocannabinoid system (ECS) as well as the serotonin system and even in the gut via receptors here. It also works on regulating inflammation signaling, neuroprotection and may improve mitochondrial health, all mechanisms that are likely relevant to people with ADHD/ADD.
For different times of day and different effects, medical cannabis treatments should be tailored to each person’s circadian rhythm, which is often different in those with ADHD/ADD.
There is increasing recognition in recent years of the relationship between neurodevelopmental disorders and ADHD in particular, and the gut microbiome as well as the gut environment.
Neurodiverse people have more digestive or GI symptoms than the general population. It has been shown in animal models that ADHD symptoms can be induced by transplanting human feces from people diagnosed with ADHD into mice, causing them to begin to show ADHD behaviors as well as brain structure and function changes. (Hsiao et al., 2013, Mathee et al., 2020, Sharon et al., 2019, Tengeler et al., 2020; Tengeler et al., 2020).
People with neurodevelopmental disorders also often suffer with many food intolerances and immune mediated reactions to foods and increased intestinal permeability markers as well as altered gut bugs, decreased beneficial bacteria and overgrowth of pathogenic species of bacteria, yeast and in some cases mould species.
By using advanced stool and urine testing looking at the microbiome and brain-gut-immune axis biomarkers, we are able to intervene to shift the microbiome, reduce microinflammation and improve tight junction function to reduce ‘leaky gut’ and impact brain and behavior via this brain-gut axis.
Certain types of diets can modify behavioral symptoms in ADHD/ADD in both children and in adults, which is now well documented in the research literature, due to the biological effects on the microbiome, cytokines (inflammatory chemicals), neurotransmitter levels, neuroinflammation and other pathways.
A low allergen diet, or elimination diet, customized to each patient may be undertaken with the doctor. Often, you can start with a no gluten and low-casein diet.
People with ADHD/ADD tend to have more tendencies towards food addictions and cravings which are often related to food intolerances which can be tested for if needed.
We develop a personalized therapeutic diet as part of your treatment plan to allow you to get the most benefit from this strategy and make it sustainable and practical for you.
Mindbody practices help to actually change the brain structure and function in multiple ways, turn down the volume on stress, anxiety and pain signals and help our brain’s become more resilient.
Utilizing the bi-directional brain-body communication link can be very effective at reducing anxiety, overwhelm, improve mood regulation ability and help improve the ability to concentrate.
Mindfulness training has been shown to be helpful in adults with ADHD. Biofeedback and neurostim devices are also often helpful to help regulate what is called ‘vagal tone’ and to help with shifting brain states and working on a maladaptive stress response and limbic system hyperarousal.
We can use functional medicine testing to look at factors such as gut microbiome and gut-brain axis function, inflammatory biomarkers, circadian rhythm dysfunction, mycotoxin and pathogenic yeast and microbiome factors creating bioactive substances that can affect brain and behavior and more, based on testing results.
They can help further customize your treatment plan to your specific biochemistry and help us create a personalized nutraceutical plan to use on its own or in conjunction with medication to support optimal brain functioning and address nutrient insufficiencies relevant to your symptoms.
These interventions are often extremely helpful in the treatment of ADHD for both core and secondary symptoms, especially for those who are very sensitive to medication side effects.
Patient: Philip, Aged 45.
Goal: To feel less overwhelmed, be able to perform better at work and have less conflict at home with his partner over his ‘disorganized’ and forgetful behavior.
Overview: Philip had suspected he may have ADHD for a ‘long time’ but was never picked up as a child. He remembers having lots of issues at school paying attention and that school was not ‘fun’ for him, but rather stressful except for excelling at sport. He always managed to ‘get by’ but would always cram at the last minute for exams and received school reports of not meeting his full potential. As an adult, Philp had difficulty keeping one job for more than a year, became bored easily and performance would suffer and reported lots of interpersonal conflict with his wife, especially since having children. This conflict was usually around him forgetting important family events, everyday chores and not being able to stay organized with the family calendar. It had started to affect his marriage and his relationship with his kids. He wasn’t sleeping well, felt anxious as well as not being able to sustain focus at work consistently.
The Plan: After an initial ADHD assessment, a holistic treatment plan was devised including stool testing for microbiome health using a detailed functional medicine panel. He was started on a personalized therapeutic diet and specific botanicals and supplements to help restore a more optimal balanced microbiome and repair the tight junctions in the gut wall leading to food related symptoms like fatigue and brainfog. He then started on a low dose stimulant medication and then a few months later, a low dose medical cannabis product to help with his sleep and overall function was added to this. He also participated in home nervous system retraining exercises which helped to calm his limbic system and reduce stress reactivity and improve his mood balance.
The Outcome: 8 months later, he was excelling in his career and performing at what he called his ‘best level consistently’ for the first time in his life. He had less conflict at home because he was able to meet more of his obligations with his partner and kids without the major mental distress and overwhelm he had experienced previously. His mood was more stable and he was able to consistently get to bed before midnight and felt rested in the morning. He had more energy and felt focused and more motivated.
The first step is getting a comprehensive integrative holistic medicine assessment for ADHD with Dr. Gordon.
In addition to assessing core ADHD symptoms and areas after extensive intakes and rating scales you will complete for our analysis, other areas of mental and physical health will also be looked at in a holistic manner, as many symptoms overlap and affect each other when you have ADHD.
These include problems with mood, anxiety, pain, fatigue and overall functioning. You will get a holistic integrative medicine treatment plan that goes beyond just stimulant medication. This is extremely important since although medication can be an important part of treatment, on its own it is often not the whole solution, especially if you have other symptoms too.
This holistic approach includes diet and microbiome, nervous system retraining, supplements and nutraceuticals, medications (including if appropriate, stimulant medications, cannabinoid medicines and non-stimulant medications).
This approach to treatment is more common in North America, where Dr. Gordon trained and practiced for a decade before relocating to the UK.
If you have not yet been formally diagnosed, you must receive a formal ADHD assessment and report in order to get a diagnosis and if deemed appropriate, start on a medication including a stimulant medication.
As part of this process, you will complete in-depth assessments for ADHD and a comprehensive report based on the results of your assessments and the clinical interviews with our ADHD specialist psychiatrist and Dr. Gordon will be generated for you.
After this has been done and once stable on a medication (if included as part of your treatment plan), we can then create a shared care plan with your NHS GP so you can receive your medication on the NHS to reduce the ongoing costs of medication and care.
If you do not wish to try a stimulant medication or do not feel it is necessary to receive a formal ADHD Assessment and report, you can still receive holistic adhd treatment including other medications, diet, functional medicine testing and microbiome testing, nervous system retraining approaches and environment optimisation strategies as well as effectively treating common comorbidities such as anxiety, low mood, mental fatigue and sleep difficulties.
Please get in touch with our team if you have further questions about treatment and assessment options.