As we enter the third year of a global pandemic, researchers have begun to examine how new societal norms have impacted neurodiverse individuals. For people with attention deficit hyperactivity disorder (ADHD), the pandemic has led to “unprecedented challenges” associated with increased social isolation, difficulty engaging in online learning, and issues related to motivation, boredom, and sleep disturbance1,2. If these experiences resonate, you are not alone. Fortunately, an emerging branch of research has linked physical exercise to improved mood, concentration, impulse control, and cognitive performance3,4. These are promising findings for people with ADHD. In such times where the daily commute may be a few steps from our bed to our computer desk, remembering to slot in 30 minutes of daily exercise may be key to defeating the “covid blues,” clearing pandemic brain fog, and remaining grounded and resilient amid these trying times.
Living with ADHD (in a pandemic)
ADHD brains process attention and concentration differently than non-ADHD brains. People with ADHD are more likely to experience wandering thoughts, have attention spans that jump from one thing to the next, and have no problem summoning the impulse to get up and try something new5. When ADHD brains are provided adequate structure, expectations, and feedback, attributes that were once difficult to manage can become instrumental for fostering inspiration, creativity, and inventiveness5,6. According to a 2014 article by Forbes, several highly successful people such as the CEO of Ikea have harnessed their ADHD as an entrepreneurial “superpower” which facilitates out-of-the-box thinking7. On the flip side, when lacking critical supports, individuals with ADHD can struggle with procrastination, forgetfulness, and disorganization7.
The pandemic brought a myriad of changes at all levels of society and has re-shaped how we structure our daily lives. These sweeping changes, though difficult for all, have had a greater impact on individuals with ADHD who once relied on consistent routines5. Due to increased stress and high workloads, university students with ADHD are particularly vulnerable to pandemic related challenges and they more often struggle with depression, anxiety, addiction, substance use, and academic difficulties1,8. Furthermore, decreased access to social support and professional services have compounded existing challenges for neurodiverse individuals8.
ADHD and Physical Exercise
ADHD is the most common neuroatypical diagnosis in pediatric psychiatry and has become a central subject of study in neurology and developmental psychology9,10. ADHD brains are characterized by biochemical compositions and structures that differ from non-ADHD brains, and those with ADHD are often prescribed stimulant medication to compensate for these differences11. Even with medication, ADHD impacts and shapes a person’s developmental trajectory, and individuals with the diagnosis behave, think, and interact in a manner which manifests as inattention, hyperactivity, and impulsivity10. People with ADHD often find it difficult to focus on mundane and repetitive tasks, can become intensely focused on subjects or activities that interest them while ignoring everything else, and may experience co-occurring social, psychological, and academic/career set-backs due to their neurodiverse presentation12. Clearly, without proper support and structure, living with ADHD can feel more like a curse than a “superpower.”
Thankfully, researchers have explored the possibility that intense physical activity can assist the management of ADHD symptoms with comparable effectiveness to medication. A 2009 study found that 30 minutes of physical activity resulted in improved attention for children with ADHD irrespective of their use of stimulant medication11. Several researchers theorize that the structural and neurodevelopmental vulnerabilities associated with ADHD can be mitigated by physical exercise, which has been linked to better impulse control, working memory, attentiveness, and reduced stress, anxiety, and depression13. A 2014 research study found that a 5-minute sprint resulted in a 30.5% increase in cognitive performance for subjects with ADHD, who displayed similar performance to a control group without ADHD that did not exercise14. These findings reveal the benefits of physical exercise on brain function and highlight how a little bit of exercise can go along way in alleviating adverse ADHD symptoms.
In terms of type of exercise, intense cardiovascular activity (e.g., running, swimming, cycling) has been shown to have the most benefit and improves cognitive function, attention span, emotional regulation, and behaviour3. A mere 30 minutes of exercise has been found to dramatically improve executive function for individuals with ADHD4; however, the positive benefit of exercise increases proportionately with longer and more intense activity sessions15. Specific kinds of exercise may be useful for targeted outcomes, such as Yoga and Tai Chi for emotional and behavioral regulation, team-based sports for social skills training, and aerobic or endurance exercises for cognition and attention16.
So, how to Exercise? Try gamifying.
Okay! So, physical exercise will help with my brain function and will also help if I have ADHD. But now what? Jumping into a new exercise routine is easier said than done, and amid ongoing gym closures and capacity restrictions, who really wants to venture into a public locker room or hire a personal trainer (and will he/she/they wear a mask!?). Don’t worry I got you covered. Well… not completely. Admittedly, preparing for, starting, and maintaining an exercise routine is difficult even without a pandemic. So, how to exercise? Let’s draw from the information we’ve seen so far and come up with a rough action plan that might (no guarantees here!) work for you. If you identify as a person with ADHD, you have the superpower of creativity, imagination, and the ability to become so engrossed with stimulating activities that experts have coined the phrase “hyperfocus”7,12. Thus, our “ADHD exercise plan” must be creative and stimulating to the point where we can trigger hyperfocus, so we don’t get bored and quit halfway through. In this context, “gamification” might be the answer.
Gamification is a relatively new concept and strategy that has emerged with the advent and popularization of, well, video games17. It refers to the process of turning an activity or task into a game or something that resembles a game and works by increasing dopamine availability when you engage in the desired task18. By applying game mechanics like quests, points, and rewards to non-game applications, we can trick our brains into “having fun” even when confronting a less-than-fun activity. Gamifying activities works well with ADHD brains, as it taps into the desire for stimulation and fosters intrinsic motivation19. Having the mindset that “my quest today is exercise” and rewarding yourself for completing the task can create excitement that the ADHD brain needs to engage in hyperfocus. There are phone apps and smart watches that further gamify the exercise experience by tracking your “points” and progress20. Walk around the block: 10 points. 15-minute sprint: 20 points. Give yourself a goal (like that thing you want to buy on Amazon) and at 100 points reward yourself! Get a friend involved to spice up the competition. Gamifying your workouts can make it easier to set goals and stick to them!
If you identify as a person with ADHD, physical exercise can be a great coping strategy. However, it is not a replacement for medication or professional services. Please do what is best for you in consultation with your doctor or mental health professional. However, for some, physical activity is a great option for improving the mind and body.
Edited by Jeffrey Lynham & Curtis D'Hollander
References
1. Cortese S, Asherson P, Sonuga-Barke E, et al. ADHD management during the COVID-19 pandemic: guidance from the European ADHD Guidelines Group. The Lancet Child & Adolescent Health. 2020 Jun;4(6):412–4.
2. Sibley MH, Ortiz M, Gaias LM, et al. Top problems of adolescents and young adults with ADHD during the COVID-19 pandemic. Journal of Psychiatric Research. 2021 Apr;136:190–7.
3. Den Heijer AE, Groen Y, Tucha L, et al. Sweat it out? The effects of physical exercise on cognition and behavior in children and adults with ADHD: a systematic literature review. J Neural Transm. 2017 Feb;124(S1):3–26.
4. Grassmann V, Alves MV, Santos-Galduróz RF, et al. Possible Cognitive Benefits of Acute Physical Exercise in Children With ADHD: A Systematic Review. J Atten Disord. 2017 Mar;21(5):367–71.
5. Low K. 8 Simple School Strategies for Students with ADHD [Internet]. Verywellmind. 2020 [cited 2022 Jan 1]. Available from: https://www.verywellmind.com/help-for-students-with-adhd-20538
6. White H. The Creativity of ADHD [Internet]. Scientific American. 2019 [cited 2022 Jan 7]. Available from: https://www.scientificamerican.com/article/the-creativity-of-adhd/
7. Archer DD. ADHD: The Entrepreneur’s Superpower [Internet]. Forbes. 2014 [cited 2022 Jan 8]. Available from: https://www.forbes.com/sites/dalearcher/2014/05/14/adhd-the-entrepreneurs-superpower/
8. Mochrie KD, Whited MC, Cellucci T, et al. ADHD, depression, and substance abuse risk among beginning college students. Journal of American College Health. 2020 Jan 2;68(1):6–10.
9. Kalat JW. Biological Psychology. 10th ed. Belmont, Calif: Cengage Learning; 2009. 579 p.
10. Mash EJ, Wolfe DA. Abnormal child psychology. 6th ed. Boston, MA: Cengage Learning; 2016. 628 p.
11. Medina JA, Netto TLB, Muszkat M, et al. Exercise impact on sustained attention of ADHD children, methylphenidate effects. ADHD Atten Def Hyp Disord. 2010 Mar;2(1):49–58.
12. Porter E, Legg TJ. What Is Hyperfocus and How Does It Affect Kids and Adults? [Internet]. Healthline. 2012 [cited 2022 Jan 7]. Available from: https://www.healthline.com/health/adhd/adhd-symptoms-hyperfocus
13. Archer T, Kostrzewa RM. Physical Exercise Alleviates ADHD Symptoms: Regional Deficits and Development Trajectory. Neurotox Res. 2012 Feb;21(2):195–209.
14. Silva AP, Prado SOS, Scardovelli TA, et al. Measurement of the Effect of Physical Exercise on the Concentration of Individuals with ADHD. Lidzba K, editor. PLoS ONE. 2015 Mar 24;10(3).
15. Vysniauske R, Verburgh L, Oosterlaan J, et al. The Effects of Physical Exercise on Functional Outcomes in the Treatment of ADHD: A Meta-Analysis. J Atten Disord. 2020 Mar;24(5):644–54.
16. Neudecker C, Mewes N, Reimers AK, et al. Exercise Interventions in Children and Adolescents With ADHD: A Systematic Review. J Atten Disord. 2019 Feb;23(4):307–24.
17. When You Have ADHD and Need Motivation, Turn Your Life into a Game [Internet]. Edge Foundation. 2017 [cited 2022 Jan 7]. Available from: https://edgefoundation.org/when-you-have-adhd-and-need-motivation-turn-your-life-into-a-game/
18. Walz A. Gamification: The Science and Software to Make You More Productive [Internet]. 2016 [cited 2022 Jan 7]. Available from: https://zapier.com/blog/gamification-apps/
19. Alqithami S. A serious-gamification blueprint towards a normalized attention. Brain Inf. 2021 Dec;8(1):6.
20. Coleman E. 5 Ways to Gamify Your Exercise Routine / Fitness [Internet]. [cited 2022 Jan 7]. Available from: https://www.fitday.com/fitness-articles/fitness/5-ways-to-gamify-your-exercise-routine.html