ADHD and Stress

We have had a particularly stress free summer and my children have been overwhelmingly delightful. They have done the math homework that I have given them cheerfully, they have done their computer training with only minor griping, they have sat quietly for hours reading, and they have argued very little with each other. I attribute their happy go luck temperaments to the fact that they have had a really fun holiday period with very little or no stress.

It is a no brainer that we perform less well when we are preoccupied or stressed. You do not have to have Inattentive ADHD to be totally spaced out when you are stressed. Most people who are stressed cannot think properly and for people with ADHD, stress can be catastrophic.

About mid-summer, I started thinking about what a powerful role stress plays in our lives. I came to realize that, for my children, school is an incredibly powerful stressor. School, to a certain extent, adds gasoline to their ADHD fires. They go to the best school imaginable but this does not really matter. For both of them, school is amazingly stress filled. I do not think that this is the case for all children but I believe it is probably true of other children with ADHD.

Stress makes all of us perform less well but people with ADHD may be especially vulnerable to alterations in their brain activity when exposed to stress. When any individual identifies a threat, activity in the sympathetic nervous system rises and the adrenal glands release the hormones epinephrine and norepinephrine into the blood stream.  The brain's hypothalamo-pituitary-adrenergic axis is responsible for this activity and disruptions in these hormones are thought to be the root of ADHD problems.  The medications used to treat ADHD target this hormonal disruption.

Animal studies have raised concerns about the role of stress in the emotional and behavioral development of children, particularly as regards to their vulnerability to stress but also with regards to a possible increase in the incidence of ADHD. It has been proposed that epigenetic mechanisms, the switching on and off of certain genes, may be involved in persistent alterations of the hypothalamo-pituitary-adrenergic axis. A persistent malfunctions in the brain's hypothalmic-pituitary-adrenergic axis is thought to be largely responsible for the inattention, impulsive behavior, and hyperactivity in people with ADHD.

Activities that increase stress such as cigarette smoking, illness, substance abuse, and social pressures worsen the symptoms of ADHD. Activities that lessen stress such as Yoga, meditation, and exercise have all been found to be helpful in the treatment of the symptoms of ADHD.

It makes sense that anything that we can do to lessen the life stressors of people with ADHD, will, at least, improve ADHD symptoms.  Who knows, in the future, as studies in epigenetics continue, we may find that managing stress can alter the genes involved in ADHD in such a way that the symptoms of ADHD are eliminated completely.


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