Written by Dr. Daniela Steyn
Good news! If you struggle with concentration, there are things you can do to improve your focus and clarity. In this article, I will discuss how Cognitive Behavioral Therapy (CBT), in conjunction with lifestyle changes, can be a powerful tool in your journey to tackle ADD. Discover the science behind CBT, gain insights into the world of ADD, and learn how these two complementary approaches can make a significant difference in your life or the life of your loved one.
What is ADD?
Attention Deficit Disorder (ADD) is a term used for people who have excessive difficulties with concentration. This often leads to procrastination, disorganization, poor time management, emotional turbulence, impulsivity, and inconsistent motivation.
Individuals who grow up with ADD (particularly if it has gone undiagnosed) encounter more frequent and frustrating setbacks in life situations — on the job, in social interactions, and everyday organization. It is no wonder that most of my clients with ADD are self-critical and pessimistic. Over several years, this may cause them to experience negative emotions, cognitive distortions, and unhealthy self-beliefs. It is common for individuals living with ADHD/ ADD to think they are at fault when situations don't turn out well when, in many cases, they aren't. They may bring the same pessimism to the future, imagining that tomorrow will go as badly as today.
What is CBT?
Cognitive behavioural therapy (CBT) is a short-term, goal-oriented form of psychotherapy that aims to change these negative thinking patterns and change how patients feel about themselves, their abilities, and their future. Consider it brain training for ADHD. With short-term, we generally mean twelve weeks. This is the minimum time commitment I require. Clients who have obtained great success choose to stay clients lifelong. However, you can expect to notice improvement after only three months.
CBT is based on the recognition that cognitions lead to emotional difficulties. Automatic thoughts are spontaneous interpretations of events. These impressions are susceptible to distortion, such as unfounded assumptions about yourself (or others), a situation, or the future. Such unhealthy internal dialogues hinder an individual from working toward an intended goal, working to develop productive new habits, or generally taking calculated risks.
CBT aims to change irrational thought patterns that prevent individuals from staying on task or getting things done. For an individual with ADD, "This has to be perfect, or it's no good," or "I never do anything right," CBT challenges the truth of those cognitions. Changing distorted thoughts and the resulting change in behaviour patterns effectively treats anxiety and other emotional problems.
During CBT, we identify and address the following thought processes:
All-or-nothing thinking: This involves viewing everything as either entirely good or bad, leading to a sense of failure if something isn't executed perfectly.
Overgeneralization: In this process, a single negative event is perceived as part of an ongoing pattern, such as constantly forgetting to pay bills.
Mind reading: This is the tendency to assume that we know what others think about us or something we've done, often assuming negative judgments.
Fortune telling: Predicting that things will inevitably take a turn for the worse, even without concrete evidence.
Magnification and minimization: Exaggerating the importance of minor problems while downplaying personal accomplishments.
"Should" statements: Focusing on how things should be, which often leads to harsh self-criticism and resentment toward others.
Personalization: Blaming oneself for negative events while absolving others of responsibility.
Mental filtering: Solely focusing on the negative aspects of any given experience.
Emotional reasoning: Assuming that our negative feelings accurately reflect reality, such as believing that feeling bad about a job means "I'm doing badly and will probably get fired."
Comparative thinking: Measuring oneself against others and feeling inferior, even when the comparison may be unrealistic.
How we use CBT to Treat ADD
At Wellness MD, we offer CBT for Wellness MD clients who struggle with ADD.
CBT doesn't cure ADD. However, numerous fascinating studies have shown evidence of how CBT significantly improves outcomes for people with ADD.
CBT intervenes to improve daily life struggles — procrastination, time management, and thinking based on subjective beliefs rather than facts. We further offer coaching around self-compassion and self-compassion meditation.
CBT sessions focus on identifying the situations in which poor planning, disorganization, and poor time and task management create challenges in a patient's day-to-day life. It is critical for our success that all my clients work with one of our health coaches as well to address general well-being, sleep, healthy nutrition, exercise and hobbies.
With CBT psychotherapy, we spend the first sessions explaining what CBT is. We take time to understand the patterns of criticism towards yourself and others that you might have developed over your lifetime, and you get to identify your avoidance patterns and self-defeating behaviours.
Ultimately, the main goals of CBT are to overcome impairments and implement coping strategies. CBT helps in processing new experiences and finding new ways to handle setbacks. It adjusts the old rules to align with present-day life.
When you encounter a difficult situation, you will write it down and reflect on it for our next session. You will journal and review the impact of thoughts, feelings, behaviours, and other factors that have interfered with handling the situation.
Using the CBT framework breaks down the challenging task of "managing ADHD" into specific tactics for navigating transition points in a day — getting up and off to work on time, starting a project that you've been avoiding, or setting a time to review a daily planner — which increases coping skills. These coping steps are strategized in a session (and written down as take-away reminders) to use between sessions.
Most adults with ADD say, "I know what I need to do. I just don't know how to do it." Despite having plans for what they want or need to do, they do not carry them out. CBT focuses on adopting coping strategies, managing negative expectations and emotions, and unwinding behavioural patterns that interfere with the strategies.
Nutrition and ADD
When it comes to managing symptoms of Attention Deficit Hyperactivity Disorder (ADHD), your diet plays a crucial role. The good news is that making the right dietary choices can optimize brain function. Begin with a protein-rich diet of lean meats, poultry, fish, eggs, beans, nuts, soy, and low-fat dairy products. Protein aids in neurotransmitter production, which is essential for effective brain cell communication. Moreover, it helps stabilize blood sugar levels, reducing hyperactivity and impulsivity. Starting your day with a protein-rich breakfast sets a positive tone for the day.
To maintain a consistently balanced diet, include a variety of vegetables, complex carbohydrates, fruits, and ample protein. Dr. Ned Hallowell, an expert in ADHD, recommends dividing a plate into half: half filled with fruits or vegetables, one-fourth with protein, and one-fourth with carbohydrates. Prioritize whole grains to prevent blood sugar spikes and crashes.
Supplements to Enhance Your ADHD Diet
Nutritional deficiencies can exacerbate ADHD symptoms. Testing for nutrient shortfalls is essential for individuals diagnosed with ADHD. Zinc, iron, and magnesium play pivotal roles. Zinc regulates dopamine, a neurotransmitter, and enhances the brain's responsiveness to it. Iron is crucial for dopamine production, and low iron levels are associated with cognitive deficits and severe ADD. Magnesium contributes to neurotransmitters involved in attention and concentration while promoting a calming effect on the brain. These minerals are found in lean meats, poultry, seafood, nuts, soy, and fortified cereals. Consider supplementing your diet with a multivitamin/ multimineral that includes iron to ensure you meet daily reference values.
Vitamin B-6, known to increase dopamine levels and alertness, is another valuable supplement. Studies suggest children with low B-vitamin levels showed improved IQ scores and reduced aggression. If your child is a picky eater or consumes a diet lacking essential nutrients, a daily multivitamin/multimineral can fill these gaps. Omega-3 fatty acids, primarily found in cold water fatty fish like salmon and tuna, are crucial for brain and nerve cell function. A study conducted at Göteborg University showed a 50% reduction in ADHD symptoms with daily omega-3 supplementation. Consult a healthcare professional to find the best omega-3 supplement for your needs.
Foods to Avoid in Your ADHD Diet
Certain foods may worsen ADHD symptoms. High-sugar foods and snacks have been linked to increased restlessness and destructiveness in hyperactive children. Avoid high-fructose corn sweeteners, dehydrated cane juice, dextrin, dextrose, maltodextrin, sucrose, molasses, and malt syrup. Artificial dyes and preservatives can also affect some children with ADHD negatively. Lastly, consider food allergies. Some people may react to gluten, wheat, corn, and soy, leading to focus issues and hyperactivity—screen for food allergies before pursuing ADHD medication, as experts like Dr. Vincent Monastra recommended.
Why work with Wellness MD?
Our goal is to establish the root cause of illness, treat it and enable our clients to live optimally using the six pillars of health. We do the same with ADD. Most of our clients can identify one of their parents whom they inherited ADD from. Then we look at things that make it worse, for example, sleep deprivation, poor nutrition, lack of exercise, lack of relaxation, cellphone addiction, heavy metal poisoning, inflammation from diet, dyes in your food, preservatives in your food, stress, etc.
We start all our clients on an elimination diet where we remove toxins and food they are allergic to or intolerant to. If they have any nutritional deficiencies, we work with a dietitian and nutritionist to supplement them. (I always prefer foods first; some clients need supplements.) Many people see significant improvement in their attention and focus by sleeping 8 hours a night, going to bed at the same time every night, exercising in nature every day, minimizing screen time and eliminating processed foods from their diet. Our coaches at Wellness MD will take you by the hand and help you through the process. So, although these measures don't cure ADD, they support you in the best way possible to give them the maximum benefit.
What is my opinion on ADD medications?
CBT does not replace medication. I work with clients whether they are on medication or not. Whether you choose to use medication or not, we will work through the same steps to target ongoing struggles with disorganization and procrastination. A 2010 study by Boston's Massachusetts General Hospital found that a combination of drug therapy and CBT was more effective at controlling ADHD symptoms than drug therapy alone.
Medication commonly prescribed in Canada for ADD
Amphetamine
Methylphenidate
Lisdexamfetamine
Dextroamphetamine
Supplements that might be helpful for ADD
Rather than treating blindly, we test for deficiencies first and supplement what the client is low on. Supplements I recommend to patients are:
Omega 3
Zinc
Vitamin D
Magnesium
Gingko Biloba
Iron
At Wellness MD, we've witnessed remarkable transformations because we believe in nurturing every facet of your well-being – from nourishing nutrition to restful sleep, exercise, and the power of meaningful social connections. Remember, the lifestyle change journey takes time, but it is a path worth taking. Our most successful clients often work with us on a lifelong commitment to be their healthiest selves. Join us, and let's embrace this inspiring journey together!
Reference List:
How to Change Your Life by Changing The Way You Think | Core Spirit. https://corespirit.com/articles/how-to-change-your-life-by-changing-way-you-think
Adhd thought patterns. https://thewrightinitiative.com/misc/adhd-thought-patterns.html
Does ABA help ADHD? – Ask & Know. https://askandknow.com/posts/does-aba-help-adhd/
https://www.camh.ca/en/professionals/treating-conditions-and-disorders/adult-adhd/adult-adhd---treatment/adult-adhd---pharmacotherapy