Nurturing Mental Wellbeing: A Holistic Approach to ADHD

Firstly, let’s be clear. As a mental health nurse, I am not specifically trained to assess or diagnose Attention Deficit/Hyperactivity Disorder (ADHD). I also want to acknowledge my own biases: my primary agenda is to advocate for people regardless of their difficulties to have the knowledge and skills to help themselves and take pride in their own self development. I wish for those with mental illnesses to get the help they need, alongside encouraging those who can self-help to do so. My dream is to see a cultural shift in our approach to mental health – from an emphasis on illness and labels to a focus on resilience building, self-development, and holistic wellbeing.

Understanding ADHD

So, a little about ADHD which, I’ve sourced all this from the DSM V diagnostic criteria (APA, 2013). The prevalence of ADHD is largely unknown for many reasons. Still, the National Institute for Health and Care Excellence indicated that in adults it’s around 3-4% (as of Nov 2022). ADHD is a neurodevelopmental disorder characterised by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with functioning or development. Inattention involves difficulty staying focused, being easily distracted, and struggling to complete tasks or follow instructions. Hyperactivity refers to excessive physical activity, such as constant fidgeting or squirming, while impulsivity is acting without thinking, often resulting in higher-risk behaviours. Diagnosis of ADHD typically requires these symptoms to be present before the age of 12, to be present in more than one setting (e.g., at home, at school, or at work), and to cause significant impairment in social, academic, or occupational functioning.

The Problem with Overdiagnosis?

Today, a growing concern is the exponential increase in individuals seeking ADHD assessments, as recently highlighted in a BBC Panorama documentary. While many of those seeking evaluations likely have ADHD, I believe some might mistakenly believe they do. This misunderstanding may contribute to the escalating waitlists, thus delaying essential help for those whose lives are significantly impacted by ADHD. I also wonder if the rise of technology and social media plays a role in this trend, potentially by altering our neurotransmitters and inducing stress, leading to a host of symptoms. But that’s a topic for another blog post.

Last year, amid the uncertainty of COVID-19 and the residual stress from various lockdowns, I began seeing advertisements for an online ADHD quiz on my feed. I did a quiz, and it told me categorically, I have ADHD. I probably don’t. Intriguingly, the quiz questions resembled Barnum statements’ – broad statements that seem specific to an individual but could apply to a wide range of people. For instance: ‘How often are you easily distracted by external stimuli…?’ or ‘How often do you have difficulty organising a task…?’ These questions could apply to anyone dealing with multiple psychosocial stressors. Since COVID in particular, I have seen a rapid rise in those seeking evaluation and appearing on social media. People of all ages and backgrounds.

The Broken Leg Analogy

Let me share an analogy (though admittedly imperfect) to illustrate my point. Imagine there’s a waitlist for treating broken legs. They are assessed, treated appropriately, and the waitlist is short. However, now people with sprains or bruises are also added to the list, and the proportion of genuine broken leg cases drops to 80%. The waitlist grows, causing those with broken legs to wait longer for treatment. Even if everyone were promptly assessed, treatments for broken legs wouldn’t necessarily help those with sprains or bruises.

This analogy can extend to social media algorithms targeting people with ‘sore legs.’ Private assessors are attempting to reduce waitlist burdens and pharmaceutical companies seeking to profit where there’s demand. Maybe now people with ‘sore legs’ might mistakenly believe that they have broken legs. Now under 50% of the list is broken legs. Now it’s hard to actually spot the broken legs. The waitlist is saturated, under-resourced and even when someone gets to the top, the treatment of a broken leg isnt going to help over half that list. Supply doesn’t meet demand and to get highly specialised professionals trained and in post is unlikely. It’s a blunt analogy, but does this analogy link up with what is happening with ADHD? Happy to be proven wrong.

Consider a young person in their early 20s, who came of age alongside the ‘like’ button. They’ve dealt with exams and the lack thereof, online classes, and are now transitioning into adulthood, a period fraught with stress and change. They might be feeling unmotivated, easily distracted, and struggling with sleep and mood, among other things. These are very real struggles and can certainly be challenging to manage. However, it is also possible that these symptoms are not due to ADHD but to psychosocial stressors. For this person, the allure of ADHD will be strong as it’ll most definitely provide an explanation for a lot of symptoms. But in the end they may not have it.

This is not to say that everyone can overcome their difficulties alone; some face severe, debilitating struggles that necessitate professional assistance. However, we need to consider whether jumping straight to ADHD assessment for everyone exhibiting ADHD-like symptoms is the most beneficial approach. Instead, perhaps we need a more holistic approach to mental health, one that considers multiple contributing factors such as lifestyle, nutrition, exercise, sleep, stress management, and emotional processing, to name a few.

Tips for Managing ADHD Symptoms

If you’ve read this far, fair dos. Here are just some general health and wellbeing tips to manage ADHD type symptoms more holistically:

• Stress Reduction Techniques: Excessive and long term stress significantly contributes to every mental/physical health problem (see my other blog on it here), especially difficulties in attention and impulsivity. Implementing stress reduction techniques such as Stress Based Mindfulness Reduction (MBSR), deep breathing exercises, regular physical activity, and maintaining a balanced work-life can mitigate symptoms and improve overall mental health. Although it sounds obvious, if you are spinning too many plates at one time, one will eventually smash.
• Building Resilience: Resilience is crucial in managing ADHD-like symptoms. Developing coping mechanisms, such as problem-solving skills, emotional regulation techniques, and fostering a positive mindset, can help individuals navigate challenges effectively, thereby improving focus and concentration. I personally find exercise of some sort great for building resilience.
• Prioritising Wellbeing: Taking care of one’s overall wellbeing is fundamental. Focusing on nutrition, regular exercise, adequate sleep, and activities that foster relaxation and joy can form a strong foundation for mental wellness and improve attention.
  • Regular Exercise: Evidence suggests that regular physical activity can help manage ADHD symptoms. It boosts mood, improves concentration, reduces feelings of anxiety and depression, and can lead to better sleep.
  • Healthy Eating: A well-balanced diet can help improve energy levels, mood, and cognitive function.
  • Good Sleep: Regular sleep schedules and good sleep hygiene practices can help manage inattention, impulsivity, and restlessness.
  • Maintain Social Connections: Regular interaction with friends and loved ones can offer emotional support and reduce feelings of isolation.
• Seeking Support: While medication and psychiatric interventions might not always be the first line of defence, seeking support from mental health professionals can be extremely beneficial, regardless if it’s ADHD or something else.

Useful Tools and Resources

Here are some tools that I have personally found helpful:

• Palousemindfullness.com  – free mindfulness-based stress reduction.
• Get on Youtube and search; Progressive Muscle Relaxation, Tension Control Training, pace breathing, gratitude meditation. Whatever works for you.
• Silvercloud – Online Cognitive Behavioural Therapy modules, such as space from Stress (free in Wales)
• Cold Water exposure. *always seek medical advice first.
• I Love the ‘overcoming’ book series. Have a look at Overcoming Stress

Final Thoughts

Please understand, this is not to discourage anyone from seeking help if they genuinely believe they may have ADHD. But, it’s a call for all of us to pay more attention to our holistic mental health and wellbeing, to question the information we consume, and to exercise a bit of patience and grace with ourselves in these challenging times.