By Roberta Waite and Meghan S. Leahy
In the 1970’s, Kabat-Zinn popularized mindfulness meditation (MM) as many people sought non-medication interventions for a variety of conditions. Consequently, mindfulness interventions are increasingly used to address many health-related concerns. Today, MM is seen as a practical skill to use that benefits well-being, including being viewed as an option for individuals affected by ADHD.
Mindfulness focuses attention on the person’s current experience, preparing them to be receptive to experiences instead of avoiding them via repression. This allows the person to adopt a fresh perspective or apply a
"beginner’s mind” to ways of receiving life experiences (Greenberg et al., 2012). MM suggests an open and purposefully attentive state of mind (Thomas & Atkinson, 2016). The individual’s attention remains in the here-and-now, and thoughts and emotions that surface are observed non-judgmentally (Bachmann et al., 2016). Because ADHD is characterized by a persistent pattern of age inappropriate displays of attention and/or hyperactive-impulsive behaviors that create functional impairments across multiple settings, consistent practice of MM may help to improve one’s attentional control, thereby decreasing their inattention and impulsivity. Specifically, mindfulness can facilitate improvement of ADHD on three fundamental levels - neuropsychological, structural/functional, and behavioral.
Neuropsychological and Structural/Functional Level
On a neuropsychological level, MM can improve functioning on tasks measuring executive functioning including attention, cognitive control, as well as working memory. Since we also know that neuronal plasticity can be improved by intense, persistent, and habitual restorative interventions, MM may improve psychological performance. This is of interest since ADHD is recognized to be linked to structural, functional, and neurochemical brain abnormalities. MM which is characterized as a form of mental training, may moderate neuropsychological deficits in ADHD. Specifically, areas of attention control and emotion regulation can be positively affected by strengthening areas of brain thought to bring about these deficits.
Through use of MM, individuals affected by ADHD can foster behavioral inhibition skills by learning to observe emotional states as transient events, thus promoting emotional regulation. While emotion regulation does not serve as a primary diagnostic trait of ADHD, it is a factor in many areas of functioning, particularly in interpersonal relationships. By enhancing emotional regulation through MM the person develops strategies that aid in affecting the occurrence, experience, and expression of emotions (Bachmann et al., 2016).
Although the full mechanism of mindfulness mediation remains elusive as it relates to changes within the neurobiological process, it can be postulated that MM alters “brain structure and function by myelinogenesis, synaptogenesis, dendritic branching, or adult neurogenesis” (Bachmann et al., 2016, p. 117). Even more, it seems that MM may have favorable effects on neuronal protection, renewal, and/or preventing cell death as well as improving cognitive control to create a steady pattern of deactivation in brain regions related to a mindfulness state (Bueno et al., 2015). Taken together, it is evident that “habits of mind” such as practicing MM modifies both the structure and the functioning of the brain. By stimulating both neuroplasticity and mental self-discipline, MM also aids in stress reduction which is quite relevant for persons affected by ADHD, as stress magnifies restlessness and concentration difficulties, as well as frustration and irritability. Cultivating ways of managing stress via MM (e.g., focusing on the present and increasing self-awareness) ultimately promotes the overall well-being of individuals who practice it. Healthy psychological functioning among persons affected by ADHD appears to depend on the well-coordinated operation of neuronal networks. To that end, great promise exists with MM since it provides a tool with which persons with ADHD can better promote self-regulation (Bachmann et al. 2016).
On a behavioral level, MM places emphasis on improving the ability to control attention and inhibit automatic responses. Practitioners of MM have improved ability to self-reflect and consequently are better able to foster self-esteem and empathy for others. Abrams (2013) reports that MM reduces behavior problems, and increases on-task behavior and academic performance. Cassone (2015) sees MM as a useful tool for improving self-regulation, specifically, orienting, alerting, and executive attention.
By identifying and acknowledging their thoughts in the here-and-now, patients with ADHD have the opportunity to fully consider them in a non-judgmental way, which can lead to improved self-awareness and focus on managing behaviors. Research has shown that MM has reduced both the inattentive and hyperactive symptoms in children and adults (Thomas & Atkinson, 2016). These behavioral changes have been shown to have effects that last beyond end-of-treatment. The changes prompted by MM do not simply improve the daily lives of the individual patients, but can make a meaningful difference in their relationships with their family, friends, and colleagues. It reduces stress in daily interactions and as a result, improves not just mood, but quality of life.
Take Away: Benefits of Mindfulness Meditation and ADHD
• “Mindfulness” is a term that has dual meanings: it can be both a process and an outcome.
• Mindfulness techniques can be taught to children as young as 7 years-old.
• Mindfulness makes it easier to exist in the moment, experiencing and processing events as they take place rather than automatically reacting to them, which allows for behavior change.
• Mindfulness practice leads to becoming more engaged in activities, with family, friends, and colleagues, which can deepen relationships on many levels.
• With practice, mindfulness meditation improves the ability to handle challenges and adverse events.
• Mindfulness, with or without medication has shown to be a viable treatment for adults with ADHD.
• Mindfulness works especially well when used in conjunction with Cognitive Behavioral Therapy and other treatments for ADHD.
• Mindfulness can be used to address many issues that are co-morbid with ADHD, including anxiety, OCD, depression, substance misuse/abuse, and eating disorders.
• Mindfulness improves physical health by reducing stress, lowering blood pressure, and improving sleep, cardiac, and GI issues.
Abram, J. (2013). The impact of mindfulness practice on the behavior, wellbeing, and cognition of preadolescent students. Retrieved from http://archives.evergreen.edu/masterstheses/Accession89-10MIT/Abrams_MIT2013.pdf
Bachmann, K., Lam, A., & Philipsen, A. (2016). Mindfulness-based cognitive therapy and the adult ADHD Brain: A neuropsychotherapeutic perspective. Front Psychiatry, 7. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4921925/
Bueno, V., Kozasa, E., da Silva, M., Alves, T., Louza, M. & Pompeia, S. (2015). Mindfulness meditation improves mood, quality of life, and attention in adults with attention deficit hyperactivity disorder. BioMed Research International. Retrieved from https://www.hindawi.com/journals/bmri/2015/962857/
Cassone, A. R. (2015). Mindfulness training as an adjunct to evidence-based treatment for ADHD within families. Journal of Attention Disorders, 19(2),147-157.
Greenberg, J., Reiner, K., & Meiran, N. (2012). "Mind the trap": Mindfulness practice reduces cognitive rigidity. PLoS One, 7(5) doi:http://dx.doi.org/10.1371/journal.pone.0036206
Kabat-Zinn, J. (1996). Full Catastrophe Living. Piakus Books, London.
Thomas, G. & Atkinson, C. (2016). Measuring the effectiveness of a mindfulness-based intervention for children’s attentional functioning. Educational & Child Psychology, 33(1), 51-64.