Have you found that mornings are a struggle for your child? Is waking your child like trying to wake a bear in winter? Or maybe you have noticed that your child over or under reacts to stressful events. Does your child have “meltdowns” or get “wired” just before bedtime?

Does this have anything to do with ADHD? The answer is: Yes!

Did you know that children with ADHD tend to have more peer problems, more major accidents, hospital visits, ER admissions and car accidents than their peers (CDC 2013)? Clearly, navigating our complex world is even more difficult for a child with ADHD.

Our bodies are well equipped for navigating emergencies but not necessarily for the on-going complexities that make children with ADHD feel like they are under fire all the time. Things like schoolwork, extra-curricular activities, having to sit still or process information when their brains can’t or won’t work the way that is expected.

Typically, when we are confronted with a problem that our brain determines is a threat, we go into the “fight or flight” response. When the threat is over, we return to baseline or homeostasis. This response is very complex but the Hypothalamus-Pituitary-Adrenal Axis (HPA) is most involved. The adrenal glands secrete a hormone called cortisol that responds to the stress. My experience with kids with ADHD and other disorders is that that they try hard, every day, to please their parents, teachers, and peers. Unfortunately, their brains don’t always cooperate and so they experience chronic stress. They rarely return to homeostasis.

In addition to reacting to daily stressors, studies show that children with ADHD often do not regulate cortisol the way that other children do. In other words, their bodies simply do not work the way that others do whether they are experiencing stress or not. Cortisol levels are either too high or too low and vary depending on whether the child has hyperactivity, inattentive type, anxiety or depression (Slatcher, Kariyawasam, Ma, Chen, Isaksson). They even become more dysregulated when the child is confronted with a stressful situation like a dentist visit (Blomqvist). Cortisol also regulates our circadian rhythms so when these children have irregular cortisol secretion, they also have trouble waking in the morning or controlling their behavior in the evening!

How can you help your child?

Lifestyle choices are important to support the adrenal glands.

Eat a nutritious, whole food diet. Food is the fuel for your child. Food provides the materials we need for our bodies to run optimally. Organic fruits and vegetables, wild caught fish, grass fed beef, organic chicken, nuts and seeds all provide the nutrients we need to maintain health. A diet that is heavily processed and has a lot of white flour and sugar actually depletes your child and makes it harder to get through the day.
Sleep eight hours a night. Our bodies need the night to reset. Try to send your child to bed at the same time every night and practice good sleep hygiene i.e. a cool, dark room, no electronics, bed time rituals.
Sunshine and exercise. Sunshine during the day helps us sleep better at night. Exercise helps burn off that excess cortisol and feeds our brains with the oxygen it needs.
-Learn relaxation techniques. Deep breathing, Tai Chi and Tapping are some of the tools that are easy to learn and can make a huge difference on a daily basis.
-Supplement. Remember, you cannot supplement away a poor diet. However, there are some supplements that help the adrenal glands. Vitamins B and C are important for normal adrenal gland function. There are also herbal supplements that specifically support the adrenal glands called adaptogens. Herbs like Ginseng, Ashwaghanda and Rhodiola have been shown to be helpful. Do not take these without consulting with a professional. They can interfere with meds.
-Talk to a practitioner who can help you develop a plan that best suits your child.

Vicki Steine, LCSW is a private practice clinician and a Doctoral Candidate in Holistic Nutrition. She is located in Marietta, Georgia and specializes in families with ADHD and other neurological disorders. She can be reached at Vicki@yourhealthystructure.com or 404-275-6200.

References:

CDC. (2013). Attention Deficit Disorder/Hyperactivity Data and Statistics, from http://www.cdc.gov/ncbddd/adhd/pubs.html
Blomqvist, M., Holmberg, K., Lindblad, F., Fernell, E., Ek, U., & Dahllöf, G. Salivary cortisol levels and dental anxiety in children with attention deficit hyperactivity disorder.
Fairchild, G., van Goozen, S. H., Stollery, S. J., Brown, J., Gardiner, J., Herbert, J., & Goodyer, I. M. (2008). Cortisol diurnal rhythm and stress reactivity in male adolescents with early-onset or adolescence-onset conduct disorder. Biol Psychiatry, 64(7), 599-606. doi: 10.1016/j.biopsych.2008.05.022
Hastings, P. D., Fortier, I., Utendale, W. T., Simard, L. R., & Robaey, P. (2009). Adrenocortical functioning in boys with attention-deficit/hyperactivity disorder: examining subtypes of ADHD and associated comorbid conditions. J Abnorm Child Psychol, 37(4), 565-578. doi: 10.1007/s10802-008-9292-y
Isaksson, J., Nilsson, K. W., Nyberg, F., Hogmark, Å., & Lindblad, F. (2012). Cortisol levels in children with Attention-Deficit/Hyperactivity Disorder. Journal of Psychiatric Research, 46(11), 1398-1405. doi: http://dx.doi.org/10.1016/j.jpsychires.2012.08.021
Kaneko, M. H., Y. et. al. . (1993). HPA axis function in children with ADHD. J. Autism Dev. Disord, 23(1), 59–65.
Kariyawasam, S. H., Zaw, F., Handley, S.L. . (2002). Reduced salivary cortisol in children with comorbid attention deficit hyperactivity disorder and oppositional defiant disorder. Neuroendocrinology Letters, 23(1), 45-48.
Ma, L., Chen, Y.-H., Chen, H., Liu, Y.-Y., & Wang, Y.-X. (2011). The function of hypothalamus–pituitary–adrenal axis in children with ADHD. Brain Research, 1368(0), 159-162. doi: http://dx.doi.org/10.1016/j.brainres.2010.10.045
Slatcher, R. B. R., Theodore F. . Preschoolers' everyday conflict at home and diurnal cortisol patterns. Health Psychology, 31(6), 834-838. doi: doi: 10.1037/a0026774
van Goozen, S. M., W.; Cohen-Kettenis, P. et. al. (1998). Salivary Cortisol and Cardiovascular Activity Stress in Oppositional-Defiant Disorder Boys Normal Controls BIOL PSYCHIATRY S.H.M. van Goozen et al
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Wilson, J. D., ND, PhD. (2011). Adrenal Fatigue: The 21st Century Stress Syndrome. Petaluma, California: Smart Publications.