Q: I am a 60-year-old mom with ADHD. (Three of my four adult children still live at home.) I eat a low carb, organic diet. I practice hot yoga 4 times a week. Does this raise my heart rate enough to provide the benefits of regular cardio exercise? And what else would you suggest I do to manage the scatter of my multitasking self?

A: You are likely getting good benefit from the routine you have in place, controlling your glucose levels and gaining strength, balance and calm from the yoga. However, if you are interested in helping yourself stay focused, you may wish to add a highly structured, more aerobically intense workout to your routine, according to Dr. John Ratey. He suggests martial arts, ballet, figure skating - things that require discipline and physical exertion and coordination but also raise the heart rate. Certain types of dancing or coordinated aerobic classes could help, too. In a small study of children with ADHD, those who took martial arts did better on their schoolwork than those who did aerobic exercise only - and both did better than they would have without the exercise. Exercise has been shown repeatedly to help with ADHD symtpoms - so keep it up!

Q: I am an adult who has just been diagnosed with ADHD and am wary of taking medications for it. Do you have any advice?

A: When medication works, it works as safely and as dramatically as eyeglasses, and can help about 80% of people with ADHD. With your doctor you can experiment to see which type and dose of medication gets you the best results with the fewest possible side effects. (Your goal should be to have no meaningful side effects, so if you find that you feel groggy, hyped up or that the medications simply don't seem to be working, try a different dose or medication.) Understand that medication is just one element of good treatment for ADHD. You should also seek therapy and behavioral coaching.

Some people, like Dr. Hallowell, find that there is no medication that works for them or decide they simply don't wish to take medication. They use other forms of treatment. For a good overview of treatments, go to this link at Dr. Hallowell's blog.

Dr. Hallowell's new book, Shine: Using Brain Science to Get the Best from Your People, is an extraordinarily inspiring look at what it takes to get those who work for you - and with you - to perform at their best. Published by Harvard Business Review Press and ostensibly written for a business audience, this book transcends the workplace - Hallowell's logic and suggestions can be applied to succeeding at any work an adult wishes to take on.

Shine outlines the five steps to peak performance in adults. He lays bare the false assumption if you struggle at your job it means you need to work harder. In fact, he suggests (and then supports) the idea that people will work hard because they want to, given the right job and the right conditions, simply because it feels supremely good to excel. How to get all the pieces in place to make that happen is a riddle he's worked to solve for close to thirty years, and is the heart of Shine.

Those of you who have read The Childhood Roots of Adult Happiness will recognize the underlying principles used in Shine. But Hallowell's logic and examples for this book are all adult and all business. I can say without reservation it's one of his best books yet. To read the introduction to Shine or see a FOX television interview in which Dr. Hallowell talks about Shine, go to this link and look for his early January blog posts.

There has been a lot of talk recently about executive function issues and ADHD. What are "executive functions" and how are they related to ADHD?

Executive functions help you exhibit control over your actions so that you can get to a specific goal you wish to achieve. That can be something lofty and long-term, such as "graduate from college" or something small and immediate like "make my lunch." There are five areas of executive functioning that are impacted when you have ADHD. Some find extreme weakness in one area, such as planning, and less in another, such as verbal working memory.

Non-verbal working memory is the name given to the way our mind uses visual maps or images to orient us and remember things in order to reach our goals. Picturing something in our minds helps us parse it into steps, imagine what a sequence of steps might mean to us in the future (foresight) and analyze what a series of steps in our past means (hindsight). Non-verbal working memory also allows us to see ourselves across time. Some with ADHD have trouble creating these images and hanging onto them, making following a sequence difficult or seeing themselves in time difficult.

Verbal working memory. This is the "little voice in your head" that gives you direction - convincing you that it's okay to put something off, telling you to turn right or reminding you that you'll get in trouble if you don't do your homework. We often use this voice to problem solve - "if I do X, will Y happen?" for example. It also plays a role in reading comprehension. Cognitive Behavioral Therapy can help some with ADHD specifically because it helps people learn to actively use their verbal working memory to better reach their goals.

Response inhibition Your ability to "put on the brakes" is an important part of self-mastery that allows us to think before we act. Those who find impulsivity is one of their primary ADHD symptoms suffer in this area. In addition, response inhibition allows us to delay gratification and resist distraction. Many find that medication can help calm the mind enough to provide better response inhibition.

Emotional and motivational control. Spurts of anger, difficulty keeping oneself from over-reacting and keeping oneself headed towards a long-term goal are all part of executive functioning. When you think of "motivational control" think of "reward" that inspires you to keep going until you get what you want. People with ADHD have a brain chemistry (low dopamine, serotonin and endorphins) that typically does not clearly indicate "reward" in the attention centers of the brain. This leads to having trouble "keeping your eye on the prize" or completing tasks that only reward after a long time (doing well in college so you can get a better job).

Planning and problem solving Many projects include multiple steps, and sorting out what those steps are and what order they should be in is particularly difficult for many with ADHD. While many people with ADHD consider themselves creative problem solvers because they think outside the box, this is different from organizing a project or problem. Sometimes one of the issue with planning is the weak non-verbal working memory, which makes it hard to "see" or imagine how a complex series of steps will line up.

Hallowell Center Executive Function Training (EFT) - Since some patients find that they still have difficulty with executive functioning even after they've gotten some relief from ADHD symptoms with medication and habit changes, the Hallowell Centers in Needham and Sudbury now offer Executive Function Training. This is a form of skills-based training with a coaching component, designed to help people with ADHD improve their executive functioning. A team from the Center works with EFT clients to personalize their training to that clients' specific needs.

If you are interested in finding out more about EFT, call Rebecca Shafir at 781-864-0180.

Dr. Ned Hallowell on CNN CNN Newsroom interviewed Dr. Hallowell on 11/13/10 about the recent study that 1 in 10 children have ADHD. To watch the interview, Go to this link.

CDC Study on ADHD ADHD is the most commonly diagnosed neurobehavioral disorder of childhood, with increasing prevalence during the past decade. National estimates of the number of children reported by their parents to have been diagnosed with ADHD and taking medications were published in 2007. The report indicated that the percentage of children aged 4-17 years with a parent-reported ADHD diagnosis increased from 7.8% to 9.5% during 2003--2007, representing a 21.8% increase in 4 years. The findings in this report help to further characterize the substantial impact of ADHD on families. Go to this link to read the study.

Gene Tied to ADHD Though it's not a diagnostic tool, researchers at Georgetown University suggest that specific genes that control dopamine transmission help explain distraction. Inefficient use of dopamine neurotransmitters in people with two of these particular genes leads to greater distractibility. Go to this link to read the article.

Dr. Ned Hallowell on Good Morning America Dr. Hallowell was interviewed on GMA on ADHD in adults. To watch the interview, go to this link.

ADHD Kids Benefit From Coaching Researchers have found that college students got enormous benefits in scholastic life from a "coaching" model designed by the Edge Foundation, an organization that helps young people with ADHD reach their potential in their academic and personal lives. They presented their results on November 12th at an international ADHD conference sponsored by CHADD. Go to this link to read the article.

Vyvanse Approved for Adolescent ADHD Shire Pharmaceuticals announced that Vyvanse capsules have been approved by the U.S. FDA to treat ADHD among adolescents aged 13 to 17. Benefits of Vyvanse include more even coverage, and less ability to abuse the drug because of how it is delivered, which is beneficial in treating teens. Go to this link to read the article.

Every Other Tuesday Beginning October 19, Sudbury, MA - Free ADHD Adult Support Group 7:00 pm - 8:30 pm Sudbury Hallowell Center. No registration necessary and free to the public. For more information: Call Rebecca Shafir (978) 287-0810

The Human Experience of ADHD - February 18, Lake Wells, FL 1:00 - 2:30 pm The Vanguard School 22000 Highway 27, Lake Wales, FL. For information please email Melanie Anderson melanie.anderson@vanguardschool.org

Raising A Happy Child - March 8, Concord, MA 7:00 - 8:30 pm Hosted by: Concord Carlisle Parent's Initiative. Thoreau Elementary School Auditorium, 29 Prairie Street, Concord, MA For information email: nancyhartshorne@verizon.net

Unwrapping the Gift: Embracing Learning Difference through the Lifetime - March 29, Hingham, MA 9:00 am - 10:30 am. Hosted by: Youth Health Connection. Linden Ponds, 203 Linden Ponds Way, Hingham, MA. For information or to register, email Karin Farell at Karin_Farrell@sshosp.org South Shore Hospital Website

Childhood Roots of Adult Happiness - April 6, Locust Valley, NY 7:00 pm - 9:30 pm Hosted by: Friends Academy. Dolan Center Theater, Friends Academy, Piping Rock Road Locust Valley, NY. For information email: Ron_Baskind@FA.org Friends Academy Website

ADD & Marriage: A Surprising Impact - April 7, New York, NY 6:15 pm - 9:00 pm A presentation by Melissa Orlov and discussion on ADD and Marriage for the Manhattan Adult Attention Deficit Disorder Support Group (MAADDSG) West End Collegiate Church 245 West 77th Street (near West End Avenue) New York, NY.

Five Steps to Help Create and Sustain Lifelong Joy - April 12, Newton, MA 7:00 pm - 8:30 pm Hosted by: The Newton Partnership at Newton South High School, Newton, MA For information email: nancy_holczer@newton.k12.ma.us Website

ADHD Summer Enrichment Camp at Leelanau School - July 18 - 22, 2011 Glen Arbor, Michigan Click HERE to learn more about Dr. Hallowell's ADHD Summer Enrichment Camp

Unwrapping the Gifts: A Strength-Based Approach to ADHD Across The Life Span - August 8 - 12 Cape Cod, MAThis week-long series meets Monday - Friday from 9:00am - 12:00 pm. Hosted by: The Cape Cod Institute. For information click HERE

email: morlov@hallowellconnections.com

phone: 508-545-2250 Hallowell Connections

web: http://www.drhallowell.com