Mental Health Performance - ADD / ADHD & Athlete Considerations
About the Author
Ben Foodman is a licensed psychotherapist & performance specialist. He owns his private practice located in Charlotte North Carolina where he specializes in working with athletes to help them overcome mental blocks (the yips), PTSD, ADD / ADHD and achieve flow states through the techniques of Brainspotting & Neurofeedback. If you are interested in services, use the link here! Enjoy the article below!
Athletes & ADD / ADHD
Many of the patients that I have worked with who have been diagnosed with ADHD will describe the experience of ‘walking through a fog’ until they received proper medications and therapy to help alleviate the symptoms of ADHD. However, there are just as many patients that I have worked with that have been diagnosed with ADHD, taken multiple medications, and still find themselves ‘stuck’ in this fog like environment. Whatever one’s experience with ADHD is, I’m here to inform you that this diagnosis is incredibly complex easily misunderstood, and over diagnosed.. For this Training Report, I want to review the diagnostic criteria for ADHD, the commonly misunderstood features of this diagnosis, unique considerations that athletes need to be aware of with ADHD, and strategies to help deal with ADHD. Let’s start by first reviewing how ADHD is diagnosed.
Understanding The ADD / ADHD Diagnosis
According to the DSM-V the diagnosis of ADHD falls under the category of Neurodevelopmental Disorders. In order to meet diagnostic criteria for ADHD, the following are some examples of symptoms that clients need to present with: often fails to give close attention to details or makes careless mistakes in work; has difficulty sustaining attention in tasks or play activities; does not seem to listen when spoken to directly; does not follow through on instructions; has difficulty organizing tasks and activities; is often ‘on the go’ acting as if ‘driven by a motor’; often runs about or climbs in situations where it is inappropriate. While these are most certainly important features of having ADHD, this diagnostic criteria only tell part of the story.
As previously mentioned, while there are commonly known symptoms that are associated with ADHD, there are many co-occurring issues that patients commonly present with that are not usually discussed within the field of mental health. Some of these factors include processing control, mental energy control, self-monitoring, temporal-sequential, transitional, prospective retrieval, language processing, and sensory issues. The term attention is broad and the reason these other features need to be explored is because they can have a significant impact on focus. Furthermore some these issues such as language processing may actually need to be the main point of focus in treatment but will be ignored as a secondary byproduct of ADHD.
ADD / ADHD & Athlete Performance
Athletes with ADHD competing at the collegiate, professional, and even high school level have unique considerations that must be accounted for given their participation in high performance environments. First, athletes that have ADHD may present as if they do not have the hyperactive component of the diagnosis due to the fact that they are regularly engaged in physical activity and therefore could be unintentionally satisfying the urge to be moving (it’s also possible that individuals unknowingly became involved in sport because frequent physical movement provided a soothing for the urge to move). Another consideration that people need to be aware of is that athletes that exhibit difficulty listening or following instructions may in fact be presenting symptoms of ADHD and are not necessarily purposefully ignoring their coaches. This can be a sensitive point of discussion as often times coaches and even members of the athlete’s support system will misinterpret this behavior as if the athlete does not care, when in fact the athlete cares immensely and wants to improve at listening & focus.
Should athletes seek to consult with a doctor regarding the possibility of medication use, they will need to consider several crucial points. First, it is imperative that athletes consider seeking help from a psychiatrist as the primary prescribing physician. Psychiatrists specialize in practicing psycho-pharmacology on a much more regular basis compared to most GPs and other physicians. Athletes will also need to be aware of drug testing protocols as they relate to USADA and WADA regulations. The psychiatrist that athletes utilize will need to possess an understanding of drug testing policies and will most likely need to work in coordination with the medical director of the organization that the athlete is involved in. There may be instances where athletes are approved to take medication to help with ADHD but unless the athlete has received permission from these agencies they will be potentially at risk for taking unapproved banned substances. Athletes should have in depth conversations with their physician and support system to make sure that their health needs are being met and then evaluate how to best follow testing procedures with their doctor/psychiatrist.
Treatment Interventions For ADD / ADHD
There is no therapy that can directly alleviate the symptoms of ADHD. You cannot talk your way out of having a neurodevelopmental disorder. There is however therapy for processing the trauma that ADHD has inflicted upon one’s life and strategies that one can implement to help with symptoms outside of medication. ADHD can have a profound negative impact on an individual’s confidence due to the fact that many people with this diagnosis have had extreme difficulty successfully completing tasks, difficulty accomplishing long-term goals, being accused of not listening and/or caring, and being unable to focus. This accumulation of stress can be incredibly traumatic for people and should be addressed through psychotherapy.
In terms of some strategies that individuals with ADHD can use to help with focus, standing while working and heavy weightlifting are great starting points. In regards to standing while working, individuals with ADHD typically will have an urge to move or will have trouble sitting down for long periods of time to complete work. By standing while working (and occasionally incorporating a calf raise every couple of minutes), this process will help soothe the individual’s neurologic desire to reorient oneself to their surroundings. Heavy weightlifting can also help soothe the urge to move and improve focus due to the fact that recruitment of type II motor units will improve central nervous system functioning through increased muscle activation.
Conclusions On ADD / ADHD Treatment
Accurately diagnosing people with ADHD is incredibly difficult to do and should only be done by licensed professionals. ADHD is particularly one of the more complex diagnoses as there are many co-occurring symptoms that may appear to be byproducts of the primary diagnosis, but are in fact the main source of stress. Athletes in particular can easily be misdiagnosed or misunderstood due to the added factors of being involved in sport performance. Should athletes decide to investigate if medicine is the appropriate intervention, they will need to make sure that they consult with a psychiatrist with an understanding of USADA and WADA protocols.
Athletes and non-athletes alike should also recognize that a diagnosis of ADHD has no correlation with intelligence, and that there are actually positive aspects to having ADHD. While there are many stressful aspects of dealing with this diagnosis, many individuals also report the ability to hyper focus on certain areas of interest and also possess high levels of creativity and imagination. Individuals who seek counseling and treatment have the opportunity to turn ADHD from a hinderance into a tactical advantage in both their personal life and work life!
Note To Reader:
If you are an athlete reading this segment of the TRAINING REPORT, hopefully this content was helpful! I put the Training Report together because I felt like many of the discussions on issues such as the Yips/mental blocks, strength training & other subject matter on athlete performance concepts were really missing the mark on these ideas (e.g. how trauma is the direct cause of the Yips). If you are interested in learning more, make sure to subscribe below for when I put out new content on issues related to sport psychology & athlete performance! Also, if you are looking to work with a mental performance specialist, you are in the right place! USE THIS LINK to reach out to me to see if my services are the right fit for your goals!
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