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Comment by guiambros | Hacker News Reader

It's sad that the article didn't even mention exercise as a potential treatment for ADHD. The OP implies that kids will simply "grow out" of ADHD, drugs, or changing the environment may be enough.

While these are valid solutions, exercise may be equally or even more effective.

John J. Ratey, one of the pioneers of ADHD [1], recently wrote the excellent Spark: The Revolutionary New Science of Exercise and the Brain[2]. In it, he explains in colorful details what happens in the brain, and why exercise may be the best treatment for a bunch of neurochemical imbalances - including ADHD.

[1] http://en.wikipedia.org/wiki/Driven_to_Distraction_(ADHD)

[2] http://www.amazon.com/Spark-exercise-improve-performance-bra...

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IMO the terminology of neurochemical imbalance should be avoided. It's the sort of framing that is much preferred by the pharmacological industry, because it suggests that the nature of the problem is well understood and can be directly addressed with their products. In reality there is only a very vague idea of mental illness and related neurotransmitters. To make a computer analogy, it's like calling a problem an "electron imbalance", without even knowing whether hardware or software is to blame.

In fairness, software runs on hardware and a faulty instruction would send electrons to the wrong place and cause an imbalance... /melvin

That said, this has been proven many times over to be rooted in an atypical response to normal levels of neurotransmitters which then results in the appearance of an imbalance or, depending on your perspective, a real imbalance as that specific set of neurons requires higher baseline levels for normal functioning.

This isn't Big Pharma vs The People for most of us. Just soccer moms in LA. The rest of us are helped by low doses of magic pills and are happy that solution is out there and infuriated at cases of abuse and overprescription.

No, nothing has been "proven" about ADHD or other sorts of mental illness. We only have clusterings of symptoms, but know nothing about root causes. Certain chemicals seem to interact well with the symptoms, but again there is no known mechanism that fully explains the mechanism of action. There have been hypotheses that e.g. schizophrenia is explained by dopamine and depression by serotonin, but these have all proven to be too simplistic, because in many patients the levels of these neurotransmitters do change after taking medication, but the symptoms stay.

I should say I'm not at all anti-pharma. I just think that the marketing should be honest. It should be "this addresses some of the symptoms", and not "this corrects your imbalances" because the scientific hypotheses about those imbalances have long been disproven. My hunch is that the structure of neural connections also has to play a big role. This would explain why simply changing levels of chemicals does not immediately fix things.

I'd never noticed this before, but you're right - "neurochemical imbalance" sounds convincing but holds no explanatory power by itself, and sounds very much like an updated version of "imbalance of the humours".

Exercise is the miracle cure for everything, it would seem.

Though it'd be a moderate help if we could agree on what "counts as exercise" - a 15 minute walk? Resistance training (how many sets/reps)? HIIT? The fads can be tough on the average person who just wants health.

Clearly Crossfit solves everything.

The book (Spark, link above) analyzes a handful of studies comparing the correlation between the type and duration of exercise, and its effects.

In short: you won't see any long lasting benefits from a single 15min. The best results were achieved at 75-85% of your aerobic capacity, at least a couple of hours per week (total).

You can also benefit from mixing simple aerobic exercises with others that require more coordination and fine movement of your body - martial arts, for example.

Swimming is a pretty good exercise for those who are bored by most other exercises. It may take six months or longer to see results from exercise, though, so it's hard to suggest exercise as a be-all-end-all fix.

Thanks for linking to this book. I'm realizing how much better I can think after I've gotten exercise (I have ADD) and I'm interested to read 30% of this book ;)

You can't rely on exercise to treat ADHD. It may prove beneficial, but medication is clearly more effective.

At the very least, if exercise does indeed work as well as medication, then the medication can provide the catalyst to get on a regular exercise schedule!

as someone who was diagnosed adhd but am probably not any longer, i think basketball is a perfect solution. the game requires constant improvisation, which is a like crack to most novelty seekers. and then you get the second benefit (the intense physical work out) as a bonus, which maybe helps you grow out of adhd.

Racquetball and mountain biking are what do it for me.

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