The Influence of ADHD on your Relationship with Exercise
It can affect both ends of the activity spectrum
The prevalence of attention deficit hyperactivity disorder (ADHD) in adulthood is increasing, as folks are recognizing that their symptoms may be something more than simply being stressed. The CDC reports that roughly 55% of those diagnosed with ADHD received their diagnosis as adults. Having an official diagnosis for challenging symptoms can feel like a breath of fresh air and compel those living with the condition to find strategies to support their day to day activities.
ADHD, in short, can consist of a number of symptoms aside from the inability to concentrate. Impulsivity, difficulty completing tasks, or the inability to simply sit still can impact one’s ability to work, learn, or thrive at home. Compensatory behaviors to counteract these challenges can result in people wanting to sit and do nothing (or scroll, for stimulation) or self-medicate with substances.
Individuals with ADHD are 8x more likely to be sedentary, and 3x more likely to have poorer diets than those without the disorder. Adults with ADHD experience higher rates of obesity, due in part to sedentary behavior and lack of adherence to exercise. Links to these behaviors and late diagnoses in adulthood place individuals with ADHD at risk for premature death.
Exercise Avoidance
A concept known as “effort discounting” is one way researchers evaluate goal-driven behavior. By attempting to quantify how our brains decide whether the reward for engaging in a task is worth the effort required, they can predict our likelihood of completing it.
It has been used in many adolescent studies, but rarely used in analyses of adults with ADHD. However, in a recent study of 181 young adults with ADHD, their symptoms were correlated with sedentary behavior and effort discounting. The connection of an increase in symptoms with higher effort (physical activity) in this study may also be driven by issues with executive function and motor skills that are common in many individuals with ADHD.
Ultimately, this study reveals the way that some adults with ADHD may view physical activity, and the trade offs they may be willing to make to avoid the discomfort of exercise (e.g. knowing that they should be moving, but would rather be comfortable on the couch instead).
If you’re a person living with ADHD, this may help you make more sense of your thought processes. For fitness professionals working with individuals with ADHD, this provides insight into lifestyle factors that we may be helping to address. It can also compel us to make movement more approachable by incorporating it into one’s regular routine.
Coping with Exercise
While some people are sedentary, others with ADHD can be drawn to exercise as an outlet for expending extra energy or the for quick change of pace that sports can offer. A recent push in supporting athletes’ mental health has resulted in more opportunities for screening and assessment. While screening tools are one step in the diagnostic process, it can give athletes insight into their current symptoms and help them pursue next steps in a comprehensive evaluation.
It’s important to note that while some individuals with ADHD may self-medicate with substances, others may self-medicate with exercise. One project, aimed at evaluating mental health and health behaviors in athletes, examined the rates of ADHD in endurance runners. 9.7% of runners (n=601) screened positively for ADHD characteristics, with half-marathoners having higher rates than the other distances (marathon, ultra).
ADHD often presents with other mental health conditions (e.g. anxiety, depression, etc.). Collaborating with a team of mental health professionals to help athletes manage their symptoms is another consideration for fitness professionals and coaches who work with this population.
In extreme cases, individuals (even those without ADHD) can develop exercise addiction (EA). EA is defined by behavioral characteristics of “salience, tolerance, mood modification, withdrawal, conflict, and relapse”. Additionally, those addicted to exercise will do so even while injured and lose control of themselves within their training. Oftentimes, it can coexist with body image or eating disorders. Depression appears to have a stronger link to EA than ADHD, but both are predictive of this extreme behavior.
Walking Points
Conditions such as ADHD have the ability to not only impact your executive functioning, but can also alter the way you approach health behaviors. It’s not necessarily a lack of willpower on your part.
Your body’s primary goal is to keep you safe and comfortable. It’s an expert at talking you out of anything that seems remotely uncomfortable or scary. If you are diagnosed with ADHD or any other coexisting mental health condition, especially those rooted in trauma, your body can be hyper vigilant in avoiding threats to the system, like exercise.
Knowing how your brain works can help you develop systems and rewards that work with your ADHD tendencies. If you’re new to exercise, start out with activities you enjoy. Walk while listening to your favorite audiobook or podcast. Try a circuit style group fitness class with multiple stations and fellow exercisers to keep your brain engaged.
Pick a worthwhile reward to help you build the habit. Based on what you just learned about effort discounting, your brain will convince you that you can start next week, skip a session, eat fewer calories instead of working out, or (insert ridiculous tactic here). So, name your price. If feeling better and a healthier body aren’t good enough, find another tangible reward that cues your brain and body into action. Once the external reward is “won”, the intrinsic benefits can take over from there.
Regular exercise is a great outlet for ADHD. Routinely taking an objective look at your relationship with exercise is important, as too much of a good thing can quickly become a not so good thing.
If you suspect you have symptoms indicative of a mental health disorder, talk with your primary care doctor. They can refer you to the appropriate specialist. You can take the World Health Organization’s ASRS-5 online for free as a first step in the ADHD assessment process.
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