Many people with attention deficit disorder have found relief with cannabis. But, is this just self-medication or can the herb actually treat the condition? The first segment of HERB’s new mental health series, All Kinds of Minds, takes a close-up look at how this controversial plant impacts ADD and ADHD. Here’s what everyone should know about cannabis and ADD/ADHD.
What is attention deficit disorder?
Imagine hearing someone talk, but having no idea what words are actually being said. You can understand them, but for some reason, they don’t quite come together. You quickly become bored with the conversation. You’re ready to move onto something else. If they ask you a question, you might come up blank. This situation is common in those with attention deficit disorders.
Attention deficit disorder (ADD) and attention deficit/hyperactivity disorder (ADHD) are two forms of a cognitive disorder that impact learning and attention. The difference between the two is hyperactivity. People with ADD are capable of being calm and peaceful.
Those with ADHD often experience intense restlessness, which can be disruptive. Cognitive issues begin at around five to seven years old. The first sign is when children begin to have intense difficulties in school.
Symptoms of ADD/ADHD:
- Difficulty maintaining focus and concentration
- Poor organization
- Being forgetful or easily distracted
- Difficulty paying attention to details
- Hyperactive (fidgety, squirmy, talking excessively or talking really fast)
- Issues with mood
ADD/ADHD also impacts women differently than men. Women are less likely to be diagnosed, and the condition hasn’t been as widely researched in women. Women with attention deficit are more likely to suffer from depression, anxiety, eating disorders, and obesity. Men, on the other hand, are more likely to get into car accidents, experience anger and behavioral issues, and have trouble with substance abuse.
As if having ADHD alone wasn’t troublesome enough, the condition often goes hand in hand with several other major mental health disorders. Some of the big ones include major depression, anxiety disorders (especially obsessive-compulsive disorder), and bipolar disorder.
Attention deficit disorders also share many symptoms with these mood and anxiety disorders. This means that getting a diagnosis that rules out or distinguishes ADD/ADHD from these other conditions is absolutely vital. Co-occurring conditions can drastically influence your treatment, regardless of whether or not that’s with pharmaceuticals or medical cannabis.
Cannabis and ADD/ADHD
In general, those with ADD/ADHD are 50% more likely to use some sort of drug or alcohol to help cope. Interestingly enough, the substance of choice is cannabis. Those with attention deficit are more likely to start using the herb at a young age when compared to peers without the condition. Believe it or not, this actually makes a lot of sense.
Do you turn to cannabis when you feel hyperactive or agitated? If so, you’re not alone. Research from 2014 found that those who experienced impulsivity and hyperactivity are much more likely to use cannabis.
Yet, that’s not the only reason why many attention deficit patients take up the plant. Side effects of traditional treatments may also be partly responsible. The most common treatments for these disorders are amphetamine and methylphenidate stimulants, like Adderall and Ritalin. These stimulants increase focus, concentration, and improve cognitive functioning.
What these stimulants don’t do, however, is help you relax. They also can suppress your appetite, cause nausea, give you diarrhea and abdominal cramping, and reduce sleep. It’s here that cannabis takes the stage.
Amphetamine and methylphenidate are very harsh on the body. Especially when you first begin treatment or up your dose, they can make you feel excessively nervous, agitated, and amped up. Cannabis can relieve some of the uncomfortable side effects of these medications.
If for some reason you take an evening dose of your medication, chances are you’ll be awake for quite a while. ADHD drugs drastically impact your sleep. If your dose is strong enough, you might find yourself awake all night. Cannabis has the opposite effect.
Deep sleep is the restorative stage in the sleep cycle. This is when the body clears out waste products in the brain and repairs day-to-day tissue and cellular damage. If you go without sleep for too long, you miss out on this restorative phase. Your body will not be able to repair itself.
This puts you at higher risk for high blood pressure, diabetes, obesity, and other health problems over time. If you’ve missed out on some deep sleep, a little cannabis allows you to catch up.
Drugs like Adderall have drastic implications on your appetite. Food may not smell or taste good. You might have a difficult time mustering any sort of desire to eat. You may have become absorbed in a particular project, and felt that finishing was more important than taking a food break.
To be frank, not eating is horrible for your health. Your body needs food to perform its most basic tasks. Abstaining from food only increases anxiety, agitation, restlessness, and anger.
Medication may be suppressing your appetite, but that doesn’t mean that your body isn’t hungry. It’s well known that cannabis is a potent appetite stimulator. It kick starts your metabolism, causes your body to release hunger hormones, and makes food taste better than you ever thought imaginable. This is key to preventing ADD/ADHD and mood symptoms from becoming worse because of prolonged fasting.
There’s a reason why medical cannabis is given to patients going through chemotherapy. The herb has powerful anti-nausea and anti-vomiting effects. When nausea is preventing you from being able to eat, undesirable health problems will only get a lot worse. Not to mention that feeling sick to your stomach all the time can have significant impacts on your work and general wellbeing.
A little herb may help ease the pain and discomfort so you can get back to feeling like yourself again.
Calms and relaxes
Perhaps the reason why cannabis is such a popular choice among those with ADHD is because of its ability to calm you down, reduce stress, and pay attention. Feeling wired or agitated all day can be mentally exhausting, so it makes sense that people would turn to the herb to find a little peace. Similarly in those taking stimulants, it may be difficult to “turn off” after a day of medication.
A nice indica can give you some peace of mind and help calm an anxious body.
Does cannabis actually treat ADD/ADHD?
So, we’ve established that cannabis can be helpful for dealing with the side effects of ADHD medication. But, can it actually help treat the condition? Recent research suggests that it might.
Is it endocannabinoid imbalance?
Some medical professionals suggest that a disruption in the endocannabinoid system may play a role in ADD/ADHD. Endocannabinoids are chemicals like THC that our bodies produce naturally. Endocannabinoids help maintain balance in our bodies. They have significant impacts in our mood, cognition, pleasure and reward systems, sleep, and digestive systems.
If the endocannabinoid system is disrupted for some reason, it can cause a very wide range of possible effects. Dr. David Bearman, a physician who was once on the fence about cannabis and attention deficit, has changed his mind about the herb. He explains the reason why those with ADHD may benefit from cannabis therapies:
When you don’t have enough cannabinoids, your neurotransmission is too rapid. So, if you have a rapid assault, if you will, on the cerebral cortex, a substantial number of ideas, concepts, sensory input, then it may be difficult for the cerebral cortex to concentrate.
But, if you slow these down, these neuro-impulses down by a few nanoseconds, then you’re going to give the cerebral cortex more of an opportunity to focus and concentrate because you’re going to have neuro-impulses moving more slowly, and you’ll probably have fewer neuro-impulses. – Dr. Bearman
Said simply, the brain is firing a little too quickly in those with ADD/ADHD. This is super distracting and prevents the brain from being able to pay attention to a single out one thought, idea, or sensation. A rapid-fire brain can quickly become overwhelming. Cannabis may be an effective treatment for ADD/ADHD because it slows down the constant chatter between brain cells.
In theory, it does this by improving endocannabinoid tone. If those with ADD/ADHD are not producing enough endocannabinoids, adding some back in via cannabis helps restore balance in the brain.
Dopamine and attention
Dopamine plays an important role in ADD/ADHD. Dopamine is a key neurotransmitter and is crucial for attention and motivation. Studies have shown that there’s a disconnect between anandamide and dopamine in those with this condition. A paper published in 2009 examined the connection between the endocannabinoid system and the dopamine system in those with ADHD.
For some reason, those with ADD/ADHD seem to have increased levels of anandamide, our body’s natural version of THC. The researchers found that the enzyme that is supposed to break down anandamide in the body doesn’t function properly. That enzyme is called FAAH. Those with ADD/ADHD actually had less FAAH than they needed to de-activate anandamide.
This causes a major problem. Very simply stated, in those with ADD/ADHD, anandamide seems to cause dopamine to burn up too quickly. According to lead study author Dr. Diego Centonze and his team:
…The endocannabinoid [Anandamide] reduces the activity of the [dopamine] transporter, and might therefore be implicated in the dysfunction of the [dopamine] uptake mechanisms involved in ADHD pathophysiology. – Centonze and team
This is where cannabis comes in. THC increases dopamine concentrations and activates dopamine neurons. In this sense, the herb is not unlike Adderall or Ritalin, or other common ADHD medications. These medications increase the amount of dopamine available for you to use. More dopamine means heightened concentration and attention.
Of course, cannabis doesn’t come with the extreme digestive side effects associated with prescription stimulants.
When traditional pharmaceuticals don’t work
Back in 2015, a group of German researchers treated 30 ADHD patients with cannabis. None of the patients had been responsive to traditional pharmaceutical treatments for ADHD. The majority of the study participants had discontinued medication because of harsh side effects. In their abstract, the researchers write:
All patients had experienced an improvement of a variety of symptoms by cannabis flowers, including improved concentration and sleep, and reduced impulsivity, by the use of cannabis. In five cases dronabinol [THC] was tried, which was also effective. – Eva Milz and Franjo Grotenhermen
The findings of this small study lead the authors to conclude that cannabis may be “an effective and well-tolerated” treatment option for those who either don’t respond to pharmaceuticals or have difficulty coping with adverse side effects. Many of them found that cannabis improved their attention.
These findings are corroborated by a case study published in 2008. The study detailed a 28-year-old man with ADHD. Prior to cannabinoid treatment, the man appeared inattentive, had difficulty adjusting to social situations, and demonstrated a “pushy and demanding” attitude. He had also been through therapy and a variety of pharmaceutical medications, but neither treatment aided his condition.
He was then given dronabinol, a legal synthetic THC used to treat nausea and vomiting in cancer patients. The result? A drastic improvement. When he showed up to his appointments, he was no longer pushy or disturbed. He appeared calm without being too sedated. He was less distracted. The patient was also able to make a case for THC treatment without getting too heated like he had been previously.
Additional therapies for ADD/ADHD
As with many mental health conditions, medication alone is only so effective when it comes to treatment. Regardless of whether or not cannabis, traditional pharmaceuticals, or a combination of both work best for you, there really isn’t any substitution for therapy and a healthy lifestyle. Here are a few additional treatments that can help you manage attention deficit disorder.
Diets high in iron and omega-3s are critical to those with ADD/ADHD. Several studies have shown that those with attention deficit have lower levels of serum iron and ferritin than age-matched controls. Iron supplementation has been shown to improve the symptoms of ADD/ADHD as well. Additional studies have found that omega-3 fatty acids were associated with decreased symptoms in some children with ADHD.
Good sources of iron include:
- Leafy greens (especially cooked spinach, kale, swiss chard, etc.)*
- Lean meats (chicken, lean beef)
- For optimal absorption of plant-based iron, make sure to pair your veggies with vitamin C. Add some lemon juice to your broccoli, some pomegranate seeds to a salad, or some berries to your oatmeal.
Good sources of omega-3 fatty acids include:
- Hemp (shelled seeds, hemp oil)
- Fish (salmon, tuna)
- Flaxseed (ground)
- Pumpkin Seeds
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy (CBT) is a type of psychotherapy. But, you won’t find yourself sitting and reminiscing over your childhood much in this type of therapy. Obviously, whatever you and your therapist discuss is up to you.
Rather than take a Freudian approach, CBT helps you develop problem-solving strategies. In CBT, you’ll learn tips and tricks to help you cope with symptoms and improve your quality of life and relationships with others. It’s solution-focused rather than analysis focused.
Mindfulness therapy may also be incredibly helpful to those with ADD/ADHD. Mindfulness practice improves your attention and concentration over time. It teaches you how to work with distracting thoughts and get back to living in the present moment. Research from 2007 found that adults with attention deficit who received mindfulness therapy had improved depression and anxiety symptoms, greater attention, and high levels of satisfaction with the results.
It’s important to note: We are not doctors. Experimenting with various treatments can have profound impacts on your mental and physical health. Always consult a medical professional before making any changes to your treatment plan. The only person who completely understands how any medication, be it cannabis or something else, interacts with your unique body.
Browse a forum for very long, and you’ll be quick to find many anecdotal testimonies from those who have found success with cannabis for ADD/ADHD. However, some people may not find relief with the herb. A medical professional will be able to help you determine the best course of action based on your individual needs.
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