Treating ADHD Without Medication

Exploring the Power of Neurofeedback as an Alternative to ADHD Medication

Written by Dr. Keri Chiappino, DC DACNB BCN

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects millions of individuals, young and old, around the world. Characterized by persistent challenges in maintaining attention, controlling impulses, and managing hyperactivity, ADHD can significantly impact various aspects of one’s life. For those who have been diagnosed with ADHD or care for someone who has, the journey can often be marked by uncertainties, questions, and an overwhelming need for effective solutions.

In this article, we will explore neurofeedback (EEG biofeedback) as a holistic treatment option that offers an alternative to ADHD medications. Backed by the research, this non-invasive treatment option offers help to both kids and adults with ADHD, especially the ones who didn’t receive success with conventional medication-based ADHD treatment protocol.

The Search for Non-Medication ADHD Treatment Options

In the quest to navigate the intricate landscape of ADHD, parents, caregivers, and individuals with ADHD themselves are increasingly seeking non-medication treatment options. While medication can be an essential tool in managing ADHD symptoms for some, others are exploring alternative approaches that offer hope beyond traditional pharmaceutical interventions. This shift is driven by a growing awareness of the desire to address the core challenges of ADHD without the potential side effects and stigmas associated with medication. 

Whether you’re a parent seeking the best path for your child or an adult looking for alternative ADHD treatment solutions, this article will shed light on a holistic approach to managing ADHD: one that offers hope, empowerment, and a new beginning.

What “Kind” of ADHD Do You or Your Child Have? 

Understanding the type of ADHD that you or your loved one has can help you find the most effective treatment option (with or without medications.) Most people know about Inattentive ADHD and Combined ADHD which has both hyperactivity symptoms and inattention. However, clinically, I have seen patients who tend to suffer in one of two ways:  the classic staring off into space, daydreaming type of ADHD and others who are spinning so many plates in the air that they cannot concentrate on what is in front of them!

Under-Arousal ADHD (“daydreamer” type of ADHD) 

The common symptoms of this type of ADHD, also known as sluggish cognitive tempo (SCT) include:

• Sluggishness: Individuals with under-arousal ADHD often appear slow-moving and lethargic. They may have difficulty initiating tasks and might seem to lack energy.
• Daydreaming: Excessive daydreaming is a common symptom. Individuals may get lost in their thoughts and have trouble staying focused on tasks.
• Mental Fog: A feeling of mental fog or haziness is typical. Cognitive processing may be slower than expected.
• Inattentiveness: Like other forms of ADHD, individuals with under-arousal ADHD may struggle with inattention, making it challenging to focus on tasks or maintain concentration.
• Forgetfulness: Forgetfulness and difficulty retaining information can be common.
• Procrastination: Procrastination is a frequent challenge, with tasks often delayed or left incomplete.
• Low Energy: Individuals with under-arousal ADHD may experience low energy levels, even if they get adequate sleep.
• Social Withdrawal: This subtype is often associated with social withdrawal and isolation, as individuals may lack the energy or focus to engage in social interactions.

If we take a look at brainwave patterns for these patients, what we see is the daydreamer type of ADHD presents with too many sleepy brainwave patterns, specifically theta waves in the frontal part of the brain. We call this an under-arousal ADHD. For those who choose medication, stimulant medications are often the first ones tried and with under-arousal ADHD some patients feel a benefit. Unfortunately, as the medication wears off the attention issues resurface. 

Over-Arousal ADHD

• Racing Thoughts: Individuals with over-arousal ADHD often experience a constant stream of thoughts, as if they have multiple “tabs” open in their minds simultaneously, making it difficult to focus on the task at hand.
• Difficulty with Task Prioritization: They may struggle to prioritize tasks or concentrate on what’s most important because of the constant mental distractions.
• Intrusive Thoughts: Thoughts about what’s for dinner, to-do lists, weekend plans, and replaying past conversations frequently intrude on their attention, causing difficulty in maintaining focus.
• Sensory Sensitivity: Sound sensitivity is common, and even minor noises may be distracting or distressing.
• Sleep Disturbances: Sleep issues are prevalent, with some individuals struggling to fall asleep due to racing thoughts and others waking up during the night and finding it challenging to return to sleep.
• Emotional Rumination: Over-arousal can lead to persistent emotional rumination, where individuals go over and over thoughts, events, and concerns in their minds, making it challenging to let go of emotional stressors.
• Obsessive-Compulsive Issues: They may exhibit obsessive-compulsive tendencies, such as repetitive behaviors or recurring thoughts.
• Anxiety: Chronic worry and heightened anxiety are typical, as over-arousal can lead to a constant state of alertness and anticipation.
• Overwhelm: Overwhelming feelings of being unable to cope with life’s demands are common. The constant mental chatter and sensory sensitivity can be emotionally draining.

When we look at brain waves in this case we see an abundance of beta waves. Beta waves are the fast brain waves that are associated when normalized, to process information. However, when they are dysregulated they can cause all the above symptoms. 

Medication vs Non-Medication Treatment Options for ADHD

Medication may help some patients however, there are reasons why people seek alternative forms of help for ADHD. Side effects, continued symptoms, desire for a longer-term solution or philosophically not choosing to use pharmaceuticals are some of the reasons patients may seek alternative ADHD treatment options in the form of neurofeedback. 

Historically, we have seen many patients who didn’t respond to medication or suffered side effects like decreased appetite, sleep disruption, headaches, suicidal ideation, tics and moodiness. We tend to see these challenges correlated to the over-arousal presentation of ADHD. If the brain is essentially already wound up a stimulant could exacerbate the problem!

Neurofeedback as an Alternative ADHD Treatment Option for Adults and Children

Neurofeedback can help re-train the brain to be in optimal brainwave patterns. A healthy brain is able to shift all day into different states depending on what you are doing and even the time of day! 

• At bedtime, we want to transition into slower and sleepy brainwave patterns. Delta and theta waves are the predominant ones when we are sleeping and falling asleep. 
• Alpha waves are present when we are doing routine activities. An example of an alpha state is when you drive to somewhere you habitually go to and when you get there you wonder how you got there! Your brain was in a sense on “auto-pilot”! Athletes and creatives tend to describe this state as “being in the zone”. 
• Beta waves are the fastest brainwave pattern and they are present when we are conversing, learning something new and processing information. 

Where we can run into problems is if we are in a beta or high brainwave state and we want to go to sleep! If your brain has habituated to this state in an abnormal way it will be very hard to shift your brain into the lower brainwave patterns. And the same is true if we are habituated to the lower brainwave pattern and you have to learn something new! It can be so difficult to process that information if you are accustomed to a lower brainwave state. 

A healthy brain is one that can transition seamlessly based on the demands of life. Shifting our state is not something most of us can do volitionally. Neurofeedback for ADHD can help strengthen that “muscle” and make your brain more adaptable.

How will you know if neurofeedback can work for you?

A Quantitative Electroencephalogram (QEEG) is a brain map that measures your brainwave activity. It is this objective test that helps us determine which ADHD patients can be helped with neurofeedback. If your dysregulation patterns match the symptoms you wish to see improved then neurofeedback can be a viable option. If there is no evidence of dysregulation then neurofeedback would not be an option for you. It is worth noting that according to the FDA there are no reported side effects with neurofeedback. In fact, many patients choose to use neurofeedback to improve their performance and many athletes are hopping on board to gain an edge. Neurofeedback may not only remediate your ADHD symptoms but also provide a long-term solution for your condition and improve your overall well-being.

Are you ready to see if Neurofeedback can help your ADHD?

Make an introductory neurofeedback appointment (QEEG) with DR. Keri Chiappino in our Smithtown office to see if you are a good candidate for neurofeedback therapy. A Brain Map or QEEG is the first step on your journey to a brain that performs exactly the way you want it to. 

References and Research

• Mahesh Shrestha, Julianna Lautenschleger, and Neelkamal Soares. (2020.) Non-pharmacologic management of attention-deficit/hyperactivity disorder in children and adolescents: a review. Journal of Child and Adolescent Psychiatry, 25(1), 34-46.
• Tieme W P Janssen, Marleen Bink, Katleen Geladé, Rosa van Mourik , Athanasios Maras , Jaap Oosterlaan. (2016.) A randomized controlled trial into the effects of neurofeedback, methylphenidate, and physical activity on EEG power spectra in children with ADHD. Journal of Child Psychology and Psychiatry. Epub 2016 Jan 8.
• Ute Strehl, Pascal Aggensteiner, Daniel Wachtlin. (2017.) Neurofeedback of Slow Cortical Potentials in Children with Attention-Deficit/Hyperactivity Disorder: A Multicenter Randomized Trial Controlling for Unspecific Effects. Frontiers in Human Neuroscience, epub.
• Naomi J Steiner, Elizabeth C Frenette, Kirsten M Rene, Robert T Brennan, Ellen C Perrin. (2014.) In-school neurofeedback training for ADHD: sustained improvements from a randomized control trial. The Journal of Pediatrics, epub.
• Victoria Meisel, Mateu Servera, Gloria Garcia-Banda, Esther Cardo, Inmaculada Moreno. (2013.) Neurofeedback and standard pharmacological intervention in ADHD: a randomized controlled trial with six-month follow-up. Biological Psychology, epub.