When ADHD Meds Fail: 10 Lifestyle Changes That Can Help (2024)

Jaclyn Paul, 37 of Baltimore, Maryland, has blogged about her ADHD since 2014. The author of Order from Chaos: The Everyday Grind of Staying Organized with Adult ADHD, is a big proponent of finding the right ADHD medication and says for her, meds help create a huge shift in perspective and bring some clarity.

“That said, they don’t do any work for me. And they won’t compensate for lifestyle factors known to worsen ADHD symptoms,” says Paul.

What’s more, Paul says that when she’s stressed or fatigued her meds don’t seem to work that well anyway because her ADHD seems to intensify: “This happened to me during a big renovation on our house. The disruption and stress were just too much for my brain. I started to function as though I was not on meds at all.”

Worse, thinking about the past two years of pandemic life, it’s not surprising to hear other people with the condition say their ADHD feels more debilitating these days.

First, it should be said that if you feel your medication isn't working or it stops working, tell your doctor. They can help adjust the dose or find another drug that may work better for you. The same goes for if a medication's side effects get to be too much.

However, know that about 30% of those with ADHD don't get the desired effect out of stimulant medications.

Medications used for ADHD are typically stimulants that can help improve attention and focus by boosting dopamine and norepinephrine in the brain, neurotransmitters that may be less active in people with the condition.

But medicines aren't magic. Ned Hallowell, MD, a child psychiatrist who specializes in ADHD, founder of The Hallowell ADHD Centers in Sudbury, Massachusetts, whose latest book is ADHD 2.0, says when you unwrap what he calls the “gifts” of ADHD, some people get super results from medications, others not so much.

Meds may improve your ability to focus, control impulsivity better, and lessen hyperactivity but they don’t work on your executive function, the processes involved in things like time management, organization, and prioritizing tasks—the big three that people with ADHD have trouble with. And that’s OK as Hallowell also believes the traits (symptoms) of ADHD can be eased by some lifestyle and productivity tools you can learn to master.

“ADHD means I need to rely on my organizational systems, my calendar, my notes, all that, probably a lot more than the average person. Meds don’t change that,” acknowledges Paul.

If you have ADHD and have found medication either doesn’t work well for you, has too many negative side effects, or you have comorbidities like anxiety or depression—studies show about 50% of adults with ADHD also have anxiety disorders—that can make it difficult to take ADHD medications, you may be pleased to learn that a host of lifestyle changes can help you thrive.

“A lot of the work I do is research-based in helping people find ways that they can succeed or make progress with their ADHD if they find that medications aren’t working or if they have to stop taking them for medical reasons,” says Lara Honos-Webb, PhD, a California-based clinical psychologist who specializes in ADHD, and the author of The 6 Super Skills for Executive Functioning.

Both Hallowell and Honos-Webb agree that learning about the condition, figuring out what works well for you, and working with a therapist or ADHD coach—Hallowell calls it a “mom minus the nagging”—are some of the best ways to learn the lifestyle habits and tips that can help you manage your symptoms. Here’s what they both recommend:

#1. Exercise, but not necessarily at the gym.

Honos-Webb says exercise is like a little bit of Ritalin (the well-known ADHD medication) and a little bit of Prozac (the first game-changing drug that targeted depression) combined. We’re not talking about hours at the gym or getting in shape. Instead, research shows that a little bit of exercise—a 10-minute walk, bouncing a ball up against a wall, any physical activity you can do for a reset—can work to increase your focus.

"One hour of the right kind of exercise can provide four hours of improved attention and focus," Dr. Hallowell told Psycom in 2021. "Exercise encourages the production of dopamine, norepinephrine, and serotonin in the brain, which play roles in regulating the attention system. The effects are similar to" Ritalin. So, bike, run, walk, play, swim, jump, move, and watch it improve your symptoms.

#2 Get plenty of sleep.

Most people with ADHD need eight hours of sleep. If you’re not able to get good sleep, you won’t be able to focus.

Honos-Webb says getting sleep is foundational. “If I stay up until 3 a.m., all my meds will do is help me notice how much I need a nap,” says Paul.

If this piece of the ADHD puzzle eludes you, improve your sleep hygiene. Go to bed and get up at the same time every day (even on weekends), avoid alcohol and caffeine in the late afternoon and evening, and create a bedtime routine that helps you relax for the night, including low lighting, a warm shower, avoiding screens before bed, and reading. Talk to your doctor about ways to get better sleep.

#3 Manage your stress.

Stress interrupts our attention and worsens ADHD symptoms—whether you're on medication or not. So having strategies that help manage it when it comes along is key. Whether you like yoga, meditation, or zoning out with an app like Calm, you must master some stress-busting moves that help you to cope.

“One of the most powerful, simplest interventions—and I would call it essential—is deep breathing,” says Honos-Webb. Research on diaphragmatic breathing, breathing deep into your diaphragm, or belly breathing, helps your body slow down and when your body slows, your mind follows. Practice breathing in slowly through the nose, mouth closed. Inflate lungs like a balloon. Hold for a breath, then exhale through pursed lips while stomach falls downward.

#4. Limit technology.

Technology can be so addictive that it interferes and is a distraction. One study showed having your smartphone in the same room diminished attention and cognitive capacity. Take time away from tech when you’re really trying to focus or complete a tech-less task.

#5 Spend time in nature.

“Nature is a therapy that has no known side effects, is readily available, and can improve cognitive functioning at zero cost,” says Honos-Webb. Dozens of studies looked at time in nature in relation to cognitive functioning and ADHD and found that being in green space improves cognitive development in kids, expands memory and attention in adults, and relieves stress.

#6 Take breaks.

“All of us need restoration,” explains Honos-Webb. Our brains need rest. But people with ADHD may need more frequent breaks. That’s why tactics like the Pomodoro technique, where you work for 25 minutes then take a break for 5, are helpful.

“Sometimes I can feel like I haven’t ‘earned’ unproductive downtime, but I think my brain actually needs it more than I realize,” says Paul.

You may have to adapt your ratio. Maybe 15 minutes of work to 10 minutes rest or even 15 minutes of work to 15 minutes of rest may be more your speed. Find the ratio of work to rest that makes you most productive.

#7 Regulate your emotions.

Emotional regulation is also a piece of the ADHD puzzle. Called emotional granularity, keeping your emotions in check can be foundational to managing symptoms of ADHD such as impulsivity. Try making an emotional checklist: What makes you happy, sad, angry, proud, satisfied, or scared? Keep track of how your emotions affect your habits. Putting a label on your anger, for instance, may serve to prevent an impulsive action because you already identified you were angry.

“Imagine your emotions are like a big wave that disrupts your attention,” says Honos-Webb. If you can ride the wave by identifying it, recognizing it, claiming it, you likely could skip impulsive or procrastinating behaviors (the wipe-out) because you were already tuned in to it.

#8 Eat a healthy diet.

No one has developed an ADHD diet yet, but most experts think eating a Mediterranean diet is the most helpful, one filled with plant-based foods, nuts, legumes, and olive oil. Reaching for whole, limited-ingredient foods—rather than those that are heavily processed—is also smart.

Iron has been shown to affect dopamine levels in the brain, so an iron-rich diet is recommended for brain health. Good sources of iron from food include red meat, dark leafy greens, beans, tofu, and fortified breakfast cereals.

#9 Practice self-compassion.

It doesn’t pay to be hard on yourself, nor does it help you avoid procrastination or organize any better. Rather than striving to be perfect, having compassion for yourself when you mess up will serve you well.

“In the course of two days, I stuck my hand in boiling water, dumped latex paint on the floor, and would’ve backed into my neighbor’s car like it wasn’t even there if not for my car’s collision avoidance system,” Paul says. “If we’re under a lot of stress or our hormones are out of whack, it helps to just acknowledge it and give ourselves a little grace.”

#10 Recognize your talents.

“Most people are so preoccupied with the downside of the disorder,” says Hallowell, “that they fail to identify the gifts and talents that come along with it.” Traits like creativity, innovation, exuberance, leadership, intuition, intense interests, and entrepreneurial spirit abound in people who have ADHD. Finding and nurturing what lights up your brain, provides a creative outlet, and homes in on your talents is one of the most important factors that go into managing ADHD symptoms and living with them successfully and productively.

This article was originally published June 6, 2022 and most recently updated June 13, 2022.

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