How Mindfulness Can Help You Live with ADHD

People with ADHD can struggle to keep their thoughts organized and focused. But then again, everyone struggles in these areas! The modern-world, with things like cell phones and smart everythings, bombards us with an endless stream of distractions. We all have trouble with this, but there's no question that ADHD can make this even harder to deal with.

To help with this, we interviewed Dr. David Sitt, who helps people navigate this information-rich era we live in.

Dr. David Sitt is a licensed clinical psychologist in New York City with extensive experience as a therapist, evaluator and educator. He specializes in the assessment of treatments of adults with ADHD, anxiety, and mood disorders through a mindfulness-based approach that incorporates elements of mindfulness meditation, cognitive behavioral therapy, and mindfulness-based cognitive therapy.

Thanks for talking with us today, Dr. Sitt. do you often find that adults with ADHD end up having children with ADHD as well?

Among my clients that have children, I’d say a majority of them will have at least one child who also has ADHD. The research says 40-57% of children of a parent with ADHD will have ADHD themselves. And that’s if just one parent has ADD, the odds of the child having it would be even higher if both parents have ADD.

Going the other way, 25-35% of parents of ADHD children are themselves adults with ADHD (this is for each parent individually, so there’s somewhere around a 40-60% chance that a child with ADHD will have at least one parent with ADHD).

I have ADD myself, and I have a 7, 5, and 2 year old. I’m sure my 7 year old has it; my 5 year old might too, but it’s a bit too early to tell right now.

Tell me about CBT and MCBT - how do they work and what are the differences between the two? Are they related?

They’re very much related. Cognitive Behavioral Therapy is based on the work of some clinicians in the 60’s and 70’s who believed that to adjust our emotional states, we need to adjust the thoughts that typically precede our emotions.

To paraphrase Shakespeare, there is nothing good or bad, but thinking makes it so. For example, in a room full of people you could think, “great, this is a chance to work the room and do some networking,” or you could be afraid and think, “Oh god, I’m going to embarrass myself.”

So, that’s the classic cognitive therapy model. The behavior piece was added on later. The way CBT started is that cognitive therapy and behavior therapy developed separately at the same time in the 60’s and 70’s, and towards the end of the time frame merged into the combined approach of CBT because people realized they worked well together.

Other things like mindfulness have been added to CBT in later decades. The mindfulness element was added on later by Jon Kabat-Zinn. Mindfulness is being aware of your thoughts in the present moment, without judgment towards those thoughts.

So MCBT, Mindfulness Based Cognitive Therapy, is similar to classic CBT with the additional mindfulness component.

You’re an advocate of mindfulness meditation - could you tell us more about the mindfulness component? How can people reading this interview get started doing that on their own?

Mindfulness is the practice of being more aware of your thoughts, your breathing, and your body - simply aware, without passing judgment.

I encourage people to start off with just one minute of focusing your mind towards your breathing. When you narrow your awareness, for those of us with ADHD for instance, that’s a significant effort.

So I tell myself for the next minute, “I’m going to inhale, hold, and exhale” - three times in a row. This is practicing focusing your mind for one minute on one thing alone. You may not achieve complete focus at first; most people’s minds drift, and that’s normal! Just be aware of it, without judging yourself. Most people come out of this with a greater sense of calm, clarity, and focus.

Try doing this for one minute once per day at minimus to start. Use an app like Waking up, Headspace, or Calm. Work up to doing guided meditation for three, five, eight, then ten minutes at a time.

But even doing those three breaths once or twice per day will have benefits. Before Covid, I said to use the elevator ride as your meditation space. Try to find circumscribed opportunities for the intentional practice of awareness.

You say something on your website about advising people on the impacts of technology on productivity, brain functioning, and communication - what does that involve? 

When cell phones evolved from flip phones to smart phones, we experienced a societal shift in the functioning of our mind and the functioning of awareness itself. So now we have this device on us at all times that can powerfully enhance productivity, but it can also suck up all our time and attention, and fool us into thinking we can multitask all the time.

Become aware of you and your phone. Are you aware that 70-80% of people sleep with their phones either on them or on their nightstand? And that this increases insomnia and decreases sleep quality?

So for starters, I say don’t see with your phone in the bedroom. Charge your phone outside your room. Nine, ten o’clock at night, put your phone outside your room for the night. Maybe reduce the number of apps on your phone, delete the ones you don’t use, and put the rest into folders so the phone isn’t so cluttered

And practice going phone-free! From time to time, put the phone away and just don’t have it on you for a while.

How important are drugs in treating ADHD? How often do you find patients are able to do just fine without them?

It’s hard to give numbers. People should be open to exploring it. ADHD medications can be tried very easily; you can see within a week or less, often just within a couple of days, whether or not they work. And they can really help give you a sense of calm, focus, and organization.

That being said, if you have other ways of developing tools, like I do in the group therapy I run, I try to teach people tools. If you meditate on a regular basis, you might not need drugs.

I personally was on medication, but I rarely use it now because meditation, yoga, MCBT and the like helped me get over the need to always be on medication. I still have medication that I use occasionally, but it’s no longer a daily thing for me.

That’s for adults, to be clear. When it comes to children, I think medication is more imperative. It’s not as loose and light; kids don’t have that self-awareness yet to develop alternative coping mechanisms on their own.

In your opinion, to what degree do people tend to grow out of ADHD?

My knowledge of the research is that we don’t really understand who grows out of it, how much they grow out of it, or why they grow out of it. It tends to get somewhat better with age.

Overall, it’s a very small minority who completely grow out of it. Those who do grow out of their ADD are usually those with the hyperactive/impulsive subtype, making us crave constant stimulation.

As for how to grow out of it, the research I’ve seen mostly supports that growing out of it is a natural consequence of neurodevelopment rather than directly caused by therapy or better coping. In my experience, therapy, MCBT, coping tools - they all help to reduce symptoms and manage they symptoms you do have, but I don’t describe them as a cure.

What’s your parenting advice for parents with ADHD?

I think a big challenge is the emotional disregulation - the anger, how easy it is to get frustrated. And that’s something to pay attention to because you’re modeling things for your kids. So if you’re displaying poor impulse control and poor anger management, you’re making it that much harder for your kids.

So parents need to work on themselves, do their own work as well. Do the MCBT, meditate, get therapy if you need to. And also practice compassion and forgiveness. Not just towards your kids, but also yourself. These issues don’t go away so you need to forgive yourself.

Apps can help a lot. I recommend an app called Woebot - it’s a cognitive behavior therapy app. And I recommend getting a meditation app like Headspace, Insight Timer, or Calm.

Take those two apps and really engage with them, both meditating and cognitive behavioral therapy.

Thanks for reading!