ADHD and Cycling

Following up to our story on how and why Cycling Makes Your Kid Smarter, we wanted to share with you an article from Bicycling.com by Bruce Barcott. Riding is My Ritalin tells the story of the Leibovitzes, a boy diagnosed with ADHD and his parents who were looking for an alternative to the medication that’s frequently diagnosed for the disorder. Below are excerpts from the article:

 

Most of the advice pointed in one direction: a prescription for amphetamines such as Ritalin. The powerful stimulants (the Food and Drug Administration labels them as Schedule II drugs, the same category as morphine and methamphetamine) have a paradoxical calming effect on the minds of ADHD patients. They’re convenient, effective and popular—90 percent of ADHD patients who take them see improvement. Pop a pill; problem solved. Many parents swore by them. Teachers praised them for bringing calm to unruly classrooms.

 

With side effects like heart palpitations, sleeplessness, dizziness, irritability, headaches and nausea, the Leibovitzes were reluctant to have their son, Adam, on such medication. Instead, they made sure Adam got plenty of exercise.

That plan worked for three years. “Adam became a high-energy kid who was also very bright.” But when Adam reached middle school, the demands of schoolwork became too much.

 

Specialized Back to School BikesHis parents worried that he wouldn’t keep up. “As he grew older, every year he’d be expected to concentrate a little harder and sit a little longer in his seat,” his mother says. “When it came time to do his homework, he’d be rolling around under the table or running into the next room. He’d shout out the answers to us. He always knew the answers. He just couldn’t sit still to write them down.” When Adam turned 10, his parents decided to try the medication. On Adam’s first day on Ritalin, he came home from school and declared it a success. “I felt clearer,” he told his parents. “I could sit in class and pay attention.”

 

During this time, his father attached a trailer bike to his own and tempted Adam to join his Saturday morning training rides with the promise of donuts. That simple weekend ritual would eventually change the boy’s life.

 

For the past 30 years, athletes, coaches, sports psychologists and medical researchers have probed and debated one of the most complex mysteries of the human body: How does exercise affect the brain? Common sense and our own experience tell us it does something. Every parent knows the best way to settle down a hopped-up kid is to take him out to the playground and run the bug juice out of him. A generation ago, teachers and coaches frequently used this approach as well.

This seemed a homespun, intuitive remedy, but in fact there was a scientific basis for it. In 1978, two years before the National Institute of Mental Health (NIMH) recognized ADHD as a condition, W. Mark Shipman, MD, conducted a simple test. Shipman was medical director of the San Diego Center for Children, an institute for psychologically troubled children. Back then, kids at the center were among the few in the United States taking psychostimulants such as Ritalin to calm what was then called hyperactivity. Kids can be naturally impulsive, inattentive and overactive, but those with ADHD are more so, all the time. (ADHD is an umbrella term that also includes ADD, attention deficit disorder.)

Shipman sent a group of hyperactive kids running for as much as 45 minutes a day, four days a week. An amazing thing happened: The running kids started acting as if they were getting extra doses of medication. After a while, the doctors who monitored the behavior of each child began lowering drug doses for most of the runners. Very few nonrunning participants had their doses reduced. The doctors who were administering the doses didn’t know which students were running; the changes in behavior were that clear.

Shipman’s study might have led to a boom in physical fitness programs for ADHD-identified kids. It didn’t. Instead, just the opposite occurred: Doctors began writing more prescriptions.

At the time of Shipman’s study, few parents had heard of Ritalin. By 1988, half a million kids were taking the drug. By 1995 that figure had quadrupled. The United States was using five times as much Ritalin as the rest of the planet combined. “An increase of this magnitude in the use of a single medication,” observed pediatrician and Running on Ritalin author Lawrence Diller, MD, “is unprecedented for a drug that is treated as a controlled substance.”

It wasn’t that Shipman’s research was discredited. In fact, at least two other studies conducted in the 1980s confirmed his findings. What happened instead was a societal shift away from time-consuming natural remedies such as exercise and in favor of quick-fix solutionspart of the same cultural sea change that has resulted in the nation’s worsening obesity problem.

 

Adam stayed on Ritalin through his early teens. Disliking some of the side effects, most notably feeling “emotionally flattened.” Chicago Cyclocross Cup CCC PsychoCross CX Wauconda 2012 Joe Sullivan Gearheads Higher Gear

“I’d take it during the week, go off it on weekends, and then back on again on Monday,” Adam recalls. “On Monday I’d be droned out, kind of a zombie. I had no character, no personality. I hated that.”

So, his sophomore year, Adam asked his parents if he could go off his medication. It wasn’t long before his grades plummeted and Adam was back on medication. Meanwhile, he was riding his bike. A lot.

Jeff Leibovitz’s doughnut lure worked better than he’d imagined. When he was 13, Adam talked his dad into letting him do the TRIRI, a group ride across 300 miles of Indiana countryside, on his own. Around the same time a bike-racing craze swept through the Leibovitzes community, propelled by Guy East, now a professional rider with the Trek-Livestrong team. East, then a teenager, lived nearby, and local kids spotted him whipping past on training rides. Adam and his best friend began entering races.

Adam got really good really fast. He announced himself to the cycling world three years ago, at 15, by finishing third in his first junior national time-trial championship, one place behind 16- year-old phenom Taylor Phinney. Long and lean, Leibovitz had grown into a confident racer with a body that could absorb an uncommon amount of suffering. With his jug ears and big-toothed grin, he could have passed as Michael Phelps’s younger brother.

Adam kept racing and winning: the Quad Cities and Tour of St. Louis crits, time trials at St. Louis, Red River Gorge and the U.S. Junior National Championships. “At a certain point he grew beyond my ability to coach him,” his father says. Jeff’s friend Dean Peterson agreed to work with Adam on a training regimen. Peterson had recently taken over as head coach at Marian University, a small liberal arts school in Indianapolis with one of the nation’s top cycling programs.

Peterson’s workout schedule introduced concepts like rest weeks and peaking into the young athlete’s life. As Adam adapted to the ramped-up program, he began to notice something unusual. He was taking Ritalin on weekdays, but when he trained hard on weekends there seemed to be a carryover effect. On Mondays his mind was calm even before he popped a Ritalin. “I’d experiment with it,” he says. “When I was off the meds and rode a lot, I’d feel great. I could concentrate. When I’d take rest weeks I’d be bouncing off the walls.”

Halfway through his junior year, with his grades back up, Adam sat down with his parents. Again he said: I’ve had it. I want to quit the Ritalin. But this time he had a plan. He’d use cycling to manage his ADHD.

Higher Gear Racing at the Glencoe Grand Prix Joe Sullivan JuniorsAlmost immediately, the drug-free experiment was a remarkable success. Adam cruised through the first half of his senior year. He rode nearly every day. During recovery days he’d find other ways to exercise and soothe his brain. Adam’s progress was so impressive and his desire to move up to the next level of cycling so great that he cut a deal with school administrators to graduate a semester early. When Peterson offered him a place on the Marian University team, he accepted immediately. This past January, Lori and Jeff Leibovitz helped Adam load up the family car and moved him into the teenage glory of a cinderblock dorm room.

 

He doesn’t know how the cycling clears his head, allows him to focus. All he knows is that it works. “Riding,” he says, “is my Ritalin.”

What is really going on inside Adam Leibovitz’s brain?

It probably isn’t the endorphins, which mainly affect pain suppression and mood elevation. Researchers now understand that the clearing effect more likely has to do with a different, but similarly mysterious, process centered in the basal ganglia, a part of the brain that plays an important role in movement, coordination, attention and learning. The most accepted theory about ADHD is that it’s largely caused by a deficit of neurotransmitters, which relay signals to and from the basal ganglia. Ritalin works by boosting the concentration of two neurotransmitters in particular: dopamine and norepinephrine. Adam’s rigorous race training most likely caused his body to produce the same effect.

“A bout of exercise is like taking a little bit of Prozac and a little bit of Ritalin,” says John Ratey, MD, a Harvard Medical School professor who has treated and studied ADHD for more than 20 years. His most recent research is chronicled in his book Spark: The Revolutionary New Science of Exercise and the Brain. The Prozac effect comes from endorphins. The Ritalin effect, Ratey says, has to do with boosting the concentration of neurotransmitters in the basal ganglia. “Regular exercise can raise the baseline levels of both norepinephrine and dopamine,” he says, “which are the same neurotransmitters that Ritalin and Adderall go after.”

ADHD drugs don’t suffer from a lack of critics, but Ratey isn’t among them. “I use them for my patients all the time,” he says. “They’re very useful drugs. But in some cases, if a person does enough exercise then Ritalin becomes a little less vital in the treatment of their condition.”

And it’s not just any exercise. Some activities are better brain boosters, and cycling is one of the best. David Conant-Norville, MD, a psychiatrist in Beaverton, Oregon, who specializes in adolescents and attention deficit hyperactivity disorder, recently surveyed his colleagues about the best and worst sports for athletes with ADHD. Cycling, swimming and running are tops. At the bottom are soccer, hockey and baseball. The best sports demanded constant physical exertion and a suite of technical movements that engaged brain functions dealing with balance, timing, error correction, decision-making and focus.

“ADHD is imperfectly named,” says Conant-Norville. “People with the condition don’t have a deficit of attention. They have a problem with attention control during boring or mundane tasks. Which is why the intense focus of cycling is great for someone with ADHD. If you’re moving in the pack in a cycling race, you’re highly focused on other riders around you as well as the road ahead. And you’re constantly thinking about strategy, whether to attack or hang back.”

John Ratey agrees. “Challenging the brain and body has a greater positive impact than aerobic exercise alone,” he says. “We’re just starting to see the effects of movement complexity in recent research.”

One study in particular caught Ratey’s eye. Researchers at a German university last year asked 115 teenage students at an elite sports academy to take a baseline test that measured attention and concentration. Then they were split. One group performed 10 minutes of exercise that required complex, highly coordinated movements. The other did simpler movements at the same level of aerobic activity. The kids took another attention and concentration test. Both groups improved their original results, but the students who performed the complex movements significantly outscored the others. The complex coordination, the researchers concluded, “might lead to a preactivation of parts of the brain which are responsible for mediating functions like attention.”

There’s another aspect to it as well. Call it gallows focus. “The prospect of the gallows doth wonderfully concentrate the mind,” Samuel Johnson once famously wrote, and something similar can be said for exercise that involves a touch of risk. Let your attention drift in the peloton, and you might crash into the rider in front of you. Distraction in the dojo is rewarded with a painful body blow. By contrast, a soccer player who loses his concentration is just a guy standing in a field of grass.Racing Team Junior Higher Gear Joe Sullivan

 

Other studies have shown exercise to be beneficial to the brain.

There’s plenty of research to back up the neurotransmitter theory. In 1997, researchers found that treadmill running significantly increased the production of dopamine that key neurotransmitter, along with norepinephrine, in the brain’s attention center in rats. In a later study, German scientists found that intense exercise boosted the human body’s production of both dopamine and norepinephrine. In 1999, Michael Wendt, PhD, a researcher at the State University of New York at Buffalo, found marked improvement in ADHD kids who exercised for 40 minutes a day. In 2002, a University of Georgia study reported a promising correlation between exercise and improved focus in children with ADHD.

 

With physical education programs being cut in school districts across America, it’s no wonder we’ve seen a rise in ADHD diagnoses and a decrease in test scores.

If only we could get more kids on bikes. Now where on earth could one buy a kid’s bike? 😉

 

Above is an excerpt from Riding is My Ritalin by Bruce Barcott. For the full article, visit Bicycling.com
To learn how and why cycling can help kids perform better in school, see our story Cycling Makes Your Kid Smarter.
For more information on alternative treatments for ADHD, see this article by Dr. Mercola.
For Higher Gear‘s range of non-drug treatments for ADHD – kids bikes by Specialized – come visit us.

 

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