Attention Deficit Hyperactivity Disorder, or ADHD, is a common neurodevelopmental disorder. Here in Australia, it is estimated that around 6-10% of children and adolescents, and 2-6% of adults, are living with ADHD. These figures seem to be consistent with world-wide statistics.
Recognition and diagnosis of ADHD has increased over recent years. A condition which has often been viewed as mainly prevalent in children, there has been a rapid rise in diagnosed cases in adults. Medication use for ADHD in adults has increased 450% over a 10 year period.
But what exactly is ADHD, and how does it affect your sporting endeavours?
WHAT IS ADHD?
ADHD is a neurological condition which leads to poor concentration and control of impulses. It can affect learning and social interactions, as well as having an impact on day to day life. Traditionally it has been viewed as a childhood condition, but more and more adults are being diagnosed and treated in recent times.
The main signs and symptoms of ADHD include:
- Inattention – Forgetting instructions, difficulty concentrating, and moving from one task to another without completion
- Impulsivity – acting without thought, talking over others, lack of emotional control
- Overactivity – constant restlessness and fidgeting
Often ADHD exists in individuals without the overactivity/hyperactivity, which usually presents as being unable to focus or pay attention for more than a short period of time.
SPORT AND ADHD
Playing competitive sport, especially at the elite level, requires a great deal of focus, discipline and dedication. When it comes to training and competing, being able to follow a strict schedule is often required to reach your goals.
⁷The problems with inattention and lack of impulse control which come with ADHD can often be seen as a roadblock to successful training and competing. However, many individuals, such as gymnast Simone Biles, swimmer Michael Phelps and mountain climber Danielle Fisher, have all reached great sporting heights while dealing with ADHD.
A good combination of support and understanding from coaches, team mates, family and friends, as well as counselling and medication, can help an individual with ADHD to control their symptoms. There is no reason why those with ADHD can’t find enjoyment and be competitive within their chosen sports.
MEDICATION FOR ADHD AND SPORT
There are typically three groups of medications used in the treatment of ADHD:
Antidepressants – eg imipramine and nortriptyline
Non-stimulants – eg clonidine and atomoxetine
Simulants – eg dexamphetamine and methylphenidate
Antidepressant and non-stimulant medications are okay to use in competitive sport. However, the stimulant medications, which are typically the most commonly prescribed treatment for ADHD, are all banned for use in competition by the World Anti-Doping Agency (WADA). They are proven to give a sporting advantage.
These stimulant types of medications can lead to an increase in heart rate and core body temperature. They also have a positive impact on neuromuscular activity, leading to increased power output and endurance, as well as reduced fatigue and perceived exertion.
Some athletes may fake symptoms of ADHD to attain a diagnosis and treatment, in order to obtain a sporting advantage. This is obviously unethical, and considered to be a form of cheating. Just…..don’t.
CAN I GET AN EXEMPTION?
Although the commonly used stimulant medications are banned for use in competition, if an athlete has well documented medical records, in addition to a legitimate ADHD diagnosis and reasoning for treatment, there may not be an issue. A Therapeutic Use Exemption (TUE) may be granted for individuals where treatment with these medications is required.
However, be aware that thorough and accurate documentation and records are important when seeking a TUE. Unfortunately, there are some doctors and specialists who misdiagnose and/or over-diagnose ADHD in patients who don’t meet the clinical criteria. TUEs are not automatically given; they can be rejected.
The statistics show that ADHD is becoming more common in the community. But with proper treatment, there is no reason why it should stop individuals from being successful in their sporting endeavours.
The Sports Pharmacist 