If you were to run into Jackson, my former patient, you would meet a compact 21-year-old in jeans and an untucked shirt, who speaks articulately about his plans for the future — a typical American college kid, if not a little smarter. What stands out about him isn’t so much where he is today, but how far he has come to get here and how he did it with an alternative ADHD treatment.
As a day student at a top-ranked private academy, he simply had more work than he could get through. At one point, I had him taking Adderall, Paxil, and clonazepam, a long-acting anxiety drug. Jackson is clearly tuned in to his own state of mind. If he falls off his exercise regimen, his concentration wavers. He knows how it makes him feel, and that knowledge itself keeps him going. “When I started exercising, I suddenly was able to concentrate on things that were important to me,” he says. “There’s never been any question in my mind that exercise is related to concentration.
Girls didn’t show this improvement, which may be because of a lower incidence of hyperactivity in girls. Both boys and girls improved by another measure related to the sensitivity of dopamine synapses, although boys fared better after maximal exercise and girls after submaximal exercise. In the extreme, engaging in these activities is a matter of survival-avoiding a karate chop, or breaking your neck on the balance beam, or drowning in a swirling pool of whitewater-and, thus, taps into the focusing power of the fight-or-flight response. When the mind is on high alert, there is plenty of motivation to learn the skills necessary for these activities. As far as the brain is concerned, it’s do or die.
Everyone agrees that exercise boosts levels of dopamine and norepinephrine. One of the intracellular effects of these neurotransmitters, according toneurobiologist Amy Arnsten, Ph.D., is to improve the prefrontal cortex’s signal-to-noise ratio. Arnsten has found that norepinephrine improves the signal quality of synaptic transmission, while dopamine decreases the noise, or static, of undirected neuron chatter. This prevents the receiving cell from processing irrelevant signals.