In this article, we'll delve into the intriguing intersection of Attention Deficit Hyperactivity Disorder (ADHD) and microdosing. We'll look at a recent study into microdosing for ADHD, and how this practice is gaining attention as a potential alternative or adjunctive therapy for ADHD.
—Illustration by Josh Cochran
What are the main characteristics of ADHD?Â
Attention Deficit Hyperactivity Disorder (ADHD) is characterized by three primary symptoms: inattention, hyperactivity, and impulsivity. As a developmental disorder, these symptoms often persist from childhood into adulthood, albeit with some notable differences. While adults with ADHD may exhibit the same triad of symptoms, hyperactivity tends to be more internalized, and symptoms of inattention may be obscured by anxiety or compensatory strategies. Specific symptoms outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) include mind wandering, starting tasks but leaving them unfinished, becoming easily distracted, struggling with meeting deadlines, returning calls, maintaining organization, and experiencing restlessness. Depending on the symptoms, one can be diagnosed with either the predominantly inattentive type, predominantly hyperactive/impulsive type or the combined type of the disorder.
When diagnosing ADHD, tests are used to see how well someone can stay focused and control their impulses. These tests look at mistakes people make, like forgetting to do something (omission errors) or acting too quickly without thinking (commission errors). There are two primary assumptions regarding the cognitive markers of the disorder. Omission errors are thought to be linked to inattention, while commission errors are associated with impulsivity.
DiagnosisÂ
You may have thought before, "Do I have ADHD?" ADHD is commonly diagnosed both in childhood and adulthood; however, a significant number of cases are misdiagnosed or overlooked, rendering it an underdiagnosed disorder. This discrepancy may stem from a lack of recognition of its manifestation in adulthood, compounded by the tendency for its symptoms to be concealed. Moreover, ADHD frequently coexists with other conditions, including mood disorders, anxiety disorders, neurodevelopmental disorders, personality disorders, and substance use disorders. The high rates of comorbidity (the simultaneous presence of two or more diseases or medical conditions in a patient), further complicate the diagnostic process. Identifying ADHD amidst the backdrop of these intertwined conditions presents a formidable challenge, amplifying the complexity of diagnosis and treatment.
Impact on Quality of Life
ADHD is widely recognized as one of the most common neurodevelopmental disorders, affecting approximately 2-5% of adults. As patients with ADHD describe it, 'it is all happening in your mind', so it can be hard to imagine the adverse impact it can have on individuals' lives.
"It feels like everything coming at you all at once at equal velocity and not being able to differentiate between any of it and being expected to be able to on a moments notice.
—Duane Gordon, project manager
Unfortunately, as ADHD can be passed down in families, it tends to run and affects many people over different generations. As a result, individuals with ADHD often face challenges in forming and maintaining relationships, alongside difficulties in finding stable employment. Terry Marten, therapist specializing in ADHD, is herself as well as her daughter diagnosed with it.
"It's a chronic sense of overwhelmed. It feels like you're being attacked in all areas of your daily life— like sounds, and lights, and sensory things can be overwhelming."
— Terry Marten, therapist
These struggles extend to academic pursuits too, where educational goals can become increasingly challenging to achieve. Aside from these individuals with ADHD might also face susceptibility to financial hardships as well. These multifaceted challenges highlight the pressing need for enhanced support systems and effective interventions. Addressing the diverse impacts of ADHD is crucial for fostering improved outcomes and enhancing the quality of life for those navigating this complex disorder.
Treating ADHD
First-line treatments for adult ADHD primarily involve pharmacological interventions using stimulants like methylphenidate and amphetamine, as well as non-stimulant agents like atomoxetine. These treatments have demonstrated effectiveness in providing rapid symptom relief and improving the quality of life for adults with ADHD. However, research indicates that up to half of patients discontinue medication within two years due to side effects outweighing therapeutic benefits, including insomnia, headaches, and appetite changes. Moreover, a significant proportion of adults do not respond adequately to medication, leading to a lower quality of life. Alternative options are needed for this subset of individuals who do not benefit from or adhere to first-line pharmacological treatments.
Now, let's take a look at one of these alternatives: microdosing.
What is microdosing?
Microdosing involves the consumption of small doses of substances like LSD or psilocybin. Typically, microdosing entails ingesting only a fraction—approximately 1/10 to 1/20—of what would be consumed recreationally, with the aim of avoiding noticeable alterations in consciousness. Instead, microdosing is said to offer a range of health-related benefits, including enhanced performance, elevated mood, and improved cognitive abilities, as frequently reported in surveys among microdosers. Notably, microdosing seamlessly integrates into daily routines, making it compatible with everyday activities.
Microdosing and ADHD
Regarding ADHD and microdosing, while much of the evidence remains anecdotal, the consistent reports of positive effects have sparked significant interest among researchers, leading to an increase in studies on the subject. In a recent study comparing the self-perceived effectiveness of microdosing a combination of different psychedelics to conventional treatments for various physiological and mental disorders, including ADHD, microdosing emerged as more effective for ADHD management. While experimental research on this matter is limited, potential explanations include the absence of side effects compared to traditional treatments and the intermittent nature of microdosing, which may result in fewer reminders of the illness. This study underscores the need for further exploration into microdosing as a potential alternative or adjunctive therapy for ADHD.
Figure above: Overall self-rated effectiveness of psychedelic microdoses, conventional treatment, and regular doses of a psychedelic on the three effectiveness questions for mental disorders (A) and for physiological disorders (B). *Signifies statistically significant binary logistic regression p < 0.05. SRE, self-rated effectiveness; MD, microdose; CT, conventional treatment; RD, regular dose.
Emotion Regulation, Empathy & ADHDÂ
In addition to the core symptoms we've talked about, ADHD patients often struggle with managing their emotions effectively. Emotion regulation includes expression suppression, controlling both strong negative and positive emotional reactions, as well as the ability to rethink situations using cognitive reappraisal. Emotion regulation is closely tied to empathy, which plays a moderating role in various contexts. There are two main types of empathy: emotional empathy involves sharing others' feelings, while cognitive empathy is about understanding those feelings. Both types have been found to be impaired in individuals with ADHD, which could contribute to inappropriate social responses and difficulties in social interactions, impairing interpersonal relationships. Two very recent studies were conducted by Haijen et al. (2024) investigating the effects of microdosing on both emotion regulation and empathy in adults with ADHD.Â
Table containing the substance and dose of the microdose of the participants
The first study found improvements in emotion regulation compared to baseline, with increased cognitive reappraisal scores and decreased expressive suppression scores. However, this study lacked a control group (a group that either receives no treatment or treatment as usual [TAU]) so another one was conducted as well. Study 2 compared the microdosing group to a group that received TAU. This study found lower symptom severity after 4 weeks compared to conventional treatment. The microdosing group also scored below the symptoms threshold on all subscales whereas the TAU group only did so on 1 of them. This provides empirical evidence for the effectiveness of microdosing for ADHD.
In the graphs above, the three points indicate the three times of measurement (baseline, 2 weeks, and 4 weeks after the start). TAU refers to the treatment as usual group while MD refers to the microdosing group, and the each y axis represent an aspect related to empathy.
What about emotion regulation, the focus of this study?
Compared to the TAU group the evidence for emotion regulation was weaker as it was only shown to be superior in one aspect, emotion suppression. The scores of the microdosing group steadily dropped over the 4 weeks, reaching similar scores to those of healthy adults, while the TAU group’s score remained similar to baseline. Overall, this study showed evidence for the effectiveness of microdosing compared to traditional treatment, while also aimed to explain the improvements in sociability that other studies have previously reported. It was proposed by the authors, based on their findings, that these improvements can stem from enhancement in emotion regulation, especially that of expressive suppression.
Final thoughts
The findings from studies investigating the effects of microdosing on ADHD underscore the potential of this approach to address the multifaceted nature of the disorder. So far research suggests that microdosing may offer benefits beyond symptom alleviation, including improvements in cognitive function and emotional regulation. However, it's crucial to approach these findings with cautious optimism, recognizing the need for further research to establish strong causal claims. Ultimately, these findings definitely offer a beacon of hope for individuals seeking alternative or complementary treatments. By continuing to investigate and refine our understanding of microdosing's potential, we may unlock new possibilities for enhancing the lives of those living with ADHD.
Have you used Happy Tea to treat your ADHD? We'd love to hear your story. Send us an email about your experience sales@microdosetogether.com.