My professional inbox is stuffed with newsletter content tailored both to therapists and ADHD sufferers and my personal inbox is stuffed with newsletters targeting ADHD sufferers and people who share my interests, and one of my biggest interests is food. So I get a fair amount of content with spin like “how to eat to heal your ADHD” or “what nutrition best supports focus and attention”. And I have to say, most of that content is not very helpful, and its usually for the same reason: it’s just the exact same contemporary-consensus nutrition advice given to everyone. Try to eat 3 balanced meals. If you snack, do it consciously. Eat good fats (avocado!). Optimize for fiber and protein (legumes!). Eat a non-vegan but plant-forward diet with lots of variety. You know the drill.
So I thought it might be useful to take a step back and ask myself what issues related to food have come up most frequently in my own sessions with clients and share that information with you. Bear in mind I am not a nutritionist or dietician. But food is definitely a frequent topic in my sessions because eating is such a centerpiece to functioning. Many people with ADHD or mental health challenges more broadly struggle to consistently eat in a way that feels healthy and comfortable overall. While this is generally the way that issues related to food first come up in session, these discussions and the lifestyle changes that emerge have often revealed to these clients ways in which food makes a big difference in how their ADHD symptoms manifest. I’ll try to break some of these insights down below.
As I started writing about this topic I realized I have a lot to say, so I’ve decided to make this a series and I will link future posts here as they get written.
The Post-Meal “Crash”
Generally when you eat your body shifts the way it allocates energy towards digestion through the activation of what’s called the “parasympathetic nervous system”. This can lead to feelings of calm or tiredness along with a decrease in goal-directed thinking and activity. I want to emphasize this shift isn’t all bad, especially if you suffer from anxiety or insomnia. But for many folks with ADHD this shift is experienced very negatively. Stimulants train us to view high energy states with alert and foucs. And many with ADHD , for better or worse, use stress as a powerful tool to increase motivation and alertness. So often people find that the shift in energy that happens after a meal can be inconvenient or even debilitating. Different meals tend to have different dynamics.
Breakfast
It’s common for people with ADHD to skip breakfast or have a breakfast that doesn’t feel good because they don’t feel hungry, because they forget, or because they feel they don’t have time. There are also unique dynamics with stimulant medications I’ll cover elsewhere. Breakfast is an easy meal to skip. Intermittent fasting has also made it a very trendy meal to skip. People who feel particularly groggy or unfocused in the morning generally are more likely to skip or minimize breakfast out of concern for a “crash”. But when I’ve encouraged people to journal their breakfasts and their focus, mood, and energy level usually the narrative gets turned on it’s head.
Eating a medium-sized and “healthy” breakfast rarely results in a crash and supports performance. Usually when people experience late-morning crashes they have more to do with very large breakfasts, crashing from caffeine or excess sugar, or other morning-centric ADHD issues that have nothing to do with food. A moderate-sized breakfast low in added sugar will serve most people with ADHD very well. You may not feel hungry but from a cortisol and metabolic perspective it’s a good time to have some calories on hand to support your neurology, hopefully creating some momentum for the day
lunch
Lunch is by far the most common meal that clients bring up in connection to feeling a “crash” afterwards and there’s plenty of science to back that up. It’s fairly normal to experience a dip in energy in early afternoon and there’s some evidence these afternoon “doldrums” may be linked to circadian rhythms and thus may occur regardless of eating patterns. That said having a large of heavy lunch can definitely contribute to feeling of fatigue or sleepiness either immediately afterwards or a couple hours later when this dip might naturally occur. People’s schedules, especially work schedules, can make this a really difficult time to experience lower energy especially if that’s linked to a worsening of a range of ADHD symptoms.
Skipping or minimizing lunch can often be difficult and/or counterproductive because unlike with breakfast many people, especially those unmedicated, experience intense hunger at this time. There’s also a boredom or desire for stimulation or escape that can drive midday eating. [On the other extreme, some people taking stimulants find they have no appetite at lunch, but I’ll focus on that more in my later post on medication-related issues.] For those who do eat lunch and have a strong appetite, my approach has become much more pragmatic. First off, if you aren’t eating breakfast, you need to start, this will smooth out blood sugar spikes and help keep midday appetitive more manageable. But beyond that I just encourage people to experiment widely with the timing, size, and composition of lunch to figure out what kind of midday eating is least likely to cause a crash.
There’s no silver bullet when it comes to everyone having a crash-free lunch. Some people do need a certain amount of “fuel” to maintain energy level whereas others will be more tired the more they eat. And people respond differently to different macros. I’ve had several clients who have settled on smoothies or protein drinks at lunch as an alternative to a classic meal. Also some people do much better with a few snacks through midday with no true meal. These are just examples. But unless you have time for a siesta then very large high fat meals may not be an option for you.
Dinner
Depending on your schedule and lifestyle a post-dinner crash can be a gift or a curse. Some people are crashing from stimulants and others are simply running out of steam after a long day. But if you still have goals or responsibilities at night, or if you just want to be able to enjoy your relationship or leisure time more actively and presently, a post-dinner crash can be a problem. For people who haven’t been eating much during the day for whatever reason there can be a strong desire to overreat at dinner, a time when many people find food hyper-palatable. So even moreso with lunch, eating more consistently throughout the day is a core strategy for limiting a crash after dinner. Moving the time of dinner can also be very helpful. An earlier dinner might make it easier to avoid overeating or make the digestive lull overlap less with natural circadian deactivation. Whereas pushing dinner late enough in the European style might just give more time for higher-energy functioning before the desirable and inevitable end to the day. It can be especially helpful to focus on foods that offer satiety without necessarily being too heavy or caloric at dinner if late night snacking is a concern, and this can also help moderate meal size to some extent. A small post-dinner snack or “healthy” dessert can also be supportive of limiting the post-dinner crash.