Breathing exercises could be the answer to controlling ADHD symptoms

When a doctor gave Steve Whiteley stimulant drugs, after he’d struggled for years with undiagnosed ADHD, he thought he had finally found the answer to his problems.

Steve, from London, had hoped the medication, dextroamphetamine, used to treat attention deficit hyperactivity disorder, would end years of what he called ‘chaos’, in which he switched jobs repeatedly and lost multiple long-term relationships.

And while they helped improve his concentration, the 44-year-old also experienced the side effects which are common symptoms of ADHD drugs taken by nearly a quarter of a million Britons, including poor sleep, a loss of appetite and increased anxiety.

He said: ‘There was no doubt the drugs helped to manage my symptoms, but with the side effects I knew I could not stay on them.

‘The worst part was that they made me a lot more introverted. I couldn’t articulate myself, and that would make me more anxious.’

Initially he turned to meditation, and enrolled in a Buddhist-led training course, but he said the real change in his symptoms came when a friend introduced him to so-called ‘breath-work’.

These deep-breathing exercises are designed to reduce stress and increase focus. One is box-breathing – four steps that take four seconds each: inhale, hold, exhale, hold, and then repeat the process.

For Steve, breath-work has been ‘life-changing’, and repeating the exercises regularly has boosted his concentration and energy.

He said: ‘I do two to three rounds of deep-breathing every morning, and throughout the day I do mini breath-work breaks – particularly to get over the post-lunch slump.’

After a couple of months, Steve said he was able to come off his medication completely.

‘The effects have grown over time,’ he said.

‘Initially it helped me feel less stressed. Now, as I’ve incorporated it into my daily routine, I’ve become better-focused, but without any of the side effects I was suffering from the medication.’

Breathing exercises may seem a poor replacement for prescription medicines, but some leading experts believe that many ADHD sufferers could benefit.

Some 2.6 million Britons have the neurodevelopmental disorder that affects concentration, impulse control and activity levels. For decades it has been treated with stimulants, such as amphetamines, to boost energy and improve concentration. Nearly 250,000 sufferers in England were prescribed medication on the NHS last year – more than three times the 81,000 prescriptions issued in 2015.

However, research shows that while often effective, stimulant drugs can cause unpleasant side effects – including mood swings, rapid heartbeat, loss of appetite and, in children and adolescents, even stunted growth.

This is why some patients have turned to alternative treatments. Breath-work gained worldwide attention after author and self-­proclaimed breathing expert James Nestor claimed ADHD was caused by poor breathing.

In an interview on The Diary Of A CEO podcast with Dragons’ Den star Steven Bartlett in 2023, viewed by more than 1.6 million people, he said: ‘ADHD is a physiological problem. It is caused by breathing, and by adopting healthy breathing practices you will benefit.’

One of his techniques is the 4:7:8, which involves inhaling for four seconds, holding for seven, and exhaling for eight. He insists it reduces stress, promotes clarity and encourages relaxation.

Mr Nestor also claims it can tackle ADHD symptoms, as sufferers have a heightened fight-or-flight response – or autonomic nervous system – that can lead to restlessness and racing thoughts.

Breath-work, he argues, can increase activity in the parasympathetic nervous system – or the rest-and-digest state – which helps to control ADHD symptoms.

Professor Philip Asherson, of King’s College London, said: ‘There is certainly logic to the theory. Deep, slow breathing can have a calming effect on the body and helps address one of the overlooked elements of ADHD – that people have a higher level of stress and emotional instability.

‘Also, by focusing on breathing in the moment and training your attention, you can have a long-term impact on the condition as it can have functional changes on the brain, such as calming the nervous system and improving the function of the part of the brain responsible for decision-making.’

However, poorly controlled breathing could exacerbate ADHD symptoms. People who are overstimulated breathe faster, causing carbon-dioxide levels in the blood to fall, which can trigger fogginess and poor concentration.

Experts say more research is needed before the NHS can consider breath-work as an ADHD treatment. Professor Asherson added: ‘Breath-work can be really effective for some, but it will not be for everyone and it should be used alongside their medication.’