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Inclusion is the practice of including and accommodating people who often face discrimination and exclusion due to race, gender, ability, sexuality, or identity. In light of the current racial climate, many settings are becoming increasingly aware of their lack of diversity and representation. Such organizations have failed to represent people of all backgrounds, genders, etc. This has left the most oppressed folx feeling undervalued, ignored, erased, etc.

Defining Inclusion

Inclusion refers to “the act or practice of including and accommodating people who have historically been excluded (because of their race, gender, sexuality, or ability).”

While many organizations pride themselves on inclusion efforts, the reality is that the most oppressed people are often the ones with the greatest awareness of how much more work needs to be done in this regard. In fact, the most marginalized folx can help to show just how much an organization may lack inclusion and diversity.

Diversity vs. Inclusion

Despite often being used interchangeably, the terms diversity and inclusion indicate different efforts. Diversity efforts can often be focused on representation while inclusion practices tend to be more about how to help groups feel as if they belong.

In other words, inclusion involves more than just making sure that people are represented in a group. Instead, it refers to how diversity is utilized to create healthy, fair, and equitable spaces that help people to feel included and respected.

What Inclusion Looks Like In Different Environments

The practice of inclusivity can look different in various settings. Let’s look at how we can promote and foster diversity and inclusion in the workplace and within the educational system.

Inclusivity In the Workplace

In their 2014 book, Diversity at Work, Bernardo M. Ferdman and Barbara R. Deane describe the practice of inclusion as key to investing in diversity at work. Ferdman and Deane have engaged in education, writing, and speaking on diversity and inclusion, especially as it pertains to leadership within organizations.

As with most important initiatives, inclusion requires a great deal of investment to come to fruition.

Inclusivity In Educational Systems

Educational systems are designed for dominant groups. For example, U.S. schools are designed for English-language speakers. Experts notes that while teaching English language is not a new concept, but it may require more transformational approaches to ensure that all groups are truly included. Small-scale efforts may not result in true inclusion.

In other words, it can be helpful to understand how educational systems were designed with the needs of the dominant groups in mind (i.e., those who are cisgender, straight, able-bodied, etc.) so they may need to be revolutionized. It means thinking critically about the ways in which learning spaces may fail to meet the needs of folx who are BlPOC, LGBTQIAP+, etc.

What Organizing Inclusion Means

From the preface of their 2020 book, Organizing Inclusion: Moving Diversity From Demographics To Communication Processes, authors Doerfel and Gibbs name the institutional biases of white supremacy, sexism, settler colonialism, homophobia, etc. which have contributed to inequitable outcomes within groups, organizations, and society itself.

In doing so, they make the case for why organizations must communicate differently if they are invested in inclusion efforts given how much of the status quo poses barriers.

In their work, these authors encourage communication that identifies the forces of oppression that can be insidious and require targeted efforts to combat.

Technology Also Presents Challenges

Technology inclusion can present challenges with some groups who may lack experience, training, and access to digital resources. For example, one study looked at the challenges and benefits of digital technology for seniors alongside its policy implications. It demonstrated how some individuals who were once included required additional outreach efforts to ensure accessibility, as all seniors did not necessarily learn how to make use of technological advances.

In this way, it is easy to see how a group may require additional considerations to maintain inclusion as they age while technology evolves beyond their typical use.

Folx With Disabilities Deserve Inclusion

Unfortunately, evidence suggests that inclusion efforts often fail to focus on people with disabilities. This is unfortunate because disabled folx are often sorely underrepresented in the workforce.

Researchers suggest that certain approaches can be helpful for increasing inclusion and addressing this equity gap. These include:

• Diversity and inclusion statements
• Employee resource groups
• Supplier diversity initiatives
• Targeted hiring and recruitment plans

With such evidence-based actions for the inclusion of folx with disabilities, organizations can take tangible steps to diversify their workforce.

For far too long, folx with disabilities have had to bear the burden of ableism at all levels of society.

If organizations are interested in inclusion, they could learn a great deal from BIPOC disability justice activists like Alice Wong, Vilissa Thompson, Imani Barbarin, and Sarah Jama.

Understanding the Need For Inclusion

While it can feel daunting to become more aware of all the ways in which society fails at inclusion of the most oppressed groups, that ability to recognize such gaps can be a big part of taking action.

Just as the problematic status quo was developed over a long period of time, investing in inclusion will take a great deal of work, but it is well worth the effort.

Active Inclusion

To get meaningul responses about what needs to change, organizations need to start by asking the right questions. This includes recognizing and understanding that BIPOC and LGBTQPIA+ folx have often been left out of such discussions.

Experts suggest that such efforts are unlikely to succeed unless they are enforced from the top of the organization all the way through.

Gathering and Incorporating Feedback From Marginalized Groups

When it comes to inclusion work, folx often do not yet know what they do not know. It is common for people who come from backgrounds of privilege to have had a limited understanding of the ways in which systems that may have worked effectively for them have actually been rigged against communities that are BIPOC, LGBTQIAP+, disabled, undocumented, etc.

In fact, it may be well worth assuming that your initial efforts at inclusion may not go as planned, and yet failed attempts only require accountability and greater investment.

All too often, the appearance of progress is prioritized over actual strides with inclusion work.

If you find yourself getting frustrated, that does not mean that the effort in which you are engaging is problematic. In fact, even when inclusion efforts are efficient, they may not necessarily be well-received, especially by groups who view such work as a threat to historical ongoing power systems from which they may still benefit.

What You Can Do to Promote Inclusion

Here’s some ways in which you can help to promote inclusion in your daily life:

• Ask yourself which marginalized folx may not feel welcome in a space, and make an effort to change that.
• Identify the barriers to inclusion to those in leadership positions when it is safe to do so to address them.
• Assess how much privilege you have and how much space you hold and amplify more oppressed voices.

Keep in Mind

As you have probably gathered, it would be impossible to explain all that inclusion is in one article, but hopefully, these insights have helped to inform your understanding of this practice, as well as the need for it.

Every setting you encounter may be one in which you have an opportunity to promote inclusion. If you have the capacity to do so, that effort could benefit the lives of those who may not otherwise have access to those spaces.

While many believe that bullying only happens throughout childhood, it doesn’t always stop once we grow up. In fact, almost one in three adult Americans report being bullied, with 43% feeling that adult bullying has become a more acceptable behavior. Making it an unacceptable behavior is important since bullying can have damaging effects—even for those doing the bullying.

Here we clarify what an adult bully is and the different types. We also share the mental health effects of adult bullying, followed by ways to deal with bullying as a victim, bystander, or even as a perpetrator who wants to stop engaging in this harmful behavior.

What Constitutes an Adult Bully?

The American Psychological Association (APA) defines bullying as “a form of aggressive behavior in which someone intentionally and repeatedly causes another person injury or discomfort.” Just like children and teenagers can be bullies, so can adults.

An adult bully can regularly make the victim of their actions feel oppressed, belittled, humiliated, or de-energized. Some of the behaviors that they engage in include:

• Invasion of the other person’s personal space
• Personal insults
• Public shaming
• Ridiculing jokes
• Threats
• Unwanted personal contact

Harassment vs. Bullying 

The terms ‘bullying’ and ‘harassment’ are often used interchangeably when talking about hurtful or destructive behavior. This is understandable since they both involve:

• Power and control
• Acts that intentionally hurt or harm another person 
• An imbalance of power between the victim and the perpetrator 
• The target having trouble stopping the action directed toward them

However, the difference between the two is that when these behaviors are based on a protected status (race, color, religion, age, etc.), it is harassment. Harassment involves inappropriate conduct that becomes a condition of employment or creates a hostile, abusive, or intimidating workplace.

Types of Adult Bullies

There are numerous different types of adult bullies, some of which include:

• Tangible/material bully: These types of bullies use their formal power, such as when in a position as a boss or manager. Or, they have some sort of authority or control over the other person’s finances and use it to intimidate others.
• Verbal bully: A verbal bully shames and insults the other person with their words. Often, they offer constant criticism or engage in cruel teasing. Sometimes the language used by this type of bully is sexist, racist, homophobic, or threatening.
• Passive-aggressive bully: While not always considered a bully, this type is the most cunning in some ways because they act amicable on the outside but then take unexpected swings. They also engage in gossip, sarcasm, and hurtful jokes. They may roll their eyes, make rude facial expressions, and ridicule their victims by mimicking. They might also isolate their targets, causing them to feel anxious and insecure.
• Cyberbully: This person bullies their victims through a computer, cell phone, or other electronic device. Cyberbullying is a significant problem for teens, especially LGBTQ teens and those who are White or multi-racial. Regardless, anyone can be a victim of emails, text messages, and social media posts designed to bully them. 
• Physical bully: Physical bullies can exhibit a range of behaviors, from simulating violence by raising their fists as if about to strike to throwing and breaking objects to violent acts of physical, domestic, and sexual abuse.

Mental Health Effects of Bullying

Bullying can affect our mental health short and long term. Both victims and perpetrators of bullying face:

Adult bullying can have harmful effects on bystanders as well. One study found that people who witness bullying tend to have more psychological symptoms. They also have less life satisfaction.

How to Deal with Adult Bullying

Strategies for dealing with adult bullying vary depending on whether we are the victim, bystander, or the perpetrator.

As a Victim

There are a few things victims of adult bullying can do to protect themselves:

• Decide when to respond. If the behavior is not excessive or harmful and contact with the bully is infrequent (such as only at yearly family gatherings), it may be possible to just avoid the other person. Because of the amount of time it can take to handle bullying behavior in many cases, picking one’s battles if it isn’t directly harmful may be the best option. 
• Make eye contact. Eye contact can be significant, as bullies have less empathy when they can’t see your face or eyes. Having strong eye contact is also a sign of greater self-confidence, which can reduce the likelihood of being bullied in the first place because it makes us a less desirable target.
• Escape if possible. If being bullied at work, for instance, we might ask to move our desks further away from the bully or limit our interactions with them whenever possible. If that fails, we may consider going one step further and ask to switch to another position in the organization, if one is available and desirable.
• Document the offenses. Document every single offense and keep those records for as long as possible. They may be needed later to file a complaint at work or, in some cases, a police report if the bully’s actions become emotionally or physically damaging.

As a Bystander

There are several things that, as bystanders to adult bullying, we can do:

• Question the behavior of the bully to shift the focus of the interaction.
• Utilize humor to redirect the conversation.
• Since there is strength in numbers, bystanders can intervene as a group to demonstrate their disagreement with bullying.
• Walk with the victim of the bullying to help diffuse potential interactions.
• Check in privately with the bullied person to let them know that we disagree with the other person’s actions and that we care.

As a Perpetrator

In many cases, people who bully have had a traumatic childhood and/or regularly endured domestic violence, physical abuse, or other forms of abuse. Dealing with the effects of this trauma or violence can help reduce bullying behaviors.

Psychotherapy is one option for healing emotional trauma or reducing traumatic stress. A mental health professional can help us find healthy ways to cope with the experiences we’ve endured, enabling us to not take our hurts out on others.

Self-care is also important after experiencing traumatic events. This includes:

Getting Help for Adult Bullying

Dealing with a bully can take a toll in various ways. Help exists for its effects, whether those effects are physical, mental, or both.

For physical consequences of being bullied, like experiencing sleep issues or having pain conditions triggered by elevated stress, a primary care provider can help. To cope with the mental effects of bullying, consider working with a mental health professional.

It’s also beneficial to utilize our support network. Find support from co-workers, friends, or family. Sometimes the best way to buffer the impact a bully has on us is to reach out to others in our life, giving our feelings a voice and having our emotions validated. 

Lexapro is the trademark name for the generic drug escitalopram, an antidepressant medication. Like Zoloft (sertraline), it is a selective serotonin reuptake inhibitor (SSRI) that was introduced in the late 1980s. Available in pill or liquid form, it’s prescribed to treat a variety of mental health conditions, such as depression and anxiety.

SSRIs like Lexapro are generally effective and have fewer side effects than older antidepressants, such as monoamine oxidase inhibitors (MAOIs). They also lack the addictive potential of Xanax (alprozolam) and other benzodiazepines.

Uses of Lexapro

Escitalopram, the generic form of Lexapro, is primarily used to treat depression and generalized anxiety disorder (GAD). Initially, it was used only to treat depression, but research has shown that it is effective for treating both mood disorders and anxiety disorders.

A doctor may prescribe Lexapro for other uses if they believe it might be of benefit. For example, they might prescribe Lexapro for conditions such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder, and even migraines.

How Lexapro Works

Scientists are still learning how Lexapro works, but there is a general neurological understanding.

According to an article in the journal National Library of Medicine, “SSRIs exert their mechanism of action by binding to the sodium-dependent serotonin transporter protein (SERT) in the presynaptic neuron. SERT is responsible for reuptaking serotonin from the synaptic cleft into the presynaptic neuron. Inactivation of SERT by escitalopram leads to an elevation in synaptic serotonin levels.”

In other words, Lexapro helps raise or balance serotonin levels in the brain, which can reduce anxiety and enhance mood. Serotonin is a neurotransmitter involved in mood, sleep, and other functions.

Before Taking Lexapro

Lexapro is prescribed for the treatment of anxiety disorder, depressive disorders, and other mood disorders, sometimes in combination with other medications. Therefore, you generally need a mental health diagnosis before a doctor prescribes Lexapro for you.

Your primary care physician can write a prescription for Lexapro. But a mental health professional can prescribe medications and handle other your treatment needs, such as by combining medication with psychotherapy.

Prior to starting Lexapro for anxiety or depression, tell your doctor if you are allergic or hypersensitive to escitalopram or if you are pregnant or breastfeeding. Also alert your doctor if you have a history of any of these medical conditions, which may be exacerbated by Lexapro:

Tell your doctor about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may cause outright harm or prompt more careful consideration as to whether the pros of treatment outweigh the cons in your case.

Precautions and Contradictions for Lexapro

There are many precautions involved when taking Lexapro. You can reduce your risks by being aware of who should not take this medication and understanding the black box warning.

Who Should Not Take Lexapro

Lexapro is not safe for everyone. Certain people should either not take Lexapro at all or take it with caution, including:

• People with escitalopram allergies: You should not take Lexapro if you’re hypersensitive to escitalopram oxalate. This means that you have a known allergy to the medication and experience symptoms of allergic reaction when taking it, such as difficulty breathing or swelling of the face, mouth, or tongue.
• Children: The safety and effectiveness of Lexapro for children under 12 years of age have not been well-established. Some smaller studies have found that this drug may be helpful for young children with anxiety disorders, and with minimal side effects, but more research is needed to know for sure.
• People who are pregnant or breastfeeding: Use Lexapro with caution if you’re pregnant or breastfeeding, as the medication can be passed to your child. The FDA also reports that SSRIs taken after the 20th week of pregnancy have been found to increase the risk of persistent pulmonary hypertension in infants by six times. Your doctor should discuss this with you; if not, be sure to ask about potential risks.
• Older adults: Side effects of this medication can be more severe in older adults, such as by causing blood sodium levels to lower to dangerous levels. Your doctor should monitor your dose and adjust as necessary to reduce the severity of its effects.

Lexapro Black Box Warning

A boxed warning, also referred to as a black box warning, is the strictest warning for prescription drugs. It is issued by the Food and Drug Administration (FDA) to help draw consumers’ attention to serious or life-threatening risks of taking that medication.

Lexapro has a black box warning as taking it can result in an increased risk of suicidal thoughts and behaviors—particularly in children, adolescents, and young adults. Close monitoring by your psychiatrist or doctor is important when taking Lexapro, particularly if you are a younger person.

Lexapro Dosage

Lexapro tablets are available in 5 milligram (mg), 10mg, and 20mg strengths. The 10mg and 20mg tablets are scored and can be cut in half. The oral solution comes in a strength of 1 mg per milliliter (mL).

The usual recommended daily dosage of Lexapro is 10mg, but you may begin at a lower dose that is increased slowly if needed. The manufacturer recommended doses for Lexapro based on condition and age are:

• Major depressive disorder, ages 12 to 18: 10mg per day; can increase dosage to 20mg per day after three weeks if necessary
• Major depressive disorder, over age 18: 10mg per day; can increase dosage to 20mg per day after one week if necessary
• Generalized anxiety disorder, adults only: 10mg per day; can increase dosage to 20mg per day after one week if necessary

If you are experiencing your first episode of depression or anxiety, you may take Lexapro for a defined period—such as between six months and one year. For individuals with a chronic mental health condition, it may be necessary to take Lexapro for an extended period (over many years).

Modifications

Dosage modifications may be required in people with severe kidney impairment. Your doctor can provide guidance in these situations to help you take this drug safely.

How to Take and Store Lexapro

Taking and storing Lexapro properly helps keep the medication both safe and effective. Lexapro is typically taken as a tablet or oral solution once daily, in the morning or evening, with or without food.

If you miss a dose, take your prescribed dose as soon as you remember unless it is very close to your next dose. In that case, take your regular dose instead. Never take two or more doses of Lexapro at the same time.

Doses higher than 20 mg are not approved by the FDA. Staying within the recommended dose helps to reduce the risk of side effects or adverse reactions.

It’s important to recognize that you will not experience immediate relief from taking Lexapro. It can take anywhere from one to four weeks to feel better once you start taking this drug.

You might notice improvements in your sleep, energy levels, and appetite within the first week or two. But you may not experience the full benefits of the medication until you’ve been following a recommended treatment plan for a couple of months.

Storage

Lexapro should be stored at room temperature, away from light and moisture. Do not store it in the bathroom. If you’re traveling with Lexapro, be sure to carry your medication in its original packaging in your carry-on luggage and have your prescription with you.

Lexapro Side Effects

Lexapro is generally well-tolerated and effective. As your body adjusts to taking the medication, the side effects should gradually go away.

If you notice that side effects are getting worse or interfering with your quality of life, talk to your doctor. Side effects can be minimized by carefully following the dosage directions given by your doctor and reporting any negative effects.

Common

The most common side effects of Lexapro or escitalopram are:

Severe

Seek immediate help if you experience any of the following unusual but severe side effects of Lexapro:

• Difficulty breathing or swallowing
• Swelling of the face, mouth, or tongue
• Fever
• Stiff muscles
• Fast heartbeat
• Vomiting
• Seizures
• Rash
• Confusion
• Hallucinations
• Suicidal thoughts or behaviors

Lexapro Warnings and Interactions

Caution should be used when taking Lexapro along with other medications. The following serotonergic medications should not be used at all or only with significant caution and close monitoring when combined with Lexapro due to the increased risk of serotonin syndrome:

Other drugs that can negatively interact with Lexapro include blood thinners; taking NSAIDs, aspirin, and warfarin can increase the risk of bleeding in people taking Lexapro. While rare, there have been reports of people developing a life-threatening reaction after combining escitalopram with linezolid, a drug used to treat infections like pneumonia.

To help avoid any possible drug interactions, let your doctor know about any other prescription and over-the-counter medications you are currently taking. Avoid drinking alcohol when taking Lexapro as well since it can reduce the effectiveness of the medication and also may increase its toxicity.

Discontinuing Lexapro Use

You should only discontinue taking Lexapro under the guidance of your doctor at an appropriate time—such as when symptoms have been stable for a certain period. Your doctor will help you to taper off the medication to minimize any withdrawal effects.

If you stop taking escitalopram suddenly, you may experience withdrawal symptoms, including:

• Dizziness
• Muscle tension 
• Chills
• Confusion
• Trouble concentrating
• Trouble remembering things
• Crying

If you are discontinuing Lexapro to try another SSRI, it is recommended that your dosage be reduced over a 4-week period when making the switch.

Keep in Mind

This overview of the use of Lexapro for mental health conditions does not cover every possible outcome of taking this medication. If you have been prescribed this medication, be sure to follow the instructions carefully. If you have additional questions, speak to a healthcare provider.

Behaviors can be confusing, especially when they are things we’d rather stop doing. We might ask, “Why did I do that, anyways?” Unfortunately, the answer isn’t always obvious, but a process called behavior chain analysis can be a useful tool for getting to the bottom of pesky bad habits and destructive behaviors.

A behavior chain analysis is a process that can help people better understand why certain behaviors happen. Addressing maladaptive behavior means understanding why it happens in the first place. A chain analysis can help you identify all of the different factors that contribute to that behavior.

Chain analysis can be helpful in the treatment of different mental health problems, including post-traumatic stress disorder (PTSD), bipolar disorder, borderline personality disorder (BPD), substance use, and other conditions. It is an important technique in a type of therapy known as dialectical behavior therapy (DBT).

What Is a Behavior Chain Analysis?

Also known as functional analysis, a chain analysis is a technique designed to help a person understand the function of a particular behavior. During a chain analysis of a particular problem behavior (for example, deliberate self-harm), a person tries to uncover all the factors that led up to that behavior.

Behaviors can serve multiple functions. Therefore, go through a chain analysis for a number of different situations that led to problem behavior and try to identify all the functions a problem behavior serves for you.

In other words, a person tries to discover all the links in the chain that ultimately resulted in problem behavior. Therefore a chain analysis will help you figure out all the things that can contribute to problem behavior.

Doing a chain analysis takes time and effort, but it can be a useful tool when a person is trying to address specific problem behavior. In many cases, people will try to change a behavior without fully comprehending what is causing it. Chain analysis allows people to better recognize the factors that contribute to it, identify triggers, and look for solutions to stop the problem at many different points.

When to Do a Behavior Chain Analysis

Reasons a person might want to do a behavior include risky behaviors such as:

• Risky behaviors such as substance use or drunk driving
• Aggressive behaviors and violence,
• Behaviors associated with mental disorders
• Self-injury
• Suicidal ideation and suicidal behavior
• Any other action that creates distress, harm, or disruption in a person’s life

Behavior chain analysis can often be useful for addressing specific symptoms of mental health conditions. For example, research has found that it can be useful for negative symptoms of schizophrenia. 

It might also be helpful to identify what things might have made you more susceptible to responding to the situation as you did. For example, when people do not eat well or do not get enough sleep, they may be more susceptible to experiencing negative moods or having more reactive emotional experiences.

How to Do a Chain Analysis

To do a behavior chain analysis, a person identifies the situation they were in, the thoughts they were experiencing, and the feelings they were having just prior to engaging in that behavior.

In doing so, a person can increase their awareness of all the factors that may put them at risk for problem behavior. This way a person has a better ability to intervene early on to prevent that behavior in the future.

Choose the Behavior to Analyze

The first step is to identify the behavior you want to change. For example, do you want to stop engaging in self-medication through alcohol? Binge eating? Try to identify a behavior that is causing problems for you in your life.

Questions you might ask yourself include:

• What was the exact event that led to the behavior?
• When did the problem first start?
• What was happening when it began?
• What thoughts, feelings, or behaviors were you having at the time?

Identify the Links in the Chain

Next, think about what happened prior to you engaging in the problem behavior. After you write down the initial precipitating event, ask yourself what happened next. Questions you can ask yourself include:

• What thought or feeling did you have after it happened?
• What actions followed?
• How did you feel during and after the behavior? 
• What were you doing?
• What was going on around you?
• Were you in an argument?
• Did you have a memory of your traumatic event triggered?

Pay Attention to Thought Patterns

Now, identify what kinds of thoughts were brought up by the situation or event that led to the problem behavior. Questions to ask yourself at this point include:

Understanding the thought patterns that led up to the behavior is important and will allow you to look for ways to change those unhelpful thoughts.

Look for Solutions

The next step is to think about solutions that can address different aspects of the behavior. These solutions will vary depending on the individual, the behavior, and the resources that each person has available. 

• What could you have done differently at each point in the sequence?
• What coping strategies could you have used?
• What skills do you have that would help you deal more effectively with that behavior, thought, or feeling?
• Are there new skills you could learn that would help?

Review the Chain of Events

Think about what emotions you were having as a result of that situation. Try your best to list as many emotions as you possibly can, such as fear, sadness, anger, shame, guilt, embarrassment, or dread.

For example, did you experience shortness of breath? Muscle tension? An increased heart rate? Think about how your body reacted to the situation.

Next, list what your thoughts, emotions, and bodily sensations made you want to do. That is, did they make you want to escape the situation or do something to make those feelings stop? Did you feel a need to engage in your problem behavior?

Finally, think about the consequences of engaging in your problem behavior. Did you feel better afterward? Did you feel disappointed in yourself? Ashamed? Try to list as many consequences (both positive and negative) as you can.

The idea that sugar can cause attention-deficit/hyperactivity disorder (ADHD) or make ADHD symptoms worse is a pervasive myth that continues to be widely believed despite a growing body of research that suggests it simply isn’t true. This persistent belief is likely because there seems to be a link between sugar consumption and hyperactivity in children.

In this article, we’ll look at what the science says about the link between sugar and ADHD and what you can do about your sugar intake if you feel it’s negatively impacting your mental health.   

Sugar Does Not Cause ADHD

Sugar can cause a burst of energy, popularly known as a sugar rush, but this should not be confused with ADHD-related hyperactivity. Studies on the connection between sugar and ADHD have found little to no evidence that sugar directly influences ADHD symptoms, let alone causes the neurodevelopmental disorder.

The evidence does suggest that there is a positive association between sugar intake—particularly from sweetened beverages—and specific ADHD symptoms. However, association does not mean one causes the other.

In a systematic review and meta-analysis of studies on the relationship between ADHD and sugar, researchers found a positive association between sugar-sweetened beverages and AHDH risk; however, “dietary sugar alone did not increase the risk of developing ADHD symptoms.” This means that other variables may be involved, and more well-designed research studies are needed to isolate the different contributing factors.

Another meta-analysis on the effects of sugar on behavior and cognition concluded that sugar had no effect on cognitive performance or behavior and that the strong belief among caretakers that there was an effect was likely due to the expectation that sugar does cause hyperactivity and other symptoms.

The authors noted that a small subset of children may respond in idiosyncratic ways to sugar or have rare allergic reactions, but this is the exception and not the rule.

For one, many studies relied on information from questionnaires given to parents or caretakers of children with ADHD rather than direct observation or interviews with the subjects with ADHD. Research shows that parents who expect sugar to make their children hyperactive are more likely to perceive their children as hyperactive after consuming sugar than an outside observer.

Another confounding factor is that the sugary foods and beverages consumed contain many other ingredients, including caffeine and micronutrients, that could also impact energy levels and behavior. So, determining the role that sugar specifically played is hard.

Understanding the Relationship Between Sugar and ADHD

There may not be enough evidence to say that sugar is a direct cause of ADHD, but what does that “positive association” mean then? Right now, there’s not enough data to say with certainty how sugar impacts ADHD, but researchers do have some theories.

Sugary Diets Are Also Low in Nutrients

One of the leading theories is that ADHD symptoms are made worse by nutritional deficiencies, and diets high in sugary foods and beverages tend to also be low in nutritious foods. Many studies evaluated the intake specifically of refined sugar, which is found in processed sugary foods like juice, soda, candy, and desserts.

These processed foods tend to contain higher quantities of sugar (such as high fructose corn syrup) than naturally occurring sweet foods like fruit, and they also contain less fiber, protein, and other nutrients that the body needs to function.

One systematic review of the relationship between diet and ADHD found that while a nutrient-lacking diet didn’t necessarily make symptoms worse, a nutritious diet tended to have a “protective effect” against ADHD in the form of reducing symptom severity.

For example, people with ADHD often have lower levels of iron and zinc, both of which play a role in regulating dopamine function. A diet high in sugary, nutrient-lacking processed foods isn’t providing the iron and zinc people with ADHD need to increase levels of those key dopamine regulators.

Sugar Activates the Dopamine System

Another theory is that increased sugar intake is a consequence, rather than a cause, of ADHD. Impulsivity and the preference for immediate rewards rather than delayed rewards make people with ADHD prone to crave sugary foods because sugar triggers a dopamine response in the brain.

Because the dopamine system is already severely dysregulated in ADHD, sugar’s ability to activate it might lead to a kind of self-medicating behavior where people with ADHD consume sugary foods or drinks in order to compensate for low dopamine levels. According to this theory, then, sugar isn’t the cause of ADHD symptoms; it’s an attempt—conscious or unconscious—to treat them.

How to Cut Back on Sugar and Switch to an ADHD-Protective Diet

Even if a diet high in sugar doesn’t cause ADHD, it can cause plenty of other health problems like heart disease and tooth decay. Likewise, even though a healthy diet won’t cure your ADHD, it can make your symptoms easier to manage. So, it’s still worth cutting back on sugar and replacing processed foods with more nutritious items. Here are a few ADHD-friendly tips for reducing sugar and improving your diet.

Don’t Keep Sugary Snacks in the House

Impulse control is hard for people with ADHD. On the upside, object permanence is also challenging, so if the sugary snacks aren’t right in front of you, you might not think about them as much. If you can’t ignore the craving, keeping them out of the house at least makes the sugary snack harder to get.

If possible, enforce a rule that you must walk or bike to the store to pick up the snack (and only buy enough to indulge the current craving). Physical activity may help boost dopamine levels sufficiently enough to make the craving less intense. If not, at least you get some exercise before eating something sugary.

Eat a Fruit or Vegetable first

ADHD brains can be stubborn once they fixate on a reward they want (like the cookies you’re craving), so it can be hard to ignore a craving. But if you eat a big handful of carrots or an entire banana before you reach for the cookies, eating a smaller portion of the sugary snack can be easier.

By the same token, drink a glass of water before a sugary beverage. When you’re thirsty and craving soda or juice, fill your glass with water first. Chug that and then pour in the juice or soda. By the time you start drinking the juice or soda, you can sip it to savor the taste rather than gulping it down to quench your thirst.

Don’t Overcomplicate It with Strict Diets

Having ADHD can make sticking to even the simplest routine seem impossible. Hence, a rigid diet where you’re denying yourself entire food categories or meticulously counting calories is not ideal. Instead of adhering to a completely unfamiliar and strict diet plan, take it one step at a time and opt for simple changes.

You don’t have to give up your favorite sugary foods; try to gradually eat less of them than usual. You don’t have to stock up on the latest expensive superfood; buy some carrots, apples, and other produce that doesn’t spoil too quickly, and make sure those are the first things you see when you open the fridge.

Experiment With Alternative Dopamine Boosters

Since the sugar craving might be your brain’s way of saying it’s low on dopamine, finding other ways to boost dopamine levels can help address that problem without resorting to sugar. Some dopamine-boosting alternatives to sugar include:

• Spicy or flavorful foods. Peppers and other foods that cause a burning sensation also trigger the release of dopamine and endorphins. If you can’t stand the heat, some research suggests that other aromatic herbs and spices like rosemary, sage, lavender, cinnamon, nutmeg, and so on provide a similar dopamine-boosting effect.
• Fun physical activity. Exercise is one of the most well-researched ways to boost dopamine levels. “Working out” might sound like an unbearable chore, but there are many ways to incorporate regular exercise into your day without even glancing at a treadmill. Dance around the house to your favorite playlist when you’re getting ready in the morning. Go for a walk in a nearby park during lunch. Try hiking, horseback riding, tennis, surfing, gymnastics, or any activity that catches your interest on the weekends.
• Go outside in the sunlight. Some research suggests that sunlight may increase dopamine synthesis. Find ways to move some of your daily activities outdoors during the day. Move your coffee date to the park. Grab your laptop and answer emails while sitting on the bench outside your office. Head out to your backyard to take that phone call. Just remember to wear sunscreen.

In the long run, incorporating more of these activities and foods into your daily routine may help reduce your sugar cravings.