Mindful Awareness and ADHD

Interview with Dr. Lidia Zylowska

Dr. Lidia Zylowska is a psychiatrist specializing in integrative treatment of adult ADHD and application of mindfulness-based training in mental health.

Mindful awareness can help reduce stress and improve one's cognitive and emotional functioning. It is also showing great promise in helping adults with attention deficit hyperactivity disorder (ADHD) improve focus and better monitor their attention.

Lidia Zylowska, M.D., is a board-certified psychiatrist specializing in adult psychiatry, mindfulness-based therapy and adult ADHD. In collaboration with the UCLA Center for Neurobehavioral Genetics, she developed the Mindful Awareness Program for ADHD: a meditation-based training in attention self-regulation.

Dr. Zylowska is one of the co-founders of the UCLA Mindful Awareness Research Center and serves at the Center as the Assistant Clinical Professor teaching clinicians about mindfulness-based approaches. Additionally, Dr. Zylowska is author of The Mindfulness Prescription for Adult ADHD. I had the opportunity to connect with Dr. Zylowska so she could share more about mindful awareness and how it can help adults with ADHD.

Q: What is mindfulness or mindful awareness?

Dr. Zylowska: There are many ways people talk about mindfulness (or mindful awareness), sometimes referring to it as 1) a type of meditation training, 2) a mental state, 3) a quality of a person or 4) a way of living. In my work with ADHD, I like to describe mindfulness as a particular mental state of tuning into the present moment while keeping an attitude of openness and curiosity. Such mindful observing is something we can all do but may need to strengthen through practice.

As we learn to be open, we learn to suspend our judgments, preconceived notions and expectation and also strive to be kind and compassionate with ourselves and others. So it is a way of refining attention and attitude. Once mindful attention and attitude are brought to what is happening in us and outside of us, it can expand our understanding.

With new understanding comes new choice, especially a choice to step back from old reactions, patterns or behaviors.

Q: In what ways can mindfulness training help a person with ADHD?

Dr. Zylowska: Living with ADHD can be challenging since the core problems with attention, executive functions and emotional regulation can lead to additional problems with stress, anxiety, depression, self-doubt, and conflict in relationships. Mindfulness has the potential to help with the core problem as well as the additional problems. It can strengthen attention and emotional regulation and help manage stress and negative emotions. One of the most important ways mindfulness can help is by developing acceptance, self-compassion and understanding of one's unique strengths and weaknesses -- the pillars of thriving with ADHD.

Q: Can you explain a bit about how someone with ADHD who has such difficulty with self-awareness and self-regulation can learn these skills through mindfulness training?

Dr. Zylowska: Mindfulness is an invitation to engage, practice and strengthen self-awareness and self-regulation.

And while the attention step can be challenging for those with ADHD, I believe the attitude step, openness and curiosity, can come quite naturally to those with ADHD. And I like mindfulness because it can be very gradual, playful, and creative. It can be adapted to where each person is in terms of their ability or how they want/can practice. It is also something we can easily bring to our daily activities -- e.g., noting our breath in the midst of doing something else. In this way, mindfulness does not have to feel like "another thing on the to-do list" but a different way of relating to "what is."

Q: Is there a specific subset of ADHD adults who would benefit most from mindfulness training?

Dr. Zylowska: I think we all can benefit from mindfulness training, ADHD or not, especially at the time when our culture often makes us more distracted and stressed. Within ADHD, depending on the type of symptoms a person has, different mindfulness aspects can be emphasized. Those with inattentive type may benefit most directly from enhanced awareness and control of attention and learning to remember one's intention in executing tasks. Mindfulness can help them become less spacey and more self-directed. Those with hyperactive/impulsive type may benefit most directly from better emotional regulation, learning to pause before reacting and becoming more self-aware in interactions with others. Those that struggle with self-doubt or negative emotions can benefit from developing a more supportive, compassionate way of being with their own inner experiences. In addition, the type of ADHD symptoms can make certain aspects of mindfulness practice easier or more appealing. For example, those with hyperactive symptoms may find it more difficult to do sitting meditation practice and may resonate better with mindful movement (e.g. mindful walking meditation) or with incorporating mindfulness to physical activities.

Interview with Dr. Zylowska continued on page 2.

Q: What does the research find about the effectiveness of mindfulness training for adults with ADHD?

Dr. Zylowska: While we have good evidence that mindfulness helps with stress and can improve one’s cognitive and emotional functioning, mindfulness training specifically in ADHD is still a new area of research and we have a limited number of studies. But the evidence is growing. At UCLA, I led a pilot study with a group of 24 adults with ADHD and a group of 8 teens with ADHD receiving an 8-week mindfulness program.

After the training, we found improvements in self-reported ADHD symptoms, lower anxiety and depression, lower perceived stress and improved measures of conflict attention (or paying attention under distracting conditions). This initial study, though promising, did not have a control group so we need additional studies to replicate these findings.

A controlled study, using our mindfulness training, is now ongoing at Duke University with adults with ADHD. Of note, the same training was adopted for children 8-12 years old by researchers in Australia and showed similar improvements in ADHD symptoms and measures of attention in a controlled study.

Other investigators are doing similar research. In Germany, two well-designed studies of a skill program that included mindfulness showed improvements in ADHD symptoms and other mental health measures and the participants listed mindfulness as one of the most valuable components of the program.

In the Netherlands, a study of mindfulness training with parents and their children who had ADHD showed that the parents reported improvement of their own ADHD symptoms and reported less over reactive parenting and stress.


Lidia Zylowska et al., “Mindfulness Meditation Training in Adults and Adolescents with Attention Deficit Hyperactivity Disorder: A Feasibility Study,” Journal of Attention Disorders 11, no. 6 (May 2008): 737–746.

Anna Uliando, at al. Mindfulness training for the management of children with ADHD: A randomised controlled trial (under review).

Bernd Hesslinger et. al., “Psychotherapy of Attention Deficit Hyperactivity Disorder in Adults: A Pilot Study Using a Structured Skills Training Program,” European Archives of Psychiatry and Clinical Neuroscience 252, no. 4 (2002): 177–184; and Alexandra Philipsen et al., “Structured Group Psychotherapy in Adults with Attention Deficit Hyperactivity Disorder: Results of an Open Multicentre Study,” Journal of Nervous and Mental Disease 195, no. 12 (2007): 1013–1019.

Saskia van der Oord, Susan M. Bögels, and Dorreke Peijnenburg, “The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents,” Journal of Child Family Studies (February 2011): 1–9.

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