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Personal story: Perinatal stress and ADHD

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Couple Hear Shape Hands on Pregnant BellyAs I cradled my newborn son for the first, joyous time as a new parent, I sensed both the deepest love and unexplained anxiety. The joy of being a mother and loving this tiny human (so darn much!) was undeniable, and at the same time, I also battled a huge wave of concerns and anxiety throughout my pregnancy that I couldn’t quite explain to myself. After birth, it began to lift some, but it left an impression. 

My son is six years old now. He’s a great kid: energetic, athletic, funny, and kind. And, he was recently diagnosed with ADHD. Right after the diagnosis, I started reading everything I could about how to support him best. I came across an article that highlighted developments in research that speak to a link between maternal stress before birth and childhood development disorders like ADHD.

I couldn’t help but wonder if my struggles influenced him somehow. I want to be very clear: I do not blame myself for how my son’s brain is developing. I believe that we all do the best we can with the tools we have. But, I can take responsibility for learning about my son’s unique challenges and sharing what I know to support others.

In sharing my story, I want other mothers to know they’re not alone and that their anxieties and stresses matter. I want to spark a conversation that raises awareness among parents and healthcare professionals. 

What follows is a simple expression of my own lived experience and understanding of the effects of maternal stress on an unborn child. I’m not a scientist, psychologist, or educator. Any mother with concerns that match mine should talk with her healthcare provider and trusted family members. If there are still worries, approach trained counselors who have expert knowledge in the fields of prenatal psychological distress and ADHD.

What is the science behind a likely link between psychological stress during pregnancy and behavior disorders in the child?

Studies into childhood development disorders such as Attention-deficit/Hyperactivity Disorder (ADHD) are beginning to highlight the possibility that psychological distress to an expectant mother during pregnancy can have an impact on the child long after birth. Specialists in related areas such as developmental psychology and perinatal psychiatry are evaluating the importance of early intervention and supportive measures for a child when unusual stress is present for the mother before birth.

What are the signs of psychological distress during pregnancy?

Just as I did in my pregnancy, many women experience physical, emotional, and psychological changes during pregnancy. This experience of psychological distress, with elements of stress, anxiety, or depression, is not uncommon. Studies have shown that such distress can disturb the physiology of pregnancy, potentially impacting fetal development.

Over recent years, a series of studies in the field of behavioral perinatology has been dedicated to exploring how stress-related psychoneuroendocrine processes during human pregnancy affect fetal development and health. The outcomes of these studies highlight the distinct impact of maternal prenatal stress on the likelihood of conditions in the child. 

What could be the impact of elevated stress during pregnancy on a child’s development?

The research shows that the effects of maternal stress during pregnancy extend well beyond birth and can influence the child’s developmental trajectory. It goes on to indicate that there is a correlation between prenatal stress and the increased risk of ADHD in children. This, when it manifests as symptoms of inattention, hyperactivity, and impulsivity, can significantly affect a child’s academic performance, social interactions, and overall well-being. The risks are not confined to an elevated possibility that a child could be subject to an increased risk of ADHD but also a broader range of mental health concerns such as anxiety and depression.

What does new research reveal about the relationship between pre-birth stress and ADHD?

A paper published in the Psychological Journal, an arm of the American Psychological Association, investigates “the association between prenatal psychological distress (anxiety, depression, and perceived stress) and offspring externalizing behaviors.”

The results revealed a significant link between prenatal distress and subsequent behavior patterns in the child. The clear conclusion was that high levels of maternal stress during pregnancy are associated with an increased risk of ADHD in children

Also, the degree of distress from prenatal to postnatal periods directly influenced the outcomes. The probability of a behavioral disorder appeared lower for nonaggressive behaviors (rule-breaking and inattention) than for aggressive behavior (antisocial behavior, destroying property, picking fights, and mistreating animals.)

This research suggests that there is a strong correlation between the levels of maternal stress during pregnancy and the probability of ADHD developing as children mature. This increase in risk can be attributed to the consequent changes in fetal brain development, particularly in the regions involved in attention and behavioral regulation.

What are the implications of prenatal stress for parents, teachers, and caregivers?

Based on my own experience, the advice I can offer to both parents and professional people who are involved in the care of children is that they should understand the impact of maternal psychological distress on child development because early identification and intervention are critical in reaching the most favorable outcome.

After numerous consultations with trusted therapists and counselors, our family came to the decision that we would, at least in the beginning, steer clear of conventional therapies. In more than 70% of cases, doctors prescribe stimulant medications such as methylphenidate (Focalin, Methylin, Ritalin, Concerta, Biphentin, and others) and amphetamines (Adderall, Dexedrine, Dextrostat, Vyvanse, and others). This choice is based largely on their speed and dosing flexibility. These are chemicals that are meant to correct imbalances in the levels of neurotransmitters like dopamine and norepinephrine in the brain. As such, they have generally short-term effects and have to be taken for as long as the symptoms of ADHD are evident – perhaps for the rest of the person’s life. The deciding point for us was the knowledge that they also carry with them some side effects that can impose unwanted outcomes, especially when it is necessary to use them on younger people living with ADHD, such as our son.

Further research brought us the knowledge that there are ways other than prescribed meds that address the problems brought about by imbalances in the brain’s chemicals.  Simple dietary supplements have been shown in studies to have similar effects on dopamine and norepinephrine levels to the most common medications. Dietary supplements for ADHD must supply vitamins, minerals, trace elements, and polyunsaturated fatty acids (PUFAs, specifically omega-3 fatty acids.) 

What is the best way to overcome a deficiency in omega-3 fatty acids?

Nutritionists told us that to get sufficient levels of the required PUFAs into our child’s diet, he would have to eat at least two to three meals of omega-3-rich ocean fish (salmon, sardines, tuna) per week just to keep up with routine bodily needs, and maybe more if he already had a deficiency. Since we felt this would be hard to achieve (and pretty expensive), finding an alternative to such a diet that supplies the missing elements became our goal. One way suggested was to take fish oil, krill oil, cod liver oil, or algal oil directly, but like most children, he found this difficult. 

Fortunately, I was already friendly with another family that for years had been buying a dietary supplement from the US that had done exactly what they wanted for their own young kid with ADHD. He was now past the stage of needing extra omega-3, but they showed us a label from the old product, called Vayarin. Our search for Vayarin yielded no results because that product was taken off the market pre-COVID and hadn’t been brought back. But we did learn that there is now an equivalent called Zoomind that provides a specially designed mixture of essential omega-3 fatty acids in the proper ratios (3:1 DHA to EPA,) together with components like L-tyrosine and Phosphatidylserine, which enhance the effectiveness of PUFAs in treating ADHD. 


I was happy now to have an explanation for my feelings of anxiety before childbirth and even happier now that we have found a simple, healthy, and affordable way to treat our son’s disorder. I pass on to readers of this blog some of the knowledge I gained in the hope that they can benefit from knowing more about the relationship between maternal stress before birth and the development of behavioral problems such as ADHD in children. Awareness of this relationship is key for parents and professional caregivers to provide comprehensive care and support. By integrating this knowledge into practice, they can contribute to more positive developmental outcomes for children who were exposed to prenatal stress.

Questions I asked during my learning process.

What is the psychoneuroendocrine process?

Psychoneuroendocrine processes refer to the interactions between the body’s psychological, neurological, and hormonal (endocrine) systems. These processes play an essential role in regulating various physiological functions and responses. The main influence of the three major systems is:

  • Psychological: encompassing thoughts, emotions, and mental states.
  • Neurological: concerning the communication of information throughout the nervous system, including the brain.
  • Endocrine: concerning hormones that influence bodily functions.
  • Regulation of reactions to stress: such as triggering “fight or flight” responses by means release of adrenaline, followed by the release of stabilizing hormones like cortisol.
  • Immune responses: in response to infections.

In the context of pregnancy, psychoneuroendocrine processes can influence fetal development and health, highlighting their importance during this critical period. One of the key new understandings from the latest research is that the degree of stress experienced by a pregnant mother, and also the individual mother’s personality as it determines her reactions to stress, have a significant influence on whether, and to what degree, maternal stress can, later on, affect the personality of a child.

How does maternal stress before birth create a reaction in the fetus?

Understanding this requires required digging into the role of the placenta, which has a very fundamental but complex role from the start of pregnancy. The placenta begins to form as soon as a fertilized egg implants in the uterus (around seven days after conception) and continues to grow throughout pregnancy to support the fetus. It links mother and fetus, providing oxygen and nutrients necessary for survival and removing toxins and waste. It is a complex vascular, endocrine, and immune organ that also acts as a barrier to prevent infections from reaching the fetus and to protect the fetus from exposure to unwanted stressors and toxins. The placenta is crucial for the development of the fetal endocrine glands in response to maternal cortisol levels and itself forms part of the mother’s stress response system. Excessive stress, or unusual responses to stress, may cause dysregulation of placental biology, which can affect the fetal metabolic pathways proportional to the degree of stress.

What physical or chemical changes are going on when maternal stress before birth affects a fetus?

These effects appear to be channeled in part through the maternal-placental-fetal neuroendocrine pathway, particularly via the action of the placental corticotropin-releasing hormone. This research indicates that the environment provided by the mother plays a crucial role in shaping fetal neurodevelopment, particularly in aspects like recognition, memory, and habituation. Even in these early stages, the research suggests that prenatal stress and the hormonal interplay between the mother and placenta have a lasting impact on the fetus and go on to influence behavioral responses in the child’s early years.

What is behavioral perinatology?

Behavioral perinatology is an interdisciplinary field of research that focuses on understanding the behavioral and psychological aspects of pregnancy, fetal development, and perinatal outcomes. It encompasses various aspects related to stress before birth can influence the emotional and psychological well-being of expectant mothers, fetal behavior and development, and how these factors may influence the health and development of both the mother and the unborn child.

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