Attention-deficit hyperactivity disorder (ADHD)
A syndrome characterised by hyper- activity, impulsivity, or inattention, and interferes with cognitive, academic, behavioural, emotional, and social functioning. It manifests in early childhood and often continues into adulthood and is about four times more common in males. As many as one in 10 children are diagnosed with ADHD, up two thirds from a decade ago. Of those, 66-97% are treated with psychostimulant medication. But perturbing reports of drug-induced personality changes and negative health consequences abound. Although the cause of ADHD is unknown, biology (including abnormalities in brain structure and function), genetics and environmental factors (surroundings, social and dietary) appear to contribute to the disorder. What exactly is ADHD, why is the diagnosis so common, is there any truth to the medication allegations and what alternatives are available to quell this widespread disorder?
Proper diagnosis and treatment of ADHD is important for more than just quelling disruptive classroom behaviour and underachievement. In the long run, ADHD can evolve into conduct and learning problems, antisocial behaviour and drug abuse. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV), which is the most widely used diagnostic tool in the US and Africa, lists 18 behavioural symptoms of inattention, hyperactivity and impulsivity. A child must display six or more of the listed symptoms to a greater degree than other children of the same age and in a way that’s disrupting to their daily lives over a period of at least six months. If some of these behaviours have been present before the age of seven and are displayed in more than one environment (home and school for example), then an initial diagnosis can be made.
An ADHD child falls into one of three subtypes: inattentive type (six or more of the inattention symptoms are present), hyperactive-impulsive type (six or more of the hyperactivity or impulsivity symptoms are present), or combined type (six or more of symptoms from both categories are present).
But beware of the lay diagnostician; an ADHD diagnosis must be made through psychiatric evaluation in order to eliminate other possible causes for the behaviour, such as sleep deprivation, illness, medication side effects and other psychiatric (eg. Asberger’s) or mood disorders. Gifted or creative thinkers, with superior intellectual functioning, like Thomas Edison, Robert Frost, Einstein and da Vinci, display similar traits for different reasons (eg. daydreaming up a poem, or being academically understimulated in the classroom), and are often mistaken for having ADHD. It’s thought that medicating gifted children may impair cognitive performance. With so many conditions easily mistaken for ADHD it’s simple to see why over- diagnosis and over-medicating may be common, emphasising the importance of a correct diagnosis by an experienced diagnostician.
Many sociologists believe that ADHD is not a medical condition at all, but rather a result of constraints imposed on lively children who are cooped up in artificial environments, which causes seemingly deviant behaviour. One theory contends that societies determine the line between normal and abnormal behaviour, and this line moves as society changes. In Europe, where ADHD is diagnosed according to the more strict ICD-10 criteria, it’s diagnosed far less frequently than in countries, like SA and the USA, which use the more lenient DSM IV.
THE OPIATE OF THE MASSES
Conventional medication can effectively treat ADHD symptoms, resulting in attentive and compliant behaviour. However, the most frequently prescribed medications have common and significant adverse effects including nervousness, anorexia, insomnia, weight loss and growth retardation, stomach upset, sleepiness, mood swings and skin rashes. Although it may seem incongruous to use stimulants for the treatment of ADHD, they are largely believed to be effective because symptoms indicate an inability to self-stimulate, which explains the need for outside stimuli and subsequent disruptive behaviour. ADHD is associated with low levels of the brain messengers dopamine (responsible for reward and focus) and noradrenaline (responsible for vigilance, attention and fight-or-flight responses). The stimulant medicines, methylphenidate and amphetamines, boost brain levels of these messengers, in a way very similar to cocaine. And like cocaine, they can be addictive.
In incorrectly diagnosed children, heightened dopamine levels can change how the brain develops, desensitising it to rewards like food, romance and social interaction, leading to depression or acting as a gateway to drugs. A common alternative to stimulant medication, the nonstimulant atomoxetine, boosts brain levels of noradrenaline, not dopamine. It’s less addictive and less effective than extended-release stimulant medications, but as effective as the fast-release version of these medicines While it lacks the stimulants’ addictive qualities, it’s associated with infrequent suicidal thoughts and liver damage.
So, although many parents and teachers are desperate for a cure, perhaps medicine with so much potential for collateral damage shouldn’t be the first port of call when safer alternatives are available.
ADRESSING THE UNDERLYING CAUSES NATURALLY
The advantages of complementary and alternative interventions reach beyond the absence of conventional medicines’ serious adverse effects; they are also able to address multiple factors contributing to ADHD.
• Brain biology: In addition to low levels of the brain messengers dopamine, noradrenaline, serotonin and GABA, connections between brain regions and nerve cells may be impaired, especially those involved with movement, cognition and behaviour. Certain brain regions are smaller in ADHD sufferers and different parts of the brain are activated during cognitive tasks. Brain regions associated with attention and motivation may be less active. Both genetics and environmental factors are thought to contribute to these abnormalities. Supplementing with the brain-messenger amino acid building blocks (tyrosine, tryptophan or 5-HTP, theanine, glutamine) and the nutrients needed for their conversion (vitamin B6, iron, vitamin C, copper, SAMe) can help boost levels. The beneficial brain nutrients omega-3 fats (EPA and DHA) and phospholipids have also proven valuable
• Diet: More often than not ADHD goes hand in hand with food allergies and intolerances. A child with ADHD should be tested for allergies and visit a dietician for appropriate allergen-free and elimination diets (to determine the presence of any food intolerances). Gut problems are also common in ADHD and probiotic and prebiotics can help. Food additives, colourants and a Western diet, high in refined carbohydrates, sugar and processed food may exacerbate ADHD. Avoiding food additives, preservatives and colourings can be extremely difficult in today’s world. However, if care is taken to eliminate sugary, refined and processed food, providing instead a healthy balance of fresh, natural, high fibre food and omega-3 fatty acids (EPA and DHA), a marked difference in behaviour can be achieved. Nutritional deficiencies (especially iron) are common in ADHD and can worsen behaviour. Taking a complete multivitamin and mineral supplement as well as checking iron levels and supplementing as necessary is essential
• Environmental toxins: Exposure to alcohol, tobacco smoke, pesticides and heavy metals in the womb or in early life can affect the developing brain and have been linked to ADHD. Children with ADHD often have higher levels of lead in their bodies and research shows that removing heavy metals using a chelating agent under medical supervision can make a positive difference
• Electronic environment: One study showed that babies exposed to cell phones in the womb or after birth were more likely to be hyperactive or have behavioural problems by school-going age. Watching TV from a young age (1-3 years) is associated with attention problems at age seven. And the more TV your child watches the worse the effects. This could be because TV replaces other activities that require concentration or it may lead to sensory addiction. Artificial, indoor lighting and lack of natural light have also been implicated
• Social: The relationship with a caregiver has a profound effect on attention and self-regulating abilities. A high number of fostered children display typical ADHD behaviour, as well as children who have been abused, or suffer from post-traumatic stress syndrome. Although this isn’t a cause of ADHD itself, the behaviour is similar.
Methods of treatment often involve a combination of behaviour therapy, lifestyle changes, counselling and medication. Looking at each child as an individual and assessing their unique circumstances and environment is essential; no one treatment method can be seen as a universal remedy.
Despite the controversy, there seems to be enough evidence to support the existence of a certain set of behaviour patterns that can be disruptive to a child’s development, whether because of current social norms or other factors. However, it’s clear that diagnosis of ADHD must be taken very seriously and certainly not handed out willy-nilly to “misbehaving” children. The treatment of an accurately diagnosed child must also be taken in a serious light, with all avenues of behavioural and dietary treatments exhausted before resorting to the use of prescribed medication.
- Krill Oil Omega-3
- or Omega-3 Double Strength™
- or Omega-All™
- or Fish Oil (Extract) Omega-3
- or Sol-Oil Omega 3 & 6
- or Flaxseed Oil Omega-3
- Magnesium Glycinate
- Probiotic -Maximum Potency
- Iron Plus™ (if deficient)
PLEASE NOTE: Products are ranked in decreasing order of potency. Products listed nearer the top of any particular health need are the most effective and have the most scientific research to support their use in respect of such health need. Multiple products, one from each bullet (•) can be combined with products from other bullets for added effectiveness, if needed, since products from different bulleted lines have different mechanisms of action. However, where more than one product is listed within a particular bullet (•), then only one of these products should be used, since all products listed within the same bullet share an identical or similar pharmacology (mechanism of action) for that condition. This is because whenever a particular condition is treated via multiple different mechanisms of action, the result is generally improved effectiveness. However, when products are combined that work via exactly the same mechanism of action, then no extra benefit is obtained.