Conditions

Attention Deficit Hyperactivity Disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD), or attention deficit disorder (ADD) with hyperactivity, is a condition that affects the central nervous system. Currently, the most accepted definitions are that ADD should be used when referring to the inattentive form without hyperactivity and ADHD should be used for hyperactive-impulse and the combined form (inattentive/hyperactive-impulse).

This disorder mostly effects children; however, it can continue into adulthood. Also, boys are ten times more likely than girls to be diagnosed with ADD or ADHD.

It's still unclear as to what causes ADD or ADHD. Some doctors believe that diet figures prominently into the disease while others feel it is strictly brain chemistry. Other possible contributing factors are heredity, anxiety, allergies, smoking during pregnancy, hyperinsulinemia, oxygen deprivation at birth, environmental stress or pollutants, artificial food additives, injury, infection, lead poisoning, allergies, and prenatal trauma.

Signs and Symptoms:

One, or a combination, of some of the following may characterize ADHD/ADD. Any of these symptoms can be present in a person with ADD either with or without hyperactivity.

Symptoms of ADD:

• Difficulty solving problems or managing time
• Extreme distractibility
• Procrastination
• Forgetfulness; a tendency to lose things frequently
• Disorders of speech and hearing
• Difficulty in organizing or finishing tasks
• Absentmindedness; inability to remember sequences or events
• Sloppy and/or impulsively done schoolwork that contains obvious mistakes
• Lack of concentration
• Continuous "brain chatter"
• Learning disabilities
• Emotional instability; daily or hourly mood swings
• Sleep disturbances
• Lack of goals
• In adulthood, failure in career or relationships

Symptoms of ADHD:

• Problems adapting to new things
• A tendency to disturb other children
• Self-destructive behavior
• Difficulty doing assignments or chores on one's own
• Temper tantrums
• Impatience; difficulty in waiting
• Low tolerance for stress and otherwise ordinary problems.
• A tendency to become frustrated quickly
• Inability to sit still for any length of time
• Impulsive, unpredictable or daring behavior
• Clumsiness or awkwardness
• A tendency to talk too much
• Disruptiveness in the classroom
• A tendency to blurt out answers without having heard the entire question
• Failure in school despite average or above-average intelligence

Diagnosis:

The doctor will look for the above symptoms and check for symptoms of other physical and mental ailments. He or she will also ask you for a complete nutritional history including the amounts of caffeine stimulants, sugar, and preservatives that your child/you consume.

The doctor may also order the following lab tests: hair analysis (to eliminate heavy metal toxicity), five-hour fasting glucose tolerance tests (to rule out a connection to poor carbohydrate metabolism), thyroid function studies (to rule out hyperthyroidism), scratch test for food allergies (and for sensitivity to wheat gluten, lactose, or red dye).

The doctor may also want to check for low levels of dopamine or MHPG (which breaks down norepinephrine) and differences in brain structure.

Imaging is not required for diagnosis but may be asked for in certain cases. These tests can include PET scans (to determine brain metabolism/activity) and MRI (to view brain structure).

Your doctor will require an extensive, detailed history from parents, teachers, baby-sitters, or grandparents. He or she may also want to observe your child's behavior in a comfortable environment. The doctor may also ask to review report cards for comments pertaining to inattention, hyperactivity, and disruptive behavior.

Finally, the doctor may wish to perform the following psychological tests:

In adults:

• Wechsler Intelligence Test to measure IQ
• Conners' Continuous Performance Test
• Rey-Osterrieth Complex Figure Test (to measure neuropsychological functioning)

In children:

• Conners' Parent and Teacher Rating Scales
• McLean Test to measure both attention and body movement

Treatment Options:

Treatment generally involves medication and behavioral therapy. It's highly recommended that parents and schools work together to help in treatment.

Traditional Treatments:

• Ritalin (methylphenidate) has been the subject of widespread controversy. However, drug therapy may be the only viable alternative in severe cases.
• Methylphenidate or dextroamphetamine (dexedrine) are sometimes used in extreme cases.
• Stimulants (amphetamines or methylphenidate), ironically, can be used to treat hyperactivity.
• Lately, diet control has become the focus of ADD and ADHD therapies.
• Your doctor may refer you to a child psychologist to help with behavior therapy and counseling.

Complementary and Alternative Therapies:

Alternative therapies are offering a more viable option as doctors are discovering the important role nutrition plays in ADD and ADHD.

Nutritional Supplementation:

The following supplements have been shown to be beneficial. Be sure to discuss any supplements with your doctor before giving them to your child.

• Mineral supplements ­ children with ADD can suffer from a variety of mineral deficiencies. Make sure to get a good, powerful organic-based supplement with chelated minerals.
• Calcium/Magnesium can help to calm the nervous system and is vital for normal brain function. Use chelated varieties and look for calcium citrate or gluconate.\
• GABA has been shown to help decrease hyperactivity in some studies.
• Vitamin B6 is an extremely important vitamin for normal mental function.
• Gotu Kola can improve the mental abilities of children with ADD due to its anti-anxiety properties.
• Valerian root has been used in Germany to treat a number of childhood behavioral disorders with a high rate of success.
• Quercetin may help prevent allergies from aggravating symptoms.

Alternative Therapies:

• Lemon balm (Melissa officinalis) is a mild sedative that can help treat ADD/ADHD, especially those cases where insomnia is an issue.
• Lavender (Lavandula angustifolia) is a mild sedative that alleviates restlessness.
• Chamomile (Matricaria recutita) can help reduce acute hyperactive episodes and may alleviate any associated muscle tics.
• Passionflower (Passiflora incarnata) can be used to treat nervous gastrointestinal complaints that often accompany ADHD.
• Linden (Tilia cordata) is a mild sedative and antispasmodic herb.
• Catnip (Nepeta cataria) can help calm the nervous system.
• Kava Kava (Piper methysticum) is a well known anti-anxiety herb.
• See a homeopathic specialist for a personalized treatment plan. There are many therapies that can help.
• Try the following essence oils (one at a time) until you find the right aromatherapy regime: jasmine, lavender, myrrh, sandalwood, ylang ylang, frankincense, geranium, neroli, patchouli or bergamot.

General Recommendations:

• Include cold-water fish such as tuna, salmon, and herring in your diet. These are all good sources of docosaheaenoic acid (DHA).
  Avoid food additives, such as BHT, BHA, artificial colors and flavorings, emulsifiers, nitrates, and sulphites might induce hyperactivity in children according to Dr. Feingold's study which came up with 3,000 different food additives that should be studied. In controlled clinical trials, up to 50 percent of hyperactive children improved when their diets were altered by controlling the ingestion of food additives, sugar and eliminating possible food allergens.
• Try an elimination diet to check for food allergens such as: cow's milk, chocolate, grape flavoring, orange flavoring, cane sugar, tomatoes, wheat products, eggs, dairy products, nuts and fish.
• You might also try following a very simple diet and slowly adding in different foods. This way you can eliminate any possible triggers. Some foods to eliminate at the beginning are foods with salicylates (almonds, apples, apricots, cherries, currants, berries, peaches, plums, prunes, tomatoes, cucumbers, and oranges), salt, soda pop, catsup, mustard, soy sauce, cider vinegar, colored cheeses, boxed dinners, lunch meats, hot dogs, smoked meats, ham, wheat, corn, colored butter, margarine, ice cream, candy and perfumes.
• Keep a chart of foods that you consume and any emotional reaction that may be linked with those foods.
• Follow a high-protein diet.
• Do not use antacid tablets, cough drops, perfume, throat lozenges, or commercial toothpaste. Use a natural toothpaste from a health food store or a baking soda paste.
• Limit exposure to television, video and electronic games, and loud music.
• Consider trying cognitive-behavioral therapy.
• If not done in the diagnosis stage ­ have a hair analysis to rule out heavy metal intoxication. Both lead and copper have been linked to behavioral problems.
  

Warnings:

• Do not give nutritional supplements or herbal treatments to children without first consulting your physician.
• Studies are showing that people with ADD/ADHD are at extreme risk for depression, alcoholism, restlessness, difficulties with careers and relationships, and antisocial behavior. If you notice any signs of these conditions, seek counseling immediately.
• A strong link has been established between learning disabilities and juvenile crime. Therefore, it's important to start working with your doctor and school to address these issues as early as possible.