Most of us have heard about ADHD, or attention deficit hyperactivity disorder, in kids. It’s often cited as a major cause of learning and behavior problems at schools. But what most people, including many doctors, don’t realize is that ADHD is also a big problem in adults. In fact, since the condition is estimated to affect 5% of the population, ADHD may well be the single most common chronic unrecognized mental health disorder in the United States.
An adult with the disorder always had it as a kid—sometimes the diagnosis was missed during childhood and the youngster was simply labeled as ‘rambunctious.’ In other situations, a child with known ADHD had his medicine stopped when he reached his teens because he seemed to be less hyperactive. Currently psychiatrists believe this decision to stop medication is a mistake. The teen may appear to have calmed down, but the learning and behavior problems remain throughout life, and it’s during the turbulent adolescent years that the medicine may be needed most. While many experts do feel that ADHD is “over-diagnosed” in children, the opposite appears to be true in adults, in whom the diagnosis is often overlooked.
Unfortunately, the consequences of missing the diagnosis often worsen with time. What began as behavior problems and poor grades in the youngster with ADHD can become repeated job firings and botched relationships in the grown-up years. Careless childhood injuries may forecast irresponsible driving and perhaps a fatal auto accident. The impulsive behavior as a child can develop into criminal activity, unwanted pregnancies and sexually transmitted diseases. And ultimately, a lifetime of repetitive failures may lead to a sense of hopelessness, endless frustration, and serious depression.
At WholeHealthChicago, I present both alternative and conventional choices that may help you to cope with ADHD. Ritalin and other stimulant medications, which are so helpful for many children, can be remarkably effective in adults as well. But in some cases, lifestyle changes, nutritional approaches and other natural therapies may reduce the need or even eliminate the need for medication.
What Is ADHD?
A common neurological disorder in children as well as adults, attention deficit hyperactivity disorder, or ADHD, is characterized by an inability to focus, hyperactivity, impulsivity, and other disruptive behaviors. Also sometimes called simply attention deficit disorder, or ADD, the condition is typically apparent in children by age seven. Because the hyperactivity component of ADHD actually seems to lessen during adolescence, a common myth is that most children will “outgrow” the condition. But it is now recognized that in up to two thirds of cases, ADHD is a lifelong problem that carries over into the adult years. Unfortunately, medications that can effectively treat the disorder are commonly discontinued at a very vulnerable time–during the teen years, when a kid is entering high school or heading off to college and needs all the help he or she can get.
The diagnosis may be particularly hard to make in adults. Psychological evaluations, brain scans or laboratory testing cannot definitely confirm or rule out whether ADHD is present in an individual. Like different people’s height, the disruptive behaviors that define ADHD have different ways of expressing themselves, so it may not be clear-cut that someone actually has the disorder. It’s especially unfortunate that most physicians who treat adults tend to think of ADHD as a pediatric disorder. Because of this, they rarely inquire whether a patient knew he had the condition as a child or even consider asking the pertinent questions that could lead to a diagnosis. To the detriment of everyone— the patient, his family, and society as a whole, the diagnosis ADHD is thus frequently overlooked.
To help determine the presence of ADHD, those with the condition do share certain traits: chronic forgetfulness; an inability to carry out instructions or finish tasks; emotional storms triggered by relatively minor events; talking too much; and becoming easily distracted. Persons with ADHD are just as intelligent as their peers, but find it hard to focus and finish the tasks at hand. They also often have problems with short-term or working memory, although their long-term memory is fine. This means they’re forever forgetting appointments, losing prescriptions, incessantly and unexpectedly changing the subject of a conversation. On the other hand, since long term memory is fine, they can remember details of their childhood quite vividly. Not surprisingly, an adult with ADHD will often develop a relationship with someone who acts as a ‘finisher’ for his numerous ‘unfinished’ projects.
ADHD in Children: According to the National Institute of Mental Health, ADHD is the most common mental health disorder in children, affecting around 4%, or some 5 million, youngsters. Boys are diagnosed with the condition much more often than girls. It may be just as common in girls, but because girls are less likely to exhibit hyperactivity, they may be much less likely to be referred to a health-care professional for evaluation. In fact, hyperactivity need not even be present to make a diagnosis of ADHD at all. In some studies, nearly 20% of kids have been found to have symptoms of the disorder, though many health professionals argue that the condition is over-diagnosed. Interestingly, the U.S. accounts for nearly 90% of the drugs that are prescribed for ADHD, a situation that reflect differences in attitudes among physicians elsewhere in the world. For example, most primary care physicians in Great Britain are strangely skeptical about the existence of ADHD altogether. Americans who move there may experience difficulty convincing a physician to write a prescription for their child’s medication.
ADHD in Adults: Whereas all of us feel overwhelmed, distracted, and scattered from time to time, the estimated 2 to 5 million American men and women with ADHD feel they are fighting a constant battle that often threatens to spin out of control. Everyday tasks such as balancing a checkbook, keeping appointments, and paying bills on time can become a daunting challenge. This is especially true when they find a task not particularly interesting. Not surprisingly, ADHD patients usually function well when confronted with a job they find fascinating. But most will have trouble with tasks requiring several steps to complete. Such tasks require the services of the brain’s “executive” functions: planning, organization, persistence, completion. And this function in particular is impaired in the ADHD patient.
Consequences of ADHD: Far more serious than problems with getting organized are the long term consequences of ADHD in an affected individual. The lifetime impairment that began in childhood as behavioral and school problems can progress to low self esteem, impulsive and potentially dangerous choices, serious accidents, and persistent underachievement. Poor self worth, frustration, depression, and anxiety all may ensue, compounding the problem even further. Social problems that began in childhood continue into adolescence. Having poor social skills, ADHD teens will have fewer friends, and feel isolated as they become excluded from groups for their seemingly thoughtless behavior. Later, they will be adults with poor communicative skills. By being unintuitive about people and situations, they’re often tactless, blurting out things before thinking. With this lack of insight, they appear as individuals “who just don’t seem to get it.” Moreover, it is not unusual for them to “self-medicate” with illicit drug use or alcoholism. They’ll often have a history of repeated mental health consultations, failed marriages and multiple jobs. Long term studies of individuals with untreated ADHD show an unusually high rate of arrest, conviction and jail time
Inattention: Fails to pay close attention to detail, makes a lot of careless mistakes, has difficulty sustaining attention, often appears not to listen
Distractability: Easily distracted by sights and sounds in busy settings, such as the classroom or a crowded store (though may be fine in a quiet doctor’s office), is disorganized, fails to follow through on chores or finish tasks, especially if they require sustained mental effort, loses or forgets things.
Impulsiveness: Talks excessively, blurts out answers to questions before they’ve been completed, has trouble waiting for turn, interrupts others, pinches or hits, has frequent temper tantrums.
Hyperactivity: Fidgets or squirms when seated, runs about or climbs excessively in inappropriate setting, finds to hard to play quietly, spins out of control.
Family History: May have a parent or sibling with ADHD.
Had symptoms of ADHD as children, some of which may persist into adulthood.
Inattention: Can’t concentrate, with thoughts jumping from one task to the next, forgets or misplaces things or misses appointments, has trouble planning or finishing projects, schedules time poorly, appears unmotivated, procrastinates, changes jobs frequently, switches from one project to the next in the middle, unable to get organized or multitask.
Hyperactivity: Feels restless or fidgety or always “on the go,” prone to taking risks and seeks novelty, prefers fast-paced activities and is easily bored, jumps to a new book, project, or relationship when an earlier interest becomes routine.
Impulsiveness: Speaks without thinking first, interrupts and annoys others, is quick to anger and emotional outbursts, is unpredictable, drives recklessly.
Forgetfulness: generally regarded as ‘airheads,’ frequently missing their appointments, losing their prescriptions, unable to carry out instructions
Hypertalkative: others find it difficult to follow the ADHD person’s conversation. (“I’m sorry, but I lost your train of thought”)
Low self-esteem: Avoids new challenges, expects failure, discounts success as an aberration, may appear confident to others but not to self.
Trouble with authority. History of being asked to leave schools, dishonorable service discharge, job firing, arrests
Family history of ADHD: Also a family history of bipolar disorder, substance abuse, Tourette’s Syndrome
What Causes ADHD?
Scientists have myriad theories for the origins of ADHD, but despite intensive research, the cause still remains somewhat murky. It’s likely that many factors contribute to the array of symptoms of ADHD.
Genetics: Genes are thought to play an important role in ADHD, accounting for up to 80% of cases. ADHD also runs in families: If you have a child who has the disorder, there’s a decent chance you may have it yourself. In fact, many times a kid is diagnosed first, before an affected parent or relative puts two and two together and realizes that they, too, have a name for their lifelong problem. As with many conditions, it’s likely that carrying a certain gene or genes makes you susceptible to the disorder and other factors come into play. Conduct problems, anxiety, and addictions may likewise run in these families.
Brain Defects: Irregularities in certain brain chemicals or structures may also play a role in ADHD. Some research suggests that the brains of people with ADHD can’t effectively process glucose, the blood sugar that fuels energy. ADHD sufferers may also have problems processing dopamine or norepinephrine, chemical messengers in the brain called neurotransmitters that foster effective communication between nerve cells. Deficiencies in these chemicals, in fact, may boost the urge for seeking “rewards,” such as those supplied by nicotine, alcohol, or illicit drugs, which may be one reason adults with ADHD are so susceptible to substance abuse and high-risk activities.
Aberrations in brain structures may also be to blame. Brain scans have revealed defects in the right front portion of the brain that acts as the brain’s executive secretary, helping to organize and prioritize and put the brakes on excessive activity. Abnormalities in other areas near the brain’s center may also lead to impulsive behavior.
Nutrition: Some, but not all doctors believe that particular foods and food additives may alter levels of certain brain chemicals and contribute to ADHD. Some research indicates that artificial colorings (especially red, yellow, or green dyes), milk, chocolate, eggs, wheat, and salicylates (an ingredient in aspirin and many fruits, vegetables, and spices) may be culprits. Deficiencies in zinc, certain essential fatty acids (the key components of fats and oils) and certain amino acids (building blocks of protein), may have similar effects on behavior. Anyone who works with children will remark that sugar can contribute to hyperactivity, although clinical studies (especially studies funded by the sugar industry) have not demonstrated a strong connection. Children who are malnourished as infants are also prone to developing ADHD.
Environmental Toxins: Complications during pregnancy or prenatal exposure to alcohol, nicotine, or environmental pollutants such as dioxins or PCBs may also be partly responsible. In addition, accumulation of even minimal amounts of lead in the body, which usually arises when children consume paint chips that are peeling off the walls of old homes, may cause distractibility and troubled thinking typical of ADHD.
The most effective way to diagnose ADHD is to be aware of the signs and symptoms, including disruptive behavior patterns during childhood, that may have persisted into your adult years. Early reports from teachers or parents can be helpful in tracking down the diagnosis.
ADHD can’t be diagnosed by a brain scan or lab test. However, researchers are studying various tests to track down physical or cognitive changes that may help to clarify the diagnosis. For example, investigators have conducted advanced imaging tests such as PET scans, MRIs, and something called SPECT and have noted alterations in brain wave patterns that may suggest a problem. Still, you shouldn’t have to undergo these high-tech tests. They are very expensive and don’t paint a clear picture of what’s going on or what treatments might work for you.
Parents whose child has been diagnosed with ADHD are frequently reluctant to start medications and seek alternative approaches. Considering that most psychiatrists agree that ADHD in children is probably ‘over-diagnosed,’ meaning that there may be a cause other than ADHD for the learning and behavior problem, it does seem reasonable to rule out correctable factors, especially nutritional ones.
Food Sensitivity Testing (Great Smokies Diagnostic Lab) is a simple blood test that looks for antibodies the immune system may be creating to any of 96 commonly eaten foods. Any positive results need to be clinically confirmed. That means, eliminating a ‘culprit’ food or foods should make an apparent change in the patient’s behavior.
Amino Acid Testing (Great Smokies) measures levels of amino acids in either blood or urine. Any abnormalities can be corrected with a ‘made-to-order’ protein powder which is given an a daily basis
·Toxic Metal Levels (Great Smokies) should be considered if there is a possibility of exposure especially to either lead or mercury. If present, these can be easily removed with medications.
·Essential Fatty Acid Profile (Great Smokies) is a blood test that will reveal any imbalances in fats and lipids in the body. Any abnormalities present can usually be corrected with appropriate nutritional supplements
Medications and counseling are the cornerstones of conventional treatment for ADHD. Drugs therapies can produce remarkable improvements in some people and are among the safest prescription medicines around. However, the very best approach to ADHD will combine drugs with behavioral therapies. With a two-pronged approach, school or job performance almost always improves. Depression and anxiety, if present, also often ease.
Stimulant medications such as Ritalin and the amphetamines often provide quick and effective relief from the symptoms of ADHD. Hundred of studies (many done in kids) have confirmed that such drugs are generally safe and effective, though they don’t work for everyone. In some individuals, these stimulant medications may produce unpleasant side effects, such as insomnia, jitteriness and irritability though these are generally mild and temporary. Patients often wonder why a ‘stimulant’ is given to someone for hyperactivity. This is a perfectly reasonable question. The answer is that the ADHD brain is actually ‘sleepy’ and by being in this state, has trouble controlling itself. Not surprisingly then, the commonest brain stimulant, caffeine, can frequently work quite nicely to relieve ADHD symptoms and help an ADHD patient relax and focus his thoughts.
Antidepressants designed to balance the brain’s neurotransmitter levels are considered a second choice for adult ADHD. These can be especially helpful if depression, anxiety or panic attacks co-exist with ADHD
Counseling and behavioral techniques can often be tried before drugs, or are prescribed in addition to medications. In adults, counseling can be especially important for helping you to “unlearn” the disruptive behaviors and poor organizational skills you have carried since childhood and to acquire new ways for coping and improving efficiency.
Drugs that have long been used in children with ADHD are also proving effective for adults with the disorder. You may notice a profound improvement soon after starting on a medication, usually a stimulant such as Ritalin. Generally doctors will start with a low dose and slowly adjust it upward until the patient (or parent) believes the situation is under good control. You may need to try various medicines or combinations to find a regimen that works for you. With the right medications, your concentration and ability to go about your daily tasks can improve dramatically.
Stimulants: The most commonly prescribed stimulant for ADHD is Ritalin (methylphenidate), which appears to work by boosting levels of dopamine in the brain. As an alternative, some people do better on a dextroamphetamine, such as Dexedrine or Adderall, a longer-acting mix of amphetamines.
Newer, long-acting forms of these stimulants that can be taken once a day are now available, and are often the best choice for ADHD patients, both children and adults. These include Ritalin-LA, Concerta, Metadate, and Adderall XR. They are less likely to produce “rebound” effects, in which symptoms return quickly once a dose wears off. These longer acting forms are occasionally supplemented by a shorter acting one, either to help you ‘ramp up’ in the morning, or keep you going in the late afternoon with the longer form is wearing off. Longer acting medications are especially good for ADHD patients because by definition they are disorganized, forgetful and tend to lose things (like their medication).
Another stimulant that may be effective is pemoline (Cylert), which may take several weeks to achieve effectiveness. However, because it can affect your liver, you will need occasional liver tests monitored by your doctor.
Antidepressants: These are second-line medications for ADHD, and may be used in combination with stimulants. They are an especially good choice if you’re also depressed. Among the antidepressants that may be useful are venlafaxine (Effexor) and bupropion (Wellbutrin), which alter levels of the mood-enhancing brain chemicals norepinephrine, dopamine, and serotonin. Tricyclic antidepressants such as imipramine (Tofranil) and amitriptyline (Elavil) may also be beneficial. One recent study reported that lithium, which is commonly used to treat manic depression, may be as effective as Ritalin for adults with ADHD.
Additional Medications: Other medicines are being tested in adults with ADHD. One promising candidate is a new drug called atomoxetine (Strattera), a unique non-stimulant that floods the brain with norepinephrine. Another interesting possibility is the bio-engineered drug modafinil (Provigil), which keeps people awake without causing the buzz and jitteriness typical of stimulants. It is currently used to treat narcolepsy, a disabling condition that causes people to drop off to sleep for brief periods throughout the day.
The blood pressure drugs clonidine (Catapres) and guanfacine (Tenex) are effective for some people, including those who also have Tourette’s syndrome, a mysterious condition that sometimes accompanies ADHD and is characterized by verbal and physical outbursts and tics. Because these drugs also affect the heart, however, they must be used with caution. Other drugs under investigation include the Alzheimer’s drugs donepezil (Aricept) and tacrine (Cognex), and nicotine gums and patches.
Once it is confirmed that you do have ADHD, behavioral therapies are very valuable to help you cope with the condition, though they do require an investment in time and money. Treatments might consist of one-on-one counseling sessions as well as family support and group sessions.
• By focusing on practical ways to change self-defeating thoughts and habits, a form of counseling called cognitive-behavioral therapy restores self-confidence and a sense of organization and control. Studies are under way to test the effectiveness of cognitive-behavioral therapy in adults with ADHD who have been stabilized with medications.
• A more inward-looking approach, psychotherapy can help you better live with the disorder and provide you with a more realistic sense of your abilities and needs. It can also help you to adjust to the life changes that can occur once you begin taking medications for ADHD.
• Other forms of counseling that may be helpful include support groups, where you can share concerns with others who have the same condition; social skills training, which encourages smooth interactions with others and help you to improve efficiency; and family counseling and parenting skills training, which offer tools and techniques of coping to family members. The dictum “pills do not teach skills” is a very important one to remember in the overall treatment of ADHD
The causes of ADHD still remain somewhat poorly understood, and there are no ways to prevent the disorder from occurring in the first place. Nutritionally oriented physicians do have very strong opinions regarding factors that can trigger ADHD-type symptoms in children and recommend to all parents the following:
· Avoid foods with artificial colors, chemicals and preservatives as much as possible
· Make sure your child has a well balanced diet with plenty of fresh fruit and vegetables
· Keep TV watching, videogames and computer time to a minimum
· Avoid foods with sugar and refined white flour
How Supplements Can Help
Various nutritional supplements can help to ease distractibility, hyperactivity, and impulsive behavior. They won’t work for everybody and are not intended as a cure, but they are safe and may be helpful. Effects are not immediate but are usually felt within several weeks. They can be all be taken together as well as with conventional stimulant drugs.
Just a reminder: If you have a serious medical condition or are taking medication, it’s always a good idea to check with your doctor before beginning a supplement program.
Note: The doses and treatments listed are for adults. If you have a child with ADHD, be sure to consult a physician who is experienced in using natural therapies in children.
The following nutritional supplements can be helpful in managing attention deficit hyperactivity disorder.
· The mineral magnesium may help to lessen symptoms of ADHD. One study from Poland, where stimulant drugs are rarely used, reported that many children with ADHD were deficient in magnesium, and that providing the mineral along with other treatments eased hyperactivity and other symptoms. Magnesium is often included in multivitamin formulas.
· Taking a vitamin B complex, which contains a mix of B vitamins along with extra B3 and B6, helps to promote nervous system health. In one small study, extra B6 was more effective than Ritalin at relieving symptoms of ADHD in children. B3, also called niacin, may also help to relieve depression, anxiety, and insomnia.
· Damage from free radicals, oxygen compounds produced during ordinary metabolism, can harm brain, nervous system, and other body tissues. The antioxidant vitamin C, taken with flavonoids, is important for preserving cell health throughout the body.
· Evening primrose oil and borage oil are both rich in GLA (gamma-linolenic acid), a “good” type of fat that promotes nervous system health. Some studies suggests that GLA can be particularly beneficial in those who are deficient in the mineral zinc.
· The nutritional supplement DMAE (dimethylaminoethanol) helps to foster production of brain chemicals essential for healthy mental processing. Taking DMAE may therefore help to improve focus and concentration. Some researchers suggest that DMAE improves short-term, or working, memory, deficits of which have been noted in people with ADHD.
· If depression is contributing to the problem, the herbal pick-me-up St. John’s wort can lift mood. The supplement 5-HTP, which boosts levels of the brain chemical serotonin, may also help to ease symptoms of depression. If anxiety or even panic attacks occur, consider kava or GABA (gamma amino butyric acid). You can use either of these supplements as a nonsedating, non-habit forming mild natural relaxant.
Nutritionally oriented physicians who treat ADHD typically wait to prescribe Ritalin and comparable stimulants until dietary and lifestyle changes have proven ineffective
Dietary changes. So many foods and substances have been shown to enhance hyperactivity that it’s truly worth the effort of at least giving the following dietary elimination program at least a six to eight week trial. If you notice improvement by eliminating certain foods, you can gradually reintroduce certain foods to determine which are the real culprits.
· Look for chemicals. Remove as many additives, artificial colorings, and other chemicals as possible. You will learn to become an expert label reader. After a few days, you’ll be surprised by how many chemicals we routinely ingest.
· Check for hidden food allergies and remove any “positives” from your diet. Some research has reported that behavior improves when likely allergens are restricted.
· Eliminate salicylates, including aspirin and salicylate-rich foods, from your diet. Such foods include some spices (chili powder, cloves, oregano, paprika) and an array of fruits, vegetables, and nuts (apples, grapes, oranges, plums, peaches, all types of berries, tomatoes, bell peppers, almonds, and peanuts). This program, called the Feingold diet, also restricts additives as well as petroleum-based preservatives such as BHA and BHT from the diet. Eliminate such foods for about two weeks, then gradually re-introduce them into your diet to see which may be contributing to behavioral problems.
· Try caffeine. Caffeine acts as a stimulant, like Ritalin, and some nutritionally oriented doctors actually prescribe it in capsule form.
· Cut out white sugar. Many people report a “sugar high” when they ingest sugary foods and drinks such as candy, cakes, sweetened fruit juice, or soda pop.
In addition to dietary changes, a few simple strategies for dealing with everyday issues more effectively may help. Time-tested tips include:
· Break large projects into smaller, simpler tasks, setting deadlines for each part. Create a daily “to do” list, with a schedule for completing each one, and reward yourself when you are done. Write notes to yourself to help you remember.
· Choose quiet settings to work and relax. Limit TV watching and computer games. Instead, listen to music, audiotapes or stories, or old-time radio shows.
· Ask for clarification. If you don’t understand an assignment or task, ask a teacher or your boss to repeat the instructions.
· Try to stay organized, keeping phone numbers and addresses in one place, and other related groups of items (such as CDs or photos) in another.
· Focus on a new activity or sport. Many people with ADHD benefit from activities that limit stimulation, such as tai chi, yoga, or tae kwon do. Learning these kinds of focused exercises helps to teach self-restraint and discipline
Certain alternative therapies can complement the effects of medications and other treatments for ADHD. Some are useful for treating the stress, anxiety, and depression that can accompany the disorder.
Most alternative therapies for ADHD have not been rigorously tested. In the few small studies that do exist, they are often not as effective as stimulant drugs such as Ritalin that are commonly prescribed to treat the disorder. However, just as medications can be used along with behavioral therapies to boost effectiveness, alternative therapies and self-care measures can likewise complement the work of conventional treatments. Use of certain supplements and biofeedback techniques, for example, may allow you to cut back on your Ritalin dosage.
In general, unless otherwise noted, these alternative therapies can be safely used along with drugs or other therapies. In many cases, these complementary and alternative therapies are aimed at what seem to be the root causes of the problem.
· Neurofeedback. A form of biofeedback that measures brain waves is showing promise for the treatment of ADHD. Called neurofeedback or EEG biofeedback, the therapy is used to treat hyperactivity, learning difficulties, and attention problems. Selected children, teens, and adults have experienced significant long-term relief using the technique, and some were even able to stop taking stimulant medications altogether.
During a neurofeedback session, the person sits in front of a computer monitor, with sensory leads wired to the scalp that measure brain wave activity. When the mind becomes calm and focused, the computer program responds with a blip, beep, or other “reward.” In this way, selected patients can train themselves to become attentive. Some studies have shown benefits after only a few sessions, with better attention, less impulsive behaviors and response times, and an increase in IQ. More typically, however, up to 40 to 50 costly sessions are required, and it does not work for everyone.
· Massage. One trial reported that teens with ADHD felt better after receiving daily massage therapy. They fidgeted less and were better able to focus on the tasks at hand. Massage can be done at home and combined with aromatherapy Lavender or Roman chamomile essential oils, added to a carrier base, can be relaxing. A few drops of these oils can also be added to your nighttime bath to promote sleep.
· Homeopathy. Practitioners of homeopathic medicine may recommend various remedies to help relieve symptoms of ADHD. These homeopathic pills and liquids are thought to provide balance and restore focus and concentration. For a chronic condition such as ADHD, you would need to visit an experienced homeopath, who would examine you and take a thorough history before prescribing an individualized remedy.
· Bach flower therapy. Remedies extracted from a number of flowering plants and trees form the basis for Bach flower therapy, a method that aims to heal the emotional problems that are thought to underlie ADHD and many other disorders. A therapist knowledgeable in this technique might, for example, prescribe vervain to quell over-enthusiasm, impatiens to restore calm and patience, or cherry plum to bolster self control. Like many alternative treatments, Bach flower therapy can be used to complement conventional treatments.
· Herbal teas containing chamomile, skullcap, vervain, passion flower, or valerian may have a calming effect.
· Cranial osteopathy. A gentle hands-on therapy, cranial osteopathy has been reported to ease symptoms in some people with ADHD. The technique involves stimulating the flow of nutrient-rich healing fluids through the brain and spinal cord by applying light pressure to the head and other areas of the body. It is similar to craniosacral therapy but is practiced by highly trained osteopathic physicians (D.O.’s) who undergo years of medical training.
· Music, art, or dance therapy. Learning to play an instrument or to draw or dance helps to develop a more balanced sense of self. In one interesting study, boys with ADHD who were coached to keep time to a metronome became less distracted and better able to concentrate and control impulsive behaviors.
When to Call a Doctor
If you feel constantly distracted and overwhelmed and are concerned that you may have ADHD.
If your child has behavior problems at home or school that may indicate possible ADHD. The child should be evaluated thoroughly by a trained health professional before drugs or other treatments are tried.
It’s important to remember that given the complexity of ADHD, using supplements alone, without any lifestyle changes, is not going to be the solution for your ADHD. If you are a parent and want to try some non-pharmacologic therapies for your ADHD child, you’re best bet is to work with a nutritionally oriented physician who can order appropriate tests and individualize pediatric dosages of supplements. If you are an ADHD adult, start the supplements listed below, but do remember all the self-care and dietary suggestions in the Library entry.
How to Take the Supplements
Natural therapies may provide effective relief for the disruptive symptoms of ADHD with few of the side effects of prescription drugs. It may take several weeks to notice any benefits, although some people note improvements almost immediately.
Start with magnesium, B vitamins, vitamin C and flavonoids, GLA, and DMAE, following the dosage schedule in the chart below. To reduce the number of pills, these can be taken at different times in the day. Like almost all supplements, you will reduce the chance of a stomach upset if you take them with food.
Because depression is such a common problem in those with ADHD, St. John’s wort and 5-HTP may be included in your ADHD regimen if you are also feeling depressed. Some experts recommend that the two supplements be taken together, although one or the other can be tried individually. They should not be combined with conventional antidepressants except under your doctor’s supervision. Like most antidepressants, it may take four weeks or longer to feel the mood elevating effects of these supplements.
If anxiety is troublesome, consider either kava or the amino acid GABA (gamma amino butyric acid). Both have a calming effect without sedation.
· Many nutritionally oriented physicians routinely test for levels of various amino acids, the protein building blocks that are essential for the health of your brain and all your organs. If deficiencies are found, your doctor may recommend supplementation with one or several amino acids as part of the nutritional regimen for ADHD.
· These physicians may also test essential fatty acids. Again, abnormalities would be corrected by proper dosing of EFA’s such as the GLA indicated above
We at WholeHealthChicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Supplement Recommendations for ADHD
Magnesium glycinate Two capsules each morning.
Magnesium Glycinate A highly absorbable form of magnesium.
Vitamin C with flavonoids 1000 mg. of C; 500 mg of flavonoids each morning
Vitamin C-1000 Contains 1000 mg of C plus lemon bioflavonoids.
Vitamin B complex Look for a B-100 complex with 100 mcg vitamin B12 and biotin; 400 mcg folic acid; and 100 mg all other B vitamins. This size will provide the extra B-3 and B-6 recommended.
Tri-B Complex High potency balanced formula of the B’s.
DMAE 100 to 300 mg daily, taken orally twice a day.
DMAE 100 mg caps.
GLA Take as either borage or evening primrose oil, 240 mg
twice a day
GLA Forte This is the most potent of the many GLA products available and
Contains 240 mg. of GLA per capsule.
Meta EPO Pure evening primrose oil is 9% GLA.
St. John’s wort 450 mg twice a day with food, if depression is also present.
St. John’s Wort This is the purified freeze-dried form.
5-HTP 50 mg in the morning and 100 mg at bedtime, if depression is also present.
5-HTP Allergy Research is probably the best producers of neurotransmitter
Kava one capsule three times a day for anxiety
Kava Look for a purified freeze dried form. Liver disorders with kava seem to have been caused by an acetone extraction process used in Europe.
GABA one capsule three times a day for anxiety
GABA an important amino acid; the brain’s calming agent.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700, ext. 2001.
David Edelberg, MD