ADHD, are medications the only way?
ADHD is often misunderstood. Kids with ADHD get labeled as hyper-active, class clowns, disobedient, or space-cadets. The stereotypes are often unfair, misguided, and often lead to shame and low self-esteem in the children with the condition. So if ADHD isn’t just a behavior problem, what is it? ADHD is a neurodevelopment disorder- meaning it is a condition in which the development of the central nervous system is disturbed. The brain itself is affected in ADHD- in development of specific areas. Brains of those with ADHD mature at a slower rate than typical brains, primarily in the pre-frontal cortex which is an area of the brain that controls all of our cognitive processes such as making decisions, motor planning, social expression, focus, attention, and learning. The condition affects millions of children with 11% of children in the U.S. having an official diagnosis. And although it once thought to only affect children but has shown to have lasting effects into adulthood for 66% of those diagnosed.
ADHD has a multitude of symptoms and can even look different between boys and girls. Some symptoms include carelessness, distraction, losing items constantly, hyper-activity, inattention, distractability, excessive energy/talking, interrupting, trouble focusing or staying on task, fidgeting, impulsiveness, missing social cues or not fitting in, being on the outside of peer groups, in addition, many with ADHD are also high intelligent and creative. Often times, symptoms appear when children reach school-age as it becomes increasingly difficult to stay focused at school, fit in with friends, stay seated in class, etc. Because learning disabilities can coincide with ADHD, having trouble with school work- such as reading or writing- may also appear during this time. There are many causes of ADHD. As mentioned above, the brain itself matures differently than typical brains. There is also issues with certain neurotransmitters in the brain particularly dopamine. Other risk factors can include maternal smoking during pregnancy, pre-term birth, and family history of the condition, and various nutrient factors including omega 3 fatty acids and gut health.
Conventional treatment for ADHD primarily includes stimulant pharmaceuticals. Although these medications have been shown to improve symptoms of ADHD in many kids, as many as 35% of those with ADHD do not respond to medications at all. Besides this fact, medications carry with them many side effects - such as problems sleeping, decreased appetite, delayed growth, stomachaches, headaches, rebound effects (when coming down from medication), tics, moodiness and irritability. So, what if daily medication is not what you want for your child? There are many dietary and lifestyle factors that have shown improvement in ADHD symptoms.
Diet:
Researchers have explored the fact that diet plays a role on symptoms of hyperactivity/inattention. Food additives, refined sugars, food allergies, and mineral and fatty acid metabolism all are potential players in ADHD.
-The Feingold Diet is an example of a successful dietary plan that shows positive results for children with ADHD by removing all artificial colors, dyes, preservatives from the diet. The GAPS (Gut & Psychology Syndrome) diet, although not studied as significantly, works to heal the gut and detoxify the person and restore brain function through fermented foods, probiotics, and whole, organic foods.
-Food intolerances and sensitivities have been scientifically proven to manifest as or exacerbate symptoms of ADHD. Eliminating major allergens should be considered. Some can include gluten, casein (dairy), caffeine, chocolate, sugar, preservatives, and MSG. Research shows that more than 50% of kids with ADHD show improvement in behavior and sleep when on a diet that restricts many of these major allergens.
-Magnesium plays a vital role in neuron function and in the formation of neurotransmitters. Deficiency is common and supplementation helps to protect neurons from excessive excitability and help kids taking stimulant medication.
-Iron is responsible for the dopamine system in the body and treatment of deficiency showed improvement in inattention. Kids low in iron can also display restless leg syndrome and trouble sleeping.
-B vitamins relax the nervous system and help with mental function. ADHD can be associated with B deficiencies.
-Zinc plays a role in hormones, neurotransmitters, nutrients, immune function and structure and function of the brain. When deficient, symptoms can affect attention, motor activity, cognition and behavior.
-Vitamin D deficiency is common in children with ADHD and is incredibly important in maintaining a healthy immune system.
-Omega 3 fatty acids seem to have the greatest impact on the condition. Kids with ADHD have shown to have lower amounts of fatty acids than typical even when consumption was equal. This suggests that there may be a dysfunction in fatty metabolism in people with ADHD. Omega 3s are essential in brain function and central nervous system development. Supplementation and increasing omega 3 rich foods, such as fatty fish, chia seeds, or walnuts, shows significant improvement in all symptoms of ADHD.
Gut Health:
ADHD is also associated with dysfunction in the gut. The gut microbiota contains 100 trillion microorganisms and it regulates both intestinal health and the majority of immune function. The microbiota influences nearly everything in our body including digestion, growth and development, and emotions to name a few. The gut and brain communicate and disruptions in the balance of bacteria in the microbiota can result in many conditions, including ADHD. Disruptions can occur through stress, infections, improper diet or food sensitivities, antibiotic use, to name a few. Re-balancing the gut microbiota is a key factor in improving symptoms of ADHD.
Other supplements that are useful include Ginkgo Biloba, Pyconygenol, and probiotics.
Lifestyle:
In addition to nutrition therapies, lifestyle modifications help immensely.
-Getting outside into nature, increasing physical activity, healthy sleep habits and limiting screen times all positively impact ADHD.
-Neurofeedback is a studied technology that has high rates of success. During neurofeedback, the brain is monitored through EEG and the brain is trained with a positive reward system. Over the course of time, the brain begins to correct its wave patterns to the correct wave patterns. EEG studies have shown that children with ADHD have excess slow wave activity and abnormal spike and wave activity. Research has shown neurofeedback to have significant improvement in ADHD- primarily inattentive types.
-Behavioral and occupational therapy, regular schedules and routines and support for family members, including parents, are also ways to improve symptoms of ADHD.
The options for treatment are vast. Because we know that no single thing causes ADHD, it is important to provide a holistic approach to figure out what will work for your individual child. It is important to remember that THERE ARE OTHER OPTIONS than medication.
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Comment below any strategies or therapies that you have found helpful in dealing with ADHD... What worked or didn't?
References:
Center for Disease Control. (2016). Children with ADHD. Retrieved from: https://www.cdc.gov/ncbddd/adhd/data.html Curatolo, P., D’Agati, E., & Moavero, R. (2010). The neurobiological basis of ADHD. Italian Journal of Pediatrics, 36, 79. https://doi.org/10.1186/1824-7288-36-79 Schmidt, S., & Petermann, F. (2009). Developmental psychopathology: Attention Deficit Hyperactivity Disorder (ADHD). BMC Psychiatry, 9, 58. https://doi.org/10.1186/1471-244X-9-58 Esparham, A., Evans, R. G., Wagner, L. E., & Drisko, J. A. (2014). Pediatric Integrative Medicine Approaches to Attention Deficit Hyperactivity Disorder (ADHD). Children, 1(2), 186–207. https://doi.org/10.3390/children1020186 Colter, A. L., Cutler, C., & Meckling, K. A. (2008). Fatty acid status and behavioural symptoms of Attention Deficit Hyperactivity Disorder in adolescents: A case-control study. Nutrition Journal, 7, 8. https://doi.org/10.1186/1475-2891-7-8 Kanarek, R. B. (2011). Artificial food dyes and attention deficit hyperactivity disorder. Nutrition Reviews, 69(7), 385–391. https://doi.org/10.1111/j.1753-4887.2011.00385.x Königs, A., & Kiliaan, A. J. (2016). Critical appraisal of omega-3 fatty acids in attention- deficit/hyperactivity disorder treatment. Neuropsychiatric Disease and Treatment, 12, 1869–1882. https://doi.org/10.2147/NDT.S68652 Soto-Insuga, V., Calleja, M. L., Prados, M., Castaño, C., Losada, R., & Ruiz-Falcó, M. L. (2013). [Role of iron in the treatment of attention deficit-hyperactivity disorder]. Anales De Pediatria (Barcelona, Spain: 2003), 79(4), 230–235. https://doi.org/10.1016/j.anpedi.2013.02.008 Gevensleben, H., Holl, B., Albrecht, B., Vogel, C., Schlamp, D., Kratz, O., ... Heinrich, H. (2009). Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial. Journal of Child Psychology & Psychiatry, 50(7), 780–789. https://doi.org/10.1111/j.1469-7610.2008.02033.x Loo, S. K., & Barkley, R. A. (2005). Clinical Utility of EEG in Attention Deficit Hyperactivity Disorder. Applied Neuropsychology, 12(2), 64–76. https://doi.org/10.1207/s15324826an1202_2 Cerrillo-Urbina, A. J., García-Hermoso, A., Sánchez-López, M., Pardo-Guijarro, M. J., Santos Gómez, J. L., & Martínez-Vizcaíno, V. (2015). The effects of physical exercise in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis of randomized control trials. Child: Care, Health & Development, 41(6), 779–788. https://doi.org/10.1111/cch.12255 Peppers, K. H., Eisbach, S., Atkins, S., Poole, J. M., & Derouin, A. (2016). An Intervention to Promote Sleep and Reduce ADHD Symptoms. Journal Of Pediatric Health Care: Official Publication Of National Association Of Pediatric Nurse Associates & Practitioners, 30(6), e43–e48. https://doi.org/10.1016/j.pedhc.2016.07.008 Kuo, F. E., & Faber Taylor, A. (2004). A Potential Natural Treatment for Attention- Deficit/Hyperactivity Disorder: Evidence From a National Study. American Journal of Public Health, 94(9), 1580–1586.
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