ADHD (Attention Deficit Hyperactivity Disorder) and ADD (Attention Deficit Disorder) are complex. Misdiagnosis in ADHD related cases is very common. Where there are similar symptoms with other conditions/disorders these are termed "comorbid." Many of these so called comorbidities are the other condition and not ADHD at all. There is no one-size-fits-all solution to ADD and ADHD.
While there seems to be an ADHD epidemic, this may be caused by a misdiagnosis epidemic and defining what is considered normal, with an arbitrary boundary.
Many successful alternative ADHD treatments actually treat the cause, meaning that an ADHD disorder was not there in the first place. There is no single cause for ADHD, research on a neurological disorder is really studying and presenting symptoms.
Anyone who is diagnosed as having ADD or ADHD, should be screened for other conditions. Even the DSM-IV has a caveat at the end of the list of diagnostic criteria: “The symptoms are not better accounted for by another mental disorder.”
Many mental disorders have overlapping diagnostic criteria. For example, it is common for people with ADHD or ADD symptoms to be depressed and suffer from anxiety. Anxiety can cause the child to behave hyperactively (ADHD) and depression can be interpreted as inattentiveness (ADD).
The causes are listed in no specific order or categorising. The purpose with this list, which is not definitive, is to encourage the search for the cause, instead of treating the symptom. All these conditions can result in ADHD like symptoms.
There is no ONE cure for ADD and ADHD. There is no ONE cause for ADHD and ADD. Every child and adult is unique. Our metabolisms differ from person to person. Even identical twins, after being exposed to different environments and different experiences, are not the same.
ADHD, Hyperkinetic Syndrome and ADD are controversial conditions. This means that we should deal with it responsibly and with an open mind.
This is list of some disorders, emotional traumas, medical conditions and other conditions, which have signs and symptoms similar to ADHD (Attention Deficit Hyperactivity Disorder), to show how complex ADHD is. Among the causes of ADHD like behavior are:
1. Learning disabilities. The behavior is a result of the child's frustration at not understanding what the rest of the class understands, their difficulty not being understood by the teacher, and as a consequence a low self-esteem. Examples are:
2. Communication difficulties, speech and language disorders. Unable to express themselves verbally. Lack of a vocabulary to describe feeling. Many times being able to put a name to a feeling gives a sense of being in control. The behavior is a result of the child's inability to express him or her self.
3) An inner ear infection.
4.Auditory Processing Disorder (APD). This is a term for a range of problems with the brain that can interfere with processing auditory information. It is not a hearing disability, but a problem processing sound.
5. Sensory Integration Dysfunction. The inability of the brain to correctly process information brought in by the senses. These children are over-sensitive or under-sensitive dealing in touch, taste, smell, sound, or sight.
6. Eyesight problems. One example is Convergence Insufficiency.
7. Education not meeting special learning style needs in some pupils. There are seven learning styles and many personality types..
8. Tactile or kinetic learner. The child needs to move and use his/her body to learn. “Hands on” learning.
8. Auditory Learner. Has difficulty comprehending and becomes frustrated if most of the information the teacher gives in class is through writing on the board.
9. Visual learner. ADHD behavior resulting from frustration at not understanding a teacher who is only lecturing.
10. A lateral thinker. These children think in a different way than “normal” children do. They look at problems and will see answers that are not obvious. This child may appear distracted or daydreaming.
11. A visual thinker. Visual and spacial thinkers are good at abstract reasoning and problem solving, but are relatively weak in processing and sequencing auditory information.
12. The gifted child or highly intelligent child. The child is bored, under-stimulated and misunderstood at school.
13. A creative mind. Daydreaming (introvert) or hyperactive (extrovert) to stimulate in an under-stimulating school environment.
14. An overly extrovert or overly introvert personality. There are many personality types.
15. Viral or bacterial infections
16. PANDAS. A cuddly acronym for Paediatric autoimmune neuropsychiatric disorders. Result of strep or Streptococcal infections.
17) Candida Albicans infestation (Yeast Infection). The symptoms are varied and include headaches, inability to concentrate, depression, mood swing, hyperactivity etc. These symptoms often overlap those of food allergies.
18. Hypoglycemia (low blood sugar). This can give ADD like symptoms.
19. Hyperglycemia (high blood sugar). This can give ADHD like symptoms.
20. Metabolic disorders causing lack of glucose to the brain. This includes early onset diabetes. The symptoms include anxiety, aggressive behavior and depression.
21. Hypothyroidism a metabolism imbalance from an underproduction of thyroid hormones. This can give ADD like symptoms.
22. Hyperthyroidism a metabolism imbalance from an overproduction of thyroid hormones. This can give ADHD like symptoms.
23. Heart conditions. This has an effect of starving the brain of oxygen, glucose and other nutrients.
24. Medication side effects. Some cough and cold over-the-counter medicines contain pseudoephedrine which can cause hyperactivity. Pain killers and asthma medication can also cause ADHD like symptoms.
25. Cushing’s disease or hypercorticism, an overproduction of cortisol. It is a hormone disorder caused by high levels of cortisol in the blood. The cure is usually by surgery as it can be caused by tumours producing cortisol. Taking ADHD stimulant drugs in this case will only do harm.
26. Addison’s disease or hypocorticism, an underproduction of cortisol. This is a rare endocrine disorder where the adrenal glands produce insufficient cortisol, generally diagnosed by blood tests. Treatment involves hormone replacement and definitely not ADHD stimulant drugs.
27. Generalized Anxiety Disorder (GAD).
29. Sleeping disorders. Sleep-disordered children are hyperactive. An example isSleep apnea. A disorder where the sufferer stops breathing many times during their sleep. This causes a bad quality sleep.
30. Child-like Bi-Polar disorder. Early-Onset Bi-polar should be ruled out before ADHD, as ADHD medication can make the child-like bipolar disorder psychotic. The symptoms are similar to ADHD, with impulsivity, restlessness, distractibility and hyperactivity among other symptoms.
32. Emotional abuse.
34. Mild psychosis.
35. Post Traumatic Stress Syndrome or Post Traumatic Stress Disorder (PTSD). This condition can share symptoms of ADD like poor impulse control and concentration difficulties.
36. Death in the family.
37. Life stresses such as the parents divorce, moving to a new town or country.
38. Low self esteem.
39. Sexual abuse when young.
40. Emotional difficulties.
41. Neglect by parents.
42. Bullying at school.
43. Lack of rules at home. Lack of discipline at home.
44. Lack of rules and discipline at school.
45. Feelings of rejection.
46. Over stimulation sitting in front of the TV and playing videogames together with lack of physical excercise. A Canadian study showed that for each hour TV more per day a toddler viewd raised the risk of developing ADHD by 10%.
47) Lack of exercise.
48) Bad diet. Skipping breakfast. Malnutrition.
50) Conduct disorder (CO). There are indications that this is different than ADHD. The mechanisms causing ADHD and CO are different; the similarities are a result of overlapping sets of criteria.
51. Turner syndrome or gonadal dysgenesis.
52. Jacob's Syndrome also called XYY syndrome, is a rare chromosomal disorder that affects males. It is caused by the presence of an extra Y chromosome. Males normally have one X and one Y chromosome. Males with Jacob's syndrome have one X and two Y chromosomes. The extra Y chromosome has been associated with antisocial behavior and Conduct Disorder.
53. Tuberous sclerosis complex (TSC). TSC is a genetic disorder with tuber-like growths in the brain and other organs to varying degrees of severity.
54. Tourette syndrome. Some of the symptoms are similar to the impulsive form of ADHD.
55. Angelman syndrome.
56. Phenylketonuria (PKU). People born with phenylketonuria, are alergic to aspartame, the sugar substitute food and drink sweetener.
57. Williams Syndrome.
58. Fragile X syndrome.
59. Klinefelter syndrom. Probably the most common genetic disorder in which a male has an extra X chromosome (XXY).
60. Sickle cell anaemia.
61. Cysts in the brain.
62. Brain tumour.
63. Brain trauma.
64. Post-concussion syndrome. Mild cases of brain trauma, but with no physical evidence. Child may feel confused and frustrated and act in a hyperactive manner.
65. Minimal brain damages from birth trauma and low oxygen levels at birth.
67. Absence seizures. Can be misdiagnosed as the daydreaming, inattentive form of ADD.
68. Post-traumatic sub-clinical seizure disorder.
69. Low birth weight. Under 1.5 kg or 3.3 lbs
70. Spinal Problems. Some spinal problems can cause ADHD like symptoms because if the spine is not connected to the brain properly nerves from the spinal cord can give the brain all of signals at once making a child rambunctious and always on the go.
71. Fetal alcohol syndrome (FAS). The damage done to a child's brain when the mother drinks alcohol during pregnancy. Fetal Alcohol Syndrome is the biggest cause of non-genetic mental handicap in the western world and the only one that is 100% preventable.
72. Worms. This usually a problem in preschool and kindergarten children.
73. The mother smoking cigarettes during pregnancy.
74. Stimulants, e.g. caffeine in the diet. In some children caffeine causes hyperactivity, while in others it can act as a mild stimulant to treat hyperactivity, instead of powerful drugs such as Ritalin. We all have different metabolisms. The different causes of ADHD have different mechanisms.
75. Substance abuse.
76. Anaemia. Iron supplements may help. A study found serum iron levels were abnormal in 84% of children with ADHD and 18% of controls.
77. B vitamin deficiencies. Especially B-6. Vitamin B-6 is important for neurotransmitters, which affect behavior. The Recommended Dietary Allowance (RDA) figures are an average requirement for an average person, below which a deficiency complications develop. Stress and other factors in an individuals environment determine the lower threshold, not a statistical variable. Some people might need more. We have different metabolisms.
78. Omega 3 fatty acid deficiency. This is an essential fatty acids found in fish sardines, mackerel, tuna and salmon. Vegetarian sources are Soya, hemp, flax and pumpkin seeds. The omega-3 family, play essential roles in the maintenance of energy balance and glucose metabolism.
79. Magnesium deficiency. Studies have shown that children with ADHD are deficient in magnesium.
80. zinc deficiency.
81. Food preservatives. e.g. sodium benzoate (E211).
82. Food dye allergy. Among suspect food dyes found in sweets and soft drinks are:
83. Aspartame allergy. People with who have Phenylketonuria (PKU), cannot metabolize the phenylalanine (a breakdown product of aspertame), which may result in toxic levels in the body. There are 92 reported symptoms of aspartame allergy including depression and anxiety attacks, both of which cause ADD or ADHD symptoms in children. This is controvertial, as people who suffer from aspartame allergy have different symptoms, making diagnosis very difficult.
84. Gluten allergy or coeliac disease.
85. Casein allergy.
86. Specific dust, such as from dust mites.
87. Chocolate allergy.
89. Mould allergy.
90) Monosodium Glutamate (MSG). Attention deficit is one of many symptoms of MSG. Some people experience reactions and others do not. It is not know if monosodium glutamate causes the condition underlying the reaction, or whether the underlying condition is simply aggravated by the monosodium glutamate.
91. Milk allergy. Milk is presented as the perfect food. Milk allergy is implicated in many different disorders, including behavioural disorders. and often goes unnoticed for years since milk is so common in our society.
92. Sniffing solvents like modelling glue, fingernail polish, permanent markers and gasoline fumes.
93. Pesticide poisoning. Both herbicides and insecticides.
94. Household chemicals, such as air fresheners, polish, disinfectants.
95. carbon dioxide (CO2) poisoning.
96. Vitamin overdose
97. Lead poisoning. Children who live in old buildings in which there is still lead plumbing or lead paint may be at risk.
98. Mercury poisoning.
99. Manganese poisoning.
100. Aluminium poisoning.
101) A normal, lively, healthy child, possibly under-stimulated at school. The DSM-IV criteria are based on teachers' and parents' perceptions of how a child should behave.
This list is intended to show the complexity of diagnosing attention deficit syndrome. A good child psychologist who has experience with treating ADHD children should be consulted before any medicinal treatment is tried. A doctor should be consulted for screening for possible physiological causes of the behaviour.
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