May 10th 2010
An alternative ADHD treatment focusing on the cause of the ADHD behavior is a healthy approach to the problem. The person with ADD or ADHD behavior and their families, are the ones who live with the consequences of the chosen treatment.
The choice of taking ADHD medication, a natural ADHD remedy or some other ADHD treatment without medication needs to be done together with a competent health professional. Unfortunately, many doctors naively believe the marketing mantras from the big pharmaceutical companies, without studying the subject. Therefore the first step is to choose a physician who is aware of the need of screening for the cause of the ADD behavior and is aware of healthy alternative ADHD therapies.
Understanding Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) is possible for a normal person with a child or spouse showing ADD or ADHD type behaviour. A professionally minded physician or psychologist is there to support and guide a person through the minefield of confusion ADHD research has created.
If a physician is competent in their subject they can speak using normal vocabulary. If a physician or psychologist has to revert to psychobabble, it indicates the knowledge of the subject is still theoretical and abstract in that doctor's mind. It is “book knowledge” as opposed to practical hands on competence which is necessary in helping an ADHD person.
Confidence is needed to stand one's ground. It is worth remembering that the industrial revolution happened through of normal industrious working people, the craftsmen and inventors. It was not a product of university educated people. We need to have confidence in ourselves, and not be intimidated by diplomas.
There are good physicians and not so good physicians. When we ask advice in areas where there is such controversy as on the subject of ADD and ADHD. We need to use common sense and not trust the first advice we get. There is too much at stake.
The professional’s education is a broad-based education attempting to give the student a broad overview of the subject. Specialisation and depth in few fields come at a later stage, and each individual studies a narrow field there. ADHD or ADD specialization is not necessarily in a doctor’s CV. Therefore it is possible for a reasonably educated person to have more knowledge of a subject than a professional, especially if there is a motivational stimulus involved, such as helping one’s child or spouse.
The doctor being consulted might have studied ADHD at medical school. The subject was passed many years before. A course over two months, or three hours a week for a semester, and based on one or two books, gives a limited insight into a complex subject. If the books were biased towards ADHD and ADD medication, and pharmaceutical companies hosted the subsequent seminars on ADHD the doctor has attended, then the physician will, by default, be ignorant on the subject. However, since the doctor does not know that he does not know, he is under the delusion that he is competent in the field of ADHD, even knowing the “latest research.” Even what is considered “latest research” can be biased and needs to be carefully evaluated.
As an example of evaluation, a research paper's abstract starts as follows: “Attention deficit hyperactivity disorder (ADHD) is a common childhood-onset neurodevelopmental disorder.”
Where does the “childhood onset” idea come from? In the first opening sentence two assumptions without ANY scientific base has been made. The “childhood onset” was an arbitrary decision. The manual defining ADHD as a disorder, DSM-IV-TR, (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision) clearly states on page 88 that there is no neurological diagnosis for ADHD.
Much research is based on the unsubstantiated presupposition that ADHD is a disorder. ADHD is a behavioural symptom with many causes and not a disorder as in sickness. There might be a disorder which causes the behavior, such as autism or sleep apnea. ADHD is symptoms, not a disorder with NO physiological diagnosis. Prolonged Ritalin use may cause physiological and neurological changes, but that is the result of medication and not the condition ADD or ADHD.
This is where the “brain damage” hypothesis comes from; the study of ADHD children who have been on ADHD medication for a period of time, have been compared to “normal” children who have never been medicated.
Research is not published as absolute fact, but one of its purposes is to allow other researchers in the particular field to evaluate what the authors have concluded. There is evidence that there is systematic under reporting in pharmaceutical companies drug trials, especially antidepressant trials.
A physician might tell a questioning parent that there is no evidence food dyes cause ADHD symptoms. The physician is naively repeating information given at some seminar. Firstly, stating that there is no evidence shows an ignorance of the subject, as this has been shown to be the cause in many ADHD cases. The food additives or food dye ADHD connection has been shown to be one cause of ADHD behavior. That does not mean everyone reacts that way, but for those children who are sensitive, food dyes cause an ADHD reaction.
The statistics are said to not show a statistically significant difference. The same “statistical insignificance” in found in antidepressant trials, but there it is defended to justify putting the drug on the market. In the one case the statistics are accepted and in the other case rejected. Both times they are in the pharmaceutical companies favour.
If, for example, if in a trial 100 patients with depression are given a placebo, and 100 patients are given the active antidepressant. The results show an improvement in 30 patients who received the placebo, and in 50 patients who received the active antidepressant pills.
The results are given by the drug company as 50 % improved with the antidepressant. But 30% were actually placebo, leaving only 20% of the patients being helped by the antidepressant. This is known as the placebo effect.
A concerned parent, in contrast, starting out in ignorance (which is a good place to start) reading half a dozen or more books from different viewpoints over a year, has a far better understanding of the ADD and ADHD condition. That parent has a vested interest in the knowledge. That parent can continue an in-depth study reading scientific publications in university libraries, and be competent in the field of ADHD/ADD.
The physician and psychologist has not gained knowledge in an objective and neutral manner. They have been presented a biased set of information based on their particular institution's leanings. The lay person coming to the subject is initially confused by conflicting opinions, but can approach the subject in an objective and neutral manner as the lay person is not being force fed a certain opinion.
Although this is difficult, it is not an impossible task. There is not the need to understand all peripheral subjects in depth. Unfortunately the medical profession is, generally speaking, rather insecure on this point. Other professions, such as engineering, do not suffer this pathological insecurity. An engineer does not feel threatened by a knowledgeable layman understanding structural and mathematical concepts, questioning construction methods.
Maybe the Hypocritic Oath is partly to blame. It does say that those taking the oath must keep their secrets to themselves and not let outsiders into those secrets.
In these modern times university libraries are usually open to the public.
For some, a minority of individuals who exhibit ADHD or ADD behavior patterns, medication is the best solution. But medication should be a final solution when all else has been tried. Since medication is not a cure, and in fact creates a dependence on the drug, alternative methods should still be tried to deal the cause, or learn coping skills. Medication can also be used for a limited time, as a “crutch,” while other long lasting therapies are used to treat the child, such as Cognitive Behavioural Therapy, or learning coping skill strategies.
The creative, and gifted child who behaves in an ADD or ADHD manner needs coaching in coping skills, not a strong drug.
To give medication as a first and only option, is from the physician's side naivety (believing without question all they are told by someone senior to them), ignorance (not being open to new ideas), laziness (in not verifying information given), or plain irresponsibly sloppy.
Parents listening to a “medications only” doctor may be so relieved to get a break that they cannot think straight. Assuming it is the doctor's responsibility does not save the ADHD child being medicated from the side effects of the drugs.
Two physicians can undergo the same education; one will blindly follow his prescribed text books and lecturers, while the other will think and attempt to find the best solution for the patient.
Research in the field of Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder, is confusing as there are many confliction solutions. This is because the Attention Deficit syndromes ADD and ADHD have many causes and co-morbidities and therefore alternative treatments or alternative methods of dealing with ADHD behavior patterns should be a first choice.