May 10th 2010
ATTENTION DEFICIT DISORDER and ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADD and ADHD)are often treated by ADHD stimulant medication treatment, especially in the USA. The ADD and ADHD diagnoses are controversial. Since the ADHD diagnosis is based only on perceptions of behavior, and no diagnosis exists based on physiological or neurological evidence, the ADHD therapy should be looked for outside of hard drug based ADHD medication treatments.
The second category is alternative ADHD therapy addressing the actual cause of the behavior problem. This therapy is the healthier approach.
ADHD as a genetic disease cannot be a major factor. For a genetic factor to be in a child, it has to be present in a parent, a grand parent, a great grand parent and so on. Genetic factors do not cause epidemics, unless there is a specific sources for the defective genes in one generation, such as an atom bomb on Hiroshima, or masses of bombs with depleted uranium in Iraq.
If it is a genetic cause, then the individuals with ADHD genes emigrated to the United States from Europe, and the ADHD individuals easier were to catch in Africa as slaves. This left an ADHD deficient populations in Europe and Africa, where there is far less prevalence of ADHD.
Cases of ADHD have increased with epidemic proportions over the last 15 years, especially in the United States. The question to ask is if there is an ADHD epidemic, or if there is a diagnosis epidemic.
There are numerous other conditions which mimic ADHD and ADD in their symptoms. These othercauses of ADHD like behaviour need to be screened before the diagnosis ADHD is considered.
ADHD was not a major problem thirty or forty years ago. Figures with a wide range are now given, such as 3% to 20% of the children in the United States have ADHD. Those figures are not precise. An explanation could be that the ADHD epidemic is spreading faster than the statistics are able to keep up. According to Science Daily, in 2002 the figure for the frequency of Attention Deficit Hyperactivity Disorder affected up to 7.5 percent of school-age children. By the end of 2007 it had increased to 9%, or 2.4 million children meet the criteria for ADHD.
There are many therapy concepts for emotional or mental difficulties. In the West there are basically three paths.
The first is psychiatry where healing is attempted through medication. This seldom cures, merely suppresses the symptoms while if there is healing, that takes place under the surface.
The second is through psychology by some form of Cognitive Behaviour Therapy. Sometimes these two are used together, the medication used as a psychological “crutch” to enable the patient to get a better benefit from the psychological approach.
The third path is really a spectrum of therapies from the psychological on one end to the spiritual on the other. Here finding a strict scientific explanation is not required, it is enough if it works. It is based on practical experience and wisdom that are found within cultures.
Since the causes of ADHD like symptoms are many and varied, the first step if a person has been “diagnosed” as being ADD or ADHD is to be screened for the many illnesses that result in ADHD like behaviour. this is treating thecause of ADHD behavior and not the symptom.
If the physician is quick to suggest am ADHD drug such asRitalin, Concerta or Adderall, then the warning flags are flying, drawing attention to conflicts of interest. Much of the research doctors rely on have been funded by the major pharmaceutical companies, as well as doctors being encouraged by these pharmaceutical giants to use their drugs. The problem is that despite what the drug companies and their supporting doctors may proclaim, they do not know how their drugs actually work. The reason for this is that we have not got enough knowledge on how the brain works. The knowledge we have is still superficial and the interrelations between the neurotransmitter systems are so complex and so many variables play a role that much research is no more than educated guesswork.
This is not criticism. That is the present state of our knowledge. What we know is overwhelming, but at the same time we, who are personally affected by the results of scientific research, need a rational perspective on what is science and what is speculation wrapped in a smog of pseudoscientific waffle.
ADHD drugs have harmful side effects; no two people are identical so nobody can predict how the drug will affect the particular individual and what the side effects will be. Therefore finding the most efficacious drug has to be through the trial and error method. The patient is the experimental guinea pig.
There is no physician alive who can predict if the drug will work, and if it does, whether there will be side effects or not. The judgment of the physician is based on on a basic question. Given the patient's condition, do the possible benefits outweigh the risk of possible side effects? This is a question of statistics. Doctors are making these decisions every day. They rely on statistics from the drug companies and their intuition from experience.
An example is anti depressants. There are many to choose from, and no doctor can say which will suit the individual patient. If the first drug prescribed does not work as expected, then the doctor prescribes a second drug. If that does not work, well, there are more to try. This trial and error is not science. It is a lottery with the patient’s health, and the pharmaceutical industry’s greed for profits, as stakes.
Another example is the medication given to treat children with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD), all lumped together as ADD/ADHD. There appears to be an alarming connection between increased prescription of these drugs and violent acts such as school shooting incidents. The drug companies use statistics to defend their products. Statistics in the 1% to 100% range might appear good at first sight, but if 0.01% turn homicidal, then there are roughly 250 potentially homicidal children and adolescents going to school each day in the United States. In 2006, 4.5 million children between 3 and 17 were diagnosed for ADHD in the United States. About 56% were on medication. That means that over 2 ½ million children between 3 and 17 were on ADHD medication. The 0.01% was an arbitrary figure as an example, it could be 0.1 % giving 2500 potential homicidal children. Even if it is 0.001% that is 25 potential Columbines.
Medication is a quick fix masking the symptoms, not treating the cause. Some children become zombies on these drugs. They are after all in the same drug classification as cocaine and ecstasy. American schools priding themselves as “drug free zones” are deluded.
Parents who want an instant cure with no effort are pushing the problem into the future and building the base for dependency. Before trying medication, all other options should be tried. It is irresponsible of parents not to research ADHD treatments. Saying “my doctor says,” or “the experts say.” That is not a reason to opt out of responsibility, as there is no consensus on this subject.
To be scientific requires knowledge of the cause, and a proven, verifiable explanation of the mechanism through which the condition was caused. So far no cause of ADHD has been verifiably proved. If one follows the reasoning of the ‘medicate ADHD’ lobby to its origins, it is founded on unsubstantiated presuppositional assumptions. That is marketing, not science.
It may be tempting as a parent with an over-active child and a “pushy” school to go the “easy” way. The doctors who advocate medication only, have taken the easy way for themselves, stilling their consciences by reading one-sided literature from one or other pharmaceutical company.
The ADHD drugs expose the user to unnecessary risk and possibly long term implications and devastating side effects. If one chooses to go the medication way, then it should be based on a well thought through sound decision.
The National Institute of Mental Health Multimodal Treatment Study of ADHD initially showed medication to be better than behaviour therapy, but that difference disappeared as the study progressed. After three years there is no significant difference between medication and behavior therapy. The initial results were influential in the subsequent boom in prescription medication mainly Ritalin.
The study showed that, unfortunately, even when state of the art behavioral treatment was provided to families at no charge, almost 40% of families were unable and/or unwilling to fully take advantage of it. This can lead to schools encouraging medication, as it is the easiest quick fix.
Cognitive Behaviour Therapy is an invaluable method after screening for physiological explanations, such as sleep apnea, hypoglycemia, diabetes, etc. Highly intelligent, gifted, innovative, talented children who feel frustrated by conventional education can learn coping skills to deal with their frustration.
Cognitive Behaviour Therapy, changes the individual's thought process in a structured way. This is especially relevant with Attention Deficit children, as they tend to get 90% negative comment and only 10% encouragement and so tend to think in negative patterns.
To really tackle the problem at the roots requires effort. The real long-term benefits for the majority would be with behavioural therapy. This includes coping strategies, building the child's or adult's self esteem, which prepare the individual for coping throughout life, and living a better quality life than under medication.
The Third Way
Neuro-linguistic programming is based on models of how we think,Neurofeedback for treatment of add and adhd has been succesful for some, homeopathic and herbal remedies and Ayurvedic medicine together with a number of New Age therapies are in this path. Many of these methods are criticised by the sceptics and those considering themselves to be “scientific”, but the fact is they work for some people. In the end, that is what counts.
Since looking for a solution to the stress of being ADHD in a non-ADHD world is a very individual search, these alternatives are worth trying. They cannot hurt the individual, and if the perfect fit is found, then the ADHD child or adult can get on with life.
These methods are not to be looked down on as they are in the sphere of the practical, what works as opposed to the scientific need to have a mechanistic explanation. Sometimes something as basic as dietary advice and lifestyle changes can help many.
Interview with Dr Scott Saunders
So, what then is the cause of ADD-ADHD?
This is the most important question to ask the doctor.
The answer is that there is NO clear scientific answer.
The “chemical imbalance” theory that is so confidently promoted by many doctors, has a basic flaw. This is explained in thedepression - serotonin article. Without knowing the cause of the “imbalance” it is gambling with one's health to take this type of medication.
The chemical balance is very complex and trying to correct an interrelated intricate chemical system with one chemical without understanding the system is not science. The system is thrown more out of sync, even though the initial symptoms are gone. The medication cannot cure, as it does nothing for the underlying cause of the behaviour. The ADHD person has to take it as long as they have ADHD symptoms, in most case for life. The pharmaceutical companies have then created a customer base.
To give a name to a set of behaviours and call it a diagnosis and say one knows what it is, is a marketing spiel; not science.
As the Nobel Prize Physicist, Richard Feynman said:
“You can know the name of a bird in all the languages of the world, but when you're finished, you'll know absolutely nothing whatever about the bird. So let's look at the bird and see what it's doing – that's what counts. I learned very early the difference between knowing the name of something and knowing something.”
ADHD and ADD are not disorders per se, but symptoms. Symptoms do not need treating. What gives rise to the symptoms needs to be treated. Alternative ADHD therapies treat anything from a sleep disorder or diabetes, to a need of coaching to cope with emotions and frustrations.