Treating Attention Deficit Without Drugs

Do what works; but those who refuse to consider medicine as one possible remedy are as foolish as those who refuse to consider anything but.

ADD is not just an “American disease.” I know Europeans with it! It usually goes undiagnosed instead of over-diagnosed. I’ve also lived in the developing world where there is no such thing as depression. Of course it exists out there, but they don’t have the resources to spend on psychology research that exist in America. Also traditionally Europeans haven’t let their food systems get as corrupt as the American model, though that too is changing over there. I know I certainly felt better eating the food I had in Spain than I do in the United States.

I was diagnosed with ADD in fourth grade. They would have noticed earlier except I was on Tegretol to curb a seizure disorder that made me so drowsy and listless that it impeded my academic performance. Later on in life I find that being vegetarian has helped me, mostly because that makes me take interest in what I eat. The biggest help to me in high school was dance that I started when I was three years old. Dance class requires a lot of self-discipline. There are strict codes of conduct and dress, and focus is required for first learning the movement and then reproducing it in a formation. It also works every muscle in the body and clears my busy ADD mind like nothing else ever has.

I have a question for Tara about gender differences in ADD diagnosis and treatment. I don’t know if it’s possible to even answer it, but I’ve never seen it discussed in a big public forum. It’s evident even in these comments that “little boys” do all these hyper things. My brother was one of them. I used to get in trouble for talking in class , humming, drawing, and being impatient when answering questions. My ADD was diagnosed simultaneously with an IQ test in fourth grade, but also suspected because my brother (five years older) had it and so did my mother. I wonder if there is a disproportionate amount of boys diagnosed with it because the social expectation enforced early on of little girls is that they are not rambunctious and roughhousing and may not be hyperactive. I bet there are plenty of dreamers who sat in class and weren’t labeled ADD because they weren’t beating their own drum so loudly. It happened to my mother, and she got diagnosed at 40.

One of my friends recently heard at the age of 24 that she’s ADD and said “Why did no one tell me earlier!” The reasons were that she was more inclined to drift off in class, do a lot of running during recess and “never seemed to listen” in the words of her mother, who had long before decided that her girl was just “flighty, scatter-brained, and a little lazy.” In fact her mom had a hard time accepting the diagnosis precisely because her daughter didn’t exhibit as much hyperactivity as she perceived was needed for an ADD child.

I have 2 sons with ADD/ADHD. After both started running cross country and track, the symptoms subsided substantially. H*ll, they became slugs. After they started running daily with their team for a couple of hours, all the wanted to do is sleep. Now they run year round even in the off season. I encourage them both but make no demands that they do. Their self esteem is better. Their grades have improved.
Maybe we’re genetically programmed to be active at least part of the day? Could the issue be primarily with our expectations rather than any real problem? Could this explain part of the regional differences in diagnosis and drug treatment rates. I think so. It’s just easier to be physically active in some locales/ lifestyles. I’m happy we live in a part of California, where the weather is mild and the kids are relatively safe even when I’m not directly supervising them.
I would tell any parent to encourage their kids to be really physically active to the degree possible as appropriate for their ages. For my sons’ I didn’t see the improvement till they started being active at a pretty high level which meant middle school. Soccer practices helped but wasn’t enough. I saw the improvement when they started riding their bikes or skating the 3 miles to the practice field and walking to school a couple of miles.

I am a young adult who has been affected by ADD (without hyperactivity). My symptoms showed as soon as I received homework in the first grade, but I was not actually diagnosed until my 3rd year of high-school. Since then, I’ve tried three different medications with less than satisfactory results, and am weary of playing the guessing game on what to do next. A psychologist I spoke with recommended I try QEEG brain mapping/scanning which can show exactly which parts of the brain of not functioning properly, and thus help you target your therapy towards that specific fault. From what I’ve read, there are a mix of professional reviews on brain mapping for ADHD ranging from calling it the treatment of the future to a ploy for cash. Though it has not been mentioned in this section or this article. Does anyone have an opinion on it?

There is a very promising non-medical intervention for ADHD called Cogmed Working Memory Training that has been developed by Neuroscientists at the Karolinska Institute in Sweden. It has published randomized controlled clinical trials to support its effectiveness (Klingberg, etc, Journal of the American Academy of Child and Adolescent Psychiatry, 2005 Feb 444(2):177-186). More information can be found at http://www.cogmed.com.

Adam G. Stein, Ph.D.
Clinical Psychologist
Irvington, NY

The brain is a giant self-medicating gland. The nerve cells in the brain produce psychoactive substances at all times and modify their production commensurate with our experiences. Any type of intervention will influence the biochemical make-up of the brain. There is no reason to believe that substances purified from natural products should be more beneficial than pharmaceuticals synthetized in laboratories, solely because the former originate in nature. Only thorough research and experience will tell which drugs produce positive results regardless of provenance.

Prudence is advised when examining the options discussed in this article. The assessment of recently developed treatments is wrought with difficulty. The time for gathering experience with a novel therapy is commonly too short to allow a valid comparison with the risk/benefit analyses of established therapies supported by large bodies of data.

Compared with therapies that require systemic administration of drugs, biofeedback therapies may target the brain regions involved in the disorder more specifically. As an extension of biofeedback therapies, neurofeedback is an emergent technology. The technique requires stable, reproducible recordings of miniscule electrical potentials from the scalp. A slight detachment of a surface electrode may easily compromise an entire treatment session.

A detailed comment on this issue can be found here.

My oldest child is 6 yrs old and was diagnosed with ADHD two years ago. My child is allergic to Red 40 food dye and it makes him extra hyper. Strattera is working for him right now and he is focusing at school. To the people that are so against medication, you obviously do not have a child with true ADHD. You can not possibly understand unless you have a child with it. I will try the feingold diet too. Thanks for all of the great advice. No parent wants to put their child on medicine, but you must weigh the benefits verses the risk.

its easy to discount something you may not completely understand or have been exposed to. while reading down these comments, it is clear many people are misinformed and making judgments based on inadequate data.

adhd is real and those with the disorder lead lives very different because their neurology is different. frequently, there are overlays of other clinical syndromes that mimic or worsen adhd symptoms. there are also degrees of severity and character traits that influence behavior. it is not a clean disorder in that you either have it or you don’t, like a broken arm. it is messy and more like a head injury. in fact, you should consider this to be a right frontal lobe insult because that is where the deficits lie.

get some good information before you judge whether adhd is real. just because a doctor may have misdiagnosed your daughter or because your son in less inattentive when he doesn’t ingest food dye doesn’t mean this isn’t real and negatively affects thousands of people. in fact, 90% of adults with adhd do not receive treatment. look around you and see who they are and what professions they are in.

while medications aren’t for everyone, they are extremely effective and should be used for moderate to severe cases. if your child needed medication to treat another illness such as insulin would you medicate?

yes, adhd is very real and results in a variety of societal problems including reduced income potential, less education, car accidents, poor marriages and lost potential. these are not moral problems but neurological. get the facts and begin to see this as what it is. i don’t know one person with adhd that says they want this disorder.

I have either ADD or ADHD (without the hyperactivity), made much worse after a 13+ hour heart operation 7 years ago. I finished ONE neurofeedback session with my therapist and I can already see subtle differences. I am looking forward to doing the full protocol (we anticipate about 20).

What is essential to using this method (and biofeedback was also very helpful to me), is to remember that communication with the therapist is essential–the person cannot make the required adjustments unless you are honestly communicating how the various wavelengths are translating in your brain. Perhaps this variable is what keeps the range of outcomes so broad.

I am already able to think more clearly, and hope to cut down on my Ritalin usage using neurofeedback. But, if I need the meds, I will have them. My only goal is to think more clearly and be able to do my work!