Multi-faceted Treatment for ADD/ADHD
In our schools today, we are seeing two conditions that are reaching epidemic proportions. The conditions are Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder. These disorders are marked by hyperactivity and inability to concentrate. The parent is usually alerted to it by bad grades and input from teachers. This happened to me. My son’s teacher approached me one day and gave me her opinion. Yes, she thought my son was ADD (he doesn’t have marked hyperactivity, and he does get along with other children. He just has trouble “staying on task”.) Of course, she was careful to say that she was not qualified to make such a diagnoses, and that we should see his pediatrician.
So off to the doctor we went. I was given two questionnaires, one for me and one for his teacher. I had to rate my son 1-5; one being rarely, five being all the time: daydreams a lot, gets along with other children, cries easily etc. We both filled out the sheets. I was surprised to see that she’d answered most of the questions quite differently than me. The doctor added up the score, which came to 70. Even though this is considered to be right on the borderline, he promptly prescribed Ritalin.
Ritalin is a Schedule II narcotic (the same classification as amphetamines.) It’s a stimulant and like any drug, it carries side effects. Ritalin’s side effects range from decreased appetite, stunting of growth, weight loss, abdominal pain, tachycardia (increased heart-rate), and insomnia.
Many kids, as well as many adults do benefit from this form of treatment, but my son had barely made the cut.
I began researching and found some startling statistics. In 1996, the Drug Enforcement Agency (DEA) called a conference of experts together from the fields of research, medicine, public health and law-enforcement. The DEA had found that since 1990, prescriptions for Ritalin increased by 500% and prescriptions of amphetamines for the same purpose have increased 400%. It is estimated that 7-10% of the nation’s boys are on these drugs at some point. The conference found that while some children do benefit from these drugs, there is strong evidence that the drugs have been greatly over-prescribed in some parts of the country as a remedy for behavioral problems. Ritalin and other drugs have been over-promoted and over-marketed to the amount of $450 million annually. Data shows, there has been a 1000% increase in drug abuse injury reports involving Ritalin in the 10-14 year old age group.
An earlier report by the DEA shows that the U.S. manufactures and consumes 5-times more Ritalin than the rest of the world combined. In 1994, a national high school survey indicated that more seniors in the U.S. abuse Ritalin than are prescribed Ritalin. Students are giving and selling their medication to other students who then crush and snort them like cocaine. College students have now joined the fold, using Ritalin, also known as Vitamin K, to help them stay awake the long hours needed to study.
As I mentioned before, there are some people who do benefit from this stimulant form of treatment. However, the biggest problem I have is not necessarily with the drug itself but with the process of diagnosing ADD/ADHD. As a trained medical professional, I know that a diagnosis of any disease or disorder should not be limited to one subjective questionnaire filled out by a teacher and a parent.
The drug manufacturers own literature states, “Specific etiology of this syndrome is unknown and there is no single diagnostic test. Adequate diagnosis requires the use not only of medical but of special psychological, educational, and social resources.”
The Diagnostic and Statistical Manual of Mental Disorders is pretty broad in their diagnosing criteria. But they suggest observation of the child, a detailed family history of mental and physical disorders, input from parents and teachers, as well as diagnostic tests to rule out other brain disorders or learning disabilities. While many family pediatricians may be qualified to give initial diagnosis based on the subjective questionnaires, it is better that parents seek out qualified mental health professionals, preferably specializing in ADD/ADHD.
Just as the diagnosis of these disorders should be multi-faceted, so should the therapy, involving not just drug therapy, but also cognitive therapy, behavior therapy, family therapy and social skills training.
So, just what are we teaching our children? We’re teaching them that by simply taking a pill, without addressing behavioral, social and environmental issues, it will rid them of their problems. My next-door neighbor’s son has to take a growth hormone. He’s small for his age. I know from taking a hormone myself for Crohn’s that this can cause hyperactivity. So his doctor has him on Ritalin also. But he has been a handful at school and at home. So the doctor has now placed him on an anti-depressant. This child is 9 years old. In the long run, is it really a benefit to have this child on all this medication without addressing behavior or coping skills? Children learn by example. Giving them a pill every time something is wrong is not leading by example. It is teaching dangerous, and misleading habits.
For those completely opposed to the drug, there is good news. A kind of grassroots movement has sprung up, replacing this chemical therapy with more natural, healthy, and holistic remedies. Hipocrates, the father of medicine, is translated as saying, “Let your food be your medicine and your medicine be your food.” In the name of progression and convenience, we have polluted our bodies with fast foods containing additives and preservatives. Other diseases such as Cancer, Heart Disease and Crohn’s have been linked to diet and environment. Experts believe that ADD/ADHD people, especially children, lack certain minerals, enzymes and antioxidants to adequately process refined sugar. This can be fixed by specific natural supplements through various companies, who also suggest changing the diet to exclude refined sugar. Many of these companies have had independent outside research performed and their profits go towards more research of ADD/ADHD. Two examples of this approach are the Feingold Diet and God’s Recipe.
However, even the holistic therapy needs additional support. Doctors are realizing that ADD/ADHD disorders can be helped with positive behavior modification and giving the child a structured environment.
The natural way in conjunction with psychological therapy may not be convenient, and may be more costly, but the child’s long-term welfare is what should be most important. It is better to sacrifice time and energy than endangering his health through long-term use of a synthetic and abusable drug. There is nothing to lose by trying the natural, multi-modal way. All there is to gain is a healthy child with healthy eating habits who has a better understanding and increased control over his behavior. Many children being treated with behavior modification, dietary changes and structured environments have been able to completely forgo the medicine all together.
A May 2005 report on WebMD states, “behavior therapy in combination with adhd drugs such as Ritalin reduces the need for the drug by two-thirds.”
As a nation, we should demand more funding in our educational system for developing alternative programs that better aid students’ needs, without labeling, pigeon-holing them or forcing kids take a synthetic drug to make educators’ jobs easier.
The bottom line is parents shouldn’t take one doctor’s word–seek a second and even third opinion. Seek out trained mental health professionals who specialize in these two disorders. Only the parent can be his child’s best advocate, and by doing so, can help stop the over-prescribing of a potentially dangerous drug such as Ritalin.
