The Attention Deficit Hyperactivity Disorder: A Naturopathic Perspective - Coursework Example

ADHD: A Naturopathic Perspective The attention deficit hyperactivity disorder (ADHD) is impacting 5% of school going children. 40% of these children develop symptoms in the adulthood (Elder). The patients lose self-control, get demoralize, becomes inattentive, hyperactive, loss interest in the job, become socially inactive, remain isolated and get overly anxious. The therapy is intended to manage the chemical imbalance in the brain resulting in appearance of these symptoms. Various management approaches are used to treat the symptoms of ADHD in children and in adults (Chaput). The allopathic practitioners prescribe stimulants; naturopaths suggest natural ways of bringing balance, which entails elimination of certain food items, taking some dietary supplements, physical activity and mind soothing techniques. It has been found that a combination of all management approaches has been effective in bringing sustainable recovery in ADHD patients. This paper presents an over view of all management approaches and mainly focuses on naturopathic perspective of ADHD management in detail. Attention deficit hyperactivity disorder (ADHD) Attention deficit hyperactivity disorder (ADHD) is the most common developmental and behavioral disorder targeting 3% to 5% of school going children below the age of 7 years (Shah). The disease is characterized by neuro-biological symptoms as difficulty in paying attention, controlling impulsive behavior and hyperactivity. These symptoms are so dominant in ADHD patients that they immensely disturb their daily routine activities. 1% to 6% of kids having ADHD exhibit these symptoms after adolescence. ADHD is categorized in to following sub-divisions (Shah): Predominantly hyperactive-impulsive Most symptoms in ADHD fall in hyperactivity-impulsivity category. Another prominent symptom is inattentive. Predominantly inattentive The main symptoms in this type of disorder belong to inattention category, and few symptoms represent hyperactivity-impulsivity. Children having this category of ADHD are not hyperactive; they may appear sitting idle and quite without paying attention to what they do. Parents and teachers may ignore such children, and their ADHD remain undiagnosed. Combined hyperactive-impulsive and inattentive Children who fall in this category show both types of symptoms, inactivity, as well as hyperactivity-impulsivity. Mostly kids develop combined category of ADHD disorder. Causes of ADHD Following are the main causes leading to ADHD disorder Genetic and hereditary factors and Prenatal and postnatal brain development Disturbed brain function Low level of dopamine the mood and emotions regulating neurotransmitter. Slow wave activity in brain parts Risk Factors Inheritance – ADHD can be transferred from parents to offspring. Mother or father having genes of ADHD can transmit the disease to their children. Sex- Boys have 90% more chances of developing ADHD than girls. Prenatal and Postnatal physical health – If a fetus is exposed to drugs, alcohol and cigarette during pregnancy, suffered from nutritional deficiencies, or exposed to toxins like lead and polychlorinated biphenyls (PCBs) then he/she has chances of developing ADHD symptoms. Learning and Behavioral disorders. Nutritional factors – low nutrient diet, food allergies, high sugar and CHO intake, intolerance to food colors and additives may lead to ADHD. Different Management Approaches for ADHD. Diagnosis Behavior Analysis The main step before starting management of the symptoms of ADHD is the correct diagnosis. The DSM-IV - Diagnostic and Statistical Manual of Mental Disorders clearly defines the diagnostic criteria for ADHD patients, which depends on observing their behavior (Verma and Shah). Parents and Teachers can provide valuable information regarding patients’ behavior, which is crucial for diagnosis. Hair Analysis: Analyze hair specimen for detecting minerals and heavy metals. Blood Analysis For detecting nutritional deficiencies and food allergies in blood specimen. Management through Allopathic / Conventional Approach The conventional approach of managing ADHD symptoms includes behavioral therapies, Lifestyle changes, patient counseling, family education, social skills training and school remediation. All these approaches have been proved to be effective for the treatment of the disease. The conventional medicines used for treating ADHD include stimulant medications. These medicines are found to have severe adverse effects in the long term such as anxiety, insomnia, loss of appetite, hallucinations, liver damage, addiction, psychosis, etc. Because of these adverse effects the psychological and Naturopathic approach of therapy is getting more famous for the treatment of ADHD (Benkert, Krause and Aidelsburger). However, it is evident that the treatment of ADHD with stimulants has proved not to develop Comorbid psychiatric disorders including depression, anxiety disorders and disruptive behavior in adults (Biederman, Monuteaux and Spencer). The most commonly prescribed psycostimulants include Methylphenidate, dextroamphetamine, methamphetamine, and pemoline. The act on CNS and activate dopamine and related compounds. Dopamine is responsible for increasing mind alertness, therefore, its activation improves brain functions. The Naturopathic Perspective The naturopathic approach for the management of ADHD includes identifying the root cause of the disorder. This intervention involves collection of patient’s clinical and family history and analyzing blood and hair sample for studying physiological changes. After collecting basic diagnostic information, patient specific treatment plan is developed by the physician followed by multiple therapy options such as lifestyle changes, homeopathic interventions and botanical and Traditional Chinese medicine. Naturopathic Causes of ADHD Hypoxia during labor resulting in brain damage. Prenatal excessive alcohol Adrenal gland over functioning Nutritional deficiencies Zn, Mg, vitamin B6, Fe, Cr, Mn, Li, Essential fatty acid deficiency Environmental toxins Inhalants / pollutants Bad parenting Heavy metal toxicity Hg, Pb, Cd, Cu, Al Food allergies Functional hypoglycaemia Naturopathic Treatment Principles in ADHD Eliminate the food allergens. Replace digestive enzymes. Heavy metals chelating. Treat neuro-chemical imbalance. Cover nutritional deficiencies. Reduce environmental toxin exposure. Strengthen the nervous system. Shift to organic compounds and avoid chemical pesticides and insecticides. Food Allergens Food allergy is one of the most common causes of ADHD. If a person is allergic to some substance, he should curtail it from the diet. Most common substances causing food allergy in ADHD patients include preservatives, sulphites, benzoates, artificial flavors, antioxidants and nitrates. Other chemicals, which can produce hypersensitivity, include bleaching agents, anti caking agents, etc. Environmental Impact Various substances in our surroundings can also initiate allergic reactions in ADHD patients such as chlorine containing compounds, propylene containing substances, cleaners, dishwashers, air fresheners, pesticides and insecticides. Exposure to Heavy metals Children’s exposure to heavy metals such as lead, chromium, mercury, nickels and arsenic and cadmium has been found to cause severe psychological disorders such as learning the disability, behavioral and cognitive problems. Lifestyle Changes Hyperactive children with ADHD can be treated by two methods: i) Changing patient’s surroundings: by encouraging children to be more active socially. The process initiates with parent’s education. ii) Altering patient’s behavior: By giving stimulant medication – Ritalin to the subject. A report by National Institute of Mental Health (NIMH) indicated that the success rate of the ADHD management has increased tremendously by combined therapy including both the behavioral interventions like parent’s education along with medication. Adults having ADHD symptoms can be benefited by behavioral interventions like: family counseling, couples therapy and cognitive remediation (Wigal). Nutrition and Dietary Supplements The Feingold Program – suggests that elimination of certain dietary elements from food intake can help in improving condition of ADHD patients. It consists of two stages: Stage 1- First period in which two food groups have to be eliminated, food items having synthetic or artificial colors and flavors and antioxidants’ containing food. The other group presents food items containing natural salicylates. Stage 2 – After cutting down the above-mentioned food groups from the diet observe the response for about 4-6 weeks. The food items from the second group can be reintroduced in the diet by testing each separately. The food items in the first group are not generally reincorporated. Benjamin Feingold claims that removing all these substances from food instantly brought improvement in 50% ADHD patients and reincorporating them causes the symptoms to reappear. However, it is suggested that the elimination of food should only be followed as prescribed by a registered naturopath otherwise it may result in malnutrition (Shah) Sugar and Artificial Sweeteners N. Girardi proclaims that sugar intake initiates metabolic abnormalities in ADHD children resulting in reactive hypoglycemia. He also stated that the hormone regulation and sugar metabolism is already impaired in ADHD children, which may get exaggerated by sugar intake. Refined sugar also causes nutrient depletion as it involves many other nutrients for metabolism. This indicates that in children with ADHD where there is already nutritional imbalance, sugar intake can lead to nutrient deficiency. Dietary supplements A number of nutrients are required for the proper brain functioning especially for children of growing age. Many children with nutritional deficiency show considerable cognitive and behavioral issues. ADHD patients usually show improper eating patterns, which result in increased risk of nutrient deficiency. Magnesium Magnesium deficiency shows significant cognitive and behavioral abnormalities in children such as difficulty in learning, excessive body movement, mental confusion, restlessness, slow concentration on work and anxiety. Studies showed that ADHD patients provided with Magnesium supplements (200 mg per day) showed considerable improvement as compare to the control group, which received only standard therapy (Ehrlich). Vitamin B6 Vitamin B6 (pyridoxine) is an integral component for brain functioning and development. It also helps in the production of brain neurotransmitters norepinephrine, serotonin and dopamine. The study reveals that the effect of pyridoxine is more responsive than methylphenidate (stimulant) in treating behavioral abnormalities of hyperactive children (Ehrlich). Iron Iron deficiency is a common problem in lower socioeconomic structures. Normal brain function requires optimum level of iron. Iron deficiency results in low social responsiveness, decreased voluntary activity, arousal and decreased attention span. Zinc Zinc is a major element, which regulates the function of neurotransmitters, melatonin, fatty acids and others associated with behavioral changes. Studies reveal that children with ADHD also have very low level of Zinc. It is also observed that patients with Zinc deficiency when treated with stimulants showed slow improvement. Essential Fatty Acids Fatty acids are very important for normal brain function. Our body is unable to synthesize essential fatty acids (EFA) therefore; they should be incorporated in our diet. EFAs are of two types: omega-3 fatty acids and omega-3 fatty acids. Omega-3 fatty acids are present in high concentration in the brain and have a major role in regulating cognitive and behavioral functions. Some enzymes convert EFAs (such as alpha linolenic acid [ALA]) in to polyunsaturated fatty acids (PUFAs). Some researches show that patients having ADHD cannot properly convert EFAs to PUFAs and have a deficiency of both substances. A study compared hyperactive boys with non-hyperactive boys and presented following observations: Lower levels of omega-3 fatty acids and PUFAs in blood. More health issues linked with EFA deficiencies Fewer chances of having breastfeeding as (breast milk contains PUFAs). More allergies and other health problems associated with EFA deficiencies. Another research shows boys having lower levels of omega-3 fatty acids exhibit more cognitive and behavioral problems (such as sleep disorders and temper tantrums). Massage and Physical Therapy Patients with psychological disorders related to mood, behavior and attitude could be managed by different massage techniques and physical therapies causing mental relaxation. Exercise: Physical activity also helps in reducing anxiety, depression, boosting self-esteem and improving attention. Exercise and physical activity improve blood regulation, which increases the oxygen level in the brain resulting in improved brain function. Many patients of ADHD also suffer from decreased blood flow and congestion, which can be managed by exercise (Verret, Guay and Berthiaume). Mind / Body Medicine There are some other mind and body techniques like biofeedback, progressive relaxation and hypnotherapy. Children with ADHD respond quickly to the visual process of biofeedback works and accept hypnotic suggestions as this generation is more comfortable with computer and graphics. These techniques help in developing skills in children so that they can combat their disorder. This therapy helps in reducing stress, depression, increasing self-esteem, confidence and self-control. For ADHD, these treatment methods can be incorporated in a combined regimen with Naturopathic management approach (Ehrlich). Herbal Medicines ADHD symptoms like inattentiveness, hyperactivity, anxiety, less focus, etc. can be treated by using natural herbs. Naturopathic approach greatly supports the use of these natural herbs for treating an ailment. These herbs include holy basil, bacopa ashwagandha, ginseng, schisandra, black current, and rhodiola. Homeopathy Naturopathic management approach also includes Homeopathic medicines, which are originated from fresh herbs and minerals. Homeopathic takes in to account the constitutional makeup of the patients considering physical, psychological and emotional aspects. Following are the most effective homeopathic medicines used for ADHD: Hyoscyamus Niger - for treating hyperactivity symptoms Stramonium - for treating the fear in children particularly having nightmares. Cina - for treating aggression and violence in children. Conclusion Naturopathic approach suggests that ADHD is nor merely a neurological disorder or learning disability. Patients with ADHD have imbalance in adrenal gland functioning, which regulates the release of many hormones related to behavior and cognition (Evans, Morrill and Parente). The ADHD symptoms related to memory, using natural herbs as bacopa, black current and herb as common as ginseng can treat concentration and focus. Naturopathic approach believes that by bringing variation in our dietary pattern, adding certain important nutrients as Zinc, Iron, Vit B6, Essential Fatty Acids, etc. and balancing some food elements like sugar, proteins and carbohydrates ADHD symptoms can be managed easily. Certain amino acids: dl-phenylalanine, l-theanine and l-tyrosine supplements are also very helpful in altering the disease condition specially hyperactivity, attentiveness and concentration issues. The conventional remedial method believes on the symptomatic treatment of the disorder where as naturopathic perspective of treating ADHD proposes the identification of the root cause of the disease first and then treating it accordingly. There are multiple reasons and causes of developing ADHD in children, which can be easily treated by using naturopathic management approach as it entails a complete therapy covering all psychological, physical and pharmacological aspects of the patients. Works Cited Benkert, Diana, et al. "Effectiveness of pharmaceutical therapy of ADHD (Attention-Deficit/Hyperactivity Disorder) in adults – health technology assessment." GMS Health Technology Assessment 6.13 (2010): 1-15. Print. Biederman, Joseph, et al. "Do Stimulants Protect Against Psychiatric Disorders in Youth With ADHD? A 10-Year Follow-up Study." Pediatrics 124.1 (2009): 71-78. Print. Chaput, Mario. The Attention Deficit with or without Hyperactivity Disorder ADHD: The Naturopathic Approach. 10 September 2010. Web. 20 June 2014 . Ehrlich, Steven. Attention deficit hyperactivity disorder. 13 May 2013. Web. 19 June 2014 . Elder, Todd. "The importance of relative standards in ADHD diagnoses: evidence based on exact birth days. J Health Econ." Journal Health Econnomics 29.5 (2010): 641-656. Print. Evans, William, Melinda Morrill and Stephen Parente. "Measuring inappropriate medical diagnosis and treatment in survey data: The case of ADHD among school-age children." Journal of Health Economics. 29.5 (2010): 657-673. Print. Shah, Sushma. Attention Deficit / Hyperactivity Disorder. 2014. Web. 19 June 2014 . Verma, Neha and Salvi Shah. "Attention Deficit Hyperactivity Disorder (ADHD)-Causes, Diagnosis And Management." Innovative Journal of Medical and Health Science 4.3 (2014): 1-15. Print. Verret, Claudia, et al. "A Physical Activity Program Improves Behavior and Cognitive Functions in Children With ADHD: An Exploratory Study." Journal of Attention Disorders 16.1 (2012): 71-80. Print. Wigal, Sharon. "Efficacy and safety limitations of attention-deficit hyperactivity disorder pharmacotherapy in children and adults." CNS Drugs 23.1 (2009): 21-31. Print. Read More