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The Treatment of ADHD
by Karen Donahue, M.Ac.

Conservative estimates of the prevalence of ADHD suggest that 3-5% of all school age children in the US are afflicted with ADHD. Of that group, 70 % of these children also have learning disabilities. This leaves us with the mind-boggling questions of why and what do we do about it. How are parents to come to terms with this when even the experts cannot come to agreement about diagnosis, treatment, and the pathogenesis of the disorder? Current theories recognize that there is a psychosocial component to the disorder but the morphosis of that component is not known - is it the ADHD that causes the psychosocial disruptions or is it the psychosocial problems that contribute to the ADHD.  What is the best treatment for this disorder?

Much of the research has indicated that the incidence of ADHD in boys is greater than that of girls.  Recent literature is showing that there are two subsets of ADHD -- impulsivity and inattentiveness. The boys generally will fall into the impulsivity category and the girls into the inattentive category.  The nature of impulsivity makes ADHD easier to recognize in boys than in girls. Impulsive behavior is disruptive in the classroom and will be attended to. The shy withdrawn behavior exhibited by the inattentive subset does not draw attention. It may even be thought of as desirable behavior by over-worked and underpaid teachers.

What is it that distinguishes a child that is just shy from the child with ADHD?  In Understanding Girls with AD/HD, Kathleen Nadeau et al. cites behaviors that can signal parents and teachers that there may be a problem. They are:

school phobia or avoidance

high IQ and creativity, but low academic

poor organizational skills, messiness

shyness

withdrawal in the classroom

low self-esteem
disheveled appearance, grooming problems
sleep problems
poor social skills

The authors continue, suggesting the following solutions to help the child to overcome their limitations: 

understanding their struggles

attention and affection to offset daily assaults to their self-esteem

recognition of their high IQ

affirmation and encouragement of their creativity

appropriate stimulation and challenges

help with structure and organization

help with sleep problems

support to develop assertiveness skills

recognition of social difficulties and help in learning social skills

acknowledgment of their need of a different learning environment

Aside from these solutions, it is important to get the child diagnosed as early as possible and provide them with a comprehensive treatment plan. There remains some controversy over whether ADHD stems from a neurological disorder or a psychosocial behavioral disorder. There is research implicating that differences found in the thalamus and the putamen of the child with ADHD may account for the disorder. These studies as yet are inconclusive.  There are also studies that show experience (or behavior) can incur an alteration of brain chemicals and genes in animals. Whether the origin is neurological or not, it is clear that there are learning, psychological and social functioning issues that need to be addressed.

Psychopharmaceutical interventions are commonly used for those with the hyperactive component of the disorder.  As Michael Brown's article in the Journal of Counseling and Development states, the medication "decreases inappropriate behavior but it does not improve appropriate behavior without additional intervention." There are other factors to consider in choosing the pharmaceutical route.  These are controlled drugs that are stimulants -- they can cause problems with sleep as well as damage the liver and kidneys when taken on a long-term basis. Is this really how we want to treat a population that is already at risk for addictive behavior? What are the alternatives?

Traditional Chinese Medicine has a lot to offer in addressing the problems associated with ADHD.  There is acupuncture, Eastern nutrition, herbs, movement (T'ai Chi), Qigong (breathing exercises) and tuina massage.  In TCM, by treating the organ system you treat the emotions associated with that organ.  Many of the emotional and the physical symptoms that contribute to the manifestation of ADHD are routinely treated with acupuncture. The emotional factors are frustration -- associated with the liver energy, anxiety -- associated with the Spleen energy, and fear, which is associated with the Kidney energy.  The physical symptoms: hearing difficulties, asthma, sleep apnea, rheumatoid arthritis, irritable bowel syndrome, PMS, migraines, chemical sensitivities all respond well to TCM therapies.

Whether the root cause is behavioral or neurological TCM looks at the body, mind and spirit as one interactive system.  When the body and mind are in harmony, the spirit is calm and the person is able to perform to potential.  TCM is certainly no panacea but it will help to enable the child, adolescent or adult plagued with ADHD to better utilize the resources within themselves.

If you have questions or would like to share your experiences with ADHD please contact the author via email:  Karen_Donahue@alum.wellesley.edu.

____________________

Karen Donahue, M.Ac.,Lic.Ac.

Karen holds a BA in Psychology from Wellesley College and a Masterís degree from the New England School of Acupuncture. Her practice includes Chinese and Japanese styles of acupuncture, Tuina massage, Tíai Chi instruction and Eastern nutritional counseling. She is licensed by the Massachusetts Board of Registration in Medicine.  Karen's background includes several years teaching T'ai Chi, meditation, and working as a behavior specialist. She is currently involved in research on acupuncture in an occupational health setting and ADHD. She can be reached at: Karen_Donahue@alum.wellesley.edu

 

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