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Health Update - ADD/ADHD

What is Attention Deficit Disorder?

ADD is a syndrome that is characterized by serious and on-going difficulties in all areas of one's life. Most adults with Attention Deficit Disorder are restless, impulsive, impatient and disorganized. They are easily distracted, have difficulty sustaining attention, and have frequent mood swings. Because of these characteristics, adults with ADD often experience career difficulties. Some lose jobs because of poor performance, while others simply and frequently quit out of boredom.

Approximately 3-5% of all American children -- up to 3.5 million children -- have an Attention Deficit Disorder (ADD). It is a leading cause of school failure and under-achievement. ADD is often accompanied by poor self-esteem and behavioral difficulties.

What causes the difference in attention, communication and memory skills for those with ADD? Scientific evidence shows that for those with this type of attention, the front part of the brain (the frontal lobe) is under stimulated. The frontal lobe is used to make decisions, sequence tasks, integrate new and old information, organize and plan and provide effective social communication. The effect of under stimulation is to produce a lessened ability to do these tasks.

Children with Attention Deficit Disorder often make life difficult for themselves and everyone around them. They can easily produce chaos in a classroom or turn a family home into a battleground. Sometimes they seem to be provoking conflict just for the love of excitement. Exasperated parents and teachers may regard them as lazy, irresponsible, and arrogant; other children often find them obnoxious and avoid them. They rarely perform up to the expectations generated by the abilities they erratically display, and they almost inevitably develop a poor opinion of themselves in reaction to constant criticism and failure.

Diagnosis of ADD presents many problems. One question is when a high level of physical activity or a short attention span constitutes a psychiatric disorder. Parents, teachers, and mental health professionals do not always agree. Parents and teachers may have unrealistic expectations, especially about the behavior of schoolboys. Sometimes a child who is fidgety or easily distracted simply needs a different environment - more interesting, less constraining, or smaller classes, a new way of presenting schoolwork, a less chaotic family home.

There are also cultural differences that affect the behavior of children (and adults) or influence what is expected of them. Attention Deficit Disorder is diagnosed in the United States much more often than in Europe, and one especially interesting study has shown that Chinese are more likely than Americans or Japanese to find symptoms of ADD in videotapes of children's play.

Most mental health professionals in the United States believe that ADD can be reliably diagnosed and treated, but a thorough evaluation is often time consuming and expensive. The requirements may include a medical examination, tests of vision, hearing, speech, IQ, and academic achievement, ratings of the child's behavior, laboratory tests of impulsiveness and attention, and, most important, interviews with parents, teachers, and the children themselves to provide a detailed history of the symptoms.

The causes of ADD are difficult to study, because the definition has been changed so often and the symptoms are so easily confused with other disorders. Family and social circumstances and possibly traumatic stress influence the form and severity of the symptoms, but something more is almost certainly involved. At various times blame has been laid on birth complications, head injuries, food additives, food allergies, sugar, vitamin deficiencies, radiation, lead, and fluorescent lights. None of these theories is accepted today, but most experts agree that ADD is a brain disorder with a biological basis.

A genetic influence is suggested by studies comparing identical with fraternal twins and by the high rates of ADD (as well as antisocial behavior and alcoholism) found in the families of children with the disorder.

One reason for regarding Attention Deficit Disorder as a distinct disorder with a biological origin is the immediate and striking relief from some of its symptoms provided by the stimulant drugs methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and magnesium pemoline (Cylert). These drugs are helpful for about 75% of children and adults with ADD. They become less irritable and restless, and their attention and motor coordination improve; others begin to like them better, and they begin to think better of themselves. The drugs have no direct effect on learning disabilities, but may make special education and tutoring easier.

There is little danger of drug abuse or addiction, because patients do not feel euphoria or develop tolerance or craving. They become dependent on stimulant drugs, it has been said, only in the same sense that a person with diabetes is dependent on insulin or a nearsighted person on eyeglasses. The main side effects - appetite loss, stomach aches, nervousness, and insomnia - usually subside within a week or can be eliminated by lowering the dose. A child's rate of growth may be slowed for a few years while he is taking a stimulant, but it returns to normal in adolescence. There is no evidence of long-term deleterious effects.

Methylphenidate and dextroamphetamine are short-acting drugs, but they are now available in time-release capsules that prolong the effects to eight or ten hours. Pemoline is longer-acting. The drug is started at a low dose that is gradually increased if necessary; parents can make adjustments according to the child's level of activity. If the symptoms do not improve after two weeks at the highest acceptable dose, drugs will probably never be useful. Some experts recommend that children take stimulants only during school hours and not on weekends or vacations. Most believe that drug treatment should be discontinued for several weeks once every six months or once a year to see whether it is still needed.

One natural form of treatment shown to dramatically relieve ADD/ADHD symptoms is the use of Pycnogenol.

Gotu Kola is an herb that has demonstrated mild tranquilizing, anti-anxiety and anti-stress effects, as well as enhancing mental functions such as concentration. It is commonly used to improve memory and treat mental and physical fatigue. The herb assists in balancing energy levels and aids in alleviating anxiety and depression.

These beneficial qualities make Gotu Kola an excellent herb for children with Attention Deficit Disorder because it has a stimulating effect on the brain that increases one's ability to focus while having a soothing and relaxing effect on an overactive nervous system. In clinical studies from India, this herb increased the IQ, mental ability, and behavioral habits of mentally retarded children.


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