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| Knight Ridder Photo |
| Charles Ryder tosses a bean bag from hand to hand as part of his non-drug ADD therapy at a Schaumburg, Ill., treatment center. |
Introduction
When Charles Ryder was finally diagnosed with adult attention-deficit disorder at age 25, his doctor immediately started him on the medication Strattera. For the first time since childhood, Ryder’s focus partially improved.
But Ryder didn’t feel like himself when he took the drug. He also hated putting a chemical into his body, especially one that now comes with federal warnings about increased suicide risk in younger populations.
In his quest for a holistic alternative, Ryder tapped into the burgeoning market on the Internet of largely unproven non-drug treatments for ADD, therapies that range from special diets and supplements to biofeedback and spending time in nature. Now, every six weeks, the father of two girls drives seven hours from his home in Traverse City, Mich., to a Dore Achievement Center in Schaumburg, Ill., where he learns simple balance and coordination exercises designed to stimulate part of his brain.
‘‘I definitely notice a difference,” said Ryder, who sees too much of himself in his easily distracted 4-year-old daughter and will likely start her on the Dore program. ‘‘I used to feel like I was always in my own world. My mind was always in so many other places. I didn’t know if I was stupid or what the problem was, because I could excel in other things.”
Symptoms of ADD
Untreated, ADD’s hallmark symptoms of hyperactivity, impulsivity and inattention can have serious consequences. Studies have shown it doubles the chances of being arrested, divorced and to have held six jobs or more in any 10-year span. Untreated ADD also has been shown to affect self-image and hurt on-the-job performance.
Psychostimulant medications, in conjunction with behavioral therapy, are considered the most effective way to treat ADHD, largely because drug companies have the money to fund clinical trials. However, not only are the long-term effects of medication unknown, but the most common one, methylphenidate (Ritalin), is in the same class as cocaine, morphine and amphetamines, all drugs that carry the potential for abuse.
But now there’s no shortage of complimentary or alternative treatment methods that can be used either in conjunction with drugs or on their own.
Alternative Therapies
Most alternative ADD therapies offer only anecdotal, rather than scientific, evidence of success. But experts say a good rule of thumb is if it’s safe, you believe in it and it’s good for you anyway, it’s worth exploring.
‘‘Just because it hasn’t been in a (rigorously controlled) study doesn’t mean it’s worthless,” said Edward Hallowell, who discusses alternative treatments for adults in ‘‘Delivered From Distraction” (Ballantine Books, $25.95). ‘‘On the other hand, you have to watch out for inflated claims. People have turned ADD into a little industry.”
Enduring controversies such as the effect of sugar on behavior in children, the use of electroencephalography (EEG) biofeedback and the efficacy of eliminating artificial food additives, colors and/or preservatives have been well studied. But they lack support as effective sole treatments for ADD, according to a published study by researchers Neal Rojas and Eugenia Chan at Children’s Hospital in Boston.
But the researchers also found that early evidence for therapies such as essential fatty acid supplementation, yoga, massage, homeopathy and green outdoor spaces ‘‘suggests potential benefits as part of an overall ADHD treatment plan.”
Chicago social worker Laurie Walsh believes the best core treatment is ‘‘individual and group support, diet, exercise, medication and counseling. If one falls down you have four other areas to hold you up,” she said.
Do You Have ADD?
Everyone fidgets, lacks concentration and has impulsive outbursts at some point in life. So how do you know whether you’re suffering from a case of modern life or attention-deficit disorder? There is no definitive test. But the Adult Self-Report Scale, or ASRS, is a screening tool that was developed in conjunction with the World Health Organization. Experts have found that 80 percent of the people who score positive on the ASRS will have ADD when a full evaluation is done.
These six questions will not tell you whether you have ADD, and beware of any written test that promises a diagnosis. But if you find yourself answering ‘‘sometimes” or ‘‘often” to at least four questions, it’s a sign to consult your health-care provider.
- How often do you have trouble wrapping up the final detail of a project, once the challenging parts have been done?
- How often do you have difficulty getting things in order when you have to do a task that requires organization?
- How often do you have problems remembering appointments or obligations?
- When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
- How often do you fidget or squirm with your hands and feet when you have to sit down for a long time?
- How often do you feel overly active and compelled to do things, as if you were driven by a motor?
Assessing Alternative Treatment Options
Whether you’re on medication or not, support groups are a key, but often overlooked, part of ADD treatment.
‘‘We’ve gone through life feeling misunderstood and all alone,” said a 44-year-old father from Naperville, Ill., who withheld his name to protect his 14-year-old son, who also has ADD. ‘‘When you go to these support groups, you feel like you belong. It allows us to embrace the positives.”
Here’s a look at some other non-drug treatments that can be used as part of a multifaceted plan that may or may not include medication.
ADD Coaches
A life coach with special training (but not a therapist) who can come to your home or work with you by phone on quality-of-life issues.
Pros: Many coaches recast ADD as a gift, rather than a disorder, and help clients identify their positive characteristics and strengths. Coaches can focus on improving executive functioning skills, such as planning, organizing and prioritizing.
Cons: No quality control. Anyone can claim to be an ADD coach. Even ‘‘licensed” coaches can be self-licensed. Try to get a referral from someone who had a good experience. Also, be wary of the prices. Most coaches should be around $60 a session. Beware of coaches charging $150 to $200 a session, but pay something so you take it seriously and don’t blow it off. One resource is the ADD Coach Academy (www.addca.com ).
Biofeedback
Used for decades, biofeedback allows people to increase brain-wave activity through training. One company, Play Attention ( www.playattention.com ), uses an EEG biofeedback-based system (the patented name is ‘‘Edufeedback”) that attempts to form new neural networks.
During each session, the user wears a helmet equipped with sensors that record theta (daydreaming) and beta (focused) brain-wave activity.
The video-game-like interface coaches ADD subjects through tasks designed to maintain concentration for a certain period. For example, the screen might show a bird flying through the sky. A loss of concentration would cause the poor bird to fall. A live ‘‘coach” could be present to give instruction encouragement and verbal feedback.
Pros: Biofeedback has been used for conditions including seizure disorders, mood disorders and ADD for the last 30 years. The evidence shows biofeedback is ‘‘probably efficacious,” according to a June study in the journal Applied Psychophysiology and Biofeedback.
Cons: The knock against biofeedback has always been that the benefits likely vanish once you unhook yourself from the machine. It’s also expensive and time-consuming. Hourly fees at freestanding Play Attention ‘‘learning” centers can range from $35 to $250, and about 40 hours of training (two hourlong sessions per week) is recommended.
Brain Exercise and Movement
The Dore Achievement Centers (www.dorecenters.com ) use what they call ‘‘cerebellar stimulation.” The cerebellum, a clump of neurons in the back of the brain, has long been associated with balance and coordination. The Dore theory, which is still being researched, asserts that the cerebellum is underdeveloped in those with ADD. Dore clients might balance on a wobble board, toss a bean bag from one hand to another while sitting on a Swiss ball, or move the eyes from side to side to stimulate the cerebellum.
The idea is that the exercises will help build correct neural pathways and improve frontal lobe performance.
A similar technique, used by The Brain Gym (www.braingym.org ), works to ‘‘develop the brain’s neural pathways through movement.”
Pros: Though skeptical at first, psychiatrist Dr. Edward Hallowell, director of the Hallowell Center for Cognitive and Emotional Health, put his son Jack through the Dore program and says the founders deserve credit for ‘‘developing an innovative method of tapping into the untapped power of the cerebellum.” Both methods are enjoying anecdotal reports of success.
Cons: More research is needed. The Dore method is ‘‘essentially a combination of physical therapy and occupational therapy,” said psychology professor Robert Resnik, author of ‘‘The Hidden Disorder: A Clinician’s Guide to Attention Deficit Disorder in Adults.” ‘‘You wonder about the placebo effect,” he said. ‘‘I think it’s a gimmick.”
Fatty Acid Supplementation
Fatty acids, which are essential for brain development, maintenance and function, are mainly found in fish oils. Omega-3 fatty acids suppress inflammation and have been shown to be useful in treating adults with depression and bipolar disorder. Studies also show fatty acids promote the body’s production of dopamine, which could be good for those with ADD.
Pros: Excellent safety profile. In this age of fast and processed foods, they should be part of your diet anyway. Humans can’t make fatty acids; they must be consumed through diet.
Cons: Evidence on its success with ADD is mixed. Also, not all fish oil is created equal. Fresh fish oil capsules should taste fresh; if you’re experiencing unpleasant burping and foul taste, look for a brand with quality control, like Nordic Naturals.
Green Outdoor Spaces
Some studies have shown that children were more able to concentrate, complete tasks and follow directions after spending time in natural, especially green, settings, according to psychologist Lara Honos-Webb in ‘‘The Gift of ADHD” (New Harbinger Publications, $14.95). Camping, fishing or playing soccer outside were all considered green activities.
Activity alone couldn’t explain the findings, because ‘‘playing basketball in paved surroundings didn’t result in the improvements in concentration that even passive activities in green settings did,” Honos-Webb wrote. Still, other studies contradict this to some extent.
Pros: Getting some outside exercise is good for you anyway, whether you’re trying to treat attention deficit or another modern malady: obesity.
Cons: Not enough research to prove whether it works as a sole treatment.
Nutrition
Three primary dietary inventions are used to treat ADD: the Feingold (additive free) diet, the oligoallergenic/oligoantigenic (few foods) diet and sugar restriction.
Feingold asserted quite controversially in 1975 that the increase in learning disabilities and hyperactivity was related to an increase in the use of artificial flavors and colors. Overall, the science is still lacking, but recent studies focusing on behavior effects of artificial colors and preservatives suggest that some children (not necessarily those with ADD) might have sensitivities, according to Neal Rojas and Eugenia Chan of Children’s Hospital Boston.
Others have taken Feingold’s theory and eliminated not only additives and dyes but also sugars, dairy products, wheat, corn, yeast, soy, citrus, egg, chocolate and nuts.
Pros: Diet modification can offer a sense of control and help promote a healthy lifestyle. Some foods do exacerbate the condition, and food allergies are underdiagnosed. Anecdotal evidence is strong, especially among families who removed gluten and dairy products. It never hurts to eliminate refined sugar from the diet.
Cons: Elimination diets are notoriously hard to stick to, especially if other family members aren’t in the same boat.
Quality-of-Life Improvements
Get daily physical exercise, join support groups, avoid foods with trans-fatty acids (often hidden on labels as partially hydrogenated oils) and get some sleep. Israeli researchers found that treating sleep disorders in children can lead to a significant reduction of ADD symptoms and improved cognitive performance levels.
Yoga and meditation have also been shown to be excellent adjunct therapies.
Pros: ‘‘Exercise can’t hurt, but if you have ADD you need it tenfold,” said social worker Laurie Walsh of Insight Employee Assistance Provider. ‘‘Even if it’s just 10 minutes to help you release chemicals. You can regain focus without needing medication.” We should all be doing these things anyway.
Cons: None.
©1996-2006 The Pueblo Chieftain Online
Reprinted with permission of The Pueblo Chieftain
