Few things in life are more vital, and thereby more rigorously debated, than the health of our children. Especially when it comes to the discussion of Attention Deficit Hyperactivity Disorder, or ADHD. It’s one of the most commonly diagnosed neurodevelopmental mental health disorders on the planet.
If you add the complexities of raising a child in a volatile big city environment like Brooklyn, New York, the stakes can get very high very quickly. So If you’re having trouble wrapping your mind around how to handle it, take heart - you’re not alone. Many people still question the reality of ADHD. Keep in mind that symptoms of inattention, impulsivity, or hyperactivity do not automatically equate to a diagnosis. Some medical conditions, mental health disorders, and even stressful life events can cause those kinds of symptoms. However, by and large, the established medical community (American Academy of Pediatrics, American Medical Association, American Psychiatric Association, and National Institutes of Health) agree on the validity of the condition and the necessity of treatment upon a valid diagnosis.
Still, as with so of many health concerns, the key lies in verifying that the symptoms match the root cause - thereby validating the necessity for treatment. You’ve likely got some very direct questions that need answers:
‘Does my child have ADHD?’ ‘Should I have my child on medication for ADHD?’ ‘Is there any hope?’
Take heart, and we’ll get you answers. So while you try to settle your highly energized child-wonder from their latest fun-filled burst of energy, let’s calm your mind with some some simple facts. First - a bit of sobering news. For many children there is no simple and easy cure for ADHD. Improving lifestyle - optimal sleep, a clean and healthy diet, sufficient exercise, time in nature, detoxifying, appropriate school setting and replenishing nutrient deficiencies address the root causes of ADHD. Often it takes time to implement these major lifestyle changes and at times because ADHD is a neurodevelopmental condition - some of the symptoms remain.
However, there are many treatment options that can help with managing symptoms. You can also discover a myriad of methods and skills that help to mitigate the impact that ADHD has on academics, relationships, and overall lifestyle.
:: Recognizing the Symptoms of ADHD ::
ADHD occurs more frequently in boys than girls and behaviors can vary. Boys can manifest more hyperactivity, and girls may be more introverted. Experts have identified three subtypes of ADHD: inattentive, hyperactive-impulsive, and combined inattentive/hyperactive-impulsive. In general, inattentive types fail to pay close attention to detail, have trouble focusing, appear not to listen when spoken to, forget daily activities, and have difficulty following through on instructions. Hyperactive-impulsive children fidget frequently, interrupt or intrude on others, run around in inappropriate situations, and are easily distracted. Symptoms must be present for at least six months and have a negative impact on multiple life settings, such as school and home.
:: Treating ADHD with Behavioral Interventions ::
So you may be wondering if there is any hope for meaningful improvement in your child’s overall outlook. Good news. New research suggests that ADHD is a developmental impairment of the brain’s self-management system. We are growing in our ability to understand and treat this condition. Generally, ADHD can be treated with behavior modification, medication or a combination of the two.
Lifestyle Modifications: improving lifestyle patterns of sleep, exercise, nutrition, time in nature, removing harmful activities and toxins from the environment, replenishing nutrient deficiencies
Psychotherapy: developing coping skills, enhancing relationships and self-esteem
Behavioral Therapy: improving behavior and capacity to make healthy choices; time management & organizational skills training.
Social Skills Training: learning appropriate social behaviors (sharing, awaiting your turn)
Support Groups: support network and coping strategies for parents
Parenting Skills Training: tools and techniques for managing your child’s behaviors.
:: Treating ADHD with Medication ::
Medication can be an important component of treatment for ADHD. The most common approach is the use of central nervous system stimulants, such as Ritalin (methylphenidate) or Adderall (an amphetamine). These stimulants tend to act quickly and are generally well tolerated. They’ve also been shown to help improve concentration and focus.
In the case of ineffectiveness or negative side effects, psychiatrists and pediatricians may consider non-stimulant medications, such as Atomoxetine (Strattera), Clonidine ER (Kapvay), or Guanfacine ER (Intuniv) which have been shown to help with attention and memory.
Side effects of both the stimulants and non-stimulants are similar - with headaches, trouble sleeping, upset stomach, irritability and weight loss cited as the most common. The more serious side effects in the case of stimulants include hallucinations, increased blood pressure and allergic reaction; and, for non-stimulants seizures or suicidal thoughts. While these side effects are serious, they are rare, and a qualified psychiatrist will be closely monitor your child’s progress.
Research reveals that a combination of both medication and behavioral interventions is the most effective approach. While the direct effects of medication are limited to the duration of the medication’s action each day, functional improvements while on medication can help your child to improve school classroom and test performance and lead to other achievements that can have lasting effects. Also note that some children with ADHD gradually outgrow their ADHD-related impairments. Medication can also be a great bridge to support a child’s quality of life while waiting for further brain development. Be sure to discuss which options might work best for your child with their psychiatrist and psychotherapist.