Stillwater Healing Arts Clinic
By Dr. Sara Hart
In a society that pushes for everyone to have more, be more, and do more, our children quickly get swept into the rapid pace of life that seems impossible to resist. Our over-stimulated world exists as juxtaposition to the inherent needs of a child whose development is best supported by a simple, consistent routine.
With soccer practice, dance class, sheets of homework each day, 10 minute recess, and 15 minute lunch breaks, SUGAR, SUGAR, SUGAR, parents divorcing, new siblings being born, moving to new towns, television, internet, radio, cell phones and more… It’s easy to feel like our heads are spinning sometimes!
Somehow we manage to survive and even thrive with a world of so much opportunity and over-stimulation. However, statistics on children’s health and behavior shows us another picture that’s worth re-evaluating the way we’re doing things.
In 1970 there were approximately 150,000 children who were diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) in the US. By 2000 there were 4 million and by 2009 6.7 million children in the US were being treated for attention difficulties. That reflects a 21.8% increase in diagnosing this disease between 2007 and 2009.
US children consume five times more ADHD drugs then the rest of the world combined as of 2000. Some schools have as many as 20% of the children on medication to enhance their ability to be functional students. There is a significantly higher incidence of use in less-educated families and lower socio-economic areas.
With the dramatic surge of this relatively new disease in our communities, you would think that we know a lot about it in the medical world. Unfortunately, that is not the case. The cause of ADHD is unknown. There is no biological basis for diagnosing this disease. Neuroanatomy is found to be completely normal on a child diagnosed with ADHD compared to one who is not. The diagnosis is made only by symptoms and typically by the referral from school educators.
Some of the symptoms that would drive an educator or parent to raise concern that a child might fit into the ADHD diagnosis include: has trouble playing quietly, talks excessively, has trouble waiting his/her turn, does not seem to listen when spoken to directly and is easily distracted. While there are many more details on the diagnostic criteria, anyone who has children can recognize that these are all normal behaviors of childhood and the degree to which they require medical intervention is not a defined line.
However, for millions of children ADHD has been determined to be a significant obstacle for their well being and measures are taken to attempt to remedy the situation. While stimulant medications work to create more compliant children, the long-term effects of Ritalin and other forms of methylphenidate enhance the difficulties that they are initially prescribed to correct.
Like cocaine, Ritalin is a powerful stimulant that increases alertness and productivity. Ritalin and cocaine have a similar chemical structure, and both increase dopamine levels in the brain. They do this by blocking a dopamine transporter protein responsible for the reuptake of dopamine at the synapse.
In addition, they both constrict blood flow to the brain with a 20-25% reduction overall, particularly in the higher brain centers.
Dopamine is a neurotrasmitter in the brain that affects all aspects of reward-based learning. However, dopamine also plays a major role in diseases such as schizophrenia, restless leg syndrome, and Parkinson’s disease. Issues in dopamine production and regulation result in significant and complex impairment as people age.
In review, we have a poorly defined mental illness affecting a very large portion of American children that hardly existed fifty years ago. Simultaneously, we have no biological basis for diagnosis yet we are treating it with a drug that causes significant biological changes that affect far more than just the symptoms presented. If we could clearly say that there was more benefit in providing drug therapy to these children than there is harm, ultimately we would be better equipping modern children for the world in which they live.
The National Institute of Mental Health conducted an eight-year observational study on children using Ritalin to manage symptoms of ADHD. Outcomes of this study demonstrated that the major effects of stimulants in the classroom is improving social factors by reducing disruptions in the first two years of therapy. There was no significant improvement in academic factors and children were found to be less interactive. Beyond three years of use, children had increased symptomatology: stunted growth, increased likelihood of getting into trouble in school, and committing acts of violence. At any point, discontinuing the drug commonly results in an increase in symptoms beyond the level that was present when a child was initially prescribed the medication.
With the overwhelming surge of violence in our news headlines committed by young people, we need to carefully consider what might be contributing factors to their angst. In nearly every case, the offenders had been on prescription medications for several years with many incidences of recent changes in their dosages.
From a physician’s perspective, there are a number of factors that must be addressed in order to work toward correcting a child’s health imbalance.
Causes of ADHD can be: food intolerance, reactions to food additives, stress, unresolved emotional trauma, imbalance in the nervous system – inadequate dopamine production, nutritional deficiencies, and genetic errors of metabolism.
Having a child diagnosed with ADHD or other mental health conditions creates a myriad of difficult decisions. While the current trend of treatment focuses primarily on pharmaceutical interventions, addressing all areas of potential causes is an important way to prevent long-term use of medications that have not been proven to be safe and effective for improving child development and health.
Overall, optimal child neurological development requires a simple, consistent routine, adequate nutrition, sleep, patience, and lots of love. For more information and a lengthy list of references for this article, please contact Dr. Sara Hart at Stillwater Healing Arts Clinic. If you need help supporting your child with mental health concerns, we are happy to help.