What has impressed us the most in treating over 2000 children with behavioral and learning problems, the majority of them diagnosed with ADHD, is their intensity that many of them exhibit and is disseminated among those around them. How easily that intensity, tension, and pressure is passed on from one member of the ADHD child’s network to the next, including us. Parents most frequently use the word “desperate.”A sense of urgency, a fix-this-child-fast mentality that parents, teachers, and caregivers often share. Even though ADHD by itself is not life-threatening, and is truly physically dangerous only in the case of relatively infrequent accompanying conditions such as serious drug addiction, homicidal anger, or suicidal impulses, there is a sense of immediacy that permeates the condition. This may be more true in cases of ADHD with hyperactivity or violence, however we have also seen it to be the case among children who have attention problems without the hyperactivity.

The behaviors associated with ADHD, particularly if it is moderate to severe, are not easy for anyone, least of all the child or adult suffering from it. The child, who in some way is not happy or comfortable in his own skin, sets off a type of chain reaction. He can’t control his impulses, words, or actions and, consequently irritates, disturbs, aggravates, or infuriates those around him, depending on which of their buttons is pushed. It might be a teacher who is already trying to manage 30 other little rug rats or testy teenagers, a parent who is overworked, underpaid, and underappreciated, or a physician who may be pushed to prescribe medications that she may or may not believe are indicated for that child.

The bottom line: it’s not easy for any member of the ADHD family, social, and academic group. Children with ADHD are often frustrated with their own behaviors and deficits, they just can’t figure out a way to be “normal” and acceptable. The teachers may be pushed beyond their patience and abilities, and may react punitively out of their own performance stress and anxiety. The parents simply want some peace and quiet and to do what is best for their child. The caregivers want to do their best for the child to the extent their patience allows. The doctors may feel compelled to prescribe medications without sufficient information or conviction. Welcome to the ADHD pressure cooker!

Nick: A Child with ADHD

My name is Nick and I am an eight year old in the second grade. I’m kind of nervous about doing my homework right, doing okay on tests and getting good reports from my teacher. I want to please my parents so they’ll be proud of me and will let me watch my favorite T.V. shows, play video games whenever I want, and let me have my friends over for sleepovers or to play.

My parents don’t seem very happy with me. They’re constantly telling me to do the same thing a bazillion times over then yelling at me when I forget it again. They tell me that I’m zoning out, not listening to them, not doing what they tell me to do. I try, but it just doesn’t seem to make a difference. I don’t want to make them mad, but whatever they tell me to do just flies out of my mind. And they tell me too many things at the same time. How can anybody remember to do five different things at the same time? I didn’t mean to leave my brand new jacket at school where it never turned up again or to forget to bring home my notebook with all my assignments in it, or to spill grape juice on my mom’s new champagne-colored sofa. These things just happen to me.

Then there’s my older sister, Sasha, and my little brother, Sky. I don’t mean to bug them and get on their nerves. I don’t try to tap my feet and move around all the time and ask too many questions. Or to break their favorite toys or go into their rooms when they don’t want me there. It’s not my fault that my mom and dad have to spend so much extra time trying to help me with my homework that there’s not much time left for them. Why do they seem so mad at me and why does Sasha make me feel like she wishes I weren’t even around?

It’s not much better in the friends department. Nobody likes me and I never get invited to birthday parties like the other kids. I eat lunch by myself and there’s nobody to play with at recess. They just make fun of me and don’t pick me for their teams.

And then there’s school. I really don’t think Mrs. Claremont likes me either. Whenever she calls on me, my mind is off somewhere else and I don’t know the answer. Or I get in trouble for clicking my pencil or tapping my feet when I’m just bored. It seems like Mrs. Claremont is always mad at me for something I’m doing or not doing. I didn’t mean to lose those homework assignments or to not be able to finish my tests. And she never has anything nice to say on the notes she sends home. They usually get me grounded or I lose my allowance for the whole week.

I guess I don’t like myself any more than anybody else likes me. No matter how hard I try, I still feel like a loser.

Mrs. Claremont: Second-grade teacher

This is my eleventh year of teaching and this is the toughest class yet! Not only did they give me a class of 30 kids, but they cut my aides to one and she’s brand-new and not much help. They expect me to do a great teaching job and I want to help those kids. That’s why I went into teaching in the first place. But it seems to get harder and harder every year!

It used to be that I had one difficult kid in my class and now I have four. Two have IEPs [individualized educational programs] and get taken out of class at various times and at least two others need an IEP. The kids are so much harder to control than they used to be. Either they won’t stay in their seats or they don’t care about learning or they’re moving around incessantly. Those three kids with ADHD are so distractible that they keep the other kids from learning. I don’t know how to make them sit still. When I went into teaching, nobody told me I’d have to be a policewoman to make sure they don’t bring guns to school or that I’d have to spend half my time just telling them to stay in their seats and keep their mouths shut.

I really don’t know what to do with Nick. He’s a nice kid, but he drives me crazy. Can’t sit quietly at his desk to save his life and blurts out the answers before anyone else has a chance to say anything. That kid can’t remember to take home his assignment sheets much less turn in his homework. I don’t see how he’ll pass second grade unless he shapes up. I just don’t have time to give him the kind of attention that he needs. It’s been a month since the school year started and he still isn’t catching on. I think he’s one of those kids described in that pamphlet I read about ADHD. The one that talked about stimulants as a way to turn these kids around. It said that parents who aren’t willing to give their kids Ritalin are committing a form of neglect. That’s what I’ll do – I’ll tell his parents I think he needs Ritalin. And if they don’t want to and he keeps up like this, I just can’t have him in my class.

Betty and Jim: Nick’s parents

We love Nick and want him to do the very best he can. We know he’s a good kid, but we worry about him. He’s absent-minded, loses everything in sight, and is weak on follow through. We just can’t figure out why he can’t concentrate. We never had this problem when we were in school. All that seems to hold Nick’s attention is Nintendo and Pokemon. And the other kids give him such a hard time. His self-esteem is down the tubes.

We’ve read about ADHD and it does seem to fit him, but the idea of giving him amphetamines isn’t very appealing. He’s already thin and we’re afraid he’ll lose even more weight. And it’s already hard for him to get a good night’s sleep. But what should we do?
Are we being unfair to him if we don’t give him stimulants? Depriving him of his ability to succeed?

You read so much about ADHD these days. How overdiagnosed it is and how they’re giving kids all kinds of medications that have only been tested on adults. And the huge jump in Ritalin production, most of which is used in the U.S. We know the school will start pushing us to have Nick diagnosed with ADHD and get stimulants. That’s what we hear from the parents of other kids like Nick. But what if he ever wants to go in the military? He won’t be accepted later if we give him Ritalin now. What do we do?

Bill Murphy: Nick’s pediatrician

So, here’s Nick. A nice kid with a moderate case of ADHD. His parents aren’t pressuring me to prescribe Ritalin, which often happens in my practice. He hasn’t had a psychological workup, but he certainly does have the symptoms. Funny, how many kids seem to have ADHD these days. It wasn’t like that when I started out 15 years ago. Kids seemed much more normal back then. Ear infections, strep throats…..I hardly ever saw a case of ADHD. And now millions of kids out there on Ritalin. And more on Prozac or Clonodine.

I want to do the best for Nick, but what does that mean? Give him Ritalin till he outgrows the ADHD, if he ever does? Refuse and let his parents find another doctor who will? Make some other suggestion? The information I get says that Ritalin is very likely to help him. I haven’t read about anything else that seems as effective. I have an obligation to the family to help Nick, whatever that means. In the past I might have referred him to a child psychiatrist or psychologist, but there are so many children like Nick and stimulants seem to work if the side effects aren’t a problem.

An Epidemic of ADHD?

Each member of this scenario is under pressure and has his or her own needs. This situation is far too common. So much so that a recent study in Pediatrics found that nearly three times as many children in the U.S. have emotional or behavioral problems as 20 years ago.1 Since 1990, the number of children and adults diagnosed with ADHD in the United States has increased from under one million to five million. The amount of Ritalin produced in the United States during the same time frame has risen 700%.2 Ritalin, or methylphenidate, is an amphetamine created in 1955 which now accounts for 90% of the stimulant use in ADHD in this country.3 Hundreds of studies have documented the short-term benfits of stimulant medications in the treatment of ADHD, but there remains a lack of evidence demonstrating long-term benefits of these drugs on school achievement, peer relations, or behavior problems in adolescents.4 Accusations of overdiagnosis and overmedication of preschoolers for ADHD has prompted the federal government to fund a $5 million research project to study children who are taking Ritalin,5 and the Colorado Board of Education to pass a resolution urging teachers to rely on discipline and instruction to handle behavior problems in the classroom and discouraging teachers from making recommendations for medical evaluations for ADHD and treatment with Ritalin.6

Ritalin is Not the Only Answer

Given these facts of life relative to ADHD, you would think that parents, teachers, and physicians would be looking to more natural, effective solutions, but this is much less often the case than we would like to see. Yes, there are over 50,000 people (mostly parents) who are curious enough to have picked up a copy of Ritalin-Free Kids, but a limited number of teachers, physicians, and other caregivers, if they do receive, or read the book, it is usually thanks to the parents of a child diagnosed with ADHD. There is a general feeling that “stimulants work so why look further?” In fact, many parents and children are unhappy with the side effects as well as with their children taking amphetamine medication, possibly for life.

For many people, it is a matter Ritalin or nothing. There is little or no awareness or recognition of non-drug approaches to ADHD. This outlook is encouraged by Novartis, the manufacturer of Ritalin, CHADD (Children and Adults with ADD), the nationwide support group that provides most of the education for parents of kids with ADHD, and by the majority of child and behavioral psychiatrists and psychologists and by some pediatricians. Few, even those who believe that ADHD is overdiagnosed and Ritalin overprescribed, will consider the possibility that non-drug alternatives outside of behavioral therapy or, possibly, neurofeedback, may be effective. We hope, given the climate of questioning the tremendously increasing prevalence of ADHD and prescription of stimulant medication to school-age children and preschoolers, as well as the prevalent off-label prescribing of a number of other drugs such as SSRIs (selective serotonin reuptake inhibitors), other antidepressants, and Clonodine, more people will be open to hearing about alternatives that work.

Having treated numerous children with behavioral and learning problems with homeopathy, with considerable success, we urge those who are looking for a safe, effective, and natural answer to ADHD and other behavioral and learning problems to at least entertain the possibility that homeopathy may work for them or their children. And if, for whatever reason, homeopathy is not available or feasible, that other alternatives to stimulant medication will be explored.

Children and adults with ADHD, teachers, parents, and physicians are all under duress to find quick answers for this not-so-straightforward problem. They all deserve information, support, and time to make the best decisions possible and we encourage them to do so with an open mind. Most of all, we owe it to these children to find additional answers to assist them in finding happiness and in fulfilling their optimal potential.

References

1. Reuters and the Associated Press. Doctors see big increase in troubled children: study cites stressed-out families. The Seattle Times. June 6, 2000, A1.
2. Diller, Lawrence. Running on Ritalin. New York: Bantam, 1998, 2.
3. Goldman, L et al. Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. JAMA, Apr 8, 1998, 279, 14, 1103.
4. Jacobvitz, D et al as cited in LeFever, G el al, The extent of drug thereapy for attention deficit-hyperactivity disorder among children in public schools. Amer J of Public Health, Sept 1999, 89, 9, 1363.
5. Anderson, N. U.S. pledges hard look at use of behavior drugs on children. The Seattle Times, Mar 21, 2000, A4
6. Janofsky, M. Behavior drugs for the young debated anew. New York Times, Nov 25, 1999, 1.