ADHD is an increasingly common diagnosis. Whether this diagnosis is a misdiagnosis or not will not be discussed here. Rather, I wish to highlight how the patient will be feeling or what the parents may have observed when they seek medical intervention, and how Herbal Medicine is standing in the wings ready to help.
For the diagnosis of ADHD or ADD to be made the child will demonstrate 5 to 9 of these criteria.
- The child does not like to complete tasks that require mental stimulation.
- Child often misplaces items of clothing, and other possessions.
- Child finds it difficult to focus on any one task until completion.
- Child answers questions before the question is finished being asked.
- Child blurts over people in conversations and finds it difficult to wait their turn.
- Child is unable to plan the material and time required for a task without guidance.
- Child is unable to sit still and enjoy a leisurely activity.
- Child often runs and jumps or climbs when it is inappropriate to do so.
- Child cannot sit in a seat to complete an activity.
(Attention-Deficit/Hyperactivity Disorder (ADHD), 2020)
This breakdown of the diagnostic criteria does not mention the common overlap of anxiety associated with ADHD (Reimherr, Marchant, Gift, & Steans, 2017). The criteria does not mention how other children and teachers react to the child when they do not wait their turn, or accidentally knock someone over when they show enthusiasm, and how this affects the child’s self-confidence. The criteria does not highlight that as the child grows older, they notice that they find it difficult to keep up with their peers academically and may feel that they are not as good. Neither does the criteria mention possible bed wetting (Haid & Tekgül, 2017), and the shame involved, making sleep overs difficult for the child.
Herbal Medicine intervention looks at the anxiety and self esteem related to the condition. Supporting the nervous system, using herbal intervention, means that the child will have the resilience required to cope with the effort they need to make to control their impulses, and react as society requires. One such herb is Bacopa monnieri, this herb is borrowed from Ayuverdic medicine, and is clinically proven to support the development of neurological pathways and the reduction of anxiety (Kean et al., 2015).
The medication that is frequently prescribed by paediatricians for the maintenance of focus on tasks is Vyvanse which is lisdexamfetamine (Heal, Smith, Gosden, & Nutt, 2013). This medication works by keeping dopamine and norepinephrine in the neural synapse, so that the person feels more alert (Goodman, 2010). Vyvanse is preferred over amphetamines because in this form the medication requires enzymatic action by the liver to turn into amphetamine, in theory thereby reducing the addictive side effect as well as overstimulation (Ekstrand, Murphy, & Wideman, 2019). Clinical trials reveal that the patient does not always report any significant improvement when on this medication, and compliance is low due to the side effects related to it (Castells, Blanco-Silvente, & Cunill, 2018).
The focus of Herbal Medicine is in improving the efficacy, of this medication while reducing side effects. The additional dopamine requirements associated with the function of Vyvanse means an increase in the nutritional requirement of the amino acid tyrosine. Tyrosine is present in meat, nuts and egg and is essential for the production of dopamine and norepinephrine (Stoker, 2013, p. 562). Ensuring a balanced diet is followed is very important, but without a healthy digestive function, full absorption is not taking place. The Herbalist will investigate gut function and support the absorption of essential nutrients to reduce side effects.
Herbal Medicine is a complimentary medicine. We aim to support the individual to reach their full health potential. This means Herbal medicine is there to ensure the allopathic medicine applied gives the best result for the person, without reducing any quality of life.
Attention-Deficit/Hyperactivity Disorder (ADHD). (2020). Retrieved from: https://www.cdc.gov/ncbddd/adhd/diagnosis.html
Castells, X., Blanco-Silvente, L., & Cunill, R. (2018). Amphetamines for attention deficit hyperactivity disorder (ADHD) in adults. The Cochrane database of systematic reviews, 8(8), Cd007813. doi:10.1002/14651858.CD007813.pub3
Ekstrand, E., Murphy, H. M., & Wideman, C. H. (2019). The effects of the prodrug Vyvanse on spatial working memory and adiposity in rats. Pharmacol Biochem Behav, 186, 172765. doi:10.1016/j.pbb.2019.172765
Goodman, D. W. (2010). Lisdexamfetamine dimesylate (vyvanse), a prodrug stimulant for attention-deficit/hyperactivity disorder. Pharmacy and Therapeutics, 35(5), 273.
Haid, B., & Tekgül, S. (2017). Primary and Secondary Enuresis: Pathophysiology, Diagnosis, and Treatment. European Urology Focus, 3(2), 198-206. doi:10.1016/j.euf.2017.08.010
Heal, D. J., Smith, S. L., Gosden, J., & Nutt, D. J. (2013). Amphetamine, past and present–a pharmacological and clinical perspective. Journal of psychopharmacology (Oxford, England), 27(6), 479-496. doi:10.1177/0269881113482532
Kean, J. D., Kaufman, J., Lomas, J., Goh, A., White, D., Simpson, D., . . . Stough, C. (2015). A Randomized Controlled Trial Investigating the Effects of a Special Extract of Bacopa monnieri (CDRI 08) on Hyperactivity and Inattention in Male Children and Adolescents: BACHI Study Protocol (ANZCTRN12612000827831). Nutrients, 7(12), 9931-9945. doi:10.3390/nu7125507
Reimherr, F. W., Marchant, B. K., Gift, T. E., & Steans, T. A. (2017). ADHD and Anxiety: Clinical Significance and Treatment Implications. Current Psychiatry Reports, 19(12), 109. doi:10.1007/s11920-017-0859-6
Stoker, H. S. (2013). General, Organic, and Biological Chemistry (2013 ed., Vol. Sixth Edition, pp. 559). Belmont, CA 94002-3098 USA: Brook/Cole.