ADD, Hyperactivity, and Ritalin

This entry was published at least two years ago (originally posted on November 30, 2004). Since that time the information may have become outdated or my beliefs may have changed (in general, assume a more open and liberal current viewpoint). A fuller disclaimer is available.

Jacqueline is curious about using drugs to offset the effects of ADD:

It’s been 13 years since I’ve taken anything for my attention deficit disorder — my childhood experience with Ritalin was awful. But things haven’t been going so well in school lately and I may have to relax my “no drugs, no way” position if I want to get it together and actually do the grad school thing.

Now, before I go any further, I need to put a big disclaimer on what follows: I am not a doctor — I don’t even play one on TV. I don’t have children. I don’t have ADD. I have never been on any prescription medication for anything other than antibiotics. I did go through a period of time when I was playing with recreational drug use, but that was confined to three drugs: a few instances of getting stoned (boring), three attempts at ‘shrooming (two of which times I went to sleep before they kicked in), and about two years of dropping acid on a fairly regular basis (fun for a while, then it was time to stop).

In other words, the following is opinion, and opinion only. Take it as such.

Now.

I have serious issues with the current obsession with ADD and the associated pharmaceutical treatments. My personal belief is that it’s an incredibly overblown and overmedicated issue. This does not mean that I don’t “believe” in ADD, or that I don’t believe that there are people who are affected by it and can benefit from treatment. What it means is that I believe that it’s often diagnosed too quickly, and that the current trend is too quick to depend on chemical treatments that are likely more detrimental in the long run.

My little brother Kevin was an unusually active baby. He had problems paying attention for more than a few minutes at a time, and was rarely still — even in his sleep, he was so constantly wired that he would bruise himself in his sleep thrashing around in his crib. Eventually, it got to the point where my parents were concerned enough that they decided to take him to a doctor and see if there was any medical explanation.

Now, this was back in the late 70’s, long before ADD/ADHD became the catchphrase of the decade. My brother was diagnosed with hyperactivity — an overabundance of energy and inability to focus, brought on by a chemical imbalance within his system. My parents were given a few choices on how to combat this. I don’t know if there were more options given than the two I’m about to mention, but I believe these were the primary options.

The first was Ritalin, a drug that is actually a central nervous system stimulant that has a calming effect on hyperactive individuals because of their unusual body chemistry.

The second was a more natural remedy — dealing with the hyperactivity by monitoring and adjusting Kevin’s diet. The chemical imbalance that triggered Kevin’s hyperactivity was brought on by excessive amounts of certain types of sugars in his system. The hyperactivity was believed to be an allergic reaction to sucrose and a few other compounds: essentially, he was allergic to cane sugar (sucrose), artificial flavors and colors, and honey. It was thought that by eliminating those elements as much as possible from his diet, it should be possible to regulate the imbalance and allow Kevin to lead a calmer, more normal life.

A little bit of Googling has turned up a few pages on the subject of hyperactivity and diet, leading me to this Q and A page that pinpoints this approach to treating hyperactivity as the Feingold Diet (further searching for “finegold diet” returned that same page as the top result). It’s apparently a somewhat controversial approach, as testing Dr. Finegold’s theories resulted in “mixed and inconsistent results” — see paragraph eight of the “20th Century History” section of Wikipedia’s ADD page for more information.

I don’t know how much was known about the Finegold Diet at the time that my parents were investigating Kevin’s unusual behavior, or how it was viewed at the time. Whatever the situation was, my parents decided that it was at least worth trying before resorting to drugs, and so Kevin’s diet was changed (along with the rest of us, of course — something that I’ve always half-believed is responsible for why I have such a sweet tooth: until the age of about four or five, I had a normal little-kid diet high in sugars; suddenly, nearly all sugars and sweets were removed from the house, and I missed them — but I digress…). We found that he could process fructose (fruit sugars) normally, and so that became the sweetener of choice in our family.

And it worked. It worked quite well, in fact. Suddenly, Kevin was manageable — at least, no more hyper than any other young child. And, in case there were ever any doubts as to whether it was the diet making the difference, the changes in his behavior when he did manage to get ahold of anything with high amounts of sugar were staggering (I remember one instance where after getting into a stash of Oreos I had hidden in my room he got to the point of physically attacking our dad — a rather scary situation for all of us). When his sugar levels did start to get a little high, all it took was a couple cups of coffee to calm him down, as the caffeine worked with his body chemistry in a similar way to how the Ritalin works: what’s a stimulant to a normal person acts as a depressant to a hyperactive person.

Now, obviously, no two people are going to have the same body chemistry, and a solution for one person isn’t necessarily a solution for all. Even when one solution does present itself, something as simple as time can make a huge difference — as my brother aged, he became less and less adversely affected by the sugars that sent him into fits as a child, and to my knowledge, he hasn’t had to worry about any medical dietary restrictions for quite a few years now. According to the above referenced Wikipedia article, testing on Dr. Finegold’s methods resulted in wildly inconclusive results, with success rates reported as anywhere from as much as 60% to as little as 5% of the test subjects.

So no, it’s not a catch-all, and I harbor no wild beliefs that because it worked for my brother, it will work for everyone else. However, I know it helped my brother, and even working with the low end of the reported success rate — five percent — if four million children are diagnosed with ADHD each year, then that’s around 200,000 that could see a substantial difference simply by experimenting with their diet (and I’d bet that choosing your foods wisely is a lot cheaper than filling a Ritalin prescription for years).

It just seems to me that if there’s a possibility of being able to help someone with something as simple as a little attention to their diet, than shouldn’t that be one of the first things investigated? It may not work — there may even be a 95% chance that it won’t — but if it does, than it’s easier, healthier, cheaper, and it would probably take no more than a few weeks or a few months to be certain as to whether a different diet is making the difference. Why start with the howitzer when a slingshot might be all you need?

What concerns me are two things: firstly, that I rarely (if ever) hear of people who know about the potential benefits of the dietary approach; and secondly (and more importantly), I really wonder sometimes if people these days are overly quick to assign their children the label of ADHD.

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Quite simply, children are supposed to be hyper! Yes, if it’s excessive, get it checked — but please don’t jump to the conclusion that a child is hyperactive simply because you’re having troubles controlling them. Children need to be active and interested in everything around them, it’s how they learn. They’re plopped down in the middle of this huge world, with all sorts of stuff to explore and investigate and taste and pound on and break and put together and figure out how it all works — and it really worries me when it seems to me that some parents are in far too much of a hurry to drug their children into insensibility because it would make their life easier.

Okay, I think I’m done.

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