“ADD and ADHD – Brain Gym a Natural Alternative Option”

DR. CARLA HANNAFORD

From her book ‘Smart Moves’ Chapter 14 Drugs and Hyperactivity

‘Man is so made that whenever anything fires his soul…... impossibilities vanish’

Our society has long had strong but mixed feelings about relying on wonder drugs for the troubles that afflict us. Trust and dependence on magic bullet type cures alternate with suspicions about exaggerated claims of success and concerns about unintended and unadvertised side effects. In the treatment of behaviour that adversely affects learning, the pendulum is now definitely swinging in the direction of recognising the need for non invasive, natural and common sense alternatives to drugs.

The drugs we use to treat hyperactivity are a good place to start. There are compelling reasons to question the continued practice of treating hyperactivity and attention deficit disorders with Ritalin and other such drugs.

Firstly, ADHD (Attention Deficit Hyperactive Disorder) is just a label with no proven genetic or pathological background. The casual agents are most certainly environmental factors already delineated in the chart on ‘What Inhibits Learning’ (Smart Moves, chapter 8).

These complex environmental factors are headed up by lack of adult attention and non-stimulating learning environments. Peter and Ginger Breggins (in their book ‘War Against Children’) point out that when faced with an ADHD labeled child, adults have two divergent choices: transform themselves and then the education system – or suppress the child. Too often drug therapy seems the easier route. Children are naturally curious, active and dependent on parental attention for their learning. When children have something interesting to do, or when they are given a reasonable amount of quality attention, ADHD often disappears.

Secondly, non-intrusive, child centred, common-sense methods work better in the long run. Suitably applied, these methods will allow children to be in charge of their emotions and physical energy and give them tools to use throughout their lives.

And thirdly, the risks of drug use usually outweigh the benefits. Drugs interact with the brain and the body in intricate, often undesirable ways. Valium, one of the most commonly used tranquilisers in our society today, gives us a warning. Valium competes with the neuropeptides responsible for causing feelings of anxiety (octadecaneuro-peptides). The drug’s calming effect confuses the nervous system as a whole at the same time it pre-empts emotional release. Valium also acts on the monocytes (white blood cells that destroy disease organisms) thus directly affecting the immune system. The behaviour of monocytes is delicate and vulnerable. Adding mood-modifying chemicals to the already complex chemical structure of the body and immune system seems very risky at a time when the incidence of life threatening diseases (cancer, Aids and heart disease) is rising.

Hyperactivity, ADD and ADHD are characterised by a lack of fine motor coordination and constant erratic non-graceful adrenalin-initiated movements . Constant external chatter is also characteristic, pointing to a lack of ‘inner speech’ development that controls social behaviour.

RITALIN AND THE BRAIN

The National Health Institute of Mental Health (USA) estimates that well over a million US children are currently taking Ritalin. Ritalin acts on the brain just like ‘speed’. Neuropharmacologically, it has the same effects, side effects and risks as cocaine and amphetamines. The FDA (Food and Drug Administration of USA) classifies Ritalin in the high addiction category schedule 2, together with amphetamines, cocaine, morphine, opium and barbiturates.

Ritalin (methylphenidate), Dexedrine (dextroamphetamine), Cyleit (pemoline) and sometimes the tricyclic anti-depressants (Tofranil and Norpramine) used in the treatment of hyperactivity, may also have detrimental long-term effects on the immune system and the body in general. These drugs affect the basal ganglion and corpus striatum – the brain areas responsible for increased motor control and sense of time. All of these drugs modify the levels of neuro-transmitters in the brain, particularly in the frontal lobes.

The frontal lobes control our ability to shift from a free association open state, to a detailed, focused, state of awareness. This ability to shift from a broader, diffuse state to sharper, narrow focus is important for human thinking and problem solving. This is the way high level formal reasoning occurs as we easily move back and forth between the big picture (broad input) and the details. Drugs used in the treatment of hyperactivity, principally Ritalin, though they allow attention to repetitive school work, detail and rote memory, inhibit the ability to shift focus between open focus and detail-focus consciousness.

And there is no evidence that Ritalin improves learning or academic performance.

One study of hyperactive adults who had been treated with Ritalin showed that nearly one-quarter failed to finish high school. Only one of the hyperactive boys, compared with eight of the control group, went on to obtain a graduate degree. Far fewer members of the hyperactive group held professional-level jobs compared to the control group. As adults, between one-third and one-half continued to experience ongoing hyperactivity. Overall it is not a great record for Ritalin.

PET Scan studies also show a marked decrease on dopamine in ADHD labeled people.

Dopamine is a neurotransmitter that plays a role in the control of movements. Nerve cell bodies containing Dopamine project axons widely into the prefrontal area of the frontal lobe of the brain as well as to the sub cortical structures including the basal ganglia. These areas have to do with regulation and control of normal fine motor movements. Some medical conditions have been helped by treatment with dopamine. For instance, dopamine has been administered medically in Parkinson’s Disease to control shaking and erratic movements.

Ritalin is thought to activate increased dopamine production within the brain, causing a decrease in hyperactive movement. However, if the brain reacts to Ritalin as it does to the other researched stimulants (Thorazine, endorphins, marijuana and cocaine), there may be long term side-effects.

Studies show a feed-back mechanism in the brain that adjusts brain chemistry in response to these stimulants. The feedback mechanism will attempt to rid the brain of excess stimulant by reducing the amount of its own natural production. The mechanism is so over stimulated that when the stimulant is discontinued, the natural brain levels may be left even lower than before, exacerbating the situation. Though these studies did not include Ritalin, this same mechanism may be occurring.

Parents complain of children going into depression and showing even greater hyper-activity when taken off Ritalin at weekends. As an addictive stimulant, Ritalin can cause withdrawal symptoms which include depression and irritability. Unaware of this withdrawal reaction, parents may feel the child should be put back on the drug

Danger also lies in the long-lasting changes in brain chemistry that may result from long-term use. Since Parkinson’s disease is related to low dopamine production, children who are medicated for hyperactivity may be more at risk of Parkinson’s Disease in later life.

Some of the precautions and adverse reactions stated for Ritalin include: loss of appetite, abdominal pain, weight loss, insomnia, tachycardia (irregular heart beat) nervousness and possible hypersensitivity, anorexia, nausea, dizziness, palpitations, headache, dyskinesia and drowsiness.

There is a very specific statement in the Physicians Desk Reference (PDR) with regard to Ritalin: “When symptoms are associated with acute stress reactions, treatment with Ritalin is usually not indicated”.

This stress connection can be seen in a recent PET Scan study on the effects of
Ritalin on adults labelled with ADHD. By the end of the study there was less restlessness and improved attention among subjects, but their brain activity still exhibited the stress reaction. From these results, David Schaffer (paper in American Journal of Psychiatry) concluded that adult ADHD is caused by unrecognised and untreated stress. “I feel strongly that my label SOSOH (Survival Oriented Stressed Out Human – see note) addressed the root cause – stress – of people having difficulties with maintaining attention and exhibiting hyperactivity. And so I agree with the PDR’s recommendations regarding the stress reaction, that Ritalin is not indicated for use with ADHD.”

(Note re SOSOH : Re non-integrated, lopsided brain functioning: a tendency to operate reflexively and/or reactively from survival centres in the brain stem and the sympathetic nervous system.)

Interestingly, no consistent brain abnormalities have been found in children labelled ADHD. However, ominously enough, a study has found brain shrinkage in labelled ADHD adults who have been taking Ritalin for years.

In my work with schools, I have been shocked at the rising number of children on Ritalin. In one school I recently visited, almost one half of the students in a particular classroom were on “Ritalin, many at the insistence of the teacher or school administration.

How does stress fit in ? Stress from various environmental, developmental, family and social influences is a trigger setting off events in the nervous system that induce and regulate survival-oriented behaviour. I believe that chronic exposure to stress inhibits full brain development.

BRAIN GYM - AN ALTERNATIVE TO DRUGS

Thinking and learning are not all in our head. On the contrary, the body plays an integral part in all our intellectual processes from our earliest moments right through to old age. It is our body’s senses that feed the brain environmental information with which to form an understanding of the world and from which to draw when creating new possibilities. And it is our movements that express knowledge and facilitate greater cognitive function as they increase in complexity

We need to become more aware of the body’s role in learning as it is being dramatically clarified by scientific research.

Physical movement, from earliest infancy and throughout our lives, plays an important role in the creation of nerve cell networks which are actually the essence of learning.

There are beneficial alternative strategies for helping people labeled hyperactive, ADD and ADHD. Dr. Eberhard Mann, a physician and Director of the Hyperactivity Clinic at Kapiolani Counselling Centre in Hawaii, advocates a comprehensive treatment for ADHD. “By comprehensive treatment we mean a treatment programme that deals with each problem that inhibits a child’s learning potential and positive social interactions. Treatment components include creative education, peer group counselling, self control training, parent and teacher education, motivation and self-esteem building, anger management and, in a few cases, ‘stimulant’ medication like Ritalin.” He also points out that Ritalin does not improve specific learning deficits or reduce aggressive behaviours.

Brain Gym is a non-invasive, common sense alternative to drug therapy. It appears to fit within Dr. Mann’s idea of a comprehensive treatment programme. It effectively assists self-control training, motivation, self esteem and anger management. Natural neurotransmitter production (GABA and dopamine) is stimulated when the whole brain is activated, as it is with Brain Gym. Hyperactive children and adults that I’ve worked with, after doing the Brain Gym activities, have been able to slow and coordinate their movements, shift easily between details and the broad picture and focus on learning. With daily Brain Gym the person gains more and more control as the frontal lobe and basal ganglion are being activated regularly. Symptoms of ADD and ADHD greatly lessen or completely disappear in an amazingly short time.

Dyslexia –According to Albert Galaburda: “the way dyslexics – or anyone else – use their brains is a critical factor in modifying them. Even people with true dyslexia, where there may be deficits in the left hemisphere of the brain, do well with right hemisphere skills” The practice of Brain Gym movements has helped dyslexics show improved performance. Autistic children and patients recovering from brain trauma also benefit.