Welcome to the 21st-century lab, where hormones, brain pacemakers and magnetic coils can treat and cure depression, even treatment-resistant depression.

We've come a long way. Some psychiatrists used to think you could cure depression by removing a patient's colon or teeth. In the late 1800s, there was a doctor who observed his anxious patient become calm on a bumpy train; thereafter treatment consisted of shaking the poor man for greater and greater lengths of time.

In an attempt to cure the ancient malady of melancholia, we have resorted to scads of strategies, some of them plainly stupid or cruel, others, like Prozac (Fluoxetine), that work. But an estimated 30 percent of depressed patients are what's called treatment-resistant; they don't respond to pills or talk or even electroshock therapy. The good news is that there are new treatments for depression making their way into the 21st-century world; depression treatments that offer hope for the newly diagnosed or for someone who has been suffering without, so far, a cure in sight.

The Gold Standard of Treating Depression

We want to urge you to read our special depression treatment section: "The Gold Standard for Treating Depression." It's an in-depth, authoritative examination of the best treatments for depression (covering all aspects of treatment for depression, from getting a correct diagnosis to antidepressant medications, therapy and lifestyle changes.) written by award-winning author, Julie Fast, exclusively for HealthyPlace.com. This section includes depression videos; interviews with Julie Fast.

Miracle Medications for Depression

It used to be that psychiatrists would try a patient on one antidepressant medication, wait eight weeks and, if it didn't work, switch to another one. While this is still a viable (if frustratingly slow) tactic, psychiatrists are relying more and more on secondary, and even tertiary, drugs to boost the primary player. One of those booster drugs is Cytomel, a thyroid stimulator. Even women with normal thyroid levels can, under a psychiatrist's supervision, take Cytomel in addition to an antidepressant. About 50 percent of the time, it helps the primary drug work more effectively. Other popular booster medications are lithium (Eskalith) and Ritalin (Methylphenidate).

Hormone Therapy As A Treatment for Depression

Scientists have spent years and years investigating chemicals like serotonin and their effects on mood, while neglecting to study brain chemicals still more common, and abundant, like estrogen and progesterone. Andrew Herzog, M.D., a neuroendocrinologist at the Beth Israel Deaconess Medical Center in Boston, treats many women who don't respond to Prozac (Fluoxetine) and its chemical cousins with sex steroids. "The future of psychiatry lies largely in the realm of using hormones to regulate brain states," Herzog says.

He believes many women become depressed either because they have a measurable imbalance of estrogen and progesterone or because their brains are too sensitively tuned to normal fluctuations. "Hormones are psychoactive," Herzog says, "and there's no doubt that they can have huge effects on our feelings." Progesterone, claims Herzog, is seven times stronger than your average barbiturate, and it exerts a strong calming, even sleepy, effect. Estrogen, the opposite, provides pep just as well, if not better, than that Prozac (Fluoxetine) pill you're taking. For women with agitated depressions that make them nervous and jumpy, Herzog might prescribe progesterone to calm with a bit of estrogen to brighten, in the form of a cream the woman rubs into her skin. For lethargic depressions, Herzog emphasizes the estrogen instead, and he's had remarkable success treating women who were deemed "untreatable." "These hormones gave me my life back," says one of his patients, who became depressed in her 40s and was incapacitated by her 50s.

Hormone treatment for depression requires that you see a knowledgeable neuroendocrinologist and that you undergo a hormone profile, having your levels of progesterone and estrogen measured at the beginning and end of the month. The procedure is new but so far highly promising.

"Get Happy" Pacemakers

The vagal nerve connects your brain stem with your upper body, specifically your lungs, heart and stomach. The nerve is a critical conduit for relaying information to and from your central nervous system, carrying electrochemical signals up its tubing and depositing them directly into your cortex.

Some years ago, researchers began implanting a small pacemaker into the vagal nerves of epileptics to see if tiny pulses might help stop the seizures. The pacemakers did indeed reduce or eliminate seizures in some epileptics, but they did something else, as well, something surprising and critical. Epileptics with vagal-nerve pacemakers got happy. Their moods improved. That's when researchers decided to try using them in people with treatment-resistant depression.

No one quite knows how or why they work. Some doctors hypothesize that vagal-nerve stimulation (VNS) instigates changes in norepinephrine and serotonin, two neurotransmitters closely associated with mood. John Rush, M.D., at the University of Texas Southwestern Medical Center at Dallas, and colleagues did a study of 30 people with treatment-resistant depression. They implanted the pacemakers into those people and, over a two-week period, gradually increased the amount of stimulation current to levels the patients could tolerate comfortably.

Forty percent of these patients showed a substantial decrease in depression as measured by a verbal test asking them about their thoughts and feelings; 17 percent had a complete remission.

After one year of VNS, more than 90 percent of the patients who benefited from the initial treatment continued to show a decrease in depression.

Magnetic Healing of Depression

Transcranial magnetic stimulation (TMS) may someday replace electroconvulsive therapy (ECT) altogether. In TMS, an electrical current passes through a handheld wire coil that a doctor then moves over your scalp. The electrical current makes a powerful magnetic pulse, which passes straight through your scalp and stimulates nerve cells in the brain.

TMS is in part remarkable because of its specificity. Researchers now believe they can target brain structures that they know are involved in the creation and maintenance of depression and anxiety.

Many studies indicate that magnetic brain stimulation once daily for two or more weeks may relieve depression (a typical patient's symptoms are reduced by almost 30 percent). Although TMS is still considered an experimental form of treatment, various hospitals and clinics offer it. Within five to ten years, TMS may become a common form of treatment for people with depression.

And this is just the beginning. Twenty years ago we had only the crudest psychiatric drugs; in the space of two short decades, we've developed an arsenal, and more important than that, we've shown we're capable of ever more complex and innovative treatment strategies. The next few decades will bring as-yet-unheard-of kinds of cures, for us, for our children and so on down the line.

next: Overcoming Depression and Finding Happiness
~ depression library articles
~ all articles on depression

In an effort to treat ADHD, some turn to alternative therapies. How do you know if these alternative treatments for ADHD work or are they a hoax?

In the past decade, there has been a tremendous upsurge of scientific and public interest in attention-deficit/hyperactivity disorder (AD/HD). This interest is reflected not only in the number of scientific articles, but also in the explosion of books and articles for parents and teachers. Great strides have been made in the understanding and management of this disorder. Children with AD/HD who would have gone unrecognized and untreated only a few short years ago are now being helped, sometimes with dramatic results.

There are still many questions to be answered concerning the developmental course, outcome and treatment of AD/HD. Although there are several effective treatments, they are not equally effective for all children with AD/HD. Among the most effective methods to date is the judicious use of medication and behavior management, referred to in the scientific literature as multimodal treatment. Multimodal treatment for children and adolescents with AD/HD consists of parent and child education about diagnosis and treatment, specific behavior management techniques, stimulant medication, and appropriate school programming and supports. Treatment should be tailored to the unique needs of each child and family.

In an effort to seek effective help for AD/HD, however, many people turn to treatments that claim to be useful but have not been shown to be truly effective, in agreement with standards held by the scientific community.

The following terms are important in understanding treatment interventions:

1. Medical/medication management of AD/HD refers to the treatment of AD/HD using medication, under the supervision of a medical professional. See CHADD Fact Sheet #3, "Evidence-based Medication Management for Children and Adolescents with AD/HD," for more information.

2. Psychosocial treatment of AD/HD refers to treatment that targets the psychological and social aspects of AD/HD. See CHADD Fact Sheet #9, "Evidence-based Psychosocial Treatment for Children and Adolescents with AD/HD," for more information.

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   Alternative treatment is any treatment — other than prescription medication or standard psychosocial/behavioral treatments — that claims to treat the symptoms of AD/HD with an equally or more effective outcome. Prescription medication and standard psychosocial/behavioral treatments have been "extensively and well reviewed in the extant literature, with undoubted efficacy."¹

4. Complementary interventions are not alternatives to multimodal treatment, but have been found by some families to improve the treatment of AD/HD symptoms or related symptoms.

5. Controversial treatments are interventions with no known published science supporting them and no legitimate claim to effectiveness.

Before actually using any of these interventions, families and individuals are encouraged to consult with their medical doctors. Some of these interventions are targeted to children with very discrete medical problems. A good medical history and a thorough physical examination should check for signs and symptoms of such conditions as thyroid dysfunction, allergic history, food intolerance, dietary imbalance and deficiency, and general medical problems that may mimic symptoms of AD/HD.

How are Treatments Evaluated?

There are two ways that treatments may be evaluated: (1) standard scientific procedure or (2) limited case studies or testimonials. The scientific approach involves testing a treatment in carefully controlled conditions, with enough subjects to allow researchers to be comfortable with the "strength" of their findings. These studies are repeated a number of times by various research teams before arriving at a conclusion that a particular treatment helps a particular problem.

The studies need to include techniques that decrease the chance of reaching incorrect conclusions. These techniques include comparing the particular treatment to placebo or other treatments, assigning people to the particular treatment or the comparison treatment in a random fashion, and when possible, not letting families or researchers know which treatment the person is receiving until the study is finished, or at least having people evaluate the outcomes of the study who are not associated with the study and are unaware of what each person received. It is also important that the people in the study have the same diagnosis, which is obtained using a clearly defined process, and that sound scientific measures are used to assess outcomes.

Good scientific studies are often published in scientific journals, and must go through a peer review before they are published. Peer review is the analysis of research by a group of professionals with expertise in a specific scientific or medical field. Findings are not considered substantive until additional studies have been conducted to reaffirm (or refute) the findings.

In the second method of evaluation, conclusions are drawn from a limited number of patients and are often based solely on testimonials from doctors or patients. A treatment that is evaluated only in this manner is not necessarily a harmful or ineffective treatment. However, the lack of standard scientific evaluation raises questions about the effectiveness and safety of a treatment.

How Do I Assess Alternative Treatments for ADHD?

Alternative treatment approaches are usually publicized in books or journals that do not require independent review of the material by recognized experts in the field. Often, in fact, the advocate of a particular treatment approach publishes the work himself. Measurement techniques and statistical means of evaluation are usually not present, and "proof" of the effectiveness of the treatment often comes in the form of single case studies or descriptions of the author's clinical experience with a large number of patients.

References

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Questions to Ask Alternative Health Care Providers

The following questions should be asked of health care providers regarding any intervention being considered. Negative or incomplete answers to these questions should be a cause for concern because it suggests the absence of adequate research on the intervention.

• Have clinical trials (scientific tests of the effectiveness and safety of a treatment using consenting human subjects) been conducted regarding your approach? Do you have information regarding the results?

• Can the public obtain information about your alternative approach from the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health? (The NCCAM supports research on complementary and alternative medicine, trains researchers, and disseminates information to increase public understanding of complementary and alternative medicine.) The office can be reached toll free at 888-644-6226 or through its Web site(http://nccam.nih.gov).

• Is there a national organization of practitioners? Are there state licensing and accreditation requirements for practitioners of this treatment?

• Is your alternative treatment reimbursed by health insurance? Checklist for Spotting Unproven Remedies

This list has been adapted from Unproven Remedies, Arthritis Foundation, 1987.

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1. Is it likely to work for me? Suspect an unproven remedy if it:

• claims to work for everyone with AD/HD and other health problems. No treatment works for everyone.

• uses only case histories or testimonials as proof. It is essential that promising reports from individuals using a treatment be confirmed with systematic, controlled research.

• cites only one study as proof. One can have far more confidence in a treatment when positive results have been obtained in multiple studies.

• cites a study without a control (comparison) group. Testing a treatment without a control group is a necessary first step in investigating a new treatment, but subsequent studies with appropriate control groups are needed to clearly establish the effectiveness of the intervention.

2. How safe is it? Suspect an unproven remedy if it:

• comes without directions for proper use;

• does not list contents;

• has no information or warnings about side effects; and

• is described as harmless or natural. Remember, most medication is developed from "natural" sources, and that "natural" does not necessarily mean harmless.

3. How is it promoted? Suspect an unproven remedy if it:

• claims to be based on a secret formula;

• claims to work immediately and permanently for everyone with AD/HD;

• is described as "astonishing," "miraculous," or an "amazing breakthrough;"

• claims to cure AD/HD;

• is available from only one source;

• is promoted only through infomercials, self-promoting books, or by mail order; and

• claims that the particular treatment is being suppressed or unfairly attacked by the medical community.

Evaluating Media Reports

Develop a healthy skepticism and be sure to watch for red flags when evaluating media reports of medical advances. When evaluating reports of health care options, consider the following questions:

1. What is the source of the information? Good sources of information include medical schools, government agencies (such as the National Institutes of Health and the National Institute of Mental Health), professional medical associations, and national disorder/disease-specific organizations (such as CHADD). Information from studies in reputable, peer-reviewed medical journals is more credible than popular media reports.

2. Who is the authority? The affiliations and relevant credentials of "experts" should be provided, though initials behind a name do not always mean that the person is an authority. Reputable medical journals now require researchers to reveal possible conflicts of interest, such as when a researcher conducting a study also owns a company marketing the treatment being studied or has any other potential conflict of interest.

3. Who funded the research? It may be important to also know who funded a particular research project.

4. Is the finding preliminary or confirmed? Unfortunately, a preliminary finding is often reported in the media as a "breakthrough" result. An "interesting preliminary finding" is a more realistic appraisal of what often appears in headlines as an "exciting new breakthrough." You should track results over time and seek out the original source, such as a professional scientific publication, to get a fuller understanding of the research findings.

References

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Tips for Negotiating the World Wide Web

The good news is that the Internet is becoming an excellent source of medical information. The bad news is that with its low cost and global entry, the Web is also home to a great deal of unreliable health information.

In addition to the tips cited earlier, Web surfing requires special considerations:

• Know the source. The domain name (e.g., www.chadd.org) tells you the source of information on the Web site, and the last part of the domain name tells you about the source (e.g., .edu = university/educational, .biz/.com = company/commercial, .org = non-profit organization, .gov = government agency).

• Obtain a "second opinion" regarding information on the Web. Pick a key phrase or name and run it through a search engine to find other discussions of the topic or talk to your health care professional.

Financial Resources Required by Families

Families need to be aware of the financial implications of any treatment. Ask the following questions to determine the financial impact of a treatment:

1. Is the treatment covered by health insurance?

2. What out-of-pocket financial obligation will the family have?

3. How long will this out-of-pocket financial obligation be?

Forewarned is Forearmed

Get into the habit of actively seeking out information about AD/HD and every prescribed medication and intervention that is proposed for you or your child. If you use alternative medicines, don't forget that they, too, are drugs. To prevent harmful interactions with prescribed medications, inform your health care provider of any alternative medication used. Before actually beginning an intervention, check with your medical doctor.

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Overview of Alternative, Complementary, and Controversial Treatments for AD/HD

This information is provided for educational purposes only. Because not every treatment for every individual is effective, CHADD encourages additional research on all complementary interventions that demonstrate some potential.

Dietary Intervention

Dietary interventions (as contrasted with dietary supplements) are based on the concept of elimination, that one or more foods are eliminated from one's diet.

The most publicized of these diet elimination approaches is the Feingold Diet.² This diet is based on the theory that many children are sensitive to dietary salicylates and artificially added colors, flavors, and preservatives, and that eliminating the offending substances from the diet could improve learning and behavioral problems, including AD/HD. Despite a few positive studies, most controlled studies do not support this hypothesis.¹ At least eight controlled studies since 1982, the latest being 1997, have found validity to elimination diets in only a small subset of children "with sensitivity to foods."1 While the proportion of children with AD/HD who have food sensitivities has not been empirically established, experts believe that the percentage is small.^1,3,4 Parents who are concerned about diet sensitivity should have their children examined by a medical doctor for food allergies.

Research has also shown that the simple elimination of sugar or candy does not affect AD/HD symptoms, despite a few encouraging reports.^1,5

Nutritional Supplements for ADHD

Nutritional supplementation is the opposite of the dietary elimination approach. While the elimination diet assumes that something is unhealthy and should be removed from the diet, supplementation is based on the assumption that something is missing in the diet in an optimal amount and should be added. Parents who are concerned about possible missing nutrients should have their children examined by a medical doctor.

While the Food and Drug Administration (FDA) regulates the sale of prescription medication, the FDA does not strictly regulate the ingredients or the manufacturer claims about dietary supplements. Go to the FDA Web site (http://www.fda.gov) to learn about existing regulations.

AD/HD is a brain-based disorder where the chemistry of the brain (neurotransmitters) is not functioning as it should. Nerve cell membranes are composed of phospholipids containing large amounts of polyunsaturated fatty acids (omega-3 and omega-6). Studies have been conducted to examine the impact of omega-3 and omega-6 deficiency and the possible impact of fatty acid supplementation. Further controlled studies are needed.¹

Recently, organizations exclusively promoting glyconutritional supplements have come into business and are widely publicizing their products. Glyconutritional supplements contain basic saccharides necessary for cell communication and formation of glycoproteins and glycolipids. These saccharides are glucose, galactose, mannose, N-acetylneuraminic acid, fucose, N-acetylgalactosamine, and xylose. Two small studies showed a reduction in inattention and hyperactivity symptoms after a program of glyconutritional supplements,^6,7 but a third study found no impact of the supplements on symptoms.¹

References

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The following conclusions regarding various supplements are based on an extensive review of the scientific literature:¹

1. Treatments with supplements that "are neither proven nor found lacking in definitive controlled trials" include essential fatty acid supplementation, glyconutritional supplementation, recommended daily allowance (RDA) vitamins, single-vitamin megadosage, and herbals.

2. Megadose multivitamins (as opposed to RDA multivitamins) "have been demonstrated to be probably ineffective or possibly dangerous," and "have not only failed to show benefit in controlled studies, but also carry a mild risk of hepatotoxicity and peripheral neuropathy."

3. "For children with demonstrated deficiencies of any nutrient (e.g., zinc, iron, magnesium, vitamins), correction of that deficiency is the logical first-line treatment. It is not clear what proportion of children have such a nutritional deficiency." The deficiency as a cause of AD/HD without other symptoms has not been demonstrated.

   Antimotion Sickness Medication

   The theory behind this approach is that there is a relationship between AD/HD and problems with the inner ear system, which plays a major role in balance and coordination.¹⁵ Advocates of this approach recommend a mixed array of medications, including antimotion sickness medication, usually meclizine and cyclizine, and sometimes in combination with stimulant medications. The only controlled, blinded study that examined this treatment found the theory not valid.¹⁶

   This approach is not consistent in any way with what is currently known about AD/HD, and is not supported by research findings. Anatomically and physiologically, there is no reason to believe that the inner ear system is involved in attention and impulse control other than in marginal ways.

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   Candida Yeast

   Candida is a type of yeast that lives in the human body. Normally, yeast growth is kept in check by a strong immune system and by "friendly" bacteria, but when the immune system is weakened or friendly bacteria are killed by antibiotics, candida can overgrow. Some believe that toxins produced by the yeast overgrowth weaken the immune system and make the body susceptible to AD/HD and other psychiatric disorders.^17,18,19 They tout the use of antifungal agents, such as nystatin, in combination with sugar restriction. There is no "systematic prospective trial data" to support this hypothesis.¹

   EEG Biofeedback

   EEG biofeedback — also referred to as neurofeedback — is an intervention for AD/HD that is based on findings that many individuals with AD/HD show low levels of arousal in frontal brain areas. The basic understanding is that the brain emits various brainwaves that are indicative of the electrical activity of the brain and that different types of brainwaves are emitted depending on whether the person is in a focused and attentive state or a drowsy/day dreaming state.

4. Amino acid supplementation does not appear to be "a promising area for further exploration."

5. "No systematic data regarding AD/HD efficacy could be found for hypericum, Gingko biloba, Calmplex, Defendol, or pycnogenol."

Interactive Metronome Training

Interactive Metronome Training is a relatively new intervention for individuals with AD/HD. The Interactive Metronome (IM) is a computerized version of a simple metronome — i.e. what musicians use to "keep the beat" — and produces a rhythmic beat that individuals attempt to match with hand or foot tapping. Auditory feedback is provided, which indicates how well the individual is matching the beat. It is suggested that improvement in matching the beat over repeated sessions reflects gains in motor planning and timing skills.

The rationale behind IM training is that motor planning and timing deficits are common in children with AD/HD and are related to problems with behavioral inhibition that some experts believe are critical to understanding the disorder. In addition, these deficits are alleviated by stimulant medication treatment. Thus, it is plausible that interventions to improve motor timing and planning abilities directly, such as IM training, could also be helpful to children with AD/HD. There is no evidence that motor in-coordination is related to behavioral inhibition.

To date, there has been a single study of IM training for boys with AD/HD.⁸ This was a well-conducted study with appropriate control groups, and the results indicated that boys who received IM training showed improvements in a wide range of areas. Thus, this intervention appears to be promising.

Additional research using IM training in individuals with AD/HD is necessary, however, before the value of this approach can be known with greater certainty.

Sensory Integration Training

Sensory integration (SI) therapy, which is delivered by occupational therapists, is not a treatment for AD/HD. It is an intervention for SI dysfunction, a condition in which the brain is overloaded by too many sensory messages and cannot normally respond to the sensory messages it receives. The theory behind SI therapy is that through structured and constant movement, the brain learns to better react and integrate the various sensory messages it is receiving.^9,10 SI therapy attempts to treat developmental coordination problems.¹¹

References

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Some pediatricians and occupational therapists acknowledge that SI dysfunction is a possible associated finding or disorder in some children with AD/HD, but it is not universally recognized and diagnostic criteria are not well established. There is practically no published clinical research on SI therapy. There is considerable anecdotal support for its value in treating SI dysfunction, particularly children with tactile hypersensitivity.¹²

Recent meta-analyses of SI training for various disabled children have not found it to be superior to other treatments, and several studies found that its contribution was not significant at all.^13,14 AD/HD was not examined in these studies. SI therapy is not a treatment for AD/HD but some children with AD/HD may have SI dysfunction.

Antimotion Sickness Medication

The theory behind this approach is that there is a relationship between AD/HD and problems with the inner ear system, which plays a major role in balance and coordination.¹⁵ Advocates of this approach recommend a mixed array of medications, including antimotion sickness medication, usually meclizine and cyclizine, and sometimes in combination with stimulant medications. The only controlled, blinded study that examined this treatment found the theory not valid.¹⁶

This approach is not consistent in any way with what is currently known about AD/HD, and is not supported by research findings. Anatomically and physiologically, there is no reason to believe that the inner ear system is involved in attention and impulse control other than in marginal ways.

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Candida Yeast

Candida is a type of yeast that lives in the human body. Normally, yeast growth is kept in check by a strong immune system and by "friendly" bacteria, but when the immune system is weakened or friendly bacteria are killed by antibiotics, candida can overgrow. Some believe that toxins produced by the yeast overgrowth weaken the immune system and make the body susceptible to AD/HD and other psychiatric disorders.^17,18,19 They tout the use of antifungal agents, such as nystatin, in combination with sugar restriction. There is no "systematic prospective trial data" to support this hypothesis.¹

EEG Biofeedback

EEG biofeedback — also referred to as neurofeedback — is an intervention for AD/HD that is based on findings that many individuals with AD/HD show low levels of arousal in frontal brain areas. The basic understanding is that the brain emits various brainwaves that are indicative of the electrical activity of the brain and that different types of brainwaves are emitted depending on whether the person is in a focused and attentive state or a drowsy/day dreaming state.

In neurofeedback treatment, individuals with AD/HD are taught to increase arousal levels in these regions so that they are more similar to those found in individuals without AD/HD. When this has been learned, it is expected that improvements in attention and reductions in hyperactive/impulsive behavior will result.

Recent research suggests that the theory underlying EEG biofeedback treatment is consistent with what is known about differences in brain activity between individuals with and without AD/HD.^20,21,22 This treatment has been used for over 25 years²³ and there are many parents who report that it has been extremely helpful for their child. There have also been several published studies of neurofeedback treatment that have reported encouraging results.^24,25,26,27

It is important to emphasize, however, that although several studies of neurofeedback have yielded promising results, this treatment has not yet been tested in the rigorous manner that is required to make a clear conclusion about its effectiveness for AD/HD.²⁸ "The aforementioned studies can not be considered to have produced persuasive scientific evidence concerning the effectiveness of EEG biofeedback for ADHD."²³ Controlled randomized trials are required before conclusions can be reached.²⁹

Until then, buyers should beware of the limitations in the published science. Parents are advised to proceed cautiously as it can be expensive — a typical course of neurofeedback treatment may require 40 or more sessions — and because other AD/HD treatments (i.e., multi-modal treatment) currently enjoy substantially greater research support. (See CHADD Fact Sheets #8 and #9.)

Chiropractic

Some chiropractors believe that chiropractic medicine is an effective intervention for AD/HD.^30,31,32 Chiropractic is based on the belief that spinal problems are the cause of health problems and that spinal manipulations ("adjustments") can restore and maintain health. Advocates of this approach believe that imbalance of muscle tone can cause an imbalance of brain activity, and that spinal adjustments as well as other somatosensory stimulation, such as exposure to varying frequencies of light and sound, can effectively treat AD/HD and learning disabilities.³²

Other chiropractors believe that the skull is an extension of the spine and advocate a method called applied kinesiology, or Neural Organization Technique. The premise behind this approach is that learning disabilities are caused by the misalignment of two specific bones in the skull, which creates unequal pressure on different areas of the brain, leading to brain malfunction.³³ The bones are the phenoid bone at the base of the skull and the temporal bones on the sides of the skull. The theory says that this bone misalignment creates unequal pressure on different areas of the brain. This misalignment is also said to create "ocular lock," an eye-movement malfunction that contributes to reading problems. The advocates argue that since eye muscles are attached to the skull, if the cranial bones are not in proper position, malfunctions in eye movement (ocular lock) occur. Treatment consists of restoring the cranial bones to the proper position through specific bodily manipulations.

These theories are not consistent with either current knowledge of the causes of learning disabilities or knowledge of human anatomy, as even standard medical textbooks state that cranial bones do not move. No research has been done to support the effectiveness of chiropractic approaches for the treatment of AD/HD.

References

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Optometric Vision Training

Advocates of this approach believe that visual problems — such as faulty eye movements, sensitivity of the eyes to certain light frequencies, and focus problems — cause reading disorders. Treatment programs vary widely, but may include eye exercises and educational and perceptual training.

There is "no systematic data on optometric training for AD/HD despite its widespread use."¹ In 1972, a joint statement highly critical of this optometric approach was issued by the American Academy of Pediatrics, the then American Academy of Ophthalmology and Otolaryngology, and the American Association of Ophthalmology.

Thyroid Treatment

In children with thyroid dysfunction, the thyroid status seems related to attention and hyper-active-impulsive systems.^34,35 Experts recommend that all children with AD/HD be screened for signs of possible thyroid dysfunction.³⁶ However, thyroid hormone syndrome appears extremely rare in AD/HD.³⁷ Thyroid function tests are not recommended unless there are other signs and symptoms to suggest thyroid dysfunction.³⁸

Lead Treatment

Hyperactivity in animals is a symptom of lead poisoning³⁹ and thus chelation therapy⁴⁰ is advocated as an approach to lessen lead levels in the blood. Chelation therapy should be considered for children with blood lead elevations. There is significant professional disagreement over how low the lead blood level should be.1 Consultation with a medical doctor is recommended.

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Conclusion

Before actually using any of these interventions, families and individuals are encouraged to consult with their medical doctors. Some of these interventions are targeted to individuals with very discrete medical problems. A good medical history and a thorough physical examination should check for signs of such conditions as thyroid dysfunction, allergic history, food intolerance, dietary imbalance and deficiency, and general medical problems.

Each child and each individual is unique. While multimodal treatment is the gold standard of treatment for AD/HD, not all individuals can tolerate medications, and medications are not always effective. Some individuals experience side effects that are too great. Being an informed consumer about the published science behind an intervention and frequently communicating with your medical doctor are important factors in determining if the interventions identified in this paper should be considered.

CHADD encourages greater independent and objective research on all treatments and interventions.

Suggested Reading

• Arnold, L.E. (2002). Treatment Alternatives for Attention-Deficit/Hyperactivity Disorder. In P.J. Jensen, & J. Cooper (Eds.), Attention-Deficit/Hyperactivity Disorder: State of the Science and Best Practices. Kingston, NJ: Civic Research Institute.

• Ingersoll, B., & Goldstein, S. (1993). Attention deficit disorder and learning disabilities: Realities, myths and controversial treatments. New York: Doubleday Publishing Group.

• Zametkin, A.J., & Ernst, M. (1999). Current concepts: Problems in the management of attention-deficit hyperactivity disorder. New England Journal of Medicine, 340, 40 - 46.

back to: Alternative Medicine Home ~ Alternative Medicine Treatments

References

1. Arnold, L.E. (2002). Treatment Alternatives for Attention-Deficit/Hyperactivity Disorder. In P.J. Jensen, & J. Cooper (Eds.), Attention-Deficit/Hyperactivity Disorder: State of the Science and Best Practices. Kingston, NJ: Civic Research Institute.
2. Feingold, B.F. (1975). Why your child is hyperactive. New York: Random House.
3. Wender, E.J. (1986). The food additive-free diet in the treatment of behavior disorders: A review. Journal of Developmental and Behavioral Pediatrics, 7, 735-42.
4. Baumgaertel, A. (1999). Alternative and controversial treatments for attention-deficit/hyperactivity disorder. Pediatric Clinics of North America, 46, 977-992.
5. Wolraich, M.L., Lindgren, S.D., Stumbo, P.J., Stegink, L.D., Appelbaum, M.I., & Kiritsy, M.C. (1994). Effects of diet high in sucrose or aspartame on the behavior and cognitive performance of children. New England Journal of Medicine, 330, 301-307.
6. Dykman, K.D., & Dykman, R.A. (1998). Effect of nutritional supplements on attentional-deficit hyperactivity disorder. Integrative Physiological and Behavioral Science, 33, 49-60.
7. Dykman, K.D., & McKinley, R. (1997). Effect of glyconutritionals on the severity of ADHD. Proceedings of the Fisher Institute for Medical Research, 1, 24-25.
8. Shaffer, R.J., Jacokes, L.E., Cassily, J.F., Greenspan, S.I., Tuchman, R.F., & Stemmer, P.J. (2001). Effect of interactive metronome training on children with AD/HD. American Journal of Occupational Therapy, 55, 155-162.
9. Sensory Integration International. (1996). A parent's guide to understanding sensory integration. Torrance, CA: Author.
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Source: www.chadd.org

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Important things for parents to consider when talking to your children about divorce.

Divorce can be a traumatic experience for a child. How you talk to your children about divorce can greatly affect how they are impacted by divorce.

• What to expect at this age
• How to talk about it
• What kids ask ... What parents answer

What to Expect from Grade-Schoolers When You Talk About Divorce

For kids of any age, divorce raises big issues: shock, loss, uncertainty. But grade-schoolers often take on another set of burdens as well: feeling guilty, worrying about the welfare of one or both parents, worrying about money, worrying about how friends will react, feeling caught in the middle of parents who are — or might be — feuding. "Kids find themselves right in the middle of their own soap opera," says psychologist Anthony Wolf, in his book Why Did You Have to Get a Divorce and When Can I Get a Hamster? After the initial shock of the news has worn off, be prepared for a full range of reactions. Your child may act spiteful, uncooperative, depressed, or withdrawn. You'll need to be as empathetic as possible to help him get through this major transition.

How to Talk About Divorce with Your Children

Tell him together. Ideally, parents should break the news about the divorce in tandem. Telling your child together avoids confusion — he'll hear only one version of the story — and conveys that it was a mutual decision, so he won't blame one parent for the split. According to Paul Coleman, psychologist and author of How to Say it to Your Kids, there's a more important reason as well: It helps preserve your child's sense of trust in both his parents. If it's not possible or practical to discuss the split as a pair, then the adult who has taken the primary parenting role — the one who makes the child feel safest — should handle this task.

Choose your timing. There are two things to consider when telling your child about an impending divorce. First, make sure the decision is final; he'll be in agony if you try to "prepare him" for a mere possibility by saying, "We're thinking about getting a divorce." Second, when you do decide to tell him, remember that the news will be a big shock, even if you and your spouse have been fighting for months. Your child needs time to let it sink in, and though there's never a "good" time, there are bad times: school days, right before you head off to work or he goes to soccer practice, or right before bed. "When he's suddenly feeling very unsafe and very alone, he'll need you to be there for him," says Wolf. Choose a moment when you'll be with him afterward.

Keep it simple. Don't assume your grade-schooler knows exactly what "divorced" means. A 6-year-old may need a definition that's short and straightforward: "Divorced means Mom and Dad won't live together anymore. But we'll always be your parents, and we'll always love you."

Be honest. Your child needs an explanation for why Mom and Dad won't be together anymore. Without one, your child is likely to blame himself for the divorce, and he may come up with reasons you might never have dreamed of: "Dad got mad because I kept losing my allowance money," "Mom left because I talked back to her," or, "They argued all the time about what my punishments should be — it's all my fault." Your child needs a real reason instead. But he's not ready for all the details, such as "Mom's been fooling around," or "Dad's having a mid-life crisis." You can say, "We weren't happy living together, even though we tried really hard to make things work out. We think it will be better if we aren't together and fighting all the time."

Don't blame your ex. Do all you can to avoid demonizing your former partner in front of your child, even if you are hurt and angry over the breakup. Your child doesn't see the situation the same way you do - she just wants you both to be with her, and she'll be hurt and confused if she hears one of her beloved parents criticizing the other. And remember, she can hear you even when you're not talking to her. Negative comments overheard when you're on the phone with a friend or your attorney can be just as damaging as if you had made them to your child.

Be empathetic. All children grieve over divorce — some openly, some quietly. Give your child a chance to talk by saying, "You feel bad about the divorce, don't you?" Whether he opens up or not, it's good for him to know you understand how he feels. Use empathetic responses even when your child attacks you or your ex with comments like, "Dad's a jerk. It's all his fault," or "You're so mean, of course he left," or "My life was great until the divorce." He's angry, and the easiest way for him to react is to blame someone — often you. Although it can be hard, try not to attack back. Saying something like "I know the divorce has been hard for you" acknowledges that he's having a rough time, and that understanding is what he really needs.

Discuss it often. Be prepared to go over the same questions again and again, for weeks or even months. Divorce is difficult for children to understand and accept, and many harbor strong fantasies that their parents will reunite one day.

What kids ask about divorce and what parents answer

"Why are you getting divorced?" At this age, your child may be able to talk more fully about his feelings, and you can help by discussing emotions as you answer his questions. "Divorce is sad — nobody wants to split up a family. But Mom and Dad don't get along anymore. Grownups sometimes change from when they got married. It wasn't because of you or anything you did. Parents never stop loving their kids, and we'll never stop loving you." It's best to emphasize that the divorce was a mutual decision, but if it's obvious that one parent initiated the breakup, an older child might be ready to hear "Mom/Dad decided to make a fresh start."

"I really miss Mom/Dad." Even if you're relieved that your marriage is over, your child probably is not (unless your partner was very abusive). Let him vent his sadness. Sympathize and remind him about the arrangements for seeing the absent parent. "I know you miss Dad, and he misses you too. Even though you don't always see him, you can call him every day. Remember, Dad isn't far away. You have your own bedroom at his house, and you'll see him every week. And we'll both come to your piano recital and the school play." Depending on your child's relationship with your ex's family, he may also need reassurance on questions like, "Will I still see Grandma and Grandpa? Can I still go to baseball games with Uncle Bill?"

"Who's going to take me to school?" At this age, your child will also be worried about the divorce's impact on his daily life: "Will I still go to my same school? Who gets the dog? Who's going to take me to piano lessons?" They may sound trivial to you, but they're very real concerns for him, so go over the details: "You'll still live here in our house with me. At Dad's/Mom's new house, you'll also have your own bedroom for when you visit." Some children this age may start to worry about whether finances will become a problem — and sometimes they are. Reassure him that you have enough money to live, and though there might be a moratorium on buying new video games, he will have everything he needs.

"Is it okay if you and Dad don't come to our soccer team's playoffs? It's not such a big deal." Grade-schoolers, especially slightly older ones, are sensitive to their parents' perceived feelings, and they worry about being in the middle of what could be a bad scene. They may also just be angry with both parents. Sometimes it's hard to tell what your child is really concerned about; he may worry that you'll be sad or angry at a public function, or that he'll have trouble dividing his attention between two feuding parents. Try to figure out what he's really thinking by gently asking, "Are you feeling upset with Mom and Dad? Or do you just want some time alone with Dad after the big game? That's okay with me. I know he's the one who helped you most with your soccer playing. But if you're afraid that Dad and I will get into a fight at the game, don't worry — we wouldn't do that. We're both happy just to be there watching you play."

"Do you still love me?" Your grade-schooler needs to know that both his parents still love him, and that the divorce wasn't his fault. The lurking question — which even your child may not recognize — is, "Are you going to leave, too?" It's logical for him to think that if one parent can leave, maybe the other can, also. Plus, being separated from a parent, even for short periods of time, is an inevitable reality of shared custody arrangements. Be ready to reassure your child that even though he may be sleeping at Dad's this weekend, Mom is at home waiting for him. Tell him as often as he needs to hear it: " Dad and I will always love you, and we'll always be here to take care of you."

Source: Parentcenter

Thoughtful quotes about longing and searching.

Words of Wisdom

"Many men go fishing all of their lives without knowing that it is not fish they are after." (Henry David Thoreau)

"You can never have enough of that which we really do not want." (Eric Hoffer)

"Every great achievement is the story of a flaming heart." (Harry Truman)

"One should never consent to creep when one feels an impulse to soar." (Helen Keller)

"Adventure is not outside; it is within." (David Grayson)

"The real voyage of discovery consists not in seeking new landscapes, but in having new eyes." (Marcel Proust)

"Be patient toward all that is unsolved in your heart and learn to love the questions themselves, like locked rooms and like books that are written in a very foreign tongue. Do not seek the answers, which cannot be given you because you would not be able to live with them." (Rainer Maria Rilke)

"Ah, but a man's reach should exceed his grasp, Or what's a heaven for?" (Robert Browning)

"Our greatest weakness lies in giving up. The most certain way to succeed is to always try just one more time." (Thomas Edison)

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Discover how genetics and environmental factors can influence whether a child will develop bipolar disorder.

Genetics Play Significant Role in Development of Bipolar Disorder in Children

The illness tends to be highly genetic, but there are clearly environmental factors that influence whether the illness will occur in a particular child. Bipolar disorder can skip generations and take different forms in different individuals.

The small group of studies that have been done vary in the estimate of risk to a given individual:

• For the general population, a conservative estimate of an individual's risk of having full-blown bipolar disorder is 1 percent. Disorders in the bipolar spectrum may affect 4-6%.
• When one parent has bipolar disorder, the risk to each child is l5-30%.
• When both parents have bipolar disorder, the risk increases to 50-75%.
• The risk in siblings and fraternal twins is 15-25%.
• The risk in identical twins is approximately 70%.

In every generation since World War II, there is a higher incidence and an earlier age of onset of bipolar disorder and depression. On average, children with bipolar disorder experience their first episode of illness 10 years earlier than their parents' generation did. The reason for this is unknown.

The family trees of many children who develop early-onset bipolar disorder include individuals who suffered from substance abuse and/or mood disorders (often undiagnosed). Also among their relatives are found highly-accomplished, creative, and extremely successful individuals in business, politics, and the arts.

next: Scientists Close in on Multiple Gene Sites for Bipolar Disorder
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