One of the most important things you can do as a parent of a child with ADHD is get an accurate diagnosis and an appropriate ADHD treatment plan. As you have learned, all children may show indications of emotional over responsiveness, inattention, and over activity from time to time.

However, it is the persistence of the symptoms over time and in many situations that is important in the diagnosis of ADHD. Furthermore, it is important for us to rule out or consider a number of issues that may cause a child to be overactive, to act impulsively, and to be distractible before making a diagnosis of ADHD.

How Effective Is Treatment of ADHD?

Over 75 percent of children with ADHD can be helped with medication. We wish we could say it is 100 percent as it is with current treatment programs for PKU. ADHD is the most common childhood mental disorder, so the fact that as many as 75 percent of children with ADHD can show a positive response to ADHD treatment (medication and behavior management) is important.

That figure is in the same range as treatment success for depression, the most common adult mental disorder. It is our belief that most children with ADHD can live successful, productive lives with appropriate diagnosis and a broad based ADHD treatment plan.

Why Medication at All in the Treatment of ADHD?

ADHD, or hyperactivity, is a disorder that can be caused by many conditions. Regardless of the ultimate cause, ADHD is thought to be associated with a disturbance in the functioning of neurotransmitters in the brain. Neurotransmitters are natural body chemicals that transfer information from one brain cell to another.

Neurotransmitters like dopamine, norepinephrine, and serotonin are now thought to be present at different levels in the brains of individuals who have hyperactivity as compared to others who have normal abilities to show sustained attention and stay alert. People with ADHD seem to have a decreased supply of these transmitters in areas of the brain that control attention and self control.

Medications to treat hyperactivity appear to increase arousal and alertness of the brain by increasing the supply of chemical neurotransmitters like dopamine, norepinephrine, and serotonin. These neurotransmitters help information move from one brain cell to another.

Many parents ask why would anyone give a stimulant to children who are already overactive and impulsive? When we use the word stimulant as applied to medications such as Ritalin, Cylert, and Dexedrine, we mean that they stimulate neurotransmitters in the brain, like dopamine, to help the brain work better.

The word stimulant when applied to these medications is not meant to imply that they stimulate children to make them more active. For a long time most people thought that hyperactive children had a paradoxical or opposite reaction to stimulants. We know that by stimulating neurotransmitters in the brain these medications help an overactive child become less active. People with hyperactivity have the same reaction to stimulants that “normal” people do; however, the improvements for people with ADHD are indeed more dramatic than they are for “normal” people.

Ritalin alone is not a magic pill. It cannot cure a child with ADHD like penicillin can cure an ear infection. Medications are usually not sufficient in themselves to solve the many problems associated with hyperactivity. However, stimulant medications can be an important part of a treatment program and should be used with behavioral management therapy and any other remedial educational programs needed.

The main ADHD treatment effects of the stimulants (Ritalin, Dexedrine, and Cylert) are as follows:

1.    Improve attention span
2.    Reduce impulsive behavior
3.    Reduce disruptive behavior
4.    Increase compliant behavior

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If your child tells you she he is thinking about killing herself, don’t panic. She needs you to be able to reassure her and to help her cope worth the situation. But don’t act totally blase either you don’t want het to get the idea that you don’t care. Do not promise her that you won’t tell anyone.

Let her know that you understand she must be in a great deal of emotional pain, but that you also know she will not always feel this way. Tell her that she does not have to feel guilty about this pain, that it isn’t her fault. She does not need to feel ashamed of her pain or of her suicidal thoughts.

Tell her that she can be treated, that she will definite feel better. Don’t promise that the improvement will be immediate or even soon, but reasume her that you will be there to help her through the process. Make sure she knows that the way she is feeling is temporary, but that suicide is permanent.

Let your daughter know how much you love her and how devastating it would be to you and other family members if she killed herself. Tell her some specific ways she knows that the way she has enriched your life. Hold her hand, hug her, use your body language to show that you care.

Don’t leave her alone. It only takes a moment to go into the bathroom and find a razor blade or a bunch of pills. You have probably already locked up or gotten rid of any lethal medications or firearms in the house. If not, get someone to do this while you stay with your daughter.

Ask your daughter to promise that she won’t kill herself within a certain period of time.

Get her to make a promise she can keep. Don’t ask her to promise never to kill herself. This is too big a thing for someone to commit to. She can say to herself, “I didn’t know I would ever feel this bad when i told her that.” Instead, get her to promise that she will talk with you, in person, before she attempt suicide. The “in person” par is important. You don’t want her calling you from a pay phone or a e-mailing you about this. This is a promise that many teens have to parents or therapists and have kept.

Get help. If she says she has been thinking about killing herself but doesn’t have a plan or doesn’t think she would really do it, get her to a therapist, family doctor or pediatrician. If she was a more definite plan, exhibits some of the warning signs outlined above or cannot reassure you that she will not kill herself, take her to an emergency room.

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1. How To Tell If Your Depressed Teen Is Using Drugs

The argument has been made that since many teens experiment with drugs and few go on to have serious drug problems, parents do not really nee to try to “catch” their children taking drugs. However, with a depressed teen, the consequences of drug use, especially alcohol, can be major, so parents who suspect that their depressed adolescent is taking drugs should seek help tight way.

The two most commonly abused drugs in adolescence, alcohol and nicotine, have the advantage from the parents’ point of view of being detectable by smell. Of course, many teens who smoke say they smell like smoke because their friends smoke and the smell gets on their clothes. If your teen comes in after you have gone to bed, you will be less likely to detect the smell of alcohol, as it will be out of his system by morning.

There are not very many physical signs of drug use. Your teen’s fingers may be stained from nicotine, eyes bloodshot from marijuana. Although there can be many causes of a chronic cough, like asthma, it may be associated with smoking. Similarly, a runny nose could be caused ny allergies or a cold that won’t let go, but it may also be caused by cocaine or heroine use.

Psychological changes in your teen may also be a sign of a drug use but are very non specific. They include loss of enjoyment in life and activities, withdrawal and irritability. Social changes might show an exaggeration of symptoms. If he was irritable before, he might become verbally abusive or even physically destructive. Mood swings may become much more pronounced. Periods of social withdrawal may become longer. Appetite changes that are a result of the depression may reverse when the teen starts taking drugs, so a teen who wasn’t eating may turn into one who is eating all the time. Any unexpected change, such as a depression getting worse while the teen is receiving adequate treatment, can also be a warning sign.

None of these signs are specific, but even if they are not associated with substance use,many of them are caused for concern. Your teen may not repsond honestly to a question about substance use, even if you ask in a non accusatory way, but it is still worth asking and talking abut the negative effects of drug and alcohol use during depression.

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Some of this information comes from people who want to convenience you that the depression treatments they are proposing are the best. Someone who has extensive training in one type of depression treatments will feel validated if you pick this type. A friend might feel  reassured that she made the right choice if your teen has the same treatment as her son or daughter.

And, of course, there are people who are primarily interested in selling you their particular services, whether they are appropriate or not. With any treatment, you must ask yourself, “Is there any evidence that this works?”

Finding this evidence may be difficult, but it is important because you waste time and money trying ineffective treatments. Meanwhile, your teen may feel unhappy, hopeless and perhaps even suicidal. Moreover, some treatments haven’t been tested, and others have been researched in a less than satisfactory manner. You also need to consider that much depression research has been done with adults and is not always generalizable to teenagers.

Although it can be very helpful to talk with someone who has had a treatment you are considering, this person’s insight is not the same as evidence. Evidence, to be valid, must be based on large numbers of people who have used the treatment in controlled conditions. These results should then be compared with a control group people who though they were getting the treatment but weren’t.

You doctor may have up to date advice, but you should expect any practitioner to tell you why she is recommending a particular treatment, what you can expect, it might take to work, how much it costs and how she will monitor your teen’s progress. She should react to questions in a non defensive way. You should view with suspicion broad statements, such as “This always works,” or “There are never any side effects.”

Everything has possible side effects. We often think that unwanted effects are associated only with prescribed medication, but they can also occur with herbal therapy, psychotherapy and alternative treatments.

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Abstract thinking skills and the ability to concentrate are both negatively affected by depression. Although this is also true of adults, ten’s thinking abilities are constantly called upon and evaluated at school, so there can be major, early repercussions such as school failure.

Difficulties with problem solving may make it more difficult for the teen to seek help or to benefit from it.

Teens are at stage of life in which major changes are not only possible but inevitable. They are used to change and may therefore be able to recover from a depression and its effects more completely or more quickly than an adult. This is not to say that depression in teens is a passing stage that doesn’t need to be addressed, but rather that adolescence is a window of opportunity to personal growth.

Teens may also be more willing to believe that things have improved sooner than an adult would, perhaps because they have had less experience of failure and disappointment, and thus have less on which to base a gloomy outlook.

It can be difficult for teens to talk about what they are feeling, especially in the early stages. In this regard, they are no different from adults. Unlike an adult, who has had previous episodes of grief or depression, a teen may not even realize that she feels sad.

Adults often feel embarassed about being depressed, as if they have done something wrong. This is much more rarely the case with teens, who seems to view a depression as something that has descended on them, or as someone alse’s fault.

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The many examples of professional sports figures who have publicly acknowledged having tics underscores that this does not have to be impairing. An invaluable source of support for both patients and their families is the Tourette Syndrome Association, a self help group with both national and local chapters.

The goals of therapy are to eliminate tics and treat the conditions most commonly associated with them, like the inattention, hyperactivity, and impassivity in Attention Deficit/Hyperactivity Disorder and the obsessions and compulsions in Obsessive Compulsive Disorder.

There are a number of medications that can reduce and cure tourette’s syndrome and tics, if not get rid of them altogether. It turns out that many of the medications used to treat psychosis are also effective at suppressing tics, Haldol, Prolixin are the most commonly used.

Medication side effects, like sedation, muscle spasms, and feelings of restlessness are unfortunately also quite common, to some degree limiting their usefulness. It will be interesting to see whether the never atypical anti psychotic medications (Clozapine, Zyprexa) are helpful without the side effects. Clodine, a medication used to treat high blood pressure, and Klonopin, a medication used to treat anxiety and seizures, are less likely to cause side effects but are also often less effective.

A behavioral therapy technique called habit reversal training can be used as an alternative or supplement to medication. The person is taught to actively use an opposing muscle group to counteract the tic movement. For example, someone with a shoulder shrugging  tic can actively do the opposite, lower his shoulders, when he feels that the tic is about to happen.

Since tics often get worse when the person is in a stressful environment, interventions  that teach stress management can indirectly lower tic frequency. A structured and predictable environment with clear expectations both at home and at school is also helpful. Family therapy may address the strains on the family imposed by the illness.

Up to 60 percent of children with Tourette’s have symptoms of ADHD. Tics and the ADHD symptoms must each be addressed in treatment. One wrinkle is that the most commonly used treatment for ADHD, namely stimulants, often makes tics worse. For such children, behavioural approaches to ADHD may be preferred.

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Learning disorder does not refer to the expectable range of strength and weaknesses in various school subjects that all of us have. For instance. a child who is a math whiz but relatively less excellent at reading does not have a Reading Disorder.

Parents and kids sometimes put too much pressure on themselves to be perfect at everything and may assume that anything less than great performance must constitute a problem. Learning disabilities usually require intensive educational remediation. Until recently, children with learning problems were often taught in segregated special education classes with the unfortunate side effect of stigmatizing them.

Remedial education now uses more of an “inclusion” approach special education teachers come to the classroom and work with entire class while devoting special attention to the learning disabled children.

It is crucial that the teaching approach be flexible and designed to match the strengths and weakness of the child. It does not make sense to teach reading by focusing on phonics for a child who has the most difficulty with auditory processing. Educational programs surmount specific processing problems by integrating several sensory modalities simultaneously.

For example, the child learning the alphabet would be encouraged to read, feel, speak aloud, write, and mime the letters. Supplementing school by providing a language rich environment at home can be very helpful for children with reading problems. Reading each day with your child can lead to improved reading skills.

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We often think of the elderly as not being very healthy because they have had to endure years of insults to their bodies. But your children can also be at the bottom if the mountain, teetering on the brink of disease even very early in life.

This has been case with many of the children i see who have been diagnosed with ADHD. when we remove the most troubling irritants to their bodies and help build up their immune systems, we see dramatic improvement and even elimination of their symptoms.

When a child has symptoms of ADHD, it is because something has caused that child to slide down the Mountain of Health. Giving a child a drug to cover symptom will not help the child back up the mountain. It will not help the child’s body work optimally in its most natural state. In fact these drugs will interfere with the natural function of the body. That is why i look for the treat the underlying cause.

Years ago when we thought children outgrew the symptoms of ADHD, it was probably all the right to treat them temporarily for the symptoms. If they outgrew the symptoms, the drug could be stopped.

But today we know better. We know that they do not outgrow the symptoms and must stay on drugs forever if the problems is not corrected. This is why the medical attitude must change. These children are not growing out of the problems, and the drugs don’t even help with all the symptoms.

We cannot leave these children on these kind of drugs for life. We don’t even know what the long term side effects might be. And the drugs do not fix the problem. This is such a major change in thought proves for doctors.

Anything that happens to be different from their own medical model is poorly tolerated. Since they know nothing about these other ways to treat, many feel they must say such alternatives are wrong.

These other on treating AHDH are not wrong, but are based on the basic elements and concepts of physiology, anatomy, biochemistry, and immunology. And they are based on the recognition that we do not yet know everything there is to know in medicine.

The only way to learn, understand and improve is to keep an open mind.

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Proponents of orthomolecular medicine claim that mineral deficiencies can result in learning and behavior problems. They also claim that such deficiencies can be detected by measuring the concentration of certain minerals in the hair and that supplemental treatment with the appropriate minerals will result in improvement in learning and behaviour problems.

Like the orthomolecular theory of vitamin deficiency, the notion that learning and behavior problems can result in a broad range of problems. Iron, for example, is an essential component of hemoglobin, the oxygen carrying component of the blood. Iron deficiency results in anemia, which is characterized by pallor, fatigue, headache, and shortness of breath. Magnesium deficiency, which can occur as a result of alcohol abuse or prolonged treatment with diuretic drugs, can produce anxiety, restlessness, tremors, palpitations, and depression.

This theory, however, is not consistent with what is actually known about mineral deficiencies, which the exception of anemia and magnesium deficiency, are quite rare in any population which receives a minimally adequate diet. Now are there any well controlled studies which provide support for the theory or for the treatment approach.

Like vitamins, minerals are necessary for normal physical and mental functioning, and like vitamins, they pose dangers when taken in excessive amounts. An excess of iron, for example, can result in nausea, abdominal pain, and liver damage. In excessive amounts, zinc can interfere with the body’s ability to absorb iron and copper, in turn resulting in nausea, vomiting, fever, headaches, fatigue, and abdominal pain.

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However, there is also a group of youngsters with learning problems who do not seem to have coexisting problems with attention and impulse control. When these children are given stimulant medication, the results are not nearly as clear cut.

Children with Learning and Attention Problems.
When researchers examined the effects of stimulant medication in children in whom both learning and attention problems were apparent, the results did not appear promising. However, as researchers refined their methods and measures, it soon become apparent that AHDH children treated with stimulant medication often showed impressive gains in both work output and accuracy in the areas of spelling, reading, and arithmetic. The amount of improvement observed was quite substantial, ranging from 25 to 40 percent.

In spite of these documented improvements, it is clear that stimulant medication alone is not always sufficient to help learning impaired youngsters with attentional problems who have fallen far behind their classmates. Common sense dictates that these children receive specific remedial help to enable them to make up for lost time. Research is quite clear in showing that for youngsters with both AHDH and reading disorders, the greatest improvements in reading result when the children are treated with a combination of stimulant medication and remedial teaching.

Children without Attentional Problems.
When we ask “Is stimulant medication helpful to learning impaired children who do not have obvious accompanying attentional problems?” we are on less solid ground in terms of scientific evidence. We have only a few studies in which dyslexic children without accompanying attentional problems have been studied, so the available evidence is very scanty. Studies seem to indicate that the contribution of stimulant medication to improved reading skills in these children is minimal.

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