Why Treat ADHD Without Medication?

 

Sleep:  Sleep is very important in ADHD. Sleep apnea must always be ruled out and length and quality of sleep are important. Many children do not get enough sleep in our society, with corresponding deficits in performance.

Parenting: I believe parenting has a major impact on the severity of ADHD symptoms. Many parents have a difficult time with the frustrating, unpredictable, and often oppositional nature of their children’s behavior. Parents can be caught in a cycle of anger and negativity which has a very deleterious impact on a child’s performance. Referral to a mental health practitioner for parenting help and support is an important part of the treatment plan in many of my patients.

Other Lifestyle Factors: These could warrant an entire article as well, but there is increasing evidence that life style factors such as exercise, yoga, mindfulness meditation, and time in nature can have highly positive effects for ADHD children.

EEG Neurofeedback: Most children with ADHD have abnormal brain wave patterns, with a decreased ratio of beta to theta waves. A diagnostic test measuring this ratio was licensed by the FDA last year. The fascinating thing is that children can change these brain wave patterns using this biofeedback technique. The research supporting this is strong. Unfortunately, it is, at this point, too expensive for the average family and not covered by insurance. Other home-based computer programs may turn out to be helpful but have not been well researched.

Other “Alternative” Modalities: Modalities like traditional Chinese medicine, homeopathy, and various types of energy medicine can be employed but have little research support at this point.

In summary, non-pharmaceutical treatment of ADHD has a reasonable evidence base and I have found it to be effective in many children. The particular interventions chosen would depend on the individual child and family, taking into account their interests and resources. This approach can have very beneficial aspects, whether or not a psychostimulant is ultimately judged to be necessary.

Sanford C. Newmark, MD, is the head of the Pediatric Integrative Neurodevelopmental Program at the Osher Center for Integrative Medicine at the University of California, San Francisco. He is also the author of the book ADHD Without Drugs — A Guide to the Natural Care of Children with ADHD.