article For ADHD, lots of snake oil, but no miracle cure

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For ADHD, lots of snake oil, but no miracle cure

By Ellison

Sunday, November 21, 2010; B04

As the mother of a teenager who got a diagnosis of

attention-deficit/hyperactivity disorder in 2004, I wasn't surprised to read the

new report from the Centers for Disease Control and Prevention that said the

number of ADHD cases in children jumped by 22 percent between 2003 and 2007 - an

increase of 1 million kids.

From the day my son started school, I've watched popular awareness of disabling

distraction rise, to the point where it's easy to believe the CDC estimate that

one in 10 U.S. children - a total of 5.4 million kids - now has ADHD, as

reported by their families. This might even be positive news, in that at least

some kids who need medical attention are getting it. Except for one problem.

Growing along with those numbers is one of the most aggressive, lucrative,

bewildering and often just plain useless sales forces humanity has ever seen -

call it the ADHD-industrial complex.

This includes not only the U.S. pharmaceutical industry, which by one measure

sells more than $5 billion worth of ADHD medications each year - and which only

in the United States and New Zealand may market directly to the public - but a

growing league of all-but-unregulated, usually costly and sometimes wildly

imaginative alternatives, including herbal supplements, complicated exercise

regimes to stimulate specific brain regions, magnetic mattresses, personal

coaches and therapy " assisted " by dolphins.

If modern mothering is madness, what metaphor might suit the straw-grasping of

parents of children with this disorder, whose main symptoms are distraction,

inattentiveness, forgetfulness and impulsivity? The ADHD industry's exuberance

matches the vulnerability of its target market: millions of desperate parents

who, given the strongly hereditary nature of ADHD, are often just as distracted

and impulsive as their progeny.

Oh, did I mention that I got my own ADHD diagnosis at age 50, just a few months

after my son's? This double whammy inspired me to spend a year investigating the

grab bag of symptoms constituting the current definition of ADHD and trying to

figure out the best ways to cope. I was extra-motivated to seek

non-pharmaceutical treatments when my son balked at continuing to take stimulant

medications after a year-long trial - about the average amount of time kids will

keep taking them, as I later learned, and a big reason pills usually aren't

reliable as a single or long-term strategy.

In the course of my year of focusing on distraction, I got my head examined by

Amen, the legendary Southern California clinician who says he can detect

ADHD with a brain scan for $2,000; tried stimulant meds for myself; stretched my

equity loan to pay for scores of sessions of neurofeedback (a computer-based

treatment in which a therapist helps you train your brain to function better);

and even went on a five-day silent meditation retreat, which I only just managed

to survive.

I fed my son fish oil capsules until the aftertaste made him rebel, subjected

him to two days of neuropsychological tests ($4,000), hired pricey tutors and

summoned my nerve to lobby public schools to grant him special accommodations,

such as being allowed to chew gum while studying algebra. We did not, however,

after due consideration, send in his hair follicles for lab analysis to detect

heavy metals or purchase custom-made colored contact lenses, on the chance that

his problem was not actually ADHD but a controversial perceptual disorder known

as scotopic sensitivity syndrome.

I also skipped the dolphin therapy after learning enough to suspect that it was

not only a waste of money but really unkind to the dolphins.

I've got plenty of company in my quest for non-pharmaceutical techniques. A 2003

survey of parents of children with ADHD in Boston found that 54 percent had

tried non-medical treatments. Yet even though we may have lots of good reasons

to distrust Big Pharma, medication is still the devil we know. It has many

problematic side effects and carries social stigma, but it also has decades of

research establishing its upsides and downsides.

This isn't usually true for the alternatives. Children's livers may be overtaxed

by megavitamins. Too much ginseng can raise their blood pressure. Parents may

exhaust their savings on brain scans and exercise programs that lack evidence of

their effectiveness. And despite often-Herculean efforts on the part of their

families, millions of kids may still end up fulfilling the direst outcomes of

this diagnosis, including higher rates of high school dropouts, unemployment,

teen pregnancy, car accidents, depression, anxiety and jail.

I was lucky: I was in a nice, supportive marriage, and my contract to write a

book on the subject gave me a handy professional excuse to call up experts for

advice. Even so, I joined many other parents in anxiously watching my son's

self-esteem erode while a succession of teachers judged him lazy, troublesome

and - they implied - poorly parented. If I, with all my advantages, had so much

trouble dealing with the academic train wreck, how much can we expect of parents

who may be divorced, working overtime and/or intimidated by hucksters online and

off, including the flood of self-help books with such optimistic titles as " Dr.

Bob's Guide to Stop ADHD in 18 Days? "

I am relieved to report that despite many setbacks, my son and I made some

progress by the end of my year. Looking back, I suspect that his time on

medication helped us out of a crisis and gave him a useful taste of what it felt

like to have more self-control. It may also be true that our budget-breaking

neurofeedback treatments helped curb his irritability and my anxiety.

At the same time, I discovered that some of the most effective interventions are

also the simplest and cheapest. Such as educating myself enough to know how much

of my son's behavior is truly within his control. And getting in the habit, with

my husband, of finding something to praise about him every day ( " Way to

breathe! " we began, although we soon found more substantial causes for

celebration).

Regular physical exercise, I found, can also be hugely helpful - and this

strategy is backed by a significant amount of research. Barkley, a

leading ADHD researcher, cites studies showing that rigorous exercise can

increase the brain's capacity for willpower and emotional self-control, arguably

the most important skills lacking in many of the clinically distracted. So too,

he says, can maintaining adequate levels of glucose, which has led me to stop

pestering my wiry, active son about his many trips to the refrigerator.

Another useful (and cheap) strategy was abandoning my sheepishness around my

son's teachers and principals and visiting them early, insistently and often.

Despite growing awareness about ADHD (the National Library of Medicine lists

more than 18,000 papers and articles on the disorder), the continuing depth of

misunderstanding in schools can be startling. In one school district in

Massachusetts, I was told by Harvard neuroscientist Todd Rose, teachers have

even made ultra-restless kids wear lead vests to weigh them down.

Probably most important, I learned that it's key for a parent of a seriously

distracted child to keep calm. Children with ADHD can be unusually provocative.

Punishments, particularly the corporal kind, are notoriously ineffective. So

whatever it takes to understand your own role in the family conflict and tone

down your reactions may yield benefits that last a lifetime.

None of this has " stopped " my son's ADHD or my own. We still struggle and

suffer, individually and together. I still take meds, on occasion, and he knows

they're there if he decides they can help him again. Meanwhile, we play

Ping-Pong, talk and laugh together more than we have for years, and, as much as

a 15-year-old will tolerate, we even occasionally hug.

Our journey to this somewhat better place took a lot of work, a lot of

persistent trial-and-error and a lot of self-criticism. And all of that, in

turn, took a heck of a lot of time and attention - commodities in sadly short

supply for many of us. Still, we did save on the ginseng, magnetic mattresses

and dolphins.

Ellison is a Pulitzer Prize-winning journalist and author of the new

memoir " Buzz: A Year of Paying Attention. "