Happy Fall to all of you. I hope you've had as spectacular a fall season as we've had in Boston!
We get an awful lot of questions around alternative therapies for ADHD - so in this edition we've tackled the question from quite a number of directions. Everything you've wanted to know about omega-3s, as well as information about the link between chocolate, ice cream, caffeine and dopamine (yikes!). We also dig in to explain LENS therapy and the home-based (and affordable) Learning Breakthrough.
Next issue I would like to focus in on educational issues. If you are a teacher, I'm hoping you'll take a moment to send us success stories and tips you would like us to share. Parents - the same.
Please have a happy Thanksgiving and remember to both create some memorable moments and some much needed "down time".
Melissa Orlov, editor
Q: Should I be concerned that giving my child stimulant medication could lead to a potential for substance abuse later in his life? My mother-in-law recently brought this idea up.
A: Adults with ADHD do have higher rates of substance abuse than adults without. However, this is due to a combination of low self-worth and poor impulse control, not stimulant medication. Depression (and a resulting desire to self-medicate to feel better) is also a known contributor to substance abuse. In fact, your mother-in-law has it backwards. Untreated ADHD is highly likely to result in low self-esteem, continued impulse issues and depression, while good treatment can help people with ADHD avoid these issues.
You'll be interested to know that a study funded by the National Institutes of Health and reported in the American Journal of Psychiatry in 2008 found that there is no link between prescription ADHD medicatins given in childhood and the risk of substance abuse later.
Q: We find that meds seem to work for our son for a few days, then stop working. We'll up the dose or add a low dose of something else, but the same pattern emerges. Is there something else going on?
A: (from Dr. Hallowell) When meds stop working, as they sometimes do, most people think that it is time to increase the dose. Instead, I suggest discontinuing the medication altogether for a week, then restarting it at the same dose, no increase. I have found the this little "rest period" often allows the medication to kick back in effectively without the need to raise the dose.
I'm excited to introduce you to the Learning Breakthrough Program (LBP), an effective, innovative, inexpensive, exercise-based treatment for ADHD and reading problems.
I am always looking for new, non-medication treatments for both ADHD and reading problems, and I believe this is one of the best. It is actually not new, in that it has been in use clinically for 30 years. However, some of the science behind it is new. It is based upon the principle of stimulating the cerebellum, a region at the back of the brain that has connections to the front parts of the brain, which is where the symptoms involved in ADHD and reading problems originate. By stimulating the cerebellum through physical exercises, like standing on a balance board, juggling, standing on one leg with your eyes closed, and a variety of others, you can actually bring about improvement in concentration and reading fluency, by taking advantage of the connections from the cerebellum to the front parts of the brain.
The beauty of the Learning Breakthrough Program is that it makes this therapy affordable, convenient, and actually fun. You order the kit and do the exercises at home. You can demonstrate for yourself that it is working by doing the before and after comparisons the kit shows you how to do. So, you get immediate positive reinforcement, which is a powerful motivator to keep you, or your child, doing the exercises.
One of my sons and my wife benefitted enormously from cerebellar stimulation exercises, my son with a reading problem, and my wife with a coordination problem (yes, these exercises also improve coordination and athleticism!).
LBP can--and should--be used as part of a comprehensive treatment program that also includes education, coaching, tutoring, perhaps medication, and perhaps additional complementary treatments.
I am so enthusiastic about LBP that I have leant my name to endorse the product. I have become a consultant to the company, and while they do pay me for my time, I would never endorse a product I did not totally believe in. While we do need more research to prove the efficacy of LBP, I have seen enough anecdotally for me to be a big-time fan of this effective, convenient, and affordable treatment.
I think LBP is one of the most exciting innovations in the treatment of ADHD and reading problems since the advent of stimulant medication in 1937. And it carries the possibility of going one better than medications, in that it addresses underlying causes.
The only drawback to LBP is that not enough people know about it. I hope to help in the effort to change that soon!
You can learn more and receive the Learning Breakthrough services through my offices in Sudbury, MA and in New York City. You can call the Sudbury office at 978-287-0810, the New York office, 212-799- 7777, or got to my main web site, and be directed to either office.
Editor's note: We get a lot of questions about omega-3s, so we thought it would make sense to write about them in depth this month.
The discovery of the importance of omega-3 fatty acids in our diet may be the most important discovery in nutrition in the past fifty years. Indeed, it may be one of the most important medical discoveries of our era. Omega-3 fatty acids may hold the key to preventing and treating such disparate and devastating diseases as diabetes, heart disease, Alzheimer's, depression, and cancer.
Most Americans don't eat nearly enough of these essential fatty acids. Current estimates are that the average American east 125 milligrams of omega-3 fatty acids per day - only about 5% of what the average American ate a century ago. The consequences of this deficiency are dire. Low levels of omega-3 fatty acids leads to chronic inflammation throughout the body, which in turn increases the risk of our most notorious diseases.
We also know that omega-3s increase the levels of dopamine in the brain. Dopamine is the neurotransmitter that the medications we use to treat ADD also act to increase. A recent study in Sweden, which followed a group of children ages 8-18 who have ADHD found that taking fish oil each day can reduce ADHD symptoms. These reductions come over time. Within six months there was a reduction in 25% of the children, and by the end of the study a reduction in fully half of those taking fish oil. A small study we did in our own offices, also with children, also indicated significant improvement of ADHD symptoms after taking fish oil.
The reason we need to add omega-3s to our diet is that we are unable to synthesize certain fatty acids (including omega 3s and omega 6s) on our own. Yet they are critical for life, particularly for the life of the human brain. Most western diets are rich in omega- 6s, but low in omega-3s. So, you can add omega-3s to your diet with: salmon; sardines; tuna; flaxseed; flaxseed oil and by fish-oil supplements. If you buy fish oil supplements, make sure to get a pharmaceutical grade product so that you don't add mercury to your diet.
How much do you need? If you want to be very scientific and exact about it, then you'll want to carefully balance omega-3s and omega-6s, for the balance is important. You can get a standard blood test through your doctor to understand your balance, or from Nutrasource Diagnostics (they are rolling out a consumer test that uses a finger prick for analysis - currently you need to email them to get one but they say they will soon have online ordering available. Go to this link for more information.) A good ratio should be between 1.5:1 and 3:1
If you do not wish to do the blood test, a safe dosage for children is 2.5 grams a day of an omega-3 supplement like fish oil and 5 grams a day for an adult.
As if that's not enough, omega-3s as part of a healthy diet can help boost your immune system, according to a spokesperson for the American Society of Nutrition. It's flu season - what are you waiting for?!
More resources on this topic:
by Rebecca Shafir M.A. CCC
It has been over three years since we started offering Low Energy Neurofeedback therapy (LENS) at the Hallowell Center. This system, designed to help normalize brain wave patterns in children and adults, has shown that 79% of all patients showed significant improvements in sleep, mood energy and/or clarity by the end of their treatment. The average treatment time has been 17 sessions.
Here at the Hallowell Center, we see more than just AD/HD. For LENS I may see clients with or without attentional problems, but several with histories of concussions, addictions, depression and/or anxiety. The clients that are self referred or referred to me by physicians do not tolerate traditional medications or find the medications undesirable. While one of the reasons many start LENS treatment is to avoid medications, a patient can remain on medications over the course of LENS treatment. However, at least 20% of my clients, that I am aware of, have cut way back on their medications or have stopped taking them altogether.
LENS neurofeedback is safe and cannot cause any harm. Barring any new head injury or significant trauma to the brain, the improvements stick. It's rather amusing, but patients will often come into me asking how much electric current I'll be using on their brain! I tell them that the signal to the brain runs on a radio wave - about a trillionth of a watt. It is a million times more dangerous to hold a cell phone to your ear for a second than it is to have LENS. If I could put it in a nutshell, I would say that LENS is an enabler; not a cure. It sets the brain on a course of better function. One becomes more enabled to use strategies, or it gives one better sleep, or greater awareness and initiative to make the changes in one's life that need to be made. Mood is more stable and energy is greater.
With the children, the "enabling" action of LENS therapy helps them move towards school goals they would not have previously been able to handle. I'll often help them apply homework and study strategies that pre- LENS would have been a waste of time. This is the most exciting part - to see my patients start to flourish on their own.
LENS is not for everyone and we can determine that fairly early in the process. There is very good research which you can read about at the LENS website. You can also read more about LENS in SuperParenting for ADD, Dr. Hallowell's latest book.
If you would like to have a conversation about LENS for you or your child please call Rebecca Shafir at 978.287.0810 x117.
Editor's Note: Rebecca Shafir is offering a free information session about LENS at The Hallowell Center in Sudbury on Tuesday, November 10th from 7:00-8:30 for those in the Boston area. Please call ahead to register at 978-287- 0810 x117.
We recently were asked by a reader to write about the connection between the ADHD mind and the need for mood enhancers. Her question, and our answer, which was too long to put in the Q&A:
Q: Could your please write about the correlation between the need/abuse for Mood enhancers (alcohol, maruijuana, chocolate) and dopamine and the slippery slope folks with ADD sometimes fall down overusing these unbalanceing mood enhancers for some peace of mind? How can we satisfy our need for dopamine in a natural way?
So frequently, I read or hear about psychiatrists as the only professionals able to prescribe medications that I felt compelled to point out that this is not accurate. I have been providing therapy and medication for 36 years within my successful outpatient practice filled with patients with ADHD."
Many with ADHD receive "reward" signals more weakly than those without, so they need higher levels of stimulation to feel satisfied. In addition, people with ADHD have a higher likelihood of having a genetic predisposition to addiction. These two facts combined mean it's particularly important to guide oneself away from potentially addictive substances and towards a process of engaging yourself (i.e. the stimulation/stress mentioned by Ratey) in healthy ways. Dr. Hallowell notes that many with ADHD can find stimulation through creative endeavors (he, for example, writes to channel his need to "scratch the itch of ADD") and learning to identify the signals that you are about to move towards unhealthy habits so you can "redirect" yourself into a healthy one is extremely useful. An example - if you are feeling the need to comfort yourself with ice cream, take a brief, brisk walk instead.
Some healthy, non-medicinal ways to increase
dopamine production in your brain include:
Unhealthy ways to boost dopamine include:
Of course, you probably already know that a brisk walk is healthier than a gallon of ice cream or a few martini's, so the real question becomes, "How do I change my habits?" You need to find activities that you like that also scratch the itch. In Dr. Hallowell's case, writing fits that bill, as does watching pro football in person or on TV. One is productive, the other stimulating albeit not socially valuable. He believes that of all the steps a person can take to develop healthier ways to scratch the itch, the two at the top of list are personal relationships and creative activities. Whatever you pick, it ought to be something you enjoy for it to become a regular part of your life.
Staying Sharp - Brain Training for Boomers and Seniors - Rewire, don't retire, your brain! That's the idea behind this seminar to be given by Rebecca Shafir at the Hallowell Center, starting November 17th. Shafir is a neurotherapist and speech/language pathologist.
Current research shows that with proper brain training healthy older people can rejuvenate and improve their memory, concentration and learning abilities.
The November 17th session is a free introduction to the seminar, so people over 50 can learn about how they can keep working, advance at their job or just fight getting older. After November 17 the group will meet for 8 sessions from 6:30-8:00 p.m. for 8 weeks starting Tuesday, November 24.
Brain training is the structured use of cognitive exercises aimed at improving specific brain functions; much more effective than Suduko or crossword puzzles. "Staying Sharp" includes memory exercises, tips on diet and exercise, anxiety reducers, interactive discussions, guest speakers and some regular homework. Basic ability to use a computer is highly recommended for participation. Re-wire don't retire your brain. Get sharp, gain confidence and take on those challenges that other boomers and seniors just dream about. If you would like to register for the free introductory session or the eight week program please contact Rebecca Shafir (978) 287 0180 x117. Private, one-on-one brain training sessions are also available.
ADD and Loving It - a fun film about having ADHD aired in Canada but can be found at the Global TV web site. It's a light-hearted yet serious look at ADHD. Dr. Hallowell is one of several experts interviewed.
Lowering ADHD Costs: Health Insurance and Treatment Help - an article in ADDitude Magazine about ways to approach your insurance company to help pay (or pay more) for ADHD treatment at this link.
Sudbury Center Events:
Call 978-287-0810 unless otherwise noted
Dr. Hallowell's Speaking
Go to this link for full details