Alternative Treatments for ADHD: A Look at the Neuroscience of the Disorder
Current popular treatments involve regular medication. However, with young children, is this the best method? Are there additional options available?
Though one of the most common ways of treating the symptoms of attention deficit hyperactivity disorder (ADHD), medicating our youth is questioned by medical community. Throughout their adolescent years, youth experience a variety of changes in hormone levels. Many of these, including sex and growth hormones, impact the brains of growing teens. Adding in additional medication to alter serotonin and dopamine levels further complicates this already stressful time.
As neurobiologist David Anderson points out, “You can’t take the kid off the drug after puberty and say, ‘Whoops, let’s go back and do puberty without the drug.’” Anderson believes that drug treatments should be avoided until all other options are exhausted. In a recent TEDxCaltech talk, he outlines how Adderall and other common drug treatments for ADHD are impacting the brains of our youth.
Recent data from the Centers for Disease Control and Prevention (CDC) claim that 11% of children between 4 and 17-years old have been diagnosed with ADHD with rates steadily increasing each year. The same data points out 25% of preschoolers are treated using only medication while less than 33% receive behavioral therapy in conjunction with medication.
Newer research is shedding new light on this disorder. Anderson highlights this, describing ADHD as “disturbances in the neural circuits that mediate emotion, mood and affect.” A discovery that, for many professionals, reinforces the importance of behavioral therapy in treating the disorder. It also brings to light the potential impact of a child’s environment on the symptoms of their disorder.
Anderson notes in his talk, “There’s this traditional view that common brain disorders like ADHD, anxiety and depression are caused by chemical imbalances in the brain, as if the brain were some kind of chemical soup that just needed a little more salt.” However, most of this is based on aging research. “Many of the drugs that are taken for conditions like these were discovered by accident, not through an understanding of the underlying physiology of the disorder,” Anderson states. “It was just discovered that they work, and we don’t know how they work really or why they work.”
Andersen uses Adderall to showcase this point. He says, “Adderall is basically amphetamines, and it works by increasing the amount of dopamine that is released into the brain. There are dopamine fibers in many regions of the brain, and around ten different kinds of dopamine neurons in the brain, and most of those neurons will be affected by amphetamine, and those neurons may be doing many different things.” While Dopamine might help with the symptoms of ADHD, it is treating a localized problem with a global scope. This is one reason side effects with common ADHD medications are so common.
As Andersen compares, “It’s a little like trying to fix your car by pouring oil over the engine — some of it may dribble into the right place, but a lot of it will do more harm than good.” Worse still, these medications bathe the brain in chemicals and hormones. Little research is available into the impact of this in terms of response and brain function on a long-term scale. These responses and changes may be long-lasting. Andersen explains this, continuing his automotive comparison, “So you’re not just pouring oil over the engine — the engine is actually changing as a consequence of being bathed in engine oil all that time.”
Andersen believes prioritizing this research is a necessity to ensure the safety of our youth. He states, “there should be more public pressure on the pharmaceutical industry, and also on our federal funding agencies, to perform and support studies of the long term consequences of treating pre-adolescent and adolescent children with these drugs over periods of years, and to look at what happens as these individuals are taken off the drugs after periods of time.”
However, he doesn’t limit blame for the push toward medication-based treatment to the medical community and pharmaceuticals. “There’s a societal issue here, as well as a public policy issue,” says Anderson. The first-line recommended treatment in most cases is behavioral therapy. However, this isn’t always the easiest treatment. For large families or rural families, access to alternative therapies might be too difficult. For those with lower income, taking the time off of work to seek treatment might not be feasible. For teachers and childcare providers, medication offers a consistent set of standards and practices. When you have a class full of children, each with different needs, the balancing act becomes complex quickly.
So where does that leave the future of ADHD treatment options? Andersen remains hopeful, saying, “If we want to understand what goes wrong in these disorders, we have to understand how the wiring of the brain and the computational parts of the brain contribute to emotion.” This will allow targeted treatment that is both more effective and less likely to create widespread side effects.
One promising advance comes in the form of neurofeedback. This technology allows scientists to measure brain activity down to the level of individual neurons—a level of precision thought impossible just decades ago. While it might not offer immediate answers, it offers the hope of progress. “The thought that we’re going to unravel all of this complexity and come to a quick fix any time soon is overly optimistic,” says Anderson. “But at least we’re getting to know how high the mountain is we’re trying to climb.”
In the meantime, he pushes for society to inspect what they consider to be ADHD behaviors. He says, “For the environment and the conditions and society and family in which you function on a day-to-day basis, is this condition adaptive or maladaptive? That’s the key.” As movements grow to improve acceptance of behavior far from the “normal” distribution, so do the chances of finding improved and less disruptive ways of treating the extremes of ADHD.