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ADHD and the REWARD DEFICIENT BRAIN

ADHD and the REWARD DEFICIENT BRAIN: Drugs that Harm, Alternatives that Heal!  David Melendez, D.C., C. Ad.

"Our son is now Ritalin free!  He is now doing remarkably well in a busy classroom setting, something never possible before without drugs!"                                             C.B., A Thankful Mom.

Attention Deficit, Hyperactivity Disorder has become the number one pediatric complaint in America, surpassing even ear infections, for children seeking medical help.  It has been labeled the "Diagnosis of the 90's", with a 700% increase seen between 1990 and 1997.  Researchers in Virginia, as reported in the American Journal of Public Health (9/99), report that 8-10% of children in second through fifth grade routinely take medication for ADHD.  Among fifth graders, one out of every five white males is taking ADHD medication, primarily Ritalin, which is a schedule II narcotic drug in the same class as cocaine, methamphetamine, heroine, and opium.  Most experts agree that doctors are over prescribing drugs to grade school kids and they are misdiagnosing these children.  In addition, as reported in the February 2000 Journal of the American Medical Association, the number of 2 to 4 year old children on psychiatric drugs including Ritalin and anti-depressants such as Prozac, soared 50% between 1991 and 1995.  Experts are troubled by these findings because the effects of such drugs in children so young are largely unknown.  Doctors worry that such powerful drugs could be damaging to children's development.

"Methylphenidate (a.k.a. Ritalin) has effects that are essentially the same as those of amphetamine and methamphetamine (Speed, Crystal meth.).  The abuse of Ritalin can lead to tolerance and severe psychological dependence.  Psychotic episodes, violent and bizarre behavior have been reported."   International Narcotics Board, 1996.

The standard medical approach can seemingly treat the symptoms of ADHD but not without a price and that price can be much higher for some then others. Is there another way, a natural non-drug solution, to stem the tide of this supposedly childhood epidemic?  The answer, for many, is a resounding yes!
There are four keys to achieving a non-drug success with the ADHD child and adult.  Those four keys encompass an understanding of genetics, the immune system, nutritional and the nervous system connections in ADHD.

Genetic:

"Many experiments since 1990 have found the D2 dopamine receptor gene to be associated with a variety of impulsive, compulsive and addictive behaviors, including poly-substance dependence, crack cocaine, smoking, carbohydrate bingeing, pathological gambling and most important, behavioral conditions such as Tourettes Syndrome and ADHD.  Realizing that there was a common underlying genetic route to all these behaviors we decided to give this complex condition a name.  I chose Reward Deficiency Syndrome (RDS), related to the deficiency in the reward part of the brain where dopamine works (the Limbic System)."  Kenneth Blum, PhD.  Overload: ADD & the Addictive Brain.                        

Children and adults with true ADHD have a physiological inability to filter out incoming stimuli and an inability to physiologically feel good.  This is primarily a result of a deficiency of dopamine in the reward center of the brain (the Limbic System), causing  the inability to focus, remain attentive or control impulsivity and reach a state of well being, hence the term Reward Deficiency Syndrome.  The deeper reason is genetic, associated with the A-1 allele of the D2 dopamine receptor gene, which has been linked to all the addictive, impulsive and compulsive disorders including ADHD.                       

It's very common, while taking a case history of an ADHD child, to discover a family history of ADHD and/or addiction on either side of the family, with alcohol, drug, and smoking addictions common.  In addition, depression, on the mother's side of the family, is all too common as well.  Once the addictive, compulsive connection is understood, and that children with ADHD share a similar brain chemistry as an addict, the  need to seek a natural non-drug approach to healing the reward center of the brain quickly becomes paramount.                                               

"Our conviction was that ADHD was indeed an important precursor to a life of despair and potential addiction to mood altering drugs."  Kenneth Blum, PhD.                               
Immunological:

Researchers say that the nervous system and the immune system are intimately connected in a flowing wave of continuous electrical and chemical messages described as a feed back loop or "The Safety Pin Cycle".  They even go as far as to say that the immune system is merely a circulating nervous system.                                       
"Immune cells also make, store, and secrete the neuropeptides themselves.  In other words, the immune cells are making the same chemicals that we conceive of as controlling mood in the brain (Brain Reward Cascade).  So immune cells not only control the tissue integrity of the body, but they also manufacture information chemicals that can regulate mood and emotion. This is yet another instance of the two way communication between brain and body."  Candace Pert. PhD., Molecules of Emotion.

Immune system breakdown, malfunction, or weakening in any way affects immune cell production of its own neuropeptides, which can negatively affect the Brain Reward Cascade and accentuate true ADHD or mimic the symptoms of ADHD.
As the immune system goes the nervous system goes, including the negative effect on brain chemistry, especially in sensitive individuals like an ADHD child.               
Nutritional: Today there are many common medications, dietary foods, and toxic substances that damage our children's nervous and immune systems and therefore adversely affect brain chemistry.  A short list: Sugar, Caffeine, Cows Milk, Preservatives (MSG, NutraSweet, etc.), Artificial Colorings, Sodium Nitrites, Partially Hydrogenated Oils, Pesticides, Antibiotics, Over the Counter Drugs (Aspirin, Tylenol, Advil, etc.).  Exposure to these substances should be avoided, especially for the ADHD child.

 Nutritional:

Yeast Related Complex (YRC) is associated with an imbalance of intestinal flora, commonly from past use of antibiotics, which weakens the mucus lining of the intestines. This weakening allows toxins from the yeast to enter the blood stream, which affects the area of the brain that controls moods and emotion (Brain Reward Cascade), causing symptoms of depression, irritability, poor concentration, and many other health problems.  Many of the symptoms can either mimic ADHD or greatly amplify true ADHD.       

Hypoglycemia or low blood sugar is another common problem in children with a diet high in simple refined carbohydrates (Sugar).  Remember, many ADHD children have Reward Deficiency Syndrome and thus crave simple carbohydrates (sugar) which stimulates dopamine and helps them temporarily feel good leading to a kind of self-medication effect.  These constant spikes and valleys of blood sugar lead to symptoms of hypoglycemia, which mimic or accentuate the symptoms of an ADHD child.  Some of the most common symptoms of Hypoglycemia include fatigue, irritability, mood swings, muscle twitches, wiggly legs, headaches, problems concentrating, dizziness, and anxiety.

In addition, most ADHD children are deficient in Essential Fatty Acids (EFA) such as Omega 3 and Omega 6 fatty acids commonly referred to as "good" fats.  These fats are essential for proper brain and immune system function.  Examples of "good" fat EFA's are Flaxseed Oil, Evening Primrose Oil, and Fish Oils.  Omega 3 fatty acids are converted in your body first into eicosapentanoic acid (EPA) and then into docosahexanoic acid (DHA).  DHA is vital for brain health because most of your brain is made up of it.  A shortage of DHA causes inevitable brain degeneration.  Some common symptoms suggesting a need for EFAs are irritability, poor concentration, dry flaking skin;  "chicken skin" or bumps on the outer upper arms, thigh, or cheeks; brittle, soft, or splitting finger nails; nails with longitudinal lines; dry hair; dry scaling in the ear canal; Hyperactivity; eczema; asthma.  It is evident that a deficiency of Essential Fatty Acids in the ADHD child can either mimic or accentuate the symptoms of ADHD.               

Remember, true ADHD is genetic in origin, creating a Reward Deficiency Syndrome in the part of the brain that releases dopamine.  In other words, a deficiency of reward being dopamine release. Dopamine is a neurotransmitter.  Neurotransmitters are chemical proteins made up of amino acids, which allow the transmission of nerve impulses to cross the nerve synapse.  ADHD is, in a sense, a protein metabolism problem or an inability to make enough dopamine.  There are certain amino acids essential for the health and healing of the Brain Reward Cascade.   

D-Phenylalanine: Restores enkephalines (Neurotransmitter) and creates anti-craving and anti-depression behavior.
L-Phenylalanine: Restores Dopamine and Norepinephrine, which creates a sense of will being, attention, and anti-depression behavior.
L-tyrosine: Restores Dopamine and Norepinephrine, which creates a sense of well being, attention, and anti-depression behavior.
L-Glutamine: Restores GABA, which creates anti-craving and ant-stress.
L-Tryptophan: Restores Serotonin, which creates anti-depression, anti-craving, and anti-insomnia behavior.
A diet rich in protein and essential fatty acids is necessary for an ADHD child or adult.  Fresh turkey and salmon sandwiches are ideal morning, noon, and night.

Neurological:   

"We can no longer consider the emotional brain to be confined to the classical locations of the Amygdala, Hippocampus, and Hypothalamus (The Limbic System)… We have discovered other anatomical locations where high concentrations of almost every neuropeptide receptor exist, such as the dorsal horn of the spinal cord, which is the first synapse within the nervous system where all somatosensory information is processed."   Candice Pert, PhD., Molecules of Emotion.

The reward center of the brain (Limbic System), the very location of the Brain Reward Cascade where dopamine is released, extends from the center of the brain down into the entire backside of the spinal cord.  Therefore any distortion or interference of the spinal cord can disrupt and negatively influence the Brain Reward Cascade.  In 1993 researchers from Harvard Medical School found evidence for direct projections of the spinal cord neurons into the Limbic System.  They strongly suggest that these neuronal pathways affect behavior functions.   

Structural:

The common occurrence of Vertebral Subluxation (spinal misalignments) creates interference to the nervous system.  Ninety percent of all children born by forceps delivery, vacuum extraction, or difficult delivery are subluxated at birth.

"The birth process even under optimally controlled conditions is a potentially traumatic and crippling event for the fetus.  Mechanical stress imposed by obstetrical manipulation, even standard orthodox procedures, may prove intolerable to the fetus."  Abraham Towbin, PhD. Harvard Medical School.

Spinal subluxation can either negatively influence the Brain Reward Cascade aggravating true ADHD or create some of the symptoms of ADHD.
Chiropractic's greatest contribution is the detection and correction of Vertebral Subluxation, which reduces abnormal nerve tension and interference, allowing maximum production and flow of neurotransmitters, healing the Brain Reward Cascade. 

"My son has been coming for adjustments and is improving everyday.  Thanks to the doctor's expertise, he is able to concentrate and follow directions.  His depression is gone and his level of frustration and anxiety are much less.  Now professionals specializing in this condition, remark that they never would have known that my son has ADHD.  His ability to sit calmly, follow directions, and concentrate amazes them!"    D.R., A thankful mom.

"This further supports our speculation that via adjustment of the spine, a subluxation - free spine would facilitate an enhanced sense of well being by way of limbic activation of dopamine release at the nucleus accumbens (limbic tissue)."   Dr. Ken Blum, Dr. Jay Holder, Reward Deficiency Syndrome, Journal of Psychoactive Drugs, Nov. 2000.                                                                                                               

As ADHD becomes the most common diagnosed mental health disorder in children, the pharmaceutical companies jockey for market share and the medical profession uneasily joins with the belief that the only way to improve brain chemistry is with drugs.  On the contrary, we now know that unlocking the strength of the immune and nervous systems through proper nutrition and specific chiropractic adjustments to correct vertebral subluxation is one of the most powerful, non-drug approaches to heal and improve brain chemistry available today!