Attention Deficit Disorder (ADD) is a broad syndrome that may include hyperkinetic syndrome, hyperactivity, and Attention Deficit Hyperactivity Disorder (ADHD). Although hyperactivity is commonly observed, it is not necessarily a component of ADD. There is likely to be a group of related problems, with some different etiologies, encompassed by the term ADD. In some instances, ADD might be a misdiagnosis for behavioral problems that are related to home and social situations without an underlying physiological dysfunction.
The most common manifestation of ADD is a combination of inability to remain at rest while awake, less total sleep time, and difficulty concentrating on a particular activity. The disorder may be somewhat apparentat birth (or even in utero) with excessive movement of the arms, legs, and head, but is usually not diagnosed until lack of concentration at school is deemed a problem, typically in the first or second grades (ages 7 to 8). As much as 10% of the U.S. population is believed to be affected; if that is the case, then ADD is one of America’s most prevalent mental disorders. Males are at least four or five times as likely as females to have the disorder. This differential is probably partly genetic in nature, though hormones clearly play a role. The hormonal component of the expression of ADD is revealed in the fact that puberty may alter the course of the symptoms. Furthermore, thyroid hormone disorders are frequently found in persons with ADD.
A genetic basis for the disease is suggested by the fact that children with ADD are more likely to have fathers who suffered from the disorder. But, there are probably preventable environmental factors that lead to developing ADD, a disorder which seems to be occurring in much greater frequency now than just a few decades ago. It is possible that some cases of ADD arise from exposure in utero to harmful chemicals, such as from smoking, alcohol consumption, prescription and illicit drugs, and environmental pollutants, all of which have become wide-spread problems for women during the past four decades. Nutritional deficiencies might also contribute to the development of ADD. It appears that ADD arises from a neurological defect, with abnormalities in the brain tissue or neuron biochemical functions. ADD is found more often in children who have other brain defects, such as those leading to mental retardation, cerebral palsy, or temporal lobe epilepsy.
While for many children affected by ADD there is some reduction in the symptoms as the child enters puberty, the disorder will often continue for the rest of the individual’s life, and the impact of the disorder on early childhood behavior, which often includes impulsiveness, recklessness, irritability, aggression, and poor emotional development, in itself produces effects felt throughout life even if the ADD is in remission. Sometimes, puberty brings about a switch from hyperactivity to persistent sluggishness, depression, and moodiness, which is liable to be equally disruptive. Children who suffer from ADD are much more likely, as adults, to be involved in crime, have unsuccessful marriages, and difficulty keeping a steady job, than those who do not experience this disorder. The primary treatment for ADD is the administration of stimulant drugs. This strategy may seem paradoxical in the context of a hyperactivity disorder. However, it is postulated that the controlling action of certain mid-brain activities may be deficient in these individuals and therefore a stimulant is able to bring about the desired control. The stimulation of brain function may enhance alertness and concentration. The primary drug used for this disorder is methylphenidate (Ritalin), a relatively mild derivative of amphetamine. Ritalin is also used in the treatment of mild to moderate depression, emotional withdrawal in the elderly, and narcolepsy. This drug can have side effects, mainly the problems seen with amphetamine use: nervousness and insomnia. It may also encourage epileptic seizures in those with latent epilepsy, and can reduce red blood cell and platelet counts. Many parents of children with ADD appreciate the effects of
Ritalin but worry about the potential harm of continued administration of a drug; some note obvious adverse effects and seek alternatives. Ritalin is
ineffective in about 30% of cases diagnosed as ADD.
From the traditional Chinese medical viewpoint, ADD is caused by a kidney essence deficiency that affects brain development. Further, the yin aspect of the kidney is most deficient, leading to excessive expression of yang: this is manifest as the hyperactivity and wandering of the mind. Accordingly, it is to be treated by nourishing the kidney yin, opening the heart orifices (which are the passages that affect the brain function), and settling the agitated yang. There have been numerous studies of the effects of Chinese herbs on ADD, with a remarkable degree of consistency in the selection of herbs used to treat this condition. Some Chinese physicians rely on differential diagnosis, with selection of somewhat different formulas for each syndrome classification, while others use a standard preparation with few or no modifications.
From the traditional perspective, the marrow and essence is the foundation of the brain, and the early problems with mental development indicate deficiency of the vital essence. The main herbs used for nourishing the kidney in children with this syndrome are rehmannia, tortoise shell, deer antler gelatin, lycium, and cornus. These are ingredients of the traditional Zuo Gui Wan (Left Restoring Pill) used to treat kidney yin deficiency when there are deficiencies of “marrow and essence.”
Phlegm obstruction of the heart orifices usually leads to confusion, inability to concentrate, and poor memory. It occurs for a variety of reasons, but often because of weak digestion and/or poor diet, coupled with emotional disorders, especially agitation. The main herbs for clearing the heart orifices and enhancing the mental function are acorus, polygala, curcuma, and alpinia. Acorus is said to “open the orifices, vaporize phlegm, and quiet the spirit.” Polygala is said to “expel phlegm and clear the orifices, calm the spirit and quiet the heart.” Curcuma, which promotes movement of qi and invigorates the blood, is used to “treat hot phlegm that obstructs the heart orifices when there are symptoms of anxiety, agitation, or mental derangement.” The Chinese name for alpinia, yizhiren, means “the seed that benefits intelligence.” It aids digestion (preventing phlegm accumulation), astringes the kidney to restrain the essence,
and prevents the development of heat from deficiency of kidney; the deficiency heat can cause phlegm to become a “mist that obstructs the heart orifices.”
To settle the agitated yang energy (which may manifest as hyperactivity and insomnia) the so-called “heavy sedating agents” are used. The traditional concept is that these mineral-rich substances bear down on the rising and disordered yang. The main substances given for ADD by Chinese doctors are dragon bone or dragon teeth, oyster shell or mother of pearl, succinum, and cinnabar. In some cases, herbs to purge deficiency fire that accompanies yin deficiency syndrome might be employed. Phellodendron and anemarrhena are the most commonly used items for this purpose.
As an example of applying these methods, 30 children with ADD were treated with herbal pills for two to four months, with the result that 22 of them (73%) showed strong improvement.
Since the herbs recommended for ADD are non-toxic and readily available in the West, the main problem with adopting these methods is managing the dosage and administration. The high dosage decoctions may serve in China as a source of mineral substances (e.g., calcium and magnesium) which are more
readily administered in the West through nutritional supplements and/or by direct ingestion of natural substances rich in those minerals given in capsules
or tablets. Careful selection of ingredients in an herb formula can help to minimize the total amount to be ingested. It is important to note that one formula, even if well designed, will not be ideal for all children. Following the traditional differential diagnosis, phlegm-resolving, fire purging, qi-tonifying, or other combinations may be necessary as adjuncts or substitutes for a basic ADD formulation.
Treatment times reported in the Chinese literature are generally two weeks to two months. When using a low dosage form, one would expect to undertake a longer term of treatment, perhaps four months. Fortunately, some degree of improvement is said to be observed in a relatively short time, so a decision to continue such therapy might be made after just one month (as is the cases with Ritalin). Among reports received by ITM regarding effects of Chinese herbal pills, the beneficial effects are noted during the first month of therapy.
Significant adverse effects have not been reported with use of herbal pills.
The most commonly used herbal pills for ADD are:
Stress/Emotions Support Angelica Longona Extract: Gui Pi Wan
Six Flavor Rehmanii: Liu Wei Di Huang Wan
Restore the Left Kidney pill: Zuo Gui Wan
From the traditional perspective, the marrow and essence is the
foundation of the brain, and the early problems with mental development
indicate deficiency of the vital essence. The main herbs used for nourishing
the kidney in children with this syndrome are rehmannia, tortoise shell, deer
antler gelatin, lycium, and cornus. These are ingredients of the traditional Zuo
Gui Wan (Left Restoring Pill) used to treat kidney yin deficiency when
there are deficiencies of “marrow and essence.”
Phlegm obstruction of the heart orifices usually leads to
confusion, inability to concentrate, and poor memory. It occurs for a variety
of reasons, but often because of weak digestion and/or poor diet, coupled with
emotional disorders, especially agitation. The main herbs for clearing the
heart orifices and enhancing the mental function are acorus, polygala, curcuma,
and alpinia. Acorus is said to “open the orifices, vaporize phlegm, and
quiet the spirit.” Polygala is said to “expel phlegm and clear the
orifices, calm the spirit and quiet the heart.” Curcuma, which promotes
movement of qi and invigorates the blood, is used to “treat hot phlegm
that obstructs the heart orifices when there are symptoms of anxiety,
agitation, or mental derangement.” The Chinese name for alpinia, yizhiren,
means “the seed that benefits intelligence.” It aids digestion
(preventing phlegm accumulation), astringes the kidney to restrain the essence,
and prevents the development of heat from deficiency of kidney; the deficiency
heat can cause phlegm to become a “mist that obstructs the heart
orifices.”
To settle the agitated yang energy (which may manifest as
hyperactivity and insomnia) the so-called “heavy sedating agents” are
used. The traditional concept is that these mineral-rich substances bear down
on the rising and disordered yang. The main substances given for ADD by Chinese
doctors are dragon bone or dragon teeth, oyster shell or mother of pearl,
succinum, and cinnabar. In some cases, herbs to purge deficiency fire that
accompanies yin deficiency syndrome might be employed. Phellodendron and
anemarrhena are the most commonly used items for this purpose.
As an example of applying these methods, 30 children with ADD
were treated with herbal pills for two to four months, with the result that 22
of them (73%) showed strong improvement.
Since the herbs recommended for ADD are non-toxic and readily
available in the West, the main problem with adopting these methods is managing
the dosage and administration. The high dosage decoctions may serve in China as
a source of mineral substances (e.g., calcium and magnesium) which are more
readily administered in the West through nutritional supplements and/or by
direct ingestion of natural substances rich in those minerals given in capsules
or tablets. Careful selection of ingredients in an herb formula can help to
minimize the total amount to be ingested. It is important to note that one
formula, even if well designed, will not be ideal for all children. Following
the traditional differential diagnosis, phlegm-resolving, fire purging,
qi-tonifying, or other combinations may be necessary as adjuncts or substitutes
for a basic ADD formulation.
Treatment times reported in the Chinese literature are generally
two weeks to two months. When using a low dosage form, one would expect to
undertake a longer term of treatment, perhaps four months. Fortunately, some
degree of improvement is said to be observed in a relatively short time, so a
decision to continue such therapy might be made after just one month (as is the
cases with Ritalin). Among reports received by ITM regarding effects of Acorus
Tablets or similar herbal preparations, the beneficial effects are noted during
the first month of therapy.
Significant adverse effects have not been reported with use of herbal
pills.
The most commonly used herbal pills for ADD are:
- 1. Stress/Emotions Support Angelica Longona
Extract: Gui Pi Wan - 2. Six Flavor Rehmanii: Liu Wei Di Huang Wan
- 3. Restore the Left Kidney pill: Zuo Gui Wan
About the author: ChineseHerbalAdviser
