Wednesday, July 25, 2007

Attention Deficit Disorder

By John Douillard, DC, PhD

The diagnosis of Attention Deficit Disorder (ADD), or Attention Deficit Hyperactivity Disorder (ADHD), is classified by three symptomatic characteristics: inattention, hyperactivity and impulsive behavior. In recent years much research has gone into identifying the cause of ADD. Thorough investigations have gone into lifestyle, sugar intake, excessive TV watching, and even chemical toxicity during pregnancy, an occurrence once thought to be the cause of minimal brain disorders. In all the research only a small and insignificant percentage of cases with ADD proved positive for such causative factors. To date, these factors remain neither proven nor disproved.

In Ayurveda, ADD or hyperactivity falls under the heading of Unmada, which is a general heading for manias, or in this case a type of minimal brain disorder. The definition given by Caraka, Ni. Ch VII, V5, states that Unmada is a wandering of mind, intellect, consciousness, knowledge, memory, inclination, manners, activities, and conduct. It also describes five possible causes for this condition: Vata, Pitta, Kapha, sannipata (the aggravation of all three doshas), and exogenous factors (genetic or outside factors).

We must remember that many of our modern diseases did not exist as such in the past, therefore an exact differential diagnosis may not be drawn or quoted from the original texts. I do believe, however, that the texts will describe the underlying factors that would elicit the symptoms of ADD.

The Western classification of ADD is by three consistent symptoms. Each of these symptoms specifically relates to one of the three doshas when out of balance:

Inattention, when the individual is unable to focus on any one thing for a length of time, is primarily a Kapha symptom. The mind seems dull and lethargic unless it is accompanied by physical or kinetic activity. Imbalances are an accumulation of the dosha: too much Kapha creates depressed mental faculties, or inattention. However, when the mind is hyperactive, excessive Vata can create inattention and/or hyperactivity.

Hyperactivity – this symptom is a classic depiction of a Vata imbalance. The mind is restless and racing, legs and feet cannot be still. It seems impossible for the mind or body to settle down and relax and/or focus.

Compulsive Behavior – these symptoms of action without thought are typically controlled by Pitta. Students will blurt out answers, jump up in class and show little ability to think through or control their actions.

Although everyone at times will seem either a bit compulsive, hyperactive, or unable to keep their mind on their work, this disorder is classically a combination of all three imbalances at the same time – known as sannipata. Because all three doshas are out of balance simultaneously, sannipata becomes a chronic condition and more difficult to treat. In extreme cases the disorder of sannipata is said to be incurable. ADD, however, is a minor disorder classified by no known neurochemical imbalances to date and can be successfully treated with a comprehensive Ayurvedic regime.

The final category of cause mentioned by Caraka is the exogenous factors. These factors
translate from Ayurveda to genetic susceptibilities, and the factors that can exacerbate genetic weaknesses are many. Each individual body type may be triggered into an ADD response by a variety of the previously mentioned factors (TV, sugar, lifestyle, and toxicity). There will probably not be one cause for every case of ADD. Each individual must be treated as an individual and offered a unique and tailored package of therapies for his or her condition.

One factor that has been overlooked by researchers when examining dietary factors is the ingestion of growth hormones. Growth hormones are stimulants injected into animals to increase growth rates, and there have not been any long-term studies on the effects and use of these hormones. However, in vegetarian societies such as India, ADD is relatively unknown. In America, on the other hand, where the diet includes large amounts of red meats, poultry, and milk, ADD has become prevalent. The consumption of hormone-free meats, eggs, and milk, or a vegetarian diet, should be examined as potential treatment and prevention.

In the case of all the above described causes of ADD, the underlying factor is a deficiency of prana, or energy, in the body. This may not seem the case as kids are jumping off walls and displaying hyperkinetic behavior. It appears that they have too much energy and need to be settled down. In Ayurveda this apparent excess in energy is caused by a lack of prana (energy that controls Vata) which must be sufficient to naturally calm the nervous system. Without sufficient prana, the nervous system can run out of control and lead to ADD symptoms. A similar phenomenon is seen with insomnia, a symptom of prana depletion. Insomniacs actually need more energy or prana to settle their nervous system. A sedative could actually further deplete the patient. Ritalin, the common Western drug for ADD, is a stimulant drug that seems to work well for the symptoms of ADD, possibly for the same reasons.

General Treatment

In a situation when all three doshas seem to be out of balance and the symptoms indicate that a lack of prana Vata is present, the treatment protocol should be strengthening and building. Remove all chemicals and preservatives from the diet. Eat organic meats and foods whenever possible.

Incorporate the following formulas:

Formula for Nervous System Dysfunction and Depletion:
Soak 3 unpeeled almonds overnight in a glass of water with one whole black pepper and one teaspoon fennel seeds. In the morning, remove the skins from the almonds and crush all three ingredients into a paste. Add equal parts sweet butter and honey to taste. Take this first thing in the morning on an empty stomach and do not eat for 11⁄2 hours afterwards. Continue every morning for 15 days.

Formula to Rejuvenate and Detoxify the Nervous System through Synergistic, Free Radical Scavenging Effects:
Equal parts Brahmi, Ashwaganda, and Gudduchi. Take 1 teaspoon of the combination 2 times a day with hot water or with ghee and honey to make a paste.

Formula to Strengthen and Calm the Nervous System – a Nervous System Tonic:
Equal parts Jatamansi, Shankpushpi, and Brahmi. Take 1⁄2 teaspoon of the combination after meals t.i.d. Vacha (Acorus calamus) can also be added to this combination if easily tolerated by the patient.

Meditation

Meditation is probably one of the most important self-help techniques employable in the treatment ADD. Meditation will accustom the mind to being calm. In time, the individual will begin to take this calm into all activity, and will replace stress-induced hyperactivity with composure.

Pranayama (Breathing Exercises)

Specifically, chandra bhedna, or the cooling and calming breath, is indicated for ADD. All pranayama techniques will move prana or energy. Chandra bhedna will both increase the availability of prana and provide a neurological calm needed by the body. To perform pranayama, inhale deeply through the left nostril with the right nostril closed, then exhale out deeply through the right nostril with the left nostril closed. Repeat this for a minimum of 10 breaths and a maximum of 10 minutes.

Panchakarma

Panchakarma is a very powerful seasonal detoxification and rejuvenating process that can be extremely useful in the treatment of ADD. It provides not only a cleansing on a cellular level but also deep calm and subsequent access to one’s own being or consciousness. Once this experience of being is accessed and infused into every cell in the body, the body can heal. The Vedic concept of Pragya Praradh, “the mistake of the intellect,” wherein the intellect forgets its true reality as a field of consciousness and love, is credited as the cause of all disease. Ayurveda is dedicated to the restoration of this reality.

Swedana

Swedana is an herbal (using dashamula, or “ten roots decoction”) steam, which one performs for 20 minutes for seven days. This is followed by abhyanga, or Ayurvedic massage, for 40 minutes, and shirodhara, in which body-temperature oil is poured over the forehead for 20 minutes.

Basti

Basti is an herbal enema, made with bala, vacha, and haritaki boiled down from four cups of water to 1 cup. Add 1 cup sesame oil and administer each night for seven nights.

Home Nasya with Brahmi Ghee for ADD

Massage the head and neck, then take a hot shower. Following this, steam the face and neck by using the following method: fill a large bowl with freshly boiled water. Add 1 2 drops eucalyptus oil or Vicks Vaporub. Take a clean, large towel and drape it over the head to make a tent. Lean over the bowl so that the steam is trapped inside the towel tent. Inhale the steam for two to three minutes. Gently apply hot towels to the neck and face. After steam inhalation follow instructions below to sniff Brahmi ghee.

Using an eye dropper, place two or three drops of brahmi ghee (see recipe, below) directly into both nostrils. Sniff the oil into the sinus cavity. Hold both nostrils closed and breathe in through the nose while rapidly closing and opening the nostrils. Repeat the sniffing procedure three times.

Alternate lubrication method – Place a few drops of the oil in the palm of the left hand. Dip the little finger of the right hand into the oil. Insert the oiled finger into both nostrils until they are well lubricated. If you use this method, make sure that your hands are clean and that the nail of your little finger is clipped short. Continue with the sniffing procedure described above.

Repeat as needed. Do not perform within two hours of bedtime.

Brahmi Ghee Recipe
Boil 3 teaspoons of Brahmi (powder, leaves, or crushed tablets) in one cup of water for 5 minutes. Strain the liquid through a cotton cloth. Add a cup of ghee to the remaining liquid and boil this mixture until the water is evaporated (approximately 15 minutes). Take care that the brahmi-ghee doesn’t burn once the water is evaporated.

Vata Balancing Diet

Although ADD could be due to an imbalance in any one or all three of the doshas (Vata, Pitta or Kapha), the Vata balancing diet best rejuvenates and calms the nervous system in ADD because Vata controls the nervous system. See: The Vata-Pacifying Diet, below.

The Vata-Pacifying Diet
Favor foods that are warm, heavy, and oily. Minimize foods that are cold, dry, and light.Favor foods that are sweet (e.g., wheat, milk, rice), sour (e.g., yogurt, tomatoes, citrus fruit), and salty.Minimize foods that are spicy, bitter (e.g., green leafy vegetables), and astringent (e.g., apples, beans).

Specific recommendations:

Eat larger quantities of food, but not more than you can digest easily.

Dairy: All dairy products pacify Vata. Always boil milk before you drink it, and drink it warm.

Don’t take milk with a full meal.

Sweeteners: All are good for pacifying Vata (but don’t overdo).

Oils: All oils reduce Vata.

Grains: Rice and wheat are very good. Reduce intake of barley, corn, millet, buckwheat, rye, and
oats.

Fruits: Favor sweet, sour, or heavy fruits, such as oranges, bananas, avocados, grapes, cherries, peaches, melons, berries, plums, pineapples, mangoes, and papayas. Avoid or reduce dry or light fruits, such as apples, pears, pomegranates, cranberries, and dried fruits.

Vegetables: Beets, cucumbers, carrots, asparagus, and sweet potatoes are good. They should be cooked, not raw. The following vegetables are acceptable in quantities if they’re cooked, especially with ghee or oil and Vata-reducing spices: peas, green leafy vegetables, broccoli, cauliflower, celery, zucchini, and potatoes. It’s better to avoid sprouts and cabbage.

Spices: Cardamom, cumin, ginger, cinnamon, salt, cloves, mustard seed, and small quantities of black pepper all help reduce Vata.

All nuts are good.

Avoid all beans, except for tofu and mung dhal.

Meat and fish (for non-vegetarians): Chicken, turkey, and seafood are fine; beef should be avoided.

Further Information

http://www.lifespa.com/article.asp?art_id=27

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