Medication may not be the solution for children with attention disorders

Graphic ADHD
Growth of child ADHD cases in the past years.

In the United States 6.4 million children have been diagnosed with Attention deficit hyperactivity disorder (ADHD) in the last eight years, according to the Centers of Disease Control and Prevention. This year 11% of American kids are being treated for ADHD, and half of this number is being treated only with medication, such as Ritalin and Adderall, and this number continues to grow. From 2003 to 2011 the number of diagnostics have increased 42%, and it keeps rising at a rate of 5% per year.

What is ADHD?

For American paediatric psychiatric ADHD is considered a biological disorder. The most common symptoms are academic or behavioural problems and symptoms of inattention, hyperactivity, or impulsivity. The information for the diagnostic of the disorder is obtained from reports made by parents or guardians, teachers, and other school and mental health clinicians involved in the child’s care.

Doctors haven’t come to an agreement on a specific cause for ADHD. The most accepted theory is that it is genetically transmitted; if one of the parents has ADHD the child has a 50% chance of having it too. But it is also said that pregnant women who drink alcohol or smoke during pregnancy increase the chance of their child having the disorder.

The treatment

The treatment is part of a big discussion in the medical and psychoanalyst fields. In one hand there are the physicians who say that the treatment is based on a continuous ingestion of the medicine based on methylphenidate. In the other there are psychoanalyst who says it should be made by looking at the issue that might be causing those reactions on the child. They say the problem is not in their brain but in the social context that they are inserted.

The medication

Ritalin-SR-20mg-full
Ritalin, the drug used in the treatment for ADHD. (Photo: Wikimedia Commons)

The US represents more than 80% of the world’s consumption of medications based on methylphenidate (where Ritalin is the most known of them). The formula of the medicine created to treat the symptoms of ADD/ADHD uses two derivatives of catecholamine out of a total of three components. Both of them are used specifically to create mental alertness and sustained concentration, two states of mind created by adrenaline, a natural hormone produced by the human body.

According to a research done by students of the University of Stockholm, in Sweden, based on the study of Lambert, Johansson, Frankenhaeuser & Klackenberg-Larsson (1969) a higher level of this hormone was found in children who “were more lively, decided, open, curious and playful than their peers”. They also found out that “individuals with some higher levels of adrenaline tended to be relatively less anxiety-prone and less aggressive than others”.

The research results lead to the conclusion that hormones of the catecholamine family, such as adrenaline, “may play an equally important part in the regulation of behaviour in children as in adults”. The positives effects of this type of hormone in kids is highly studied in modern days by physicians who work with children that are said to have any kind of attention disorder.

Here begins the wide divergence in the medical world, where it is discussed the real necessity of giving a medication to children that present an attention disorder, such as ADHD. Some doctors say that the medication only masks the problem; it is not a form of healing.

There are also researches about the side effects of this sort of medication. The United States Food and Drug administration said that Ritalin and other drugs of the same family may cause visual hallucinations, suicidal thoughts and psychotic and violent behaviour.

What do psychoanalysts think about ADHD?

To Enedina Martins, a psychoanalyst for children and adolescents, the ADHD is not a disease. For her, what may be called ADHD, appears when the child is missing “the name of the father”, an expression created by Jacques Lacan to design an individual that symbolizes in a person’s mind the “figure of the law”. It means that the child doesn’t have the significant – what will give the child the elements for his constitution – that will underline his behaviour.

She says that “nowadays we are living an era where we see the fall of the ideals in the world, and subsequently the fall of the ‘name of the father’ who came to build the person as it is”. For her this might explain why we have such an increasing number of cases of “what has been called” ADHD; “children are more hyperactive because they have much less parental authority”.

For her the treatment should be to talk to the child and try to understand where the problem is, and how this emptiness of the authority can be filled. This changes from case to case and it isn’t only the ingestion of medication that will fulfill this lack. It may even mask the real symptoms and make it more difficult to treat.

But she emphasizes that in case of psychosis – when correctly diagnosed – must be properly monitored and then the medication may be necessary. Still those cases are less encountered.

For her, in the end it all falls in the hand of the parents to choose what they think is best for their child. It doesn’t make sense to start a therapy if the child and the family is not involved with the treatment.

Sarah Bazin

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