Dr. B.P.Kalra

Symptoms and Treatment for Attention Deficit Hyperactivity Disorder (ADHD)

I’m Dr. Prashant Shah, a psychiatrist from Ghatkopar, Mumbai. Today I am going to speak about Attention Deficit Hyperactivity Disorder also known as ADHD. ADHD as the name suggests the full form is Attention Deficit Hyperactivity Disorder. This is a common disorder seen in children and adolescence and at times may extend also into adult life. The common features of this problem are diminished attention, hyperactivity, and impulsivity. As I said earlier, it is most commonly seen in children and adolescents, the usual complaints will be from the parents and teachers. The parents and teachers will complain that these children have difficulty sustaining attention, they are hyperactive and they are impulsive in their day to day activities.

Sustaining attention means that these children cannot sustain or carry out any particular task to the end. They get bored very easily, they will lose interest, they may want to start many activities; they will say that they want to join this activity, they want to do this thing but then halfway down the line they will get bored, and they will stop doing that activity. They would have difficulty in focusing which will result in making careless mistakes in their works, in their calculations, in their day to day works, in their homework. They will be making careless mistakes because they cannot just focus on what they are doing. They get distracted very easily. The teachers will complain that in the school when the teacher is teaching they are looking out of the window or they are speaking with other children. They will drop down their pencil, eraser, and maybe make mischief with other children. Many times there are younger children; they are always on the go. They cannot sit in one place. They are not in their seat; they are roaming around in the class; they talk excessively; they will blurt out answers; they are forgetful; they will not mention about homework or assignment which has been given to them or the project work which has been given. They will inform their parents just at the last minute and then everything will have to be rushed. They will forget or they will misplace their books. Their clothes will be in disarray at home if you visit their room. Everything will be like it is not in its place. They cannot wait for their turn. Now all these are problems which the children-parents pick up.

What is the effect of this on the children? Because of this kind of behavior they are labeled as mischievous. They are the ones who get pointed out whenever something goes wrong in the class. They will be the first ones to be signaled out and given punishment. And at times maybe it is not their fault also but because they show this kind of behavior they are labeled as mischievous and it is they who get the punishment. Everyone ridicules them for this kind of behavior. Even the parents punish them. This will lead to many times frustration, decreased confidence which in turn affects their school performance. Many times this results in deviantju8 behavior. In adolescence if we go on to see this may result in risk-taking behavior, seeking novelties and at times in drug-addiction also.

Now, what can be done about this?
As I said earlier it is a neuro-developmental disorder, we do not know as psychiatry illnesses, we don’t know what the causes are of this illness or why does this illness occur. It may range from genetic to neurological to psychopharmic or neuro-developmental problems in the brain. But what is good is that treatment options are available. So what treatment options are there for ADHD? They are both pharmacological and non-pharmacological treatments available. Usually for children less than five years initially we advise non-pharmacological treatment. This non-pharmacological treatment is occupation therapy and sensory integration where depending upon the severity of the problem, children are called for occupation therapy sessions, parents maybe also given some home programme which they can carry out at home and this results in improvement. The improvement is slow but carried out religiously, diligently by the parents for a period of 1 year to two years this definitely is going to show improvement.

In other children or if the problems are severe enough, we do start medicines. In children parents are hesitant to start medicines and that too from a psychiatrist. But believe me there are good medicines available for ADHD, they do show response, there are no major side effects. The groups of medicines that are available are stimulants or non-stimulants. Stimulants are the first choice of drugs, usually we start with a low dose, so that the child can tolerate the dose, there is no side effect and then we gradually build up the dose so that the improvement is seen. Even if there is some side effect there is minor side effect which can be always taken care of. It is not that there is only one drug available, the child is not responding, we can definitely shift to some other. But the thing to understand is that treatment is required. This ADHD can be controlled and if the signs and symptoms of ADHD are controlled then the child’s performance is definitely going to improve. It will not only reflect in the child’s studies but also overall development of the child. So it is for the parents and teachers working in this field to find out these kinds of children who maybe having this problem and refer them for treatment.

Thank you. For any further enquiries you can always get me to me through Lybrate

Sexual abuse of children may sound very scary and degrading, but the truth is it is a very prevalent problem. As much we may not want to believe, the number of boys and girls who are sexually abused, and that too by close family and friends is very high. This may be difficult to digest, but is the truth. The sexual abuse in male and female children is 50% in each group which is again unbelievable but true.

What is considered child sexual abuse?

Child sexual abuse includes touching and non-touching activity. Some examples of touching activity include:

1. touching a child's genitals or private parts for sexual pleasure.
2. making a child touch someone else's genitals, play sexual games or have sex putting objects or body parts (like fingers, tongue or penis) inside the vagina, in the mouth or in the anus of a child for sexual pleasure.

The thing to ponder, however, is that people who abuse children have a deeper problem. This could be due to a combination of social and psychological issues that the person is facing. Often helping identify the underlying problem could be a solution to the problem too, but this is rarely done. If you think a child could be subjected to abuse, look out for the following symptoms.

1. A feeling of guilt or shame.
2. Irritability and anger with minimal reasons.
3. Mood swings, often uncommon in children.
4. Feeling very isolated and sad.
5. Very anxious and angry.
6. Symptoms of withdrawal, not wanting to be left alone.
7. Sleeplessness.
8. Fatigue and pain in the back, legs.
9. Loss of appetite, energy.
10. Bruises (look out for these, which may not be in visible areas).

How to handle?

Given the fact that the offender is in close family and/or friends circle, the suspicion levels are quite low.

1. The first step, therefore, is to open up and talk with either your parents or someone close.
2. Look for support groups which can be very helpful.
3. Do not be isolated though the urge is very strong.
4. Build a daily schedule to ensure your routine continues (studies, work, etc.).
5. Focus on exercise or other passions as they help you deviate your mind.
6. Be sure to not be alone with the offender, stay in a group.
7. Give out a strong message saying it is not acceptable, and do not keep quiet.

Homoeopathic remedies:

Homoeopathy can come rescue of the offender all well as the victim. If we see according to the point of view of who committed the crime, many reasons may come to the light and we can be treated accordingly. Usually, these criminals have a very painful and sad childhood. This could lead them to commit a crime like child abuse. 

The following are the medicines to treat such people with anti-social behaviour-

1. Aur.
2. Bar-C.
3. Hyoscyamus.
4. Stramonium.
5. Merc.
6. Tarentula.
7. Med.
8. Nux V.
9. Syphilinear.

There are certain homoeopathic medicines which are helpful in the treatment of children who are victimized. The most common symptom is nightmares.

1. Calc.carb. 
2. Aloes. 
3. Phosphorous. 
4. Cechris. 
5. Sepia. 
6. Staphysagria. 

For treatment for actual physical and mental symptoms of the victim child, following homoeopathic medicines may help:

1. Aconite. 
2. Ignatia. 
3. Arnica. 
4. Staphysagria. 
5. Calendula. 
6. Nat. mur. 

Homeopathy is a safe and effective way to treat the victims as well as the culprits of sexual abuse. It focuses on the way patients have reacted to events and the personality of the patient. It helps to bring complete harmony of physical, mental and social well being. 

If you wish to discuss about any specific problem, you can consult a homeopath.