ADHD or Attention Deficit Hyperactivity Disorder has seen a rise in prevalence since 1995. In the US alone, 5.1 million children are currently diagnosed with ADHD. In Australia, attentional and behavioural problems are also on the rise. ADHD trends show that boys seem to be diagnosed more often than girls.
What is ADHD?
ADHD is a neurodevelopmental condition which starts at childhood and can continue through to adulthood. Its major symptoms include difficulty focusing, trouble controlling impulsive behaviours and being overly active, bordering on self-destructive tendencies without thinking about the consequences.
Although most children at a very young are known to have trouble focusing and behaving, those with ADHD may have the symptoms persist until adulthood. If this is the case, school, home and relationships can be greatly effected.
Children with ADHD tend to daydream, forget things, fidget, talk too much, take unnecessary risks, can't resist temptation, can't take turns and have difficulty in socialising and getting along with other kids (or adults).
ADHD is usually categorised according to the severity of symptoms experienced. These categories are called presentations. The three presentations include the Predominantly Inattentive Presentation, the Predominantly Hyperactive-Impulsive Presentation and Combined Presentation. The first presentation is when a child has difficulty in organising tasks, paying attention to details and gets distracted easily. The second presentation may include symptoms of too much talking, an inability to sit still, restlessness and impulsive tendencies. The third presentation is a combination of the first two.
DSM - 5 defines two more presentations in case the above three do not apply to a particular case. These two other presentations are known as Other Specified ADHD and Unspecified ADHD.
Attention Deficit Hyperactivity Disorder is said to be caused by the following risk factors:
- brain injury
- premature delivery
- low birth weight
- exposure to environmental contaminants such as lead
- substance abuse of mother during pregnancy
Diagnosis of the condition is tricky at times and may include several processes. In fact, ADHD may exhibit the same symptoms as conditions like depression and anxiety, making it more difficult to diagnose.
Diagnosing steps may include medical exams and tests, observation by a professional, checklist from parents, ADHD symptom ratings and history from parents and schools. The World Health Organisation developed a symptom checklist for adults, which can be found here: Adult ADHD Self-Report Scale - V1.1 (ASRS-V1.1)Symptoms Checklist from WHO Composite International Diagnostic Interview.
Children with ADHD respond well to both pharmacological and non-pharmacological interventions, although there is no exact cure for the condition. As for medications, there are four known types of meds that are licensed for the treatment of ADHD. These include methylphenidate, dexamfetamine, lisdexamfetamine and atomoxetine.
The above mentioned pharmacological treatments may not altogether wipe out ADHD symptoms but they can help the child to have better concentration, reduce impulsiveness and induce calm to be able to learn effectively in school. Depending on a doctor's advice, these medications are either taken daily or as scheduled. Although they may diminish the symptoms of ADHD, they may not come without side effects such as headaches, stomach aches, insomnia, loss of appetite, diarrhea, mood swings, nausea, aggression, vomiting, drowsiness, irritability and a slight increase in blood pressure and heart rate.
Among the non-pharmacological options, therapy is most recommended to help medications. Experts suggest psycho education behaviour therapy, cognitive behaviour therapy and social skills training among the list of possible treatments. Parents of children with ADHD can also be included in parent training and education programs.
Other than these two known treatments, other alternative treatments (not all are doctor approved) have been found to benefit some who tried them. Possible alternatives include:
- Yoga, meditaiton and hypnosis
- Use of mirrors to complete tasks
- Diet cautions (avoiding preservatives and potential allergens)
- EEG Biofeedback
- Taking supplements (St. JohnsWorts and Omega-3 among others)
ADHD and Omega-3
A new Dutch study headed by Dienke J. Bos from the University Medical Center Utrecht in the Netherlands found that omega-3 supplementation is associated with improved ADHD symptoms. The study was published in the Neuropsychopharmacology journal in March of this year.
The study focused on 80 boys aged 8 to 14 with altered diets. Half of the participants were diagnosed ADHD sufferers. Further, half the participants were supplemented with omega-3 fatty acids and the other half was given a placebo supplement. After the study, parents were asked to rate the behaviours of their children. The EPA/DHA was included in 10 grams of daily margarine.
Those who received the EPA/DHA supplement were found to have improved behavioural problems overall. While most of the boys were known to be taking pharmacological treatments already, the study recommends omega-3 fatty acid as an added supplementation to help treatment.
In an AustralianTstudy, children with a higher level of DHA in their red blood cells had improved reading and spelling capacity and their ADHD symptoms lowered. The researchers form the University of South Australia, the Queensland University of Technology, and the Australian Technology Network Centre for Metabolic Fitness released results suggesting that an increased level of omega-3 intake could improve attention, literacy and behaviour problems among children with ADHD.
The study involved 90 participants aged 9 to 12 in a randomised controlled trial wherein children were randomly assigned to received four 500mg capsules per day of EPA and DHA rich fish oil (1,109 mg of EPA and 108 mg of DHA and 264 mg of EPA and 1,032 mg of DHA).
Those who had increased DHA in their red blood cells experienced improved reading and lowered behavioural issues. Lowered hyperactivity and lowered overall ADHD symptoms were reported. However, EPA enriched capsules yielded results of improved anxiety and shyness which suggests different benefits from these two PUFAs.
(Calamari and DHA will be discussed later.)
In another study linking ADHD and omega-3, it was found that there is a link between omega-3 supplements and better brain function.
Researchers from the Sahlgrenska Academy of the University of Gothenburg gathered data from 75 participants, children and teens, with ADHD. The participants were either given omega-3/6 supplements or placebo for three months. At the end of the study, symptoms had improved by 35% for those given the supplement. The study suggests that fatty acids supplements can be a good alternative to other treatments and a balance between omega-3 and omega-6 is highly important.
The addition of omega-3 in the diet of children with ADHD may help in reduction of ADHD symptoms, a report from Montreal states. A team from the ADHD clinic at CHU Sainte-Justine University Hospital in Montreal studied 37 children, aged 6 to 11, who were diagnosed with ADHD and had never been on any medication. Half were given fish oil capsules and the other half were given placebos.
After the study, 20% of the omega-3 participants were less agitated and showed a decrease in hyperactivity and impulsivity. The reduction of such symptoms improved the children's ability to function in school and social situations. Although not all children in the study experienced the benefits, the subgroup that did show positive results has shed light on omega-3 and its ability to help with ADHD symptoms.
Omega-3 from Calamari
Calamari is a sustainable source of omega-3. It is sourced from the unused (but clean) part of the squid. Compared to fish, calamari have only a short lifespan which makes it resilient to fishing pressure.
Among the studies presented, especially from the Australian study, it has been inferred that DHA plays a vital role in brain and mental health and has an ability to improve symptoms of ADHD. Compared to fish oil, calamari is said to have higher omega-3 DHA.
DHA is known to have many positive benefits for brain growth and development, prevention of CVD and prevention of age-related macular degeneration.
Based on our above list of trusted studies, it is safe to say that omega-3 sourced from marine life may be the best alternative to help children with ADHD. It may even provide other benefits aside from its ability to improve brain function and behavioural problems exhibited by children with ADHD.
A combination of personalised and medical treatments seems to work best for the treatment of ADHD symptoms. Nevertheless, it is still best to leave the decisions to doctors and medical professionals.