Concept of mental health has been dealt in great detail in Ayurveda. Understanding childhood neurobehavioral diseases according to principles of Ayurveda helps in proper diagnosis and management. Attention deficit hyperactivity disorder (ADHD) is one of the most common Neurobehavioral childhood disorders and can continue through adolescence and adulthood. Child suffering from ADHD finds difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity.   Types of ADHD 1. Predominantly hyperactive-impulsive 2. Predominantly inattentive 3. Combined hyperactive-impulsive and inattentive   It is normal for all children to be lacking concentration, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often. To be diagnosed with the disorder, a child must have symptoms for 6 or more months and to a degree that is greater than other children of the same age.    Your child is ADHD ? • Easily distracted, miss details, forget things, and frequently switches from one activity to another. • Difficulty focusing on one thing. • Bored with a task only after a few minutes, unless they are doing something enjoyable. • Difficulty in focusing attention on organizing and completing a task or learning something new • Troubled with  completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities • Does not pays attention to what elder say. • Daydreaming, easily confused, and moves slowly • Have difficulty processing information as quickly and accurately as others • Struggle to follow instructions.

Causes of ADHD

• Fidget and squirm in their seats

• Talk nonstop

• Dash around, touching or playing with anything and everything in sight

• Have trouble sitting still during dinner, school, and story time

• Constantly in motion

• Have difficulty doing quiet tasks or activities.

• Very impatient

• Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences

• Have difficulty waiting for things they want or waiting their turns in games

• Often interrupt conversations or others' activities.

Unknown till date. However, scientist now believe that genes along with other factors play a role in the pathogenesis of ADHD. Apart from genetic cause, associations have been found with environmental factors, excess of sugar in diet, brain injuries and artificial preservatives-additives.

Treatments can relieve many symptoms, but there is no cure. With treatment, most people with ADHD can be successful in school and lead productive lives. Modern Researches contributed brain imaging technology for better understanding and have discovered more effective ways to treat and prevent ADHD.  The drugs prescribed for the management are CNS stimulants like methylphenidate and amphetamines. These agents cover a lot of adverse effects and need constant monitoring.

According to the Ayurvedic principle, Mana is the controller of attention and activities. Thus, the main cause of ADHD is thought vata vitiation along with derangement of sadhak pitta. Various medhya herbs are advised for its proper management.

Ayurvedic Management of ADHD: 

Shirodhara: This procedure helps to reduce inattentive, impulsive and hyperactive behaviour. Shirodhara involves gently pouring liquids over the forehead. The name comes from the Sanskrit words shira 'head' and dhara 'flow'. The liquids used in shirodhara depends on  prakriti of the child. oil, milk, buttermilk, coconut water, or even plain water can be used for conducting shirodhara.

Medhya herbs

Use of following medicinal plants under the supervision of physicians help in managing ADHD effectively:-

Mandookaparni (Centella asiatica):

Centella asiatica is a small, herbaceous, annual plant of the family Apiaceae, native to India, Sri Lanka, and other parts of Asia. used as a medicinal herb in management of psychiatric as well as behavioral diseases in Ayurvedic medicine. The stems of this medicinal plant are slender, creeping stolons, green to reddish-green in color, connecting plants to each other. It has long-stalked, green, reniform leaves with rounded apices which have smooth texture with palmately netted veins. The leaves are borne on pericladial petioles, around 2 cm. The root stalk  consists of rhizomes, growing vertically down. They are creamish in color and covered with root hairs. This medicinal plant is widely appreciated in Ayurveda for its notropic acitivity.

Brahmi (Bacopa monnieri):

Bacopa monnieri is a perennial, creeping herb found in marshlands and muddy shores of India. The leaves of this plant are succulent and relatively thick. Leaves are oblanceolate and are arranged oppositely on the stem. The flowers are small and white, with four or five petals. It has been used in traditional Ayurvedic treatment for epilepsy and asthma. Bacopa monnieri has many chemical constituents including alkaloids (brahmine and herpestine), saponins (d-mannitol and hersaponin, acid A, and monnierin), flavonoids (luteolin and apigenin). This herb is very effective in relieving symptoms of ADHD.

Other herbs

Aswagandha (withania somnifera), Sankhapuspi (convolvulus pluricaulis), Tagar (Valeraian wallichi), and Jatamansi (Nordostachys Jatamansi) are quite effective in managing ADHD.

Diet and Nutrition

Green vegetables and fruit along with traditional balanced diet are thought to be good for these children. Despite multiple studies in the last 20 years suggesting that diet and food additives can exacerbate hyperactivity, the current medical study is that there is no causal link between food and ADHD. Reducing child’s intake of sugar, refined foods, and foods with chemical additives (food dyes, preservatives, MSG, etc.) report significant improvement in their child’s behavior over four to eight weeks. Children are less disruptive and more focused when they eat plenty of cooked vegetables and whole grains along with moderate amounts of protein and organic unrefined oils.

Behavioral therapy

Apart from the above mentioned step always consult behavioral therapist for effective management of Children with ADHD. Simple behavioral intervention like rewards and time out are very helpful in improving the symptoms of ADHD.

ADHD is commonest neurobehavioral disorder of the childhood. This disease is characterized by lack of concentration, impulsive and hyperactive behaviour. Early diagnosis and intervention is necessary for its effective management. Principles and interventions described in Ayurveda such as use of medhya drugs, panchakarma, yoga and satvavjaya chikitsa is helpful in managing ADHD.

 

BAMS (UU), MD (Ay.) Kaumarbhritya, PhD (Cont)

Sr. Research Fellow, PG Department of Kaumarbhritya

National Institute of Ayurveda, Amer road,

Jaipur-302002