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If we use the model of Yin and Yang, basically, any condition that is "hyper" is an Excess of Yang (and a Deficiency of Yin), while any "hypo" is an Excess of Yin (and a Deficiency of Yang). An imbalance of the forces of Yin and Yang account for a wide variety of health problems, and the goal from the perspective of Oriental Medicine is to return to a more balanced state.
Our society as a whole is becoming one of Excess Yang and Deficient Yin. Everything is fast paced, a Yang characteristic. We must get from point A to point B as rapidly as possible and we get frustrated if we get caught in traffic and are 5 minutes late. Computers are the ultimate example of our need for speed, as consumers demand faster and faster processors. Most people are abusing stimulants in the form of caffeine, nicotine, as well as "herbal speed" such as ephedrine (ma huang). This is all done with the idea that we need stimulants to keep up with an over-stimulating environment. Television (like all products that encourage addiction) is engineered to be overly stimulating so that we don’t turn it off, but instead stare at the flashing lights for hours and hours.
Like all addictions, people believe they need to continue taking their stimulants in order to relax. "I just feel awful until I have my first cup of coffee, or cigarette, or crystal methamphetamine." Many people say they watch television to relax, yet there is nothing relaxing at all about what is being displayed. This is the mechanism behind Ritalin (methylphenidate), which is speed for children, which allows them to keep up with the constant barrage of sensory input.
What is lacking in all our lives is a nourishing, Yin, environment. Just trying to find a quiet place to enjoy some quiet time is a challenge. If we try to work at a more relaxed (and therefore more healthy) pace, we are branded as "slackers" and start to feel our job security is at risk. If we drive a little slower (and therefore more safely) we are assaulted by angry honks and stares, or even shouts of intimidation. Although children don’t drive or go to work, they are still part of the same environment, and are especially vulnerable to the Excess Yang influences around them.
Nutritionally, children are also at greater risk of an Excess of Yang. The Number One offender is sugar, which is the equivalent of pouring gasoline on a fire. "Fast Food" is similarly high in fats and oils, which burn almost as fast and bright as sugar. Most children’s diets are severely lacking in vegetables and whole grains, which is not surprising since so is the diet of their parents.
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The Biomedical Approach
Definitions:
Attention Deficit Disorder (ADD, hyperactivity): Developmentally inappropriate inattention and impulsivity, with or without hyperactivity.
Inattention: A failure to finish tasks started, easy distractibility, seeming lack of attention, and difficulty concentrating on tasks requiring sustained attention.
Impulsivity: Acting before thinking, difficulty taking turns, problems organizing work, and constant shifting from one activity to another.
Hyperactivity: Difficulty staying seated and sitting still, and running or climbing excessively.
Incidence:
ADD is estimated to effect 5-10% of school-aged children.
ADD is seen 10 times more frequently in boys than girls.
Onset of ADD occurs typically before age 4 and invariably before age 7.
Etiology:
Etiology is unknown. Several theories advocating biochemical, sensory and motor, physiologic, and behavioral correlates and manifestations have been proposed. Less than 5% of children with ADD have evidence of neurologic damage, but CT scans and EEGs have not shown structural abnormalities. Toxins, neurologic immaturity, and environmental problems have also been hypothesized.
Diagnosis:
Diagnosis often is difficult. No particular organic signs or set of neurologic indicators are specific. The DSM-III-R lists 14 signs, 8 of which must be present for the diagnosis. Inappropriate inattention must be present for diagnosis. Many people believe that children with ADD and aggressive behavior constitute a specific subtype.
Treatment:
No single treatment has been completely effective with all children; however, psycho-stimulant medications combined with behavioral and cognitive therapies have the greatest controlling influence of symptom expression. Used alone, medication has been effective predominantly with less aggressive ADD children coming from stable home environments. Elimination diets, megavitamin treatments, psychotherapy, and biochemical interventions have had the least effect.
Methylphenidate (Ritalin) is the drug of choice. It has proved more effective than other psychostimulants. Common side effects are sleep disturbances (insomnia), depression or sadness, headache, stomachache, suppression of appetite, elevated blood pressure, and, with large continuous doses, a reduction of growth.
Prognosis:
Follow-up studies have found that children identified as having ADD do not grow out of their difficulties. Later problems in adolescence and adulthood occur predominantly as academic failure, low self-esteem, and difficulty learning appropriate social behavior. ADD individuals with hyperactivity seem to adjust better in work than in academic situations. Low intelligence, aggressiveness, social and interpersonal problems, and parental psychopathology are predictors of poor outcomes in adulthood.
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