View Full Version : Integrative management of ADHD


Kunga Dorji
12-19-13, 08:01 PM
This post is in response to a comment by Dizfriz that I am producing too much of a deluge of information to allow us to see the overall big picture.

So - all the core material for my ideas has been laid out in preceding threads re upper cervical problems, stress and the autonomic nervous system.

The most important information pertaining to the upper cervical problem is Biedermann's description of the clinical syndrome he calls KIDD syndrome.
That is in the Upper Cervical thread.

The following summary makes specific reference to my own history as the historical data helps understand how I arrived at this significantly different position- otherwise-- no evidence-- just the core model:



1)I am looking at managing ADHD by the approach of removing obstacles to good attention. The structure of this approach is going very well and I am being encouraged to formally develop it into a book.

2) Chronic stress/overarousal is one very easy issue to identify and address. It certainly degrades attention, and if chronic, is usually regarded as "normal" or "just the way I am" by the affected individual.

We now have clear, published data that correlates a balanced state of parasympathetic/sympathetic arousal with a measurable improvement in respiratory sinus arrhythmia - this state is known as coherence.

Both basic mindfulness training and cheap biofeedback devices can train anyone to reach this state, and eventually maintain it.

3) So the issue becomes "what is the cause of this state"? I have found the rebound into stress states very puzzling- as though this was the state my body wanted to be in.

This is where the neck issue comes in:
i)
It causes issues with sensory integration- a mismatch between proprioceptive and sensory data from the left and the right sides of the body. That causes balance problems and issues with an overload of working memory.
Imbalance triggers a stress response- which worsens attention.
Working memory overload is obviously undesirable in
anyone with any attention problem.

ii) The subtle imbalance is worse at night when the lights are out- so degrades sleep and causes nightmares. The stress state gets the mind active and promotes rumination. Sleep debt worsens attention. Chronic sleep problems are well known in ADHD.

iii) The neck issue also triggers a kyphoscoliotic posture which has a series of undesirable effects including direct disruption of normal autonomic activity by multiple mechanisms both at brainstem level and segmentally in the thoracic and lumbosacral spine.
This posture is easily identified once you know how to look- I count people as they walk past me in the street. Many people have mastered the autonomic and attentional problems caused by it and have no overt psychiatric sequilae. However- they probably go on to need hip replacements, or have crush fractures in their spine, or suffer a range of medical complications too long to fullylist here.(However, compromise of CSF and venous drainage of the skull secondary to the neck postural issues may well be a contributor to Alzheimer's disease).
iv) If all these go on long enough- one acquires a chronic pain problem. Pain- stress- sleep disruption- more degradation of attention.

v) The whole course of neuromotor development is disrupted and this generates underactivation in the cerebellum - which feeds in to produce underactivation of the contralateral frontal lobe.
Again - more degradation of executive function.

So detail from my own issues which has made me aware of this way of analysing attention problems:



[I had a SPECT scan when being investigated- and the drop in right cerebellar and left frontal lobe activation when I did the second scan (sitting up doing a Stroop test) was dramatic.
Equally, I have been having neurological rehabilitation focussed on vestibular, cerebellar and basal ganglia function.

This week, I encountered this:
http://www.dyslexiaonline.com/blog/intriguing-dyslexia-adhd-research-explains-hidden-origins-successful-treatment-phobias-announced-dr-harold-levinson/

I started Serc (betahistine) 3 days ago. This increases blood flow to the vestibular apparatus- and is usually used in Meniere's disease.

That has produced a dramatic drop in the underlying stress state that I was having to be mindful of and manage, my sleep is much better, need for stimulants is really falling away and my neck jams up much less.

On the issue of the atlas subluxation,
because I have had such significant neurological injury to my balance and body awareness, I have had multiple minor subluxations since the big one was corrected, often several times a day.

The right occipito-atlantal joint slides forwards, and neck movements immediately become awkward and make lots of grating noises.
If I am quick I can massage it back into place or just shake my head and it will settle.
If not- I rapidly descend into a terrible state of spatial disorientation and find myself bombarded by noise and overloaded by visual stimuli.
This is what Biedermann describes in his description of KIDD syndrome and it is startling to think that I lived in that state for 48 years, and still did as well as I did.

There is an excellent picture in Biedermann's book of the rapid and dramatic improvement in a child's drawing ability following a neck adjustment.
That is the best possible illustration of the change that this treatment causes. If anyone wants a copy of that picture please pm me with your email address.
Now my full model of integrative management of ADHD also involves dealing with metabolic issues (especially poor diet) and especially psychosocial issues- such as poor self esteem and interpersonal problems--

but maybe you can see that there is a clear structure emerging and a very solid organising principal behind it.

In this regard the very analytical thinking patterns of Buddhist meditation, which teach us to dissect our difficulties with attention in a very surgical way, have been the key to my own progress and the structuring of my understanding.