Understanding Your Excessively Creative Kid
When I first started practice, parents who were exasperated by an overly creative kid were surprised to hear that their child could be helped by medication. Today parents arrive asking why Johnny isn’t on drugs yet. We may indeed be in the throes of an epidemic of inattentiveness, perhaps aggravated by our modern lifestyle that bombards us with sensory stimuli at an ever-increasing pace. Proof: standard TV commercials switch scenes more quickly every year, sometimes at the rate of several per second, and would have probably given a child of the fifties a headache if not frank seizures.
The phenomenon of inattentiveness is not a new one. An ancient Sanskrit text, Yoga Sutras of Patañjali, a collection of 161 aphorisms that lays out the essence of yoga, is essentially devoted to aiding the aspirant to minimize movement in the mind. Patañjali’s second sutra states, “Yoga is the restriction of mental fluctuations.” Scholars trace the word yoga to the Sanskrit root “yuj” meaning “to repose,” and not to the root “yuk” meaning to “yoke or unite” as most yoga teachers claim. Yoga is the therefore the discipline of bringing the mind to a state of repose.
One of the most practical methodologies for evaluating children whose parents complain of behavioral problems and who ask me if their child could have attention deficit disorder (ADD) is to refer to Vedic medicine. This approach gives a practical means to individualize the initial therapy, including interventions such as diet, play activities, sleep routines, and adjunctive medications.
Ayurvedic medicine describes the functioning of every living organism in terms of biological operators, called doshas, which govern physiological activity. Vata dosha governs movement, pitta dosha governs the metabolic fires, and kapha governs the bodily structures, creating walls through which vata and pitta flow. In their balanced state, these operators create health, but if aggravated, they lead to increasing imbalance and disease. Hyperactive patterns in both adults and children correspond closely with imbalances in the three doshas. So as not to ruffle too many feathers with this terminology, let us call these categories Types 1, 2 and 3.
Type 1 is a child with an Ayurvedic vata imbalance. Aggravated vata is characterized by excessive movement, irregularity or shifting in the physiological functions and nervous system. This child is the one who usually carries the epithet ADHD, since she is the only one who is truly hyperactive. These kids tend to shift attention quickly and are in constant motion. They are distracted from eating, burn a lot of calories running around, and thus tend to be underweight. This child doesn’t sit still long enough to be bullied, and may tend to frustrate other kids who attempt to initiate interactions. This child will fall asleep easily at or before bedtime, sometimes with her face in her plate of spaghetti, simply because she has exhausted her mental energy or depleted her neurotransmitters with her overly shifting mind. After the medical interview, the contents of my office have been completely reorganized. This child is exquisitely sensitive to stimulant medications, often responding to small amounts.
Type 2 children are characterized by aggravated pitta dosha, which is excessively sharp, intense, heating and inflamed. This ADD child is not hyperactive as much as frustrated, and is irritable, angry and violent. Type 2’s may tend to bully other kids. After the interview the contents of my office are more likely to be broken than displaced. This child is often made worse by stimulant medications.
The Type 3 child has kapha aggravations in the nervous system, which is characterized by inertia, stickiness, heaviness, torpor, obstruction and lethargy. Because the child’s nervous system is a couch potato, she may also typify the kapha body type: heavy, slow, dull, but sweet. Kapha type ADD children appear to be stuck on a task or preoccupation that is not the one at hand. In this sense they may seem hyperactive because they are distracted and distractible, but usually by the same preoccupations. Neurologists may call it perseverance. Parents often call it procrastination. They need inordinate amounts of sleep and are difficult to get out of bed in the morning. They will drive a parent crazy just lying in bed twirling a lock of hair in their fingers and responding that they are getting up, when realistically their brainwaves would appear still asleep. These kids are perceived as stubborn and unteachable, thus creating anger in the caregiver or teacher. After the interview the office is intact, but the interviewer needs a break.
Kapha kids tend to be prone to bullying by other children, usually a Type 2, because unlike the vata child who is a moving target, they have sweet temperaments and are literally “sitting ducks.” They respond to stimulant medications, often requiring surprisingly large doses, and may continue to respond to the medication well into adolescence and adulthood. In the kapha child, the stimulant does not have the paradoxical settling influence as in the vata and pitta child, but a more directly stimulating effect.
Subtle Variations in Treatments
Therapy for the vata child is easiest for the parents, because things that most kids love are pacifying for vata. Vata, being light, dry and moving is helped by nutrients we associate with comfort foods, the ones we crave in times of stress. The diet needs to be warm, rich, unctuous and heavy. Interestingly, these kids are helped by sweets. The myth that hyperactive kids could be helped by low sugar diets was debunked by a comprehensive study published a few years ago in the New England Journal of Medicine, but today’s “fossils” continue to repeat the mistakes of their own “boomer” parents, subjecting their charges to diets that are as hard on themselves as their kids. In fact, in that study, the kids allowed to take sweet foods liberally actually did a little better.
Vata in the nervous system is helped by garlic, a food not used by yogis because it makes the mind dull. That very property of garlic makes it useful in settling down a racing mind. An Ayurvedic remedy for vata children is milk boiled with a clove of garlic, to which you can add a little sugar if needed. If you start with tiny doses and work up, most kids like the taste. The house smells like an Italian kitchen, but your vata-aggravated kid will be more focused.
Vata kids thrive in settled environments, most critically environments with a minimum of potential sensory stimuli including extraneous noises (like televisions left on) and with not more than one activity available at a time. Vata kids need more order in their lives: every activity at the same time of day, orderly rooms, and items stored in the same place. The watchwords for the parents of a vata child are “structured environment and routine.”
Our Type 2, or pitta child, needs a learning and living environment that creates fulfillment and minimizes frustration. She should be complimented for behaviors that are correct, and helped in a non-judgmental way for behaviors or attempts to learn that do not succeed. The key for this child is the non-judgmental approach, as the pitta child does not tolerate criticism and responds poorly to any attempts to correct her that do not involve tenderness and softness in the voice. Her diet should favor foods that have a cooling influence such as fresh, sweet, juicy fruits or fresh fruit juices and should minimize foods that are hot, sour, salty and stimulating, including vinegar and chili peppers.
The Type 3 or kapha child needs a diet that counteracts lethargy, and thus thrives on spices, as long as they don’t flavor heavy foods like pizza and pasta. The diet needs to be light, favoring vegetables, beans, fruits and soups. Dried fruits make a good snack for this kapha child. This child is best kept in movement, as long as it involves one activity at a time. The parent needs to develop vigilance that the child is not settling into distracting activities for too long a time, such as TV and video games. If you perceive that your kapha child is stubbornly resisting more enlightening activities, the two of you need to have a good discussion.
All three types of children respond to the face of an undistracted adult right in front of theirs, while they are being held tenderly, and making the child the center of their universe during the ensuing interaction. None of these kids will respond well to any request that is delivered out of this context, especially one that is yelled across the room. Additionally, none of these kids respond well to a television, which overstimulates a vata child’s busy brain, exposes the pitta child to anger and violence, and mires the kapha child deeper in torpor.
This Ayurvedic understanding is useful because it gives an alternative language with which both parents and children can understand unwanted behavior. It also provides a vocabulary with which children can relate to each other in a more positive way. For example, lazy, lethargic, or unhelpful behavior is understood as a kapha imbalance instead of selfishness, preventing resentment and allowing children to maintain friendships and positive sibling relationships.
Jay Glaser, MD is a board certified internist in Massachusetts.