Ms FEBRUARY 15, 2015
ISSUE NO. 139
A parents’ guide to ADHD
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Dealing with the grey area
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inside En vogue — Pretty in pastel
Domestic goddess —
Enjoy winters with the sweetness of gur papri
Section In-Charge: Sarah Munir Sub-Editors: Amna Hashmi Nisma Chauhan Feedback: women@tribune.com.pk
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The evergreen Atiya Khan
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The buzz
THE EXPRESS TRIBUNE, FEBRUARY 15, 2015
DISCIPLINE without
REGRET
ADHD
By Zohaib Amjad
| Design by Eesha Adam
Did You Know? October has been appointed the global ADHD awareness month.
Physicians, psychologists, social workers, teachers and parents all play a role in diagnosis. In general, adequate assessment includes:
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Family and medical history.
Interviews with those close to the child and the child herself.
Observation of the child at school or at play.
Psychological tests in order to evaluate IQ and social/emotional adjustment.
Physical and neurological examinations to rule out all other possibilities.
Uzma Khalid found her son Usman’s behaviour overwhelmingly disturbing ever since he was a toddler. Easily angered by the most trivial of situations, Usman would oppose, deride, curse and physically abuse anyone who came in his way, regardless of where he was or who he was with. His performance at school was mediocre at best, with report cards replete with red marks and frequent warning letters issued by the school staff. “He put immense pressure on the whole household,” shares Uzma who had had enough by Usman’s 9th birthday and finally sought professional help on the suggestion of a friend. After rigorous assessment, the perpetually frustrated and displeased child was diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Today, Usman’s fate is shared by almost 7% of children between the ages of six years and 12 years. ADHD has become the most common neurodevelopmental problem around the world. In fact, according to a survey conducted by pharmacy-giant Shire Pharmaceuticals in July 2014, these numbers might be underestimated. The study also revealed that most parents and teachers are unaware of ADHD altogether and often dismiss its symptoms as everyday personality traits. Dr Angel Adams, a London-based clinical psychologist and ADHD specialist, highlights the vague line between mental issues and the general attributes of a child, claiming that many patients go unattended due to this grey area and their parent’s inability to recognise the symptoms. In general, unusually short attention spans, hyperactivity, impulsiveness and unruly and loud behaviour are indicative of ADHD in a child. Patients may resist learning, be unable to comprehend instructions and find it difficult to focus on a task, sit still or even hold back in-
appropriate comments. Based on a coalition of these symptoms, three forms of ADHD exist: the inattentive type, the hyper-activity impulsive type and lastly, a hybrid type that includes symptoms of the first two. What’s more is that these types may be exacerbated further in the form of other by-product problems like Oppositional Defiant Disorder, Tourette syndrome and other learning and anxiety disorders. “These symptoms can have detrimental consequences on a child’s social life, relationships and academic success,” explains Dr Adams. “As the child is told off often (due to their behaviour), the symptoms might trigger a vicious psychological cycle of trauma and insecurity.” Modern research has focused on unearthing the underlying pathophysiology of ADHD to understand exactly what it might be that prompts these children to act out this way. Dr Russel Barkley, a psychologist and professor of psychiatry at The Medical University of South Carolina, reports that, “These children are unable to control their behaviour.” He further explains that neuroimaging techniques have elucidated a general reduction of brain structure in children with ADHD, including the cerebellum, frontal cortex and white-grey matter. Various circuitries in the brain have shown to be impaired. For instance, children with hyper-active impulsivity ADHD have reduced dopamine (a nuero-transmitter hormone) levels. Similarly, inattentive ADHD is characterised by less norepinephrine production (another nuero-transmitter hormone). Studies of the link between reduced brain volume and functioning revealed a positive correlation between the reduction and severity of the patient’s symptoms. Nonetheless, it is equally important to understand the etiology of ADHD before it can be treated. Experts cite some external and internalised factors which could explain the occur-
THE EXPRESS TRIBUNE, FEBRUARY 15, 2015
rence of the disorder, such as genetics, nutrition and a child’s surrounding environment. Certain types of gene variations have been shown to be present in patients and a child with a relative suffering from ADHD is four times more likely to develop it himself. Inappropriate nutrition (increased sugar intake or lack of omega-3 fatty acids) have also been proved to trigger symptoms, along with smoking and drinking during pregnancy. But, the occurrence of some symptoms doesn’t necessarily mean that a child has ADHD as many of them mesh with those of other disorders. If a child is, however, diagnosed with ADHD after assessment, a number of effective treatment plans comprising of psychotherapy and medicines are available. The two main types of therapy options are: • Cognitive Behavioural Therapy (CBT): Based on the philosophy of thoughts, feelings, actions and physical sensations, this form of therapy is also known as ‘talking therapy’ and aims to understand where ADHD conditions arise. In general, CBT involves regular 30 to 60 minute sessions with a therapist who explores a child’s negative thoughts and behaviour and tries to rectify them. • Behavioural Therapy: Children with ADHD must be acknowledged for their good points regularly to boost self-esteem and positivity. The praise can be given via different creative means, such as star charts, small gifts or compliments. When all else fails, doctors resort to medication to calm — if not cure — ADHD. Stimulant medicines like Ritalin and Adderal are prescribed to boost dopamine production while nonstimulant drugs like Strattera work on norepinephrine. Although these may not cure ADHD completely, they allow the patient to learn new skills and develop new, improved habits and help them concentrate better and control their impulses. Unfortunately, much like any other medicinal treatment, these drugs pose certain sideeffects which could hinder progress. Strattera, for instance, has been associated with severe consequences like liver injury, heart defects and even suicidal thoughts. Other common problems include headaches, insomnia, mood instability, nausea, vomiting and loss of appetite. Doctors might, therefore, try breaks in between treatment to ascertain whether further medication is needed or not. Nonetheless, for treatments to work, support from parents is absolutely crucial. As worldrenowned ADHD expert Dr Ned Hallowell said, “Parenting a child with ADHD isn’t a sprint but a marathon!” Strength, support and a whole lot of patience is necessary when dealing with patients, so much so that many hospitals around the world offer therapy for parents along with children. Books such as Parenting Children with ADHD: 10 Lessons Medicine Cannot Teach by Dr Vincent J Monastra and Super Parenting for ADD: An Innovative Approach to Raising Your Distracted Child have been published as guides for desperate parents. Having an afflicted child is never easy. Parents must not only be patient with the child but remember to love and support one another as well to present a united front. More importantly, they must realise that the emotional turmoil and stinging regret that might creep up during a tantrum is absolutely normal. Some easy strategies for even the worst of fits which can make one feel less like a monster and more like parents include: Discuss in detail: Explaining why something is wrong might encourage a child to refrain from doing it again. Apologies should be encouraged so that the child take more responsibility for their actions. If a child makes a mistake, parents should reenact the situation, doing it correctly.
3 Say it differently: Parents must keep in mind that different children respond differently and changing the way you speak to them might help. For instance, when giving them a task, phrasing it in two completely different tones will definitely get the message across. Ground them reasonably: This is particularly important for parents dealing with troublesome teenagers. If the teen abuses a certain privilege (eg cellphones), it is best to remove the privilege briefly and make them earn it back via household chores or improved grades. Look for a better way: Disciplinary moments can be made into learning opportunities by reminding children that everyone makes mistakes and there are better ways to deal with similar tensions in the future. Parents should brainstorm these ways with their child, making them think and develop their own ideas. In fact, every time things get tense and one feels the urge to yell, they should instead hold a private conversation with the child in a quiet room where no one will disturb them. This will cut off a possible unpleasant exchange which might be regretted later. Take a moment: Simply counting to 10 before lashing out can save parents from a great deal of verbal negativity which will only worsen the situation. The best discipline combines a stringent code of conduct with basic respect for a child. Experts encourage parents to listen to their children’s concerns and empathise with them rather than behave like a strict drill sergeant. It is also important for parents to remind their troubled little ones that no matter what happens, they will always be loved. Leadership and love are the two main pillars of effective parenting.
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En vogue
Sanober Azfer’s latest collection is a combination of unique cuts and pastel shades. Coordination: Umer Mushtaq Styling: Aatika Majid Hair and Make-up: Angie Marshal Designer: Sanober Azfer Photography: Khawer Jadoon Model: Abeer Rizvi
THE EXPRESS TRIBUNE, FEBRUARY 15, 2015
THE EXPRESS TRIBUNE, FEBRUARY 15, 2015
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Lifestyle
THE EXPRESS TRIBUNE, FEBRUARY 15, 2015
MsT delves into grey matter to determine why so many youngsters are already sporting the salt and pepper look
By Haris Sayal
| Design by Maryam Rashid
Scientifically speaking, the concept of ‘grey hair’ is somewhat a misnomer. There really is no such thing when you take melanin — the natural, colour pigment of the body — into consideration. For most of us in Pakistan, this pigment is black or brown in colour and it doesn’t ‘fade out’ into lighter shades. Instead, the progressive demise of melanin increases melanocyte (cells which infuse the hair follicle with colour) production, causing the normal-pigmented hair to become interspersed with white. With a loss of melanin, new hair produced is without any pigment. So while some of us may appreciate the salt-and-pepper look sported by celebrities like George Clooney, let’s not forget that grey hair is an indicator that one part of your anatomy is calling it quits. And if you are under the age of 35, this is not a good thing. Most people tend to blame early greys on their genetic makeup while others consider the environment to be a direct cause. According to Philip Kingsley, a world-renowned trichologist and author of The Hair Bible, “If either one of your parents went grey early, then you probably will too.” But scientists and health experts around the world have determined another key factor which brings on the silver strands well before time — stress. Jennifer Lin, a researcher at the Harvard Cancer Centre in Boston has noted that the expression of stress hormones hinders the delivery of melanin to new hair. According to Jennifer, “If the signal is disrupted,
melanin will simply not deliver pigment to your hair.” Even Philip has cited excessive stress as a cause of prematurely aging hair, and says, “Emotional stress, illness and poor diets deplete the body of Vitamin B, causing whiteness of hair.” A research entitled ‘Oxidative Stress in the Aging of Hair’, published in the International Journal of Trichology in 2009, takes a substantial leap forward by evaluating the ‘free radical theory of greying.’ The theory argues that oxidative stress from external environmental stressors like smoking and excessive sunlight can accelerate aging and prompt premature greying. But that is just the half of it! While stress and genetics are indeed precursors for early greys, other important stimulators include hormonal imbalances and common medical conditions like sinus. Twentyfour-year-old university student Mishaal Wahab, for example, has had a full head of white hair since puberty. “I have had white hair since I was 12,” shares Mishaal. “I remember visiting two different doctors to find out why. One associated it with my sinus while the other attributed my hair to my menstruation cycle which was disbalanced.” All in all, there are four fundamental factors with a direct effect on your overall health: diet, sleep, stress and level of activity. Fortunately or unfortunately, all four are linked and necessary for one another. The relationship between stress and premature greying shouldn’t be ignored, considering that stress is easiest to fix.
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One of the best home remedies for premature greying comprises of curry leaves. Include them in your daily diet or put some curry leaves in coconut oil and boil it. Strain the oil and let it cool down. Apply it over the scalp. Massage the scalp with butter made out of cow’s milk. This should be applied at least two times a week.
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One teaspoon of gooseberry juice mixed with a teaspoon of almond oil and some lime juice, applied and kept overnight, not only boosts colour but the texture and radiance of hair as well.
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It is advisable to avoid unhealthy food items such as those which contain refined flour and sugar (soft drinks, pastries, jams, etc) and spicy, oily and hot food will benefit not just your hair but the overall functioning of your body as well. Fresh fruits and vegetables are much more effective in treating premature greying. Make it a habit to consume some yogurt every day. Mix a litre of yogurt with a tablespoon of yeast and take a bowl of the mixture at least once a day, before your main meal.
Domestic goddess 7
THE EXPRESS TRIBUNE, FEBRUARY 15, 2015
By Gulnaz Mondegarian
Gur Papri
This jaggery-based desert has all the goodness of gur and almonds
The goodness of jaggery (gur) Satisfy your sweet tooth by switching to a healthier option: jaggery. Essentially unrefined sugar, jaggery is derived from raw sugarcane, date palm or coconut juice by boiling it and making it into blocks. This natural sweetener may not be ideal for diabetics but it has a great deal of other health benefits. Eases constipation: Did you know that jaggery is stimulant for the digestive system and so, relieves constipation? It activates the digestive enzymes in our body, which is why many people take a small dose of jaggery after their meal.
Ingredients • Jaggery (crushed) 1/2 kilo • Oil 1 tbsp • Water 1 tbsp • Peanuts or almonds (slightly roasted) 500 grams • Fennel seeds (slightly roasted) 3 tbsp
A mineral mine: Jaggery is rich in micronutrients and minerals crucial for certain physiological functions in the human body. Therefore, it is often referred to as ‘medicinal sugar.’ It is also an excellent source of iron which is the reason behind its dark brown colour. Cleanses the liver: Just one small portion of jaggery can detoxify your liver. Boosts immunity and cures minor health problems: Water retention, bloating, coughs, migraines and other everyday ailments can be curtailed with the help of jaggery. Add it to your tea or simply drink it with some warm water and you should be good to go. Jaggery also fights infections and strengthens the immune system, thanks to its high-concentration of antioxidants like zinc and selenium. Calms post-menstrual syndrome: Jaggery regulates hormones and therefore, calms the mood swings and anxiety levels that tend to sky-rocket during that time of the month. In fact, it releases a hormone called endorphins which trigger happiness.
• Saunth (dried ginger) 1 tsp
Indulge in elaichi chai (cardamom tea)
Method
Nothing compliments gur papri like a cup of warm, aromatic elaichi chai.
Method
• In a large pan, mix the oil, water and jaggery together and cook it over slow heat until the mixture becomes dark brown in colour. Keep stirring continuously to mix the ingredients. • Ascertain whether the mix is ready by placing a drop on a cold plate. If the drop hardens upon touching the ceramic, it is ready. • Once the mixture is cooked, quickly add the remaining ingredients and stir. • Glaze a baking tray with butter and pour the mixture in it. Allow it to cook for a while and once it has, cool it and break it into small pieces to serve.
Ingredients: • • • • •
Water 1 and 1/2 cup Milk 2/3 cup Green cardamom seeds 2-3 pods Sugar 2 tsp Loose tea leaves (non-scented) 2 tsp
• Boil water in a medium-sized steel pot and add the cardamom and tea leaves to it. Allow the ingredients to simmer in it for about a minute or two. • Add the milk and sugar to the pot and boil the mixture until your desired colour is obtained. You will know the tea is ready when it emanates a sweet aroma. • Be careful not to boil the tea more than need lest its flavour changes. Once cooked, cover the tea and let it sit for a minute before straining it into cups. • For best results, serve the tea while it is piping hot. Note: This recipe is for two cups of tea. The amount of milk and water can be varied depending on personal preferences.
Woman of the week 8
Atiya Khan.
With my son.
With cast and cr ew
of Yalgaar.
Motherhood Made Easy
www.Babyandbabybump. momtastic.com
Childbearing and raring is perhaps one of the most difficult experiences in a woman’s life. Anyone who has raised a child will concur that one never really knows the strength, patience and sacrifice motherhood requires. In the yesteryears, things were made relatively easier by our own mothers, sisters, aunts and other close relatives who were almost always around to lend their support when you got too exhausted. In the modern world, however, everyone is too busy leading their own lives that we often find ourselves in a tight spot. Your younger sister might be super excited about becoming an aunt but who’s going to help feed the baby while she’s at school? In such circumstances, being pregnant or raising a child can become even more daunting than before. Many women
— especially those living abroad without any domestic help — begin exhibiting signs of depression and anxiety whilst trying to keep the house clear. Add to that the additional burdens of a cranky toddler who refuses to get potty-trained and you have a recipe for disaster. Unfortunately, the emotional and physical stress of motherhood can affect a woman adversely, making her weak both physically and emotionally. Thankfully, the internet has answered our prayers in the form of online forums and mobile apps we can refer to for help. These are open to just about anyone with a stable internet connection and offer tips on everything pre and post natal. From baby care tips to forums and discussion boards you can share concerns on these virtual motherhood manuals. Check out our list of top forums, websites and apps for a happy and stress free motherhood.
What better way to understand and enjoy motherhood than to share it with others in the same boat as you? Register yourself on this popular parenting forum for a ‘mom-tastic’ experience. The forum offers hundreds of discussions and message boards where not only can you share your own dilemmas but also learn from those of other members. From maternity apparel to potty-training, this forum is a complete motherhood manual.
My Pregnancy Today App: Want to know what your baby is up to in the womb? This app will help you understand the behaviour of your unborn child throughout pregnancy and answer all your pregnancy related queries. Liaise with other new or experienced moms via the Birth Club videos or rummage through the nutrition guides and pregnancy health tips posted online, all from your very own smartphone device! Pregnancy Assistant: Just as the name suggests, the Pregnancy Assistant is a virtual companion for expecting mothers to unload their stress. You can even track your fetal development via pictures on this easy-to-use app.
www.Momforums.com
Baby Bump Pregnancy Pro:
This website offers a variety of discussion boards, divided into sundry categories for easy use. Each category is further broken down into smaller problems, such as toddler poop and first pregnancy. You can read about the experiences of your fellow members and post your own questions for help. This forum is proof that if you are feeling anxious about becoming a mother, you are not alone.
Listed amongst the top 10 Best Wellness Apps by Time Magazine and Top Apps for Moms by The Huffington Post, this Pregnancy Pro addresses all your concerns regarding parenthood. From discussion forums to photo albums, weight tracking to recording your baby’s kicks, this app literally covers everything! You can also shop for baby goods at the Baby Bump online store.
Design by Maryam Rashid