ADHD is a complex condition. A patient must be carefully evaluated to identify the physiological, biological and environmental factors that contribute to the resulting symptoms. A successful solution often requires that parents, educators and other professionals work together to identify the underlying problems triggering ADHD behavior.

Digestive, nutrition, emotional stress, educational, lifestyles, medical problems, prescription medications, and recreational drugs, are a few of the contributing factors. Nutritional problems and toxic exposure often play a significant role in these conditions. The health of our digestive system is fundamental to our psychological, neurological and immunological health. This connection is vitally important to consider when treating ADHD and mood disorders.

More specifically, the following factors are considered when establishing a treatment regimen for an individual:

Nutritional deficiencies
· Neurotransmitter deficiency,
· Gastrointestinal imbalance (hydrochloric acid depletion from Cola drinks, insufficient amino acids, essential fatty acids, and digestive enzymes),
· Candida yeast, leaky gut,
· Food allergies,
· Lactose intolerance,
· Iron-deficiency anemia,
· Hypoglycemia (low blood sugar),
· Vitamin and/or mineral deficiencies,
· Additives in prepared foods, fast food and fizzy drinks colorings,
· Flavor enhancers like monosodium glutamate artificial flavorings, and
· Preservatives.

Toxic exposure
· Lead (often in paint chips and dust; can be in the dirt or old plumbing),
· Mercury (vaccinations, metal tooth filings, farm raise fish, floors),
· Carbon monoxide (heating systems),
· Air pollutants,
· Pesticides, and
· Radiation (e.g. TV/computers).

Emotional problems:
Emotional problems can produce ADHD-like behavior and are often overlooked.
· Marital difficulties and divorce,
· Frequent moving (house/school/country),
· Parent trauma, depression or anxiety/panic,
· Parent drug or alcohol abuse,
· Abuse (physical or mental),
· Lack of trust in adults, usually due to bad experience(s),
· Trauma, including prenatal, infant/baby trauma, and
· Putdowns, labeling, (everyone else is doing well).

Educational problems
Many children diagnosed with ADHD are only hyperactive or inattentive at school. This clearly indicates that there is something there that disturbs them. Unfortunately some schools put considerable pressure on parents to put a child on stimulants rather than examine the roots of the problem.
· Sitting too far back to pay attention,
· Discomfort (the chair/hot/cold/hungry),
· Poor eyesight/hearing,
· Boredom (e.g. child is too intelligent for the class),
· Anger with teacher/classmates,
· Lack of discipline and clear guidelines,
· Poor study skills (panic about how to write an essay),
· Learning difficulties,
· Poor teaching,
· Independent spirit,
· Unsuitable school environment,
· Peer pressure, isolation, loneliness, need of attention,
· Pressure to perform,
· Rebellion against 'the system',
· Exam nerves and other terrors associated with education,
· Curriculum-based teaching fails to inspire,
· Large class sizes,
· Teacher burnout,
· Long lessons and long days.

Lifestyle problems:
This is thought to be the fastest area of growth in ADHD-like behavior, responsible for the surge in ADHD diagnoses.
· Poverty or poor quality of life,
· Junk food (see Nutritional problems),
· Abandonment,
· Single parent household,
· Parents no longer supported by strong communities and extended families,
· Loss of traditional routines (bed-time, meal-time, variety of organized activities),
· Too much passive and artificial stimulation building up adrenalin that is not released through sport (e.g. TV, computers, video games),
· Lack of exercise,
· Chronic tiredness,
· Insomnia,
· Prescription or recreational drug-taking by child or parent, and
· Eating disorder, or regularly missing breakfast/lunch/dinner.

Prescription drugs:
Any medication that acts on the central nervous system can provoke ADD/ADHD-like symptoms.
· Antibiotics
· Mood-altering medications (stimulants, neuroleptics, anti-psychotics, tranquillizers, sedatives, sleeping pills, barbiturates, mood stabilizers, some drugs used for nausea),
· Anti-epileptic medications,
· Asthma medications,
· Antihistamines,
· Over-the-counter cold, allergy and sinus medications, and
· Steroids.

Drugs taken recreationally (including prescription drugs)
These are often a hidden cause of ADHD symptoms. Commonly misused drugs include:
· Amphetamine, methamphetamine,
· Ritalin (passed round the playground, crushed and snorted),
· Cocaine,
· Ecstasy,
· Glues and aerosols, and
· Alcohol.

Medical problemsFrom minor to major ailments and diseases, the range of medical problems behind ADHD-like symptoms is so great that it can easily be overlooked:
· Infections (causing earache, headaches or fever),
· Stomach problems (cramps),
· Bowel problems (constipation),
· Poor eyesight,
· Poor hearing,
· Insulin-dependent diabetes,
· Brain tumor,
· Chemotherapy,
· Kidney disease,
· Lupus with CNS inflammation,
· Hormonal disorders (most commonly, thyroid),
· Neurological disorders,
· Learning difficulties,
· Inborn metabolic disorders,
· Head injury,
· Problems in uteri (maternal malnutrition; use or abuse of cigarettes, alcohol or drugs),
· Birth complications