Calm (Jr)™

TCM herbal formula for ADD and ADHD in children and adults — extinguishes Liver wind; nourishes Liver yin; tranquilizes the shen (spirit); cognitive effect to improve memory and learning; neuroprotective; anxiolytic; detoxifying

⚠️ Discontinue once the condition is stabilized or desired effects are achieved. Contraindicated during pregnancy and nursing. Contraindicated in individuals with yang deficiency or coldness.

CLINICAL APPLICATIONS

* ADD (attention deficit disorder)

* ADHD (attention deficit hyperactivity disorder)

* Hyperactivity, anxiety, impulsiveness, difficulty focusing, inattentiveness, restlessness

Background: ADD/ADHD is a developmental condition in which the affected person is unable to concentrate and is easily distracted, with or without accompanying hyperactivity. Onset of symptoms must occur before age seven with significant social or academic impairment. Incidence is 3–7% in school-age children and 2–7% in adults. In children, ADD/ADHD is 3–5 times more common in boys than girls; in adults, the gender ratio is closer to even. At least 15–20% of children with ADD/ADHD will maintain the full diagnosis in adulthood; up to 65% will have ADD/ADHD or residual symptoms as adults. The pathology is not fully clear — findings suggest that certain areas of the brain related to attention are deficient in neural transmission involving the neurotransmitters dopamine and norepinephrine. Childhood ADD/ADHD is a risk factor for subsequent conduct and substance abuse problems. According to TCM, ADD/ADHD is diagnosed as Liver wind rising with shen (spirit) disturbance arising from Liver yin deficiency — treatment requires both calming and nourishing herbs to restore normal balance.

Key herb-level clinical data:

— Mu Li (Concha Ostreae / Oyster Shell): extinguishes Liver wind; calms Liver yang rising; neutralizes mood — addresses irritability, hyperactivity, and short temper

— Jue Ming Zi (Semen Cassiae / Cassia Seed): extinguishes Liver wind; calms Liver yang rising; obtusifolin — marked effect to improve learning and attenuate scopolamine-induced memory impairment; neuroprotective — marked protective effect against dopaminergic neuron toxicities involved in Parkinson's disease

— Gou Teng (Ramulus Uncariae cum Uncis / Uncaria): extinguishes Liver wind; calms Liver yang rising; neuroprotective against chemical-induced neuronal damage; protects and alleviates damage to hippocampal neurons induced by acute hypoxia; marked anxiolytic effect — calms anxiety and hyperactivity

— Bie Jia (Carapax Trionycis / Turtle Shell): tonifies Liver yin; assists the first three herbs in extinguishing Liver wind

— Gui Ban (Plastrum Testudinis / Tortoise Plastron): tonifies Liver yin; assists in extinguishing Liver wind

— Bai Shao (Radix Paeoniae Alba / White Peony): addresses yin deficiency; softens the Liver; relieves spasms, cramps, and stiffness associated with anxiety or hyperactivity; paeoniflorin — enhances aging-induced learning deficit; balances the central nervous system; reverses drug-induced excitation; harmonizes the cardiovascular system

— Di Huang (Radix Rehmanniae / Rehmannia): addresses yin deficiency; neuroprotective — ameliorates cognition deficits and attenuates oxidative damage in the brain; treats senescence and neurodegenerative diseases including Alzheimer's and Parkinson's (catalpol); regulates the endocrine system to ensure normal production and release of endogenous hormones

— Mai Dong (Radix Ophiopogonis / Ophiopogon): addresses yin deficiency; sedates Heart fire to relieve shen (spirit) disturbance; balances the central nervous system; reverses drug-induced excitation; harmonizes the cardiovascular system

— Shi Chang Pu (Rhizoma Acori Tatarinowii / Acorus): disperses phlegm obstructing the orifices; restores cognitive and sensory functions; treats forgetfulness and inability to concentrate; dose-dependent improvement of memory; beta-asarone — neuroprotective against neuronal apoptosis in the hippocampus induced by beta-amyloid (Abeta); balances CNS; reverses drug-induced excitation; clinically with Yuan Zhi: syrup 10–15 mL 3x/day effective in managing 90 of 100 children with hyperactivity disorders; 30 children with low IQ showed mild to moderate improvement in classroom performance (twice daily for 2 weeks per course, 3 months total)

— Yuan Zhi (Radix Polygalae / Polygala): disperses phlegm obstructing the orifices; restores cognitive and sensory functions; treats forgetfulness and inability to concentrate; neuroprotective — dose-dependent protection against Abeta-induced neuronal damage; inhibits acetylcholinesterase (AChE) in a dose-dependent and non-competitive manner; beneficial cognitive effect on memory impairment induced by scopolamine or cholinergic system dysfunction

— Yu Jin (Radix Curcumae / Curcuma): clears Heart heat; opens orifices; promotes consciousness; hepatoprotective against chemical- and tetrachloride-induced liver damage and liver cancer

— Tai Zi Shen (Radix Pseudostellariae / Pseudostellaria): neutral — tonifies both qi and yin

— Chuan Xiong (Rhizoma Chuanxiong / Ligusticum): promotes blood circulation; relieves stagnation and pain in channels from long-term muscle stiffness or twitching; ferulic acid — reduces cerebral infarct area and minimizes neurological deficit following transient focal cerebral ischemia; balances CNS; reverses drug-induced excitation; harmonizes the cardiovascular system

— Zhi Gan Cao (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle / Honey-Prepared Licorice): nourishes the Heart; harmonizes the formula; detoxifying — treats drug poisoning (chloral hydrate, cocaine, barbiturates, mercury, lead), food poisoning (tetrodotoxin, snake, mushrooms), and others (enterotoxin, herbicides, pesticides); hepatoprotective; cognitive effect — ameliorates memory impairment (BACE1 inhibitor)

WESTERN THERAPEUTIC ACTIONS

* Cognitive / memory — Shi Chang Pu (dose-dependent memory↑); Bai Shao (paeoniflorin, learning deficit↑); Jue Ming Zi (obtusifolin, memory impairment↓); Zhi Gan Cao (BACE1 inhibitor, memory↑); Yuan Zhi (AChE inhibition, scopolamine-induced impairment↓)

* Neuroprotective — Gou Teng (chemical-induced neuronal damage, hypoxia); Shi Chang Pu (beta-asarone, Abeta-induced apoptosis↓); Yuan Zhi (Abeta-induced neuronal damage↓); Di Huang (catalpol, Alzheimer's, Parkinson's); Jue Ming Zi (dopaminergic neurons, Parkinson's); Chuan Xiong (ferulic acid, cerebral ischemia)

* Anxiolytic / CNS balancing — Gou Teng (anxiolytic, hyperactivity↓); Mai Dong, Bai Shao, Shi Chang Pu, Chuan Xiong (CNS balance, drug-induced excitation reversal)

* Cardiovascular harmonizing — Mai Dong, Bai Shao, Chuan Xiong (heart rate and blood pressure stabilization)

* Detoxifying / hepatoprotective — Zhi Gan Cao (broad-spectrum detoxification); Yu Jin (hepatoprotective)

* Endocrine regulation — Di Huang (endogenous hormone production and release)

CHINESE THERAPEUTIC ACTIONS

* Extinguishes Liver wind; calms Liver yang rising (Mu Li, Jue Ming Zi, Gou Teng)

* Tonifies Liver yin (Bie Jia, Gui Ban, Bai Shao, Di Huang, Mai Dong)

* Tranquilizes the shen (spirit); improves focus and concentration (Shi Chang Pu, Yuan Zhi, Yu Jin)

* Tonifies qi and yin (Tai Zi Shen)

* Promotes blood circulation; relieves channel stagnation (Chuan Xiong)

* Nourishes the Heart; harmonizes formula (Zhi Gan Cao)

DOSAGE

Adults: 3–4 capsules three times daily on an empty stomach. Children: refer to the Strategic Dosing Guidelines to determine the proper dose based on age or body weight. Take herbs for three months continuously prior to evaluating progress. Use only as needed during school — not necessary during vacations (summer and winter).

Supplementary formulas: Poor memory or forgetfulness — use Enhance Memory. Anger and/or insomnia — add Calm (ES). Stress — add Calm. Stress and insomnia with underlying deficiency and weakness — add Calm ZZZ. Depression — add Shine or Shine (DS). Muscle stiffness, cramps, and spasms — add Flex (SC). Acute headache — add Corydalin (AC). Chronic headache — add Corydalin (CR). Constipation — add Gentle Lax (Excess) or Gentle Lax (Deficient). Fatigue, excessive worrying, or restless sleep from blood deficiency — add Schisandra ZZZ. Liver and Kidney yin deficiencies — add Nourish. Chronic exposure to chemical or toxic substances — add Herbal DTX. Blood stagnation — add Circulation (SJ). Hyperactivity and impulsivity from excess heat — add Gardenia Complex.

Nutrition: Ensure adequate calcium and magnesium — they have a calming effect. Cold-water fish (tuna, salmon, herring) are excellent sources of DHA (docosahexaenoic acid), essential for proper brain development. Increase complex carbohydrates (fresh vegetables, fruits, beans, whole grains); decrease simple carbohydrates (glucose, fructose, sugars, processed grains). Avoid exposure to chemical and toxic substances, food additives, colorings, and allergens. Eliminate from the diet: sugar, candy, junk food, artificial color and flavor, fried foods, antacids, cough drops, throat lozenges, and carbonated beverages. Avoid warm/hot natured foods that damage qi and yin: heat-producing fruits (mango, durian), stimulants (coffee, alcohol, energy drinks), and spicy/pungent/aromatic vegetables (pepper, garlic, onions, basil, rosemary, cumin, fennel, anise, leeks, chives, scallions, thyme, saffron, wormwood, mustard, chili, wasabi). Avoid artificial coloring and processed meats (lunch meats, hot dogs, sausages) — nitrites are linked to inflammation and chronic disease.

Tao of Nutrition (Dr. Maoshing Ni and Cathy McNease): Incorporate ¼ cup of fresh or frozen blueberries into breakfast daily for 2–4 weeks.

Lifestyle: Psychosocial support is extremely important for complete and long-term treatment — approaches include contingency management (reward and timeout systems), parent training (child management skills), clinical behavior therapy (coordinated contingency management by parents and teachers), and cognitive-behavioral treatment (self-monitoring, verbal self-instruction, problem-solving strategies, self-reinforcement). Encourage activities that foster calm and concentration: reading, meditation, qi gong, and tai chi chuan. Discourage activities that impose disruption and short attention span such as video games and television. Educate and/or treat over-anxious parents — if necessary, Calm or Calm (ES) can be used to calm the shen (spirit) of the parents.

CASE STUDIES

— 36-year-old male (B.K.): ADD with poor memory; rapid wiry pulse; Liver yin deficiency. Calm (Jr) 3–4 capsules 3x/day for 3 months. Result: calmer, more focused personality; memory improved.

— 9-year-old male (J.S.): Unable to complete tasks, unable to focus on school work, irritability, restlessness, easily angered, insomnia; skinny, pale complexion, dark circles under eyes; ADHD (Western); Liver wind rising, Liver yin deficiency, shen disturbance. Calm (Jr) + acupuncture. Result: great improvement in ability to stay on tasks; less irritability and fewer anger outbursts; sleep improved. (Patient continued high simple carbohydrate diet — parents not yet willing to consider dietary changes.)

— 5-year-old female (S.A.): First seizure attack May 2, 2002; hospitalized 2 days; placed on Tegretol (carbamazepine); developed stomachaches and was not herself; mother suspected immunization shots as cause; Liver wind. Calm (Jr) + cranio-sacral therapy. Result: able to decrease Tegretol dosage; seizures diminishing in frequency and intensity; able to endure seizures in a more relaxed manner.

Related Reading

Also see: Enhance Memory – for poor memory and forgetfulness | Calm – for stress and Liver qi stagnation | Calm (ES) – for anger and insomnia | Calm ZZZ – for stress and insomnia with deficiency | Shine – for depression | Nourish – for Liver and Kidney yin deficiencies | Schisandra ZZZ – for fatigue and restless sleep from blood deficiency | Gardenia Complex – for hyperactivity from excess heat | Herbal DTX – for chronic exposure to toxic substances | Corydalin (AC) – for acute headache | Flex (SC) – for muscle stiffness, cramps, and spasms | Circulation (SJ) – for blood stagnation | Brain Health & Neurological Support Collection.