ADHD And The Various Causes That Contribute To Its Development

Attention-deficit/hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder that can significantly impact an individual’s life. The disorder’s complexity is reflected in the ongoing uncertainty surrounding the exact causes of its development. Experts have hypothesized for years about the potential sources of ADHD; and while they have not yet developed a unified theory of the cause of ADHD, they have identified several potential contributing factors. Learning about these sources of ADHD can help us better understand how it manifests, why it produces certain symptoms, and how it can be treated. To that end, below we’re providing you with an overview of ADHD and its causes. 

What is ADHD?

ADHD is a neurodevelopmental disorder that typically develops in childhood and, in many cases, persists into adulthood. It is characterized by hyperactivity, impulsivity, and trouble paying attention for long periods of time. These symptoms can seriously affect an individual’s daily life, including their academic or professional work, personal relationships, and ability to perform care tasks. People living with ADHD often struggle to finish assignments, focus during meetings or lectures, or follow detailed instructions. Early scholastic challenges are often a catalyst for seeking a diagnosis.

Research continues to add to our understanding of ADHD, providing us with information on how it presents, develops, and is treated. Previously known as attention deficit disorder, or ADD, the disorder was renamed ADHD in 1994 when the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders was published. The disorder was also divided into three different subtypes: inattentive, hyperactive/impulsive, and combined type (when an individual experiences both inattentive symptoms and hyperactive symptoms). The symptoms an individual with ADHD experiences will generally vary based on the subtype they present with.  

Symptoms of ADHD

It is important to remember that symptoms of ADHD can vary from individual to individual and may impact people at different levels. However, some of the most commonly expressed symptoms of the disorder include:

Difficulty paying attention

People with ADHD often have difficulty sustaining attention to complete tasks (like completing forms), conversations, or other activities for sustained periods. While ADHD is not a learning disorder, symptoms of ADHD, like difficulty paying attention, can affect a child’s ability to succeed at school. 

Being easily distracted

When the individual is able to pay attention, they may be more likely to have their focus interrupted by their own thoughts, outside influences, or other stimuli. 

Impulsivity and impulsive behavior

Sometimes with ADHD, an adult or child’s behavior can become disruptive. An individual with ADHD may interject frequently during conversations, have trouble waiting their turn, and make decisions without considering the possible outcomes. 

Impulse control disorders, such as oppositional defiant disorder and conduct disorder, are some of the most commonly occurring disorders with ADHD. 

Difficulty completing tasks

An individual with ADHD may frequently abandon projects after starting them.  

Hyperactivity

ADHD is associated with neurotransmitter overactivity which can contribute to overactivity in the areas of the brain that control movement or behavior, leading to hyperactivity and extreme restlessness in many individuals with the disorder.

Trouble with organization

ADHD often leads to executive dysfunction, which can make managing the details of one’s day-to-day life difficult. People with ADHD often experience time blindness, which is difficulty organizing and keeping track of time, causing them to struggle to stick to a schedule and make and keep appointments. The disorder can also make it hard for an individual to organize tasks, their space, and other aspects of their life. 

Difficulty controlling emotions

ADHD often causes emotional dysregulation, which can lead to unwanted reactions, relationship conflict, and comorbid mental health conditions and mood disorders (e.g., depression, anxiety disorders).

These symptoms can have a serious impact on an individual’s life, but as we’ll discuss later, they are treatable. Many individuals who seek treatment are able to manage the disorder effectively and find success in their personal and professional lives.

Diagnosis process

Primary care providers and mental health professionals can give an ADHD diagnosis and treat ADHD. There is no one test for diagnosing ADHD. Since the symptoms of ADHD tend to resemble symptoms of other conditions, healthcare providers will conduct a thorough medical evaluation that includes a physical examination, a neurological examination, and a series of interviews to assess one’s symptoms. 

What causes ADHD

Experts have studied the development of ADHD for years, producing research that suggests there is likely one main factor, genetics, that combines with less potent influences in some cases. Though studies have that found various genes, environmental contributors, lifestyle factors, and societal effects may all play a role, there is no unified theory of the exact cause of ADHD. 

Genetics are thought to be the primary factor in the development of ADHD, with most experts agreeing that numerous genes are involved (as opposed to one genetic variation or a select few genes causing the disorder). A person with a blood relative with ADHD has an increased risk of developing ADHD.

Genetics are thought to be at the root of several of the causes of ADHD, such as variations in brain function and structure. Among the genes that have been identified as potential contributors are DRD4 and DRD5, which are dopamine receptor genes; DAT1, a dopamine transporter; and COMT, which can lower dopamine levels. 

As discussed above, variations in brain development are considered major factors in the development of ADHD. Research suggests that deficits in the neurotransmitters dopamine and noradrenaline are principal causes of the disorder. This is why genes that affect the proliferation or function of these chemicals are the focus of much of the research on ADHD’s causes. Dopamine and noradrenaline are partially responsible for a variety of functions, such as our ability to focus, regulate our emotions, and motivate ourselves. Additionally, individuals with ADHD have been shown to have less gray and white matter in certain areas of the brain. And several other structural disparities have been linked to the disorder over the years.

Certain environmental factors have also been identified as potential influences. For example, research shows that individuals who are born prematurely have a higher chance of developing ADHD. Studies have also found links between ADHD and toxin exposure, dietary patterns, smoking during pregnancy, and trauma. The fact that the heritability—a measure explaining the amount of variation in a trait that is due to genetic differences—of the disorder is close to 80% suggests that environmental factors play only a small role in its development. 

Because ADHD is complex and presents in many different ways, the research into its causes is complicated. Studies often use different methods and strategies that may only illuminate one aspect of the disorder. However, researchers continue to find connections between individual factors and ADHD symptoms.

Treatment

While ADHD is a complex and serious disorder, it is also a treatable one. The exact treatment option will typically depend on the individual’s symptoms, age, and medical history. 

Getting treatment early on for ADHD can help prevent worsening symptoms and reduce the long-term impact of the condition on an individual’s life. Research shows that adults with undiagnosed ADHD may face frustration and poor self-esteem and may experience more problems in their relationships.

Treating ADHD typically involves a combination of medication and therapy. Some people also find improvement of their symptoms with lifestyle changes and complementary health approaches, like meditation and neurofeedback.

Medication

ADHD medications are put into two classes: Stimulants and non-stimulants. ADHD medications are often prescribed to individuals to improve attention and reduce hyperactivity or impulsivity. Medication can be highly effective in managing many ADHD symptoms (studies show that up to 80% of people who utilize stimulants experience improvements in their symptoms), and it is often the first-line treatment. Always consult with a healthcare professional before starting or stopping any medication.

Psychotherapy

Therapy can help individuals with ADHD develop strategies to manage their specific symptoms more effectively in a supportive environment. It can also be a place to discuss other treatment options and gain a more robust understanding of the disorder. Therapy may also allow the individual to address the emotional challenges that ADHD can produce, improve their communication skills when it comes to discussing ADHD, and work through symptoms of comorbid conditions, if applicable.

Younger children are often referred to behavioral interventions, like behavior therapy, to discourage disruptive behaviors and encourage positive behaviors. Your child’s doctor may recommend other types of behavior therapy, like social skills training may, depending on what your child needs help with. 

Lifestyle changes

Healthy sleep habits, exercising regularly, and eating a balanced diet can help mitigate ADHD symptoms and benefit the individual’s mental and physical well-being. Studies show, for example, that a diet high in fiber, omega-3 fatty acids, and folate—and low in sugar—can help improve symptoms. 

Managing ADHD with online therapy

A growing body of research suggests that online therapy can help individuals with ADHD address their symptoms in an effective and convenient manner. In a study published in the journal BMC Psychiatry, researchers examined the effects of online therapy for ADHD compared to in-person treatment, concluding that there were no significant differences regarding the flow of sessions, positivity post sessions, participant satisfaction, or therapeutic alliance. The study also notes the increased flexibility provided by online therapy, along with its cost-effectiveness and availability. 

If you are living with ADHD or similar concerns, consider taking advantage of the flexibility and availability of online therapy. With an online therapy platform like BetterHelp, you can schedule therapy sessions easily and receive regular reminders, which can be helpful if ADHD causes you to struggle organizing your time. You’ll also be able to contact your therapist outside of sessions; so, if you have a question about an ADHD symptom or want to clarify a point made during therapy, you can send them a message, and they’ll respond when they’re able.