Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that typically arises during childhood and can persist into an individual’s adult years.
Marked by trouble focusing, hyperactivity, and impulsivity, the disorder can significantly impact various facets of an individual’s life. Below, we're going to cover everything about ADHD—its symptoms, causes (including the question Is ADHD genetic?), diagnosis, and treatment.
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that can present numerous challenges, often affecting an individual’s schooling, career, relationships, and emotional and mental health. It is characterized by trouble focusing, organizational struggles, impulsivity, executive dysfunction, and hyperactivity. The symptoms of ADHD often depend on which of three different presentations the individual experiences. These subtypes are:
- Predominantly inattentive – Characterized by trouble concentrating on tasks, organizing, and focusing during conversations.
- Predominantly hyperactive-impulsive – Characterized by fidgeting, behaving impulsively, and interrupting during conversations.
- Combined type – Characterized by both inattentive and hyperactive-impulsive symptoms.
Comorbidities are common with ADHD. Research suggests that approximately two thirds of children living with ADHD experience another developmental or psychological disorder.
Common comorbidities with ADHD include:
- Depressive disorders
- Anxiety disorders
- Substance use disorder
- Learning disorders
- Obsessive-compulsive disorder (OCD)
- Tourette’s syndrome
As a child living with ADHD gets older, certain symptoms may diminish, particularly those related to hyperactivity. However, it is thought that many ADHD symptoms continue into adulthood. Although there is no cure for ADHD, it can be successfully managed.
What Causes ADHD?
While there isn’t a unified theory explaining why ADHD develops in certain individuals, several potential contributors have been identified. For example, studies suggest that there is a link between maternal health and ADHD—premature birth, drug use, and high stress during pregnancy may increase the likelihood that a child develops ADHD. Also, data from the CDC shows that boys are more than two times as likely to be diagnosed with ADHD as girls.
Some of the primary factors thought to play a role in the development of ADHD include:
- Genetics – While the exact genes that contribute to ADHD are unknown, the disorder is thought to be passed down through blood relatives who live with it or other mental health conditions. Studies show that the heritability of ADHD is approximately 74%.
- Environmental factors – Prolonged exposure to a harmful or toxic environment (e.g., living in a building with lead-based paint) can increase the chances of developing ADHD. Traumatic brain injury has also been linked to the development of the disorder.
- Neurological variation – Several different alterations in brain structure, function, and composition have been identified in individuals with ADHD. Research suggests that variations in brain chemicals are a major cause of the disorder. People diagnosed with ADHD have been found to be deficient in dopamine and noradrenaline, neurotransmitters that are vital for many mental processes. Individuals with ADHD have also been found to have less gray and white matter in certain areas of the brain.
Symptoms Of ADHD
Particularly in children, it is often hard to distinguish between symptoms of ADHD and behavior that is neurotypical. This is partly why a diagnosis from a healthcare professional is the most reliable way to determine for sure whether ADHD is present. The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) outlines the criteria that must be fulfilled for an ADHD diagnosis to be made. Under the DSM-V, an individual’s symptoms must impair their ability to properly function in school, work, or relationships. Also, symptoms must have started before age 12.
Types Of ADHD
The following are the three different subtypes of ADHD listed in the DSM-V and their applicable symptoms.
Adolescents 16 and younger must display at least six of the following symptoms, while those 17 and older must display at least five symptoms.
- Lack of attention to detail, often resulting in mistakes
- Trouble remaining focused on tasks
- Distractibility during conversations
- Difficulty following instructions and completing projects
- Trouble organizing time and physical space
- Avoids or dislikes activities that required long periods of sustained concentration
- Easily loses or misplaces things (e.g., toys, pencils, homework)
- Distracted by external stimuli or internal thoughts
Adolescents 16 and younger must display at least six of the following symptoms, and those 17 and older must experience at least five symptoms.
- Consistent fidgeting
- Trouble remaining seated in situations where this is expected
- Running, climbing, or displaying other restless behavior in inappropriate situations
- Trouble quietly engaging in leisure activities or play
- Displaying frequent restlessness, with energy levels that are often elevated
- Talking excessively
- Trouble waiting their turn
- Displaying intrusive behavior, including interrupting to answer a question before it’s complete
Combined Type ADHD
This subtype is utilized for people who display a mix of characteristics and symptoms from both inattentive and hyperactive/impulsive types.
ADHD In Children
Most ADHD symptoms show up during an individual’s early school-going years. Hyperactive and impulsive symptoms—including fidgeting and trouble sitting still—are often some of the first noticeable signs of the disorder. Once the child starts school, inattentiveness may become more apparent. In addition to taking note of hyperactive, inattentive, and impulsive behavior, it is suggested that caretakers observe how a child interacts with others around them.
When they’re around other children, does your child:
- Avoid lending others their toys, snacks, and games?
- Appear unwilling or unable to wait their turn?
- Interrupt frequently?
- Have difficulty listening to instructions and finishing their tasks?
- Behave impulsively?
Answering these questions can be helpful in determining whether a child is displaying symptoms of ADHD.
ADHD In Teens
ADHD symptoms in teenagers are similar to those exhibited by children. However, the increasing pressures and other changes that often accompany teenage life can present unique concerns for those who live with the disorder. Emotional dysregulation, in particular, can be exacerbated by new responsibilities and changing hormones. Given the often-mounting scholastic demands during an individual’s teen years, challenges surrounding homework, projects, and other school-related activities may also become more noticeable in an adolescent with ADHD. Comorbid conditions like anxiety, depression, or other mental health disorders may also signal the existence of ADHD in a teenager.
ADHD In Adults
ADHD symptoms can persist into adulthood, typically with similar features but different impacts than those experienced during childhood or adolescence. Symptoms of ADHD in adults may manifest in the following ways:
- Frequently losing track of possessions
- Conflict in relationships
- Trouble organizing tasks or space
- Difficulty focusing for sustained periods
- Starting multiple projects without finishing them
An important point to note is that, in some cases, people are first diagnosed with ADHD in adulthood. If you are an adult and have been experiencing the symptoms mentioned above, consider consulting a healthcare professional who can determine whether further screening is necessary.
How Is ADHD Diagnosed?
As discussed above, ADHD can be difficult to identify, as almost all young people live with certain behaviors that are symptomatic of the disorder to some degree. It can also be hard to pinpoint ADHD symptoms in adults because many of them mimic symptoms of other mental health conditions. Regardless of age, an ADHD diagnosis will usually need to be provided by a mental health or medical professional prior to treatment. When screening an individual for ADHD, the provider will typically administer a medical examination to rule out other causes or conditions. Additionally, they will likely gather information about the individual’s lifestyle, medical history, and family through a series of interviews or questionnaires. Diagnosis is typically based on the fulfillment of ADHD criteria laid out in the DSM-V.
How Is ADHD Treated?
ADHD is typically managed using a combination of medication and behavioral therapy. As with many other conditions, experts suggest early intervention so that the individual learns how to manage the disorder as soon as possible. Psychotherapy, particularly cognitive behavioral therapy, can help those with the disorder develop coping mechanisms, address emotional challenges, and navigate comorbid disorders.
Stimulant and non-stimulant medications are often prescribed to increase levels of dopamine and noradrenaline, which can help individuals manage their symptoms and adhere to their treatment plan. Studies suggest that medication may be up to 80% effective in treating ADHD symptoms. Always consult with a healthcare professional before starting or stopping any medication.
Managing ADHD With Online Therapy
A growing number of studies point to online therapy as an effective form of treatment for ADHD. For example, in a recent meta-analysis of six studies, researchers found that online therapy improved participants' focus and social function. The study also notes the increased accessibility and convenience provided by online therapy platforms.
Therapy can help participants learn more about ADHD, recognize their symptoms, and develop effective management techniques. However, individuals living with ADHD may find it difficult to attend in-person therapy sessions consistently. Online therapy platforms like BetterHelp can provide greater flexibility, accessibility, and affordability, allowing you to attend therapy sessions from wherever you have an internet connection. BetterHelp works with thousands of therapists—who have a wide range of specialties—so you’ll have a good chance of connecting with someone who can address your specific concerns regarding ADHD or similar mental health challenges.
What are three signs of ADHD?
There are more than three signs that an individual might have ADHD, but these criteria can be grouped into three main categories: inattention, hyperactivity, and impulsivity.
Inattention might cause a person to make careless mistakes, be forgetful, or have difficulty managing tasks that require sustained mental effort. Hyperactivity may make a person restless, causing difficulty waiting quietly or sitting still. Impulsive behaviors might include hasty decision-making and interrupting others.
What are the nine symptoms of ADHD?
ADHD is typically diagnosed based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). There are three main subtypes of ADHD: predominantly inattentive presentation, predominantly hyperactive-impulsive presentation, and combined presentation. In total, there are nine core symptoms associated with each of these subtypes, including a range of specific behaviors related to each subtype. To diagnose ADHD, a child aged 16 or under must exhibit at least six of these, and a person aged 17 or older must exhibit at least five.
For more information about diagnosis, visit the National Resource Center on ADHD.
Is ADHD a form of autism?
While there are some overlapping symptoms between ADHD and autism spectrum disorder (ASD), they are separate conditions with distinct diagnostic criteria. Some conditions, such as oppositional defiance disorder (ODD), are common comorbid conditions with both ADHD and ASD.
Is ADHD a part of autism?
ADHD is not a direct part of autism; however, individuals with autism spectrum disorder (ASD) may also have comorbid ADHD. The two conditions can co-occur in some individuals, but they are separate diagnoses, each with its own set of symptoms and criteria.
Because ADHD and ASD have some overlapping symptoms, they might look like each other to the untrained eye, but treating ADHD looks different from that of ASD. ADHD treatment often includes medication, whereas people with ASD often respond better to nonprescriptive alternatives.
At what age does ADHD start?
According to the Centers for Disease Control and Prevention, ADHD is one of the most common neurodevelopmental disorders of childhood. Most people show signs of ADHD by age 12, but some children exhibit behaviors associated with ADHD by the age of 3.
Some risk factors include:
- Brain injury
- Substance use during pregnancy
- Premature delivery and/or low birth weight
- Exposure to toxic materials (e.g., lead) at a young age or during pregnancy
Is ADHD considered to be a disability?
Under the U.S. Individuals with Disabilities Education Act, ADHD is considered a disability and qualifies a student for an Individualized Education Program (IEP).
Though symptoms of ADHD may cause learning challenges, ADHD itself is not a learning disability. However, research suggests that approximately 30% to 50% of individuals with ADHD also have specific learning disabilities. Similarly, while ADHD itself is not among the range of mood disorders, the condition can make it difficult for an individual to regulate their emotions.
How do you test for ADHD?
Diagnosing ADHD involves a comprehensive assessment conducted by a healthcare professional — often a psychiatrist or a clinical psychologist. The assessment includes a review of the individual's medical and developmental history and symptom evaluation and may involve input from family members, teachers, or other relevant sources. Criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are used to determine whether an individual meets the criteria for an ADHD diagnosis. Behavioral interventions and psychological assessments are often part of the evaluation process.
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