What Is ADHD?
Attention deficit hyperactive disorder, better known as ADHD and formerly called ADD (Attention Deficit Disorder) is a chronic neurodevelopmental, childhood disorder. It affects millions of children every year and is one of the most commonly diagnosed illnesses in children and adolescents.
This is an extremely common disorder, which affects just over 10% of the children in the United States according to's CDC (Centres for Disease Control & Prevention) data. While there is no actual cause for why someone might develop ADHD, the science behind the disorder explains there is a difference in brain chemicals (neurotransmitters), and research shows that some parts of the brain are smaller and work differently for people with the condition.
Symptoms of ADHD can vary from person to person, but in general, the condition is known to cause hyperactive, impulsive, inattentive, fidgety behavior. The affected child has trouble focusing on any one thing and often performs poorly in school.
ADHD is divided into three subtypes:
- Predominantly inattentive;
- Predominately hyperactive-impulsive;
- Combined type.
Approximately two-thirds of the time other disorders can be present along with ADHD. While the disorder does not lead to psychological problems, research has shown that children with ADHD are more likely to suffer from other mental health problems; these include but are not limited to:
- Anxiety disorder;
- Antisocial behavior;
- Substance abuse;
- Learning disorder;
- OCD (Obsessive compulsive disorder);
- Tourette syndrome.
As the child suffering from ADHD gets older, the symptoms tend to diminish, however in some cases ADHD symptoms never go away and can continue on into adulthood. Although there is no cure for ADHD, it is a condition which can be successfully controlled and managed. Most affected adults go on to lead normal, happy lives by using a combination of medication and coping strategies.
WHAT CAUSES ADHD?
While there is no known cause of the disorder, research indicates that boys are three times more likely to be diagnosed with ADHD than girls. This may be down to biology or can partially be due to a lack of significant research on how ADHD affects girls and women.
Some of the factors that may play a role in the development of ADHD are:
- Genetics: the disorder often runs in the family and can be passed down through blood relatives who suffer from the condition or other mental health disorders;
- Environment: Prolonged exposure to a harmful or toxic environment (i.e. living in a very old building with exposure to lead) can have an impact;
- Development: Central nervous system problems.
In addition, studies have shown a link between maternal health and ADHD. Premature birth and drug use, alcohol abuse or smoking during pregnancy are all big risk factors and can make the child more susceptible to the disorder after birth.
Some of the negative effects of ADHD can include and lead to:
- A decrease / lowered self-esteem;
- Trouble maintaining relationships;
- Difficulty socializing;
- Poor academic performance.
SYMPTOMS OF ADHD:
Boys and girls display very different symptoms, and they can range from mild to severe. Some common general symptoms displayed by boys suffering from the condition are:
- Hyperactive or restless behavior;
- Difficulty concentrating or paying attention;
- Disruptive behavior;
- Impulsive behavior.
It can often be hard to distinguish between symptoms of ADHD and a child who is perfectly normal in all respects but has a very active and curious personality. This is why in order to get a diagnosis of ADHD, symptoms have to be present for at least six months and more than one symptom has to be present. At least a few where the child's life is being negatively impacted in numerous settings, such as at home and at school.
Let's take a look now at the three different subtypes and the symptoms present with each of them.
- Predominantly Inattentive:
Some of the symptoms to watch out for which fall under this subtype are:
- Lack of attention to detail i.e. making careless mistakes in schoolwork;
- Trouble with focusing on something, whether it's a task at school or during play time;
- Trouble listening and difficulty grasping instructions, often leading to unfinished school work, chores or tasks;
- Displaying poor organizational and management skills;
- Difficulty with any task (such as homework) which requires a strong focus mentally;
- Easily lose or misplace things i.e. toys, pencils, homework, etc.
- Displays distracted and forgetful behavior
- Predominantly Hyperactive-Impulsive:
When a child is diagnosed as falling within the predominantly hyperactive-impulsive subtype, it means they are displaying one or more of the following symptoms:
- Unable to sit still- the child fidgets, squirms and/or taps their hands or feet and the child is constantly on the go, in motion and restless;
- Has trouble sitting still at school or in a similar setting;
- Can't play quietly or stay engaged in quiet, low-key activities;
- Talks too much interrupts people and says things without being asked;
- Is impatient;
- Displays intrusive behavior.
- Combined Type:
This subtype is reserved for children who display a mix of characteristics and symptoms from the two previous subtypes.
ADHD Symptoms in Girls:
As stated previously the symptoms of ADHD in girls are very different than what one might see in a boy. Girls tend to fall under the Predominantly Inattentive subtype, and instead of being hyperactive and overly energetic, girls suffering from the condition tend to be daydreamers, and therefore being distracted and lacking focus.
While boys tend to blame everything around them for their shortcomings, girls typically blame themselves for their failings. This leaves them feeling emotionally insecure and uncertain about their actions and roles in society, which in turn leads to them feeling detached from others socially and makes it hard for them to have friends. Girls with ADHD are often left open and vulnerable to other disorders such as bulimia, depression, anorexia, anxiety, etc.
It doesn't get any easier when puberty hits, and as adults, women with ADHD may find it difficult to deal with stressful situations, manage certain aspects of their lives (such as finances or daily chores) and may have a harder time holding down a job.
Because girls are seen as the softer, gentler, quieter sex their symptoms are harder to spot and they are less likely to get diagnosed. As a result, less information is available on how the disorder impacts them as children and as adults.
ADHD Symptoms in Toddlers:
Toddlers, in general, are an active, energetic group, so it's hard to distinguish between what's normal and what is not. A good rule of thumb to watch out for is any type of extreme behavior.
For instance, normal behavior for a toddler is tottering around, displaying curiosity towards things while also enjoying a quiet story time or some alone time. But a toddler with ADHD will physically be unable to sit still for any length of time, and their level of energy will seem over the top. They may be climbing the walls and the furniture and be continuously running around.
That coupled with restless, fidgety behavior and the inability to focus on anything for very long can be strong indicators that ADHD might a factor. Even though these may be early signs, a concrete diagnosis won't happen until a few years down the road.
ADHD Symptoms in Kids:
Most ADHD symptoms show up or 'blossom' during the early school-going years between six and twelve years of age. Some things to watch out for in addition to hyperactive, inattentive, distracted behavior are how a child interacts with others around him/her.
When he or she is with other kids, do they:
- Refuse to share toys, snacks, games?
- Appear unwilling to wait their turn?
- Let others talk without interrupting or do they jump into the conversation?
- Listen to instructions and finish their tasks?
- Have good social skills?
- Behave in an impulsive manner?
If a child displays these characteristics while interacting with friends and family, they may be exhibiting symptoms of ADHD.
ADHD Symptoms in Teens:
ADHD symptoms in teenagers are very similar to the ones exhibited by children as discussed in the previous section. However, hormonal changes and puberty can aggravate those symptoms and make them worse.
Children who were taking medication early on often think they are cured when they hit their teens but this is not so, and studies have shown that in teenagers, ADHD symptoms pose added risks in the form of alcohol and drug abuse and can lead to impulsive and reckless behavior such as lying, stealing or promiscuity. Such risks can lead to car accidents or cause other serious injuries and accidents.
Parents are encouraged to explain the risks of stopping treatments and reinforce why it's important to keep taking the medications and combine it with counseling.
Behavioral therapy becomes even more important for teenagers because it allows them to understand their condition and provides them with coping methods and mechanisms.
ADHD Symptoms in Adults:
Generally, as children and teens with ADHD get older and enter adulthood, their symptoms fade but not always. They then have to learn how to live with the disorder for the rest of their lives.
In adults, some ADHD symptoms include:
- Losing things;
- Being disorganized and unfocused;
- Prone to risky, impulsive behavior i.e. quitting a job, having reckless sex, spending lots of money, etc.
- Alcohol or drug abuse;
- Inability to maintain lasting relationships.
In most cases as long as the person continues to work closely with their doctor, there is no reason why they can't lead a normal life. Problems arise when they stop taking medication or stop seeking the help they need in order to manage the disorder.
An important point to note is in some cases people are only diagnosed with ADHD in adulthood, while it may be more difficult to do so, it is not impossible. If you are an adult and have been suffering from any of the symptoms mentioned so far over a prolonged period of time (greater than six months), it's worth having a conversation with your doctor.
HOW IS ADHD DIAGNOSED?
Attention deficit hyperactive disorder can be tricky to diagnose as many of the listed symptoms can be considered perfectly normal behavior expected from a child. After all how many kids sit still, diligently do their homework and never lose their toys? These characteristics are very typical of most young children.
Some kids tend to be more energetic and hyper than others while others have shorter attention spans. This does not automatically mean they are suffering from ADHD.
While it's easy to dismiss concerning behavior or symptoms and blame it on an energetic child; it's equally easy to label a forgetful child with the disorder. Because children are typically not able to analyze their own behavior, it's imperative for parents to watch their child's behavior, note their personalities and seek help if and when they notice certain symptoms. At the very least, it's worth a conversation with the pediatrician or a family doctor.
The doctor will then likely seek the advice of a specialist. Verbal and written tests may be administered to rule out a learning disability, and a medical evaluation will be conducted to rule out other causes and conditions, which may be impacting the child's behavior. For instance, the child might be suffering from a different disorder or be having difficulty adjusting to a sudden or dramatic change in their life i.e. parents going through a divorce, moving from one city to another, changing schools, a new baby in the family, etc. Therefore, even though symptoms may be present early on, it is unwise to diagnose a child with ADHD before the age of twelve, unless mitigating circumstances are present.
Once the medical exam is complete, the process moves on to the next step, gathering information about the child, the family, and their life through a series of interviews or questionnaires. Diagnosis is based on the fulfillment of ADHD criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders. A rating scale is used to evaluate the child and decide which subtype (if any) they belong to.
Self-testing tools are also available online. It's important to note these tests and quizzes cannot take the place of a medical diagnosis from a professional.
HOW IS ADHD TREATED?
The disorder is treated using a combination of medication and behavioral therapy.
Like any kind of illness, early intervention is always better, and ADHD is no different. It is better managed when diagnosed early, and it can have a significant impact in the affected child's life and play a role in how well they do in their formative years.
Because there is no known cure, there is no one-stop fix for ADHD; instead, the disorder is treated via a combination of things such as:
- Medications (stimulant drugs);
- Counseling / Therapy;
- Education and Training.
Stimulant drugs are most often prescribed since they help to balance the chemicals in the brain and tone down the symptoms of inattention and hyperactivity. These medications are available for short-term boosts or long-term action.
The dosage is determined on a case-by-case basis. Like most medication, ADHD drugs can have side effects, such as nausea, mood swings, headaches, trouble sleeping and loss of appetite. But these can be minimized with the right type and dosage of medication alongside some positive lifestyle changes. But if the side effects persist for a long period of time, it's important to bring it up with the doctor.
In some extreme and rare cases, the side effects of ADHD medication can be more serious such as hallucinations, displaying angry, manic behavior or being completely unresponsive. These are not life threatening or dangerous side effects, merely unpleasant ones and a trip to the doctor's office should sort it out. In some cases (if the side effects persist or are too much to handle) the doctor might recommend behavioral therapy instead.
Providing therapy and counseling to children is another great (and highly recommended) treatment option with or without medication. Some of the different types of therapy available are:
- Behavior Therapy:
- Family Therapy:
It's on the parents, the doctors and the child themselves to figure out what combination of treatment works best to give the child as normal a life as possible.
Some alternative treatment options are also available for those who don't like the idea of medication and chemicals. These methods have not been medically proven so consulting with a doctor is advised prior to trying them. Some of these treatment options are:
- Giving children herbal, vitamin or mineral supplements;
- Chiropractic medication;
- Special diet - some people have been known to follow the Feingold Diet with success, even though there is no scientific study or research to back the claim that eliminating certain things from a child's diet will decrease their symptoms of ADHD.
Since ADHD is a disorder which stays for life and is carried with the child, parents are strongly encouraged to keep an open line of communication with their children (especially as they get older) and be honest about what's going on. This will help both the child and their loved ones have a better understanding of how to cope with ADHD and find the normal in their lives.
While it's not a pleasant disorder, ADHD doesn't have to be an ugly illness. With timely intervention and the right treatment, children, teens, and adults can lead happy, fruitful lives.
As parents, it can be a frustrating and difficult experience to watch your child suffer and perform poorly or have difficulty socializing or fitting in. If you suspect your child may have an attention deficit hyperactive disorder, make an appointment with your pediatrician or family doctor and be frank in your concerns and discussions.
As discussed earlier, it can be difficult to differentiate between a naturally active or energetic child and one suffering from ADHD, but if you have suspicions, it's a good idea to speak to a health care professional. There's no harm in being cautious, at best your fears will be put to rest and worse case if your child does have ADHD they can get the help they need and start doing better. It cannot be stressed enough that all illnesses and disorders are best caught early.
Numerous resources can be found online and in your community to help you better understand the disorder and provide you with coping mechanisms and strategies. By getting a grasp on the disorder early on, you and your child will be the ones in control of the condition, not the other way around.
Finally, being diagnosed with ADHD can also have its positives. Many people go on to channel their excess energy into something that interests them, creating highly successful careers or businesses. Impulsive behavior can also translate into living spontaneously and enjoying every moment of life.
If you have ADHD continue to use the medication, go to therapy in person or online, speak to others openly and most important of all, embrace who you are!
Source: WebMD & MayoClinic