ADHD

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Attention-Deficit/Hyperactivity Disorder (ADHD) is a psychological condition that begins in early childhood and frequently persists into adulthood. About eight percent of children in the United States are diagnosed with ADHD. Approximately five percent  of adults are diagnosed with the condition.

Symptoms

There are three broad sets of symptoms associated with ADHD: (1) inattention and distractibility, (2) hyperactivity, and (3) impulsivity. It is not necessary to have symptoms from all three areas to meet criteria for ADHD. Many adults experience only the cognitive symptoms of inattention and distractibility. The hyperactivity and impulsivity symptoms are more common in males and are typically more severe in childhood. In addition to these primary symptoms, many children with ADHD experience secondary problems, including significant academic difficulties during their early school years and/or interpersonal difficulties with peers.

ADHD is classified as a “developmental disorder,” which means symptoms should be present by early childhood and will typically persist into adolescence or adulthood. The symptoms associated with ADHD vary significantly in terms of severity and symptoms. For example, a child with ADHD may have difficulty sitting for long periods of time during classes, whereas a young adult may feel “restless” during classes and have problems with concentration and attention-span during lectures. Symptoms in childhood may resolve entirely by late adolescence or adulthood. Many individuals experience some, but not all of the symptoms associated with ADHD or not at the level required to make a diagnosis.

Many of the symptoms associated with ADHD (e.g., concentration problems) are also present in other conditions (e.g., depression). It is important to obtain a comprehensive evaluation by a mental health provider and/or a physician if you suspect you have ADHD.

Types of  ADHD

There are currently three recognized sub-types of ADHD:

Predominately Inattentive

  • The inattentive sub-type of ADHD is characterized by problems with concentration and attention-span, time management and procrastination. The symptoms of inattentive ADHD include the following:
  • Fails to give close attention to details and/or makes careless mistakes
  • Difficulty in sustaining attention (daydreaming)
  • Does not listen when directly spoken to
  • Does not follow instructions and fails to complete activities (not due to lack of understanding)
  • Difficulty with organization
  • Avoids tasks that require prolonged mental effort (doing homework)
  • Loses things required for tasks (Notebook for class, work uniform)
  • Easily distracted
  • Forgetful in everyday activities

Predominately Hyperactive-Impulsive

The Hyperactive-Impulsive sub-type of ADHD is characterized by excessive motor movements, impulsive decision-making and behavior. Hyperactive symptoms may not be present in adults even if they were present in childhood. Some adults describe a subjective feeling of restlessness rather than hyperactivity per se. The symptoms of hyperactive-impulsive ADHD include the following:

  • Fidgety or restless while sitting
  • Leaves seat in class when inappropriate
  • In children, runs or climbs excessively. In adults, excessive feelings of restlessness.
  • Difficulty engaging in leisure activities quietly
  • Appears “on the go” or as if “driven by a motor”
  • Excessive talking
  • Blurts out answers, or difficulty thinking before speaking
  • Difficulty awaiting a turn
  • Interrupts others

Combined subtype

If symptoms of both the Inattentive and Hyperactive-Impulsive subtypes are present, then a diagnosis of “combined subtype” is made.

Comorbidities

People who have ADHD are more likely to have certain other mental health conditions. When this occurs, it’s referred to as a comorbidity. A mental health or medical professional needs to evaluate whether a person is experiencing symptoms from ADHD and not one of the following conditions that may look like ADHD before diagnosis and treatment are made. Some common comorbid conditions are:

Sleep Disorders

Individuals diagnosed with ADHD may be more likely to exhibit a disrupted sleep pattern, including irregular sleep schedule, problems falling asleep and/or excessive activity levels during sleep. Some sleep disorders cause symptoms which are similar to symptoms typically associated with ADHD (e.g., concentration problems).Substance AbuseThere is a higher rate of alcohol and substance abuse for individuals diagnosed with ADHD and some substances can exacerbate symptoms associated with ADHD (e.g., concentration problems).

Conduct Disorder

Significant conduct-related problems are uncommon in adults diagnosed with ADHD, but when present they are often associated with impulsivity symptoms (e.g., gambling, driving citations for speeding, gambling or alcohol/drug abuse).

Learning Disorders

The majority of individuals diagnosed with ADHD have experienced some academic difficulties, but a significant minority of individuals diagnosed with ADHD have a co-morbid Learning Disorder. These individuals have a primary learning difficulty unrelated to ADHD (e.g., problems with reading comprehension or spelling).

Depression

A significant percentage of adults diagnosed with ADHD also experience depressive mood symptoms and some have a co-morbid mood disorder such as Major Depression. In some cases, symptoms associated with ADHD are exacerbated by the mood disorder (e.g., concentration problems).

Anxiety

A significant percentage of adults diagnosed with ADHD also experience anxiety symptoms. The anxiety is often secondary to ADHD meaning individuals tend to worry or become stressed because they are experiencing problems with time management, organization and task completion.

Employment and Interpersonal Problems

Individuals diagnosed with ADHD often experience a variety of problems in the workplace, including problems with task completion, poor performance reviews, and periods of unemployment. Difficulties such as forgetfulness, inattention, and impulsivity may also cause tension in one’s social life.

Common misunderstanding about the cause of  ADHD:

Myth: Food additives and sugar cause ADHD.

Reality: The research does not support this explanation. Sugar and food additives may cause restlessness in anyone who consumes it, but it does not cause ADHD.

Myth: Excessive time viewing television or playing videogames causes ADHD.

Reality: There is no evidence that vireing television or playing videogames causes ADHD and there are good explanations why many individuals with ADHD prefer these activities.

Myth: ADHD is caused by poor parenting and/or intolerant teachers.

Reality: There is no research evidence to support this. There is evidence that caretakers experience frustration in response to symptoms associated with ADHD because hyperactivity and impulsivity can be difficult to manage, especially in a classroom.

Myth: Living in a fast paced, hectic society causes ADHD. This is why there has been an increase in the number of individuals diagnosed with ADHD.

Reality: There is no research evidence to support this. While ADHD had been more commonly diagnosed in recent years, there is no evidence of increased prevalence.

Myth: ADHD is a product of cultural factors within the United States and not a real medical condition.

Reality: There are similar prevalence rates of ADHD in most Western countries and prevalence of ADHD does not vary by race, ethnicity or socioeconomic status.

Treatment

There are a variety of treatments available to help manage the symptoms associated with ADHD which have been shown to be very effective, especially when used in combination. There are no known treatments that resolve or “cure” ADHD, but symptoms can often be managed so that they do not interfere with a person’s functioning. There is research to support the following treatments:

Medications: There are different types of medication approved by the FDA (Food and Drug Administration) to treat symptoms associated with ADHD. Please consult your physician if you have questions about medical treatments available to treat ADHD.

Coaching: These are typically brief appointments (15-30 minutes) that focus primarily on time management, planning, and organizational tasks. A coach helps persons with ADHD develop strategies for managing their academic responsibilities and monitors progress towards these goals.

Therapy: A therapist will typically address many of the same issues as a coach. In addition, therapy can be helpful in treating some of the issues frequently associated with ADHD, including low self-confidence, anxiety, and depression.

Academic Accommodations

If you are diagnosed with ADHD, you may be eligible for academic adjustments, modifications and/or auxiliary aids and services under the Americans with Disabilities Act (ADA) of 1990 and the Rehabilitation Act of 1973. Check with your university’s disability accomodations office to learn more about reasonable academic accommodations for the  forcognitive and/or psychiatric disabilities. 

Want to Know More?

Dawson, P. & Guare, R. (2016). The Smart but Scattered Guide to Success: How to Use Your Brain’s Executive Skills to Keep Up, Stay Calm, and Get Organized at Work and at Home. New York, NY: The Guilford Press.

Barkley, R. A. & Benton, C. M. (2010). Taking Charge of Adult ADHD. New York, NY: The Guilford Press.

Mahamane, S. “ADHD sucks, but not really.” TED. December 2015. Lecture.The ADHD Resource Centeraacap.org/aacap/Families_and_Youth/Resource_Centers/ADHD_Resource_Center/Home.aspx

 

 


 

  • Neuro-developmental factors
  • Neurophysiological deficits in several neurotransmitter systems
  • Pre-natal causes such as smoking and alcohol during pregnancy, prematurity, complications during birth, or exposure to toxins after birth
  • Genetic factors
  • Some other factors and actions are believed to cause ADHD in a person, however there is no evidence for these ideas, and all are considered myths.

Myth: Food additives and sugar cause ADHD.
Reality: The research does not support this explanation. Sugar and food additives may cause restlessness in anyone who consumes it, but it does not cause ADHD.

Myth: Excessive time viewing television or playing videogames causes ADHD.
Reality: The research does not support this explanation. Although individuals with ADHD sometimes engage in these activities more frequently than others, there is no evidence that it causes ADHD and there are good explanations why many individuals with ADHD prefer these activities.

Myth: ADHD is caused by poor parenting and/or intolerant teachers.
Reality: There is no research evidence to support this. There is evidence that caretakers experience frustration in response to symptoms associated with ADHD because hyperactivity and impulsivity can be difficult to manage, especially in a classroom.

Myth: Living in a fast paced, hectic society causes ADHD. This is why there has been an increase in the number of individuals diagnosed with ADHD.
Reality: There is no research evidence to support this. While ADHD had been more commonly diagnosed in recent years, there is no evidence of increased prevalence.

Myth: ADHD is a product of cultural factors within the United States and not a real medical condition.
Reality: There are similar prevalence rates of ADHD in most Western countries and prevalence of ADHD does not vary by race, ethnicity or socioeconomic status.

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