What is ADHD?
People with ADHD aren’t “bad,” “bad kids” or “lazy.” They just have trouble filtering their impulses. This is how their brains have always worked.
Researchers think that genes and the environment contribute to ADHD. Many studies show that ADHD runs in families. Treatment can help reduce symptoms and improve functioning at home, school and work.
Signs and Symptoms of ADHD
ADHD can be very difficult for adults who struggle with it. Many symptoms that are obvious in children—for example, daydreaming or losing track of things, being unable to sit still and listen to others, acting impulsively, and forgetting to finish tasks—may appear more subtle in adults. But when these issues interfere with life at work, at home, or in social interactions, they may be signs of untreated ADHD.
In adults, untreated ADHD can lead to serious consequences. For example, you might have trouble managing work and financial obligations. You could also run into difficulties with personal relationships because of forgetfulness or trouble following instructions. It’s important to remember that it’s not your fault that you can’t seem to stay organized or follow through on your promises.
People with ADHD are more likely to suffer from depression or anxiety, and the symptoms of both conditions often overlap. If you’re struggling with ADHD and feeling depressed or anxious, talk therapy can help you manage both disorders and improve your quality of life.
Types of ADHD
Symptoms of ADHD can manifest in a number of ways. They may appear as a persistent inability to keep track of things, trouble finishing tasks on time, or an inability to control impulses. People with these symptoms may have trouble forming and maintaining relationships, struggle at school or work, and have problems with self-esteem.
There are several subtypes of ADHD, and the type a person is diagnosed with will depend on their age and the specific symptoms they display. Children with the inattentive type of ADHD are characterized by difficulty paying attention, but not by hyperactivity or impulsivity. They may also make careless mistakes or misplace things frequently. People with the hyperactive-impulsive type of ADHD generally fit the stereotype of a hyperactive child bouncing off the walls. This type of ADHD is more common in children than in adults.
The combination type of ADHD is characterized by a mixture of symptoms from both the inattentive and hyperactive-impulsive types. In order to be diagnosed with this type of ADHD, a person must show six out of nine symptoms in more than one setting (such as home and school) for at least six months. They must also not have any other conditions that could explain their symptoms.
Causes of ADHD
While people with ADHD have more attention than most, they have trouble directing it in the right ways. This is due to problems with how the brain works. Brain imaging studies show that certain brain networks work differently in people with ADHD. Chemicals that transmit signals from nerve cells also play a role in the disorder.
Symptoms of ADHD typically appear during childhood and adolescence, although they can persist into adulthood. NIMH researchers believe that genes and the environment may contribute to the development of ADHD. They also think that maternal stress and smoking during pregnancy may increase the risk of ADHD.
The newest version of the Diagnostic and Statistical Manual of Mental Disorders describes 3 subtypes of ADHD: inattentive, hyperactive/impulsive, and combined presentation. Providers assign these labels based on the symptoms that a person experiences. In addition, a person with ADHD can change from one subtype to another over time.
Unlike inattentive ADHD, hyperactive/impulsive ADHD is marked by extreme fidgeting and restlessness, an inability to sit still or focus, and a tendency to interrupt and speak without thinking. In adults, this can look like a person being constantly on the go, forgetting to complete important tasks, and blurting out thoughts without thinking about them.
How is ADHD Diagnosed?
In order for doctors to diagnose ADHD, a person’s symptoms must occur in two or more settings and cause significant problems at school, work or home. They must also start before the person is 12 years old, and they must have had the symptoms for at least six months. Doctors will also evaluate whether another disorder explains the symptoms, such as anxiety or depression.
Mental health professionals may also help parents and children manage negative feelings, such as frustration and blame, that often arise when a child has an attention-deficit/hyperactivity disorder diagnosis. They can educate the family about ADHD and its effects, teach them new skills and ways of interacting with each other, and help them develop positive strategies to improve their functioning.
People with primarily hyperactive/impulsive type display at least six of nine behaviors, including fidgeting with or tapping feet or squirming in their seat; having trouble playing or engaging in leisure activities quietly; leaving their seat when it’s not appropriate; and blurting out answers before they have the chance to think them through. These symptoms are a sign that someone’s frontal lobe, which controls planning, paying attention and using language to moderate behavior, is underdeveloped.
Treatsments for ADHD
Standard treatments include medication and behavioral therapy. The most effective medications are stimulants, which improve symptoms in 70-80% of children within a few weeks. They work by boosting and balancing levels of chemicals called neurotransmitters. Examples of stimulants are dextroamphetamine and amphetamine (Dexedrine, Adderall XR, Mydayis) and methylphenidate (Concerta, Ritalin). Nonstimulants are also available and may take longer to act.
To be diagnosed with ADHD, a child or teen must have significant trouble at home and school due to hyperactivity, impulsivity and inattention. The symptoms must have been present before age 12, and they must be recurrent and ongoing. The doctor will review a patient’s medical history and do a health check to make sure another illness is not causing the symptoms.
For children and adolescents with ADHD, a psychiatrist or psychologist can provide psychoeducation, which helps the patient and family learn to cope with the disorder. Behaviour therapy involves teaching strategies to improve concentration and self-control. It may also include parent coaching and social skills training, or both. Many kids with ADHD have comorbid problems, such as learning disorders, oppositional and defiant behavior, depression and anxiety. Doctors treat these problems along with ADHD. Mood lability, which is sometimes seen in conjunction with ADHD, is usually treated with antidepressants.
ADHD in Adults
Many adults are unaware that they have ADHD. They may have problems at work or in their personal lives, such as missing deadlines, forgetting appointments, or causing tension in relationships. They may feel frustrated, guilty or blame themselves for these problems. Women are more likely to experience these symptoms than men. They are also better at disguising their behaviors.
Stimulant medications are typically the first treatment recommended for adults with ADHD. These medications increase brain chemicals that improve focus and concentration. They are generally considered safe and effective when taken under medical supervision. However, they can interact with certain drugs used to treat common health conditions, like high blood pressure or depression. It is important to tell your doctor about all medications and supplements you are taking.
In some cases, your doctor may recommend a non-stimulant medication. These drugs take longer to work but can help improve attention, focus and impulsivity in adults with ADHD. They can be used alone or in combination with stimulants to increase their effectiveness. Other psychosocial interventions have been shown to be helpful for adults with ADHD. For example, group therapy can improve functioning and self-esteem in adults with ADHD.
Stimulant medications have been used to treat ADHD for several decades. They work for 70% to 80% of people and may help improve symptoms like concentration and impulse control.
These medicines boost levels of the brain chemicals dopamine and norepinephrine, which play an important role in thinking and attention. They are considered safe when taken under medical supervision. However, they can have side effects. The most common are jitters, headaches, and trouble sleeping.
Your doctor will prescribe a medication that fits your needs and medical history. Many children need to try different medications before finding one that works for them. The dosage and schedule will also be adjusted over time to get the best results and control possible side effects.
There are two main types of stimulant ADHD medication: methylphenidates and amphetamines. Methylphenidate is the most commonly used. It comes in a variety of forms (including chewable tablets, liquid, and a skin patch) and is sold under various brand names, including Adderall and Concerta. Dextro-amphetamines are similar to methylphenidates and work in the same way, but they have different side effects.
Other types of ADHD medicines work differently but can still improve concentration and impulse control. Your doctor might prescribe them if you have intolerable side effects from stimulants or if they didn’t help you. These include norepinephrine reuptake inhibitors and alpha-2 agonists, which are often prescribed together because they work on the same brain chemicals.
What is Social Anxiety Disorder? Is it simply a severe form of shyness? Join Dr. Granet as he talks with leading expert, Dr. Murray Stein, about this disorder that affects approximately 5% of the general population. Find out the symptoms and latest treatments that are available. Recorded on 3/1/2007. [3/2007] [Show ID: 12228]
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