What is ADHD?
While it’s common for young children to have trouble paying attention or acting impulsively, the symptoms of ADHD are more severe. For a person to be diagnosed with the disorder, these symptoms must have been present before age 12 and cause significant dysfunction in several settings, such as at home, school and work.
Signs and Symptoms of ADHD
The most common symptoms of ADHD include trouble paying attention, forgetting things and/or being impulsive. Symptoms may also interfere with school or work performance and lead to problems in relationships, family life and finances. The disorder is often overlooked or misdiagnosed, so it’s important to find a health care provider who has experience in caring for adults with ADHD.
People with inattentive ADHD have trouble staying focused on tasks and activities, making frequent errors and having trouble finishing work on time. They may be easily distracted and seem to daydream or zone out without realizing it, even in the middle of a conversation.
Those with hyperactive/impulsive ADHD always seem to be in motion and have difficulty sitting still or waiting their turn. They have a hard time playing or engaging in leisure activities quietly and have trouble with quiet activities such as homework or reading. They frequently interrupt or intrude on others during conversations, games and activities.
The specific symptoms of ADHD are different for each person, and they may get worse or better with age. Some symptoms, especially those related to inattention, may go away on their own as they grow older or develop coping skills. Other symptoms of the hyperactive/impulsive type are more persistent.
Types of ADHD
In order to be diagnosed with ADHD, children must display symptoms that are more severe than typical for their age and developmental level. In addition, the symptoms must cause significant problems in at least two settings, such as home and school. For example, a child may have trouble sitting still or waiting their turn and frequently interrupts others or blurts out answers before they are finished.
Symptoms of inattention, hyperactivity and impulsivity continue into adulthood and can have serious consequences for work, school and relationships. It’s important to understand that there are three different types of ADHD, and figuring out which one you have can help you find the right treatment plan.
Inattentive ADHD, also known as ADD, is the most common form of ADHD in adults. Those with ADD have difficulty paying attention to everyday tasks and often become bored easily or make careless mistakes. They also have trouble organizing their thoughts or following through on things they’ve agreed to do. People with this type of ADHD are more likely to be boys than girls. Hyperactive-impulsive ADHD is less common in adults, but it can occur at any time in a person’s life. This type of ADHD is characterized by symptoms of impulsivity and hyperactivity, and more often affects girls than boys.
Causes of ADHD
A variety of medical and psychological conditions can cause symptoms that look like ADHD. These include learning disorders, mood and anxiety disorders, thyroid problems and other neurocognitive disorders. Certain medications and head injuries can also cause symptoms that mimic ADHD.
Even children who only have inattentive ADHD may need help. They often get into trouble at school, aren’t able to follow their parents’ rules at home and have difficulty playing and interacting with other kids. Their frustrations and difficulties can cause friction and stress for the entire family.
Many experts believe that a combination of genetic and environmental factors plays a role in the development of ADHD. They are also looking at the role of certain chemicals that transmit signals between nerve cells in the brain.
Some children are naturally more active than others, and this can make it difficult for them to pay attention or stay focused on tasks for long periods of time. For these children, a doctor may suggest that they participate in sports or other physical activities to burn off extra energy. They may also recommend putting reminder notes or alarms on their calendar, or keeping important items in specific places to avoid forgetting them.
How is ADHD Diagnosed?
To be diagnosed with ADHD, a person must display symptoms that interfere with their everyday functioning. These symptoms must occur for at least six months and be consistent across multiple settings. To diagnose the different subtypes of ADHD, providers use a variety of tools and scales to assess individual symptoms. These are outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR).
A thorough evaluation is important for diagnosing ADHD. For children, this may include interviews with teachers and parents. It is also helpful for a child to be assessed in more than one setting because behaviors don’t always happen in the same environment. Other caregivers, such as former teachers, religious and scout leaders, coaches, or social workers, may also be able to provide valuable information.
For adults, it’s important to be as honest as possible about your symptoms. It’s also important to bring any medical, psychological, or school/work records with you to the evaluation. Many people who are evaluated for ADHD get a referral to a specialist from their primary care doctor or a therapist they already see. It’s also a good idea to research professionals online and check what their rates are before making an appointment.
Treatsments for ADHD
Treatment for ADHD can help improve day-to-day functioning and reduce symptoms. The most common treatment is medication. Doctors prescribe stimulant medications to boost brain chemicals that control attention and behavior. These medications are very effective and safe for children and adults when used as directed. It may take a few tries to find the right medicine and dose that works best for each individual person.
Nonstimulant medicines are also available for children. These medicines are less powerful and generally cause fewer side effects than stimulants. Your child’s provider may recommend combining these medicines for optimal results.
Other treatments include therapy or coaching and lifestyle changes. Behavioral therapy helps people with ADHD develop or strengthen positive behaviors, learn skills to manage their symptoms and eliminate harmful or concerning habits. Psychotherapy (sometimes called talk therapy) can also be helpful for adults with ADHD. These therapies can improve organization, planning, time management and resolve thinking distortions that contribute to negative moods and poor self-esteem.
Diet and exercise can also make a difference in how well your child performs at school or home. A balanced diet that includes fish, vegetables and whole grains may help with symptoms of ADHD. Regular exercise can help children focus and concentrate better. A structured routine for meals, naps and chores can help some children with ADHD stay on track.
ADHD in Adults
People with ADHD are more likely to make careless mistakes and misunderstand instructions. They are also more likely to be late for appointments and miss work deadlines. These problems with attention can cause stress and lead to failure in school, work and relationships. Undiagnosed and untreated ADHD can have serious consequences, including social problems, depression, substance abuse, incarceration, accidents and job loss. Many adults struggle all their lives with unrecognized ADHD symptoms, believing that they are “lazy,” “irresponsible” or “stupid.”
In addition to interviews with the patient and family members, a psychiatric evaluation may include observations by others, questionnaires for the patient and caregivers, a physical exam, educational and occupational records, psychological testing, medical history and information about the person’s family, environment, upbringing and education. Medications that increase brain chemicals like norepinephrine are often used to treat adults with ADHD.
Treatment for adult ADHD includes cognitive-behavioural therapy, couples counselling and medication. Psychotherapy can help people learn to recognize and challenge negative thoughts and assumptions, improve communication and develop a more positive self-image. Couples therapy can help people with ADHD manage their relationship more effectively and understand how their difficulties relate to their ADHD. Medication can alleviate symptoms and improve functioning in work, school and home life.
Medications help control ADHD symptoms, but they don’t treat all of them. The medication is prescribed by a health care provider, and it takes time to find the right dose and schedule for each person.
The most common type of prescription medication for ADHD is called a stimulant. It helps about 70% to 80% of people with the condition. These medicines boost levels of chemicals (neurotransmitters) in your brain that play a role in paying attention and thinking clearly. Stimulant meds have been used for decades and are considered safe when taken under medical supervision.
There are two types of stimulant medications for ADHD: short-acting and extended-release. Short-acting meds are taken as needed and last for about an hour or less. You can get them as pills, liquids, or chewable tablets for children who have trouble swallowing pill-shaped meds. You can also get extended-release pills that are taken once a day in the morning and last from six to 16 hours.
Doctors may also prescribe non-stimulant drugs, which take longer to work than stimulants and are usually prescribed for adults with moderate to severe ADHD. These include atomoxetine and certain antidepressants, such as bupropion. They don’t work as well as stimulants, but they can help improve concentration and impulse control.