What is Attention Deficit Hyperactivity Disorder (ADHD)?
ADHD is a mental health disorder that affects attention, concentration and self-control. It can cause problems in school, relationships, and in work.
The symptoms of ADHD are common in children and adults. They are usually noticeable before age 12 and can be mild, moderate or severe.
Signs and Symptoms of ADHD
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects children, teenagers and adults. It causes a person to have difficulty paying attention, staying still and controlling their actions.
Kids, teens and adults with ADHD often struggle at times to focus on tasks, follow instructions or get along with others. Symptoms may vary from child to child and can be more severe in some people.
Inattention: This symptom looks like having trouble staying focused on schoolwork or listening to instructions during work or play. Inattention can also be seen in adults when they have trouble finishing work assignments on time or keeping up with bills.
Impulsivity: This symptom is when a person is too impulsive to think before they act. They might blurt out inappropriate comments or run into the street without looking. They might grab a toy from another child or hit when they are angry.
Adults who have ADHD are more likely to experience mood disorders, such as depression or bipolar disorder. They may have a hard time making and keeping friends, as well.
Despite the difficulties, ADHD is treatable and manageable with medications and other treatment options. A doctor can help you choose the right medication, dose and combination to best meet your needs.
Types of ADHD
Attention-deficit/hyperactivity disorder (ADHD) doesn’t look the same for everyone. There are three main types, each with its own set of symptoms.
People with ADHD are diagnosed by their doctor based on behavioral symptoms that meet the criteria for each type. These symptoms must be present in multiple settings for at least 6 months and can’t be explained by another mental health disorder.
Hyperactive and impulsive type ADHD: This is the most common form of ADHD in children and adults. These patients often exhibit signs of hyperactivity and impulsivity, such as running around or climbing where it’s not safe, shifting in their chair, fidgeting with their hands or feet, or squirming when they sit still.
Inattentive type ADHD: These patients aren’t hyperactive or impulsive, but they may find it hard to pay attention or focus on tasks. They may forget a birthday party, leave a message unanswered, or miss an appointment with a dentist.
In the past, these patients were diagnosed as ADD or attention deficit disorder. But now, they’re being called “presentations.” This is a term used in the current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to describe the different ways in which ADHD can affect a person’s life.
Causes of ADHD
The exact causes of ADHD are unknown, but it seems to be a combination of genetics and environmental factors. Various studies have shown that children who have a prenatal or early birth condition, such as premature delivery or low birth weight, are more likely to develop ADHD.
Likewise, children who have been diagnosed with brain trauma (a serious head injury) may also be more susceptible to ADHD symptoms. In fact, 1 in 5 children who sustain a TBI will develop ADHD symptoms.
If your child has ADHD, it’s important to get them diagnosed as soon as possible. Having a diagnosis will help them get treatment for their ADHD and related conditions, such as anxiety, depression, or behavioral problems.
A child with ADHD often has trouble concentrating on schoolwork or tasks that require sustained mental effort. They might also be forgetful about things that need to be completed or have trouble finishing projects and assignments.
They might be easily distracted by a busy schedule or by other people or events that seem to draw their attention away from the task at hand. They might be fidgety or squirm easily in their seats, and they might blurt out answers when they are asked questions.
How is ADHD Diagnosed?
If you or your child has symptoms of ADHD, it’s important to get a proper diagnosis. This is the first step to getting the right treatment.
Diagnosis is based on how the symptoms affect a person’s life, and whether they fit certain criteria. These criteria are usually met if a person has 6 or more symptoms of inattentiveness, or 6 or more symptoms of hyperactive-impulsive behavior, for the past six months.
Children and teens with ADHD have a particular set of behaviors, and these symptoms can vary in severity. They include inattentiveness (fails to pay attention), hyperactivity or impulsivity.
Adults with ADHD are diagnosed by a mental health professional after a thorough evaluation. This includes a physical exam, neurological assessment and other tests.
During the evaluation, your professional will ask you about your symptoms and how they impact your daily life. You’ll also be asked to bring school records, if possible.
Your doctor may want to talk to your parents or other people who knew you well when you were a child, as adults with ADHD often have a hard time recalling their childhood. This is because they have been able to hide or mask many of their problems over the years.
Treatsments for ADHD
The most effective treatment for ADHD is usually a combination of medication and therapy. Psychotherapy, especially cognitive behavioral therapy, can help you learn how to manage your symptoms and change negative thinking patterns into positive ones.
Stimulants (typically methylphenidate or amphetamine) work to boost and balance levels of neurotransmitters in your brain, mainly dopamine and norepinephrine. They come in a variety of dosages, from short-acting and immediate-release to extended-release.
Nonstimulants are also available, but they work more slowly than stimulants do and may not have the same level of effectiveness. These drugs are called norepinephrine reuptake inhibitors or alpha-2 adrenergic agonists.
In some cases, healthcare providers may prescribe antidepressants as an alternative to stimulants for treating ADHD. They are usually not as effective, but they may be less likely to cause side effects.
The medications used to treat ADHD can cause different side effects in people, so your health care team will tell you about them before you begin taking them. Some side effects go away with time as your body adjusts to the medicine. Other side effects may include jitteriness, moodiness and trouble sleeping. These effects usually happen within a few days or weeks after you start taking the medicine or when you change to a higher dose.
ADHD in Adults
If you’re an adult with ADHD, you might feel like it’s difficult to stay focused and organized at work or school. You might also have trouble remembering to keep appointments, underestimate how much time you need to complete a task, or struggle to stay on top of your finances.
ADHD can affect people of all ages, but it tends to begin in childhood. It’s believed that certain genes can play a role in developing ADHD.
In addition, the symptoms of ADHD may be influenced by other mental health conditions or physical conditions. This is why it’s important to get a thorough diagnosis by a trained professional who specializes in ADHD treatment.
As you might imagine, getting an accurate diagnosis can be challenging for many adults. It requires a detailed assessment and examination of your life history, including the ways that ADHD has affected your day-to-day functioning.
A doctor or mental health professional will also examine whether you have any other conditions that can mimic ADHD, such as anxiety, mood, learning disabilities and substance abuse. These co-existing difficulties can be treated by addressing them in ways that incorporate skills such as mindfulness, cognitive behavioural therapy and acceptance-commitment therapy.
Medications for ADHD are the most effective treatments for children and teens with symptoms. They can help kids focus their attention and improve impulse control. They’re also helpful for adults who have a hard time managing their work or home lives.
Stimulant medications are the most common type of medication doctors prescribe for ADHD. These medicines target two brain chemicals called dopamine and norepinephrine.
They have a long history of treating ADHD and have the best track record for effectiveness. They can be used alone or with therapy, behavior changes, and skills training.
Immediate-release (short-acting) stimulants, such as methylphenidate (brand names Ritalin, Concerta, Daytrana, Focalin), or lisdexamfetamine, usually are taken once or twice a day. Extended-release formulations are more convenient, since they last 8-12 hours and don’t need to be taken as often.
Side effects from stimulants may include irritability, depression, and mood changes. They can also lead to a rebound effect, where ADHD symptoms return when the medication wears off.
Most people with ADHD respond better to longer-acting or extended-release formulations of stimulant medication, which build gradually in the bloodstream and then slowly wear off. This helps minimize the ups and downs caused by fluctuating doses and prevents the rebound effect.
Children with anxiety disorders such as Selective Mutism can have significant difficulty coping with situations that cause them distress. When a child with an untreated anxiety disorder is put into an anxiety-inducing situation, they may become oppositional in an effort to escape that situation or avoid the source of his acute fear.
In this video, we provide practical tips for parents of children with anxiety disorders such as Selective Mutism.
Learn more about Selective Mutism:
Learn more about Anxiety Disorders: