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Attention Deficit Hyperactivity Disorder (ADHD)

ADHD

What is Attention Deficit Hyperactivity Disorder (ADHD) 

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by an individual’s inability to focus or pay attention. ADHD is a disorder that usually develops during childhood, but is sometimes not even diagnosed until adolescence or adulthood. ADHD sufferers exhibit restlessness, impulsiveness, and a sense of disorganization. They are also extremely impatient and easily distracted, even when doing something that interests them. ADHD is often viewed as a learning disorder because it can interfere with the learning process in a dramatic way. 

History of ADHD

ADHD was first loosely described by Dr. Heinrich Hoffman in 1845. In 1902, Sir George F. Still published a series of lectures in England describing a small group of children who exhibited significant behavioral problems caused by dysfunctional genetics as opposed to bad child-rearing. Since that time, ADHD has gone through a significant period of being defined and redefined over and over again. It is important to note that until the late 80s and early 90s, ADHD was known as ADD (Attention Deficit Disorder) ADD and ADHD are essentially the same disorder, with the noteworthy distinction of ADHD including hyperactivity.

ADHD Controversy

There is a lot of controversy surrounding the diagnosis of ADHD. Some individuals find the addition of “hyperactivity” to the diagnosis inaccurate, superfluous, inappropriate and even offensive. Because the disorder is often seen in children first, many believe that it is over-diagnosed, or a fraud perpetuated by the psychiatric and pharmaceutical industries on families trying to understand their excitable child. There is little that is understood about ADHD from a scientific perspective.

There is no proof of a brain abnormality with ADHD, and the cause of it is unknown. There are no laboratory tests or radiological tests that can prove that an individual has ADHD. Additionally, the criteria for ADHD changes on a fairly consistent basis, so there is wide speculation among some that the disorder is “made up.” There is no curative treatment, and so ADHD therapy is long-term and ongoing. Some of the drugs allocated for the disorder are considered to be highly addictive, and some of the side effects are dubious. Finally, the fact that treatments differ so drastically from country to country make the diagnosis of ADHD less credible to some.

ADHD Types

There are three predominant types of ADHD:

Predominantly Hyperactive-Impulsive type - Sufferers with this type exhibit most symptoms (i.e. six or more) in the hyperactivity-impulsivity category. Fewer than six symptoms of inattention manifest themselves, but inattention is still an issue to some extent.

Predominantly Inattentive type - This type of ADHD sufferers experience a majority of symptoms in the inattention category, and fewer symptoms in the hyperactivity-impulsivity category. Children with this subtype can be overlooked, because they will generally sit quietly without paying attention at all, therefore no one notices them.

Finally, there is a Combined Hyperactive-impulsive and Inattentive type of ADHD wherein most symptoms of both types manifest themselves. Most children with ADHD have this combined type.

ADHD Prognosis

ADHD continues on into adulthood in roughly 30%-50% of diagnosed cases. Those living with ADHD develop coping mechanisms of some kind in order to manage the disorder. Children diagnosed with ADHD tend to have an extraordinarily hard time with adolescence. Many, despite receiving special care and attention, will not even obtain a high school diploma. Detention, expulsion and drop-out rates are high among those with ADHD. Very few will ever go on to pursue a college degree. Because their attention span is so short, those with ADHD tend to thrive in less structured environments where there are fewer rules.

ADHD Symptoms

ADHD symptoms are varied, and they can manifest themselves in different ways in different people. ADHD is typically marked by an inability to focus or pay attention to details. ADHD sufferers have difficulty completing tasks, employing diligence with follow-through, are easily distracted, lose track of appointments, make careless mistakes, have trouble with organizational principles, are impatient, are fidgety and restless, are excessively talkative, etc.

Commons things you should look for:

Inattentive:
  • Lacks attention to detail and often makes careless mistakes in school or other activity
  • Has a hard time keeping his or her attention on task or play activities
  • Doesn't listen when spoken to
  • Often avoids tasks that require a sustained mental effort
Hyperactivity:
  • Frequently fidgets or squirms
  • Has difficulty playing or engaging in leisure activities quietly
  • Never has "down time"
  • Talks excessively
Impulsive:
  • Difficulty waiting for his or her turn
  • Interrupts or intrudes on others
  • Answers questions before they have been completed
  

ADHD Myths and Facts 

Many people think that if you have not been diagnosed with ADHD as a child, you cannot have it as an adult. This is incorrect. Many people struggle with ADHD their whole lives and are never diagnosed, are misdiagnosed, or are diagnosed very late in life. They usually attribute their symptoms to other problems and don't get the necessary help. Additionally, someone with ADHD is six times more likely to suffer from other psychiatric disorders or learning disorders, contrary to popular belief. ADHD almost always accompanies some other major ailment. ADHD affects people of all intelligence levels, and it's not a disease that is easily overcome. Everyone could be said to exhibit mild symptoms of ADHD from time to time, but when symptoms completely impair abilities, an actual diagnosis is warranted.

Common Myths About ADHD/ADD

Myth #1: All kids with ADHD are hyperactive.

Myth #2: Kids with ADHD can never pay attention.

Myth #3: Kids with ADHD choose to be difficult. They could behave better if they wanted to.

Myth #4: Kids will eventually grow out of ADHD.

Myth #5: Medication is the best treatment option for ADHD


What You Should Know About ADHD

ADHD may accompany other disorders as well, such as anxiety and depression. When coupled with other disorders, ADHD becomes harder to diagnose and treat in any meaningful way. Depression especially seems to be prevalent with ADHD. As children get older, depression magnifies, and seems to be more common in females than in males. The hyperactivity that is abundant during childhood tends to fade and disappear in adulthood, though behavior might still be marked by inattentiveness. 

ADHD Causes

There is no exact cause for ADHD. Researchers have identified several different factors that may contribute to the disorder, but no root cause has ever been established.

Genetic Factors

Many studies have shown that ADHD is very likely a highly heritable disorder, and that genetics are a factor in 75% of ADHD cases. Researchers believe that many ADHD cases occur as a result of a combination of various genes, many of which affect dopamine transporters. ADHD does not behave in the same way as other, more “traditional” models of genetic diseases. Even though all of the dopamine transporters could play a role in contributing to ADHD, but no single gene has demonstrated that it contributes to ADHD.

Environmental Factors

Studies have shown that anywhere from 9%-20% of ADHD cases can be attributed to environmental factors. Alcohol and cigarettes have been marked as primary environmental factors, and consumption of them during pregnancy could result in ADHD symptoms. Exposure to nicotine can lead to hypoxia, or a lack of oxygen to the fetus while it is still in the womb, and this could contribute to ADHD. It’s also possible that the mother herself has ADHD and is prone to smoke, so the combination of her genetics and the smoking could result in her offspring having ADHD. If there are any issues during either the pregnancy or the actual birth, it could contribute to the ADHD.

Diet

Studies have shown that proper diet can help some ADHD sufferers, but there isn’t a lot of scientific evidence that diet has a dramatic effect. Many parents choose to minimize or eliminate additives from their child’s diet. This can help with symptoms in some ADHD children. Their hyperactivity may be reduced with proper diet. Other parents attempt to remove sugar from the diet, but again, there are no scientific studies that prove that this helps.

Social Factors

There is also a lack of scientific evidence that social factors alone can cause ADHD, but some researchers believe that relationships, especially those with the caregiver, have a profound effect on the child’s ability to self-regulate and discipline him or herself. Studies have been done in foster care, and high percentage of individuals showed signs of ADHD. Children who had also suffered from violence and emotional abuse showed strong signs of ADHD as well.

ADHD in Children

ADHD is a disorder that is a common childhood illness that can be treated. The trick with ADHD is identifying it in the first place. It is a health condition that occurs as a direct result of biologically active substances in the brain. ADHD may affect problem solving, understanding of others' actions, planning ahead, and impulse control.

The AACAP (American Academy of Child Adolescent Psychiatry) requires that the following behaviors be present before an ADHD diagnoses is given: the child must exhibit the behaviors before the age of 7, the behaviors must continue for a period of longer than six months, and the behaviors must significantly cripple the child in the classroom, the community, at home, on the playground, or in social settings.

ADHD is very difficult to diagnose, and many other triggers, such as divorce, death in the family, ear infections, undetected seizures, and anxiety or depression can lead to activity that can be mistaken as ADHD.

Adult ADHD

What is adult ADHD? We all know that children can be diagnosed with ADHD or attention deficit hyperactivity disorder, but Adults can also have ADD? Many adults don't even know they have ADHD, but it's something that if undiagnosed can cause problems dealing or relating with other people, concentration problems and a lack of self-confidence. Just because you didn't have ADHD as a child or an adolescent doesn't mean that it won't develop later in life (but it can be missed by doctors). In some cases the ADHD won't show up until adulthood. People who struggle with ADHD have a chemical imbalance and it is something that they cannot help.

Adult ADHD Symptoms

  1. Trouble with concentration to an extreme degree
  2. Keeping things organized at home and work might be an enormous challenge
  3. Finding yourself easily bored, irritated and experience mood swings
  4. You might have a pattern of making sudden decisions “on a whim” or have trouble listening to others
  5. You might have trouble following a conversation, interrupting others, answering before a question has been asked, or blurting out things you regret later

ADHD Treatment

Medication

Medication is usually an imperative for ADHD sufferers. ADHD candidates are usually prescribed stimulants to take to manage their illness. Some of the more common stimulants are Ritalin, Dexedrine, Desoxyn, and Adderall. Often times, off-label antidepressants are also prescribed. Researchers are still not sure about the cumulative effects of prescribing these drugs or whether they improve academic performance and social behaviors or not. These stimulants are not recommended for younger children.

These stimulants work by raising the concentration of dopamine and norepinephrine, which sparks an increase in neurotransmission across the brain. Under medical supervision, these stimulants are considered “safe” to take, but there has been controversy because it is uncertain whether there are long-term effects. There is also a bit of a social and ethical stigma surrounding these medications, and children must be rigorously tested for any heart problems before ever being subscribed these stimulants.

Therapy

Most ADHD sufferers benefit most from coupling medication with various types of therapy. The most common therapies for ADHD are behavioral therapy, cognitive behavioral therapy, psychoeducational therapy, interpersonal psychotherapy, and family therapy. Education and parent training can be somewhat useful, but ADHD is a solipsistic disorder: surrounding family and friends lack the ability to get into an ADHD sufferer’s head to “fix” the problem. There are many ADHD support groups that can help you come to terms with the disorder.

Therapy works more slowly than medication, but there are parents who really wish to avoid medicating their child, and understandably so. If you are an extremely dedicated parent, you will reap the benefits of working with your child to combat ADHD. Therapy largely entails communicating expectations, setting up routines, using the time-out method for undesirable behavior, practicing good behavior and discussing poor behavior before setting out on a social engagement, etc. Therapy takes discipline in order to work effectively, and you must be extremely consistent in your methods.

Online therapy is a good alternative to treat OCD. Studies show that online cognitive behavioral therapy (CBT) is just as effective as traditional face-to-face therapy. If you need dedicated online-based team of consultant therapists, cognitive behavioral therapists, practitioners and support staff that collaboratively works to help people in need of emotional support you may join by clicking here → CBT based Online Therapy

Experimental Methods

Some claim that adjusting your diet can alleviate many of the symptoms of ADHD. Some children respond well to the addition of Omega-3 supplementation as it can reduce some symptoms in a certain sub-group. EEG biofeedback (or neurofeedback) has been somewhat effective in treating the hyperactivity, impulsivity and attention in some children. Exercise can help as well, especially with younger boys experiencing ADHD. Athletics can sometimes lead to social acceptance, which can suppress some of the anxiety that accompanies ADHD.

Intervention

Sometimes behavioral intervention is needed with ADHD. Behavioral treatments can be interpersonal psychotherapy, cognitive behavioral therapy, psychoeducational input, family therapy, school-based interventions, etc. Some of these endeavors are successful, and some are not. It depends on the child and the severity of the ADHD.

There are several ADHD support groups out there that function as informational sources as well as centers to help families cope with ADHD. Studies have found that many children who suffer from ADHD move around a lot when trying to complete a task, as constant movement helps keep them awake and on point for the challenge. It is advised that you let them fidget, as preventing them may be counterproductive.

Developing an ADD / ADHD treatment plan

Once the treatment team is in place, the next step is putting together a personalized treatment plan that addresses you or your child’s specific needs. Family involvement in treatment improves the chances of success, which is why it’s so important to work closely with the treatment team.

The most effective treatment for ADD / ADHD tackles the problem on multiple fronts. This comprehensive treatment strategy is known as the multi-modal approach. Elements of the multi-modal approach include:
  • Education about ADHD (for both the person with ADHD and the parents, spouse, or other family members)
  • Behavioral intervention strategies
  • Parent training
  • A specialized educational program
  • Medication, when necessary



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