What is ADHD (Attention Deficit Hyperactivity Disorder)?
ADHD is a mental condition that affects the way one focuses and acts. It was formerly called ADD (Attention Deficit Disorder), however, this terminology is now considered outdated.
ADHD is one of the most common conditions in childhood, affecting over 11% of children between the ages of four and 17. ADHD is a very broad term, with the conditions varying from case to case. It is a chronic illness, and children affected will continue to show symptoms into adulthood.
If your child has ADHD (Attention Deficit Hyperactivity Disorder), he/she may battle with self-esteem issues, have troubled relationships and perform poorly at school. The symptoms often diminish as your child gets older, however, it is often the case that symptoms persist and become more prominent, continuing into adulthood.
There is no cure for ADHD, however, treatment can assist in combatting and lessening the symptoms.
Treatment commonly involves behavioural strategies and techniques as well as medication. The earlier the diagnosis, the higher the rate of success in dealing with the symptoms.
The following article explains all that you need to know about the condition, from symptoms to treatment, it is our hope that after reading this, you will walk away feeling educated and prepared for the challenges involved in dealing with such a condition. It is vital to note that this information is intended to serve as a guideline only and should in no way be seen as a professional opinion. If you feel that your child may have ADHD, it is best that you consult with your doctor for an accurate diagnosis.
What are the symptoms and types of ADHD?
There is a common misconception that if a person has trouble paying attention or is constantly fidgeting with something, they have ADHD. However, most children display these sorts of symptoms at one time or another and these behaviours may be encountered in adults experiencing periods of stress and anxiety.
The issue comes in when these symptoms, along with others yet to be mentioned, start to interfere with one’s ability to perform well at school or work and becomes an issue at home. In these circumstances, it may be advisable to consult a doctor in order for the child or adult concerned to be evaluated for ADHD.
In order to be diagnosed with the condition, there are a number of criteria that one has to meet, in children the symptoms must be present for over six months, be inappropriate for the child’s level of development and have a direct, negative effect on their academic and social activities. In adolescents over the age of 17 and adults, five or more of the classic symptoms must be present.
Types of ADHD
ADHD has three primary types, which can also be considered symptoms. With each of these types, there are a number of symptoms that belong to them. Children below the age of 16, will need to have six or more symptoms present, and, as mentioned above, if someone is over the age of 17, they need only have five symptoms present for a diagnosis to be made.
These three types/symptoms are:
In order for ADHD (Attention Deficit Hyperactivity Disorder) to be diagnosed, a paediatrician, psychologist, or a psychiatrist will have to conduct a comprehensive evaluation of the patient. To be diagnosed with the condition, the symptoms of one of the above three types must be long-lasting and interfere with the person’s ability to function normally. The doctor will also ensure that the symptoms are not the result of another medical issue. Most children who are diagnosed with the condition are under the age of 12 (symptoms have been known to appear in children as early as the age of three), if an adult is diagnosed, the symptoms need to have been present before the age of 12.
ADHD symptoms are able to change and develop over time. Usually, the first symptoms of this disorder are hyperactivity and impulsivity. When the child becomes an adolescent, their hyperactivity may lessen, however, inattention is likely to remain.
The three types or groups of symptoms for ADHD are explained as follows:
When it comes to ADHD, inattention may refer to a child or adult being easily distracted.
In this case, doctors will sometimes diagnose your child with ADD (attention deficit disorder), as their symptoms do not show those of hyperactivity. You may not notice these symptoms until your child goes to school, and in cases of adult ADHD, it is sometimes easier to notices these symptoms at work or in social interactions.
Procrastination in completing tasks, not completing homework or household chores, or frequently moving from one activity that is yet to be completed to another one, are some of the common symptoms of inattention.
In addition, the child or adult may also display the following symptoms:
- Missing or overlooking details, and/or making thoughtless mistakes in their schoolwork or work.
- Having issues with paying constant attention in conversations, playing, lectures, meetings or tasks.
- Seeming distracted when someone is talking to them and may appear as though they are not listening properly.
- Quickly losing focus on tasks and chores and not follow instructions correctly.
- Having issues when organising activities and tasks.
- Not being able to follow a sequence when completing activities or organising.
- Having poor time management and not being able to meet deadlines.
- Disliking or avoiding tasks that require a mental effort that is sustained.
- Always losing things like tools, wallets, keys, spectacles, cell phones and other belongings.
- Forgetfulness regarding chores needed to be done, daily activities or forgetting meetings.
Hyperactivity, which is often grouped with impulsivity, tends to vary with age. It might be difficult to notice in children during their preschool years, but these symptoms seem to become more prominent in primary school/middle school.
Children may seem to constantly be in motion or moving when they are hyperactive. They often have issues holding a conversation as others may struggle to follow their train of thought, they also may find it difficult to sit still and often battle to listen to the end of a story.
Children with hyperactivity may also display the following symptoms:
- Talking excessively
- Appearing to always be on the move
- Having issues being quiet and completing quiet tasks
- Constantly getting up and walking around
- Often squirming and fidgeting in their seats
- Climbing or running when it does not seem appropriate
In adults and teenagers, the symptoms of hyperactivity often come across as restlessness, they may also be easily bored and battle with keeping still or being quiet in order to complete activities.
Impulsivity has been known to lead to accidents such as knocking objects over or bumping into people. To be impulsive means to act without giving thought to your actions. If your child has ADHD, impulsivity may mean that they do not think about consequences and will often undergo dangerous or risky activities or have behavioural problems that come across as rude. Making friends and maintaining these relationships is often difficult.
Although not thinking about consequences is common in children, impulsivity with ADHD means that they often act impulsively at inappropriate times regardless of previous lessons or discipline.
Other symptoms of impulsivity include:
- Being impatient
- Having a hard time when waiting to talk or react
- Battling to wait their turn for something
- Blurting answers out before the question is finished being asked
- Starting conversations when it is an inappropriate time or topic
- Constantly interrupting others in a way that causes school, work or social issues
Furthermore, in adults, symptoms of impulsivity may extend to the following:
- Reckless spending
- Risky behaviour including sexual promiscuity, gambling, driving recklessly.
It is also possible for all of these symptoms to be combined.
Inattention, hyperactivity and impulsivity are key behaviours of ADHD. Some people who have the condition may only experience issues with one of these behavioural types, whilst others have a combination of all three. Children and adults may have a combination type of ADHD.
When children are in preschool, their symptoms are typically those of hyperactivity, however as they age, other symptoms may become apparent, leading to a combined ADHD diagnosis.
It is important to note that some of the general ADHD symptoms mentioned under the types above are common in most children, however, those with ADHD experience these symptoms more often, in more severe forms and often have issues with them interfering with their school, work and home life.
The following are additional criteria for an ADHD diagnosis:
- The display of symptoms of ADHD before the age of 12 years old.
- The display of symptoms in more than just school or work, but also at home or in other social activities.
- The symptoms clearly interfere with the person’s functions at school, work and home.
- The symptoms are not the result of other mental conditions such as anxiety, depression or any other mood disorder.
ADHD in Adults
ADHD in adults has often been present since they were children, however, it may only have been diagnosed later in life. ADHD often appears differently in adults than it does in children due to physical and developmental differences between adults and children. An adult may be diagnosed with one of the above-mentioned ADHD types after a careful evaluation has been conducted by a trained medical professional or specialist.
The severity of ADHD
The symptoms of ADHD range from mild to severe, however the level of severity is dependent upon the person’s own physiology and surrounding environment. . While mild symptoms are usually evident enough just to make the ADHD diagnosis, they usually only have a minor impact on the sufferer’s work, school, social and home life. In moderate ADHD cases, symptoms are more noticeable and there is some functional impairment in the person’s personal and professional or academic life. In more severe cases, multiple symptoms over and above those needed to make a diagnosis are evident, with multiple symptoms being acutely severe, and having a negative impact on the person’s functionality at school, home or work.
Some adults who had ADHD as children have said that they have managed to kerb some of their symptoms through learning how to recognise and control them. Adults who still exhibit some ADHD symptoms, but not all of those they had as children, are often said to have ADHD in partial remission.
What are the causes of ADHD?
The exact cause of ADHD is not yet known, although continuous research is being conducted. Researchers have identified a number of factors that may be directly responsible for the development of ADHD. These factors, which can be seen as risk factors, are as follows:
- Genetics – ADHD has been known to run in families, and studies have been done to show that genes may have a role to play.
- Environmental toxins –Certain factors such as lead exposure that can be found in pipes and paint in old buildings have been seen to play a part in ADHD.
- Development – Issues at key moments within the central nervous system may be linked to ADHD. This can include a pregnant mother using drugs or premature birth.
- Sugar – There are a few schools of thought with regard to sugar being a direct cause of hyperactivity, however, hyperactivity is not always associated with ADHD. Children and adults may experience a spike in their energy levels due to a high sugar intake. This, however, is not linked to the type of hyperactivity associated with ADHD.
What are the complications for ADHD?
There are a number of complications that have been identified with ADHD, including the following:
- Children with ADHD often experience academic issues and failure.
- Children and adults with ADHD tend to be more prone to accidents due to their impulsive nature and constant need for movement.
- Children and adults with ADHD may suffer from low self-esteem.
- Social interaction is often difficult in those with ADHD as their conversation may seem erratic, or they may battle to follow a storyline or interrupt the person talking.
- Alcohol and drug abuse is a risk for adults with ADHD due to difficulty with impulse control.
Complications of coexisting conditions
ADHD has not been known to cause other developmental or psychological issues. However, a child with ADHD is likely to have other conditions such as:
- Learning disabilities and being unable to communicate effectively.
- Overwhelming worry and nervousness associated with anxiety disorders.
- Depression, which is a common occurrence in those with ADHD.
- Irritability and frustration issues which are characteristic of disruptive mood dysregulation disorder – something commonly experienced in those with ADHD.
- ODD (Oppositional Defiant Disorder) which is typically defined by a pattern of defiant, hostile and negative behaviour towards those in authority. In the case of a child with ADHD, they may seem rebellious to their parents’ authority and instructions.
- Depression and manic behaviour, which are often the result of bipolar disorder.
- Tourette syndrome, which is also seen in those with ADHD. The condition is characterised by both motor and vocal tics.
How is ADHD diagnosed?
Children are normally diagnosed before age 12.
There is no specific test for the condition, but the process of diagnosis will typically consist of the following:
- A medical exam to rule out any other conditions that may be causing the symptoms.
- Gathering information about any other medical conditions, school records of behaviour and family history of the condition.
- Interviewing other family members, friends and school teachers to find out more about the symptoms the child is displaying. In the case of an adult with ADHD, colleagues or family will be interviewed if available.
- There is an ADHD rating scale that is available to collect and tabulate information on the child in order to assist in making an accurate diagnosis.
- The American Psychiatric Association has created a set of criteria that help to identify and diagnose ADHD. This is known as the Diagnostic and Statistical Manual of Mental Disorders DSM-5.
Diagnosing ADHD in very young children
Diagnosing the condition in very young children is often more challenging as language delays and developmental issues are often mistaken for ADHD.
Children suspected of having ADHD will be evaluated by a specialist such as a psychologist or a paediatrician. It is important that parents get a second opinion for these sorts of cases to ensure an accurate and conclusive diagnosis.
Other conditions that bear a resemblance to ADHD
There are a number of conditions or treatments that may result in signs and symptoms similar to those in ADHD. Some of these include:
- Language or learning issues
- Seizure disorders
- Sleep apnoea
- Psychiatric disorders and issues
- Anxiety or depression
- Thyroid issues
- Brain injuries
How is ADHD treated?
The standard treatment plan for those with ADHD typically involves education, counselling, training and medications.
These treatment options do not cure the condition, they simply help to relieve the symptoms of ADHD (Attention Deficit Hyperactivity Disorder). It often takes time and effort to determine which combination of treatment works best for the patient.
Psychostimulants are the most commonly prescribed drugs for ADHD. They seem to balance and boost the neurotransmitters of the brain and aid in improving inattention and hyperactivity.
Some examples of psychostimulants include:
- Methylphenidates – Ritalin, Concerta and Metadate.
- Dexmethylphenidate – Focalin
- Amphetamines – Dexedrine (dextroamphetamine), Adderall (dextroamphetamine-amphetamine) and Vyvanse (lisdexamfetamine)
The above drugs are available in long-acting and short-acting forms. The right dosage can vary with each case, it is best to speak to your doctor about side effects and risk factors.
Stimulant medications and heart issues
Although rare, a number of heart-related deaths have occurred in teenagers and children who took stimulant based medication for ADHD. It is important to note that in these cases, it was found that the patient already had an underlying heart defect or issue.
Your doctor should always check for any signs that may be the result of a heart condition before prescribing stimulant based medication for ADHD.
There are a few other medications that have been known to be an effective treatment for ADHD, these include:
- Clonidine (Kapvay, Catapres)
- Antidepressants (Wellbutrin, and others)
- Guanfacine (Tenex, Intuniv)
- Atomoxetine (Strattera)
Antidepressants and atomoxetine tend to work more slowly than other medications such as stimulants. However, they are often a good choice for your child if they have experienced severe side effects after taking stimulants or if they are unable to take these due to an underlying heart-related issue or condition.
Some adults may be prescribed stimulants and antidepressants as a combination therapy.
Administering ADHD medication to children safely
It is of utmost importance that you ensure you child takes the correct dosage of the prescribed medication for ADHD. This will ensure optimal treatment results. The following can be done to ensure medication is given and taken properly:
- Administer the medication carefully. Your teenager or child should not be in charge of their own medication as this may lead to misuse.
- If you have young children, keep the medication in a childproof container at home.
- Do not send the medication with your young child to school. Rather speak to the school nurse or teacher and arrange for them to give it to your child as prescribed.
ADHD behaviour therapy for children
Counselling and behavioural therapy can often be beneficial for those with ADHD, and especially in children. This involves working with a social worker, psychologist or mental health care professional to come up with coping techniques and strategies in dealing with the condition. These techniques are also helpful if the child has another condition such as depression or anxiety as well as ADHD.
Adults with ADHD are also advised to seek professional help in order to recognise symptoms and cope with the condition.
Therapy examples can include:
- Psychotherapy – This therapy explores behavioural patterns and finds ways to deal with the issues, allowing the child or adult to talk about their issues with the condition and to be involved in the formulation of workable coping mechanisms.
- Behaviour therapy – This kind of therapy involves bringing in teachers, friends and parents to help learn different strategies such as reward systems or timeouts in order to deal with the condition. It may also assist adults in dealing with impulsive behaviours by teaching self-regulation and modifications techniques that help the person to identify and divert themselves from the negative behaviour.
- Parenting skills therapy and training – This often helps parents to develop ways to guide and understand their child’s behaviour and how to deal with it.
- Family therapy – This typically involves the families of children with ADHD, where the professional will consult with them on their issues with the condition and help everyone involved in dealing with it.
- Social skills therapy and training – Children with ADHD may have difficulty socialising with others, this form of therapy allows them to learn the appropriate skills needed for interacting with others.
Ongoing treatment for ADHD
It is best when a team approach is utilised for a child with ADHD, this involves the parents, family, friends and teachers all working together with a mental health professional. In educating all parties on the condition, it will make it more bearable as everyone involved will be better equipped and able to cope with it and help your child to better cope with the various challenges they face each day.
Until the symptoms of ADHD have improved in your child, you should expect regular visits to your doctor in order to ensure that the condition is monitored.
If your child is experiencing a loss of appetite, their symptoms are getting worse or there is no improvement with the treatment, it is best to immediately consult with your doctor.
Alternative medication for ADHD
Little research has been conducted on alternative medication with regard to treating and helping to improve the symptoms of ADHD. If you are thinking about exploring any alternate means of treatment, then it is best that you first speak with your doctor so as to not have these interfere with any prescription medication being taken.
There are several alternate treatments that some people regard as effective, however, there is no scientific evidence to their effectiveness as yet. These can include:
- Meditation or yoga – Relaxation techniques such as these have been found to help ease anxiety and stress associated with ADHD. These can also help the child or adult to learn discipline and relax. Certain breathing techniques can also be taught here to help calm the symptoms of ADHD such as restlessness.
- Special diets – Most experts believe that certain foods that can promote symptoms of ADHD should be eliminated. These include sugary foods, caffeine and alcohol in adults, as well as other food groups that have been found to have common allergens such as milk, eggs and wheat. Studies have shown evidence supporting special diets and their positive impact on those with ADHD.
- Herbal supplements – Some suggest that herbal supplements such as cannabis oil can be used to ease symptoms of ADHD. However, there is no scientific evidence to support this at present and studies are still being conducted on this matter.
- Mineral and vitamin supplements – Increasing vitamins in one’s diet has been known to have positive effects on ADHD. Caution is advised with the intake of vitamins, as ‘mega doses’ of these can have negative results and side effects.
- Exercises – Regular exercise has numerous health benefits. In children exercise is an effective way of releasing pent-up energy that may be leading to agitation and restlessness.
- Neurofeedback training – This is also known as EEG (electroencephalographic) biofeedback, where the child has a session to focus on specific tasks as a machine tracks the brain waves and patterns of the child. The end-goal of this treatment is to teach the child to keep the brain waves active in the frontal brain area, so as to allow for them to focus on the task at hand more effectively.
Tips for dealing with ADHD
When dealing with a child who has ADHD, there are a number of ways in which your involvement can significantly improve their symptoms. These can include:
- Sticking to a schedule and routine as this helps your child to focus more. Meal times, bed time, homework and chore times should be kept on a schedule where your child can see it.
- Organising your everyday items by teaching your child to have a place for their toys and belongings and always returning everything to its place.
- Ensuring that your child always writes down the tasks he/she has to complete in order to ensure that they do not forget anything.
- Always being consistent and clear. If you child has ADHD, he/she will need specific rules laid out for them.
- A token reward system which can come in handy so as to ensure that praise is given when needed.
With the help and guidance of a professional mental health provider, and adult with ADHD will likely be instructed to do the following:
- Make lists for activities and tasks
- Try to break down larger tasks into smaller, more manageable steps – completing one at a time.
- Schedule events and always use a calendar.
- Make sure that everything of importance has a place – including keys, wallet and phone.
- Use sticky notes and a board to keep track of things happening in one’s life.
Outlook for ADHD
ADHD, with the right treatment and help, can be a condition that is easily managed. Through the administration of the correct medication and with education and support, those with the condition can live normal, productive and successful lives.
In order to ensure proper diagnosis and treatment, it is advised that you speak to your doctor and disclose all of your symptoms and medical history.
The issue in society is that many children are labelled as having ADHD, with little research or thought given to the diagnosis. Some may argue that medicating children for ADHD is simply an excuse for parents to calm their children as they often do not have the energy to deal with them. However, ADHD is a serious mental condition and care should be taken before administering any drugs used to treat it.
It is important to note that many healthy children are hyperactive, impulsive or inattentive from time to time. It is normal for them to have short attention spans and to quickly shift from one activity to another. Children should not be diagnosed with ADHD just because they have a high level of energy or appear different in their actions to other children.
If you receive an ADHD diagnosis as an adult, it may evoke a unique mix of emotions – with relief and elation at finally having answers to why you have experienced the symptoms on one hand, and grief at how long it took to finally be able to understand what was happening on the other. It is important to work through all of these emotions as you embark on a treatment plan that can offer you relief from the symptoms and difficulties you have faced and hope at the possibility of changing your life for the better.