What is ADHD?

What is ADHD? thumbnail

what is adhd

What is ADHD?

Doctors diagnose ADHD based on the symptoms you or your child shows and how those affect your life. They may also check your medical history.

They often use rating scales, questionnaires and interviews with family members and teachers. And they’ll ask for a complete medical exam, including eye and hearing tests.

Signs and Symptoms of ADHD

Children with ADHD are often fidgety and have difficulty sitting still, listening to a teacher or playing quietly. They also may lose things frequently and have trouble following instructions. They may have difficulty remembering important information and often miss appointments or work deadlines. Their behavior can be disruptive to classmates and family members.

They are often easily distracted by extraneous stimuli and have a hard time waiting their turn in activities such as school games or waiting for a ride. They may blurt out answers before hearing the question or interrupt other people in conversations. They might have trouble driving or doing other complicated tasks. They are likely to forget or lose things like backpacks, homework and keys.

Teens with ADHD often have difficulty keeping up with academic or social demands and struggle to balance school, work, life and relationships. They may have poor frustration tolerance and have trouble finishing tasks that are challenging or boring.

Girls and women with ADHD are more likely to hide impulsive or disorganized behaviors that go against gender norms, for fear of being judged. This can lead to problems at home, school and in relationships. Some teens or adults with ADHD act aggressively toward others and break rules, perhaps fighting or taking things that don’t belong to them. This is called oppositional defiant disorder and needs treatment.

Types of ADHD

Symptoms of ADHD vary among individuals. To make diagnosis more consistent, the American Psychiatric Association (APA) has identified three subtypes of ADHD: Primarily inattentive, predominantly hyperactive-impulsive, and combined type. People often move from one subtype to another over time, and they may experience different symptoms at different times in their lives.

People who have primarily inattentive ADHD struggle to concentrate and stay on task. They often forget things, miss important details in work or school assignments, and have trouble completing tasks that require sustained attention. They also tend to have difficulty with executive functions, which include organization, planning, prioritizing, and time management.

Children with hyperactive/impulsive ADHD are easily distracted and have trouble waiting for their turn in games or activities. They frequently interrupt or start something without waiting for permission and have trouble waiting to be served at restaurants or offices. They often get up and leave classrooms, meetings, or other activities before they are finished. They are often described as a “jumpers,” or like Winnie the Pooh series character Tigger.

Those with a combination of impulsive/hyperactive and inattentive ADHD have trouble staying on task and focusing for long periods, but they do not exhibit hyperactivity or impulsivity as often. They are often described as fidgety or restless and easily distracted by extraneous stimuli, such as social media and texting.

Causes of ADHD

There are a variety of factors that can cause ADHD. These include genetics, environmental stressors (such as parental conflict), traumatic brain injuries, smoking or alcohol use during pregnancy, and nutritional deficiencies. However, a person’s behavior cannot be solely blamed on any of these causes.

For a diagnosis of ADHD, children and adults must display at least six symptoms in more than one setting that pose a significant challenge to daily activities. The symptoms must also not be better explained by another mental health disorder.

A child with primarily inattentive ADHD may struggle to concentrate during lectures or conversations; make careless mistakes at school, work or home; and avoids or dislikes tasks that require sustained mental effort. He or she may fidget, tap fingers, or squirm in his or her seat and has trouble playing or engaging in leisure activities quietly.

In contrast, a child with primarily hyperactive-impulsive ADHD acts like a “motor” and struggles to control their behavior. They have trouble waiting their turn, blurt out answers before questions are asked and frequently interrupt others. The most recent version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR) categorizes ADHD into three subtypes: inattentive, hyperactive/impulsive and combined presentation. Some children move from one subtype to the next throughout their lives.

How is ADHD Diagnosed?

Getting a proper diagnosis for ADHD is the first step toward finding treatment. A health care provider may start by asking questions about symptoms. This is called a clinical interview. They may also do a physical exam, and/or psychological or neurological testing.

They will want to know about your or your child’s family history. They will likely ask you to describe your symptoms and how they affect you or your child’s life. They will also use checklists and rating scales. They may also interview teachers and caregivers. They will probably do a checkup to make sure that other health problems, such as vision and hearing, aren’t causing the symptoms.

Professionals will determine if your or your child’s symptoms meet the American Psychiatric Association’s criteria for ADHD. They will also decide whether the symptoms are mild, moderate or severe. People with ADHD often have coexisting disorders, such as oppositional defiant or conduct disorder, anxiety, depression, tic disorders or Tourette syndrome and substance abuse. This can complicate the diagnosis and treatment of the condition. In addition, these other disorders can mask or worsen the symptoms of ADHD. This is why it’s important for doctors to evaluate all symptoms, not just attention.

Treatsments for ADHD

People with ADHD may benefit from a combination of treatment options. These might include medication, psychosocial treatments, and lifestyle changes. These can improve symptoms and increase functioning.

The most common medications for ADHD are stimulants, which increase the brain chemicals dopamine and norepinephrine. They are often the first choice for adults and children with the condition. Examples of stimulants are methylphenidate (Ritalin) and amphetamine-based medications, such as Adderall.

These medications can help a person pay attention and stay focused. They can also reduce hyperactivity and impulsive behavior. However, they don’t prevent tics or other troublesome side effects, such as headaches, stomachaches, and changes in blood pressure and heart rate.

Taking stimulants long-term can cause the symptoms of the disorder to recur in some people. It can also lead to a rebound effect when the medication wears off. This can be frustrating for both adults and kids who rely on the drugs to manage their symptoms.

Other treatments for ADHD may include cognitive behavioral therapy (CBT). This is a type of psychotherapy that helps people change negative patterns of thinking and feelings into more positive ones. It can also help people learn more effective ways of coping with stress and frustration.

ADHD in Adults

Symptoms of ADHD persist into adulthood, although they may present differently. Specifically, women and girls and people assigned female at birth may express symptoms in ways that are more in line with cultural stereotypes than those of men, which can make it difficult to recognize them or get diagnosed.

Nevertheless, adults with the condition are affected by its symptoms just as much as children and adolescents. A thorough psychiatric evaluation that includes a review of your history, observational data from family members and friends, completion of scales and questionnaires by you and your caregivers or teachers, as well as an examination for other possible conditions that often coexist with ADHD, is required to diagnose the condition.

The severity of your symptoms determines the level of diagnosis. You can be diagnosed as mild if only few symptoms beyond the minimum requirements are present and they result in minor impairment in your social, school or work settings. Severe symptoms can lead to serious problems like poor job performance, financial instability and difficulty keeping up with bills, medical instructions and other obligations. For these reasons, it’s important to get treatment if you have severe symptoms. Treatment options include individual therapy, group support, career counselling and medication.

ADHD Medication

For many people, the best treatment for ADHD is medication. It reduces symptoms and helps kids and adults do better at school and work. The type of medication and dosage will depend on the person’s needs.

Stimulants are most commonly used to treat ADHD. They boost and balance levels of brain chemicals called neurotransmitters. They can also help children with ADHD focus and control their impulsive behavior.

Most stimulants used to treat ADHD fall into one of two drug classes: methylphenidates and amphetamines. Medication such as methylphenidate or lisdexamfetamine improves attention, focus and impulse control in children, teenagers and adults.

Many children and teenagers who take a methylphenidate or amphetamine feel more focused and do better at school. These medications have been shown to reduce symptoms of ADHD by 60 percent to 80 percent.

Atomoxetine, an antidepressant, is an alternative to stimulants. It works slower than stimulants and increases the level of a chemical in the brain called norepinephrine. This chemical passes messages between brain cells and is thought to help regulate concentration and impulsivity. This medicine is available in pill form and may be a good option for people who cannot take stimulants because of health problems or severe side effects.

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