What is ADHD?
People who have ADHD often experience trouble sitting still, paying attention and acting impulsively. These symptoms interfere with daily life at school, work and home.
Symptoms of ADHD affect the frontal lobe, which is instrumental in planning, understanding cause-and-effect and reading social cues. It also plays a role in long-term memory and reading comprehension.
Signs and Symptoms of ADHD
Children with ADHD often have trouble staying focused, following instructions, and finishing schoolwork. They also have trouble controlling their emotions and tend to act on impulse rather than thinking things through before acting. These behaviors can cause problems at school and work and make it hard to develop and maintain healthy relationships.
Symptoms of ADHD usually begin in early childhood. However, people with the disorder may not get diagnosed until they are in adolescence or adulthood. This is because a child’s behavior can change dramatically over time. They might be energetic and distracted one day, and calmer and more focused the next. This can lead to misdiagnosis.
People with the inattentive subtype of ADHD have a hard time focusing on tasks and remembering what they have learned. They may be daydreamers who lose track of homework, cell phones, or conversations. They often go undiagnosed because their symptoms do not disrupt the learning environment.
Physicians use checklists and rating scales to review symptoms when making an ADHD diagnosis. They also do a physical exam to rule out other health issues. If they suspect that someone has the condition, they will ask about family history and health problems. They will also talk to the person’s teachers and parents.
Types of ADHD
There are three subtypes of ADHD: inattentive, hyperactive-impulsive, and combined. Medical professionals diagnose people with ADHD based on the presence of certain symptoms that interfere with daily functioning. They also consider the degree to which these symptoms occur and whether the person has been diagnosed before.
Symptoms of inattentive ADHD are often less obvious than those of other types of the disorder. People with this type of ADHD struggle to follow detailed instructions, stay organized, and remain focused on tasks and activities for extended periods of time. They may also lose things they need to complete a task, miss appointments or deadlines, and have trouble remembering information. Inattentive ADHD is more common in adults and girls than other forms of the disorder. This type of ADHD was formerly known as ADD.
People with hyperactive-impulsive ADHD fit the stereotype of kids bouncing off the walls and acting out in class. But people with this type of the disorder can struggle with these symptoms throughout their lives. They can’t sit still, act before thinking things through, or control their impulses. They are restless, talk excessively, and have trouble sitting still for long periods of time. They can also get distracted by things that interest them, even when those interests are not related to their work or school assignments.
Causes of ADHD
It’s important for parents and teachers to know that problems paying attention, being active or acting impulsively don’t always mean that a child has ADHD. These symptoms are normal for kids that age. But if these behaviors persist in school and interfere with family or social life, it’s time to talk to your doctor.
The causes of ADHD remain unclear, but scientists know that genetics and heredity play a role in the development of the disorder. They also know that the frontal lobe develops slower in children with ADHD. This brain area is responsible for planning, understanding cause-and-effect, changing habits, reading social cues and thinking before acting.
People who have predominantly inattentive ADHD present with trouble paying attention or staying focused on tasks and activities; getting things done at work or school; forgetting details or making careless mistakes. They may also have difficulty sitting still, seem restless and get bored easily and struggle to follow directions or finish schoolwork and chores.
People who have the combined type of ADHD have at least six symptoms from both inattentive and hyperactive-impulsive presentations. These adults and children fidget, can’t sit or stay still and have a hard time waiting for their turn in conversations, games or activities. They also interrupt others and act without thinking.
How is ADHD Diagnosed?
The specialized health care providers who diagnose ADHD typically conduct a detailed assessment. This may include an in-person interview with the patient and their caregivers, the completion of rating scales and questionnaires by teachers, school personnel and other adults who spend significant time with the person, a medical and family history, a physical exam and neurological testing, if necessary.
For children, doctors look for a pattern of symptoms that occur in multiple settings, significantly impair functioning and have been present since before age 12. They also rule out other disorders that share similar symptoms. For older teens and adults, the provider will need to see evidence of at least five symptoms over a six-month period and they must be present in more than one setting and interfere with functional performance.
During the clinical interview, providers will ask questions about your child’s symptoms and how they impact his or her daily life. They will also interview others who know the patient well, including a spouse, parent or sibling and a teacher, coach or employer. These interviews can take up to an hour. They will often include questions about the person’s childhood and a detailed description of their behavior and how it has affected them in adulthood.
Treatsments for ADHD
There are several medications that can reduce ADHD symptoms, including stimulants and nonstimulants. Many people who take medication report improved functioning at home, school or work and better relationships with family and friends. But, there is little research on long-term effects.
Medications used to treat ADHD are typically prescribed by primary care doctors. A thorough psychiatric evaluation includes a description of symptoms by the person, parents or caregivers, completion of ratings scales and questionnaires by teachers and other health professionals, information about education and upbringing, a physical examination and a medical history.
Some medications can cause side effects, such as stomach upset, headaches and a change in heart rate or blood pressure. Some children and teenagers who take stimulant medication may experience a reduction in growth. This is usually minor and does not affect their final height.
Adults with ADHD often benefit from counseling, in which they learn strategies to improve time management and organizational skills and reduce disruptive behavior. They also can find support in groups of people with ADHD who have similar experiences and problems. They can ask co-workers and supervisors for accommodations to help them succeed in the workplace. Some adults with ADHD have found that talking to a therapist helps them gain a better understanding of themselves and realize that their challenges are not their fault.
ADHD in Adults
For adults, the symptoms of ADHD may look different than in children. They also may have different effects. They might not cause the same problems in work and school as in childhood. Instead, they might affect relationships and other aspects of adult life.
Symptoms of adult ADHD can be mild, moderate or severe. To be diagnosed, the symptoms must have been present since childhood and caused problems in more than one setting. They must have occurred at home, at school or on the job.
It is important for adults to get treatment for ADHD. The most common treatment is stimulant medication. These medications increase the brain chemicals dopamine and norepinephrine, which play a big role in thinking and attention. They are safe and effective when taken under a doctor’s supervision.
Having untreated ADHD can lead to many difficulties, including relationship conflicts, work performance issues and financial challenges. It can also lead to anxiety and depression, substance abuse, low self-esteem and mood swings. Treatment options for these co-occurring problems include psychotherapy, mindfulness and cognitive behavioural therapy strategies. Treatments that address everyday stressors, sleep and nutrition can also be helpful. Getting regular exercise, eating a healthy diet and getting enough sleep can help manage symptoms.
ADHD Medication
Stimulant medications reduce ADHD symptoms by increasing the effectiveness of neurotransmitters that pass messages in the brain. Medication can help kids and adults focus, stay organized, and control their impulses. It can also improve their ability to participate in social or work situations that require them to pay attention.
Medication for ADHD is available in two forms: instant and extended-release. Instant-release medications can be taken as pills, liquids or a chewable tablet that dissolves in the mouth or is chewed. They typically last six to eight hours before they wear off. Many people take immediate-release medication in the morning and then supplement it with an extended-release medication (like methylphenidate, atomoxetine or guanfacine) taken at noon or in the evening.
Doctors can also prescribe non-stimulant medications for ADHD. These may include bupropion (Wellbutrin), clonidine (Kapvay) or guanfacine (Intuniv). They can be taken as capsules or tablets. These medications can take a few weeks to start working and typically last up to 24 hours.
The first medicine a person with ADHD tries may not be the right one, so it’s important to keep up with visits over weeks or months until the doctors find the right dose and medicine. Doctors will also ask about all other medicines and supplements, especially over-the-counter medicines and vitamins. They can increase or decrease the dosage based on how well it works and if there are side effects.
