What is ADHD?
Attention deficit hyperactivity disorder is one of the most common behavioral disorders diagnosed in children and often carries over into adulthood. Learn about the subtypes of ADHD and what you can do to help manage your symptoms.
Doctors and researchers aren’t sure what causes ADHD, but genetics play a role. They also know that certain problems in the brain may cause it.
Signs and Symptoms of ADHD
Many kids have trouble sitting still or waiting their turn, are fidgety or impulsive and have difficulty with organization. However, when these symptoms cause significant trouble at school or work and in relationships, they might be a sign of ADHD.
There are three main types of ADHD: Predominately Inattentive Type, Predominately Hyperactive/Impulsive Type, and Combined Presentation. To be diagnosed, children must display a specific number of symptoms within each subtype.
In the Predominately Inattentive Type, symptoms of inattention and disorganization are more prominent than hyperactivity or impulsivity. Children with this form of ADHD might miss important details in schoolwork or work assignments and make careless mistakes. They might lose track of their belongings, forget appointments or chores and have trouble relaxing.
People with the Predominately Hyperactive/Impulsive Form of ADHD might be restless, talkative and have trouble sitting still for long periods. They might be disruptive in class and have trouble listening to teachers or parents. They might also have a hard time making decisions or find it difficult to calm down when they are stressed. They may be more likely to get into fights and risky behaviors. They might interrupt others often or take things that aren’t theirs.
Types of ADHD
In the past, doctors used to divide ADHD into subtypes based on behavioral symptoms. However, these subtypes didn’t always accurately capture the disorder’s defining characteristics. They also left out less obvious symptoms, such as emotional dysregulation and cognitive patterns. The most recent version of the Diagnostic and Statistical Manual (DSM) now refers to the symptoms of each type of ADHD as “presentations.” People often move from one presentation to another as they age.
The inattentive type of ADHD is characterized by problems with attention and organization. Those with this presentation may forget things easily, lose their schoolwork or other belongings frequently, and have trouble finishing tasks. They may also have trouble waiting for their turn during conversations or games. In addition, they may make careless mistakes, such as failing to follow instructions or misplacing items. People with this type of ADHD are more likely to be girls and boys.
Children and adults with hyperactive-impulsive type ADHD are more prone to run out in front of cars or take risks that put them in harm’s way. They are more likely to be distracting in class and make learning difficult for themselves and others. They can also have trouble sitting still or concentrating on tasks. More boys are diagnosed with this type of ADHD than girls.
Causes of ADHD
The cause of ADHD is not completely known, but scientists know that brain differences are involved. The frontal lobes of the brain, which are responsible for paying attention and moderating behavior, are smaller in people with ADHD. These brain changes may be a result of genetics or environmental factors that occur during development. Studies show that kids with ADHD often have a parent or sibling with the disorder. Children are also at increased risk for it if they were born early or exposed to chemicals and drugs in the environment during pregnancy.
It’s important for a doctor to evaluate a child before diagnosing them with ADHD. To be diagnosed, a child must display at least six symptoms in two or more settings. They must be serious enough to cause dysfunction and have been occurring for at least six months. Older teens and adults may need to show five symptoms. Symptoms of the combined type must appear in both the inattentive and hyperactive/impulsive categories.
It’s also important to rule out other conditions that share some of the same symptoms as ADHD, such as mood disorders (depression or bipolar disorder) and anxiety disorders. These problems can make it harder for a person with ADHD to focus and can contribute to the symptoms of the disorder.
How is ADHD Diagnosed?
Many mental health professionals are qualified to diagnose ADHD, including psychiatrists, psychologists, psychotherapists, neurologist, and some physicians. The evaluation process varies, but it usually includes a discussion of symptoms with the patient or child, completion of ratings scales and questionnaires by the evaluator and others, a review of medical, family, and educational history, and a physical exam.
Symptoms must interfere with functioning in at least two settings (home and school, for example), and they must have persisted for six months before the evaluator makes a diagnosis. The evaluator may also want to rule out other conditions that have similar symptoms, such as learning or mood disorders.
For adults, the evaluator might interview spouses, parents, friends, coworkers, and teachers. The evaluator might also ask for your permission to send questionnaires to other people who know you, such as work colleagues or acquaintances. These can give a more complete picture of how your symptoms affect your life. Untreated adult ADHD can cause problems at home and at work, and it often leads to comorbid disorders, such as anxiety disorder and depression. The evaluator might also do a physical exam and order lab tests to rule out any other medical issues that could contribute to your symptoms.
Treatsments for ADHD
Medications are the most common treatment for ADHD. The medication helps people focus better and ignore distractions. It can also reduce the severity of some of the symptoms. The type of medication that a person takes depends on the symptoms they have. The most commonly prescribed medications are stimulants, which can help improve attention and control impulsivity. They can be short- or long-acting. These medications may be prescribed alone or with psychosocial therapy.
Psychosocial therapies can teach skills to help a person cope with and live with their symptoms. Family and marital therapy can help a person with ADHD and their family members understand each other, deal with disruptive behaviors and improve relationships. Behavior therapy can help a person with ADHD learn new habits and ways to manage their symptoms.
A person with ADHD should make regular appointments with a doctor or mental health professional to keep track of their symptoms and treatment. They should not rely on self-help books or websites, which may have inaccurate information. The person should also check with their healthcare provider before taking any supplements or other over-the-counter medications. They should be careful not to take too many vitamins or other supplements that may interfere with the effectiveness of their treatment.
ADHD in Adults
People with ADHD are often easily distracted, which can result in poor listening skills that can lead to misunderstandings. They also have something called hyperfocus, which means they can get so engrossed in a task that they forget everything else around them. This can make it hard for them to organise daily responsibilities or attend social events, leading to relationship difficulties.
Difficulties with organisation can become more apparent in adulthood as the structure provided by parents and school is less pronounced. Difficulty starting tasks and procrastination are common symptoms of adult ADHD, which can cause problems at home and in the workplace. Adults with ADHD may also have trouble managing their finances, relationships and personal health.
In addition to medication, there are a variety of non-medication treatments that can help improve attention and self-regulation. These treatments can include cognitive behavioural therapy strategies, mindfulness, exercise, yoga and relaxation. It is important to discuss these options with your GP, as not all of them are appropriate for everyone.
NIMH clinical trials are a great way to explore new treatment options. Find out more about participating in a clinical trial.
ADHD Medication
There are many different medications used to treat ADHD. Stimulants are the most common and have been used for decades. They work by increasing the amount of a chemical in the brain called dopamine. This chemical passes messages between brain cells, so increased levels can help improve concentration and reduce impulsivity. These medications can also cause side effects such as heart rate increases and high blood pressure, so people who take them should have their blood pressure and heart rate checked regularly.
Other types of medications used to treat ADHD are called non-stimulants, which do not act on the central nervous system. These medicines have a slower effect than stimulants, but can improve focus and decrease impulsivity. They can also help people sleep better. They do not have the same risks as stimulants, and can be taken longer. They can also reduce anxiety and depression.
Talk to your doctor about what type of medication would be best for you or your child. You will need to have frequent appointments with your doctor until you find a dose and form of medication that works. Some places have laws or regulations that require you to see your doctor on a regular basis in order for them to prescribe certain medications, including stimulants.
