Attention-Deficit
Hyperactivity Disorder (ADHD)

What is ADHD?

Attention-deficit hyperactivity disorder (ADHD) is a condition characterized by inattention, hyperactivity and impulsivity. Although ADHD has its onset and is usually diagnosed in childhood, it is not a disorder limited to children—ADHD often persists into adolescence and adulthood and is frequently not diagnosed until later years. Identification of individuals with ADHD and appropriate management of their educational, personal and social development improves chances for a successful outcome. Effective intervention can improve self-esteem, work performance and skills, and educational achievement.  

How common is ADHD?

The most commonly diagnosed behavior disorder in young people, ADHD affects an estimated 9 percent of children aged 3-17 and 2-4 percent of adults, according to the Center for Disease Control and Prevention (CDC) 2010 National Childhood Health Study.

Signs and Symptoms

There are actually thought to be three different types of ADHD, each with different symptoms: predominantly inattentive, predominantly hyperactive/impulsive and combined.

Those living with the predominantly inattentive type often:
  • Fail to pay close attention to details or make careless mistakes in schoolwork, work or other activities
  • Have difficulty sustaining attention to tasks or leisure activities
  • Do not seem to listen when spoken to directly
  • Do not follow through on instructions and fail to finish schoolwork, chores or duties in the workplace
  • Have difficulty organizing tasks and activities
  • Avoid, dislike or are reluctant to engage in tasks that require sustained mental effort
  • Lose things necessary for tasks or activities
  • Are easily distracted by extraneous stimuli
  • Are forgetful in daily activities
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Those living with the predominantly hyperactive/impulsive type often:
  • Fidget with their hands or feet or squirm in their seat
  • Leave their seat in situations in which remaining seated is expected
  • Move excessively or feel restless during situations in which such behavior is inappropriate
  • Have difficulty engaging in leisure activities quietly
  • Are “on the go” or act as if “driven by a motor
  • Talk excessively
  • Blurt out answers before questions have been completed
  • Have difficulty awaiting their turn
  • Interrupt or intrude on others 
  •  

Those living with the combined type, the most common type of ADHD, have a combination of the inattentive and hyperactive/impulsive symptoms.

Diagnosis

 As with all types of illness, a physician must be seen to provide a proper diagnosis. After ruling out other illnesses, the doctor may recommend seeing a mental health professional, such as a psychiatrist.

Characteristics of Adults with ADHD

Adults who are living with the condition, and especially those who are undiagnosed and untreated, may be experiencing a number of problems, some of which stem directly from the disorder and others that are the result of associated adjustment patterns.

Current symptoms of an adult with ADHD may include:
  • Distractibility
  • Disorganization
  • Forgetfulness
  • Procrastination
  • Chronic lateness
  • Chronic boredom
  • Anxiety
  • Depression
  • Low self-esteem
  • Mood swings
  • Employment problems
  • Restlessness
  • Substance abuse or addictions
  • Relationship problems

The symptoms of ADHD can be variable and situational, or constant. Some people with ADHD can concentrate if they are interested or excited, while others have difficulty concentrating under any circumstances. Some avidly seek stimulation, while others avoid it. Some become oppositional, ill-behaved and later, antisocial; others may become ardent people-pleasers. Some are outgoing, and others withdrawn.

Children with ADHD

Children with ADHD have difficulty sitting still and paying attention in class. Even those of normal or above-normal intelligence struggle in school. Their behaviors disrupt classrooms and lead to rejection by other kids. As they grow older, children with untreated ADHD are more prone to drug abuse, antisocial behavior, and injuries of all sorts. More than half the children diagnosed with ADHD continue to have symptoms during their adolescent years and into adulthood. A proper diagnosis of ADHD – viewing their symptoms and struggles through the lens of a neurobiological disorder – can help an adult put his or her difficulties into perspective.

Diagnosis

Whether working with adults or children, diagnosing ADHD requires a comprehensive and cannot be done with one single test. Diagnostic assessments of adults should be made by clinicians or teams of clinicians with expertise in the area of attentional dysfunction and related conditions. The assessment is designed to surface lifelong patterns of behavior that indicate underlying attention and impulse problems. Sources of information for an evaluation may include a physical exam; thorough medical and family histories; interviews with those very familiar with the person’s behavior; personal observation; and a variety of psychological tests

When diagnosing children, a licensed health professional will compile information about the child’s academic, social and emotional functioning. He or she will also need to rule out physical factors that could be causing symptoms similar to ADHD.

Treatment

A key aspect of treating ADHD is combining multiple methods for treatment, spanning medical, educational, behavioral and psychological. Appropriate treatment is determined according to the severity of an individual’s disorder and the type and number of associated problems.

Used in conjunction with education and counseling, medication can provide a base from which adults can build new successes. The purpose of medication is to help the adult to help him or herself. It provides the biological support needed for self-control. As such, the individual is not “controlled” by medication; the efforts to succeed are his or her own. When treating ADHD, physicians frequently start with stimulant medications. Nonstimulant medications that are used include antidepressants and atamoxetine, the first nonstimulant medication specifically approved by the FDA for ADHD.

Education and counseling focus on understanding ADHD, psychotherapy and behavioral therapy, and practical support: coaching in organizational skills, as well as vocational/educational support. Behavior therapy and cognitive therapy are often helpful to modify certain behaviors and to deal with the emotional effects of ADHD. Many adults also benefit from working with an AD/HD coach to help manage problem behaviors and develop coping skills, such as improving organizational skills and improving productivity. 

Co-Occurring Conditions

Various symptoms of ADHD may be similar to those of other conditions and may coexist with ADD. These include anxiety, depression, obsessive-compulsive and some specific learning disabilities. By conducting a complete evaluation, a clinician or mental health professional familiar with ADHD and other psychiatric disorders will be able to diagnose both the ADHD and related conditions.