Attention Deficit Hyperactivity Disorder (ADHD)

Attention-Deficit/Hyperactivity Disorder

What is ADHD?

ADHD is called attention deficit hyperactivity disorder. It is a chronic disorder characterised by persistent patterns of inattention, hyperactivity, and impulsivity. These behaviours often interfere with daily functioning and development.

While many individuals occasionally lose focus or become restless, those with ADHD experience these symptoms more frequently and with greater intensity.

The cause of ADHD remains unspecified. However, research shows that a combination of genetic, environmental, social, and neurological factors play a role. Further, the symptoms can manifest differently between children and adults.

In children, it might present as difficulty in completing schoolwork or frequent meltdowns in a classroom environment. Conversely, adults might struggle with organisational tasks, time management, or maintaining relationships.

However, everyone experiences these symptoms differently. Hence, it is essential to understand that ADHD does not reflect intelligence or capability.

In this guide, let us explore how ADHD symptoms manifest in people. In addition, we will see the differences between the symptoms in adults and children and the treatment options available to manage ADHD and lead fulfilling lives.

ADHD Symptoms

Those with ADHD may sometimes only have symptoms of inattention. In contrast, others may have symptoms of hyperactivity and impulsivity. Some may have a combination of all types.

All of us, from time to time, complain of not being able to concentrate, and feeling impulsive. However, these behaviours for people living with ADHD are more severe, occur regularly, and interfere with the overall quality of life.

It is crucial to understand that ADHD diagnosis is not solely based on the below symptoms. Instead, for a definitive ADHD diagnosis, these symptoms must be chronic, hinder daily functioning, and result in developmental delays.

Inattention

Inattention is one of the main symptoms for many individuals diagnosed with ADHD. Everyone may occasionally lose focus or become distracted. However, those with ADHD face a heightened and consistent challenge in maintaining attention.

Here is a closer look at the symptoms of inattention in ADHD:

Hyperactivity-Impulsivity

Hyperactivity-impulsivity is a common symptom of ADHD. However, both hyperactiveness and impulsiveness manifest in completely different ways in individuals. 

Some of the common symptoms of hyperactivity and impulsivity are:

ADHD Causes and Risk Factors

ADHD Causes

Attention deficit hyperactivity disorder is a neurodevelopmental condition. It affects both children and adults. However, its exact cause remains indefinable. Current research has shed light on several factors that may contribute to its onset. Further, brain structure and activity differences are evident in those with ADHD.

The frontal lobe, located behind the forehead, matures later in individuals with ADHD compared to their neurotypical peers. This region is pivotal for planning, decision-making, and moderating behaviour through directed attention.

Hence, in ADHD, directed attention is often weaker, making tasks that require sustained focus challenging.
Neurotransmitters, chemicals facilitating signal transmission between nerve cells, are also implicated.

Variations in their levels or functions can influence ADHD symptoms.

Moreover, the brain’s networks, particularly the default mode (automatic attention) and the task-positive mode (directed attention), function differently in those with ADHD.

ADHD Risk Factors

Genetics is another significant factor. If a child has ADHD, there is a 25% likelihood that one of their parents also has it.

Other potential causes and risk factors include:

Due to lack of information and nuance about conditions like ADHD, people often misunderstand the disorder. 

Several people think that factors like excessive sugar intake, screen time, poor parenting, and allergies can cause ADHD.

However, that is not true. Research specifically proves that regular factors such as those mentioned above does not cause or trigger symptoms of ADHD. 

ADHD is a neurodevelopmental condition and various complex and real causes such as genetics, environment, and psychological development can play a role in the onset. 

Types of ADHD

ADHD manifests in various ways. To provide a precise diagnosis, therapists categorise ADHD based on the predominant symptoms displayed.

The four main ways ADHD manifests are:

Predominantly Inattentive

Previously referred to as attention-deficit disorder (ADD), this type is characterised by significant inattentiveness.

Children diagnosed under this category primarily struggle with focus, organisation, and task completion. Research shows that it is more typical among girls with ADHD. 

However, they exhibit fewer hyperactivity or impulsivity symptoms.

Predominantly Hyperactive-Impulsive

This indication is marked by prominent hyperactivity and impulsivity. Children may frequently fidget, struggle to remain seated, possess excessive energy, and be overly talkative.

Impulsivity can manifest as interruptions or hasty actions without forethought. This type is often seen in younger children but is the least prevalent type of ADHD among adults.

Combined

This type includes symptoms from both inattentive and hyperactive-impulsive signs.  Children with this type display at least six symptoms from each category.

Both inattentiveness and hyperactivity-impulsivity are equally evident. It is the most common type of ADHD, accounting for approximately 70% of diagnoses.

Unspecified ADHD

For some children, the severity of symptoms clearly indicates dysfunction. However, they do not align perfectly with the criteria for the types mentioned above.

In these instances, clinicians may determine the diagnosis as ‘unspecified ADHD’.

ADHD in Adults

ADHD in adults extends beyond the commonly perceived lack of concentration.

It is essential to understand the nuances of adult ADHD to ensure timely diagnosis and appropriate treatment.

  • Disorganisation: Adults with ADHD often grapple with organisational skills. They might struggle to keep track of tasks or find it challenging to prioritise them logically.

  • Relationship issues: ADHD can strain couples’ relationships, whether professional, romantic, or platonic. Traits like inattentiveness, being easily bored, or talking over others can make those with ADHD appear insensitive or uncaring, leading to misunderstandings.
  • Restlessness: Many adults with ADHD struggle with internal restlessness, constantly needing to move or act. This restlessness can escalate to anxiety, especially when there is a delay in responding to the urge. Observable signs include frequent fidgeting, tapping, or an inability to remain seated.
  • Hyperfocus: Contrary to being easily distracted, individuals with ADHD can also exhibit hyperfocus. They might become so engrossed in a task that they lose awareness of their surroundings.

  • Forgetfulness: While everyone forgets occasionally, adults with ADHD experience it more frequently. Such forgetfulness, such as misplacing items or missing important dates, can impact both professional and personal relationships.
  • Impulsivity: Impulsiveness in adults with ADHD can manifest in various ways, from interrupting conversations to making hasty decisions without considering the repercussions.

Executive Dysfunction in ADHD

Executive functions refer to mental skills that we employ to learn, work and manage daily life.

Dysfunction in these areas is highly prevalent in attention deficit hyperactivity disorder. It impedes people’s capacity to organise their thoughts, emotions, and actions.

Key Executive Functions

Working memory: This is the active memory engaged in current tasks. For instance, your working memory is at play when you are reading or conversing.

Cognitive flexibility: Often termed as fluid thinking, it denotes the brain’s ability to transition between topics. A person with high cognitive flexibility can adapt swiftly to changes and often exhibits creativity.

Inhibition control: Central to executive function, it regulates thoughts, emotions, and actions. It manifests in two primary ways:

  1. Behavioural control: The restraint one exercises to refrain from undesirable actions. Specifically, choosing not to react to a provoking individual or situation.

  2. Interference control: The capacity to focus on pertinent information while disregarding distractions. It can be external distractions or one’s own diverting thoughts.

Advanced Executive Functions

Planning: This element involves thinking of steps strategically to achieve an outcome (eg creating a daily routine and following it or solving mathematical equations). 

Reasoning: This element involves thinking constructively to improve one’s knowledge or to better understand complex topics (eg engaging in research or analysis).

Problem-solving: This element is a holistic function that uses all mental capabilities (ie decision-making, planning, and reasoning) to overcome challenges.

If any of these psychological functions in the brain are affected or disturbed due to certain factors (eg genes, environment), then a person may be highly likely to have executive dysfunction.

Lastly, a person may also find it hard to manage or control their thoughts and feelings if they have executive dysfunction.

ADHD Treatment

Treatments are available to manage and live comfortably with ADHD, either as a child or an adult.

Treatment options include psychotherapy, medication, training, or a combination of several approaches. 

Medications for ADHD

For individuals diagnosed with ADHD, medications can improve their ability to focus, learn, and manage impulsivity and hyperactivity. 

Stimulants are the most prevalent medications prescribed for ADHD. In contrast to their name, they function by increasing the levels of dopamine and norepinephrine (brain neurotransmitters), which are instrumental in attention and cognition. 

These medications are deemed safe under medical oversight. However, potential side effects can emerge, particularly if misused or consumed beyond the recommended dose.

Non-stimulants represent an alternative category of ADHD medications. In fact, their onset of action is slower compared to stimulants. Even so, they can equally improve focus, attention, and control impulsivity. 

Medical professionals might opt for non-stimulants if a person experiences adverse effects from stimulants if the stimulant. Similarly, they also opt for it if the stimulants prove to be ineffective or to complement a stimulant’s efficacy.

Certain antidepressants, although not officially approved for ADHD treatment, can be prescribed either as standalone treatments or along with stimulants. 

In fact, they might be particularly beneficial if the person has comorbid conditions such as anxiety or depression

Psychosocial Interventions for ADHD

Psychosocial interventions could include psychotherapy, support groups, or general social support. 

These interventions are important as they play a key role in improving one’s mental wellness and addresses various issues related to ADHD such as:

  • Anxiety and depression
  • Peer relationships
  • Academic performance
  • Work performance
  • Poor time management skills
  • Loneliness

When a child is diagnosed with ADHD, family members and the child may face a range of emotions, including frustration and anger. Most parents may not know how to help someone with ADHD.

TYHO Therapists can guide parents through understanding ADHD’s impact on familial dynamics. 

Cognitive behavioural therapy (CBT) is an evidence-based tool that therapists may use to improve self-awareness and acceptance. CBT also helps people with ADHD to improve focus and impulse control. 

Similarly, family and marital therapy can help change the way family members interact with each other, encourage positive conversations, resolve arguments related to lack of concentration or impulsiveness, and manage maladaptive behaviours

Additionally, learning parenting skills in therapy can also help parents manage negative actions and reinforce positive behaviours. 

For children with ADHD, classroom interventions and academic accommodations can significantly improve their educational experience. These might range from behavioural management plans to specific study skills. 

Incorporating stress management techniques can also be invaluable for parents. These skills help them handle challenges with composure and understanding.

Coping With ADHD

Living with ADHD as a child or as an adult can be hard in a world that is built for neurotypical people (ie people who have typical neurological development or functioning).

Psychological intervention, social support, and inclusivity can play a huge role in making life easy for those with ADHD. 

However, at a more personal level, you can learn how to manage ADHD by understanding your symptoms and using practical self-care tools

For adults, it can be helpful to learn organisation skills. Below are some pointers you can consider to improve daily productivity and quality of life:

  • Write detailed lists of tasks.
  • Maintain an up-to-date calendar.
  • Set reminders for important activities.
  • Use reminder notes either on the phone or in small notebooks.

For children, it can be more helpful to focus on structure and routine. Encourage children with ADHD to:

  • Note down all the homework tasks.
  • Allocate specific places for everyday items, such as school bags and toys.

Always consult a professional therapist or doctor for specific advice on managing ADHD symptoms. Medical doctors can advise if you need any medications along with therapy. 

Remember, you are not alone, and help is available.

Frequently Answered Questions

Do I have ADHD or anxiety?

It is also vital to differentiate ADHD from other conditions like stress, sleep disorders, or anxiety, which might exhibit similar symptoms. Hence, a comprehensive evaluation by a mental health professional is necessary.

Although distinct, ADHD and anxiety can sometimes present with overlapping symptoms. Consequently making the diagnosis a nuanced process. 

On one hand, persistent patterns of inattention, impulsivity, and/or hyperactivity characterise attention-deficit/hyperactivity disorder. Conversely, anxiety manifests as excessive worry, restlessness, and physical symptoms like rapid heartbeat.

To diagnose ADHD, healthcare professionals rely on DSM-5. The process involves:

  • Gathering a comprehensive medical and symptom history.

  • Evaluating developmental, academic, emotional, and social functioning.
  • Using ADHD testing like symptom rating checklists.
  • Consulting with parents, teachers, or family members about observed behaviours.

  • Assessing hearing and vision to eliminate other medical conditions.

For anxiety, on the other hand, the diagnosis is based on symptom assessment and ensuring no other medical issues are causing the symptoms. 

However, it is worth noting that individuals can have both ADHD and anxiety. In fact, a significant percentage of those with ADHD may also exhibit anxiety symptoms.

For example, someone with ADHD might frequently misplace their keys, leading to daily stress and the constant worry of being late. Therefore, this routine stress, combined with the challenges of managing ADHD, can intensify feelings of anxiety.

What are some examples of executive dysfunction in ADHD?

Executive dysfunction is a common symptom of mental health conditions that makes it hard to start or finish tasks, initiate an activity, make a decision, and so on. 

When the brain’s executive functions (ie thinking, reasoning, deciding) do not work as they should, it can affect a person’s daily life in several ways. 

Some of the common examples include:

  • Easily becoming distracted or struggling to maintain focus
  • Over-focusing (ie hyperfocus) on a single detail instead of looking at the ‘bigger picture’
  • Daydreaming during important or priority moments, such as work meetings or academic presentations
  • Challenges in visualising the end result of a particular activity or action 
  • Procrastinating excessively, especially when faced with complex tasks
  • Difficulty switching between tasks or multitasking
  • Misplacing items 
  • Making rash decisions and choices (ie impulse-control issues)
  • Speaking without prior thought, potentially causing unintended harm
  • Struggling to articulate thoughts and feelings

Is ADHD trendy now?

This is a question many ponder. Historically, mental health disorders were stigmatised. As a result, it led many to suffer in silence. Similarly, the pressure to cope in an unyielding world meant that diagnoses were often reserved only for severe cases. 

At the present time, things are changing. As society evolves, the demands for focus, organisation, and time management have intensified. Hence, it has made ADHD symptoms more noticeable. 

However, this does not mean ADHD is ‘trendy’. Instead, we (as a society) have started shedding light on previously overshadowed conditions. Moreover, with growing awareness, a lot of people are consulting professionals early on, leading to more ADHD diagnoses.

Therefore, early intervention is often a good thing when it comes to managing ADHD. In essence, more people seeking professional support means more people prioritising their mental health and wellness!

Is ADHD the correct term?

Researchers and people with lived experience often note that the ‘attention deficit’ in ADHD is a misnomer.

Rather than lacking attention, ADHD causes attention to fluctuate unpredictably. In other words, people with ADHD are driven more by interest than by what is ‘important’ or ‘urgent’. 

For example, imagine a scenario where a mother asks the teenager to clean their room. To the mother, cleaning might be important, especially if the room is messy or unclean. 

However, the teenager may be preoccupied with a hobby and may prioritise engaging in their activity rather than cleaning. 

People with ADHD often say:

“When I’m in the zone, I can focus on anything.”

‘The zone’ usually refers to a term in ADHD called hyperfocus, which is a deep and unwavering concentration on tasks that a person likes.

However, hyperfocus is not a switch to flip. A person has hyperfocus only from genuine curiosity, a sense of challenge, new experiences, or immediate necessity. When these are aligned, people with ADHD have remarkable attention.



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