Attention deficit hyperactivity disorder is a mental disorder that occurs in adults and children. It is an illness that causes its patients to have difficulty sustaining attention and being easily distracted.
A person with ADHD will find it almost impossible to sit at a library, silently reading words off a book. Not surprisingly, when you think of restlessness, the image that comes to mind is a child.
While most children outgrow their usual childhood perturbation, many symptoms of extreme inattentiveness are also found in adults.
What is Attention Deficit Hyperactivity Disorder (ADHD)?
Attention deficit hyperactivity disorder, also known as ADHD, is a complex disorder that interferes with the brain’s ability to execute certain behavioral functions.
However, attention deficit hyperactivity disorder is not a behavioral disorder but a developmental disorder (1).
In simple terms, people with ADHD usually have difficulty focusing and remaining still. In addition, they have difficulty organizing tasks, completing forms and show other similar symptoms of extreme restlessness.
According to brain imaging tests, systematic review, and neurology, attention deficit hyperactivity disorder is not a mental illness like anxiety or depression that can develop over time.
Adults with ADHD and young children usually demonstrate ADHD symptoms right from birth, even though they may lessen over time (2).
ADHD affects about 8.4% of children and 2.5% of adults. The disease is more prominent in men than women, although it is harder to diagnose ADHD in adult women than men (3).
The first signs of ADHD are typically spotted at playtime and in classrooms. For example, children with ADHD may find it hard to accomplish conversations, games, or activities in a school. In addition, they show behavioral symptoms listed, such as mood swings and impulsive behavior.
Types of ADHD
ADHD is a complex disorder that affects a person’s mental health, and after a medical evaluation, people with ADHD are grouped into classes based on what kinds of symptoms they present.
ADHD symptoms usually manifest in a pattern of behaviors that characterize each type.
Predominantly Inattentive Type
A person with the predominantly inattentive type of ADHD primarily has problems keeping their mind on one subject. As a result, they tend to lose interest in the present subject faster than ordinary people.
People with this kind of ADHD tend to procrastinate on essential points or forget what they were just about to do.
They also have trouble managing time and doing any form of lengthy reading. This affects school performance in older teens and may even retard daily tasks.
This type of ADHD is not frequently coupled with hyperactivity and impulsivity. On the contrary, they quickly get tired, a state known as directed attention fatigue.
Predominantly Hyperactive-Impulsive Type
Hyperactivity denotes an inability to stay in one position for long or maintain one trail of thought for extended periods. Hyperactivity usually manifests as fidgety behaviors such as toying with buttons or nervously tapping a table.
Children with attention deficit disorder generally have issues waiting for his or her turn in a queue.
Hyperactive, impulsive behaviors in ADHD include an inability to control one’s actions and movements. Such patients are often seen making decisions in haste, doing irregular reactions spontaneously and with little to no provocation.
This is the typical minor type of ADHD and probably the easiest to recognize. ADHD symptoms become evident in children even during kindergarten, while inattentiveness may not manifest until elementary school.
Combined Hyperactive-Impulsive and Inattentive Type
In this case, inattentiveness, hyperactivity, and impulsive behavior are present simultaneously during the diagnosis of ADHD.
People characterized as combined type ADHD, also known as ADHD-C, tick 6 out of 9 boxes of the manual for both inattentiveness and hyperactivity.
Their minds tend to trail off more than the average person, and they couple that with lots of fidgeting and squirming.
This combination is the most common type and may be hard to manage in children, except for the doctor’s handling.
On the other hand, it is more controllable in adults. Usually, it may manifest as a person who likes to talk too much and can’t finish one sentence before moving on to another, entirely on a different topic.
What Causes ADHD?
Scientists are still digging up dirt on the cause of ADHD. While it is unclear whether certain neurotransmitters such as dopamine play a part in the etiology of ADHD, one thing is proven, ADHD is not caused by bad parenting, too much sugar, or watching too many cartoons.
In several brain imaging studies carried out by scientists, it was discovered that there are physiological differences between the regular human brain and the one of an ADHD patient.
This further solidifies the statement that ADHD is not a behavior disorder, mood disorder but a neurological disorder.
Certain factors have been identified as potential risk factors for ADHD. These include:
- Genetics – three in four children with ADHD have a family member who also suffered from the same condition (4).
- Birth complications and teratogenicity – conditions such as premature birth may predispose children to brain disorders. Also, exposure to certain chemicals during pregnancy may affect the development of the central nervous system. Women who consume alcohol or smoke during pregnancy place their unborn children at unnecessary risks of mental disorders. Consuming chemicals such as nicotine found in cigarettes increases a child’s risk of developing ADHD.
- Structural differences of the brain – according to one research, people with ADHD have less gray matter than usual. The gray matter is in charge of speech, fluidity of speech, muscle control, and decision making.
- Environmental factors – exposure to lead may be one cause of ADHD, although the mechanism of this pathology is not yet known. Lifestyle habits such as not getting enough sleep and an unbalanced diet may worsen an existing attention deficit hyperactive disorder. Brain injury, especially at a young age, may trigger childhood ADHD and learning disabilities.
- Drugs abuse – studies have shown that 11% of people who suffer from substance abuse also struggle with attention deficit hyperactivity disorder, ADHD. Whether it is the condition that drives them to drugs or the reverse remains unclear.
- Other conditions – depression, autism, and oppositional defiant disorder are often found to be related to attention deficit hyperactivity disorder. These conditions increase the frequency and possible severity of ADHD symptoms.
What Does ADHD Feel Like?
Everyone experiences inattentiveness and hyperactivity to some extent. However, these behaviors become worrisome when they impede social interaction and academic performance.
Studies suggest that many symptoms of ADHD in children may be outgrown, but unfortunately, many adults live with this condition without even knowing it.
Since hyperactivity and impulsive behavior are generally associated with childishness, children need to tick more boxes from the diagnostic and statistical manual before suspecting ADHD.
At least 6 of the following boxes must be ticked in children. In adults, 5 out of 9 gives a positive indication (5).
Predominantly Inattentive Subtype Symptoms
- They do not pay close attention to details, at the workplace or in schoolwork. May not be able to differentiate similar-looking or similar sounding objects and names. May not be able to hold conversations with other teenagers.
- Starts a task but hardly finishes it. May begin filling a form but never end it, or start a course then drop it halfway.
- Zones out while being spoken to. The mind drifts during a lecture or discussion, and it seems like they are present only physically, and it seems that their thoughts are elsewhere.
- Have problems with planning and trouble organizing tasks that require attention. They miss deadlines and can’t be relied on.
- They lose things easily. Their items are always in a mess, misplace their keys, wallet, etc.
- Gets easily distracted, quickly loses focus, and can’t read in noisy places. They require extreme quietness for optimal focus.
- Forgets daily chores and responsibilities such as locking doors, making a phone call, returning a file, etc.
- Detests jobs that require prolonged mental activity such as writing, researching, and reviewing documents.
- Makes careless mistakes and are highly mistake-prone due to a lack of attention to detail. ADHD may cause boys and girls to make more mistakes in schoolwork than appropriate.
Predominantly Hyperactive-Impulsive Subtype Symptoms
- Keeps hands and feet busy by tapping or fidgeting.
- They are unable to play or socialize peacefully.
- Has inappropriate and constant motion.
- Has difficulty remaining seated for long and seems to be driven by a motor.
- Talks excessively.
- Has difficulty with patience, can’t wait their turn.
- Cuts in on other people while talking or trying to finish their sentences.
- Has difficulty waiting for permission before taking people’s things or taking over what they’re doing.
- They demonstrate noticeable hyperactivity, make hasty decisions, and motor reflexes. They may suddenly stand up even when there’s no need to.
People with combined ADHD indicate the inattentive and hyperactivity impulsivity subtypes in equal amounts. They show 6 out of 9 symptoms of each.
Symptoms of ADHD in Adults
A different class of symptoms is occasionally seen in adult ADHD. For example, hyperactivity may not be so glaring or involve as much running and standing.
They may require sustained mental effort to complete various tasks, but they become less hyperactive and impulsive as they grow. These symptoms, however, will be seen in most adults living with ADHD (6).
- Have poor time management.
- Inability to maintain proper hygiene.
- Failure to read social cues like when to stop talking, when not to laugh, etc.
- Difficulty completing assignments and other papers.
- Self-centered behaviors. They seem to only think about themselves.
- Can’t compromise with peers.
- Can’t effectively help out with chores at home.
- Have difficulty operating machinery such as clippers, land mowers, etc.
- Have trouble focusing and difficulty sustaining attention for an extended time. Often can’t drive safely.
How To Get Diagnosed With ADHD?
There is no specific test to get ADHD diagnosed. Instead, health care professionals rely on the Diagnostic and Statistical Manual of mental disorders provided by the American Psychiatric Association.
Attention deficit hyperactivity disorder is diagnosed through a series of tests and a physical exam, and symptoms have to persist over six months. To be diagnosed with ADHD in adulthood, the symptoms must have existed before the age of 12.
ADHD Diagnosis in Children
To have certified ADHD in children, they must tick at least 6 out of 9 criteria listed in the Diagnostic and Statistical Manual (DSM-5).
Teachers, parents, and caretakers play an essential role in collecting inaccurate patient data.
A summary of the child’s behavior at home is given by his parent or caretaker, while his school teachers report his behavior at school (7).
The symptoms must remain consistent at home and school to confirm attention deficit hyperactivity disorder. Therefore, a child psychiatrist usually attends to complaints of hyperactivity and inattentiveness seen in ADHD.
ADHD Diagnosis in Adults
According to the DSM-5 manual, adults who show up to 5 symptoms have attention deficit hyperactivity disorder.
In addition, other behavioral and other mental disorders have to be excluded, and possible substance abuse has to be investigated. This is because a couple of conditions give the same group of symptoms, similar to ADHD symptoms.
To come to a conclusion, physical and neurological exams will be carried out, as well as brain imaging tests, to spot the altered physiology of the brain that often characterizes attention deficit hyperactivity disorder.
ADHD results from an altered brain function and structure, which predisposes some people with ADHD to other forms of mental health conditions, sleep disorders, and other related conditions.
About two-thirds of people living with ADHD have a coexisting condition such as anxiety and various learning disabilities. These are the most prevalent disorders commonly associated with ADHD.
This features intense fear or worry that is not proportional to the matter at hand. People with anxiety disorders often have problems interacting socially and making the first steps.
Anxiety is often coupled with overthinking, fidgeting, and the inability to stay still, just like Attention deficit hyperactivity disorder. (8)
One in three people who have ADHD show signs of depression. Depression can be described as a deep, persistent sadness that lasts over 2 weeks at a time.
However, it must be differentiated from a bad mood, occasional sadness, unhappiness traced to performance in schoolwork, a heartbreak, or some kind of personal failure.
Conduct and Behavioral Disorders
Oppositional defiant disorder (ODD) is common in people with ADHD. In this case, patients refuse to cooperate with others, constantly argue and annoy others on purpose.
Other behavioral disorders include tics and Tourrette syndrome, a speech disorder that causes people living with ADHD to suddenly bark, shout or speak at inappropriate times.
About 50% of children with ADHD have a learning disorder. The most common diseases noticed in school are dyslexia and dyscalculia.
They also show speech disorders. An inability to focus appropriately often would cause low grades in ADHD patients, even if they were mentally capable of answering questions correctly.
They seldom finish schoolwork or pay attention to classes, causing them to miss details.
What Are The Treatments For ADHD?
According to the Centre for Disease Control (CDC), ADHD can’t be cured, but it can be managed with a proper treatment plan.
There are various options for the treatment of ADHD. However, since it is a complex neurological disorder, it is wise to use combined therapy instead of strictly medicinal therapy, involving only ADHD medications.
Psychotherapy includes behavioral therapy that helps the patient to recognize and control the symptoms of ADHD. Often, ADHD comes with comorbidities such as anxiety, which can make treatment ineffective.
This kind of therapy proves effective in managing symptoms in children with ADHD. Regardless, the behavioral treatment used to treat ADHD must involve both parent and child.
This helps to clear the air and eliminate any negative emotions that may have built up before the diagnosis of ADHD. (9)
In adults, the approach taken by a mental health professional to psychotherapy is called Cognitive Behaviour Therapy (CBT), where adults can analyze how their thoughts affect their actions.
CBT increases confidence and self-esteem, making it possible for people with ADHD to become more productive at work and school.
Two classes of medications are used to treat ADHD. They are stimulant medications and non-stimulant ADHD medications.
Stimulants such as Adderall, an amphetamine-based stimulant, or methylphenidate (Ritalin) are typically the first pick. This is because stimulants manage symptoms in a higher percentage of the population when compared to non-stimulants medication (10).
ADHD medications are not without their side effects. If misused or abused, they may cause addiction-like symptoms and withdrawal symptoms. ADHD patients must understand when and how to take their medications to avoid drug therapy problems.
ADHD medication may be short-acting, intermediate, or long-acting. Examples of non-stimulant drug therapy for ADHD include Guanfacine (Intuniv) and Bupropion (Zyban).
The center for disease control and prevention continues to look into new forms of drug therapy medication for children with hyperactivity impulsivity conditions.
Coping, Managing, and Natural Remedies
Stress management and lifestyle adaptation has shown a significant improvement in the life quality of patients with attention deficit hyperactivity disorder.
Techniques to improve sleep quality, a balanced diet, supplements, and nootropics for ADHD may help patients lessen the severity of symptoms.
ADHD patients are urged to join support groups and develop practical communication skills to carry out proper social interactions. Doctors recommend getting at least 60 minutes of exercise or a similar physical activity every day.
The National Institute of Mental Health urges family members to seek an individualized form of therapy called a 504 plan.
According to the Individuals with Disabilities Education Act, children who qualify for special education will get preferential consideration during tests, classwork, and regular classes.
Attention deficit hyperactivity disorder may retard social and mental wellbeing. However, it is essential to remember that there are many natural ways to lessen the symptoms of ADHD and prevent the uprising of comorbidities.
First, to manage ADHD, it must be fully recognized, then a multimodal therapy can be initiated. This includes drugs, nootropics and supplements for ADHD, and behavioral therapy.
A healthy lifestyle and mental awareness will prevent the condition from worsening and keep anxiety and depression at bay.
Early diagnosis is paramount. Behaviors that stray from typical childhood behaviors must not be dismissed so treatments can be made before the formative years of adulthood.