Attention-Deficit/Hyperactivity Disorder (ADHD)

Attention Deficit/Hyperactivity Disorder, or ADHD, is a neurological disorder that is most commonly diagnosed in children and can continue into adolescence and adulthood. Approximately 9.4% of children 2-17 years of age (6.1 million) had ever been diagnosed with ADHD, according to a parent report in 2016 for the United States. About one-third of those children diagnosed with ADHD retain the diagnosis into adulthood.

What is ADHD?

Having Attention Deficit/Hyperactivity Disorder (ADHD) means that an individual struggles with focusing and paying attention, and possibly struggles with hyperactive and impulsive behavior.
Difficulties with attention include the following:

Often fails to give close attention to detail or makes mistakes
Often has difficulty sustaining attention in tasks or activities
Often does not seem to listen when spoken to directly
Often does not follow through on instructions and fails to finish schoolwork or workplace duties
Often has difficulty organizing tasks and activities
Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort
Often loses things necessary for tasks or activities
Is easily distracted by extraneous stimuli
Is often forgetful in daily activities

Difficulties with hyperactivity and impulsivity include the following:

Often fidgets with or taps hands and feet, or squirms in seat
Often leaves seat in situations when remaining seated is expected
Often runs and climbs in situations where it is inappropriate (in adolescents or adults, may be limited to feeling restless)
Often unable to play or engage in leisure activities quietly
Is often ‘on the go’, acting as if ‘driven by a motor’
Often talks excessively
Often blurts out answers before a question has been completed
Often has difficulty waiting their turn
Often interrupts or intrudes on others

It is important to note that the aforementioned symptoms must have been present prior to the age of 12 years old and several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g. at home, school or work; with friends or relatives; in other activities). Lastly, there must be clear evidence that symptoms interfere with, or reduce the quality of, social, academic or occupational functioning.

There are three types of ADHD:

Attention Deficit/Hyperactivity Disorder, Inattentive Type
- Child: six or more of the symptoms (Table) have persisted for at least 6 months
- Adolescent/Adult: five or more of the symptoms (Table) have persisted for at least 6 months
Attention Deficit/Hyperactivity Disorder, Hyperactive Type
- Child: six or more of the symptoms (Table) have persisted for at least 6 months
- Adolescent/Adult: five or more of the symptoms (Table) have persisted for at least 6 months
Attention Deficit/Hyperactivity Disorder, Combined Type (both inattentive and hyperactive-impulsive symptoms are occurring)
- Child: six or more of the symptoms (Table) have persisted for at least 6 months
- Adolescent/Adult: five or more of the symptoms (Table) have persisted for at least 6 months
  
  It is really common for people with ADHD to struggle with social relationships, as friends, family, and loved ones may not understand the symptoms of the disorder and assume that the individual is “just not listening” or “does not care enough”. However, this is not the case. Many people with the disorder want close relationships and to connect with others, they just have difficulty with focusing and paying attention because their frontal lobe is not functioning the same way as most people. The front lobe of the brain is in charge of executive functioning, organizing, planning, decision making, emotion regulation, and higher order thinking. It would be difficult to follow a conversation when this area of the brain is not working the way it should, which is not that person’s fault. It is also difficult to pay attention when the information being shared is uninteresting to the individual with ADHD, as boredom is the most difficult for them to tolerate. It needs to be stimulating enough to maintain his/her/their attention.

In order to compensate for the symptoms of ADHD, many people develop anxiety and depression. The anxious symptoms serve the function of keeping a person on task by worrying or ruminating to make certain they remember important information or get things done. As a result, they may also feel symptoms of depression due to the shame the disorder can bring and from the exhaustion the anxiety creates.

On a positive note, it is often reported by people with ADHD have the ability to hyper-focus on things they are very interested in. This means they can become incredibly focused and invested in topics, hobbies, and activities that are enjoyable and stimulating to them. In addition, these individuals also have the capacity to be very creative.

How Do You Treat ADHD?

One of the most common and helpful ways of treating ADHD is psychotropic medication, where a medical professional often prescribes a stimulant. This stimulant helps activate the frontal lobe so that it functions in a way to allow for better focusing, organizing, concentrating, tracking, follow through, and completion of tasks. Many people taking a stimulant report being more productive and less anxious.

In addition, it is important to supplement medication management with therapy to work on developing organizational skills, decision making, impulse control, time management, emotion regulation, social skills, and task optimization. This may involve incorporating family members, friends, and loved ones into sessions. I can collaborate with your school or job to assist in helping you function in these settings and helping your teachers or co-workers achieve a better understanding of your behavior so you can all work better together.