What is ADHD?
ADHD stands for attention deficit hyperactivity disorder. It’s a brain disorder that affects how you pay attention, sit still, and control your behaviour. It happens in children and teens and can continue into adulthood.
ADHD is the most diagnosed mental disorder in children. Boys are more likely to have it than girls. It’s usually spotted during the early school years, when a child begins to have problems paying attention.
ADHD can’t be prevented or cured. But spotting it early, plus having a good treatment and education plan, can help a child or adult with ADHD manage their symptoms.
ADHD Types
Symptoms are grouped into three types:
Inattentive. A child with ADHD:
- Is easily distracted.
- Doesn’t follow directions or finish tasks.
- Doesn’t seem to be listening.
- Doesn’t pay attention and makes careless mistakes.
- Forgets about daily activities.
- Has problems organizing daily tasks.
- Doesn’t like to do things that require sitting still.
- Often loses things.
- Tends to daydream.
Hyperactive-impulsive. A child with ADHD:
- Often squirms, fidgets, or bounces when sitting.
- Doesn’t stay seated.
- Has trouble playing quietly.
- Is always moving, such as running or climbing on things. (In teens and adults, this is more often described as restlessness.)
- Talks excessively.
- Is always “on the go,” as if “driven by a motor.”
- Has trouble waiting for their turn.
- Blurts out answers.
- Interrupts others.
Combined. This involves signs of both other types.
ADHD Symptoms in Adults
Symptoms of ADHD may change as a person gets older. They include:
- Often being late or forgetting things.
- Anxiety.
- Low self-esteem.
- Problems at work.
- Trouble controlling anger.
- Impulsiveness.
- Substance misuse or addiction.
- Trouble staying organized.
- Procrastination.
- Easily frustrated.
- Often bored.
- Trouble concentrating when reading.
- Mood swings.
- Depression.
- Relationship problems.
ADHD vs. ADD
Attention deficit disorder (ADD) is the old name for ADHD. It was officially changed in the 1990s. Some people still use both names to talk about this one condition.
ADHD Causes
Experts aren’t sure what causes ADHD. Several things may lead to it, including:
- ADHD tends to run in families.
- Brain chemicals. These may be out of balance in people with ADHD.
- Brain changes. Areas of the brain that control attention are less active in children with ADHD.
Sugar doesn’t cause ADHD. ADHD also isn’t caused by too much TV, a stressful home life, poor schools, or food allergies.
ADHD Risk Factors
Studies have found that several risk factors may play a role in the development of ADHD. Some of them affect a baby’s brain development during pregnancy:
- Poor nutrition.
- Infections.
- Smoking.
- Drinking.
- Substance abuse.
Other things may affect a child’s brain development after birth. Some of the thing’s researchers have looked at include:
- Being born prematurely.
- Toxins, such as lead.
- A brain injury or a brain disorder. Damage to the front of the brain, called the frontal lobe, can cause problems controlling impulses and emotions.
- “Western” diet. One study found that children who ate a diet high in added sugar, fats, and sodium and low in fibre and omega-3 fatty acids had a greater chance of ADHD.
- Nutritional deficiencies.
- Food additives. There may be a link between food colouring additives and preservatives and ADHD, but this may only be for children who are already at a high level of risk for the condition.
ADHD Diagnosis and Testing
It can be hard to diagnose ADHD, especially in children. No one test will spot it. Doctors diagnose ADHD in children and teens after discussing symptoms at length with the child, parents, and teachers and then observing the child’s behaviours.
Doctors use the American Psychiatric Association’s guidelines, which are based on how many symptoms a person has and how long they’ve had them. They’ll also rule out other things that may be causing the symptoms, such as health conditions or problems in daily life.
To confirm a diagnosis of ADHD or learning differences, a child may take a series of tests to check their neurological and psychological status. The tests should be given by a paediatrician or mental health professional with experience in diagnosing and treating ADHD.
Your primary care doctor might refer you to a specialist such as a psychiatrist or psychologist. The tests may include:
- A medical and social history of both the child and the family.
- A physical exam and neurological assessment that includes screenings of vision, hearing, and verbal and motor skills. More tests may be given if hyperactivity may be related to another physical problem.
- An evaluation of intelligence, aptitude, personality traits, or processing skills. These are often done with input from the parents and teachers if the child is of school age.
- A scan called the Neuropsychiatric EEG-Based Assessment Aid (NEBA) System, which measures theta and beta brain waves. The theta/beta ratio has been shown to be higher in children and adolescents with ADHD than in children without it.
ADHD Treatment
There are several approaches to treating ADHD. But research suggests that for many children, the best way to manage symptoms is a multimodal approach. This involves multiple methods of treatment that work together.
Many symptoms of ADHD can be managed with medication and therapy. Close cooperation among therapists, doctors, teachers, and parents is very important.
Medication for ADHD. Although there is controversy about their possible overuse, stimulants are the most prescribed medications for treating ADHD. They can help control hyperactive and impulsive behaviour and improve attention span.
They act on the brain chemicals, like dopamine, that can make impulsive behaviour worse. Side effects of some ADHD medicines can include:
- Anxiety.
- Loss of appetite.
- Fatigue.
- Crankiness.
- Trouble sleeping.
- Skin discoloration (with patches).
- Upset stomach.
- Headache.
Most side effects are minor and improve with time. In some cases, doctors may lower a dosage to ease side effects.
In rare cases, stimulants can have more serious side effects. For instance, some are linked to a higher risk of heart problems and death in children with heart disease. They may also make psychiatric conditions like depression or anxiety worse or cause a psychotic reaction.
Before your child starts an ADHD medicine, talk to your doctor about the risks and benefits. Remember that it can take some trial and error to find the right medicine and dose.
Therapy for ADHD. These treatments focus on changing behaviour.
- Special education helps a child learn at school. Having structure and a routine can help children with ADHD a lot.
- Behaviour modification teaches ways to replace bad behaviours with good ones. Let your child know what behaviours you expect of them. Make simple, clear rules. When they lose control, have them face consequences that you’ve set up, like time-outs or losing privileges. Keep an eye out for good behaviour. When they keep their impulses in check, reward them.
- Psychotherapy (counselling) can help someone with ADHD learn better ways to handle their emotions and frustration. It could help improve their self-esteem. Counselling may also help family members better understand a child or adult with ADHD.
- Social skills training can teach behaviours, such as taking turns and sharing.
ADHD support groups of people with similar problems and needs can help you learn more about ADHD and how to manage your symptoms. These groups are helpful for adults with ADHD or parents of children with ADHD.
Education and ADHD. Educating parents about the disorder and its management is another important part of ADHD treatment. This may include learning parenting skills to help a child manage their behaviour. In some cases, the child’s entire family may be involved.
Living with ADHD
A few lifestyle changes can also help you or your child manage symptoms:
- Eat a healthy diet with lots of fruits, veggies, whole grains, and lean protein.
- Get some exercise every day. Studies find that exercise helps control impulses and other behaviour problems in kids with ADHD. Think about signing your child up for a sports team, such as basketball, soccer, or baseball. Playing a sport not only gives kids exercise, but it also teaches them important social skills, such as how to follow rules and take turns.
- Limit time spent on electronic devices.
- Get plenty of sleep.
- Simplify your child’s room to lessen distractions, like toys, and improve organization.
It’s common to get frustrated when you’re raising a child with ADHD. You’ll feel more in control if you take an active part in your child’s treatment. It may help for you to:
- Keep a clear schedule and routines.
- Talk to your child simply and honestly about what you expect from them. Make instructions simple and specific (“Brush your teeth. Now, get dressed.”) instead of general (“Get ready for school.”).
- Focus only on your child when you’re talking to them.
- Be an example of calm, focused behaviour.
- Be consistent with discipline, and make sure other caregivers follow your methods.
- Reward good behaviour.
- Boost your child’s self-esteem. Because they may have trouble processing directions and other information, they may be bombarded with corrections, leaving them with a low opinion of themselves. Do whatever you can to boost your child’s self-esteem.
- Encourage your child’s special strengths, particularly in sports and out-of-school activities.
- Learn as much as you can about ADHD and impulsive behaviours.
- Keep in close contact with your child’s doctor, teachers, and therapists.
- Join a support group to learn from other parents who have been through the same problems.
ADHD Outlook
Without treatment, ADHD can make it hard to deal with the challenges of everyday life. Children may have trouble learning or developing social skills. Adults could have problems with relationships and addiction. The disorder could also lead to mood swings, depression, low self-esteem, eating disorders, risk-taking, and conflicts with people around you.
But many people who have ADHD live happy, full lives. Treatment helps.
It’s important to keep track of your symptoms and see your doctor regularly. Sometimes, medication and treatments that were once effective stop working. You may need to change your treatment plan. Some people’s symptoms get better in early adulthood, and some can stop treatment.
