Attention-Deficit/Hyperactive Disorder : Signs, Symptoms, and Treatments

Attention-Deficit/Hyperactivity Disorder: Signs, Symptoms, and Treatments

ADHD is a disorder that makes it difficult for a person to pay attention and control impulsive behaviors. They may also be restless and seem to be active constantly. Contrary to some beliefs, ADHD is not just a childhood disorder. While the symptoms of ADHD often begin in childhood, ADHD can continue through adolescence and into adulthood. While hyperactivity generally improves as a child ages, other problems with inattention, disorganization, and poor impulse control often continue through the teen years and into adulthood.

Causes of ADHD

Current research suggests that ADHD may be caused by a combination of genetic and non-genetic factors. These factors include genetics, cigarette smoking, alcohol, or drug use during pregnancy, exposure to environmental toxins at a young age (ex: lead), low birth weight, and brain injuries.

Warning Signs of ADHD
People with ADHD typically have a pattern of three different types of symptoms:

1. Difficulty paying attention (ie inattention) 
2. Being overactive (ie hyperactivity)
3. Acting without thinking (ie impulsivity)

These symptoms get in the way of development and functioning. The way these three symptoms are manifested varies by person. 

Problems with paying attention (ie inattention) may manifest in:

– Overlooking or missing details, making careless mistakes on schoolwork, work projects, or during other activities
– Having problems sustaining attention during tasks or while playing, including conversations, lectures, or lengthy reading
– Seeming to not listen when spoken to directly
– Failure to follow through on instructions, failure to finish schoolwork, chores, or duties in the workplace, or starting tasks but quickly losing focus and getting easily sidetracked
– Having problems organizing tasks and activities, such as doing tasks in sequence, keeping materials and belongings in order, keeping work organized, managing time, and meeting deadlines
– Avoiding tasks that require sustained mental effort, such as schoolwork or homework, or for teens and older adults, preparing reports, completing forms, or reviewing lengthy papers
– Losing things necessary for tasks or activities, such as school supplies, pencils, books, tools, wallets, keys, paperwork, eyeglasses, and cell phones
– Becoming easily distracted by unrelated thoughts or stimuli
– Being forgetful in daily activities, such as chores, errands, returning calls, and keeping appointments

Problems being overactive (ie hyperactivity) and acting without thinking (ie impulsivity) manifest in:

– Fidgeting and squirming while seated
– Getting up and moving around in situations when staying seated is expected, such as in the classroom or in the office
– Running or dashing around or climbing in situations where it is inappropriate; or, in teens and adults, often feeling restless
– Being unable to play or engage in hobbies quietly
– Being constantly in motion or “on the go,” or acting as if “driven by a motor”
– Talking nonstop
– Blurting out an answer before a question has been completed, finishing other people’s sentences, or speaking without waiting for a turn in conversation
– Interrupting or intruding on others during conversations, games, or activities

Showing these signs and symptoms does not necessarily mean a person has ADHD. Many other problems, like anxiety, depression, and certain types of learning disabilities, can have similar symptoms.

Treating ADHD
Although there is no cure for ADHD, there are some treatments that may help to reduce symptoms and improve functioning. Today, ADHD is commonly treated with medication, education or training, therapy, or a combination of these treatments.

Medication for ADHD

Many people with ADHD find that medications reduce their negative symptoms of hyperactivity and impulsivity while helping to improve their ability to focus, work, and learn. 

There are many different types and brands of ADHD medications, and all have potential benefits and side effects. Sometimes several different medications or dosages must be tried before finding the one that works well for an individual person. Anyone taking medication(s) for ADHD must be monitored closely and carefully by their prescribing doctor.

Stimulants: The first line treatment for ADHD is the stimulant class of medications, and stimulants are the most common type of medication prescribed for ADHD. While it may seem unusual to treat someone that has a hyperactivity disorder with a stimulant, they have shown great efficacy in boosting concentration and reducing impulsivity and hyperactivity. The stimulant class of medication includes widely used drugs such as Ritalin, Adderall, and Dexedrine. Researchers believe that stimulants are effective because they increase the brain chemical dopamine, which plays an essential role in thinking and attention.

Non-Stimulants: These medications take longer than stimulants to start working, but they can also improve focus, attention, and impulsivity in a person with ADHD. A non-stimulant may be prescribed if a person had negative side effects from  a stimulant, if a stimulant was not effective, or if the combination of a non-stimulant with a stimulant increases effectiveness. Two examples of non-stimulant medications include atomoxetine and guanfacine.

Antidepressants: Although antidepressants are not approved by the U.S. Food and Drug Administration specifically for the treatment of ADHD, antidepressants are sometimes used to treat adults with ADHD. Older antidepressants are sometimes used because they affect brain chemicals dopamine and norepinephrine, just as stimulants do.

Therapy for ADHD: There are different types of therapy that have been tried for ADHD, but research shows that therapy alone may not be effective in treating ADHD symptoms. However, adding therapy to an ADHD medication treatment plan may help patients and families better cope with the daily challenges posed by ADHD.

Help for children and teens with ADHD: Parents and teachers can help children and teens with ADHD to stay organized and follow directions with tools such as keeping a routine and a daily schedule, organizing everyday items, using homework and notebook organizers, and giving praise or rewards when rules are followed.

Help for adults with ADHD: A licensed mental health provider or therapist can help an adult with ADHD learn how to organize his or her life with tools such as keeping routines and breaking down large tasks into smaller, more manageable tasks.

Children and adults with ADHD need guidance and understanding from their parents, families, and teachers to set goals for success and reach their full potential. Mental health professionals can educate the parents and family of a child or adult with ADHD about the condition and how it affects them. They can also help them develop new skills, attitudes, and ways of relating to each other.

If you are concerned about whether you or your child might have ADHD, the first step is to talk with a healthcare professional to find out if the symptoms fit the diagnosis. The diagnosis of ADHD can be made by a mental health professional, like a psychiatrist or clinical psychologist, primary care provider, or pediatrician.

For more on ADHD and other similar diagnoses, check out my book, Tales from the Couch, available on Amazon.com.

Attention Deficit Disorder and Attention Deficit Hyperactive disorder

Attention Deficit Disorder

ADD, Attention Defecit Disorder is a chronic condition marked by issues with attention. It is most often seen in childhood, but can persist into adulthood, and there are 3 million US cases per year. Due to it’s high prevalence, I want to take the opportunity to discuss the diagnosis, symptoms, and treatment of ADD.   

ADD has a sister disorder called ADHD, Attention Defecit Hyperactivity Disorder. What’s the difference between them? It’s pretty simple. ADHD includes the symptom of physical hyperactivity or excessive restlessness. That’s what the “H” is for. In ADD, the symptom of hyperactivity is absent. 

What are the hallmarks of this disorder?  Basically, it is a disorder of concentration, marked by problems concentrating and the inability to stay on task. These individuals are easily distracted and readily bored. They move from project to project without finishing and start projects without all of the appropriate tools needed to complete them. This all leaves them very anxious. In cases of ADHD, they are also impulsive, intrusive, disruptive, and hyperactive, often constantly fidgeting. 

What percent on the population are we dealing with here?  Roughly 20% of boys and 11% of girls have some type of attention deficit disorder. 

What are the causes of attention deficit disorder? While we don’t know exactly, there are several suspects. Maternal use of alcohol or cocaine while in utero is an extremely common finding. Brain infections when pregnant or during early childhood, head trauma, and any birth defects that affect child development are also suspected. Exposure to enviromental toxins and pesticides are suspect. Excessive video games alter brain chemistry, as does a diet of processed foods and sugar, and these are also suspected causes for attention deficit disorder. I would say the number one cause of ADD is most likely genetic, inherited from mother or father. 

What is the result of having attention deficit disorder? How does it affect one’s life? It results in having problems fitting into the academic world or the job world. People with attention deficit disorder don’t fit into a regimented or organized educational or work environment. They can be very intelligent and productive people, but they don’t fit into what we would consider the stereotypical or standard type of academic setting or work setting. Also, due to their impulsivity and their disorderly conduct, they can wind up getting in trouble in school and in trouble with the law. They can be unsuccessful at work, not because they aren’t smart enough, but because they cannot stay focused. In terms of lifestyle, they also have a much higher rate of obesity. This is likely due to lack of impulse control, causing them to overeat. They have problems in relationships, and their divorce rates are much higher. Their propensity toward domestic violence may also be higher. They may also be more prone to Alzheimer’s disease. Because of all of these failures and shortcomings in the stereotypical organized worlds of education and career, they have much lower self-esteem. There are studies that report that up to 52% of people with attention deficit disorder have drug or alcohol problems. 

So how can we help these people? How do we treat these illnesses? The number one treatment is behavioral training with a mental health professional. The gist of that is educating them to focus on one thing at a time. They are not able to handle instructions with multiple levels at once, but they can focus on one thing at a time and have success with that. Pharmacologically, ADD and ADHD are generally treated with amphetamine stimulants. Some antidepressantants may also benefit people with attention deficit disorder. Essentially, a combination of behavioral therapies, special education programs and medications show the most promise in the treatment of attention deficit disorder. But a diagnosis of ADD or ADHD isn’t all future doom and gloom. Eventually, people find their niche in the world and can become successful. The actor Ryan Gosling takes medication for his ADD and says that it may take him longer to read his scrips than other actors, but he manages to get the job done. Uber successful comedian Howie Mandel has successfully done just about all there is to do in Hollywood. I have met a lot of CEO’s with ADD, and they function well because they have people around them to take care of all the boring mundane tasks, giving them the chance to think freely and create business opportunities. They are creative and capable people. They are another example of why you can’t judge a book by it’s cover…you can’t assume that someone with a psych diagnosis will never make it in the world. Ask Richard Branson. I think he’s done pretty well for himself in the corporate world despite his ADD. Justin Bieber has ADHD and has managed to record a few hit songs. Olympian Michael Phelps has ADD, depression and anxiety, and that hasn’t stopped him.These are some examples of people that have adapted and overcome their diagnoses rather than be labeled by them. If you have ADD or any psych diagnosis, I’d suggest you follow their lead. 

For more patient stories, check out my book Tales from the Couch, on Amazon.com.