Understanding ADHD: Symptoms, Types, and Treatment

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects millions of children and adults. 1   Characterized by challenges with inattention, hyperactivity, and/or impulsivity, ADHD can significantly impact daily life. While often diagnosed in childhood, some individuals don't receive a diagnosis until adulthood. Understanding the different types, symptoms, and treatment options is crucial for managing ADHD effectively.   

What Causes ADHD?

While the exact cause of ADHD isn't fully understood, several factors are believed to play a role:

• Genetics:  A family history of ADHD increases the risk.

• Biochemistry:  Imbalances in neurotransmitters in the brain.

• Traumatic Brain Injuries (TBIs):  Can sometimes lead to ADHD-like symptoms.

• Environmental Toxins: Early exposure to substances like lead.

• Prenatal Exposure: Exposure to drugs or alcohol before birth.

• Premature Birth:  Can increase the risk of developmental disorders.

Types of ADHD: Three Presentations

ADHD manifests in three primary ways:

• Predominantly Inattentive:  Individuals struggle with focus, follow-through, and are easily distracted. This was previously referred to as ADD.

• Predominantly Hyperactive-Impulsive:  Characterized by fidgeting, restlessness, difficulty waiting their turn, and interrupting others.

• Combined Presentation:  Individuals experience symptoms from both the inattentive and hyperactive-impulsive categories.

It's important to note that the term "ADD" is no longer used clinically. It's now considered an outdated term for the predominantly inattentive presentation of ADHD.

Symptoms of ADHD: A Closer Look

Inattentive Type:

• Difficulty paying attention to detail

• Struggles with sustained attention

• Appears not to listen, even when directly addressed

• Difficulty following instructions and completing tasks

• Problems with organization

• Avoids tasks requiring mental effort

• Frequently loses things

• Easily distracted

• Forgetful

Hyperactive-Impulsive Type:

• Fidgets and squirms

• Difficulty staying seated

• Restlessness and impatience

• Difficulty engaging in quiet activities

• Constant movement

• Excessive talking

• Interrupts or intrudes on others

• Difficulty waiting their turn

For a diagnosis, children must exhibit at least six symptoms, and adults over 17 must have at least five symptoms from either category, for at least six months. A combined presentation requires meeting the criteria for both types.

ADHD in Adults: A Different Perspective

ADHD symptoms in adults can present differently than in children. They may be less obvious and more internalized:

• Difficulty meeting deadlines at work

• Inattention in meetings

• Starting tasks but struggling to finish them

• Hyperfocus on one task to the detriment of others

• Frequently losing or misplacing items

• Dominating conversations

• Impulsive or risky behaviors

• Speaking without thinking

Adult diagnoses require evidence of ADHD symptoms before the age of 12. It's worth noting that research suggests ADHD is underdiagnosed in adults, especially women, who may be better at masking their symptoms.

ADHD in Children: Recognizing the Signs

While some childhood behaviors can resemble ADHD symptoms, it's crucial to distinguish between typical childhood experiences and the consistent patterns associated with ADHD. It's also common for children with ADHD to have other co-occurring disorders, such as learning disabilities. A professional evaluation by a doctor is essential for an accurate diagnosis. Children are most often diagnosed when they enter school, but diagnoses are possible as young as two years old.

Treatment Options: Finding What Works

ADHD treatment typically involves a combination of therapy and medication, with self-care strategies and support groups playing a valuable role.

Therapy for ADHD:

• Behavioral Therapy: Uses reinforcement to encourage positive behaviors and discourage unhelpful ones.

• Cognitive Behavioral Therapy (CBT): Helps individuals identify and address negative thought patterns and develop coping mechanisms.

• Family Therapy:  Provides support and education for family members to better understand ADHD and support their loved one.

Medication for ADHD:

Stimulants, such as Adderall and Ritalin, are the most commonly prescribed medications. While it may seem counterintuitive to use stimulants for hyperactivity, they can actually help individuals with ADHD focus and regulate their behavior. Stimulants are available in short-acting, intermediate-acting, and long-acting forms.

Seeking Help: Taking the First Step

If you suspect you or your child might have ADHD, the first step is to consult with a primary care physician. They can assess your symptoms, rule out other potential causes, and provide referrals for specialists like therapists or psychiatrists. You can also seek therapy independently. If you received a diagnosis as a child but never received therapy, consider finding a licensed mental health professional to help you develop coping skills and manage your symptoms. There are many resources available to help you find the support and treatment you need.