Attention deficit hyperactivity disorder (ADHD) is a condition in which characterized by inattention, hyperactivity and impulsivity. ADHD is most commonly diagnosed in young people. An estimated 8.8% of children aged 4-17 have ADHD. While ADHD is usually diagnosed in childhood, it does not only affect children. An estimated 4.4% of adults aged 18-44 have ADHD.
With treatment, people with ADHD can be successful in school, work and lead productive lives. Researchers are using new tools such as brain imaging to better understand the condition and to find more effective ways to treat and prevent ADHD.
While some behaviors associated with ADHD are "normal" and not a cause for concern to most people, someone with ADHD will have trouble controlling these behaviors and will show them much more frequently and for longer than 6 months.
Signs of inattention include:
Becoming easily distracted, and jumping from activity to activity.
Becoming bored with a task quickly.
Difficulty focusing attention or completing a single task or activity.
Trouble completing or turning in homework assignments.
Losing things such as school supplies or toys.
Not listening or paying attention when spoken to.
Daydreaming or wandering with lack of motivation.
Difficulty processing information quickly.
Struggling to follow directions.
Signs of hyperactivity include:
Fidgeting and squirming, having trouble sitting still.
Touching or playing with everything.
Difficulty doing quiet tasks or activities.
Signs of impulsivity include:
Acting without regard for consequences, blurting things out.
Difficulty taking turns, waiting or sharing.
Types of This Disorder
There are several factors believed to contribute to ADHD:
Genetics. Research shows that genes may be a large contributor to ADHD. ADHD often runs in families and some trends in specific brain areas that contribute to attention.
Environmental factors. Studies show a link between cigarette smoking and alcohol use during pregnancy and children who have ADHD. Exposure to lead as a child has also been shown to increase the likelihood of ADHD in children.
ADHD occurs in both children and adults, but is most often and diagnosed in childhood. Getting a diagnosis for ADHD can sometimes be difficult because the symptoms of ADHD are similar to typical behavior in most young children. Teachers are often the first to notice ADHD symptoms because they see children in a learning environment with peers every day.
There is no one single test that can diagnose a child with ADHD, so meet with a doctor or mental health professional to gather all the necessary information to make a diagnosis. The goal is to rule out any outside causes for symptoms, such as environmental changes, difficulty in school, medical problems and ensure that a child is otherwise healthy.
A treatment plan is most effective when tailored to an individual's needs, and implemented early on. ADHD treatment plans should consider learning style and include medication prescribed by a professional. A doctor or mental health professional may also include behavioral therapy into treatment.
Medication improves the symptoms of ADHD so that people can focus more on the things they enjoy and improve quality of life. Finding the right medication is a process and not every medication will work for everyone.
Effective medications can improve attention span, your ability to deal with frustration. and lead to better relationships.
The most prescribed medications for ADHD are stimulants. These medications work by making it easier for nerve receptors in the brain to communicate with each other. The impact of stimulants can often noticed quickly, but they may reduce appetite and impact sleep. They can also shorten a growing child’s height a small amount if taken for many years, so be sure to track growth over time.
Stimulants affect how the brain controls impulses and help to regulate behavior and attention. They are usually the first choice of medication to use for the management of ADHD.
Methylphenidate (Methylin, Ritalin, Concerta)
Methylphenidate SR (Ritalin SR)
Dexmethylphenidate (Focalin XR, SR Focalin)
Dextroamphetamine (Dexedrine, Dextrostat, Spansule)
Amphetamine (Adderall, Adderall XR)
Lisdexamfetemine or Dimesylate (Vyvanse)
Because of the fast-acting nature and effects, stimulants have the potential for misuse. People have used these medications to improve academic or athletic performance or for the physical reaction. Possession of these medications without a prescription is illegal.
Non-stimulant medications are also commonly prescribed. It may take some time for these medications to become effective. Nonstimulants affect the nerve receptors more indirectly than stimulants. It is necessary to keep track of treatment results over time.
Nonstimulant drugs are used to increase and adjust the levels of neurotransmitters in the brain. This helps with concentration by increasing attention span and reducing impulsivity.
Clonidine Hydrochloride (Kapvay)
Antidepressants may also be something a doctor suggests. This is especially true if someone is living with ADHD and depression. For medications that are not first- or second-line treatments for ADHD, ask your doctor why they recommend this treatment. You should also ask about their knowledge and experience with treating ADHD with these kinds of medications. Always be sure to check the FDA approval status of any medicine.
Nortriptyline (Pamelor, Aventyl)
Bupropion (Wellbutrin, Wellbutrin XL, Welbutrin SR)
Venlafazine (Effexor, Effexor XR)
Remember that dosage and scheduling of medication will impact treatment outcomes. Young children need to be monitored to ensure they are taking the correct dosage of the medication. Dosage may change as they get older. Some parents choose to only give their children medication when they are in school.
Note that any medication may cause side effects. Common side effects of ADHD medications include appetite, sleep problems, anxiety and irritability. You can manage side effects with a change in dosage and often lessen and even disappear over time.
A mental health professional can help a person come up with ways to improve behavior. For example, a doctor may provide guidance on how to organize and complete homework assignments. Mental health professionals may also help you learn how to work through frustrating events. Providing feedback as well as support is key in improving behavior. Having structure, routine and clear expectations of what is allowed and not allowed can help a child learn and feel more in control of their own life. Talk about what behavior and outbursts are acceptable.
Behavior therapy can also help improve social skills, such as sharing and interacting with peers. Learning appropriate responses to everyday situations can help your child have healthier relationships. Better relationships with teachers, friends and family can improve the quality of life for your child.
Complementary Health Approaches
Outside of therapy and medications, there are many approaches to managing ADHD. These alternative methods, called complementary and alternative medicine (CAM), can supplement a treatment plan and support day-to-day health.
Elimination diets are based on the theory that people are sensitive to sugar and artificially added colors, flavors and preservatives. Eliminating these substances from the diet could improve learning and behavioral problems.
Nutritional supplements, such as omega-3s, may help the deficiency of fatty acids that are sometimes associated with ADHD.
Interactive metronome training consists of a computerized metronome making a rhythmic beat that individuals try to match by tapping a hand or foot. It is suggested that improvement in matching the beat reflects gains in motor planning and timing skills.
Chiropractic medicine addresses muscle tone imbalance that can affect imbalances in brain activity.
Neurofeedback (EEG biofeedback) teaches individuals how to increase activity in the frontal areas of the brain. This is because people living with ADHD show low levels of arousal in these areas, which results in an impaired ability to focus. Through training, people can learn how to increase arousal on their own.