Attention-Deficit / Hyperactivity Disorder (ADHD)

Attention-Deficit/Hyperactivity Disorder (ADHD) is a disorder characterized by a combination of inattention, hyperactivity, and impulsive behaviour. ADHD is generally identified early in life and is made apparent through behavioural problems at school or difficulty understanding material, completing tasks, or being easily distracted by others.

However, symptoms of ADHD can be treated effectively with a combination of medication and therapy. If ADHD is left untreated it can have long-term negative effects on academic performance, career success, relationships, and social-emotional development.

DISCLAIMER: This information is for educational purposes only and not to be used for self-diagnosis. If you or a loved one can relate to a number of features listed below, then please do use our therapist directory to find a psychiatrist, psychologist, or therapist that is right for you to receive a professional diagnosis.

• For adults to be diagnosed with ADHD, they must be present with problems related to inattention and/or hyperactivity-impulsivity for a period of at least six months which will, in turn, result in significant impacts on their performance or functioning negatively. These behaviours must also exist in two or more contexts such as at home, at work, or in social settings.
• ADHD is diagnosed in teens when they experience six or more of the following symptoms. If they are 17 or older, they need to experience just five symptoms. The symptoms must last for six months and be severe enough to negatively impact academic or social functioning. They must also be inconsistent with the teen’s developmental level, and not be a result of other mental disorders such as anxiety disorder, mood disorder, or personality disorder. The teen should have exhibited several of these symptoms prior to the age of 12.

• Symptoms of inattention include: 
  • Making careless mistakes, overlooking details
  • Difficulty in focusing on tasks or conversations
  • Being easily distracted
  • Difficulty in terms of following the given instructions or duties in a workplace
  • Difficulty when assigned to organize tasks and activities
  • Avoidance or refusal of activities that require consistent attention (reports, forms, reviewing papers)
  • Losing or misplacing things frequently
  • Being forgetful of daily activities (appointments, chores)

• Symptoms of Hyperactivity and Impulsivity include:
  • Frequently fighting, squirming, or tapping
  • Leaving the seat often when they are required to remain seated
  • Feeling overly restless
  • Can not stay still for an extended period of time
  • Tend to find difficulty when engaging in leisure activities 
  • Talking excessively
  • Can not control themselves from blurting out the answers to questions
  • Impatient to wait for their turn
  • Intruding or interrupting others

• A diagnosis of ‘Combined Presentation’ is made when a person presents with both hyperactivity-impulsivity and inattention symptoms for at least six months.
• A diagnosis of ‘Predominantly Inattentive’ type is made when a person presents with criteria for inattention symptoms but not for hyperactivity-impulsivity symptoms for at least six months.
• A diagnosis of ‘Predominantly Hyperactive-Impulsive’ type is made when a person presents with criteria for hyperactivity-impulsivity symptoms but not for inattention symptoms for at least six months.
• For adults with ADHD, symptoms of inattention are generally more prominent. Both men and women with ADHD may struggle to focus on tasks or prioritize activities, leading to difficulty in completing work, missing deadlines, and forgetting social engagements.

• Some children and adults with ADHD find it difficult to concentrate on tasks assigned to them at school or at work and may daydream frequently. Children with ADHD may become disruptive, defiant, or have trouble getting along with parents, peers, or teachers. Children who struggle with hyperactivity and impulsivity, in particular, often face behavioral challenges that can cause difficulty for adults to manage them. 
• Adults, on the other hand, may be more likely to report feeling restless or fidgety; if they struggle with impulsivity and they may make rash decisions that will adversely affect their day to day life. For both children and adults, executive functioning (planning, emotional regulation, and decision-making) is often affected as well. 

Please Note: This information is for educational purposes only and not to be used for self diagnosis. If you or a loved one can relate to a number of features listed below, then please do use our therapist directory to find a psychiatrist, psychologist or therapist that is right for you to receive a professional diagnosis.

What factors can be contributing causes?

• Health professionals are still unsure what causes ADHD. Most people question the source of their attentional problems or difficulties with impulsivity or restlessness. ADHD does not arise purely from social factors or parenting methods, and the most likely causes appear to be related to neurobiology and genetics. Environmental factors may further influence the severity of this disorder.
• Research on the causes of ADHD tends to focus (more) on younger children. In terms of genetics, 25 % of close relatives of a child with ADHD also have the condition—indicating that genetics play an important role in the development of ADHD.
• Environmental agents may contribute to ADHD. A correlation has emerged between the use of cigarettes and alcohol during pregnancy and the risk of ADHD. High levels of lead found in older buildings and exposure to lead through water sources are also possible risk factors for developing ADHD.

• A general practitioner (GP) or psychologist can usually diagnose ADHD by asking questions about a person’s medical history and symptoms.
• The GP/psychologist will also inquire about a patient’s physical health to ensure that the inattentive, hyperactive, or impulsive behavior is not caused as a result of other underlying medical conditions, or by factors such as drug or alcohol use.
• The GP/psychologist will check the symptoms that the patient presents with against the standard criteria for ADHD before making a diagnosis.

What is the recommended treatment?

• ADHD can be treated successfully with therapy and medication. Therapy provides skills to help the person direct themselves to tasks and become more knowledgeable about their behavior to regulate it effectively. Medications also help to boost focus, reduce restlessness, and improve the progress made from social skills learned in therapy.
• For children, treatments for ADHD are determined by the needs of the individual child and severity of their symptoms. ADHD in children is successfully treated with a three-pronged approach that includes close coordination between the child, family, and school-based interventions.
• Medications (are) most commonly prescribed to treat ADHD include (and this includes) a class of drugs called Stimulants that have both short-acting and long-acting properties. Short-acting medications may need to be taken more often, and long-acting drugs can usually be taken once daily (a day). Those commonly prescribed include Amphetamine/ Dextroamphetamine (Adderall), Dexmethylphenidate (Focalin), Lisdexamfetamine (Vyvanse), Methylphenidate (Concerta, Ritalin). Although some parents worry that their children may become addicted to the medication, there is no convincing evidence that stimulant medications, when used to treat ADHD, cause drug abuse or dependency.

• Antidepressants are considered a second choice for treatment of adults with ADHD. Similar to stimulants, antidepressants also target norepinephrine and dopamine neurotransmitters. These include the older class of drugs called tricyclics, but also newer antidepressants such as Venlafaxine (Effexor) and Bupropion (Wellbutrin). These medications also help with nicotine cravings and stopping smoking.
• Antidepressants have their potential benefits and side effects as well. The most common side effects are decreased appetite, insomnia, increased anxiety, and/or irritability. Some children report mild stomach aches or headaches. It is important to work with an authorizing physician who can prescribe medicine to find the right medication and the right dosage for you.
• For children therapy provides skills to help them more easily direct themselves to tasks and assignments, as well as become more knowledgeable about their behavior to regulate it better. Children are also provided tools to stay organized, maintain a schedule, and stay focused. Psychotherapy can help kids like and accept themselves despite their disorder. The support might also include practical assistance, like helping a child learn how to think through tasks and organize his or her work. Or the support might encourage new behaviors by giving praise or rewards each time the child acts in the desired way. 
• Social skills training can also help children learn new behaviors. In this training, the therapist discusses and models appropriate behaviors like waiting for a turn, sharing toys, asking for help, or responding to teasing, and then gives the child a chance to practice. For example, a child might learn to read people’s facial expressions and tone of voice to respond more appropriately. Social skills training can help teach how behavior affects others and develop new ways to respond when angry or upset. 
• Parenting skills training offered by therapists or in special classes give parents tools and techniques to manage their child’s behavior. Mental health professionals can educate the parents of a child with ADHD about the condition and how it affects the child and family. They can also help the child and (their) parents (to) develop new skills, attitudes, and ways of relating to each other. Parents may benefit from learning to develop relationships with their children where they work jointly towards targets and manage their stress better by increasing their ability to deal with frustration and respond more calmly to their child’s behavior. The therapist assists the family in finding better ways to handle the disruptive behaviors and promote change and works with the parents of young children to teach techniques for coping with and improving their child’s behavior.
• Support groups help parents connect with other people who have similar problems and concerns with their ADHD children. Members of support groups share frustrations, successes, referrals to qualified specialists, and information about what is effective, as well as their hopes for themselves and their children. Sharing experiences with others who have similar concerns helps people know that they aren’t alone. 

• Structuring the child’s school environment may also be helpful. This can include:
  • Limiting distractions in the child’s environment
  • Providing one-on-one instructions with teachers
  • Helping the child divide a large task into small steps if the child has trouble completing tasks, and then praising the child as each step is completed 
  • Requesting an IEP (Individualized Education Plan) based on assessments of the child’s strengths and weaknesses and requesting specific accommodations and services

• Structured environments also help teens which, in addition to the above, include: 
  • Ensuring the teen gets enough sleep
  • Ensuring the teen gets a healthy, varied diet, with plenty of fiber and basic nutrients
  • Helping the teen divide a large task into small steps if the teen has trouble completing tasks, and then praising the teen as each step is completed

• It is beneficial for parents to use stress management methods, such as meditation, relaxation techniques, and exercise to increase their own tolerance for frustration so that they can respond more calmly to their teen’s behavior.
•  Generally, hyperactivity symptoms are less prevalent in adulthood, but symptoms of inattention and impulsivity often continue. Therapy for adults with ADHD generally includes skills to improve everyday functions such as time management, organization, and reaching goals. Therapy also helps target emotion regulation, impulse control, and stress management. By improving emotional and interpersonal self-regulation, adults can more confidently navigate work as well as familial and social relationships. 
• Many adults with ADHD have received negative social feedback—from parents, teachers, employers, and peers—through the course of their academic or employment history that can damage their confidence, self-esteem, of beliefs about their capabilities. Cognitive behavioral therapy (CBT) can help identify negative biases in thinking that reduce motivation and lead to avoidance behaviors and help create a range of adaptive behaviors. 
• Mindfulness mediation training can also improve the ability to continually pay attention to tasks and the ability to work through problems.

• Treatment may also be targeted towards other mood and anxiety disorders that commonly co-occur in adults with ADHD.

• The estimated number of children ever diagnosed with ADHD, according to a national 2016 parent survey, is (of) 6.1 million (9.4%). (CDC).
• It is estimated that up to 5 % of school-age children are diagnosed with ADHD, and (that) boys are more often diagnosed than girls.
• It is estimated that between 2–5% of adults have ADHD. (Wikipedia)
• Around 25–50% of children with ADHD continue to experience ADHD symptoms into adulthood, while the rest experience fewer or no symptoms. (Wikipedia)

If you are experiencing any of these signs, here are some activities you can do at home until you are able to consult a professional

• Exercise
• Engage in creative outlets such as writing, painting, or music
• Keep a gratitude journal
• Talk to a family member or friend about how you are feeling
• Practice Mindfulness
• Practice Yoga
• Engage in a well-balanced diet
• Maintain a good sleep schedule 
• Recognize what you can and can’t handle