Attention-Deficit/Hyperactivity Disorder (ADHD)

What Is ADHD?

ADHD is a mental health condition that affects the brain’s development and function. It interferes with how the brain regulates attention and hyperactivity-impulsiveness and hinders self-control. ADHD can present in different ways, including predominantly inattentive, impulsive, hyperactive, or a combination. It affects many children and adults, with symptoms first appearing in childhood.

The Attention Deficit Disorder Association found that many adults claim to have experienced symptoms for the first time in adulthood. However, the association continues that these adults likely had undiagnosed symptoms in their childhood. This idea is supported by the Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-5), which defines ADHD as a disorder with symptoms starting before the age of 12, even if the symptoms don’t appear until adulthood.

How Common Is ADHD?

According to the Centers for Disease Control and Prevention (CDC), 7 million children and youth between the ages of 3 and 17 have a diagnosis of ADHD, with boys having a higher rate of ADHD than girls.

The disorder can range in severity from mild to severe. The CDC reports that 6 in 10 children have moderate to severe symptoms. In addition, 78% have a co-occurring disorder, with almost 50% having a secondary diagnosis of conduct or behavior disorder and anxiety.

Types of ADHD

Patterns of symptoms may appear in the following categories: inattentiveness, hyperactivity, and impulsivity. Some people may experience one type of symptom that is more dominant than others, while others may experience all symptom patterns.

Inattentiveness

Having trouble paying attention is a struggle for many people with ADHD. They may also have a hard time with organization and focus.

Hyperactivity

Someone with hyperactivity symptoms may find it hard to sit still. They may fidget, pace, tap their fingers, shake their feet while sitting, or speak quickly. They exhibit overall restlessness.

Impulsivity

Impulsive symptoms may appear as if someone is being rude, like when they interrupt someone who is talking or jump in line ahead of others. However, those with ADHD have difficulty controlling these symptoms. They also cannot delay gratification most of the time because their symptoms encourage achieving satisfaction immediately. They are known to think before they act.

What Are the Signs and Symptoms of ADHD

Recognizing and documenting the symptoms of ADHD can help mental health professionals give the most accurate diagnosis.

The following symptoms can present at any time in any environment.  

Hyperactivity-Impulsivity Symptoms

Symptoms of hyperactivity-impulsivity include the following:

• Being unable to sit still, even if it means breaking a rule to stay sitting
• Moving around at inappropriate times, exhibiting restlessness
• Being unable to participate in activities quietly
• Talking or rambling excessively
• Speaking out without waiting their turn, answering questions early, or interrupting

Specific symptoms of hyperactivity-impulsivity in young children may include running in circles, banging on things, constantly asking questions, jumping or climbing, moving while eating, and acquiring frequent injuries resulting from these behaviors.

Specific symptoms in older children include trouble completing tasks or chores, interrupting, making disruptive noises, taking things from others, and frequently getting into trouble.

Inattention Symptoms

Children and adults with inattention symptoms may rush through tasks, tests, or projects. They have difficulty holding lengthy conversations because they can’t stay focused long enough to listen to everything someone is saying. They are easily distracted and often start projects they never finish. For example, a child may start building a mansion out of Legos but only complete the front porch. An adult may start a repair job but quit halfway through it.

Specific symptoms of inattention include the following:

• Making careless mistakes
• Being unable to focus for long periods
• Listening poorly
• Starting tasks but not finishing them
• Lacking organizational abilities
• Being easily distracted
• Being forgetful with important dates, events, etc
• Getting bored quickly
• Losing items
• Daydreaming
• Having trouble processing information and following instructions

Symptoms of both hyperactivity-impulsivity and inattention may be mild, moderate, or severe, which is why the disorder is diagnosed on a spectrum. Symptoms can change as a child ages and may lessen for some while worsening for others, particularly if left untreated.

Mental health treatment plans, which often include medication and therapy, are created to support the diagnosis. Because there are no specific tests available to confirm an ADHD diagnosis, professionals depend on you to report accurate symptoms.

What Causes ADHD?

There is no one specific cause for ADHD. Instead, it is a combination of factors that make someone likely to experience symptoms. The causes for one person developing ADHD may be different for someone else. ADHD tends to run in families and, therefore, is thought to have a genetic basis. It is categorized as a neurobiological disorder, suggesting brain and nervous system problems can be part of the cause. Environmental and lifestyle factors also contribute, like living in an abusive environment, substance misuse, or lack of quality sleep.

It is a myth that parenting styles, gaming, watching too much television, or other environmental factors cause ADHD. There is also no evidence that sugar consumption, unhealthy foods, or allergies cause it. However, some of these factors, such as eating junk food and exposure to trauma, can worsen ADHD symptoms.

What Are the Risk Factors of ADHD?

Risk factors are experiences, events, and conditions that make it more likely for someone to develop a mental health conditions, like ADHD. ADHD may appear due to uncontrollable factors and progress or worsen due to controllable factors. Uncontrollable factors include the following.

Genetics

People with ADHD often have a parent or close relative with either ADHD or some other mental health disorder. Just like children are born with facial features similar to their parents, they can also be born with biological components that resemble their parents.

Brain Injury

Brain injuries can occur during childbirth and anytime throughout a person’s life. Injuries may happen in car crashes, falls, or other accidents. They can also occur by misusing drugs or alcohol. Trauma to the brain may trigger symptoms of ADHD.

Prenatal Problems

Many things can happen during a pregnancy that are out of the mother’s control, including premature births, lack of oxygen, and injuries. All of these may contribute to the development of ADHD in some children.

Conversely, controllable risk factors may include the following.

Lifestyles

Lifestyle factors include children being unsupervised, experimenting with drugs and alcohol at an early age, and living with parents with addiction. Living in a chaotic environment without proper coping skills can lead to more than mental health disorders, including ADHD.

Living in a calm and supportive environment promotes positive physical and mental health.

An Unhealthy Diet

Certain foods are associated with good mental health, and others with poor mental health. Much research is ongoing regarding the brain-gut connections, suggesting there is a link between diet and mental health. Eating high-sugar diets may lead to someone having ADHD symptoms.

On the other hand, healthy fruits, vegetables, fish, and most meats offer vitamins and minerals the body needs to thrive.

Lack of Physical Activity or Exercise

Lack of physical activity harms the body by weakening muscles and changing how the body metabolizes food. The less active you are, the less you can release pent-up energy, which may be one reason for hyperactivity, inattention, sleepless nights, unexplained pain, and restlessness.

Conversely, regular exercise improves mental health and increases chemicals such as endorphins, the body’s natural pain relievers, and serotonin, responsible for mood regulation.

These risk factors may impact one person differently than others, and there is no single thing that will lead someone to develop ADHD.

What Are the Complications of ADHD?

Having ADHD can lead to a variety of complications at home, work, school, and in social settings, which then lead to additional problems. For example, poor performance at work can lead to financial problems and relationship losses. Additional complications may be broken into categories, including:

Performance issues

• Work
• School
• Home
• Driving
• Relationship
• Managing money

Mental health

• Sleep disorders
• Anxiety
• Depression
• Conduct disorders

Addiction

• Misusing ADHD medications
• Misusing alcohol or drugs
• Spending too much time online

Personal Issues

• Relationship problems
• Poor physical health
• Legal trouble
• Accidents or injuries

All areas of a person’s life can be impacted by ADHD symptoms, which is why getting an accurate diagnosis and proper treatment are crucial. Working with a mental health professional can help avoid the complications listed above.

How Is ADHD Diagnosed?

Mental health professionals use the DSM-5 criteria for ADHD to accurately diagnose children, adolescents, and adults with the disorder.

Anyone under 16 must meet six or more symptoms of inattention or hyperactivity-impulsiveness, and those 17 and older must meet at least five symptoms. All symptoms must be present for six or more months. Also, according to the DSM-5, along with symptom requirements, you must have the following:

• Symptoms appear before the age of 12
• Symptoms are present in two or more settings
• Evidence that symptoms interfere with functioning
• Symptoms are not due to another physical or mental disorder

In addition to the DSM-5, professionals may use behavior rating scales, symptom checklists, psychological tests, documentation, and testimonies from friends, families, teachers, or employers.

ADD vs. ADHD

Attention deficit disorder (ADD) and ADHD are now the same diagnoses in the DSM-5. In the past, ADD was assigned to someone who did not exhibit signs of hyperactivity. Today, ADHD is divided into different categories, with the inattentive type absorbing the symptoms that previously defined ADD.

How Is ADHD Treated?

ADHD is treated by psychiatrists and licensed mental health professionals who specialize in the disorder and have experience working with people of all ages with ADHD symptoms. Treatment often consists of a combination of therapies, including the following:

• Medication, including stimulants and non-stimulants
• Cognitive-behavioral therapies that include behavior modification, family therapy, classroom management, support groups, and stress management
• Healthy lifestyle changes
• Work or classroom accommodations

There is not a blanket ADHD treatment that works for everyone. Treatment plans for ADHD are individualized because each person has different needs, preferences, and abilities.

Can ADHD Be Prevented?

ADHD cannot be prevented. However, you can reduce the risk of developing the disorder and its symptoms by:

• Eating healthy
• Exercising
• Creating a peaceful environment as much as possible
• Finding outlets for energy and creativity
• Maintaining rules, structure, and routines

What Questions Should I Ask My Child’s Healthcare Provider?

If you think your child is presenting with symptoms of ADHD, talking to your child’s healthcare provider is essential. The following are examples of appropriate questions you may want to ask the healthcare provider:

• How did you arrive at the ADHD diagnosis?
• What type of ADHD does my child have?
• Does my child have symptoms of co-occurring disorders?
• Can you give me more information on ADHD medication before we start the prescription?
• Can you recommend a mental health professional who specializes in ADHD?
• What is an ADHD diet? What foods should my child avoid?
• Are there non-medication treatments for ADHD?
• What can I do as a parent to help my child with their ADHD symptoms?

The more questions you ask, the more knowledge you gain, and the more you’ll be able to handle the ups and downs of an ADHD diagnosis.

ADHD Takeaways

ADHD impacts the lives of millions of children, youth, and adults, and if symptoms are left untreated, the conditions can worsen. Fortunately, ADHD is treatable with a combination of ADHD medication and psychotherapy. With support from teachers, parents, friends, employers, and families, someone with ADHD can live a healthy, happy lifestyle and experience many successes.

To learn more about ADHD, reach out to a local mental health professional or your family healthcare provider.