Published on Feb 18, 2019 and last reviewed on Aug 08, 2022 - 3 min read
This article discusses ADHD, whether it is a real condition, features of ADHD, how to recognize and manage this common condition, and why ADHD should be treated.
I have met several people, including some doctors, who are skeptical about ADHD (Attention Deficit Hyperactivity Disorder) and question the sudden rise in the number of young people being diagnosed with this condition. I believe that ADHD has always been there, but previously, it was not well recognized and not actively managed.
ADHD is one of the common neurodevelopmental conditions which is being increasingly recognized in the past few decades. Family and all professionals dealing with children (teachers, family doctors, etc.) should develop awareness of this condition and know when to seek further help. Pediatricians, child psychiatrists, and relevant multidisciplinary professionals commonly manage children with ADHD in their clinical practice.
ADHD is a condition where sufferers present with restlessness, poor attention, overactivity, and impulsivity, which are noticeable from an early age. These symptoms have to be present across different situations and should impair the person’s normal functioning to suspect ADHD.
Yes. Some consider ADHD as a social construct, but there is emerging evidence to show the neurobiological basis of ADHD. ADHD is highly heritable (genetic component is quite high). It is quite common for ADHD symptoms to run in families.
Various studies show prevalence to be around 5 % in school going children. Global studies show a range from 2.5 % to 10 %, sometimes even higher. So it is quite common. Prevalence decreases in the adult age group.
Untreated ADHD has a profound negative impact on the child and family. ADHD patients are at a higher risk of developing behavioral problems, poor academic and occupational achievement, drug problems, and difficulty complying with the law. With properly managed, children with ADHD perform better at school, do well academically, develop better peer relationships, and respond better to their parents and teachers.
There are clear diagnostic criteria (ICD-10 and DSM 5), which help us to diagnose ADHD after a thorough clinical assessment including a detailed developmental history and collaborative information from multiple sources.
In the case of children and adolescents, interviews with the child, parents, and information from school are essential to make a diagnosis.
ADHD is a clinical diagnosis. Brain scan (MRI, CT scan) and EEG are not necessary to make a diagnosis, but sometimes may be needed when history is suggestive of other conditions that mimic ADHD.
Not all naughty and poorly behaved children have ADHD. Neither is ADHD an excuse for poorly parented children. Children with various conditions like learning disabilities, anxiety disorder, attachment disorder, mania, and absence seizures can present with ADHD like symptoms. Also, children from a disrupted and chaotic family situation can also present with similar symptoms.
In adults with ADHD, problems with inattention are more noticeable as other symptoms are less prominent when compared to children.
Not all people with ADHD type symptoms will be seen by medical professionals. Mild to moderate symptoms in children can be managed effectively by behavioral intervention by parents and school. Moderate to severe ADHD may benefit from medication.
No. Only moderate to severe ADHD will need medication for symptomatic control, which can be decided after assessment.
Stimulant medication (Methylphenidate, Dexamphetamine) and non-stimulant medication (Atomoxetine) are some of the options available. Other medications like Clonidine and Guanfacine are also helpful in some cases.
ADHD medications are well studied and if prescribed correctly will be largely beneficial to the majority of the patients. There are some contraindications and medical conditions when these medications should be used with caution. The doctor will assess each patient individually before prescribing medication. Patients will need to be followed up regularly to ensure tolerability and safety.
ADHD symptoms may become less prominent in a significant proportion of adolescents when they reach early adulthood. The prefrontal cortex (part of the brain involved with executive function skills) continues to mature till a person is in their early 20s.
In some ADHD cases, symptoms may persist during adulthood, and it will help to continue medication. It is recommended that the need for continuing medication is reviewed every year.
Overall, we have to remember that ADHD is not a negative condition. In fact, I will say that if correctly identified and properly managed, young people with ADHD will have much better functional outcomes. Parents and teachers have to work together both during the diagnosis and management of children with ADHD.
ADHD (attention deficit hyperactivity disorder) management is done with a multi-modal treatment approach, including medications, education, skill training, and psychological counseling. Most patients require a combination of a few of the modalities, and over time the patient might gain control over their symptoms, but there is no cure for this condition.
Pharmaceutical stimulants are the most commonly used treatments against ADHD. Methylphenidate is the most commonly prescribed stimulant. The drug works by increasing neural activity in the brain, especially in the parts concerned with attention and behavior. Often, this is combined with other treatment modalities, mostly counseling.
ADHD is a mental disorder that occurs mostly in boys and is often diagnosed during the early schooling years. The children face problems with paying attention, staying still, and behavior control. The condition cannot be cured, but the children learn to manage the symptoms through various management modalities. The condition continues even through adulthood, but the individuals have better control over their attention and behaviors.
Although medications have been widely used to manage ADHD owing to their large-scale success, it is possible to manage the symptoms non-pharmaceutically. This is adjudicated via dietary regulations, regular exercises, and meditation. Supplementation with zinc, iron, magnesium and omega-3 fatty acids has shown promising results along with other non-medicine approaches. But these methods do not address the underlying brain dysfunction.
There is no gold standard or even a definitive protocol to adjudge ADHD in an individual. The diagnosis is completely dependent on the specialist’s observation and skills. A diagnosis is based on the physical examination to rule out any differential. This is followed by a series of one-on-one interviews with the child, parents, teachers, and partners. The specialist observes and enquires about the individual's behaviors during simple activities and while communicating to establish an astute ADHD diagnosis.
ADHD is believed to be caused due to imbalances in the neurotransmitter levels in the brain. Neurotransmitters are chemicals present at neural synapses (interneuron connections) and help transmit impulses through chemical regulation across different neurons. It is also studied that ADHD individuals have certain underdeveloped regions in the brain and others enlarged. This is in contrast to the normal anatomy of the brain. These size differences may also precipitate ADHD in the individual.
Although the exact cause of ADHD is yet to be determined, it is hypothesized to occur as a result of various factors. A familial run has been observed with ADHD. Research and studies indicate that having a sibling or parent with ADHD increases the probability of having ADHD in an individual. Since the exact genetic etiology is not known, it is believed to be a result of inheriting a complex rather than a single gene.
ADHD falls under conditions. Conditions are abnormal health states that disrupt normal feelings of well-being, whereas disorders are pathologic disruptions of normal body functions. ADHD affects an individual’s behavior and ability to focus, and they seem restless, having trouble with concentration and impulsivity.
ADHD is a serious mental illness with potential impairments and comorbidities. Undiagnosed adults carry the highest risk for consequences. Untreated individuals face problems throughout their lives.
ADHD people find it difficult to focus and prioritize activities. They get distracted easily and are always on edge. They tend to continually fight distractions, overstimulation, anxiety and being disorganized. Even menial tasks fail to complete due to their fickle attention span.
The three primary symptoms of ADHD are as follows:
- Inattention: Short attention spans.
- Impulsivity: Very impulsive in behavior and in communication.
- Hyperactivity: Always in constant motion with no apparent goals.
The measures to calm an individual with ADHD are:
- Follow the specialist’s instructions.
- Consistency in parenting and surroundings.
- Divide activities and tasks into smaller sub-tasks.
- Behavioral therapy to modulate behaviors.
- Allowing fidgeting.
- Let them burn off excess energy before engaging in tasks.
- Help them learn relaxation techniques.
Supplementation with vitamins B and C can help relieve some ADHD symptoms. Additional supplements of zinc, iron, and magnesium can be prescribed to induce dopamine synthesis. Vitamin B deficiencies reportedly cause irritability and fatigue in children.
Trauma and traumatic stress have been linked to ADHD. Such events can alter brain architecture and hamper the development of ADHD. Individuals with an early childhood history of trauma are more likely to develop ADHD.
Although some of the presentations might overlap, ADHD does not fall under the autism spectrum. However, having one of these conditions increases the chances of having the other. Both disorders fall under a larger umbrella of neurodevelopmental disorders. More than half of autistic children show some signs of attention deficit disorder.
Last reviewed at:
08 Aug 2022 - 3 min read
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