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Attention-deficit hyperactivity disorder (ADHD)

  • Article
  • 2021-02-28

Attention-deficit hyperactivity disorder (ADHD) is a condition characterized by an ongoing pattern of inattention and / or hyperactivity-impulsivity that interferes with functioning or development.

  • Inattention means that a person strays from task, lacks persistence, has difficulty maintaining focus, and is disorganized; and these problems are not due to resistance or lack of understanding.
  • Hyperactivity means that a person seems to be constantly moving, even in situations where it is not appropriate; or overly restless, tapping or talking. In adults, it can be extreme restlessness or exhausting others with constant activity.
  • Impulsivity means that a person takes hasty actions that occur at the time without thinking about it first and that may have a high potential for harm, or a desire for immediate rewards or the inability to delay gratification. An impulsive person can be socially pushy and excessively interrupt others or make important decisions without regard to long-term consequences.

Signs and Symptoms

Inattention and hyperactivity / impulsivity are the main behaviors of ADHD. Some people with ADHD have problems with just one of the behaviors, while others have both inattention and hyperactivity impulsivity. Most children have the combined type of ADHD.

In kindergarten, hyperactivity is the most common ADHD symptom.

It's normal to have some inattention, non-directional motor skills, and impulsivity, but for people with ADHD, these behaviors are:

  • are more serious
  • are more common
  • interfere with or diminish the quality of their social functioning, at school or in a job

Inattention

People with symptoms of inattention can often:

  • Miss or overlook details, make careless mistakes at school, at work, or in other activities
  • Have trouble holding attention during tasks or games, including conversations, lectures, or prolonged reading
  • Does not seem to listen when spoken to directly
  • Not following instructions and not completing schoolwork, chores, or workplace tasks, or starting tasks, but quickly lose focus and easily get sidetracked
  • Having trouble organizing tasks and activities, such as what to do in the right order, keeping materials and belongings in order, having messy work and time management, and not meeting deadlines
  • Avoid or dislike tasks that require sustained mental effort, such as school work or homework, or for teens and older adults, preparing reports, filling out forms, or going through lengthy papers
  • Lose things necessary for tasks or activities, such as school supplies, pencils, books, tools, purses, keys, paperwork, glasses, and cell phones
  • Easily get distracted by unrelated thoughts or stimuli
  • Be forgetful about daily activities such as chores, errands, calling back, and keeping appointments

Hyperactivity impulsivity

People with symptoms of hyperactivity impulsivity can often:

  • Fidget and squirm in their seats
  • Leave their seats in situations where you are expected to remain seated, such as in class or the office
  • Run or sprint around or climb in situations where it is inappropriate or, in teens and adults, often feels restless
  • Not being able to play quietly or pursue hobbies
  • Be constantly on the move or 'on the move', or act like 'powered by a motor'
  • Talk non-stop
  • Blurt out an answer before a question is answered, complete the sentences of others, or speak without waiting for a turn in a conversation
  • Have trouble waiting his or her turn
  • Interrupting or intruding into others, for example in conversations, games or activities

The diagnosis of ADHD requires a comprehensive evaluation by a licensed physician such as a pediatrician, psychologist, or psychiatrist with expertise in ADHD. In order to be diagnosed with ADHD, the symptoms of inattention and / or hyperactivity impulsivity must be chronic or long-lasting, affect the person's functioning and cause the person to lag behind typical development for his or her age. The doctor will also make sure that anyADHD symptoms are not due to another medical or psychiatric condition. Most children with ADHD are diagnosed during the elementary school years. For an adolescent or adult to be diagnosed with ADHD, symptoms must be present before the age of 12.

ADHD symptoms can start as early as between the ages of 3 and 6 years and can continue into adolescence and adulthood. Symptoms of ADHD can be mistaken for emotional or disciplinary problems or overlooked altogether in calm, well-behaved children, delaying diagnosis. Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships.

ADHD symptoms can change over time as a person ages. In young children with ADHD, hyperactivity-impulsivity is the most predominant symptom. As a child reaches elementary school, the symptom of inattention can become more prominent and cause the child to struggle academically. During adolescence, hyperactivity appears to decrease and may more often be reflected as feelings of restlessness or fidgeting, but inattention and impulsivity may persist. Many adolescents with ADHD also struggle with relationships and antisocial behavior. Inattention, restlessness, and impulsivity tend to persist into adulthood.

Risk factors

Researchers aren't sure what causes ADHD. Like many other illnesses, several factors can contribute to ADHD, such as:

  • Genes
  • Cigarette smoking, alcohol or drug use during pregnancy
  • Exposure to environmental toxins during pregnancy
  • Exposure to environmental toxins, such as high levels of lead, at a young age
  • Low birth weight
  • Brain injury

ADHD is more common in men than women, and women with ADHD are more likely to have problems with mostly inattention. Other conditions, such as learning disabilities, anxiety disorders, behavioral disorders, depression, and substance abuse, are common in people with ADHD.

Treatment and therapies

While there is no cure for ADHD, currently available treatments can help reduce symptoms and improve functioning. Treatments include medication, psychotherapy, education or training, or a combination of treatments.

Medication

For many people, ADHD drugs reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. Medication can also improve physical coordination. Sometimes different medications or dosages have to be tried before finding the right one that works for a particular person. Anyone taking any medications should be monitored closely and carefully by their prescribing physician.

Stimulants. The most common type of medication used to treat ADHD is called a 'stimulant'. While it may seem unusual to treat ADHD with a drug considered a stimulant, it works by increasing the brain chemicals dopamine and norepinephrine, which play essential roles in thinking and attention.

Under medical supervision, stimulant drugs are considered safe. However, there are risks and side effects, especially with abuse or when taken above the prescribed dose. For example, stimulants can increase blood pressure and heart rate and increase anxiety. Therefore, a person with other health conditions, including high blood pressure, seizures, heart disease, glaucoma, liver or kidney disease, or an anxiety disorder, should consult their doctor before taking any stimulant.

Talk to a doctor if you notice any of these or any other side effects while taking stimulants:

  • decreased appetite
  • sleep problems
  • tics (sudden, repetitive movements or sounds)
  • personality changes
  • increased anxiety and irritability
  • stomach ache
  • headache

Non-stimulants. A few other ADHD drugs are non-stimulants. These drugs take longer to start working than stimulants, but they can also improve focus, attention, and impulsivity in a person with ADHD. Doctors can be a non-st


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