What is ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that typically manifests in childhood and can persist into adulthood. It is characterized by persistent patterns of inattention, hyperactivity, and impulsivity that are more severe or frequent than typically observed in individuals at a comparable level of development.

Causes of ADHD

The exact cause of ADHD is not known, but research suggests a combination of genetic, environmental, and neurological factors. Some of these include:

1. Genetic Factors: ADHD tends to run in families, indicating a genetic component. Specific genes related to neurotransmitter systems have been linked to the disorder.
2. Brain Structure and Function: Differences in the brain’s structure, activity levels in certain regions, and neurotransmitter levels (particularly dopamine and norepinephrine) are observed in individuals with ADHD.
3. Environmental Factors: Exposure to certain environmental toxins, alcohol, tobacco smoke, or drugs during pregnancy, and early exposure to lead, can increase the risk.
4. Prenatal and Early Life Risks: Premature birth, low birth weight, and prenatal stress can also be risk factors.

Symptoms of ADHD

ADHD symptoms fall into two categories: inattention and hyperactivity/impulsivity. These can vary widely in severity and can change as a person ages.

Inattention

• Difficulty sustaining attention in tasks or play activities
• Frequent careless mistakes in schoolwork or other activities
• Often does not seem to listen when spoken to directly
• Fails to follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace
• Difficulty organizing tasks and activities
• Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
• Often loses things necessary for tasks and activities
• Easily distracted by extraneous stimuli
• Forgetful in daily activities

Hyperactivity and Impulsivity

• Fidgeting with hands or feet, or squirming in the seat
• Leaving seat in situations where remaining seated is expected
• Running or climbing in situations where it is inappropriate
• Inability to play or engage in leisure activities quietly
• Often “on the go” or acting as if “driven by a motor”
• Talking excessively
• Blurting out answers before questions have been completed
• Difficulty waiting for turn
• Interrupting or intruding on others

Diagnosis of ADHD

Diagnosing ADHD involves a comprehensive evaluation by a qualified healthcare professional. This process may include:

1. Clinical Interview: A thorough medical, developmental, and psychosocial history.
2. Behavioral Assessments: Standardized ADHD rating scales and questionnaires completed by parents, teachers, and sometimes the patient.
3. Observations: Direct observations of the child’s behavior in different settings.
4. Rule Out Other Conditions: Assessing for co-existing conditions such as learning disabilities, anxiety, or mood disorders, which can complicate the diagnosis.

Treatment of ADHD

Treatment for ADHD is often multifaceted, tailored to the individual’s specific needs, and may include a combination of the following approaches:

Medication:

• Stimulants: Such as methylphenidate (Ritalin, Concerta) and amphetamines (Adderall, Vyvanse), which increase dopamine and norepinephrine levels in the brain.
• Non-stimulants: Such as atomoxetine (Strattera) and guanfacine (Intuniv), which are used if stimulants are ineffective or cause significant side effects.

Behavioral Therapy:

• Behavioral Interventions: Techniques to help develop more effective coping strategies and manage symptoms.
• Parent Training: Educating parents on how to support their child’s behavior and improve parent-child interactions.
• School-Based Interventions: Collaborating with schools to implement classroom modifications and support.

Psychotherapy:

• Cognitive Behavioral Therapy (CBT): Helps individuals manage their symptoms by changing negative thought patterns and behaviors.
• Social Skills Training: Helps improve interpersonal skills and interactions with peers.

Educational Support:

• Individualized Education Programs (IEPs): Special education services and accommodations to support learning.

Lifestyle Changes:

• Healthy Diet: Balanced nutrition can help manage symptoms.
• Regular Physical Activity: Exercise has been shown to improve concentration and behavior.
• Consistent Routine: Structured daily routines can provide stability and predictability.