Attention-Deficit Hyperactivity Disorder (ADHD)

ADHD may seem like a harmless condition, but people with the diagnosis know how significantly it can impact their life at home, work and school.

By now, most people have heard of attention-deficit hyperactivity disorder (ADHD). However, many people continue to misunderstand the condition: they may believe myths about ADHD, not know the condition’s symptoms or confuse ADD and ADHD. Learning the truth about ADHD can positively impact those with the condition and their loved ones.

What is ADHD?

ADHD is a mental health condition marked by a collection of behavioral symptoms affecting attention, concentration, activity levels and impulse control.

Because ADHD affects a person’s actions, the condition may be evident to those around the individual with ADHD.

ADHD is more visible than many other mental health conditions. A person with depression or anxiety may not display obvious, visible symptoms. ADHD symptoms, however, are relatively noticeable.

Due to an incomplete understanding of how ADHD presents, many myths surround the condition. Some people believe that ADHD is not a real condition or that ADHD is a product of poor parenting or laziness. Others may believe that only children have ADHD, and as they age, they “grow out of” the disorder. Of course, these myths are inaccurate and can limit a person’s access to helpful treatment.

In reality, ADHD is a real condition that affects people whose brains display a chemical imbalance in certain locations. When regions of the brain built to organize thoughts and behaviors do not get enough of these chemicals, ADHD symptoms may result.

Nearly every person shows signs of the condition, but only about 5% of children in America have ADHD. Although symptoms change over time, many of these children with ADHD grow up to be adults with ADHD.

ADHD vs. ADD

Another misunderstanding surrounding ADHD is the difference between ADD and ADHD. People may think ADD stands for attention-deficit disorder, which implies they do not have the hyperactivity of ADHD.

The truth is that ADD and ADHD are the same thing. The proper name for the condition is attention-deficit/ hyperactivity disorder (ADHD), so those referring to the condition as “ADD” are using outdated terminology.

Causes of ADHD

Like many other mental health conditions, the cause of ADHD is not well-known. People may wonder if ADHD is hereditary or caused by external experiences. Many believe there are several genetic and environmental causes of ADHD.

Experts believe an imbalanced brain chemistry causes ADHD, but they continue to research what causes this imbalance. Possible causes of ADHD include:

Genes

People who have family members with ADHD are more likely to have the condition themselves.

Substance Use During Pregnancy

Mothers who smoke, drink alcohol or use other drugs while pregnant are more likely to have kids with ADHD.

Toxin Exposure

Whether it occurs during pregnancy or after the child is born, kids exposed to high levels of toxic materials, like lead, may develop ADHD.

Birth Weight

Children who have lower birth weights than others are more likely to have ADHD.

Brain Injuries

If a person sustains a brain injury, they could develop ADHD, especially if the area damaged influences organization and attention.

Sex and gender are also linked to ADHD. Boys are more likely than girls to have the condition, but females are more likely to have a form of ADHD that only affects attention, not hyperactivity.

Types of ADHD

There are three types of ADHD that are distinguished by the combination of symptoms the person displays. The types of ADHD include:

• Predominantly inattentive type
• Predominantly hyperactive-impulsive type
• Combined type

To better understand these types, it is valuable to know the inattentive and hyperactive symptoms of ADHD. The inattentive ADHD symptoms involve the person:

• Making frequent mistakes or struggling to pay attention to tasks 

• Seeming scattered and disorganized

• Failing to remember information given to them

• Failing to listen when spoken to directly

• Not following the instructions for assignments

• Avoiding work and tasks that require a lot of effort

• Frequently losing needed items 

• Becoming easily distracted at home, work or school

• Struggling to concentrate on activities

The person may display hyperactive-impulsive ADHD signs and symptoms including:

• Continuously playing with objects or their clothes
• Being unable to sit still
• Leaving their seat when they’re not supposed to
• Running, climbing and jumping instead of sitting calmly
• Being unable to play, work or complete work quietly
• Having unlimited energy and appearing very sped up
• Talking a lot or very loudly
• Speaking when it is not appropriate
• Becoming annoyed and impatient when asked to stand in line
• Being unable to maintain conversations and interrupting others

The type of ADHD a person has depends on the number of symptoms from each category that they display. Someone with few inattention symptoms will have ADHD predominantly hyperactive-impulsive presentation. On the contrary, Someone with few hyperactive/ impulsive symptoms will have ADHD predominantly inattentive presentation. Finally, a person with enough symptoms from both categories will have ADHD combined presentation.

Each person can only have one type of ADHD, but since signs and symptoms of ADHD may change during the lifespan, the person’s ADHD type could change over time.

Diagnosing ADHD

People who suspect that their children or themselves may have ADHD should seek a complete evaluation from a mental health expert. This professional can gather information from the person’s school, workplace and family members to determine if ADHD is present and which type it may be. Adults may complete an adult ADHD screening tool to determine the symptoms and their severity.

People aged 16 and under must have at least five symptoms from a category to meet the criteria for ADHD. If they have at least five symptoms from both categories, their ADHD will be combined presentation.

Attention-deficit/ hyperactivity disorder in the DSM-5, a text compiled by the American Psychiatric Association that lists mental health disorders, requires people older than 16 to have at least six symptoms from a category to have the condition. Additionally, before the diagnosis is set, the DSM-5 states the person must:

• Display symptoms before age 12
• Show symptoms in a variety of settings and situations
• Be adversely affected by the condition
• Prove that another condition is not causing the ADHD symptoms

These pieces of information are important because they state that a person cannot have ADHD if symptoms started later in life. This fact has a large impact on adults with poor attention who noted no issues during childhood. The professional will explore other possibilities to explain the presence of the symptoms attached to their condition, including depression, anxiety and substance use issues.

Co-Occurring Substance Use Disorders

Like many other mental health conditions, a person has a higher risk of having co-occurring disorders with ADHD. Some people with ADHD may have a mood or conduct disorder, but many have ADHD and substance use issues.

Over the years, experts have been investigating the connection between ADHD and substance use disorders to understand the link. Although only about 5% of people in the population have substance use disorders, more than 15% of people with ADHD also have a substance use disorder.

Researchers believe this association is due to a brain chemical called dopamine. The exact nature of the relationship is unclear, but dopamine functioning is likely abnormal in people with ADHD while substance use commonly triggers a greater release of dopamine in the brain.

Evidence shows there are links between ADHD and marijuana use and well as ADHD and alcohol use. The most notable connection is between ADHD and tobacco use, though. Nearly 50% of children with ADHD will smoke daily by age 17, which is much higher than kids without ADHD.

ADHD Treatments

One way to reduce the risk of co-occurring disorders linked to ADHD is by finding appropriate and effective treatment options. Attention-deficit/ hyperactivity disorder treatments are widely available and usually include some combination of medication and therapy.

Fortunately, many treatments for children can be used for adult ADHD treatments also. Similarly, many aspects of ADHD and addiction treatment will overlap, which allows for comprehensive care when a person has co-occurring disorders.

Beneficial ADHD treatments include:

Stimulant Medications

When it comes to attention-deficit/ hyperactivity disorder medications, prescription stimulants are used most commonly. Drugs like Adderall, Vyvanse and Concerta can improve symptoms more quickly than nonstimulant medications. The major drawback is the potential to become addicted to these stimulant medications; some individuals misuse them to study longer or to get high.

Therapy

Many ADHD therapy options for adults and children employ behavioral therapy techniques for ADHD. The therapist works with the person, their family and possibly teachers to create positive environments and reward appropriate energy levels and periods of attention.

Medical Devices

Rather than pills, patches or therapy, some use medical devices to treat their ADHD. Called the Monarch external Trigeminal Nerve Stimulation system (eTNS), this device sends electrical stimulation to a person’s brain during sleep. The eTNS for ADHD increases blood flow to the brain areas responsible for attention, emotion and behavior.

Co-Occurring Disorder Treatment

Treatment of co-occurring disorders is essential because  ADHD increases the risk of substance use; furthermore, substance use can increase ADHD symptoms. Depending on the person’s symptoms, they may need substance use and ADHD residential treatment or inpatient drug rehab before other treatments are effective.

Not all ADHD treatments are appropriate for all situations. A mental health professional can suggest the best treatment or combination of treatments for the individual’s unique situation.