Many of us feel hyper, distracted or not fully focused sometimes. It is also not abnormal to wonder if your child is abnormal. But how do you know for sure when a behavior is caused by a condition, such as attention deficit hyperactivity (ADHD) disorder and requires treatment?
ADHD is associated with symptoms including difficulty focusing, exercising self-control, sitting still and paying attention. A person who is diagnosed with ADHD typically has trouble with academic, work or social performance and relationships as a result of the disorder.
Once upon a time, attention deficit hyperactivity disorder was diagnosed as ADD or ADHD. Symptoms including trouble listening or managing time fell under the “ADD” category while symptoms involving impulsivity and hyperactivity were associated with “ADHD”. Today the symptom is just called ADHD.
What Causes Attention Deficit Hyperactivity Disorder?
ADHD is of the most researched areas on adolescent and child mental health. Despite this, the precise cause of ADHD remains unknown.
It is known that ADHD is a biological disorder that is brain-based and is characterized by low levels of dopamine, which is a brain chemical. Dopamine is a type of neurotransmitter that is common in people with ADHD.
Researchers have found several factors that can contribute to ADHD to include:
- Low birth weight
- Cigarette smoking, drug use or alcohol use during pregnancy
- Brain injuries
- Exposure to environmental toxins during pregnancy or at a young age
ADHD is more commonly found in males than females. It has also been determined that females with ADHD more commonly battle difficulty with inattention.
People with ADHD commonly have problems with other conditions, such as anxiety disorder, learning disabilities, depression, conduct disorder and substance abuse.
The 3 Types of ADHD
According to the DSM-V (Diagnostic and Statistical Manual of Mental Disorders-5), ADHD is broken down into three different types: primarily hyperactive-impulsive, primarily inattentive and combined. Each of these presentations is set apart by specific behavioral symptom criteria (listed in the DSM-V) that are used by physicians to diagnose patients.
- Primarily Hyperactive-Impulsive Type ADHD
People who have hyperactive ADHD often feel the urge to be in motion constantly. They often squirm and fidget, struggling to stay in one place. They often appear to have had “too many coffees” and run around and/or talk in excess. They often blurt out answers, interrupt others and battle self-control. Children are more commonly diagnosed with this disorder, with men being next in line.
In order for a person to be diagnosed with Primarily Hyperactive-Impulsive ADHD, they must fit at least 6 of the 9 descriptions from the DSM-V:
- Often leaves seat when required to remain in seat.
- Often taps or fidgets with hands or feet or squirms in a seat.
- I soften unable to quietly play or engage in activities.
- Often climbs or runs about in situations where it is considered to be inappropriate.
- Is often “going” or seems to be “driven by a motor.”
- Talks excessively.
- Has difficulty waiting for his or her turn.
- Often blurts answers out before questions have been completed.
- Often intrudes on or interrupts others.
- Primarily Inattentive Type ADHD
People with this type of ADHD tend to make mistakes that seem to be poorly thought out. They often have trouble following detailed instructions while paying attention as well as organizing activities and tasks. They are more often distracted by external stimuli and are easily forgetful. Adults and girls are more commonly diagnosed with this condition, which was formerly known as “ADD.”
Physicians are able to diagnose patients with Primarily Inattentive ADHD if they fit into 6 of the 9 descriptions for this category, as listed in the DSM-V:
- Often struggles to sustain attention in tasks or activities.
- Has difficulty paying close attention to details or makes mistakes that seem careless.
- Seems to not listen when spoken directly to on a regular basis.
- Has difficulty organizing activities and tasks.
- Does not follow through on instructions, often failing to finish chores, schoolwork or other duties.
- Loses things often.
- Avoids or seems reluctant to engage in tasks that require a more sustained mental effort.
- Is often forgetful in regular daily activities.
- Is easily distracted by external stimuli.
- Combined Type ADHD
Those who are diagnosed with combined type ADHD have six or more symptoms of inattention in combination with six or more symptoms of impulsivity and hyperactivity.
Physicians diagnose patients with Combined ADHD if they meet the guidelines for Primarily Inattentive ADHD in addition to Primarily Hyperactive-Impulsive ADHD, showing 6 of the 9 symptoms listed for each subtype.
Although there is no cure for ADHD, there is hope for managing the symptoms of the disorder while improving the quality of life. People with ADHD have experienced improved professional, academic and social performance as a result of treatment.
ADHD treatment is usually a team approach, involving school personnel, families, therapist, healthcare providers and coaches.
Treatment options are often based on several factors, including:
- A person’s age, medical history and overall health
- Tolerance for specific therapies or medications
- Extent of the patient’s symptoms
- Expectations for the condition and its course
Treatments may include:
- Behavioral therapy, which is often the first line of treatment recommended by doctors. It has low side effects and can help to change problematic behavior patterns in addition to responses to anxiety and anger.
- Psychostimulant medications, such as Methylphenidate (Metadate, Ritalin, Concerta), Dextroamphetamine (Dextrostat, Dexedrine), Lisdexamfetamine (Vyvanse), Atomoxetine (Strattera) or a mixture of amphetamine salts (Adderall).
- Nonstimulant medications, which are slower acting but can lsat up to 24 hours. They are believed to cause less long-term side effects (Clonidine, Guanfacine, Strattera).
- Psychosocial treatments, including classes that treat behavior management skills.
If you think you or a loved one has one of the above types of ADHD, it is advised that you see a medical professional for an official diagnosis and treatment, better improving the quality of life experienced overall.