What is ADD

ADD (short for attention deficit disorder) is one of the most common childhood mental disorders in the United States.

According to the Centers for Disease Control and Prevention (CDC), approximately 6.4 million American children (between ages 4 and 17) have been diagnosed with ADD.

A study published in BMC Psychiatry states that between 30-50% of those diagnosed with ADD as children continue to experience symptoms as adults.

Though ADD is still widely used to describe the mental disorder, the American Psychiatric Association officially changed the name of the condition to ADHD (attention deficit hyperactivity disorder).

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) lists the most common symptoms of ADD as attention difficulty, hyperactivity, and impulsiveness.

These symptoms often create problems at home, school, and recreational activities, commonly leading to other problems such as low self-esteem, depression, and trouble with relationships.

Fortunately, a wide variety of treatments are available. Medication and talk therapy (or a combination of the two) are the most effective.

We discuss the specifics of ADD in children and adults in greater detail below.

ADD in Children

Roughly 6.4 million children have been diagnosed with ADD in the United States alone, making it the most common childhood mental disorder.

And it looks to be on the rise. Research from George Washington University suggests that there’s been a 43% increase in ADD diagnoses since 2003.

According to the CDC, ADD is three times more common in males than females. The symptoms usually first start to appear when the patient is 3 to 6 years old. The average age of diagnosis is 7 years old.

The symptoms of ADD in children vary but commonly consist of difficulty concentrating, paying attention, and remembering small details. Children with ADD are often unfairly labeled as lazy or troublemakers since they have a hard time following instructions.

Other common signs of ADD in children are listed by WebMD as:

• Constant motion (squirming and fidgeting)
• Inability to listen and follow directions
• Talk loud and excessively (especially during playtime)
• Blurt out and interrupt others at inappropriate times
• Easily distracted (difficulty finishing tasks)

Yet not all children that exhibit these behaviors actually have ADD. Sometimes normal “kid behavior” is confused as the mental disorder.

A good rule of thumb is that a child with only a few of the above-mentioned signs likely doesn’t have ADD. However, those that do exhibit most of the signs, in all situations (home, school, and recreation), probably do have ADD.

Of course, the only way to know for sure whether your child has ADD is by visiting your doctor for a diagnosis.

Even doctors sometimes have a hard time making a ADD diagnosis. There is currently no definitive test for ADD.

Instead, a doctor must observe a child over a long period of time, gathering evidence from multiple sources (including their school and caregivers).

Much of the diagnosis is based off how a child acts versus other children their age.

HelpGuide.org states that childhood behavior that is similar to ADD can be caused by sudden life changes (such as divorce or moving), anxiety, or depression. Medical disorders that affect brain function is another less common cause of ADD-like symptoms.

Most children are diagnosed with ADD when they are 5 or older. It’s difficult to diagnose a child younger than this, as normal preschool-aged behaviors are sometimes similar to the behaviors of children with ADD.

ADDitude states that there are 7 main types of ADD. Though each is unique, they can be grouped into 3 main categories. These include:

1. Inattentive – Difficulty focusing and paying attention. Does not interrupt in school or other activities.

2. Hyperactive/Impulsive – Hyperactive and impulsive. Often interrupts in school and other activities. No difficulty paying attention.

3. Combined – Mixture of inattentive and hyperactive/impulsive. Most common form of ADD in children.

Several types of treatment are available to help manage ADD in children once a diagnosis has been made. The most common are medications and talk therapy. Special education programs are another option.

HelpforADD.com, run by David Rabiner, Ph.D., suggests combining medication and talk therapy for long-term ADD management.

Not only does this combination of treatments address ADD in particular, it also helps children work on associated issues like anxiety and depression.

Of course, the best treatment depends on the specifics of each individual situation. Talk to your child’s doctor to find the type of treatment that’s the right solution for your child.

ADD in Adults

ADD is most common in children, but it still affects roughly 4.1% of adults in the United States.

According to the National Institute of Mental Health, most adults with ADD were diagnosed with the mental disorder as children. In fact, most of those that are diagnosed as children continue to experience symptoms into adulthood.

Although it’s relatively uncommon, it’s still possible to have ADD as an adult even if you weren’t diagnosed as a child. Usually this means that the symptoms were unnoticed or unrecognized throughout childhood.

HelpGuide.org states that it was particularly common for childhood ADD to go unrecognized in the past. ADD behaviors were commonly brushed off with labels such as goofball, class clown, and trouble maker rather than seeing the symptoms for what they actually were.

Another problem with diagnosing ADD in adults is that its signs and symptoms are often much different than they are for children. Furthermore, every person experiences ADD differently.

The most common symptoms of adult ADD, according to the Adult Attention Deficient Disorder Center of Maryland, include:

• Difficulty concentrating and staying focused
• Trouble paying attention
• Easily distracted
• Forgetfulness
• Poor listening skills
• Poor organizational skills
• Poor self-control and social skills
• Impulsiveness

Dealing with the symptoms of ADD as an adult is much different than as a child. In addition to managing the mental disorder itself, most adults are also juggling a job, relationships, and household chores.

The stress of ADD on jobs, relationships, and everyday life causes mood swings, irritability, explosive temper, low self-esteem, restlessness, and trouble staying motivated in adults.

These problems can then lead to depression, anxiety, bipolar disorder, and a host of other mental disorders.

The key to effectively managing ADD is seeking treatment. This starts with an adult ADD diagnosis from your doctor.

ADD Testing

Just like child ADD, a diagnosis for adult ADD is complicated. There is no simple test that can prove your mental disorder is ADD.

Instead, your doctor will evaluate you over an extended period of time. They’ll take your reported symptoms into account along with your personal history.

A doctor will also take a comprehensive evaluation of your early medical history. They’ll look at your childhood to see if you exhibited any early developmental or behavioral signs that hint at undiagnosed ADD.

For adults that are diagnosed with ADD, medication is a cornerstone of treatment, according to the Anxiety and Depression Association of America. This is often paired with some type of therapy, usually talk therapy.

Treating ADD in an adult with another mental disorder (such as depression or anxiety) is more difficult. It’s often essential to pair medication and talk therapy with more intensive therapy such as behavioral, psychological, and educational interventions.

CHADD (Children and Adults with Attention Deficient Hyperactivity Disorder), the national resource on ADHD, is a great resource for adults with ADD combined with an additional mental disorder that are looking for the best treatment.

In addition to treatment, there’s a lot that adults with ADD can do to manage their condition on their own. Sometimes learning these self-management techniques reduces or eliminates the need for outside intervention and treatment.

The best self-help tips for adults with ADHD are:

• Healthy Lifestyle – Vigorous exercise and a healthy diet help burn off excess energy, limit stress, and prevent mood swings.

• Sleep – Getting enough sleep increases your concentration and ability to focus on tasks.

• Time Management – Deadlines, even for very small tasks, can help you stay on track and avoid procrastination.

• Support Network – Support of friends and family is critical for managing ADD as an adult. Maintain relationships by focusing on listening rather than talking.

If your ADD symptoms are interfering with your work, relationships, and life in general, it’s always smart to see your doctor.

Your doctor will help create a plan to manage your symptoms that’s specifically tailored to your individual struggles with ADD.

What is ADD Caused By?

The exact causes of ADD aren’t known for sure. Yet there are several factors that have been connected to the mental disorder.

First and foremost is the family connection. Patricia S. Lemer, M.Ed. states that ADD commonly runs in families. In fact, more than half of children with ADD have a parent with ADD.

The genetic reasons for the cause of ADD are unknown. Yet researchers have narrowed down the responsible genes to those that deal with dopamine. According to PsychCentral, those with ADD have lower levels of dopamine in their brains.

Another possible genetic cause has to do with brain tissue. Children with ADD often have thinner brain tissue in certain areas than children without ADD. However, this thin brain tissue often develops to the normal level of thickness as children grow up.

WebMD states that problems with pregnancy are another common cause of ADD. These include premature birth and low birth weight. Mothers that smoke or drink alcohol during pregnancy are much likelier to have children with ADD.

Nutrition and diet is another potential cause of ADD. According to the National Institute of Mental Health, a diet high in food additives and sugar can lead to the mental disorder.

However, the research into this particular cause is unclear. Many experts believe that while high levels of sugar can exacerbate the symptoms of ADD, it’s unlikely a root cause.

Environmental factors like ingestion of lead paint were likely a major cause of ADD in past decades. Yet thanks to the elimination of lead in paint, this particular cause is much less common. However, it’s still something to consider for children that grew up in older buildings with toxic levels of lead.

Finally, a very small percentage of ADD cases have been linked to brain injury at a young age, according to the Neurologic Rehabilitation Institute at Brookhaven Hospital. Such injuries (both physical and those caused by toxins) can create symptoms of ADD in children that previously didn’t exhibit them.

Despite strong evidence that points to several potential causes of ADD, the exact causes are still unknown.

Much research is still being done, focused particularly on the front lobes of the brain (the area responsible for planning, problem solving, and impulse control), to find out what causes ADD in the first place.

ADD Medication

Medication is the number one way that ADD is treated in the United States.

Though it’s often paired with other forms of treatment, it remains the central component in the vast majority of cases.

The specific type of medication and dosage depends on the individual. Your doctor will prescribe the best medication for the specifics of your condition after diagnosis.

Keep in mind that it’s difficult to find the right medication from the get-go. Most of those with ADD must try several different medications, in different doses, before finding the one that works best for them.

Stimulants

Stimulants have long been the most commonly prescribed medication for ADD in North America.

Medscape General Medicine states that stimulants are effective at treating ADD in roughly 70-80% of people. This type of medication can be safely used for children, teens, and adults.

There are three main types of stimulants to treat ADD. These are fast-acting, intermediate-acting, and long-acting.

The fast-acting form takes effect quickly but wears off quickly and needs to be taken several times a day. The long-acting form, on the other hand, takes a while to take effect but lasts for a long time. It only needs to be taken once per day.

The most commonly prescribed stimulants for ADD include amphetamine, dextroamphetamine, dexmethylphenidate, lisdexamfetamine, and methylphenidate.

Adderall and Ritalin are the most commonly recognized brand-name stimulants for ADD.

Non-Stimulants

Stimulants don’t work for a small percentage of those with ADD. In these cases, non-stimulant medication is used. It is also used for those that experience negative side effects from stimulant ADD medication.

Atomoxetine is the most common non-stimulant medication prescribed to those with ADD. It’s approved by the FDA for use in children, teenagers, and adults.

Other Medications

Stimulant and non-stimulant medications are used to treat ADD in almost all cases.

A very small number of people need another type of medication if stimulants/non-stimulants don’t work or cause unpleasant side effects.

These other medications include amitriptyline, bupropion, and escitalopram.

Side Effects

Certain ADD medications, most commonly those that are stimulants, cause unpleasant side effects.

Fortunately, the majority of these side effects make themselves known early on. It’s easy to change medications to one that doesn’t cause them.

The University of Texas Medical Branch lists the most common side effects of prescribed stimulants as:

• Loss of appetite
• Weight loss
• Trouble sleeping
• Headaches
• Anxiety

It’s also important to note that stimulants often make other mental disorders worse. Your doctor might recommend avoiding them if you are also struggling with depression, anxiety, or bipolar.

Is Your Medication Working?

ADD medications work differently for everyone. It’s important to pay close attention to how medications you’re prescribed affect you to know if they’re properly working.

The following will help you know if your medication is working as intended:

• Purpose – Understanding the intended purpose of your medication is the first step to knowing if it’s working correctly.

• Time – ADD medications don’t work right away. Be sure to give your medication a few weeks before you ask for a change.

• Outside Factors – Lifestyle changes can affect your ADD symptoms just as much as medication. A poor night’s sleep or lack of exercise can cause them to flare up.

• Recognition – A reduction in symptoms is the number one way to know that your medication is working correctly. According to Healthline, many people experience a sensation that a fog has been lifted when their medications work correctly.

• Side Effects – Noticing negative or unpleasant side effects is the key to getting your medication (or dosage) changed to a better one.

Combine with Therapy

ADD medications are much more effective for most people when they’re combined with talk therapy.

WebMD states that talk therapy reduces the symptoms of ADD by helping the patient establish better lifestyle habits. It can also improve mood and behavior by creating a more positive mindset.

Final Thoughts

ADD, also commonly referred to as ADHD, is one of the most common mental disorders in the United States, especially among children.

A large percentage of those that have ADD as children continue to experience symptoms well into adulthood. Luckily, the condition is manageable with treatment that combines medication and talk therapy.

Developing a solid understanding of both childhood ADD and adult ADD is the best way to ensure that you get the help needed to manage the condition.