What You Need To Know About Attention-Deficit Hyperactivity Disorder (ADHD)

ADHD is a very common condition. Around 9.4% of children in the US have received a diagnosis of this disorder. Within this number, there is usually a higher percentage of boys than girls. An estimated 12.9% of male children live with ADHD compared to 5.6% of the girl population.¹

When a child lives with ADHD, they are almost certain to be managing another condition. A 2016 survey revealed that six in 10 children with ADHD had at least one other mental, emotional, or behavioral condition.¹

About five in 10 children with this disorder had a behavior challenge. Likewise, an estimated three in 10 children with ADHD had anxiety.¹

The same follows with adults with impulsiveness and other symptoms of ADHD. They often live with mental health conditions such as depression, anxiety, bipolar disorder, substance abuse, or a learning disability.²

Not every sign of inattention, impulsiveness, or hyperactivity boils down to ADHD. If you suspect a case of this disorder, it’s important to look out for a pattern of behavior that affects daily functioning.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lays out common behaviors that may suggest that a person lives with ADHD. These include:

Inattention

• Difficulty maintaining attention during activities or play

• Failing to concentrate on school or work tasks causes avoidable mistakes

• Appearing to pay little attention when spoken to directly

• Does not follow instructions and finds it challenging to complete tasks

• Usually, it is a challenge to organize tasks and activities

• Easily distracted

• Often shows forgetfulness in daily interactions

• Is constantly losing things necessary for activities such as glasses, mobile phones, keys, etc.

• Dislikes tasks that require continuous mental effort over a long period

Hyperactivity and impulsivity

• Has a habit of fidgeting, squirming while sitting, or tapping the hands or feet

• Will often leave a seat in cases where sitting is mandated

• Adults may feel restless in most situations

• Children may run about in inappropriate settings

• Younger ones will often play or participate loudly in activities

• There is usually excessive talking during interactions

• There is a tendency to blurt answers out before the question is completed

• Often interrupts or intrudes on others

• Children may experience trouble waiting their turn, while adults may become impatient while waiting for an appointment or standing in a line at a store

ADHD symptoms can begin as early as three to six years old. Young people with this disorder will engage in high-risk behaviors like alcohol use, smoking, or experimenting with drugs when compared to peers without this condition. There is also a chance that people with ADHD will engage in risky sexual behavior. 

A person with these traits will likely have no other explanation (e.g., another mental disorder) responsible for their symptoms.

It’s hard to pinpoint the exact cause of ADHD. Instead, several risk factors and environmental components may be responsible for the appearance of this condition. These include:

Genetics

Multiple studies have shown that inherited genes strongly influence ADHD. In a family where a child lives with the condition, siblings have twice the risk of developing ADHD.¹ Likewise, identical twins also have higher chances of sharing this condition when compared to fraternal siblings.

Social challenges

When a child is raised in unfavorable circumstances, this can increase the odds of developing ADHD. Low parental education and social status, poverty, maltreatment, family fighting, and bullying are associated with the development of this disorder.

These conditions are not proven exact causes of ADHD. Instead, these social factors may influence the development of ADHD along with childhood behavioral disorders, anxiety, or depression, which can co-occur with ADHD. 

Maternal influences

Maintaining good health during pregnancy isn’t only for the mother’s well-being. Infants are also directly affected by maternal welfare while expecting.

When a mother smokes while pregnant, this can introduce harmful chemical influences to the child.² This can negatively challenge psychological processes, increasing the risk of ADHD.

Similarly, if a mother routinely engages in alcohol use during pregnancy, this can cause fetal alcohol syndrome. This can give rise to inattention and hyperactivity in the child. 

A mother that experiences stress during pregnancy may unknowingly increase the risk of her offspring developing ADHD.

Premature birth and low birth weight

Children born prematurely or at a low birth weight are more likely to develop symptoms of ADHD.² This risk is usually most apparent in extremely low birth or premature conditions. 

Children born in these conditions will usually display signs of inattentive ADHD.

Diet

Research has been conducted on the potentially harmful effects of a diet high in sugar, and artificial food coloring, as it is believed that this can increase the risk of children developing ADHD. A diet rich in zinc, iron, magnesium, and omega-3 fatty acids is believed to minimize ADHD risk. However, there is no clear evidence in the research of diet has a role in causing ADHD symptoms.²

Likewise, children who are exposed to toxins in the environment can, over time, show signs of ADHD. Organic pollutants, such as pesticides and lead, can damage important brain systems in children. This affects memory, impulse control, and other brain functions.

Diagnosis of ADHD

The DSM-5 specifies that an ADHD diagnosis requires a person to display symptoms of this condition for a period of at least six months. These symptoms, which include frequent fidgeting, poor listening skills, difficulty waiting for a turn, etc., must take place in at least two settings, like the home, school, or in other activities (e.g., with friends or family members).

For patients younger than 17 years old, at least six symptoms are necessary. Those above 17 years old will require at least five symptoms to receive an ADHD diagnosis.³

Parents that suspect their children may have ADHD can take them to a healthcare professional. This professional will usually evaluate the child’s medical, behavioral, family, and social history.⁴

This history will also cover possible drug or infection exposure to the child during pregnancy.⁴ It may also assess delivery complications, medication use, prior medical conditions, as well as hearing/sight abilities.

With family history having an influential role in ADHD, genetic predispositions to this disorder and other neurobehavioral conditions will also be evaluated.⁴

Families should also expect questions on traumatizing or adverse life events that may have impacted the child and contributed to ADHD symptoms.⁴

The evaluation may also require personal rating scales, or assessments from important sources such as teachers, coaches, or employers to give an appropriate diagnosis.⁴

At present, there is no catch-all treatment for ADHD. What exists are medications and suitable counseling to manage symptoms of this condition. These treatments also help to improve daily functioning. 

Medication

Through the right drugs, you can get control of ADHD by improving attention, working memory, and boosting academic performance.

These drugs can also reduce aggression and disruptive behavior associated with ADHD.

Stimulants and drugs that can reduce norepinephrine reuptake are widely used to treat adult ADHD.

Stimulants

Stimulants are first-line treatments for improving the behavioral and psychological aspects of this condition.

They help to balance chemicals in the brain that interfere with attention and impulse control.¹ 

These drugs stimulate the brain to encourage focus and reduce inattention and distractibility. Stimulants include methylphenidates like Ritalin, dextroamphetamine, and amphetamine salts like Adderall, and Vyvanse.

If you are prescribed any of these medications for ADHD, you'll receive a warning for its use. This is because stimulants have high abuse and addiction potential and should be administered carefully.¹

Non-stimulants

Drugs like atomoxetine have shown promise in managing ADHD symptoms.² This FDA-approved medication can affect the norepinephrine systems in the body. Norepinephrine is a hormone/neurotransmitter that impacts focus and attention in daily activities.

Non-stimulants are a safe and effective way for children and adults to manage ADHD.

Tricyclic antidepressants are also recommended treatments for ADHD.² These drugs influence the previously mentioned hormone/neurotransmitter norepinephrine and the hormone/neurotransmitter serotonin. Where a child has low levels of norepinephrine, it can increase the odds of developing this disorder.

Antidepressants may be used off-label to improve focus and other symptoms of ADHD. They are commonly recommended to children with anxiety or who do not tolerate stimulants properly.³

Psychosocial interventions

Having a child or loved one with ADHD can be challenging. Family members and guardians can receive classes in behavior management to provide support and important tips on caring for a child with ADHD. Patients may also receive these classes, in addition to cognitive-behavioral therapy (CBT).

CBT can teach patients the best ways to achieve a change in behavior to improve symptoms of ADHD.

Unlike most cognitive challenges, however, medication without therapy has proven benefits for managing ADHD.³

To manage ADHD, options may involve stimulants alone or in combination with other psychological drugs.² Non-stimulant medication, psychotherapy, and behavioral sessions can also improve symptoms of the disorder.

Currently, there are no known measures to prevent ADHD in children. However, what can be done is to take the necessary steps to reduce extreme symptoms. These interventions include the following measures:

Physical exercise

When children are encouraged to participate in regular physical activity, this can help ADHD management.

That’s because exercise provides a big boost to brain function. In particular, it impacts areas of the brain like the prefrontal cortex, which is important for focusing attention, decision making, and other important functions.

Environmental improvement

Children can better handle their ADHD if they participate in attention and cognitive training programs.

These training sessions can improve attention, memory, and academic performance, reducing the severity of symptoms of ADHD.¹

When should a specialist be consulted?

If your daily life is constantly interrupted by symptoms that suggest ADHD, it is advisable to get a professional opinion. 

Specialists should be consulted when signs of inattentiveness, impulsivity, or hyperactivity begin to interfere with personal and professional or academic life. 

Likewise, parents and guardians should get a professional assessment of their children if they display signs of ADHD. This can help get an early hold on the condition before symptoms worsen.