ADHD is a disorder that affects many people, but we don’t always know how to spot it. ADHD symptoms can be difficult to diagnose and sometimes even more difficult for the person suffering from ADHD to live with.
A question you might have is if it is normal to have these or similar symptoms, and if that means you have ADHD or maybe another problem.
Meet Matt, he is a 30 something professional with big dreams and a lot of energy. Matt recently has been struggling with getting his tasks done at work. His boss has given him reasonable KPI’s, however Matt can not get himself to start working on it.
He seems to start fidgeting and on a social level life is not going much better. His girlfriend complains that Matt can not wait his turn in a conversation and she does not feel heard. This is not the first time in his life that Matt has these problems. He feels like enough is enough, and takes his health in his own hands.
With these symptoms, and more we might think that Matt might have ADHD. However, some have pointed out to Matt that the problem could be autism. Read on to know what happens to Matt and how a specialist could differentiate the two.
What is ADHD?
ADHD is a disorder usually noticed first at a young age in children. It is considered a neurodevelopmental disorder. It is probably one of the most common mental health disorders in children. Your child might come in touch with challenges in attention or impulsivity.
Studies in 2016 show that about 6.1 to 9.4% of school age children in the US have been diagnosed with attention deficit hyperactivity disorder (ADHD).
The diagnosis does not just disappear when you grow older. Researchers (and the national institute of mental health) report an overall prevalence of 4.4% of adults with ADHD in the USA.
The full name “attention deficit hyperactivity disorder” already suggests it. People usually search for help as they are suffering from inattention, hyperactivity or both issues.
ADD vs ADHD. What is the difference between “attention deficit disorder” and “attention deficit hyperactivity disorder”?
The terms ADD and ADHD are usually said in one breath. People tend to use these two words and speak about the same diagnosis.
What is the difference? There is no real difference, ADHD is the more recent umbrella term for the significantly different behavior on this spectrum.
A long time ago, doctors referred to the diagnosis as ADD or attention deficit disorder. However, they found the hyperactivity component too great to ignore so they changed the name to ADHD.
When people today refer to ADD, they usually refer to ADHD as a predominantly inattentive type. You can read more about this here.
ADHD Symptoms
The American Psychiatric Association (or APA) invented a classification system of mental health disorders to be sure that we all speak the same language. They wrote this all down in a manual known as the “Diagnostic and Statistical Manual” (DSM).
The DSM makes it so that we recognize ADHD rather quickly. If little Annie can’t sit still at home and her teacher complains about her because she seems to be a dreamer, we might take action quicker.
DSM-5 Criteria
The American Psychiatric Association declares that you or your child should suffer from a consistent pattern of inattention and/or hyperactivity-impulsivity. This behavior should interfere with your/ your child’s functioning or development.
As a rule, these ADHD symptoms can not only reveal themselves as a sign of oppositional behavior, defiance or hostility.
Further, these ADHD symptoms also can’t only show because the child or adult doesn’t understand tasks or instructions.
Inattention
- Difficulty with giving close attention to details. The child frequently makes careless mistakes. You notice this in schoolwork, at work, or during other activities (for example: overlooks or misses details, work is inaccurate).
- Difficulty sustaining attention in tasks or play activities. It can be difficult to focus during lectures, conversations, or lengthy reading.
- Usually not listening to when spoken to (e.g., mind elsewhere even without clear distraction).
- Difficulty completing tasks and following instructions. This is apparent in schoolwork, chores, work duties (will start tasks but gets distracted easily).
- Often has problems organizing tasks. Keeping a to-do list and following a schedule don’t come natural. They are mostly messy and disorganized and don’t manage their time properly. Consequences can be not keeping deadlines or having difficulty doing things in chronological order.
- Tendency to avoid, dislike, or have a high reluctance to engage in large tasks. This happens when these tasks require sustained mental effort (such as schoolwork, homework). Older adolescents and adults have trouble starting or completing forms, reports or lengthy papers).
- Tends to lose necessary items for tasks or activities often. This includes school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, and phones.
- Easily distracted by outside stimuli (or unrelated thoughts).
- Often forgets daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls)
Hyperactive and Impulsive Behavior
- Often fidgety or tapping hands or feet or squirms in their seat.
- Difficulty sitting when it is expected to. They leave their spot in the classroom, office or other location where it is expected or required to stay seated).
- Often feel the need to move around regardless of where they are. This might express itself in running around, climbing things, or an overall feeling of extreme restlessness for adults.
- Often it is difficult to play or engage in quiet time or quiet leisure activities.
- Struggling to be still for extended periods of time such as in a restaurant is a common symptom. Seems always “on the go” or “driven by a motor”.
- Excessive amount of talking
- Blurts out answers or things without waiting for a question to be completed or trouble waiting for their turn in a conversation).
- Often has trouble waiting his or her turn (e.g., while waiting in line).
- Interrupts or intrudes often into games/ activities / conversations. They might start using other people’s stuff without asking or receiving permission. Adults or adolescents may intrude or take over activities.
Also, the following conditions…
Adults and adolescents should show at least five or more of these ADHD symptoms during more than half a year. They should also have a significantly negative impact on their life in more than two settings. You should for example be able to notice it in school, work, social settings or other settings.
Children should show at least 6 or more of these ADHD symptoms and should also suffer from the disorder. The DSM also notes that it should be inconsistent with their developmental level.
ADHD symptoms should be present before 12 years old. They should not be better explained by another mental disorder. They also can’t be exclusively present during the course of a schizophrenic or psychotic episode.
Presentation
Depending on the amount of symptoms in each cluster, you or your child will be defined in one of three presentation types.
You might be qualified under:
- Predominantly inattentive presentation
- Predominantly hyperactive/impulsive presentation
- Combined presentation
Severity of the Symptoms
The American Psychiatric Association defines three levels of ADHD diagnoses. They show three levels of ADHD:
- Mild
- Moderate
- Severe
How you will be diagnosed is dependant on how this neurodevelopmental disorder influences your life.
Secondary Symptoms
While the official symptoms are very clear. ADHD might come with other consequences due to problems with executive functioning or a faulty interpretation of their behavior.
- might feel or look lazy because they tend to forget daily tasks
- your partner or friends might feel like you are not listening
- Poor attention to details might lead to problems with the law (f.e. Parking tickets)
- Difficulty finishing tasks can lead to low self-confidence as you have so much difficulty finishing tasks
- hyperfocus
- problems regulating the volume of their voice
- More risk for language impairments or learning disabilities. Mazing seems to be an ADHD related issue. Mazing is when a person seems to be rambling on without making a point)
- Difficulty regulating your emotions, leading to hot temper, irritability, mood shifts.
What’s typical behavior and what is ADHD?
Low attention and hyperactivity seems to describe every toddler or young adult if they need to sit down long enough. Even many adults could recognize themselves in these symptoms.
Important is to take a look at the criteria described in the diagnostic and statistical manual. ADHD symptoms are clearly defined as a multi-setting problem. Your young child most likely does not have ADHD if the symptoms are only present at school. In those cases, there might be another explanation.
The American Psychiatric Association wants you to know that this mental health problem does not just come and go. If a big change happens, it can impact the attention span or activity level of your child, yourself or your partner.
If these symptoms are still present after more than half a year, an ADHD specialist can do a comprehensive evaluation. They might provide an ADHD diagnosis if needed.
ADHD in Adults: Does it Go Away?
Researchers believe that adult ADHD is underdiagnosed. Prevalence in a study from 2016 shows about 4% of the children who suffer from ADHD symptoms are most likely to also suffer from some symptoms as an adult. There is, however a shift in presentation.
Adults seem to suffer more from an inattentive/ combination presentation than from a hyperactive presentation.
Some symptoms might also present themselves in a different way. While some children have difficulty sitting still and will show “inobedience” in that capacity. Adult ADHD might present this symptom by being restless. You might see yourself fidgetting more with your phone or fingers or tapping with your feet.
Adults can also choose to work with their symptoms and play on their own strengths and weaknesses. Some might choose a job where you do not have to sit still or where they don’t have to pay attention to details.
ADHD in Girls
ADHD is more diagnosed in males than in females. In general the ratio boys to girls that is most accepted is 4 to 1. Studies however show a variability between 2:1 to 10:1. This depends on the sample in the study.
Researchers believe that girls might be underdiagnosed or misdiagnosed and as a result not get the adequate help they need. Girls or women tend to present more inattentive than boys.
These girls might learn early on to mask or compensate for their ADHD symptoms. Girls with ADHD also commonly show symptoms of other mental health troubles as anxiety and depression. The occurrence of these mood disorders also is a trigger for people to misdiagnose or miss the ADHD symptoms.
Although they compensate and mask, these girls still have the same risks involved with ADHD as boys. Treatment and diagnosis for them is as essential as for their male counterparts. Research shows that due to this reason girls are more likely to be treated with antidepressants instead of ADHD related care.
Cause
We don’t exactly know what causes ADHD. It most likely is a combination between genes, neurobiology and environment.
About 76% might be explained by your genes or hereditary system. That means it is very highly likely to have ADHD if someone in your family shows ADHD symptoms as well. Other theorists explain ADHD from a neurobiological viewpoint. You can read more in this article about all of that.
Environmental risk factors might play a small role. That is not to say we can prevent it, however it can give some explanation.
Risk Factors
You or your child might have a higher risk for developing ADHD symptoms if the following factors are present:
- Exposure of a baby to smoking, alcohol and drugs during pregnancy
- High stress and anxiety during pregnancy
- Premature babies (younger than 33 weeks) or babies born with a low birth weight are more likely to be ADHD diagnosed
- Brain injury early in life might show a link with ADHD. Some children however only show these symptoms later in life.
- Early exposure to environmental toxins like pesticides, PCBs and lead
- Extreme early deprivation
Diagnosis
A mental health provider can evaluate your ADHD symptoms and diagnose ADHD iff needed. Otherwise they will provide medical advice about your or your child’s behavior.
They will ask about your medical history, your mental health and other health problems you might have.
Going back to our case study Matt, he will go to the GP. A physical exam and his medical history will inform the doctor if there could be other reasons for these complaints.
Afterwards, there might be questions about his early childhood and his symptoms of ADHD. As said before, Matt was afraid that he might have autism, in the following paragraphs we will explain more about that link.
Co-occuring Mental Health Issues
About 60 to 100% of the children with attention deficit hyperactivity disorder show one or more comorbid disorder. These continue into adulthood. Statistics confirm this.
About 80% of the adults with ADHD have at least one co-occurring disorder like a mood disorder (f.e. Anxiety disorder), substance abuse, or bipolar disorder.
Neurodevelopmental disorders and ADHD
- Autism spectrum disorder
Autism spectrum disorder can provide a dual diagnosis with ADHD today. The symptoms overlap partly and are hard to differentiate. People diagnosed with both usually have heavier symptoms.
In general kids or adults who are only autistic have a different way of functioning on a social level. They usually have difficulty with social communication.
Some might say that they don’t fully understand these situations. That is not necessarily the case for a child with only ADHD. Usually they can not stop talking out of impulsivity.
Children with autism might struggle with things they don’t like and fixate on the things they do like. Children with ADHD will tend to avoid what is too tedious, and don’t necessarily fixate in the same capacity.
- Learning disorders
Children with attention deficit hyperactivity disorder ADHD have a higher rate of learning disorders than neurotypical children. They seem to mostly have troubles with written ability.
- Tic disorder and ADHD
Tic disorder or Gilles de la Tourette’s disorder is a neurodevelopmental disorder, characterized by motor and vocal tics.
About 60% of the children with Tourette’s syndrome suffer from ADHD too. Tics can impose a significant impact on day to day functioning, and can worsen with stress. It is advised to treat Adhd first as this might have an impact on the tics.
Mood Disorder and ADHD
- Depressive disorder
People who are depressed feel a deeply sad mood and might lose interest or joy in activities that they usually did enjoy. Many also experience troubles with sleeping, appetite and low energy. Some also feel worthless and don’t see the point in life anymore.
- Bipolar disorder
Bipolar disorder is a mood disorder with low depressive episodes and high manic episodes. These mood swings might last days or months and could also be accompanied with suicidal thoughts.
Depressive episodes show the same symptoms as when you suffer from depression. During a manic episode, however you have a mountain of energy and don’t need sleep. You might lose touch with reality during these times.
- Anxiety disorder
Anxiety disorder is a mental illness characterized by intense worry or fear about what might happen in the future. This deep state of fear or terror is also not in proportion to the situation presented.
It can come with sudden episodes or attacks of fear. These feelings make it so they can’t function in daily life. People with anxiety might start to avoid certain places, people or situations as to not feel the anxiety or panic.
It can also come with difficulty with concentration or other cognitive symptoms that we would associate with ADHD.
- Oppositional defiant disorder or conduct disorder
A child with “oppositional defiant disorder” might show more inobedience than another child. Children with ODD show a pattern of anger, irritability, arguing, defiance or vindictiveness towards authority figures.
- Disruptive mood dysregulation disorder and IED
This can be understood as CD or oppositional defiant disorder with symptoms of ADHD or anxiety.
In short, it is imperative to treat ADHD and your (un)related mental health disorder.
Treatment
The most common and advised treatment for ADHD is a combination of medication and therapy.
An ADHD diagnosis can give you access to treatment and extra resources. You can read more below under the section disabilities. Untreated ADHD comes with trouble focusing and problems organizing tasks. It can look like mood swings and difficulty with impulsive behavior.
If this does not get treated, chances are high that the attention deficit hyperactivity disorder makes learning more difficult. Academic success, work achievements and relationships might suffer as a result. This is not great for self-esteem or your mental health.
ADHD Medications
Adult ADHD and young children with ADHD from the age of 6 years old can be treated with medication. The FDA approved two stimulants and three non-stimulants.
Stimulant medications usually work by improving the brain chemicals dopamine and norepinephrine in the central nervous system. The stimulants approved are:
- amphetamine, brand name Adderall
- methylphenidate, brand name Ritalin.
Non-stimulant ADHD medication can be used if you react badly to the stimulants. The approved non-stimulants are:
- atomoxetine, brand name Strattera
- guanfacine, brand name Intuniv
- clonidine, brand name Catapres
Behavioral Therapy
It is recommended to treat ADHD by combining ADHD medications with behavioral therapy.
Behavioral therapy has as a goal to relieve symptoms (of attention deficit hyperactivity disorder) by changing the disruptive behavior. This behavior is replaced by a modification and is monitored.
The positive behavior gets reinforced by positive feedback. This is also used to treat many other mental disorders.
Although not officially recommended, there might be other interventions to try. Mindfulness meditation training might also be one for adult ADHD symptoms.
Many adults report improved attention and cognitive inhibition. They also improve symptoms of certain mood disorders, in specific less anxiety and depression.
Children with ADHD can also be supported by parent training. This way the parents have better tools in how to react to the attention deficit hyperactivity disorder.
Family members of people with attention deficit hyperactivity disorder ADHD can also reach out to support groups to share the burden. Research shows that talking can help, you can also learn how others manage ADHD symptoms in these groups.
Are there any natural remedies?
Drinking a magic tea will not solve your ADHD. However, you can and should take care of your physical health.
It is recommended to take care of your body and brain by:
- eating a complete diet
- sleeping the full 8 hours
- having an exercise routine.
These health interventions can help against mood swings and are known to help when you have trouble focusing. Your brain’s ability to work well is dependant on how well it is fed and rested.
They can stimulate many happy hormones. These are also recommended when you suffer from mental disorders like anxiety disorder or depression.
Is ADHD a Disability?
Attention deficit hyperactivity disorder is a disability in the USA under the Individuals with Disabilities Education Act (IDEA). This recognition can give support and equal study opportunities to those with special needs.
Attention deficit hyperactivity disorder does not fall under “Specific Learning Disabilities”. It falls under “Other Health Impaired”. Other laws that can support those needs are Section 504.
Depending on the needs, these can provide students with:
- extra time for tests,
- extra attention with instructions (written and oral)
- breaking down larger projects in sub tasks
- and so on.
Tips for Coping with Attention Deficit Hyperactivity Disorder
Coping with ADHD can be small life changes as to diminish the chances of getting easily distracted and to make less careless mistakes. Adapting environmental factors can shape a thriving context for someone with attention deficit hyperactivity disorder.
- Decrease noise and clutter
- Write instructions down and make it a habit
- Use routines
- Use checklists before going out or to structure the week
- Practice active learning
- Use your strong skills
- Reinforce what is going well
- Living with it
Although some people keep suffering from ADHD and the consequences (f.e. low self-esteem), others do have a successful life.
ADHD does not have to stop you from chasing academic or professional dreams.
Getting a handle on your symptoms can boost your quality of life. Less impulsive behavior is equal to less negative consequences. Chances for substance abuse, unlawful behavior and losing your job might be smaller.
When to See a Doctor
You should see a doctor or ADHD specialist when the symptoms make your life unliveable or when they have a direct impact on many aspects of your life.
Untreated ADHD can have risks involved. Some examples are learning disabilities, substance abuse and other mental disorders. Your medic can provide medical advice so that you can have a reduction of symptoms.
In Short
ADHD is a disorder that usually gets noticed first in early childhood. These kids usually get noticed in school first. A stereotypical presentation of these kids are usually a young boy screaming and jumping up and down it’s chair.
In reality, there are also girls and adults that suffer from ADHD. Their presentation can look different. It can look like a child that is dreaming or keeps making small mistakes. They might be late and don’t have any order. Adults might also present more inattentiveness.
People with ADHD show more than 5 or 6 symptoms of inattention or hyperactivity. in case of the combined type, they show both.
Positive news is that there are ways to keep ADHD symptoms under control. You can take medication and go to therapy to improve your quality of life.