ADD/ADHD Overview
Attention deficit hyperactivity disorder (ADHD) affects children and teens and can continue into adulthood. ADHD is the most commonly diagnosed mental disorder of children. Children with ADHD may be hyperactive and unable control their impulses. Or they may have trouble paying attention. These behaviors interfere with school and home life.
It’s more common in boys than in girls. It’s usually discovered during the early school years, when a child begins to have problems paying attention.
Adults with ADHD may have trouble managing time, being organized, setting goals, and holding down a job. They may also have problems with relationships, self-esteem, and addiction.
Symptoms in Children
Symptoms are grouped into three categories:
Inattention
A child with ADHD:
- Is easily distracted
- Doesn’t follow directions or finish tasks
- Doesn’t appear to be listening
- Doesn’t pay attention and makes careless mistakes
- Forgets about daily activities
- Has problems organizing daily tasks
- Doesn’t like to do things that require sitting still
- Often loses things
- Tends to daydream
- Often squirms, fidgets, or bounces when sitting
- Doesn’t stay seated
- Has trouble playing quietly
- Is always moving, such as running or climbing on things (In teens and adults, this is more commonly described as restlessness.)
- Talks excessively
- Is always “on the go” as if “driven by a motor”
Impulsivity
A child with ADHD:
- Has trouble waiting for his or her turn
- Blurts out answers
- Interrupts others
- Causes of ADHD
The cause of ADHD isn’t known. Researchers say several things may lead to it, including:
Heredity: ADHD tends to run in families.
Chemical imbalance: Brain chemicals in people with ADHD may be out of balance.
Brain changes: Areas of the brain that control attention are less active in children with ADHD.
Poor nutrition, infections, smoking, drinking, and substance abuse during pregnancy: These things can affect a baby’s brain development.
Toxins, such as lead: They may affect a child’s brain development.
A brain injury or a brain disorder: Damage to the front of the brain, called the frontal lobe, can cause problems with controlling impulses and emotions.
Sugar doesn’t cause ADHD. ADHD also isn’t caused by watching too much TV, a poor home life, poor schools, or food allergies.
ADHD can’t be prevented or cured. But spotting it early, plus having a good treatment and education plan, can help a child or adult with ADHD manage their symptoms.
ADHD Treatment
Many symptoms of ADHD can be managed with medication and therapy.
Medication: Medications called stimulants can help control hyperactive and impulsive behavior and increase attention span. They include:
- Dexmethylphenidate (Focalin)
- Dextroamphetamine (Adderall, Dexedrine)
- Lisdexamfetamine (Vyvanse)
- Methylphenidate (Concerta, Daytrana, Metadate, Methylin, Ritalin, Quillivant)
Stimulant medications don’t work for everyone with ADHD. Nonstimulant medications may be prescribed for people older than 6. These include: - Atomoxetine (Strattera)
- Clonidine (Kapvay)
- Guanfacine (Intuniv)
Dietary supplements with omega 3s have shown some benefit. Vayarin, a non-pharmaceutical supplement that contains omega-3s, is available by prescription only.
Therapy: These treatments focus on changing behavior.
Special education helps a child learn at school. Having structure and a routine can help children with ADHD a lot.
Behavior modification teaches ways to replace bad behaviors with good ones.
Psychotherapy (counseling) can help someone with ADHD learn better ways to handle their emotions and frustration. It can also help improve their self-esteem. Counseling may also help family members better understand the child or adult with ADHD.
Social skills training can teach behaviors, such as taking turns and sharing.
Support groups of people with similar problems and needs can help with acceptance and support. Groups also can provide a way to learn more about ADHD. These groups are helpful for adults with ADHD or parents of children with ADHD.
What to Expect
Many people with ADHD live successful, happy, full lives. Treatment helps. It’s important to pay attention to symptoms and see a doctor regularly. Sometimes, medication and treatments that were once effective stop working. You may need to change the treatment plan. For many people, the symptoms of ADHD get better in early adulthood, and some are able to stop treatment.
No one knows exactly what causes ADHD, but certain things are known to play a role.
The Family Connection
ADHD runs in families. Anywhere from one-third to one-half of parents with ADHD will have a child with the disorder. There are genetic characteristics that seem to be passed down.
If a parent has ADHD, a child has more than a 50% chance of having it. If an older sibling has it, a child has more than a 30% chance.
Pregnancy Problems
Children born with a low birth weight, born premature, or whose mothers had difficult pregnancies have a higher risk of having ADHD. The same is true for children with head injuries to the frontal lobe of the brain, the area that controls impulses and emotions.
Studies show that pregnant women who smoke or drink alcohol may have a higher risk of having a child with ADHD. Exposure to lead, PCBs, or pesticides may also have a role.
Researchers believe that some toxins may interfere with braindevelopment. That, they say, could lead to hyperactivity, impulsive behavior, and trouble paying attention.
What Doesn’t Cause ADHD
Although it’s been debated, research does not show that ADHD is linked to eating too much sugar or watching a lot of TV.
What Goes On in the Brain
Studies show that brain chemicals, called neurotransmitters, don’t work the same in children and adults with ADHD. There also tend to be differences in the way nerve pathways work.
Certain parts of the brain may be less active or smaller in children with ADHD than those without the disorder.
The brain chemical dopamine may also play a role. It carries signals between nerves in the brain and is linked to movement, sleep, mood, attention, and learning.