ATTENTION DEFICIT HYPERACTIVE DISORDER

INTRODUCTION

Attention Deficit hyperactive Disorder (ADHD) is a group of behavioral symptoms, mainly inattentiveness and easy distractibility, which is caused by a deficiency in the hormones of noradrenalin and dopamine. It is a long-term, genetic condition which has serious and undesirable consequences that last well into adulthood if not addressed properly and early. People with ADHD may also have associated problems of dyslexia, autism, conduct disorder and opposition defiance disorder, to name a few. Studies have shown that childhood ADHD may be a risk factor for subsequent substance abuse and conduct disorders in adult life.

It is a very treatable condition which, if managed properly, can allow individual to lead fulfilling lives and reach their maximum potential.

ADHD is a complicated diagnosis requiring certain criteria to be met before a child can be labelled as having ADHD. It is the most common behavioral disorder in children, with worldwide >2% people being affected. 3-9% of school children are classified as having ADHD. Symptoms of ADHD manifest from a very early age. Starting school is a stressful time, and maybe the first time that a child’s symptoms are noticed. It is normally diagnosed between ages 3-7. It is 3-5 times more common in boys than in girls.

ADHD is a lifelong condition. There is no cure, but excellent treatment is available which controls the symptoms and keeps them on par with normal functioning.

SIGNS AND SYMPTOMS

ADHD/ADD is usually described as being made up of three core behaviors:

  • Predominantly inattentive type – problems of attention, distractibility, short-term memory and learning. This is also known as ADD (attention deficit disorder). Girls with ADHD often have this form of the disorder.
  • Predominantly hyperactive type – impulsive, poorly self-monitored behavior.
  • Combined type – most children with ADHD/ADD fall into this category.

INATTENTIVE SYMPTOMS:

To be diagnosed with ADHD, a patient must have 6 or more of the following criteria, for at least 6 months, in a way which is disruptive of normal behavior:

  • very short attention span
  • very easily distracted
  • seems to not be listening/paying attention to what is being said
  • frequent careless mistakes, most prominent in homework
  • appearing forgetful, or losing things in daily tasks
  • inability to concentrate or complete tasks
  • constantly changing activity or task
  • difficulty organizing tasks
  • strong dislike of tasks that require sustained mental effort

HYPERACTIVITY AND IMPULSIVITY SYMPTOMS

These also follow the same criteria of at least 6 or more of the following symptoms, for 6 or more months, in a pattern that is inconsistent with developmental level of that age:

  • fidgeting, tapping hands or feet, squirming constantly
  • leaving seat frequently in a setting where sitting is expected
  • running about or climbing excessively
  • difficulty engaging in quiet leisure activities
  • excessive talking
  • unable to sit quietly for long periods of time
  • difficulty waiting in line in social situations
  • interrupting or intruding upon activities of others

ADHD has no effect on learning or intelligence, although a third of patients with ADHD may have associated learning difficulties due to a different condition, such a dyslexia (difficulty reading or spelling words).

ADHD SYMPTOMS IN ADULTS

15% of adults with childhood ADHD still continue to have symptoms of ADHD after the age of 25. Following are the symptoms of ADHD in adults:

  • carelessness and inattention to detail
  • poor organizational skills
  • inability to focus or prioritize
  • starting new tasks before finishing old ones
  • difficulty keeping quiet
  • poor timing while talking to others
  • quick temper and irritability
  • extreme impatience
  • taking uncalculated risks, with no regard for safety of self or others
  • inability to deal with stress

MANAGEMENT

Treatment of ADHD is a combination of behavioral therapy and medication. Nutritional balance, exercise, and development of social skills are all part of providing a child with ADHD the best best environment for personal growth and control of symptoms.

Behavioral therapy (also known as behavioral modification) is used in junction with stimulants such as Ritalin and and Aderrall for the best treatment. The medicines provide short term improvement of the symptoms.

Parent training and education programs also prove to be greatly beneficial in learning specific ways of dealing with your child to get the most out of different situations.

There are other ways of treating ADHD that some people with the condition find helpful, such as cutting out certain foods and taking certain supplements. However, there is no medical evidence that these methods work, and they should not be attempted without medical advice.

Overall, although ADHD is a challenging diagnosis that requires a lot of understanding and cooperation from the patient and his/her support system, it is manageable when approached with a broad mind. Once the diagnosis is made, it becomes more manageable due to the multiple treatment options available. There are also multiple support groups present for emotional, social and moral support of families with the diagnosis.

Dr. Annie

Physician, mom and wife

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