ADHD

ADHD stands for attention deficit hyperactivity disorder, a chronic condition that involves inattentiveness, impulsivity, and hyperactivity in children that persists until adulthood.

Children with ADHD also may struggle with low self-esteem, troubled relationships and poor performance in school. Symptoms sometimes lessen with age. Adults with ADHD may have trouble managing time, being organized, setting goals, and holding down a job.

Risk factors for ADHD may include:

  • Blood relatives (such as a parent or sibling) with ADHD or another mental health disorder
  • Exposure to environmental toxins — such as lead, found mainly in paint and pipes in older buildings
  • Maternal drug use, alcohol use or smoking during pregnancy
  • Maternal exposure to environmental poisons — such as polychlorinated biphenyls (PCBs) — during pregnancy
  • Premature birth

Types of ADHD

Inattentive Type. A person with this type must have at least six of these nine symptoms, and very few of the symptoms of hyperactive-impulsive type:

  • Not paying attention to detail
  • Making careless mistakes
  • Failing to pay attention and keep on task
  • Not listening
  • Being unable to follow or understand instructions
  • Avoiding tasks that involve effort
  • Being distracted
  • Being forgetful
  • Losing things that are needed to complete tasks

Hyperactive-Impulsive Type. To have this type, a person has to have at least six of these nine symptoms, and very few of the symptoms of inattentive type:

  • Fidgeting
  • Squirming
  • Getting up often when seated
  • Running or climbing at inappropriate times
  • Having trouble playing quietly
  • Talking too much
  • Talking out of turn or blurting out
  • Interrupting
  • Often “on the go” as if “driven by a motor”

Combined Type. This is the most common type of ADHD. People with it have symptoms of both inattentive and hyperactive-impulsive types.

 

Symptoms of ADHD

There are three groups of symptoms:

Inattention

You might not notice it until a child goes to school. In adults, it may be easier to notice at work or in social situations.

The person might procrastinate, not complete tasks like homework or chores, or frequently move from one uncompleted activity to another.

They might also:

  • Be disorganized
  • Lack focus
  • Have a hard time paying attention to details and a tendency to make careless mistakes. Their work might be messy and seem careless.
  • Have trouble staying on topic while talking, not listening to others, and not following social rules
  • Be forgetful about daily activities (for example, missing appointments, forgetting to bring lunch)
  • Be easily distracted by things like trivial noises or events that are usually ignored by others.

Hyperactivity

  • It may vary with age. You might be able to notice it in preschoolers. ADHD symptoms nearly always show up before middle school.

Kids with hyperactivity may:

  • Fidget and squirm when seated.
  • Get up frequently to walk or run around.
  • Run or climb a lot when it’s not appropriate. (In teens this may seem like restlessness.)
  • Have trouble playing quietly or doing quiet hobbies
  • Always be “on the go”
  • Talk excessively

Toddlers and preschoolers with ADHD tend to be constantly in motion, jumping on furniture and having trouble participating in group activities that call for them to sit still. For instance, they may have a hard time listening to a story.

School-age children have similar habits, but you may notice those less often. They are unable to stay seated, squirm a lot, fidget, or talk a lot.

Hyperactivity can show up as feelings of restlessness in teens and adults. They may also have a hard time doing quiet activities where you sit still.

Impulsivity

Symptoms of this include:

  • Impatience
  • Having a hard time waiting to talk or react

The person might:

  • Have a hard time waiting for their turn.
  • Blurt out answers before someone finishes asking them a question.
  • Frequently interrupt or intrude on others. This often happens so much that it causes problems in social or work settings.
  • Start conversations at inappropriate times.

Impulsivity can lead to accidents, like knocking over objects or banging into people. Children with ADHD may also do risky things without stopping to think about the consequences. For instance, they may climb and put themselves in danger.

DIAGNOSIS

Doctors check for behavior that’s:

  • Not typical for the person’s age. (Most children can behave in those ways at some point or another, though.)
  • Has a negative impact on the person’s ability to function at home, in social environments, or at work.

They also have to consistently display at least six of the above symptoms listed in the types of ADHD:

  • For at least 6 months
  • And in at least two settings, such as at home and in school

 

RECOMMENDED MEDICATIONS

Medicines are used to help control the symptoms of attention deficit hyperactivity disorder (ADHD): hyperactivity, impulsivity, and inattention. The American Academy of Pediatrics (AAP) guidelines recommend medicine and/or behavior therapy to treat children who have ADHD.

Medicine choices

Medicines to treat ADHD include:

  • Stimulants. These medicines include amphetamine (for example, Adderall or Dexedrine) and methylphenidate (for example, Concerta, Metadate CD, or Ritalin). Stimulants usually reduce hyperactivity and impulsivity and improve focus.
  • Atomoxetine (Strattera). This is an approved non stimulant medicine for children, teens, and adults.
  • Clonidine (Kapvay) and guanfacine (Intuniv). These are non stimulant medicines approved to treat aggression, inattention, and impulsivity not controlled by other ADHD medicines.
  • Antidepressants. Certain antidepressants are sometimes also recommended.

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