Have you ever had a time in your life when you couldn’t concentrate? When your mind wouldn’t stay focused on your task? Imagine growing up with a brain like that almost all the time–filled with distracting thoughts, images, and impulses to jump up and do something else NOW. Imagine it takes you an hour to finish one simple worksheet because your mind keeps wandering.
Imagine your parents and teachers scolding you for not getting your work done, being lazy and undisciplined, for forgetting to turn in the homework it took so long to complete-and feeling helpless to change. Sometimes you have a good day, but that only makes you look worse the rest of the time. That’s what it’s like to have the disabling condition Attention Deficit Hyperactivity Disorder (ADHD).
How common is ADHD?
ADHD affects 3 to 5% of children and 2 to 4% of adults. In children, 2 to 3 times more boys are diagnosed with ADHD than girls, but in adults, women have it almost as often as men. The disorder is found in every country in which it’s been studied around the world.
How is ADHD diagnosed?
People with ADHD may be mostly inattentive, mostly hyperactive and impulsive, or a combination of both. To be diagnosed, they must show some of the following behaviors for more than six months and to a greater degree than average for their age:
- Inattention: trouble paying attention to demand; difficulty getting organized and staying on task; forgetting and losing things often; making frequent careless mistakes; not seeming to listen, getting lost in daydreams and not responding when their name is called; not finishing work
- Hyperactivity-Impulsivity: trouble sitting still; difficulty being quiet or waiting or sticking with an activity; constant fidgeting and restlessness; excessive talking; impulsive behavior; blurting out inappropriate thoughts, hitting when angry, and interrupting
To be diagnosed with ADHD, these behaviors must start before age seven and create a handicap in at least two different areas of a person’s life (school, work, social life, home). Diagnosing ADHD isn’t easy, and it’s even more challenging in adults than in children. It requires a comprehensive evaluation that may include testing, interviews with the patient, and others who know them well, a medical exam and academic, behavioral, medical, and childhood history. Diagnosis is further complicated by the fact that many people with ADHD also have other problems. The most common are learning disabilities, anxiety disorders, depression, Tourette’s syndrome, substance abuse, and very often in boys, oppositional defiant disorder. It’s important to diagnose and treat each problem. For example, someone with ADHD who is also clinically depressed needs help with both issues to succeed.
What causes ADHD?
Let’s start with what doesn’t because there are many myths about it. For instance, many people still think that too much sugar and food allergies cause ADHD. But when people with ADHD are put on diets without sugar or suspected foods, very few improve. Others think poor parenting causes it. Nevertheless, people with ADHD come from all kinds of homes with all kinds of parents, so that doesn’t hold true.
ADHD occurs more often in people who had prenatal exposure to alcohol and tobacco, born prematurely or had low birth weight, who’ve been exposed to lead, or whose mothers had difficult pregnancies. It runs in families, so it’s partly genetic. And differences in the brains of people with the disorder can be seen with PET scans. They get less energy to the parts of the brain that control attention and impulses. That means it’s a biological disorder-not a character flaw.
Do adults really have ADHD? Don’t kids outgrow it?
We no longer think so. 67% of diagnosed kids continue to have serious symptoms as adults. Since ADHD used to be thought of as a kids’ problem, many adults have the disorder who’ve never been diagnosed.
They often have a very poor self-image, having been blamed and put down for being disorganized, inattentive, and impulsive their whole lives. Many adults begin to suspect that they have ADHD when their children are identified as having it. Getting diagnosed and learning about their disorder can be very healing for these folks. Treatment can open up a new world for adults who’ve struggled their whole lives to fit in-or given up on it.
It’s important to add that there are lots of very successful adults with ADHD. They often find occupations that use their strengths and have partners, coworkers, employers, or employees who organize the details for them. Many entrepreneurs, artists, inventors, athletes, and performers have ADHD.
Isn’t it extreme to give people with ADHD stimulant medicines-especially kids?
Without treatment, many people with ADHD have a tough time getting an education, holding jobs, and getting along with family and peers. Their self-esteem is lousy, and many people see them as lazy, uncooperative underachievers who just won’t “buckle down.” The symptoms of 90% of children with ADHD improve on stimulant drugs (Ritalin, Dexedrine, and Adderall.) They’re more able to participate appropriately in school, sports, social activities, and family life.
What else helps people with ADHD?
Psychotherapy, support groups, social and behavioral skills training, parenting classes, behavior modification, and school and workplace accommodations can be beneficial. Many tips can help people with ADHD get organized and focused, from using reminder notebooks and planners to creating routines and quiet spaces for work. Parents can help by breaking down large jobs into smaller tasks and giving rewards as each is done. Teachers can use a variety of tactics to help students with ADHD to learn.
ADHD is genuinely a disabling condition, and even with medicine and help getting organized, it makes life tough for both the person with ADHD and those around them. There’s research being done to further our understanding of the causes and treatment of the disorder. Perhaps someday, it will be far easier to diagnose and treat early before a child’s self-esteem and relationships are affected.
Meanwhile, understanding this brain disorder and identifying and treating it can help prevent a lot of misery in families, classrooms, and workplaces worldwide.