ADHD: What It Is, Symptoms, Causes and Treatment

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is marked by persevering excessive restlessness, difficulty keeping focus, impulsive behavior, and/or hyperactivity. These issues are pervasive and impairing in multiple contexts. ADHD is sometimes considered a childhood disorder an individual failed to overcome in adolescence. In fact, its symptoms often start in early childhood and continue into adulthood. However, in many cases, ADHD is actually not recognized or diagnosed until the individual reaches adulthood.

According to the USA's leading organization that protects public health - The Centers for Disease Control and Prevention (CDC),attention deficit/hyperactivity disorder is more common in boys and men than in girls and women. Males are much more likely to be diagnosed with attention deficit/hyperactivity disorder than females. It is also worth noting that women display the symptoms of ADHD differently compared to men. If you think you or your child might have ADHD, we highly recommend you take this accurate and free Attention-Deficit/Hyperactivity Disorder Test. Remember that even though this test is a powerful assessment tool, it is not an official diagnosis. Only a licensed mental health professional - a psychologist, a psychiatrist, or a neurologist - can diagnose someone with ADHD. In some cases, primary care providers can identify the condition, give the diagnosis, and treat ADHD too.

A psychiatric evaluation includes a description of symptoms from the patient (or his caregivers, if the patient is a minor),completion of questionnaires by the patient or caregivers/teachers, the patient’s psychiatric and medical history, family history, and information regarding upbringing and environment. Because several conditions (such as learning disorders, thyroid conditions, anxiety, mood disorders, etc.) can mimic ADHD, the evaluation may also include a referral to rule out other disorders.

It is normal for children to have difficulties paying attention, sitting or standing still, and waiting for their turn from time to time. To be diagnosed with ADHD, a child’s symptoms of hyperactivity, inattention, and/or impulsiveness must be noticeably more significant than expected for their age. The child must also have six or more symptoms of inattentiveness, hyperactivity, or impulsivity and be displaying these symptoms continuously for at least six months. Children can manifest ADHD symptoms as early as aged 3 to 6. Most children get an ADHD diagnosis in their elementary school years. If an individual has not been diagnosed with the disorder when they were children, getting an accurate diagnosis as an adult can be life-changing for them. If untreated, ADHD can cause serious health, work, and/or relationship issues.

According to numerous studies, up to 5.76% of adults display ADHD symptoms. Some of these people, without a doubt, have missed an early diagnosis. Diagnosing attention deficit/hyperactivity disorder in adults is more difficult than in children. For an adult to be diagnosed with the condition, the symptoms of hyperactivity-impulsivity and/or inattention must be long-lasting and impair the individual’s functioning.

ADHD is a condition that has been known for a long while - for example, Hippocrates in ancient Greece already observed people who had difficulty focusing. However, over time, our understanding of the condition has changed significantly. The idea that ADHD is only a disorder of childhood and affected children “grow out” of it during adolescence was common until the 1990s. Yet, recent research has revealed that about half of children diagnosed with the disorder, retain its symptoms into adulthood. There are still some disagreements among experts about whether the list of ADHD symptoms used to diagnose children and teenagers can also apply to adults.

Symptoms of the condition fall into three categories: predominantly hyperactive/impulsive type, predominantly inattentive type, and combined type. Here below is a detailed explanation of each type.

Predominantly Hyperactive/Impulsive Type

This type of ADHD is characterized by hyperactive and/or impulsive behavior. Individuals who have this type of condition frequently show the following symptoms:

• Talk a lot, interrupt others, may grab things from people;
• Have difficulty staying seated (in classroom or office);
• Constantly fidget with or tap hands or feet, or squirm in the chair;
• Seem to be unable to do leisure activities quietly;
• Have difficulty waiting for their turn - for instance, while waiting in line.

Young boys are very often diagnosed with this ADHD type.

Predominantly Inattentive Type

This type of ADHD is marked by a lack of attention and high distractibility. People with this ADHD type often display the following symptoms:

• Do not pay close attention to details and/or make careless mistakes in school or workplace tasks;
• Do not seem to listen when someone is speaking to them (i.e., they seem to be elsewhere);
• Have difficulty staying focused on tasks or activities, such as during conversations, lectures, or long reads.
• Are unable to follow instructions and/or find it difficult to complete schoolwork or job duties - they may start performing tasks but lose focus very quickly and leave them unfinished;
• Have issues organizing tasks and work - for example, they struggle with time management and/or miss deadlines.

Inattentive-type ADHD used to be referred to as attention deficit disorder (ADD).

Combined Type

Combined type is, as the title suggests, a type of ADHD that presents as a mix of predominantly hyperactive-impulsive type and predominantly inattentive type. When an individual displays six or more symptoms of each type, they can be diagnosed with the combined type of attention deficit/hyperactivity disorder.

Bear in mind that since symptoms may change over time, the ADHD type may also change.

Studies to date have shown that several things may cause ADHD. According to most experts, genetics is the deciding factor for individuals who develop attention deficit/hyperactivity disorder. However, researchers are still investigating whether specific genes, particularly ones linked to dopamine, may play a major role in a person’s chances of developing the condition.

Some scientists believe that a fair few cases of ADHD are caused by the modern stressed-out, consumer-driven, breakneck lifestyle that prevails in our society today.

• Family History: a child diagnosed with ADHD has a 1 in 4 chance of having a mother or father suffering from the condition. It is also likely that another blood relative, such as a sibling, may also have ADHD. There are many cases when a parent and a child have been diagnosed with the disorder at the same time.
• Brain anatomy and function: a lower level of a neurotransmitter called norepinephrine, which is linked with dopamine (dopamine is the thing that helps control the brain’s pleasure center) may be associated with ADHD.
• A significant head injury may also cause attention deficit/hyperactivity disorder in some cases.

Some analysts claim that high amounts of sugar and food additives may cause ADHD. Unfortunately, the research on the link between these things and attention deficit/hyperactivity disorder is limited. However, it is known that impulsive and/or inattentive behaviors associated with the condition may lead to overeating, which, in turn, may contribute to sugar addiction.

Interestingly, according to multiple studies, caffeine consumption (clearly, sugar-free) may help reduce the symptoms of the disorder. That is likely because caffeine increases the amount of dopamine in the human brain.

Here below are listed some things that may raise an individual’s risk of developing ADHD even more:

• The mother's exposure to toxins (which may include smoking, using drugs, antidepressants, corticosteroids, drinking alcohol, exposure to brain-damaging chemicals, such as phthalates, polybrominated diphenyl ethers (PBDEs),perfluorinated compounds (PFCs),bisphenol A (BPA),triclosan, lead) during pregnancy;
• The individual's exposure to one or all of the above-mentioned toxins in their early childhood;
• The mother's high levels of stress and/or high blood pressure during pregnancy;
• Being born prematurely or having extremely low weight at birth.

ADHD can make life difficult for those diagnosed with this condition. Attention deficit/hyperactivity disorder often leads to poor school or work performance, impaired social functioning, financial issues, low self-esteem, trouble with the law, frequent car accidents, or other kinds of accidents. Needless to say, ADHD combined with other mental disorders usually presents even more challenges. Therefore, healthcare providers need to screen every person with ADHD for other potential issues. These issues may include the following: social communication disorder, specific learning disorder, autism spectrum disorder, oppositional defiant disorder, and conduct disorder.

Adults suffering from ADHD are also at increased risk of developing other conditions, such as substance use disorder and intermittent explosive disorder.

There is no cure for ADHD. However, available treatments may reduce symptoms and improve functioning. Treatments are usually medication, psychotherapy, education or training, or a combination of those. To treat the disorder in young children, parent-child interaction therapy (PCIT) is highly recommended. It is an evidence-based type of therapy that can help children suffering from ADHD and oppositional defiant disorder. Specific behavioral classroom management interventions (behavior management plans or teaching organizational skills) and academic accommodations (extended time on tests and exams and/or reduced classwork load) for children and adolescents have also proven themselves to be effective.

As for adults, medications have been shown to reduce hyperactivity/impulsivity and increase attention span. However, it is worth bearing in mind that ADHD medications affect each individual differently. Often, healthcare providers may have to try different medications, or dosages to find what works for a particular patient.

The most common medications used for treating attention deficit/hyperactivity disorder are stimulants. They help increase dopamine and norepinephrine in the brain.

Non-stimulants can also be effective for some people. These medications can improve focus, attention, and impulsivity in patients diagnosed with ADHD, too. However, take longer to start working than stimulants

Antidepressants may also help reduce all the ADHD symptoms; a medical professional can prescribe them if the patient has been experiencing troublesome side effects from stimulants. It is essential to remember that all medications can have side effects, particularly if misused or taken more than the prescribed dose.

Several types of therapy can help people suffering from attention deficit/hyperactivity disorder. Behavioral therapy and cognitive behavioral therapy are the most popular therapies when it comes to ADHD treatment. Family therapy can help partners and family members of individuals with ADHD find productive ways to encourage behavior changes and improve their relationships with their loved ones suffering from ADHD.

The number of people getting treatment for attention deficit/hyperactivity disorder has risen lately. It is unclear whether more individuals have ADHD, or it is just that more people are receiving a diagnosis of ADHD. Hopefully, a larger number of people - both children and adults - are being helped thanks to more awareness and better ways of diagnosing and treating this disorder.

Austerman J. ADHD and behavioral disorders: Assessment, management, and an update from DSM-5. Cleve Clin J Med. 2015 Nov;82 (11 Suppl 1): S2-7. PubMed

Pliszka S; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007 Jul;46(7): 894-921. PubMed

Tripp, G., Wickens, J.R. Neurobiology of ADHD. Neuropharmacology. 2009 Dec;57(7-8): 579-89. PubMed

Harpin V, Mazzone L, Raynaud JP, Kahle J, Hodgkins P. (2013). Long-Term Outcomes of ADHD: A Systematic Review of Self-Esteem and Social Function. J Atten Disord. 20(4): 295-305. PubMed

Wolraich, M.L., Hagan, J.F.J., Allan, C., et al. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2019;144(4). AAP Publications