ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is characterised by differences in attention, hyperactivity, and impulsivity. ADHD is a neurodevelopmental disorder, which is a condition that affects how your brain functions and results in symptoms that can be noticed from an early age (although you might not be aware of it at the time!). According to the DSM-5 – the handbook used to guide health professionals globally in diagnosing mental and developmental conditions – these symptoms need to be present before the age of 12 years old. That being said, ADHD symptoms continue into adulthood in approximately three-quarters of cases and are often diagnosed later in life.

ADHD Symptoms:

These symptoms have been adapted and summarised from the DSM-5 manual by Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), and can be found here.

ADHD predominantly inattentive presentation:

  • Fails to give close attention to details or makes careless mistakes.
  • Has difficulty sustaining attention.
  • Does not appear to listen.
  • Struggles to follow through with instructions.
  • Has difficulty with organisation.
  • Avoids or dislikes tasks requiring sustained mental effort.
  • Loses things.
  • Is easily distracted.
  • Is forgetful in daily activities.

ADHD predominantly hyperactive-impulsive presentation:

  • Fidgets with hands or feet or squirms in chair.
  • Has difficulty remaining seated.
  • Runs about or climbs excessively in children; extreme restlessness in adults.
  • Difficulty engaging in activities quietly.
  • Acts as if driven by a motor; adults will often feel inside as if they are driven by a motor.
  • Talks excessively.
  • Blurts out answers before questions have been completed.
  • Difficulty waiting or taking turns.
  • Interrupts or intrudes upon others.

ADHD combined presentation:

The individual meets the criteria for both inattention and hyperactive-impulsive ADHD presentations. These symptoms can change over time, so people may fit different presentations as they get older. They can also differ in severity and can range from moderate to severe.

How symptoms affect daily life:

ADHD symptoms have the potential to present children, teenagers, and adults alike with specific challenges as they navigate life with divergences in attention, working memory, and executive functioning. Executive functioning refers to the brain’s set of mental skills (e.g. working memory, flexible thinking, and self-control) that are used to learn, work, and organise day-to-day life. Issues with executive functioning can make focusing, following directions, completing tasks, handling emotions, remembering things, and other daily tasks more difficult. As a result some, but not all, people with ADHD experience academic failure or delay, driving problems, social difficulties, risky sexual behavior, and substance abuse. Due to these struggles, people with ADHD often end up feeling perpetually frustrated and guilty and blame themselves for their difficulties.

Gender Differences:

While traditionally thought of as a disorder that occurs in young boys, it is now known that girls and women can also have ADHD. ADHD in girls is sometimes missed in females as it is thought that they are more likely to have the predominantly inattentive subtype, while males are more likely to have the hyperactive-impulsive presentation which is easier to spot. In addition, differences in gender socialisation, norms, and expectations are also thought to play a role in the symptom presentation and diagnosis of ADHD.

Causes:

There is no single cause for ADHD and it is still something being studied by researchers and medical professionals. Nonetheless, there are some factors that may contribute to the likelihood of a person having ADHD. These include:

  • Genetics: whether or not there is a family history of ADHD.
  • Environment: exposures to stress, tobacco, toxins, or alcohol during a parent’s pregnancy or at a young age.
  • Low birth weight or preterm birth in some instances.
  • Brain injury.

Diagnosis:

People with ADHD can be diagnosed at any age; when they are children, teenagers, or adults. There is no single test for ADHD, and symptoms overlap with a lot of other comorbid conditions. This can make ADHD difficult to diagnose, and is often quite a lengthy process. Typically, a doctor will try to rule out other conditions that have similar behaviours (e.g. trouble hearing or seeing, anxiety, depression, learning disabilities, and sleep disorders – although, these can also co-exist with ADHD). The health professional – often a psychiatrist, neurologist, or psychologist – will also ask questions to learn more about the person’s symptoms throughout the lifespan. This is usually done through the use of standardised interviews that have been developed and tested to diagnose ADHD specifically.

Comorbid Conditions:

It is common for people with ADHD to also have a comorbidity, a medical term for two or more disorders that occur at the same time. Common comorbid conditions for ADHD include but are not limited to:

  • Depression.
  • Anxiety.
  • Bipolar disorder.
  • Obsessive-compulsive disorder (OCD).
  • Oppositional defiant disorder (ODD).
  • Sensory processing disorder.
  • Myalgic Encephalomyelitis / Chronic fatigue syndrome (ME/CFS).
  • Sleep disorders.
  • Learning disabilities.
  • Language disabilities.
  • Fine and gross motor difficulties.
  • Executive function difficulties.
  • Tic disorders.
  • Or another psychological or neurological problem.

Treatments:

There are a number of different treatment options for ADHD, which can be explored with a health professional following a diagnosis. Treatments for ADHD include:

  • Behavioural therapy such as CBT or social skills training to help people develop specific capacities and monitor symptoms.
  • Psychoeducative talking therapy to talk through ADHD and its effects.
  • Medication such as Adderall, Ritalin, Vyvanse, and Dexedrine can help improve attention and focus.
  • Support groups (ADHD Women Knowing Me, Knowing You and Neurodiverse Adults) to meet other people with ADHD and learn how they experience living with the condition.
  • Alternative or additional treatments such as dietary changes, meditation, and supplements.

Experts

Professor Sandra Kooij
ADHD in Adult Women Psychiatry and Research
Website
LinkedIn

Professor Barbara Franke
ADHD Genetics and Epigenetics Research
Website

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