At a Glance:
- ADHD is a neurodevelopmental disorder that affects a person’s ability to concentrate and focus, and may also include characteristics of hyperactivity and impulsivity
- The condition was referred to as ADD (attention deficit disorder) until 2013, now it is ADHD with a type attached. The type can be inattentive or hyperactive/ impulsive, or both combined.
- Around one in 20 Australians lives with ADHD
- Attention Deficit Hyperactivity Disorder first appears during childhood but some people may not be diagnosed until they are adults
- There is no known exact cause of ADHD but a number of contributing factors include: genetic predisposition, maternal drug use, abandonment and exposure to the metal lead.
- ADHD is typically treated or managed through a combination of medication and psychotherapy
What is Attention Deficit Hyperactivity Disorder?
Attention deficit hyperactivity disorder is a neurodevelopmental disorder that affects around one in 20 Australians (approximately 1.2 million people). Neurodevelopmental disorders are a number of conditions that affect or disturb the development of the central nervous system and brain.
You may have heard the condition referred to as ADD (Attention Deficit Disorder). This is an outdated term due to the exclusion of hyperactivity and impulsivity characteristics. ADHD became the official term for the condition in 2013.
These disorders may affect a number of brain functions but are by no means a sign of low intelligence. Rather, people with ADHD have difficulty focussing or concentrating and are typically impulsive and hyperactive. They may struggle to read a book, but may be good at some games for instance.
ADHD starts in childhood but may not be diagnosed until adulthood. Depending on the dominant symptoms, attention deficit hyperactivity disorder is typically categorised with a type, such as:
- Combined ADHD - the child with ADHD displays symptoms and meets the criteria of both inattention and hyperactivity/impulsivity.
- Predominantly Inattentive ADHD - the child with ADHD displays symptoms and meets criteria for inattention but NOT hyperactivity/impulsivity.
- Predominantly Hyperactive-Impulsive ADHD - the child with ADHD displays symptoms and meets the criteria of hyperactivity and impulsivity but NOT inattention
Symptoms and Diagnosis of ADHD
Children with ADHD typically display symptoms in a number of ways, including:
- Emotional regulation and balance - such as frequent moods swings, quick to anger, trouble dealing with stress, low tolerance for frustration.
- Hyperactivity - such as constant movement, fidgeting or not being able to sit still or restlessness.
- Impulsivity - including snap decision making, being accident prone, talking over people, being quick to anger.
- Inattention - difficulty completing tasks, problems with concentration, problems following or forgetting instructions. Moving from one task to another before finishing them, requiring things to be said multiple times before responding, lack of organisational skills, losing or failing to take care of important belongings may also be indications of inattention.
- Sleep - difficulty falling asleep, broken sleep, constantly getting out of bed and wandering around.
- Socialisation - talking over people, ignoring or failure to understand social cues or standards of behaviour.
Many children display a number of these behaviours, so a diagnosis of ADHD may be difficult. There is no test for ADHD, so diagnosis takes detailed and prolonged assessment. For a diagnosis of ADHD assessment is made on a number of criteria that must have been displayed for six months or more.
If at least six criteria from one category are met, a diagnosis of ADHD may be given.
- Become easily distracted on a regular basis
- Difficulty with organisation concerning activities and tasks
- Difficulty following instructions or following through on instructions
- Difficulty with or avoidance of activities that require mental effort such as homework, school work, tests or games with multiple or complex rules
- Failure to pay attention to details leading to careless mistakes in a number of tasks or activities such a schoolwork or homework
- Failure to obey instructions or follow through
- Losing objects needed for important activities (things needed for school work or other tasks)
- Not listening to instructions even when directly given
- Not completing tasks or activities (not due to wilfulness or a lack of understanding)
- Answering questions or otherwise speaking before the other person has finished
- Difficulty with taking part in quiet activities
- Difficulty waiting for or taking turns
- Excessive or compulsive talking. Talking more than average.
- Failure to stay seated at school or in other situations where they should be seated (during meals, on public transport, at a cinema, etc)
- Fidgeting with their hands, small objects, compulsive kicking or tapping feet, squirming in their seat
- Interrupting others or intruding into their conversations or activities
- Running or climbing inappropriately during everyday activity instead of play
For a diagnosis of ADHD, the criteria must not be caused by another disorder, such as anxiety, depression, trauma or other mood or personality disorder.
Due to the difficulty of diagnosis, some people may not be diagnosed with attention deficit hyperactivity disorder until they are an adult. Some people may display fewer symptoms as they age, but others may continue to display major symptoms, most commonly difficulty paying attention, impulsivity and restlessness.
Impulsivity in adults may present as a short temper or being prone to anger, mood swings or a lack of patience.
Schedule time to see a psychologist today to discover what you may do to help.
What Causes Attention Deficit Hyperactivity Disorder?
The exact cause of ADHD is unknown but there are a number of suspected contributing factors, including:
- Genetics – research suggests gene changes, including change related to having an older father or mother, may be present in people with ADHD. Genetic inheritance also appears to play a major part, with the condition being passed through families.
- Lack of early attachment – a lack of bonding or affection from a parent or caregiver. Other traumatic experiences related to attachment, such as the early death of a parent or abuse, may also contribute to the development of inattentive or hyperactive symptoms.
- Lead metal exposure – long term exposure to lead may lead to changes in brain chemistry and function that may affect behaviour.
- Maternal drug use – use of cocaine or nicotine during pregnancy may be a contributing factor to the development of ADHD.
- Neurophysiology – there may be differences in brain anatomy, electrical activity and metabolism in people living with ADHD.
Living With and Treating ADHD
Treatment for attention deficit hyperactivity disorder typically involves a mixture of behavioural therapies and medication.
Medications are used to help people living with ADHD better control their actions and impulses. There are two main forms of medication typically used in the treatment of attention deficit hyperactivity disorder - stimulants and non-stimulants. Both of these are used to regulate brain chemistry.
Central nervous system (CNS) stimulants such as Adderall and Ritalin are the most commonly prescribed medications for people with ADHD. This category of drugs increases the amount of dopamine and norepinephrine in the brain.
If CNS stimulants don’t work to help control hyperactivity and impulsivity or cause side effects, the person living with ADHD may be prescribed nonstimulant medications. These drugs also help elevate levels of norepinephrine in the brain and include Strattera and a number of antidepressants.
Psychotherapy for ADHD
A number of psychotherapeutic therapies may be used in the treatment of attention deficit hyperactivity disorder, including talk therapy and behavioural therapy.
Talk therapy allows people living with ADHD to talk about the ways that their condition affects their day to day life. The patient and therapist may also devise ways to manage symptoms.
Behavioural therapy is an umbrella term for a number of different therapies. They are intended to identify and help patients modify potentially unhealthy, self-destructive or disruptive behaviours. These therapies include Cognitive Behavioural Therapy (CBT), and Cognitive Behavioural Play Therapy, a form of CBT for use with children.
In addition to therapy and medication, there are also a number of things people may do to help manage the symptoms of ADHD.
You may help children living with ADHD in a number of ways, including:
- Developing daily routines for them to follow at home and school.
- Remain calm, repeat instructions when necessary and keep rules clear and simple.
- Only give one or two instructions at a time and have the child repeat the instructions to you to make sure they heard and understood.
- Make physical contact or maintain close physical proximity with the child to get their attention before talking.
- Have clear rules for discipline, giving appropriate punishment (such as a time out for young children) when needed and praising and acknowledging good behaviour and achievements.
- Get physically close to the child and make sure you have the child’s full attention when you talk.
In addition, there are a number of activities that may also help adults with ADHD manage their symptoms, such as:
- Eating a healthy, balanced diet.
- Spending time outdoors. Research shows that spending time in green places may help regulate mood and help ease ADHD symptoms.
- Ensuring you get around 60 minutes of physical activity and exercise a day.
- Getting plenty of sleep.
- Limiting screen time.
If you are worried about you or your child’s inability to pay attention or hyperactivity, book an appointment with a GP . The easiest way to search for and book a medical appointment is online with MyHealth1st.