ABOUT ADHD - Everything You Need To Know
ADHD (Attention Deficit Hyperactivity Disorder) is a neurobiological disorder characterized by inattentiveness, hyperactivity, and impulsivity. It is one of the most common mental health disorders in children and adults with approximately 11% of school-aged children having been diagnosed with ADHD at some point.
ADHD is characterized by differences in brain function which impair an individual's ability to focus for extended periods or to easily transition between tasks. Those affected often have trouble sitting still, appearing disorganized, acting before thinking, talking too much without considering their words carefully, being easily distracted by extraneous stimuli, or forgetfulness that is not typical for their age group.
Which brain areas are responsible for ADHD?
ADHD affects selective areas of the brain including the frontal lobe, the prefrontal cortex, the basal ganglia, and the cingulate cortex. These regions are responsible for controlling processes such as motivation, working memory, executive functions (abstraction, problem-solving), decision making, and attention span. This accounts for some of the common symptoms that are associated with ADHD including disorganization, forgetfulness, poor impulse control, distractibility, and difficulty focusing.
What Causes ADHD?
ADHD is a neurobiological disorder that develops in early childhood due to differences in brain development or function. Research has shown that ADHD runs in families which may indicate a genetic or hereditary link. Considering the estimated 40% of ADHD cases are attributable to environmental factors, other possible risk factors may predispose an individual to develop ADHD including heavy metal toxicity, lead exposure, maternal smoking during pregnancy, head injuries, or lack of adequate sleep.
How is ADHD Diagnosed?
The diagnosis can be made based on evaluations by a mental health professional who is objective and non-judgemental. A diagnostic evaluation includes a medical history, physical examination, and blood work. Following this initial history, the mental health professional determines if the patient has coexisting conditions including depression, anxiety disorders, or substance abuse. A comprehensive psychological evaluation will be conducted which includes an interview with the patient and parents as well as a psychiatric assessment by a psychologist. A physical examination will also be conducted including a full neurological exam. There are several clinical tests that a mental health professional or neuropsychologist can administer to help in the diagnosis of ADHD.
While an individual needs to have a comprehensive evaluation, there are some common signs and symptoms along with laboratory tests that may indicate the presence of ADHD. A parent or sibling may have been diagnosed with ADHD or they may have exhibited some of the following symptoms on a repeated basis. Parents should watch for the following symptoms in their child which may be indicative of ADHD:
• Often fidgety or overly active
• Excessively messy house and clothing
• Often talks excessively without considering the consequences of their speech such as "blabbing" or "rambling"
• Difficulty sitting still and focusing for an extended period (Maybe hyperactive, impulsive, or aggressive)
Treatment for attention-deficit/hyperactivity disorder
Treatment for ADHD involves a combination of behavioural and pharmacological interventions. A behavioural intervention that is proven to be most effective for ADHD includes a multidisciplinary team approach including an educational therapist, a psychologist, a paediatrician, a psychiatrist, and a pediatric nurse. This team approach helps to provide individualized treatment plans that may include medication, counseling, and lifestyle modifications. There are also educational programs that have been specifically designed to target areas where the child is having difficulties with concentration such as mathematics or reading.
Medication options for ADHD
The most studied non-stimulant medications used to treat ADHD include Ritalin (methylphenidate), Concerta (methylphenidate), and Strattera (atomoxetine). Children with ADHD often have trouble concentrating after taking medication for several hours which can lead to side effects such as decreased appetite, headache, irritability, or insomnia. Children should have a gradual introduction of medication which will help to minimize any side effects that may occur.
Medications used to treat ADHD can be divided into two broad types: stimulants and non-stimulants. Stimulant medications like Ritalin (methylphenidate) are well known for their ability to increase attention span by increasing the levels of dopamine, the neurotransmitter responsible for the normal function of the brain. Non-stimulant medications like Strattera (atomoxetine) are believed to work by decreasing the overactivity in the chemical serotonin in the brain.
FAQ on ADHD
What is the difference between attention-deficit/hyperactivity disorder (ADHD) and attention deficit disorder (ADD)?
ADD was previously considered a different form of ADHD which involved inattentiveness but lacked the hyperactivity component. The American Psychiatric Association released guidelines in 2013 that eliminated the term ADD and instead referred to it as ADHD.
What are the most common types of stimulant medications used for treating ADHD?
Ritalin, Concerta, Adderall, and Vyvanse are all commonly used medications for treating ADHD. While each medication has a slightly different method of action, they all act by increasing the amount of dopamine available to boost concentration or reduce distractibility.