What is ADHD?

Attention deficit/hyperactivity disorder (ADHD) is a condition that involves problems paying attention. It also involves acting on impulse. It is the most common mental health problem in children. Many people think ADHD is just a childhood illness, but it can continue into adulthood.

ADHD may also be called attention deficit disorder (ADD).

How does it occur?

The exact cause of ADHD has not yet been found. ADHD seems to run in families. If a parent, uncle, or grandparent has ADHD, other family members may also develop it. People with ADHD have several small differences in the brain. These differences are in the front part of the brain (an area involved in self-control) and in some parts in the center of the brain.

Much research has looked at whether ADHD is caused by sugar or things added to foods such as preservatives and coloring. The evidence has not connected these with ADHD. Allergies are not a common factor in causing ADHD either.

What are the symptoms?

There are 3 main symptoms of ADHD: distractibility, impulsiveness, and hyperactivity.

A person with ADHD:

• Is distracted by what is going on around him or her.
• Has trouble waiting in line or taking turns.
• Starts many projects but doesn't finish things.
• Reacts to things quickly and without thinking of the outcome.
• Talks when other people are talking.
• Acts quickly without thinking first, such as buying something he or she does not need.
• Is quick to anger.
• Fidgets and cannot sit still.
• Walks, runs, or climbs around when others are seated.
• Gets bored very quickly.

Symptoms may change from childhood to adulthood. The most common changes during the teen years are less hyperactivity and better self-control. Being restless and very easily distracted are the most common features of the adult disorder.

For many people, childhood ADHD may be associated with other problems. Children who are hyperactive and have poor impulse control may be more likely to develop other mental health problems than those whose only symptom is being easily distracted. The most common problem for adults with ADHD is depression. Other problems include:

• anxiety disorders
• substance abuse
• learning disorders
• bipolar disorder
• personality disorders (such as borderline personality disorder or antisocial personality disorder)
• impulse control disorders (such as gambling addiction)
• explosive anger.

About half of children with ADHD also have serious behavioral problems such as defiance or aggression. Many adults who have ADHD continue to have behavior problems.

About one-third of children with ADHD have trouble learning to read or do math. Some adults with ADHD continue to have problems with reading, writing, or math.

How is it diagnosed?

There are no lab tests to diagnose ADHD.

Your healthcare provider will ask about your symptoms and observe your behavior for signs of ADHD. To be diagnosed with ADHD, your symptoms must persist and interfere in a major way with your daily life. You and others close to you may complete questionnaires or rating forms about ADHD symptoms. You may see a psychologist or other mental health professional for tests of attention and self-control. You may see a mental health professional to screen for mental health problems in addition to ADHD.

There are 3 types of ADHD:

• In the combined type, you have all of the main symptoms: distractibility, poor impulse control, and hyperactivity.
• In the predominately inattentive type, you have problems with focusing and attention. Often, there is very little hyperactivity or impulsivity. This form is especially common among girls and women.
• In the predominately impulsive-hyperactive type, poor self-control is the major problem.

How is it treated?

The treatment of ADHD may involve 3 types of treatment:

• Learning coping skills: You will learn to manage highly stimulating situations that distract and over-excite you. Read and work in quiet places and take frequent breaks. You may want to use day planners or pocket computers to organize your life. You tend to need more structure and daily routine than most people.
• Behavioral training: Behavior programs may help you develop a longer attention span and be able to sit still.
• Medicines: The same medicines used for children are effective for adults. Since the 1920s, the medicines methylphenidate (Ritalin) and dextroamphetamine (Dexedrine) have been used. They are stimulants, and appear to stimulate the self-control areas of the brain. Another medicine often used is dextroamphetamine/amphetamine (Adderall). These medicines do not slow you down, but rather increase self-regulation. About 70% of those with ADHD improve with these medicines. The most common side effects are loss of appetite and trouble getting to sleep. Your dosage will be gradually adjusted to reduce side effects. Sometimes, medicines are used only on workdays. When these medicines are not effective, there are other medicines that can help with ADHD.

Claims have been made that many health foods and supplements help with ADHD. Omega fatty acid supplements and certain vitamins and minerals may help symptoms of ADHD.

How long do the effects last?

Many people with ADHD seem to "grow out of it" by their early twenties. However, they are often left dealing with relationship problems, a poor education, and a reputation as a troublemaker. Men and women may have trouble keeping up with the things they need to do at home and at work. Adults with ADHD may lose job after job because of their illness. There are many jobs at which people with ADHD can excel. These include:

• fast-paced sales positions
• delivery drivers
• management positions that encourage movement about the business
• jobs that reward high energy and multi-tasking.

What can I do to help myself or my loved one?

There are many ways to help manage ADHD:

• When you need to read or concentrate, arrange tasks to be done away from the sounds of television, radio, or others talking.
• When you need to concentrate, try having low-level background sound such as white noise or instrumental music.
• Do tasks in short blocks of time with breaks in between.
• Follow a very structured daily routine for basic home and work events.
• If you have trouble slowing down at bedtime, a planned quiet time before bedtime and even background music when falling asleep are often helpful.
• Carry along worry beads or worry stones that can be played with when you are restless.
• Exercise regularly.
• Get at least 7 to 9 hours of sleep every night.
• Eat a healthy diet.
• Do not abuse alcohol and drugs.
• Limit caffeine.

For more information, contact: Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) 8181 Professional Place, Suite 150, Landover, MD 20785 Telephone: (800) 233-4050 Web site: http://www.chadd.org

Written by Gayle Zieman, PhD, and Nakeesh A. Dewan, MD, for RelayHealth
Published by RelayHealth.
© 2008 RelayHealth and/or one of its affiliates. All Rights Reserved.