Lewis Gale Physicians August 31, 2017

Attention Deficit Hyperactivity Disorder (ADHD) is a chronic behavioral disorder developed in childhood that typically onsets by age 7. ADHD affects children, adolescents, and adults. It is characterized by behavior that is hyperactive, impulsive, or inattentive. The cause of ADHD is not known at this time, but brain chemistry, genetics, and environmental factors all may play roles in the development of ADHD. It is estimated that almost 8% of American children have ADHD (about 1-3 students in every classroom of 30 children). About 60% of children with ADHD will continue to experience trouble related to their disorder into adulthood.

Symptoms

ADHD develops during childhood, but behaviors linked to ADHD can last into adulthood, often resulting in problems with relationships and employment. The primary symptoms of ADHD are inattention, hyperactivity, and impulsivity. At some time in their lives, all children are inattentive, hyperactive, or impulsive. People with ADHD, however, have symptoms that are noticeably more severe and consistent. They have difficulty in school, at work, and with their family and peer relationships.

There are several different types of ADHD. Some people are mainly inattentive and do not display signs of hyperactivity (classic attention deficit disorder or ADD). Some are hyperactive, some are impulsive, and others exhibit a mixture of these symptoms.

Specific symptoms include:

  • Being Inattentive (classic ADD)
    • Easily distracted by sights and sounds
    • Doesn't pay attention to detail
    • Doesn't seem to listen when spoken to
    • Makes careless mistakes
    • Doesn't follow through on instructions or tasks
    • Avoids or dislikes activities that require longer periods of mental effort
    • Loses or forgets items necessary for tasks
    • Is forgetful in day-to-day activities
    • Has difficulty organizing tasks
    • Hyperfocused on certain activities
    • Has difficulty with transitions
  • Being Hyperactive
    • Is restless, fidgets, and squirms
    • Runs and climbs and is not able to stay seated
    • Has difficulty playing quietly
    • Talks excessively
  • Being Impulsive
    • Blurts out answer before hearing the entire question
    • Interrupts others
    • Has difficulty waiting in line or waiting for turn
  • Combined (most common type)
    • Has a combination of the above symptoms

People with ADHD also can have:

  • Depression
  • Anxiety
  • Conduct disorder
  • Substance abuse
  • Learning disorders
  • Tourette Syndrome
  • Bipolar disorder
  • Insomnia
  • Constipation
  • Encopresis—leaking stool
  • Enuresis—inability to control urination
  • Cigarette use

Risk Factors

A risk factor is something that increases your likelihood of getting a disease or condition. Most of the known risk factors for ADHD are out of your control. For these factors there are no current guidelines for reducing the risk of ADHD. As our understanding of ADHD grows, your doctor may have more information regarding steps for reducing your risk. Understanding ADHD will help you identify its symptoms, minimize the consequences, and get appropriate treatment early on. Early recognition of the behavioral, emotional, and social factors that aggravate the condition can lead to interventions that help reduce its severity. Proper treatment can prevent problems with school, work, relationships, and drug and alcohol use disorder.

Some factors associated with the development of ADHD in children can be controlled. This includes limiting TV or screen time in young children and avoiding alcohol and smoking during pregnancy. It is possible to develop ADHD with or without the risk factors listed below. The more risk factors you have, though, the greater your likelihood of developing ADHD.

Risk factors include:

  • Gender—Boys are more frequently diagnosed with ADHD than girls.
  • Heredity—ADHD and similar disorders tend to run in families, suggesting there may be a genetic component. People with a parent or a sibling, especially an identical twin, with ADHD are at increased risk of developing the condition.
  • Age—Symptoms typically appear in young children aged 3-6 years old.
  • Maternal factors, such as:
    • Smoking during pregnancy
    • Preterm labor
    • Exposure to certain environmental toxins, such as polychlorinated biphenyls (PCBs)
    • Childhood exposures to environmental toxins, such as lead, which is found in pipes or paint in older buildings
  • Premature birth
  • Overall parental health—A child may be at a higher risk of ADHD if their parent has certain conditions, such as alcohol use disorder or conversion disorder.
  • Other factors that may increase the risk of ADHD include:
    • Head injury at a young age (less than 2 years old)
    • Being born with a serious heart condition
    • Having Turner syndrome (a genetic condition)
    • Being exposed to certain pesticides
    • Spending over 2 hours a day watching TV or playing video games when young

Living with ADHD

Any kind of stressful circumstances can worsen the symptoms of ADHD. As a result, lifestyle changes are an important part of a comprehensive treatment plan. Improvements in your environment, brought about by behavioral therapy, can reduce symptoms a great deal. The following recommendations all have the same objective: reduction of stress and distractions to help focus attention. Children and adults with ADHD are more sensitive to these stressors than the average person.

  • School or Work: modify the environment in an effort to reduce distractions:
    • Sitting on a Disc 'o' Sit inflatable cushion to maintain proper balance may help improve attention.
    • Decrease noise and clutter.
    • Provide clear instructions, preferably written.
    • Focus on success. Reward your progress and reinforce positive behavior.
    • Get organized with checklists and reminders.
    • Encourage impulse control.
    • Break big jobs down into small tasks.
  • Home: all guidelines for school and the workplace apply to the home environment too:
    • Address family tensions like spousal conflicts, alcohol use disorder, drug abuse, and sibling rivalry.
    • Create order, structure, and routine. There is comfort in knowing what is going to happen and that things are where they belong.
    • Practice good sleep habits. Try to go to bed at the same time each night and wake up at the same time each morning, even on weekends.
    • Eat nourishing meals.
    • If you smoke, talk to your doctor about how to successfully quit.
  • Professional Help
    • A family doctor should monitor your treatment to detect and treat any problems.
      • Properly selected and closely administered medications have generated life-changing results in people with ADHD. Medications are usually beneficial and well tolerated, but it also is important to use behavioral and lifestyle interventions.
    • A school or employment counselor may be helpful in making alternate educational or work arrangements.
    • Mental health professionals can teach coping skills to help reduce stress and deal with emotional and social problems.
    • Specially trained ADHD coaches are available to help provide structure, tools, and strategies.

Contact Meredith Spencer, FNP, to get more information on the symptoms, diagnosis, and treatment of Adult ADHD. You can schedule an appointment by calling the office at (540) 381-1882 or book an appointment online below.

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