Attention deficit hyperactivity disorder (ADHD)/ Attention deficit disorder (ADD)

It is a neuro-developmental disorder characterized by hyperactivity, inattention and impulsivity. It affects almost 1% of school going children and symptoms continue in adulthood in more than half of cases.

All of us would have experienced either difficulty sitting still, difficulty concentrating or controlling impulsive behavior once in a while. But for people who have ADHD, the problems are so pervasive and persistent that they interfere with every aspect of life.

Typically, ADHD symptoms arise in early childhood. According to the Diagnostic guidelines, several symptoms are required to be present before the age of 12. The common symptoms of ADHD in children :

  • Doesn't listen

  • Looses things often

  • Gets distracted easily

  • Makes careless mistakes

  • Can't sit at one place, runs about or climbs, acts as if driven by a motor

  • Keeps fidgeting

  • Blurts out answers before question is completed

  • Interrupts others

  • Difficulty waiting or taking turns

Individuals with ADHD can be very successful in life. However, without identification and proper treatment, ADHD may have serious consequences like academic decline, family and relationship issues, depression, substance abuse, delinquency, accidental injuries and frequent change in jobs. They tend to have low frustration tolerance, difficulty controlling their emotions and mood swings.

Coexisting conditions: More than two-thirds of individuals with ADHD have at least one other coexisting condition :

  • Anxiety : About 50 percent of adults with ADHD also suffer from anxiety, that significantly impairs functioning.

  • Oppositional defiant disorder

  • Substance use

  • In recent editions Diagnostic Manuals, the definitions of ADHD having been successively broadened. Which increases the risk of confusing ADHD with normal development processes, and other mental health issues having overlapping symptoms like anxiety and mood disorder.

  • Environmental factors : Prenatal exposure to Nicotine, drugs, pesticides etc might affect brain development.

  • There is less stigma associated with ADHD than twenty years ago, so professionals and families are more comfortable seeking a diagnosis and getting treatment for children.

Misdiagnosis : There are a number of other conditions and factors that can cause symptoms similar to ADHD. During the evaluation process, its very important to rule out all other causes before diagnosing someone with ADHD. Also, we need to keep in mind that with ADHD there could be other co-morbities too.

  • Environmental factors/ Current circumstances : Work related stress, Divorce, Grief, Financial difficulties etc.

  • Mental Health issues : Anxiety can make it extremely difficult for a child or adult to sit still. It can be difficult to remain focused and complete tasks. These are all symptoms that can resemble ADHD. Similarly, depression may result in difficulty with focus, forgetfulness, low motivation. Poor impulse control, Oppositional defiant disorder and Bipolar affective disorder are some other mental health issues, where the symptoms are similar to ADHD.

  • Children with hearing impairments have difficulty paying attention. They can miss details of conversations which may appear to be caused by the child’s lack of focus, when in fact they simply cannot follow along.

Treatment :There are many effective treatment options available for ADHD, but what works best can depend on the individual child and family. To find the best options, it is recommended that parents work closely with others involved in their child’s life—healthcare providers, therapists, teachers etc.

ADHD can be treated using medication or therapy, but a combination of both is often best.

Available treatment options are:

  1. Therapy

  • Behaviour therapy

  • Parents training

  • Social skills training

  • Cognitive behaviour therapy

  1. Medications

  • Stimulants - Methylphenidate and Atomoxetine