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What is ADHD and ADD
ADHD stands for attention-deficit/hyperactivity disorder. It is characterized by three main symptoms: inattention, impulsivity and hyperactivity. (1)
What is ADD?
ADHD was historically called Attention Deficit Disorder (ADD). However, since hyperactivity and impulsivity are often common or even prevalent, they have been added to the definition.
The old term ADD is equivalent in current terminology to the “predominantly inattentive presentation of ADHD”.
It is one of the most common behavioral disorders in children. However, it can also manifest in adults.
ADHD is a lifelong disorder with unknown causes. It is not acquired in adulthood but a continuation of the condition from childhood. (2) Some ADHD symptoms continue into adulthood, in up to 65% of individuals diagnosed during childhood.
ADHD affects approximately 5% of children and 3% of adults worldwide.
- ADHD is a lifelong behavioral disorder.
- It cannot be cured but medical treatments are effective in reducing its symptoms.
- ADHD symptoms manifest during childhood and often continue into adulthood.
ADHD causes are not known, however there are a few theories:
- Genetics – family history leads scientists to believe that genetics plays an important role in ADHD
- Neurophysiology – some ADHD sufferers have a different brain anatomy
- Pregnancy – there may be a link between the use of heavy drugs or even tobacco smoking during pregnancy and the child developing ADHD
- Exposure to lead – known to alter brain chemistry and behavior in children
- Early attachment with caregiver – if a child has gone through a traumatic experience related to this attachment
- ADHD causes are not known
- Contributing factors may include genetics, neurophysiology, smoking or taking drugs during pregnancy, exposure to lead or lack of attachment to the caregiver.
A 2016 survey on ADHD published by the Center for Disease Control Prevention found that: (3)
- The first symptoms of ADHD start appearing between three and six years old
- The average age of ADHD diagnosis is 7 years old
- 1 million (9.4%) children and adolescents between 2-17 years have been diagnosed with ADHD, of which 388,000 are children between 2-5 years old children, 2.4 million are between 6-11 years old, and 3.3 million are between 12-17 years old.
- The number of children 2-5 years old diagnosed with ADHD increased by over 50% between 2008 and 2012
- 2 out of 3 children with ADHD have at least one other disorder, such as depression, autism spectrum disorder or Tourette syndrome
- 1 out of 3 children with ADHD have anxiety
- 1 out of 2 children with ADHD have a behavior or conduct problem
- ADHD affects also adults. 4% of American adults are estimated to suffer from ADHD
- ADHD is almost three times more common in males than in females
Symptoms of ADHD in children and adults
ADHD starts in childhood and, in most cases, continues into adulthood.
ADHD symptoms and behavior may change over time. Adults often have different symptoms from when they were children.
For instance, hyperactivity-impulsivity in children manifests in climbing in inappropriate situations, while in adults it shows as extreme restlessness.
- Inattention symptoms inappropriate for developmental level.
The following are common symptoms of inattention:
- Lack of attention to detail and frequent careless mistakes in various activities
- No attention to tasks or even fun games
- Lack of attention when spoken to
- Difficulty in following instructions
- Difficulty in organizing tasks
- Dislike and avoiding activities that require mental effort for a long period of time
- Often losing objects required to complete activities
- Easily distracted
- Hyperactivity/impulsivity symptoms inappropriate and disruptive for the person’s developmental level.
The following are common symptoms of hyperactivity/impulsivity
- Often interrupts or intrudes upon others (e.g. in conversations)
- Frequent fidgetiness, tapping of hands or feet
- Difficulty in waiting for his/her turn
- Excessive talking
- Leaving their seat, when required to be seated
- Difficulty quietly taking part in activities
- Answers before someone completes the question
Some sources refer to three categories, by splitting hyperactivity/impulsivity into two separate categories.
- ADHD symptoms are divided into two groups: inattention and hyperactivity/impulsivity
How is ADHD diagnosed
There are three types (presentations) of ADHD, depending on the symptoms (6).
- Combined presentation: if both symptoms of inattention and hyperactivity-impulsivity are present
- Predominantly inattentive presentation
- Predominantly hyperactive/impulsive presentation
The ADHD symptoms may change over time, and so can presentations.
Since ADHD share symptoms with other conditions, such as sleep disorders, anxiety and depression, diagnosis cannot be done with a single test but in a multi-step process and must involve a trained health professional.
Health professionals include pediatricians, psychologists, psychiatrists, neurologists, family doctors, and other type of physicians or a clinical social worker.
It is important, however, that they have training and experience with ADHD patients.
The health professional investigates the child’s behavior in different environments to help obtain a diagnosis.
Health professionals should then follow the American Psychiatric Association’s Diagnostic and Statistical Manual guidelines to determine if the child or adult suffers from ADHD or another condition.
There are several criteria to diagnose ADHD:
- ADHD symptoms must be present for the last six months from either inattention and/or hyperactivity-Impulsivity symptoms list.
- Children of up to 16 years of age must display six or more symptoms from either of the above symptom lists.
- Adults and adolescents of 17 years old or older must show five or more symptoms from either of the above symptom lists.
- Several symptoms must have been present prior to the age of 12 years, in two or more environments, such as in school or in social interactions.
- The symptoms must interfere with various aspects of life, such as social environments, school or work.
- Other mental conditions are eliminated (e.g. mood disorder)
ADHD symptoms in adults can change from when they were children, which needs to be taken into account in the diagnosis.
This checklist of Signs and Symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) can help you prepare for a conversation with your health care specialist.
It is helpful to familiarize yourself with the symptoms of ADHD. This will help you with the discussion with the health professional.
- Diagnosis is complex and involves considering many criteria.
- ADHD have three different presentations: combined, predominantly inattentive and predominantly hyperactive/impulsive.
- It is advisable to familiarize yourself with the ADHD symptoms, before visiting your doctor for diagnosis.
Signs of ADHD in toddlers
A toddler’s age group is between one and three years old.
The symptoms are easier to recognize once children start school, but the warning signs can start as early as two years of age.
However, recognizing the symptoms that early in life is difficult, since toddlers, in general, rarely pay attention. In fact, many of these behaviors are quite normal.
The solution is to observe the toddler’s behavior in comparison to other toddlers of the same age. If the behavior appears to be extreme, it might be a reason for concern.
When toddlers enter their third year of life (the preschool period), some specific signs that may indicate the possibility of ADHD can be recognized.
According to the Kennedy Krieger Institute there are 10 signs you should look for in preschool children between three and four years of age:
- Disliking activities where paying attention is required for more than one or two minutes
- Loses interest and changes activities after a short time of being engaged
- Makes more noise and talks a lot more than other peers
- Climbs on things when being told not to
- Not able to hop on one foot by the age of four
- Almost constantly restless (kicks, fidgety, can’t sit still or for a long time)
- Seems to be fearless, which may get him/her into dangerous situations
- Overly trusting with strangers, not cautious
- Aggressive with peers
- Prone to injuries, due to impulsive behavior
- Toddlers from the age of two may display symptoms of ADHD, which can be difficult to recognize
- Looking for extreme behavior and comparing it to other toddlers of the same age, are ways of recognizing the symptoms
- It is easier to notice specific symptoms in preschool children of three to four years of age.
As an adult, should I get myself checked for ADHD?
In most cases, ADHD symptoms are evident early in life.
However, in some cases these symptoms become more apparent later in life, when teenagers or adults are faced with important decisions, such as further studies or career choices.
If you are an adult and suspect you might have ADHD, answer the following questions related to various aspects of life:
- Have you had poor academic results?
- Have you been experiencing problems at work: poor performance, frequently being fired or quitting?
- Do you have trouble managing daily responsibilities?
- Are you forgetful about important things?
- Do you constantly feel frustrated/guilty about things?
- Are you constantly stressed about not accomplishing your tasks?
- Do you have relationship problems, because you are not completing your responsibilities?
If you experience some of these difficulties, you might want to see a health professional. (7)
- ADHD symptoms in adults may differ from those in children
- Some signs may indicate the possibility of ADHD.
ADHD treatment options
Since ADHD causes are unknown, it is difficult to design a treatment method that is effective for all people affected.
Behavioral therapy and medication are currently the two proven methods of treatment.
Mediations, however, have side effects that may affect around 30% of people and most discontinue their medication within 3 years.
There are other methods that can be used to reduce ADHD symptoms, but the evidence of their effectiveness varies and, in most cases, more research is needed.
Some of these methods are worth investigating further, especially if medication can’t be used. Many of them are safe and reasonably easy to implement.
The following are the most common methods of ADHD treatment:
- Stimulant medications
- Non-stimulant medications
- Behavioral therapy
- Other psychosocial therapies
- Dietary therapy
- Nutritional supplements
- Medication and behavioral therapy are the two highly effective methods to reduce ADHD symptoms.
- Medications have unwanted side-effects in 30% of people.
- There are other non-pharmaceutical therapies that may be effective for some individuals with ADHD.
NUTRITION FACTS VS NUTRITION MYTHS
You will find a summary of the most common nutrition myths and evidence-based nutrition facts here.