ADHD

What is ADHD (Attention Deficit Hyperactivity Disorder)?

Health experts say that ADHD (attention deficit hyperactivity disorder) is the most common behavioral disorder that starts during childhood. However, it does not only affect children – people of all ages can suffer from ADHD. Psychiatrists say ADHD is a neurobehavioral developmental disorder.

An individual with ADHD finds it much more difficult to focus on something without being distracted. He has greater difficulty in controlling what he is doing or saying and is less able to control how much physical activity is appropriate for a particular situation compared to somebody without ADHD. In other words, a person with ADHD is much more impulsive and restless.

Health care professionals may use any of the following terms when describing a child (or an older person) who is overactive and has difficulty concentrating – attention deficit, attention deficit hyperactivity disorder, hyperkinetic disorder, hyperactivity.

North Americans commonly use the terms ADD (attention deficit disorder) or ADHD (attention deficit hyperactivity disorder). In the UK hyperkinetic disorder is the official term – however, ADD and ADHD have become widely used.

ADHD in children is completely different from normal childhood excited and boisterous behavior. Many children, especially very young ones, are inattentive and restless without necessarily being affected by ADHD.

The Centers for Disease Control and Prevention (CDC) estimates that approximately 4.4 million children aged 4 to 17 have been diagnosed with ADHD in the USA by a healthcare professional. As of 2003 two-and-a-half million American children aged 4 to 17 are being treated for ADHD with medicines. The CDC adds that in 2003 7.8% of all school-aged American children were reported to have an ADHD diagnosis by their parent.

ADHD and four other mental disorders/illnesses genetically linked –  researchers at the Cross Disorders Group of the Psychiatric Genomic Consortium believe that ADHD, schizophrenia, major depressive disorder, bipolar disorder, and autism spectrum disorders may share the same common inherited genetic variations.

Three types of ADHD

According to the CDC, there are three types of ADHD. They are defined according to which symptoms stand out the most.

  1. Predominantly Inattentive Type
    The person finds it very difficult to organize or finish a task. They find it hard to pay attention to details and find it difficult to follow instructions or conversations.
  2. Predominantly Hyperactive-Impulsive Type
    The person finds it hard to keep still – they fidget and talk a lot. A smaller child may be continually jumping, running or climbing. They are restless and impulsive – interrupting others, grabbing things and speaking at inappropriate times. They have difficulty waiting their turn and find it hard to listen to directions. A person with this type of ADHD will have more injuries and/or accidents than others.
  3. Combined Type
    A person whose symptoms include all those of 1 and 2, and whose symptoms are equally predominant. In other words, all the symptoms in 1 and 2 stand out equally.

What are the general signs of ADHD in children?

  • the child is restless, overactive, fidgety
  • the child is constantly chattering
  • the child is continuously interrupting people
  • the child cannot concentrate for long on specific tasks
  • the child is inattentive
  • the child finds it hard to wait his/her turn in play, conversations or standing in line (queue)

The above signs may be observed in children frequently and usually do not mean the child has ADHD. It is when these signs become significantly more pronounced in one child, compared to other children of the same age, and when his/her behavior undermines his/her school and social life, that the child may have ADHD.

What causes ADHD?

We are not sure. Studies reveal that a person’s risk of developing ADHD is higher if a close relative also has/had it. Twin studies have indicated that ADHD is highly heritable. We also know that ADHD is much more common in boys than girls. The scientific community generally agrees that ADHD is biological in nature. Many reputable scientists believe ADHD is the result of chemical imbalances in the brain.

Some studies have indicated that food additives, specifically some colorings, may have an impact on ADHD behaviors. In July 2008, the European Union ruled that synthetic food colorings (called azo dyes) must be labeled not only with the relevant E number, but also with the words “may have an adverse effect on activity and attention in children”.

A 1984 study by Benton and team, demonstrated that sugar has no effect on behavior. A study in 1986 by Milich and Pelham, and another by Wolraich and team in 1985, also found no link between sucrose (sugar) and behavior impact on children with ADHD. However, most sugars found in sugary foods and sweets (candy) consumed by children are corn syrup and high fructose corn syrup – these sugars were not used in any of the above-mentioned studies.

Mercury during pregnancy and ADHD risk – according to a study published in Archives of Pediatrics & Adolescent Medicinemercury exposure during pregnancy may be associated with a higher risk of ADHD-related behaviors in offspring.

The authors added that even slight exposure raises the risk of ADHD. Fish consumption during pregnancy seems to lower the risk. Several types of fish have low or no levels of mercury. Women should focus on those types of fish when they are pregnant.

Interesting link: Possible causes of ADHD (New Zealand’s ADHD Online Support Group)

How do I know if I, my child, spouse or relative has ADHD?

ADHD cannot be diagnosed physically, i.e. with a blood test, urine test, brain scan or a physical check up. As most children have problems with self-control anyway, a proper diagnosis can be quite challenging.

An ADHD diagnosis has to be carried out by a specialist – usually a psychiatrist, psychologist or pediatrician. The specialist will observe the child and recognize behavior patterns. Data regarding the child’s behavior at home and at school will also be studied. Only a specialist will be able to accurately detect whether other problems and/or conditions are resulting in ADHD-like behavioral characteristics.

Diagnosing ADHD with EEG (electroencephalogram) – in July 2013, the US Food and Drug Administration (FDA) approved the NEBA System (Neuropsychiatric EEG-Based Assessment Aid) to help doctors more accurately diagnose ADHD in children. Christy Foreman, who works at the FDA’s Center for Devices and Radiological Health, said “(the NEBA System) along with other clinical information, may help healthcare providers more accurately determine whether ADHD is the cause of a behavioral problem.”

Interesting links

Diagnostic Criteria for ADHD (ADHD Information Services)

If you do not know how to find a specialist, ask your GP.

When does ADHD start? How long does ADHD last?

According to New Zealand’s ADHD Online Support Group, the onset of ADHD usually occurs before the person is 7 years old. For about 75% of ADHD sufferers, symptoms continue into adulthood. However, levels of hyperactivity tend to decrease as the person gets older.

Adult ADHD

It was not until the 1970s that researchers began to realize that what we today know as ADHD did not always go away during a person’s teen years. It was during that decade that it was also noticed that some ADHD symptoms were identified in the parents of children undergoing ADHD treatment. In 1978 ADHD was formally recognized as a condition that also afflicts adults, and the term Adult ADD began – the ‘H’ of ADHD was dropped because it seemed the adults were not as hyperactive as children.

According to uspharmacist.com, approximately 8 million adults in the USA have ADHD. An adult with ADHD who is untreated will tend to have a chaotic lifestyle – they may seem more disorganized compared to people who are not afflicted with ADHD. Healthcare professionals believe there are millions of adults who have ADHD but do not know and remain untreated. Studies indicate that adults with ADHD benefit enormously from a combination of medication and behavior therapy.

Researchers from Boston’s Children Clinic and the Mayo Clinic found that 29% of children with ADHD still had the disorder in adulthood.