Overview: What Is ADHD?
Attention-deficit disorder – aka ADHD – is a neurological condition whose symptoms start in childhood. A behavioural disorder, it is characterized by one or more of the following symptoms: inattention, making impulsive decisions, and hyperactivity.
The symptoms of hyperactivity almost always show up by the age of 7. (They may also be present in very young children, but at that age it can be hard to distinguish hyperactivity from typical kiddo exuberance.) Instead, symptoms like inattention are more likely to show up in elementary school when children are asked to sit still, line up single file, and not run with scissors.
Behaviours such as lack of focus, impulsivity and hyperactivity are hard to measure, so an ADHD diagnosis is usually pursued when adults (often teachers) report disruptions. Although they have different learning challenges than their neurotypical peers, children with ADHD do not lack intellectual capacity or IQ. On the contrary, many children with ADHD are known as “twice exceptional,” which means their ADHD diagnosis comes along with high aptitude. These children will benefit from differentiated instruction, such as gifted programs, personal tutors or private schools with low student-teacher ratios.
What are the three different types of ADHD?
Three major types of ADHD include:
- Hyperactive ADHD or impulsive ADHD
People with this type of ADHD seem like the Energizer Bunny, always on the go, chasing the shiny object, and never at a loss for words. Although girls can certainly have hyperactive ADHD, it is more commonly associated with boys. Some common symptoms of this type of ADHD include:
- Trouble sitting still, waiting a turn, doing quiet tasks or keeping quiet
- Lack of focus and patience
- Constant running, touching things, banging into people (general physical over-activity)
- Tendency to interrupt or speak out of turn / in inappropriate settings
Inattentive ADHD?
This type of ADHD was formerly known as ADD (attention deficit disorder), until 1987 when the word “hyperactivity” was added. People with this type of ADHD – which is more commonly associated with girls – seem lost in their own world. They’re the dreamers, the distracted geniuses and the big-picture thinkers. Beyond this romanticised vision, symptoms of inattentive ADHD include:
- Poor multitaskers and direction-followers
- Intense daydreamers
- Easily distractible
- Forgetful
- Careless
- Disorganized, cluttered or messy
- Slow processing of information
ADHD, combined type. Characterized by inattention and distractibility, alongside impulsive and hyperactive behaviours.
If you look at the above list of symptoms and pull them together (for example, a daydreamer, lost in thought, who can’t stop moving), it might seem challenging to imagine how these types of symptoms mix together. In fact, the vast range of symptoms (which show up differently in different people) makes diagnosis challenging. One way to understand combined ADHD is when a person has hyperactive behaviours (such as intense, spontaneous movement) and shows a lack of attention to audiovisual stimuli.
People with combined ADHD have significant obstacles when it comes to functioning at school, at work and in relationships.
How do you diagnose ADHD
The list of ADHD symptoms is long, and people may exhibit those symptoms intermittently (for a few hours a day, for a period of weeks or months, etc.) and in various settings (at work, at home, in public, etc.). Moreover, the symptoms of ADHD are similar to other disorders, which means that if you present them to your doctor, they’ll likely try to confirm or rule out things like depression, anxiety and sleep problems.
Once your doctor decides to confirm a suspected case of ADHD, they’ll use the criteria presented in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the gold standard for diagnostic evaluations across the world. Of the nine major symptoms, a person has to exhibit at least six. These behaviours need to have been present before age 12 and for at least six months. Their severity must be such that it disrupts normal life, in at least two settings, for example home and school.
If, for example, a child day dreams at school but still gets excellent grades and shows no issue at home, that would not warrant an ADHD diagnosis.
Even though an initial diagnosis may point to one type of ADHD, symptoms can evolve. Adults who were diagnosed in childhood should keep this in mind, as they might benefit from future re-evaluation.
If you’re thinking of getting an ADHD diagnosis, ask yourself what your motivation is. Are you looking for medical treatment? A specialized learning plan in school? Accommodations at work? These questions will help guide you as you figure out the proper channels for getting a formal diagnosis, whether it’s through your physician or a state agency.
How do you treat ADHD?
There is no ‘cure’ for ADHD, but there are many available treatment options that can manage disruptive symptoms and help instill positive behaviours. These options, often used together, include: therapy, medication and lifestyle changes.
Note: Children under six years old generally start with therapy only, while older patients may choose to incorporate medication at the outset of diagnosis.
Therapy
Unlike with medication, there are few negative side effects of therapy. Since the only potential drawback is that it may take weeks or months to see noticeable change, if you’re considering therapy, it’s a good idea to get started right away.
The approach a therapist takes to ADHD will depend on their training, the age of the patient, and their problems and goals. They might incorporate:
- Social-emotional training to understand inappropriate and appropriate behaviours (and how to
- convert one into the other)
- Strategies to express feelings
- Identification of limiting beliefs that stem from / contribute to ADHD symptoms
- Behaviour management training for parents (to help them coach their child and deal with any emotions that stem from the parenting experience)
In addition to one-on-one therapy, there are also other therapeutic options, for example meeting with a coach specialised in ADHD, working with teachers on classroom management, and attending support groups.
When getting started with a new therapist, ask them:
- How long before I can expect to see results?
- What approach do you use to treat ADHD
- What experience do you have in treating ADHD?
How do you incorporate other treatment options, including medication or lifestyle modification? (This one is important, because when it comes to putting together a holistic plan of care, you need your therapist to be a team player, not a rugged individualist.)
Medication
The most common type of ADHD medication is known as a stimulant. By increasing the production of chemicals in the brain used for thinking and focus, they work fast and tend to decrease symptoms. However, they also have side effects including: anxiety, headaches, decreased appetite and stomach aches.
Since stimulants pass through the body quickly, some families manage to time the medication so the child receives the peak benefit precisely when most needed (usually during school), and then as it wears off over the course of the day, they are less able to focus but also less impacted by symptoms like decreased appetite.
There are also non-stimulant medications that can be used to treat ADHD with similar benefits and fewer side effects. However, they aren’t as fast-acting, so they are a less popular option.
A doctor will advise you if ADHD medications are right for your situation.
