Everything To Know About ADHD: Facts, Symptoms, And What To Do If You Have It
In the United States, more than six million people have ADHD (attention deficit hyperactivity disorder), according to the Centers for Disease Control. Although the disorder is so common, many people still don't understand it. ADHD does not only occur in children, and it is not all hyperactivity.
If you believe that you (or someone you know) has ADHD, you may want to learn more about it. How do people diagnose it? How do men and women react differently to the condition? Here's everything you need to know--symptoms, facts, diagnosis, and remedies--about ADHD.
How Common Is ADHD?
ADHD, which stands for attention deficit hyperactivity disorder, causes abnormal hyperactive and impulsive behaviors. At least 4.4% of Americans have ADHD, and 5.3% of people have it worldwide. Both adults and children can get it; 85% of children with ADHD carry it into adulthood, according to the Centers for Disease Control.
At least 6.4 million children in America have ADHD. And although many adults have the disorder, only 10.9% seek treatment. The diagnoses for ADHD have only increased over the past two decades, says psychiatrist Dr. John T. Walkup.
The Different Types Of ADHD
There are three different types of ADHD. Peoples' symptoms may depend on the type (or combination of types) of ADHD that they have. According to Johns Hopkins Medicine, symptoms almost always appear by age seven in children, although people may not get diagnosed until later.
The first category is the inattentive type, where patients struggle to concentrate. Hyperactive-impulsive type ADHD is characterized by excessive energy and impulsivity, while Combined Type mixes both. When psychiatrists diagnose ADHD, they keep these categories in mind as certain symptoms line up with specific types.
What Causes ADHD?
Although some have claimed that ADHD stems from food additives, sugar, or immunizations, none of these are true. Researchers have pinpointed the exact causes of ADHD. One is a lower level of brain activity in areas that focus on attention, which is likely passed down genetically.
Other potential causes include prematurity, prenatal exposure to substance abuse, or head injuries. Genetics seems to be a primary cause of ADHD because children patients have a 25% chance of having a parent with the condition.
The Difference Between ADD And ADHD
Although ADD and ADHD are sometimes used interchangeably, they are different. ADD, which stands for attention deficit disorder, is a subcategory of ADHD. In short, ADD does not include hyperactivity, although psychiatrists used to confuse the terms and symptoms in the '90s.
ADHD Predominantly Inattentive Presentation is often called ADD. Patients may struggle to focus, but they don't demonstrate the same energy levels as ADHD. That said, many psychiatrists haven't diagnosed ADD for decades. It's confusing, yes--even for people in the psychology community.
Gender Differences In ADHD
Like many disorders, ADHD symptoms differ between males and females. In 2013, a study in BMC Psychiatry analyzed these differences. Girls are twice as likely to develop the inattentive type, while boys are more likely to get hyperactive type. Girls also self-report their symptoms (especially anxiety) more often than boys.
However, surveys of parents tell a different story. Parents were more likely to notice ADHD symptoms in boys than in girls. That said, symptoms in males and females do not differ too much, and neither do causes.
Girls With ADHD Are Often Unacknowledged
According to the Child Mind Institute, boys are twice as likely to get diagnosed than girls are. The condition sometimes creates what psychologists call "subtle" symptoms. Lack of focus and struggling in school can be mistaken for low self-esteem or low motivation, especially in women.
"Paradoxically, stigma is stronger against subtle disorders than obvious ones," says Dr. Stephen Hinshaw, a chair of psychology at Berkeley. When parents don't understand ADHD, they may ignore the signs and put unnecessary pressure on their children. Girls often experience this because they have inattentive ADHD more often than hyperactive ADHD.
Women's ADHD May Change With Hormone Levels
Since hormone levels influence mood, it's no surprise that ADHD symptoms fluctuate with hormones as well. Hormonal changes, especially during puberty and menopause, may cause patients to act out. Hormones may also conflict with certain ADHD medications.
According to some doctors, this may be why some women aren't diagnosed until adulthood. "The average age of diagnosis for women with ADHD, who weren't diagnosed as children, is 36 to 38 years old," says Dr. Patricia Quinn. Before then, women may be misdiagnosed with mood disorders or have their symptoms ignored.
Why Diagnoses Have Risen
Throughout the past couple of decades, diagnoses of ADHD have risen. Researcher Dr. Wei Bao says that one in ten people currently have ADHD. Most of the increase stems from minority groups, which may indicate better access to healthcare. The more people visit the doctor, the more get diagnosed, Bao explains.
Genetics may also play a role. The condition often passes from parent to child, and many parents may not know that they have it. Complications during pregnancy may also kick-start the disorder.
How ADHD Is Diagnosed
To diagnose ADHD, psychiatrists follow the American Psychiatric Association's Diagnostic and Statistical Manual, Fifth Edition (the DSM-5). These standards, based on the most recent psychology research, detail the numbers of symptoms needed to identify ADHD. Psychiatrists also take into account how long these symptoms have prevailed.
In general, children need to display at least six symptoms, while adults demonstrate at least five. Symptoms must prevail for at least six months. Remember that many mood disorders have overlapping signs, so this is easier said than done.
Coexisting Conditions
According to Children and Adults with Attention-Deficit (CHAAD), two-thirds of people with ADHD have at least one other cognitive disorder. Around 40% have oppositional defiant disorder (ODD), which spurs people to argue, fight, or feel more spiteful than usual.
At least 38% of ADHD patients also have a mood disorder, including depression, bipolar, and mania. Even more adults--around 53%--have anxiety with ADHD. These coexisting conditions make diagnosis more lengthy and complicated, especially because symptoms overlap. It's also why patients should never self-diagnose.
ADHD In Children
One in ten children have ADHD, and teachers and parents may notice signs at a young age. Kids with ADHD may struggle to sit still, seem easily distracted, or have trouble following directions. Because many people associate ADHD with hyperactivity, patients with the inattentive type may go undiagnosed.
According to the Child Mind Institute, kids with ADHD may struggle to keep up with schoolwork in mid-elementary school. However, symptoms also occur outside of school, often with kids blowing up when they can't get their way.
Adults With ADHD
Researchers report that more than 4% of American adults have ADHD. But many people don't realize their disorder because, according to Harvard Health, symptoms become more subtle with age. For instance, restless people may not run around, but they may fidget or bounce their legs.
Adults with ADHD struggle more with memory symptoms than with hyperactivity. Some people may mistake these symptoms as another mood disorder or a natural result of aging. As a result, many adults may not diagnose their condition or receive appropriate medication for it.
ADHD Screening Tests
There are some self-screening tests available for ADHD. The World Health Organization offers an Adult Self-Report Scale (ASRS). In 2017, a study in JAMA Psychiatry analyzed the test and found it to be mostly reliable. But remember that ASRS is not a diagnostic test.
ASRS is designed to tell adults whether they should seek professional assistance. Self-diagnosing is still not recommended. If you believe that you may have ADHD, take this test to learn if you should reach out to a psychiatrist. Remember that symptoms of the condition vary for everyone.
Treatment And Therapy
Although ADHD has no cure, its symptoms can be treated with therapy. The Substance Abuse and Mental Health Administration (SAMHSA) lists two main goals of mental health recovery: living a meaningful life and developing full potential.
Behavioral therapy helps patients manage symptoms and approach their emotions with skillful tools. According to the National Institute of Mental Health Multimodal Treatment Study of ADHD, one study reported incredible improvement of children with ADHD when they received both medication and therapy. The combination can lend patients a life worth living.
Why Do Doctors Perform A Physical Exam?
During a diagnosis, some doctors will conduct physical exams as well as mental ones. Professionals may examine peoples' hearing, vision, and motor skills to see if there's a physical cause for hyperactivity. Thyroid conditions or pinworms can cause similar symptoms, such as lack of focus or fatigue.
Some doctors may recommend brain imaging or genetic testing for ADHD, although these are rare. For the most part, psychologists and doctors can diagnose through symptoms. Professionals may ask specifics about symptoms to distinguish them from other mood disorders and learning disabilities.
People With ADHD Have Different Brains
Research suggests that ADHD is caused by altered brain structure. In 2018, a study in the Journal of Attention Disorders found that ADHD brains have less gray matter than healthy brains. Gray matter governs speech, muscle control, impulsivity, and decision-making.
Other scientists believe that hormones also play a role. According to a 2009 study in JAMA, patients with ADHD also have a reduction in dopamine. This hormone helps signals move in the brain, prompting it to switch from one emotion or action to another. That may explain why patients struggle to focus or remain still.
Medications And Who Needs Them
Medication does not cure ADHD, but may reduce symptoms. The drugs can be divided into two categories, immediate-release medications (short-term) and extended-release medications (intermediate-acting and long-acting). Dosage may vary depending on the person's weight, needs, and side effects.
ADHD patients receive either immediate-release or extended-release medications based on their needs. For instance, if they only need help during school or work, they may take an immediate-release drug. People who need long-lasting relief will take extended-release medications. Patients frequently visit psychiatrists to change or adjust the medication as required.
Symptom: Poor Organization Skills
According to the ADHD Center, disorganization is one of the most common symptoms of ADHD. Because patients struggle to concentrate on a task, they also grapple with planning, cleaning, and paying bills on time. For children, symptoms may manifest in poor grades. In adults, it can influence all parts of their lives.
During a 2018 study, researchers attributed disorganization to issues in the brain with working memory. ADHD patients forget about what they're working on more quickly than others. The result is difficulty focusing, planning, and organizing.
Symptom: Hyperactivity Or Restlessness
Hyperactivity, sometimes called restlessness, is one of the most recognizable symptoms of ADHD. Patients may feel unable to sit still, which distracts them and leads to procrastination. People with Hyperactive-Impulsive Type ADHD have this symptom more often than those with Inattentive ADHD.
According to the National Institute of Mental Health (NIMH), hyperactivity may manifest in fidgeting, tapping, speaking rapidly, and moving when it's not appropriate. Restlessness may also stem from anxiety. Patients may always feel "on the go" or unable to ease their energy.
Symptom: Hyperfocus
While some ADHD patients experience a lack of focus, others have hyperfocus. According to Additude, patients "zero in" on a task to the point where they ignore everything around them. Unlike other people, ADHD patients may not stop their activity because of time, responsibilities, schedule, or hunger.
"People who think ADHD means having a short attention span misunderstand what ADHD is," says psychologist Kathleen Nadeau. "A better way to look at it is that people with ADHD have a dysregulated attention system." That's why attention may switch from chronic distraction to chronic hyperfocus.
Symptom: Sleep Troubles
According to the National Sleep Foundation, ADHD spawns a variety of sleep troubles. Complications include disordered breathing, restless leg syndrome, and sleep apnea. At least 75% of people with the condition struggle to sleep well, says the European College of Neuropsychopharmacology.
Improving the quality of sleep can do wonders for patients. In the Journal of Sleep Research, one study determined that more daytime naps improved hyperactivity in children with ADHD. However, many symptoms of sleep disorders and ADHD overlap, which makes diagnosis difficult.
Symptom: Memory Impairment
ADHD is associated with memory issues. Although patients don't struggle with long-term memory, they may grapple with short-term memory. Also called working memory, short-term memory holds facts that need to be used immediately. For example, reciting a phone number uses short-term memory.
In 2012, a study in Clinical Psychology Review reported that children with ADHD have much larger memory struggles than children without it. Due to memory impairment, patients may not be able to concentrate or follow complicated instructions. They also may not follow through with tasks.
If You Believe That You Have ADHD, Here's What You Do
According to Dr. Lenard Adler, ADHD is widely undiagnosed because doctors used to believe that it only happens in children. Now, medical professionals treat adults as well. If you think that you have ADHD, seek out an official diagnosis. Remember that symptoms of cognitive disorders may overlap, and a professional diagnosis is necessary.
However you feel about a diagnosis, understand that it's natural. Take steps to seek treatment and improve your life. Reach out to a psychologist or talk to your primary doctor. Use tools such as planners and alarms to manage your symptoms in the meantime.
Is ADHD A Disability?
An ADHD diagnosis is not enough to qualify for disability benefits. According to Disability Benefits Help, the Social Security Administration (SSA) only considers ADHD in childhood. If patients can prove that they've had ADHD since childhood, they may have a chance at filing for disability.
That said, some people with ADHD can work full-time careers. If they receive proper medication and treatment, they can lead a fulfilling life. But everyone with ADHD is different, and symptoms vary widely. Some patients may struggle with it more than others.
Consider Other Remedies
Medication and therapy are the two primary treatments for ADHD. But patients may benefit from other at-home remedies. Some simple methods can improve patients' daily life, including planners, mindfulness meditation, and organization techniques.
Most psychologists advise these remedies on top of therapy and medication. If you are going to try taking vitamins for ADHD, research whether it conflicts with medications. Some supplements may conflict with certain drugs and chronic conditions. The following are some natural remedies that patients can try.
Natural Remedy: Daily Exercise
Just as daily exercise improves the body, it also enhances the brain. During a 2014 study, researchers found that regular exercise improves brain function in children with ADHD. It also alleviates symptoms of ADHD, anxiety, and depression, all of which may benefit a patient.
Lead study author Dr. Betsy Hoza says that "exercise is a do-no-harm intervention." Working out won't conflict with medications or ailments; it'll only improve health. Even a short walk can lift peoples' mood, according to research in Health Promotion Perspectives.
Natural Remedy: A Protein-Rich Diet
Eating a diet high in protein can reduce hyperactivity in ADHD patients. Researchers at the Massachusetts Institute of Technology discovered that proteins improve neurotransmitters. Protein also increases alertness and stabilizes blood sugar, while carbohydrates can spike blood sugar and lead to fatigue.
On top of that, protein can enhance medications. According to ADD therapist Leslie Rouder, protein helps the body absorb ADHD medications, which makes them work better. That's why a diet of lean proteins--meats, beans, nuts, and fish--can assuage the symptoms of ADHD.
Natural Remedy: Omega-3 Fatty Acids
In some cases, omega-3 fatty acid supplements or fish oil can help people with ADHD. Patients often have low levels of eicosapentaenoic acid (EPA), an essential acid. According to a 2006 English study, omega-3 supplements provide a "promising complementary approach to standard treatments."
That said, most research focuses on patients with an EPA deficit. It may not work for everyone. In 2017, scientists analyzed 16 studies in the Journal of Lipids. They found that omega-3 fatty acids soothe symptoms slightly, including working memory, impulsivity, and hyperactivity.
Natural Remedy: Mindfulness And Meditation
People with ADHD may want to practice mindfulness and meditation. This technique is often taught during therapy, and it has scientific backing. According to a review of 126 studies in Cognitive Behavioral Practice, meditation subdues many symptoms, including anxiety, impulsivity, and trouble focusing.
During a 2017 survey in Additude, 40% of ADHD patients said that meditation improved their life in some way. Although mindfulness and meditation are often used simultaneously, meditation is a form of mindfulness. It forces people to focus on their current symptoms to reduce anxiety and improve clarity.
Natural Remedy: Reducing Phone/Computer Time
Although sitting in front of the TV doesn't cause ADHD, it can worsen symptoms. In 2018, a study in JAMA linked screen time to ADHD symptoms. After following 2,587 teenagers over two years, they found that phone and computer time increases peoples' likelihood of developing symptoms, even if they don't have ADHD.
During the study, symptoms depended on how often people used their phones. If they used it sparsely, ADHD signs would not follow. But engaging in screen time multiple times a day increases symptoms twofold. Try to stay off your phone, computer, or TV if you have ADHD.
