All-Inclusive Guide to ADHD

ADHD, otherwise known as attention deficit hyperactivity disorder, is a psychiatric disorder that affects the brain's ability to focus. Although widely known, there is still plenty unknown and left to explore regarding it. Like with many psychiatric conditions, the better informed the public is on the disorder, the better off those that struggle with it are, so this article aims to spread this disorder's specifics, statistics, and characteristics to better inform my readers. 

Attention deficit hyperactivity disorder was officially recognized as a mental disorder in the late 1950s. First known as hyperkinetic reaction of childhood, the name's origins are Greek-hyper meaning overactive, and kinetic being shortened from kineticos meaning to move. This name was changed in the 80s, and became two separate diagnoses: ADD and ADHD. These stood for attention deficit disorder and attention deficit hyperactivity disorder, then, in 1987 these two were again combined and are, today, both diagnosed as ADHD.

The psychiatric community now views what were these separate diagnoses as subtypes of this disorder. When diagnosed, ADD was characterized by inattentiveness, and those with ADHD struggled more with hyperactivity and impulsivity. Today, ADHD encompasses both of these types, as well as a third, which is a combination of the two. 

Of these subtypes, the inattentive, type is most difficult to diagnose, as it's more thoughts-oriented, while the hyperactive/ impulsive type is more actions-oriented. For this reason, when the disorder presents as the inattentive type it's typically diagnosed later than the others. This has led to females, who are more often of this type, being diagnosed later than males with this disorder. The average age of diagnosis among boys with ADHD is 3-7 years old, while the average diagnosis age among girls is 10-12 years old. 

Thanks to the structured environment that school provides, and the demands imposed on the students, ADHD is often first noticed in the school setting. Here, inattentiveness might look like the inability to follow instructions, overlooking assignments, and struggling to stay organized. Similarly, hyperactivity and impulsivity may stand out in students that struggle to remain still or seated or talk too much.

This inability to stay still is a good example of comorbidity in ADHD. This disorder has some of the highest rates of comorbibidy of all psychiatric conditions, which is what having multiple diagnoses simultaneously is known as. Willis Ekbom disease, also known as restless leg syndrome, is a condition that's known to cause an uncontrollable urge to move the legs. Studies have indicated that people with ADHD have 14.5 times the likelihood of having restless leg syndrome than those without it, with 18% of those with ADHD meeting diagnostic criteria for both. 

Other examples of disorder commonly comorbid with ADHD include autism spectrum disorder, insomnia, mood and anxiety disorders, learning disorders, Tourette syndrome, and substance use disorders. It's also believed that ADHD is a precursor for a personality disorder called antisocial personality disorder. This disorder is characterized by a disregard for the law and social norms and is known to act in ways immoral, irresponsible, and unethical. ADHD may prime a person for this disorder, as its symptoms are often reprimanded. Their punishments are then internalized and acts as a self-fulfilling prophecy. Since the individual believes they're already corrupted, this allows them the freedom to act with a legal, social, and moral disregard. Evidence to support this theory can be found in the fact that roughly 2.8 percent of the world population is diagnosed with ADHD, but about 25% of people in jails have this disorder. 

There are some differences in adults and children with ADHD, mostly due to children's symptoms affecting their school work and adults symptoms having a negative impact on their career. Inattentiveness, in adults, may present as poor planning, time management or prioritizing, while hyperactivity and impulsivity may affect them in areas like anger management, difficulty coping with stress, and inappropriate sexual behavior. These, and some that never change, like the inability to stay still or focus, may cause adults with ADHD difficulty in work, relationships, and life in general.

Similarly to girls being diagnosed with ADHD later than their male counterparts, women with ADHD are far more likely to be initially diagnosed well into adulthood. In recent years, a trend has emerged in diagnosis that women aged 30-40 years old are being initially diagnosed with this disorder, despite research indicating that it is always early onset. This is typically brought on by their children being diagnosed, which motivates the mother to familiarize herself with the disorder and recognize that the symptoms are present in her as well. 

This subset of the population was missed in diagnosis thanks to 15 years of error in research conducted on ADHD. These studies only involved males, which prevented the researchers from noticing the nuances between the genders and underestimating the prevalence and severity of the inattentive type, as well as the number of females meeting diagnostic criteria. The harmful effects of late-in-life diagnosis of this disorder include anxiety, depression, and learned-helplessness, making this error a significant overlook. 

There are a number of factors that cause ADHD. These include head injury, premature birth, and prenatal exposures to tobacco and alcohol, and are most often linked to genetics. There is a 1 in 4 chance that a child born to parents with ADHD will be diagnosed as well. There are also anatomical differences in those with ADHD versus those without. The frontal lobe is one area of the brain that is affected by ADHD. This disorder causes a delay in maturity of this part of the brain, which is responsible for cognitive functioning such as attention, impulse control, and social behavior. Another is the motor cortex, that develops early in individuals with ADHD and is likely to blame for the restlessness associated with the disorder. 

There are a variety of treatment options available for those with ADHD. When seeing a psychologist for this, they'll likely employ one of two methods: cognitive behavioral therapy or dialectical behavioral therapy. Cognitive behavioral therapy, or CBT for short, focuses on treating a patient's thought (cognition) patterns. This type is goal oriented, short-term, and often involves completing homework between sessions to adequately track thoughts and emotions. The goal of the treatment type for patients with ADHD is usually to transform negative thoughts into more positive ones and improve the patient's overall mental health. DBT, or dialectical behavioral therapy, is a treatment method that was first used to treat borderline personality disorder and focuses primarily on increasing mindfulness and correcting actions like in providing coping mechanisms. Practicing mindfulness can be beneficial to people with ADHD, as it can increase focus and decrease restlessness and impulsivity. 

For those not interested in seeing a therapist, there are lifestyle changes that can effectively reduce symptoms of ADHD as well. Anyone can benefit from using meditation, like in DBT, without employing a therapist. Guided meditations increase mindfulness when used effectively and are widely available online and through apps like Calm. Exercise-specifically sufficient cardiovascular exercise-is recommended for patients with ADHD. This can be beneficial for those with this disorder, as it allows them to burn off the excess energy that causes them to lose focus. Also, getting sufficient sleep can help individuals with this disorder to manage their symptoms because 7 hours of quality sleep can increase energy and improve focus. Lastly, maintaining a proper diet may be helpful. A diet low in sugar and high in protein and vitamins is recommended for those with this disorder, as it's best for promoting a stable energy supply and brain functionality.

Finally, the last treatment encouraged is medication-namely stimulants. These increase physiological and nervous system activity in the body, and are useful in treating ADHD because they allow the patient extra energy to disregard unnecessary stimuli that causes a disruption in focus and actively will against symptoms of hyperactivity and impulsivity. Some examples of these include Adderall, Ritalin, and Vyvanse, and, although widely prescribed to children as young as 3, should be taken with some caution, as they do have some addictive properties and harmful side effects. For those that would like to derive the benefit of stimulants, without the use of medication, caffeine is also a stimulant so someone can simulate the benefits of stimulant medication with the addition of coffee, tea, energy drinks, caffeine pills, soda, etc. Caffeine in any form, however, can have the negative side effect of increasing anxiety, so should be limited or avoided altogether in those with high anxiety naturally. 

ADHD can cause difficulties in life, but people successful despite struggling with this disorder, like Bill Gates, Michael Phelps, and Adam Levine, to name a few, prove to us that these difficulties can be overcome. With proper treatment, individuals with this disorder can compete with and even surpass the accomplishments of those without it in a world designed to accommodate them. If interested in seeking diagnosis or treatment for ADHD, psychologytoday.com is a useful resource.